Population Council Research that makes a difference

Good News About AIDS . . . But Why?

Until a few years ago, the global HIV/AIDS epidemic was widely expected to continue to spread, and the annual number of AIDS deaths was projected to grow from less than three million in 2004 to over six million in 2030. But in 2008 the WHO revised its 2030 estimate to 1.2 million, and recent UN projections confirm this downward revision. More than five million fewer deaths per year in 2030 is a favorable change, but how could studies just three years apart come to such different conclusions? That is one of the questions the authors of "How many more AIDS deaths?" set out to answer in their article in the 9 January edition of The Lancet.

"Earlier estimates of the epidemic were inflated because they relied mostly on HIV prevalence measures gathered from pregnant women in [developing countries'] antenatal clinics," according to Population Council Vice President and Distinguished Scholar John Bongaarts and his co-authors. In the last decade, however, national surveys have become available and "their more accurate estimates of HIV prevalence have been almost invariably lower than data from antenatal clinics suggested."

More important, the epidemic trend has reversed. Globally, the number of new HIV infections "likely peaked in the late 1990s at over three million new infections per year." By 2007, that figure had gone down by half a million. As a result, the authors estimate that "AIDS deaths peaked in 2005 at about 2.2 million deaths. This number is lower than expected from the epidemic’s natural course because of an aggressive global campaign to provide antiretroviral drugs to patients with AIDS everywhere."

According to Bongaarts, "The future course of the epidemic crucially depends on continuing ongoing declines in new HIV infections by strengthening preventive measures such as reducing high-risk sexual and drug-using behaviors; encouraging condom use, male circumcision, and partner reduction; controlling infections in medical settings; preventing mother-to-child transmission; HIV testing and counseling, especially of couples; and targeting interventions to high-risk populations."

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Bongaarts and co-authors François Pelletier and Patrick Gerland address the implications of the revised figure in “How many more AIDS deaths?” The Lancet 375(9709): 103–104, 9 January 2010. Available with free registration at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2809%2961756-6/fulltext.

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The Population Council confronts critical health and development issues—from stopping the spread of HIV to improving reproductive health and ensuring that young people lead full and productive lives. Through biomedical, social science, and public health research in 50 countries, we work with our partners to deliver solutions that lead to more effective policies, programs, and technologies that improve lives around the world. Established in 1952 and headquartered in New York, the Council is a nongovernmental, nonprofit organization governed by an international board of trustees.

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Media contact

Diane Rubino: drubino@popcouncil.org; +1 212 339 0617