COUNTRIES MOST IN NEED OF SCALING UP ARV PROVISION
Author:
Bernard Rivers
Article Type:Article Number: 2
ABSTRACT An analysis conducted by GFO shows that half of all countries that are eligible to receive Global Fund grants currently provide ARV treatment to less than 25% of those that need it, and/or have at least 25,000 people who need ARV treatment but are not receiving it.
An analysis by GFO of data newly provided at www.GlobalHealthFacts.org (see previous article) shows that 62 of the 126 countries that are eligible to apply to the Global Fund (i.e. 48% of these countries) currently provide ARV treatment to less than 25% of those that need it, and/or have at least 25,000 people who need ARV treatment but are not receiving it.
This suggests that all of these countries, and probably many others, are urgently in need of scaling up treatment through support from the Global Fund or others.
The countries in question are those shown in bold in the following table. Further explanations are provided at the end of the table.
|
Country (showing all countries eligible for Global Fund HIV grants) |
People Living with HIV/AIDS |
HIV Prevalence |
People needing ARV treatment |
People receiving ARV treatment |
Of which: |
People “needing” treatment minus people “receiving” treatment |
Coverage |
|
|
People receiving ARV treatment with GF support |
People receiving ARV treatment with Pepfar support |
|||||||
|
|
|
|
|
|
|
|
|
|
| Global |
32,900,000 |
0.8% |
9,700,000 |
2,990,000 |
1,447,976 |
1,641,000 |
6,710,000 |
31% |
|
|
|
|
|
|
|
|
|
|
| Afghanistan |
NA |
NA |
NA |
0 |
0 |
0 |
NA |
NA |
| Albania |
<1000 |
<0.2% |
NA |
<100 |
0 |
0 |
NA |
NA |
| Algeria |
21,000 |
0.1% |
4,900 |
1,000 |
850 |
0 |
3,900 |
20% |
| Angola |
190,000 |
2.1% |
47,000 |
12,000 |
9,263 |
0 |
35,000 |
25% |
| Argentina |
120,000 |
0.5% |
53,000 |
38,000 |
0 |
0 |
15,000 |
73% |
| Armenia |
2,400 |
0.1% |
660 |
<100 |
59 |
0 |
c. 610 |
12% |
| Azerbaijan |
7,800 |
0.2% |
580 |
<100 |
24 |
0 |
c. 530 |
14% |
| Bangladesh |
12,000 |
<0.1% |
2,400 |
<200 |
0 |
0 |
c. 2,300 |
7% |
| Belarus |
13,000 |
0.2% |
4,300 |
900 |
643 |
0 |
3,400 |
20% |
| Belize |
3,600 |
2.1% |
1,100 |
600 |
494 |
0 |
500 |
49% |
| Benin |
64,000 |
1.2% |
20,000 |
9,800 |
8,633 |
0 |
10,200 |
49% |
| Bhutan |
<500 |
0.1% |
<100 |
<100 |
0 |
0 |
<100 |
NA |
| Bolivia |
8,100 |
0.2% |
2,300 |
<500 |
416 |
0 |
c. 2,050 |
22% |
| Bosnia and Herzegovina |
<500 |
<0.1% |
NA |
<100 |
0 |
0 |
NA |
NA |
| Botswana |
300,000 |
23.9% |
120,000 |
93,000 |
0 |
94,900 |
27,000 |
79% |
| Brazil |
730,000 |
0.6% |
230,000 |
181,000 |
0 |
0 |
49,000 |
80% |
| Bulgaria |
NA |
NA |
NA |
<500 |
210 |
0 |
NA |
NA |
| Burkina Faso |
130,000 |
1.6% |
48,000 |
17,000 |
5,237 |
0 |
31,000 |
35% |
| Burundi |
110,000 |
2.0% |
47,000 |
11,000 |
8,935 |
0 |
36,000 |
23% |
| Cambodia |
75,000 |
0.8% |
40,000 |
27,000 |
23,587 |
0 |
13,000 |
67% |
| Cameroon |
540,000 |
5.1% |
180,000 |
46,000 |
28,773 |
0 |
134,000 |
25% |
| Cape Verde |
NA |
NA |
NA |
<500 |
0 |
0 |
NA |
NA |
| Central African Republic |
160,000 |
6.3% |
45,000 |
9,600 |
4,801 |
0 |
35,400 |
21% |
| Chad |
200,000 |
3.5% |
55,000 |
7,400 |
1,430 |
0 |
47,600 |
13% |
| China |
700,000 |
0.1% |
190,000 |
35,000 |
28,884 |
0 |
155,000 |
19% |
| Colombia |
170,000 |
0.6% |
54,000 |
21,000 |
78 |
0 |
33,000 |
38% |
