By the end of 2008, a million additional people in low- and middle-income countries were receiving anti-AIDS drugs — a tenfold increase since 2000, when just a couple hundred-thousand people in developing countries were getting the anti-retroviral drugs that keep HIV from progressing to a deadly condition.
The greatest progress was in Africa, among pregnant women who got treatment to prevent their children from becoming infected.
Currently, more than 4 million people are in treatment, says Dr. Teguest Guerma, the interim HIV/AIDS director for the World Health Organization. That's a 39 percent increase in one year.
"The greatest gains were seen in sub-Saharan Africa, where two-thirds of HIV infections occur," she said. "An estimated 2.9 million people were receiving treatment at the end of 2008."
Still, more than half of the people who need treatment are not getting it. For every step forward, there were at least two steps backward. In 2008, 2.7 million more people became infected.
There has been progress in protecting children from the disease. About 2 million children who are infected were infected by their mothers. But health care workers have been much more effective in getting pregnant women enrolled in programs that protect a child from the mother's HIV infection, something that virtually never happens in developed countries. There was a 45 percent increase in women who take drugs that prevent mother-to-child transmission.
In eastern and southern Africa, it's actually higher. Over 50 percent of mothers got the treatments. "These are countries that have very limited capacity to deliver on these programs, but we continue to see progress," said Dr. Chewe Luo, the senior adviser to UNICEF on HIV/AIDS.
Despite this progress, however, 5 million more people need treatment now, at a time when the global recession threatens to reduce funding for such programs.
Funding In Danger
The country with the largest burden of HIV/AIDS has the most people in treatment: South Africa. The government there has long resisted dealing with the epidemic, but now 600,000 of the 1.5 million South Africans who need the drugs are getting treatment.
"Initially there was a lot of reticence. It was thought that we wouldn't be able to run programs in the developing world, that patient population wouldn't be able to take therapy," said Dr. Robin Wood, the director of the Desmond Tutu HIV Center. "We've shown that they can, that we can run very large programs. But the question is can we keep the focus, the funding and political will to move forward?"
Wood works with people who are co-infected with tuberculosis and HIV. He worries that Western countries may renege on a promise of universal access to AIDS drugs by 2015. According to WHO, even where treatment is available, many people in low- and middle-income countries don't seek treatment — people like sex workers, gay men and injection drug users who fear cultural and legal actions will be taken against them.