Global HIV/AIDS Policy in Transition

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Science  11 Jun 2010:
Vol. 328, Issue 5984, pp. 1359-1360
DOI: 10.1126/science.1191804

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In 2007, the United Nations Joint Programme on HIV/AIDS (UNAIDS) concluded that “Global HIV incidence likely peaked in the late 1990s” (1), due to “natural trends in the epidemic as well as the result of prevention programmes” (1). The slow decline in new infections together with a recent rise in antiretroviral therapies (ARTs) halted the rise in the estimated number of AIDS deaths at about 2.2 million per year—equivalent to 4% of all global deaths (2). Among adults 15 to 49, the proportion currently infected with HIV (HIV prevalence) plateaued at just under 1% before declining to 0.8% worldwide (1, 3). These trends raise the question of how global health funding should be rebalanced between AIDS treatment and HIV prevention, as well as other health-care investments.