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Bringing HIV Prevention to Scale: An Urgent Global Priority

Corporate author: 
Global HIV Prevention Workgroup.
Publication details: 
Johannesburg, Global HIV Prevention Working Group, 2007

We should be winning in HIV prevention. There are effective means to prevent every mode of transmission; political commitment on HIV has never been stronger; and financing for HIV programs in low- and middle-income countries increased sixfold between 2001 and 2006. However, while attention to the epidemic, particularly for treatment access, has increased in recent years, the effort to reduce HIV incidence is faltering. For every patient who initiated antiretroviral therapy in 2006, six other individuals became infected with HIV (1, 2). If current trends continue, it is projected that 60 million more HIV infections will occur by 2015, and the annual number of new HIV infections will increase by 20% or more by 2012. Unless the number of new infections is sharply reduced, global efforts to make AIDS treatment widely available will become increasingly difficult, and millions more people may die as a result of preventable HIV infections. The dramatic rise in antiretroviral coverage, with global access increasing from 8% to 28% between 2003 and 2006, illustrates what the world can accomplish with strong global commitment, increased financing, and collective action. To date, a similar confluence of forces has not been applied to HIV prevention.

This challenge, pivotal to the future health and well-being of millions, is the focus of this report by the Global HIV Prevention Working Group. It offers a new analysis that examines the future course of the epidemic with and without a greatly scaled-up prevention response; surveys the latest evidence on HIV prevention access; reviews the experience in countries where such barriers have been overcome; and closes with a series of urgent recommendations to bring the promise of HIV prevention to the countries and communities that need it the most. As the report shows, even in the midst of global failure to make optimal use of available prevention strategies, a number of countries, including some of the world’s poorest, have made tangible progress in reducing the number of new HIV infections through implementation of comprehensive HIV prevention efforts. Strong evidence and replicable models exist for HIV prevention scale-up, underscoring the need to move beyond localized pilot projects to broad-based, comprehensive national programs. If comprehensive HIV prevention were brought to scale, half of the infections projected to occur by 2015 could be averted. We believe that the future need not be a legacy of the past.