Seventh International Congress on Drug Therapy in HIV Infection Glasgow, UK - 14-17 November 2004

Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. KL2

Helene Gayle
The Bill and Melinda Gates Foundation, Washington, USA

HIV is the most devastating disease humankind has ever faced. Since the beginning of the HIV epidemic more than 70 million people have been infected with HIV. Today, it is estimated that 38 million people are living with HIV/AIDS. Although, HIV continues to affect people throughout the world, 95% of new HIV infections are among people in developing countries. HIV/AIDS is now the 4th leading cause of death and the leading infectious cause. In 2003, 4.8 million people were newly infected with HIV and almost 3 million people died.

Sub Saharan Africa, has been the region of the world where HIV has had the greatest impact. There it is the leading cause of death. Africa accounts for about 70% of all people living with HIV. Life expectancy has declined 15-20 years in the most heavily impacted countries going from an average of 62 to 47 years.

The transmission of HIV infection in Asia began more recently than in Africa, with Thailand, the first country experiencing major spread. However, India and China, the world's most populous countries are experiencing rapid growth of HIV in certain subpopulations and geographic areas. Although overall national rates of infection are relatively low, even small increases in infection rates translates into large number of people infected with HIV.

There has been a major increase in HIV infection in Eastern Europe and the nations of the former Soviet Union. This region currently has the fastest rate of new infection in the world.

HIV prevention strategies can reduce the incidence of new infections and be cost-effective in developing countries. The most highly cost-effective strategies for prevention include condom promotion, STD control, voluntary counseling & testing, injection drug user interventions, screening blood supply, and antiretroviral drugs to prevent mother-to-child transmission. These steps range in cost-effectiveness from actually saving funds to US$ 19 per disability-adjusted life year, or US$ 506 per HIV infection averted.

Although effective treatment for HIV is widely available in rich countries, they are not in widespread use in poor countries where the problem is greatest. Major impediments to access to antiretroviral drugs are the cost and the lack of stable health care infrastructures to administer and monitor what are rather complex treatment regiments. However, many efforts are underway to accelerate access to antiretroviral therapies in resource poor setting. Absent antiretroviral drugs, treatment of associated infections can have a substantial impact of improving the health of people with HIV infection. For example, tuberculosis, a treatable infectious disease, is the leading cause of death for people with HIV in developing countries.

UNAIDS estimates that $12 billion is needed by 2005 to effectively fight the global HIV/AIDS epidemic and $20 billion by 2010.

KEYNOTE LECTURES

2004-11-14
KL2

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