| Comoros |
<200 |
<0.1% |
<100 |
<100 |
5 |
0 |
<100 |
NA |
| Congo |
79,000 |
3.5% |
29,000 |
5,000 |
4,066 |
0 |
24,000 |
17% |
| Congo (DRC) |
400,000- |
1.2-1.5% |
120,000 |
29,000 |
13,064 |
0 |
91,000 |
24% |
| Cote d’Ivoire |
480,000 |
3.9% |
190,000 |
52,000 |
46,007 |
39,700 |
138,000 |
28% |
| Cuba |
6,200 |
0.1% |
1,400 |
3,100 |
2,581 |
0 |
-1,700 |
>95% |
| Djibouti |
16,000 |
3.1% |
4,500 |
700 |
725 |
0 |
3,800 |
16% |
| Dominica |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Dominican Rep. |
62,000 |
1.1% |
22,000 |
8,200 |
7,768 |
0 |
13,800 |
38% |
| Ecuador |
26,000 |
0.3% |
7,600 |
3,200 |
2,317 |
0 |
4,400 |
42% |
| Egypt |
9,200 |
<0.1% |
2,200 |
<500 |
0 |
0 |
c. 1,950 |
9% |
| El Salvador |
35,000 |
0.8% |
11,000 |
5,800 |
4,708 |
0 |
5,200 |
51% |
| Eritrea |
38,000 |
1.3% |
10,000 |
1,300 |
1,890 |
0 |
8,700 |
13% |
| Ethiopia |
980,000 |
2.1% |
310,000 |
90,000 |
81,819 |
97,100 |
220,000 |
29% |
| Fiji |
<500 |
0.1% |
<200 |
<100 |
0 |
0 |
c. 50 |
NA |
| Gabon |
49,000 |
5.9% |
15,000 |
6,400 |
3,306 |
0 |
8,600 |
42% |
| Gambia |
8,200 |
0.9% |
2,300 |
<500 |
385 |
0 |
c. 2,050 |
18% |
| Georgia |
2,700 |
0.1% |
<500 |
<500 |
271 |
0 |
<500 |
NA |
| Ghana |
260,000 |
1.9% |
87,000 |
13,000 |
10,275 |
0 |
74,000 |
15% |
| Grenada |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Guatemala |
59,000 |
0.8% |
21,000 |
7,800 |
2,937 |
0 |
13,200 |
37% |
| Guinea |
87,000 |
1.6% |
21,000 |
5,700 |
1,411 |
0 |
15,300 |
27% |
| Guinea-Bissau |
16,000 |
1.8% |
4,400 |
900 |
517 |
0 |
3,500 |
20% |
| Guyana |
13,000 |
2.5% |
4,300 |
2,000 |
2,054 |
2,000 |
2,300 |
45% |
| Haiti |
120,000 |
2.2% |
36,000 |
15,000 |
12,921 |
15,100 |
21,000 |
41% |
| Honduras |
28,000 |
0.7% |
12,000 |
5,600 |
5,006 |
0 |
6,400 |
47% |
| India |
2,400,000 |
0.3% |
NA |
158,000 |
100,897 |
0 |
NA |
NA |
| Indonesia |
270,000 |
0.2% |
43,000 |
6,600 |
6,647 |
0 |
36,400 |
15% |
| Iran |
86,000 |
0.2% |
19,000 |
900 |
47 |
0 |
18,100 |
5% |
| Iraq |
NA |
<0.2% |
NA |
0 |
0 |
0 |
NA |
NA |
| Jamaica |
27,000 |
1.6% |
8,500 |
3,600 |
4,000 |
0 |
4,900 |
43% |
| Jordan |
<1000 |
<0.2% |
NA |
<100 |
45 |
0 |
NA |
NA |
| Kazakhstan |
12,000 |
0.1% |
1,900 |
<500 |
342 |
0 |
c. 1,650 |
23% |
| Kenya |
1,500,000- |
7.1-8.5 |
470,000 |
177,000 |
166,379 |
192,100 |
293,000 |
38% |
| Kiribati |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Korea (North) |
<100 |
<0.1% |
2,900 |
NA |
0 |
0 |
<=2,900 |
0% |
| Kyrgyzstan |
4,200 |
0.1% |
610 |
<100 |
62 |
0 |
c. 560 |
14% |
| Lao PDR |
5,500 |
0.2% |
690 |
700 |
0 |
0 |
-10 |
>95% |
| Lesotho |
270,000 |
23.2% |
85,000 |
22,000 |
17,728 |
0 |
63,000 |
26% |
| Liberia |
35,000 |
1.7% |
8,500 |
1,400 |
1,157 |
0 |
7,100 |
17% |
| Macedonia |
<500 |
<0.1% |
NA |
<100 |
20 |
0 |
NA |
NA |
| Madagascar |
14,000 |
0.1% |
3,200 |
<200 |
163 |
0 |
c. 3,100 |
4% |
| Malawi |
930,000 |
11.9% |
290,000 |
101,000 |
79,398 |
0 |
189,000 |
35% |
| Malaysia |
80,000 |
0.5% |
20,000 |
6,800 |
0 |
0 |
13,200 |
35% |
| Maldives |
<100 |
<0.1% |
<100 |
<100 |
0 |
0 |
<100 |
NA |
| Mali |
100,000 |
1.5% |
30,000 |
12,000 |
12,814 |
0 |
18,000 |
41% |
| Marshall Islands |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Mauritania |
14,000 |
0.8% |
3,600 |
800 |
531 |
0 |
2,800 |
23% |
| Mauritius |
13,000 |
1.7% |
1,500 |
<500 |
0 |
0 |
c. 1,250 |
22% |
| Mexico |
