LOS ANGELES (August 31, 2016) AIDS Healthcare Foundation (AHF) the largest global AIDS organization, which serves 600,000 clients in 36 countries, today called for more transparency and accountability on the way, data and assumptions that UNAIDS uses to make estimations of the numbers of people living with HIV/AIDS who are on lifesaving anti-retroviral treatment (ART) around the globe. In June, just before the UN’s High Level Meeting on AIDS in New York,
UNAIDS made an announcement that two million more individuals worldwide were on AIDS treatment now than in the prior year, bringing their estimate of those on treatment to 17 million people worldwide.
AHF and other advocates believe that number may be an exaggeration and note that it is crucial to have as accurate a number of those on treatment as possible in order to best deploy the resources needed to end the epidemic by 2030 as part of the 90-90-90 targets (90% of people with HIV have been diagnosed; 90% of the diagnosed receive ART and 90% of those on ART to achieve viral load suppression by year 2020).
“UNAIDS needs to be accountable to the entire international community and not just to governments and donors,” said Michael Weinstein, AHF President. “Right now, it is not clear that a site-by-site audit inside a country would produce the same numbers as what is being reported by UNAIDS. Some countries do not provide the numbers, or do not have the numbers, therefore UNAIDS estimates are based on multiple layers of assumptions. They end up with numbers that are sometimes difficult to believe, but that definitely portray an optimistic view of the progress in the war on AIDS.”
According to AHF’s Associate Director of Global Policy, Denys Nazarov, a recent Lancet article published by an independent research body called the Group on Burden of Disease (GDB) insists that with respect to treatment coverage rates there needs to be stricter adherence to the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER), which were developed by the WHO. Some of the estimates done by the GDB in some cases differ by a large margin from those done by UNAIDS.
“For example, in 2014 UNAIDS estimated a much faster rate of decline in annual new infections than GBD. Globally, GBD 2015 report estimates about 2.5 million new infections in 2014, whereas UNAIDS estimates about 2 million for the same time period,” Nazarov said. “A more dramatic case was Kenya where results from GBD 2015 show an increase in annual new infections from 60,000 in 2005, to 146,700 in 2014, whereas UNAIDS shows a decrease from 73,000 to 56,000 during the same period year. Since we have HIV services in Kenya, who should we believe? I think the responsibility for full transparency needs to come from UNAIDS.”
Jorge Saavedra, AHF’s Global Public Health Ambassador and former Head of the National AIDS Program of Mexico said experience shows that there are some methods that tend to overestimate the number of people on ART, such as only counting the volumes of procurement without taking into account if they really reached the mouth of the patient. “On the other hand,” Saavedra added, “when big countries like Nigeria, India or Russia among others, do not release their full data, UNAIDS should embrace its leadership role and fully release all the assumptions used in order to estimate those numbers.”