Better access to antiretroviral drugs has transformed outlook for 15 million people with HIV, says UN, but more funding needed to avoid Aids comeback

People living with the HIV virus today can expect to live nearly two decades longer than those who were diagnosed at the start of this century, thanks to cheaper and more readily available antiretroviral drugs, the UN said in a major report on a disease once seen by many as a death sentence to be endured in secrecy.

The average HIV-positive person is now expected to live for 55 years – 19 years longer than in 2001, according to the report by the UN’s Programme on HIV and AIDS (UNAids).

A sharp drop in the price of antiretroviral drugs, which are used to combat the HIV virus, and vastly improved access to treatment are behind the progress, UNAids said. The world has met a UN target to give 15 million people access to antiretroviral drugs by 2015. Fewer than 700,000 people living with HIV had access to treatment in 2000, the report said.

We have a fragile five-year window. We have bent the Aids curve but we haven't broken it Michel Sidibé, UNAids

“Reaching 15 million people with antiretroviral therapy is one of the greatest achievements in the history of global health, financing and development,” said Michel Sidibé, executive director of UNAids.

Since the 1983 discovery of HIV, the virus that causes Aids, a global campaign has brought together activists, celebrities and politicians to fight the virus.

But despite the increased access to treatment, experts have warned that Aids could make a dramatic comeback if governments don’t increase funding and expand access to drugs over the next five years. “We have a fragile five-year window. We have bent the Aids curve, but we haven’t broken it,” Sidibé said.

Peter Piot, director of the London School of Hygiene and Tropical Medicine, said the world must focus on prevention efforts in areas where people are at high risk of infection, as well as removing legal and societal discrimination.

Piot said: “We must face hard truths – if the current rate of new HIV infections continues, merely sustaining the major efforts we already have in place will not be enough to stop deaths from Aids increasing within five years in many countries.”

According to UNAids, between 34.3 million and 41.4 million people are living with HIV. The bulk of the world’s HIV-positive population is African: between 24 million and 28.7 million HIV-positive people living in sub-Saharan Africa. However, the number of Aids-related deaths has fallen by 48% in sub-Saharan Africa since 2000.



The cost of a year of antiretroviral treatment has tumbled from $14,000 (£8,990) in 2000 to less than $100 today, according to the study.

Sustainable development goals: all you need to know Read more

“The last decade has been about scale-up, really massive scale-up, and this could only happen with country leadership, community resilience and a shared vision of getting to zero,” said Sidibé.

The number of newly infected people has dropped from 3 million in 2001 to 2 million in 2014. HIV-related deaths dropped from 2m to 1.2m over the same period, the report said.

Funding for Aids-related responses has risen from $4.9bn in 2001 to $21.7bn today.

“When the millennium development goals [MDGs] were adopted in 2000, about 10,000 people in sub-Saharan Africa were able to access HIV treatment. To put this into perspective, Zambia registered 46,000 more people on treatment in the first quarter of 2015 alone,” said Sidibé.

The MDGs sought to halt the spread of HIV and make treatment available for everyone with the virus. As the first concerted global effort to fight the disease, the MDGs marked a “turning point”, said Sidibé. “People who were lucky enough to be on HIV treatment, who had been at death’s door, were now back at work a few weeks later.”



“I am proud that the United Nations was the platform for this change, but let’s also acknowledge that this was late in coming,” Sidibé said, noting that in 2005 the UN missed a target to get antiretroviral drugs to 3 million of the world’s poorest people.

The sustainable development goals (SDGs), which will replace the MDGs this year, have targeted ending the Aids epidemic by 2030. This means that everyone with HIV must have access to antiretroviral drugs, and new infections and Aids-related deaths must drop to 200,000 a year for the goal to be met.

The UN secretary general, Ban Ki-moon, said: “Ending the Aids epidemic as a public health threat by 2030 is ambitious but realistic, as the history of the past 15 years has shown.”

Sharonann Lynch, HIV and tuberculosis policy adviser at Médecins Sans Frontières, said the world needs to focus its efforts on developing countries now.

“We can’t lose sight of the fact that more than half of the people living with HIV still do not have access to treatment. In some countries where we work, HIV treatment coverage is as low as 17%, which stands in stark contrast to the UNAids goal of 90% treatment coverage, and much more attention needs to be paid to these neglected contexts,” Lynch said.