Global burden of HIV, malaria and TB has decreased since 'the Millennium Declaration'

In 2000, governments worldwide adopted the "Millennium Development Goal 6" to reduce the global burden of HIV/AIDS, malaria and tuberculosis. 

Assessing the impact of this "Millennium Declaration," a new analysis from the Global Burden of Disease Study 2013 finds that accelerated progress has been made since 2000.

The analysis, which is published in The Lancet, shows that the number of deaths from malaria has fallen since 2004, although the disease is still killing more people than previously estimated.

During 2000-2013, tuberculosis (TB) was shown to have faster rates of decline in incidence across 12 global regions compared with the decade before the Millennium Declaration.

The analysis also shows that the number of people with HIV rose to around 29 million in 2012. Despite this, the authors say that the HIV epidemic is smaller than previously estimated.

The analysis describes how the overall amount of ill health and premature death arising from HIV is approximately 25% lower than the most recent estimate, which was provided by UNAIDS in 2012.

Key points from the analysis are provided below.

HIV

The authors say that the HIV epidemic is smaller than had been previously estimated.

• Worldwide incidence has declined every year, from 2.8 million new infections in 1997 to current annual rates of 1.8 million new infections
• There has been a decrease of 62% of new infections in children
• The number of people worldwide infected with HIV rose to 29 million in 2012
• In 2005, HIV caused 1.7 million deaths. This fell to about 1.3 million in 2013
• Regions with ongoing increases in deaths from HIV since 2000 are: high-income Asia Pacific, central and eastern Asia, eastern and central Europe, north Africa and the Middle East, Oceania, and southern and western sub-Saharan Africa
• Antiretroviral drugs and similar treatments have saved around 19.1 million life-years since 1996.

Tuberculosis TB

• Prevalence has decreased since 2000, but the number of people living with TB worldwide has increased from around 8.5 million in 1990 to about 12 million in 2013
• Number of annual TB deaths has fallen from 1.6 million in 2000 to 1.4 million in 2013
• In 15 of 21 regions, there is evidence of accelerating declines in incidence during 2000-2013, compared with 1990-2000
• South and southeast Asia account for 35% of new cases of TB and 48% of TB deaths
• Males account for 64% of all new cases and 65% of deaths.

Malaria

• Global malaria incidence has fallen by 29% between 2003 (232 million new cases) and 2013 (165 million new cases)

Malaria is killing more people than previously estimated.
• Nigeria, Democratic Republic of Congo and India account for roughly half of all malaria deaths
• Malaria is killing more people worldwide than previously thought, with the analysis reporting 855,000 deaths in 2013 compared with the World Health Organization estimate of 627,000
• New infections have fallen in central Asia by around 38% and in sub-Saharan Africa by 31.5% since 2004.

The analysis, which has also been presented at AIDS 2014 - the 20th international AIDS conference, taking place in Melbourne, Australia - has been praised for providing "detailed information on key data sources, key adjustments to data, modeling strategies and uncertainty analyses."

Writing in a linked comment, Rifat Atun, professor of Global Health Systems at Harvard University, Boston, MA, says that the experts behind the new analysis have "pushed the boundaries of reporting in global health to levels expected of other disciplines and areas of health research - an important step in the right direction."

In other AIDS 2014 news, researchers recently reported on a study presented at the conference and published in JAMA, which found that from 2002-2011, the annual HIV diagnosis rate in the US decreased by more than 30%.