Here’s a report filled with good news. According to the United Nations’ annual report on the global AIDS epidemic, released yesterday, more people than ever are living with HIV, largely due to greater access to treatment. At the end of 2010, an estimated 34 million people were living with HIV worldwide, up 17 percent from 2001. This reflects the continued large number of new HIV infections and a significant expansion of access to antiretroviral therapy, which has helped reduce AIDS-related deaths, especially in more recent years.
At the same time, the number of people dying of AIDS-related causes fell to 1.8 million in 2010, down from a peak of 2.2 million in the mid-2000s. A total of 2.5 million deaths have been averted in low- and middle-income countries since 1995 due to antiretroviral therapy being introduced, according to new calculations by UNAIDS. Much of that success has come in the past two years when rapid scale-up of access to treatment occurred; in 2010 alone, 700 000 AIDS-related deaths were averted.
In addition, there were 2.7 million new HIV infections in 2010. This was 15 percent less than in 2001 and 21 percent below the number of new infections at the peak of the epidemic in 1997. HIV incidence has fallen in 33 countries, 22 of them in sub-Saharan Africa, the region most affected by the AIDS epidemic. (Almost half of the deaths from AIDS-related illnesses in 2010 occurred in southern Africa. AIDS has claimed at least one million lives annually in sub-Saharan Africa since 1998. Since then, however, AIDS-related deaths have steadily decreased, as free antiretroviral therapy has become more widely available in the region.)
The key to progress includes a massive rollout of anti-retroviral drugs, increasing acceptance and male circumcision, and changes in sexual behavior (including the use of condoms, reduction in the number of sexual partners and a delay of the start in sexuality activity). The Washington Post, in reporting on the story, said this:
Perhaps the most dramatic achievement of 2010, the report says, was a 20 percent increase in the use of “antiretroviral therapy” in Africa over the prior year. A decade ago, the life-extending drugs were available in Africa only to members of the elite and a few ordinary people enrolled in clinical studies.
Today in low- and middle-income countries around the world, 47 percent of people who meet the clinical criteria for antiretroviral therapy are getting it — 6.6 million out of 14.2 million eligible. Much of that treatment is underwritten by the U.S. government through the President’s Emergency Plan for AIDS Relief, started by George W. Bush, and by the Global Fund to Fight AIDS, Tuberculosis and Malaria, a charity principally funded by the United States and European countries.
In all of this I’m reminded of a passage from Albert Camus’ The Plague, a novel about a coastal town in North Africa, Oran, in which a plague sets off a chain of horror, survival, and human resilience:
Many fledgling moralist in those days were going about our town proclaiming there was nothing to be done about it and we should bow to the inevitable. And Tarrou, Rieux, and their friends might give one answer or another, but its conclusion was always the same, their certitude that a fight must be put up, in this way or that, and there must be no bowing down. The essential thing was to save the greatest possible number of persons from dying and being doomed to unending separation. And to do this there was only one resource: to fight the plague.
In this world there are lots of hands and hearts that deserve credit for no bowing down, for deciding to fight the plague. Very near the top of the list belongs the name George W. Bush.