We recognize that HIV/AIDS, malaria, tuberculosis and other infectious diseases pose severe risks for the entire world and serious challenges to the achievement of development goals.
—United Nations World Summit Outcome (2005)
Poverty, climate, and inadequate services are only some of the causes of people in developing countries to become highly susceptible to life-threatening diseases. For the most part, malaria and tuberculosis have been eliminated or largely contained in high-income countries, but continue to kill millions a year in developing regions. HIV/AIDS still remains a global pandemic where two-thirds of Sub-Saharan Africa’s population is infected. The sixth Millennium Development Goal (MDG) has been broken down into three targets and focuses on combating HIV/AIDS, malaria, and other diseases.
Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Living with HIV/AIDS
Worldwide, 33.4 million people are living with HIV/AIDS. Sub-Saharan Africa contains just over one-tenth of the world’s population but is home to two-thirds of people living with HIV/AIDS, with women more likely to be infected than men. In 2008 there were 2.7 million new HIV infections, a 17 percent decline over eight years. In 14 of 17 African countries with adequate survey data the proportion of pregnant women ages 15–24 living with HIV/AIDS has declined since 2000–01. Some of the most worrisome increases in new infections are now occurring in populous countries in other regions, such as Indonesia, the Russian Federation, and some high-income countries. Even more worrisome, an estimated 430,000 children younger than age 15 became infected with HIV in 2008. Globally, the number of children living with HIV rose from 1.6 million in 2001 to 2.1 million in 2008. Most of these children (90 percent) live in Sub-Saharan Africa.
Orphaned and vulnerable
In 2008 some 17.5 million children worldwide had lost one or both parents to AIDS, including nearly 14.1 million children in Sub-Saharan Africa. A key indicator of progress in HIV/AIDS treatment and the situation of children affected by AIDS is school attendance by orphans. Orphans and vulnerable children are at higher risk of missing out on schooling, live in households with less food security, and are in greater danger of exposure to HIV. The disparity in school attendance between orphans and nonorphans appears to be shrinking in many countries.
Target 6B: Achieve by 2010 universal access to treatment for HIV/ AIDS for all those who need it
Wider access to antiretroviral treatment has contributed to the first decline in AIDS deaths since the epidemic began. Coverage has improved substantially in Sub-Saharan Africa, but more than 60 percent of the population in need still do not have access to treatment.
Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other diseases
Curbing the toll of malaria
The World Health Organization estimates that in 2006 there were 190–330 million malaria episodes, leading to nearly 1 million malaria-related deaths. While malaria is endemic in most tropical and subtropical regions, 90 percent of malaria deaths occur in Sub-Saharan Africa, and most are among children under age 5.
Children who survive malaria do not escape unharmed. Repeated episodes of fever and anemia take a toll on their mental and physical development. Much progress has been made across Sub-Saharan Africa in scaling up insecticide-treated net use among children, which rose from 2 percent in 2000 to 16 percent in 2008.
Tuberculosis rates falling, but not fast enough
The number of new tuberculosis cases globally peaked in 2004 and is leveling off. Tuberculosis prevalence has fallen, but the target of halving 1990 prevalence and death rates by 2015 is unlikely to be met in all regions. Prevalence is still high in Sub-Saharan Africa, and South Asian countries appear to have just returned to 1990 prevalence levels in 2007. In 2007 there were 11 million cases globally, down from the 14 million in 2007, when 1.3 million infected people died. An estimated half million people who died were also HIV positive.