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COUNTRIES MOST IN NEED OF SCALING UP ARV PROVISION
GFO Issue 94

COUNTRIES MOST IN NEED OF SCALING UP ARV PROVISION

Author:

Bernard Rivers

Article Type:
Analysis

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
(equals “Receiving” as % of “Needing”)

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-
500,000

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-
2,000,000

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.)

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