200,000 |
0.3% |
76,000 |
43,000 |
0 |
0 |
33,000 |
57% |
| Micronesia |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Moldova |
8,900 |
0.4% |
800 |
<500 |
451 |
0 |
c. 550 |
58% |
| Mongolia |
<1000 |
0.1% |
<100 |
<100 |
2 |
0 |
<100 |
NA |
| Morocco |
21,000 |
0.1% |
5,300 |
1,600 |
1,400 |
0 |
3,700 |
31% |
| Mozambique |
1,500,000 |
12.5% |
370,000 |
90,000 |
78,236 |
88,200 |
280,000 |
24% |
| Myanmar |
240,000 |
0.7% |
76,000 |
11,000 |
0 |
0 |
65,000 |
15% |
| Namibia |
200,000 |
15.3% |
59,000 |
52,000 |
43,694 |
52,800 |
7,000 |
88% |
| Nepal |
70,000 |
0.5% |
20,000 |
1,400 |
1,240 |
0 |
18,600 |
7% |
| Nicaragua |
7,700 |
0.2% |
1,700 |
500 |
531 |
0 |
1,200 |
30% |
| Niger |
60,000 |
0.8% |
16,000 |
1,500 |
1,907 |
0 |
14,500 |
10% |
| Nigeria |
2,600,000 |
3.1% |
750,000 |
198,000 |
4,832 |
162,500 |
552,000 |
26% |
| Pakistan |
96,000 |
0.1% |
20,000 |
600 |
361 |
0 |
19,400 |
3% |
| Panama |
20,000 |
1.0% |
7,200 |
4,000 |
0 |
0 |
3,200 |
56% |
| Papua New Guinea |
54,000 |
1.5% |
5,900 |
2,300 |
1,546 |
0 |
3,600 |
38% |
| Paraguay |
21,000 |
0.6% |
4,800 |
1,100 |
0 |
0 |
3,700 |
22% |
| Peru |
76,000 |
0.5% |
23,000 |
11,000 |
10,610 |
0 |
12,000 |
48% |
| Philippines |
8,300 |
<0.1% |
1,100 |
<500 |
170 |
0 |
c. 850 |
31% |
| Rwanda |
150,000 |
2.8% |
68,000 |
49,000 |
44,395 |
52,400 |
19,000 |
71% |
| Saint Lucia |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| St. Vincent & Grenadines |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Samoa |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Sao Tome & Principe |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Senegal |
67,000 |
1.0% |
12,000 |
6,700 |
2,270 |
0 |
5,300 |
56% |
| Serbia and Montenegro |
6,400 |
0.1% |
NA |
NA |
481 |
0 |
NA |
NA |
| Sierra Leone |
55,000 |
1.7% |
13,000 |
2,600 |
1,623 |
0 |
10,400 |
20% |
| Solomon Islands |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Somalia |
24,000 |
0.5% |
6,300 |
<500 |
201 |
0 |
c. 6,050 |
NA |
| South Africa |
5,700,000 |
18.1% |
1,700,000 |
460,000 |
115,142 |
435,100 |
1,240,000 |
28% |
| Sri Lanka |
3,800 |
<0.1% |
780 |
<200 |
0 |
0 |
c. 680 |
14% |
| Sudan |
320,000 |
1.4% |
87,000 |
1,200 |
1,480 |
0 |
85,800 |
1% |
| Suriname |
6,800 |
2.4% |
1,600 |
700 |
656 |
0 |
900 |
45% |
| Swaziland |
190,000 |
26.1% |
59,000 |
25,000 |
21,670 |
0 |
34,000 |
42% |
| Syria |
NA |
<0.2% |
NA |
<100 |
0 |
0 |
NA |
NA |
| Tajikistan |
10,000 |
0.3% |
1,300 |
<100 |
94 |
0 |
c. 1,250 |
6% |
| Tanzania |
1,400,000 |
6.2% |
440,000 |
136,000 |
96,936 |
114,200 |
304,000 |
31% |
| Thailand |
610,000 |
1.4% |
250,000 |
153,000 |
93,839 |
0 |
97,000 |
61% |
| Timor Leste |
NA |
NA |
NA |
0 |
0 |
0 |
NA |
NA |
| Togo |
130,000 |
3.3% |
41,000 |
8,000 |
3,389 |
0 |
33,000 |
19% |
| Tonga |
NA |
NA |
NA |
NA |
0 |
0 |
NA |
NA |
| Tunisia |
3,700 |
0.1% |
1,000 |
<500 |
0 |
0 |
c. 750 |
29% |
| Turkmenistan |
<500 |
<0.1% |
NA |
0 |
0 |
0 |
NA |
NA |
| Uganda |
940,000 |
5.4% |
350,000 |
115,000 |
46,642 |
131,200 |
235,000 |
33% |
| Ukraine |
440,000 |
1.6% |
91,000 |
7,700 |
4,060 |
0 |
83,300 |
8% |
| Uruguay |
10,000 |
0.6% |
3,100 |
1,800 |
0 |
0 |
1,300 |
56% |
| Uzbekistan |
16,000 |
0.1% |
1,400 |
<500 |
277 |
0 |
c. 1,150 |
24% |
| Vanuatu |
NA |
NA |
NA |
<100 |
0 |
0 |
NA |
NA |
| Viet Nam |
290,000 |
0.5% |
67,000 |
17,000 |
2,927 |
11,800 |
