PARIS: The number of new HIV infections and deaths is falling worldwide, marking significant progress in the fight against the disease.
But HIV is far from being stamped out and more needs to be done, health experts warned ahead of World AIDS Day on Sunday.
Uneven progress
Fewer people contracted HIV last year than at any point since the rise of the disease in the late 1980s, according to a UNAIDS report on Tuesday.
But the 1.3 million new HIV cases recorded in 2023 is still more than three times higher than needed to reach the UN’s goal of ending AIDS as a public health threat by 2030, the UN agency said.
Last year also saw around 630,000 people die from AIDS-related illnesses, the lowest level since a peak of 2.1 million in 2004.
A separate study published in The Lancet HIV journal on Tuesday found that the number of HIV infections across the world declined by a fifth during the 2010s.
Deaths related to HIV, which are generally caused by other diseases during the late stages of AIDS, fell by about 40% to below a million a year, the study said.
The decline was mainly driven by improving rates in sub-Saharan Africa, which is by far the hardest-hit region in the global epidemic.
However infections did not go down everywhere. Other regions, such as Eastern Europe and the Middle East, saw HIV numbers increase.
“The world has made remarkable global progress to significantly reduce the number of new HIV infections,” said lead study author Hmwe Kyu of the US-based Institute For Health Metrics and Evaluation.
“More than a million people acquire a new HIV infection each year and, of the 40 million people living with HIV, a quarter are not receiving treatment,” she said in a statement.
Effective tools, for some
Preventative treatments called Pre-Exposure Prophylaxis (PrEP) have proven to be a powerful tool in the fight against HIV.
These daily pills reduce the risk of getting HIV from sex by around 99%, and have helped drive down HIV rates in many countries.
But “only 15% of people who need PrEP were receiving it in 2023,” UNAIDS said.
For people who have been infected with HIV, antiretroviral therapy can reduce the amount of the virus in their blood to undetectable levels.
But around 9.3 million people — nearly a quarter of those living with HIV worldwide — were not receiving this treatment, UNAIDS warned.
New drug raises hopes
These tools have worked well in wealthier countries but the high costs have meant that poorer countries — such as in Africa — have often been left behind.
There are fears that this history could repeat for a new drug that has been hailed as a potential game-changer in the battle against HIV.
Early trials have found that the antiretroviral treatment lenacapavir is 100% effective in preventing HIV infection. And it only needs to be injected twice a year, making the drug far easier to administer than current regimens requiring daily pills.
US pharmaceutical giant Gilead has been charging around $40,000 per person per a year for the treatment in several countries.
But researchers have estimated the drug could be made for as little as $40, calling on Gilead to allow for cheaper access in hard-hit nations.
Last month, Gilead announced it had signed licensing deals with six generic drugmakers to produce and sell lenacapavir in lower-income countries.
While experts largely welcomed the move, some noted that millions of people with HIV live in countries not included in the deal.
The twice-yearly injection is also hoped to help get around another problem for administering HIV drugs — the stigma that comes along with having the disease.
What about a vaccine?
Despite decades of effort, a vaccine for HIV remains elusive.
But the lenacapavir shot is “like having a vaccine basically”, Andrew Hill, a researcher at the UK’s Liverpool University, told AFP earlier this year.
A handful of patients have also been effectively cured of HIV.
But these cures happen only after a patient endures a brutal stem cell transplant for their leukaemia, so is not an option for almost all people living with HIV.
