Julio Montaner
Ronald Zak  /  AP
Overview of the opening session during which Julio Montaner from the university of British Columbia delivers a speech at the start of of the International AIDS Conference in Vienna Austria, on Sunday, July 18, 2010.
updated 7/19/2010 11:41:52 AM ET 2010-07-19T15:41:52

The number of people receiving medicines for the AIDS virus leapt by a quarter last year but more patients need to be brought into treatment before they are too sick, the World Health Organization said on Monday.

Presenting the data at an international conference on AIDS in Vienna, the WHO said an estimated 5.2 million people were being treated for the AIDS virus at the end of 2009 after an extra 1.2 million people started treatment during the year.

Between 2003 and 2010, the number of patients receiving lifesaving antiretroviral treatment increased twelve-fold, according to the Geneva-based body.

"We are very encouraged by this increase. It is indeed the biggest increase that we have seen in any single year," said Gottfried Hirnschall, director of the WHO's HIV/AIDS department.

Hirnschall, in an interview with The Associated Press, said the jump was due to improved access to treatment around the globe, especially in sub-Saharan Africa.

"That's obviously where the greatest need in terms of numbers is, but that's really where we have seen the most impressive scale-up in terms of treatment access," Hirnschall said.

'Still a long way to go'
WHO presented the new data at an international AIDS conference in the Austrian capital attended by thousands of experts and advocates. Bill Clinton, in a keynote speech, acknowledged the increase but also put it into context.

"Five million people on treatment is a lot compared to where we started — but still a third of those who need treatment today," the former American president said. "We cannot get to the end of this epidemic without both more money and real changes in the way we spend it."

"There's still a long way to go," agreed Hirnschall.

In Eastern Europe, meanwhile, there are proportionally fewer people on treatment than in other parts of the world because drug users often are not included or given sufficient access, he said.

Drug users are "criminalized, they are stigmatized, they are obviously a group that suffers inequities and human rights violations, and that's obviously a serious concern for all of us," he said.

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While in Africa AIDS is a mainly heterosexual epidemic, in Eastern Europe a lot of the infection occurs among drug users, he noted.

Complete statistics on the global situation will be released in a report in September.

Earlier HIV treatment can prevent so-called "opportunistic infections" including tuberculosis (TB), which is the biggest killer of people with HIV.

The costs for HIV treatment in 2010 will be about $9 billion, according to the Joint United Nations Program on HIV/AIDS (UNAIDS).

Start treatment earlier
The WHO says deaths from TB could be reduced by as much as 90 percent if people with both HIV and TB started treatment earlier, when their immune systems have not been weakened too much by the virus.

The strength of a person's immune system is measured by CD4 cells and this measure is used by doctors to assess when HIV-infected patients should start receiving medicines.

The WHO previously recommended starting HIV treatment when a person's CD4 count dropped below 200 cells/mm3 but it now advises starting treatment earlier, at 350 cells/mm3 or below.

Treating HIV can help stop spread of virus

In rich nations, HIV patients begin treatment before their CD4 count drops significantly. As a result they are able to live longer and more normal lives despite having the incurable virus.

A lack of funds and of healthcare infrastructure in poorer nations, where the virus is more widespread, mean patients have to wait until they are very ill before they get access to drugs.

WHO estimates that HIV-related deaths could be reduced by 20 percent between 2010 and 2015 if the new treatment guidelines were broadly implemented. Evidence from scientific studies also shows that earlier treatment can be an effective way of preventing the virus from spreading.

"Because treatment reduces the level of virus in the body, it means HIV-positive people are less likely to pass the virus on to their partners," the WHO's Hirnschall said.

Bernhard Schwartlander, director for evidence, strategy and results at UNAIDS, said investing in earlier HIV treatment could save "millions of lives" and "millions of dollars" in future.

"People with weaker immune systems who come late for treatment require more complex and costly drugs and services than those who start treatment earlier," he said.

In U.S. cities, HIV linked more to poverty than race

The aid group Medecins Sans Frontieres (Doctors Without Borders) welcomed news of the upswing in people receiving treatment but warned that future progress could be impeded by insufficient funding.

"The big worry right now is that this upward movement could be interrupted," said Tido von Schoen-Angerer, who heads the group's campaign for access to essential medicines. "We can't turn back now."

Von Schoen-Angerer said there already were signs of funding woes, with clinics in Uganda being forced to turn away patients.

"There's a fear we'll see this at a greater scale," he said.

The Associated Press and Reuters contributed to this report


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