50,000 |
26% |
| W. Bank & Gaza |
NA |
NA |
NA |
NA |
0 |
0 |
NA |
NA |
| Yemen |
NA |
<0.2% |
NA |
<200 |
0 |
0 |
NA |
NA |
| Zambia |
1,100,000 |
15.2% |
330,000 |
151,000 |
122,684 |
151,900 |
179,000 |
46% |
| Zimbabwe |
1,300,000 |
15.3% |
570,000 |
98,000 |
8,634 |
0 |
472,000 |
17% |
Technical notes:
- Further details regarding the columns are:
- Country: All countries that were eligible to apply for Global Fund HIV grants in Round 8.
- People Living with HIV/AIDS:Adults and children living with HIV/AIDS, 2007.
- HIV Prevalence: Percentage of adults who had HIV/AIDS in 2007.
- People needing ARV Treatment: Estimated number of people needing ARV treatment, 2007. (Note: ARV treatment is usually not needed until several years after infection with HIV.)
- People receiving ARV Treatment:Estimated number of people receiving ARV treatment, December 2007.
- People receiving ARV treatment with GF support: People receiving ARV treatment from programmes supported by the Global Fund, as of 1 Dec. 2007. (Original source: www.theglobalfund.org/en/files/publications/factsheets/aids/ARV_Factsheet_2007.pdf.)
- People receiving ARV treatment with Pepfar support: Number of people receiving ARV treatment from programmes supported by Pepfar, as of 31 March 2008.
- People “needing” treatment minus people “receiving” treatment: The difference between “people needing ARV Treatment” and “people receiving ARV Treatment”.
- Coverage: Those “receiving” as a percentage of those “needing”, December 2007.
- The number in the GF column or in the Pepfar column sometimes exceeds the total number shown for people nationwide treatment, because of data being gathered at different points during 2007.
- Countries are shown in bold in cases where Coverage is less than 25%, and/or where people “needing” treatment minus people “receiving” treatment is greater than 25,000 people.
- It should be noted that the people shown as needing but not yet receiving treatment will not be known to themselves or to anyone else if they have not been tested and are not yet symptomatic. And even if such people are known, the country may need to invest in health systems before such treatment can be provided.
- All data were obtained in August 2008 from www.GlobalHealthFacts.org, a website created by the Kaiser Family Foundation. Data provided at this site are primarily obtained from the Global Fund, UN agencies, Pepfar and other international entities, rather than from individual implementing countries, and therefore do not always represent the most recent data available at the country level.
- A more detailed spreadsheet-based version of this analysis, compiled by Aidspan in the course of writing this article, is available at www.aidspan.org/documents/other/Aidspan-ARV-numbers-analysis.xls.
- In countries where the Global Fund (or Pepfar) provides substantial support on a national scale for things like clinics, testing facilities, and distribution and logistics systems, the Fund (or Pepfar, as the case may be) sometimes publishes numbers (reproduced in the relevant columns of the above table) stating that all people in the country who are receiving treatment are doing so with GF/Pepfar support. Thus, for most countries, the numbers in these two columns overlap substantially if not entirely. (This point is discussed further in the Commentary, below.)
