AIDS can be brought under control by 2030, according to a report by the United Nations Aids agency. It said the number of new HIV infections and deaths from Aids were both falling.
At present, that 35 million people around the world were living with HIV. There were 2.1 million new cases in 2013 — 38% less than the 3.4 million figure in 2001.
What is most worrying is that 19 million of the 35 million people living with HIV globally do not know their HIV-positive status.
"Whether you live or die should not depend on access to an HIV test," said Michel Sidibe, executive director of UNAIDS. "Smarter scale-up is needed to close the gap between people who know their HIV status and people who don't, people who can get services and people who can't and people who are protected and people who are punished."
"If we accelerate all HIV scale-up by 2020, we will be on track to end the epidemic by 2030," said Sidibe. "If not, we risk significantly increasing the time it would take—adding a decade, if not more."
By ending the epidemic by 2030, the world would avert 18 million new HIV infections and 11.2 million AIDS-related deaths between 2013 and 2030.
The UNAIDS report shows that as people find out their HIV-positive status they will seek life-saving treatment. In sub-Saharan Africa, almost 90% of people who tested positive for HIV went on to access antiretroviral therapy (ART). Research shows that in sub-Saharan Africa, 76% of people on ART have achieved viral suppression, whereby they are unlikely to transmit the virus to their sexual partners. New data analysis demonstrates that for every 10% increase in treatment coverage there is a 1% decline in the percentage of new infections among people living with HIV.
The report highlights that efforts to increase access to ART are working. In 2013, an additional 2.3 million people gained access to the life-saving medicines. This brings the global number of people accessing ART to nearly 13 million by the end of 2013.
The report reveals that just 15 countries account for more than 75% of the 2.1 million new HIV infections that occurred in 2013. In every region of the world the report finds that there are three or four countries that bear the burden of the epidemic. In sub-Saharan Africa, just three countries—Nigeria, South Africa and Uganda—account for 48% of all new HIV infections.
HIV prevalence is estimated to be 28 times higher among people who inject drugs, 12 times higher among sex workers and up to 49 times higher among transgender women than among the rest of the adult population. "There will be no ending AIDS without putting people first, without ensuring that people living with and affected by the epidemic are part of a new movement," said Mr Sidibe. "Without a people-centred approach, we will not go far in the post-2015 era."
New HIV infections among children have fallen by 58% since 2001 and dropped below 200 000 for the first time in the 21 most affected countries in Africa.
The highest number of people living with HIV was in sub-Saharan Africa—24.7 million people. Asia and the Pacific had the next largest population of people living with HIV, at an estimated 4.8 million.
AIDS-related deaths were seen to be rising steeply in the Middle East and North Africa, by 66%. The only other region where AIDS-related deaths are increasing is eastern Europe and central Asia, where AIDS-related deaths rose by 5% between 2005 and 2013.