HIV, malaria, and other diseases directly and indirectly impact food and nutrition security, rural development, and agricultural productivity. At the same time, malnutrition and food and nutrition insecurity can increase vulnerability to disease.
In this regard, millennium development goal 6 has three targets:
- To halt by 2015 and have started to reverse the spread of HIV/AIDS
- To achieve global access to treatment for HIV/AIDS for those who need it by 2010
- To have ceased and started reversal of the incidence of malaria and other major diseases by 2015
Some of the achievements of MDG 6 include:
- 40 percent reduction in new HIV infections from 3.5 million cases in 2000 to 2.1 million cases in 2013
- A massive increase in the number of people living with HIV receiving anti-retroviral therapy (ART) globally, from 800,000 in 2003 to 13.6 million in 2014. ART have helped avoid over 7.6 million deaths from AIDS between 1995 and 2013.
- Averting over 6.2 million deaths associated with malaria between 2000 and 2015, mostly of children under five years in sub-Saharan Africa. The universal malaria incidence rate has also reduced by an estimated 37 percent, and the mortality rate by 58 percent.
- The delivery of over 900 million insecticide-treated mosquito nets to malaria-endemic countries in sub-Saharan Africa between 2004 and 2014.
- Tuberculosis prevention, diagnosis, and treatment interventions conducted between 2000 and 2013 saved an estimated 37 million lives. The TB mortality rate reduced by 45 percent between 1990 and 2013, while prevalence rate fell by 41 percent within the same time period.
Target #1: Halt and reversal of the spread of HIV/AIDS
New HIV – human immunodeficiency virus – infections have declined universally by nearly 40 percent between 2000 and 2013, indicating a drop from an estimated 3.5 million to 2.1 million new infections. Among the countries with sufficient data, 10 countries recorded a drop of more than 75 percent in new HIV infections from 2000 to 2013, while another 27 countries recorded a decline of more than 50 percent.
More than 75 percent of new infections recorded in 2013 occurred in only 15 nations, though sub-Saharan Africa is still the most severely affected by the epidemic with an estimated 1.5 million new infections in 2013. Of these, nearly 50 percent have occurred in three countries: South Africa, Nigeria, and Uganda.
That said, South Africa, which has the largest number of people living with HIV, recorded the largest decline in the total number of new infections, with 98,000 fewer infections in 2013 compared to 2010. Additionally, the number of new infections among young people (15 – 24) in the sub-Saharan region has declined by 45 percent between 2000 and 2013.
In the Caribbean, new HIV infections reduced by 56 percent, while Southern Asia and Southern Africa recorded a 49 percent decrease. There wasn’t much change in Latin America and South-Eastern Asia, while new infections increased in Western Asia, North Africa, and Eastern Asia.
AIDS related deaths dropped in 2013, with an estimated 1.5 million deaths from AIDS-related illnesses. This represents a 35 percent decline since the 2.4 million peak recorded in 2005. In the short period between 2010 and 2013, AIDS-related deaths dropped by 19 percent, though AIDS-related deaths have not decreased among adolescents aged 10 – 19, probably due to lack of testing and treatment for this age group. As such, AIDS remains the number one adolescent killer in sub-Saharan Africa.
Target #2: Universal access to HIV/AIDS treatment
In 2013, an estimated 17.7 million children across the globe (under 18) has lost at least one parent due to AIDS-related causes. Between 2000 and 2009, the number rose from 10.5 to reach a peak of 18.5 million. Since then, this number has been dropping gradually, through investment in social protection and economic support will be needed for years to come to mitigate the impact of HIV on these children.
Education is a critical source of stability and protection for vulnerable children. Fortunately, the rate of school attendance for orphaned and non-orphaned children has increased from 0.80 to 0.96 between 2000 and 2014.
Access to ART has increased at an amazing pace, with an estimated 13.6 million people living with HIV receiving ART globally. Of those, 12.1 million were in developing regions, indicating a huge increase from 375,000 in 2003.
The world is still on track to get 15 million people to receive ART by 2015, a goal set out in the UN General Assembly Special Session on HIV and AIDS in 2011. This accomplishment can be attributed to the power of community mobilisation, the political resolve of leaders, the commitment of health care workers, and international funding that continues to fuel the universal scaling-up of ART.
Target #3: Reversal of the incidence of malaria and other major diseases
Global malaria incidence rate has dropped by about 37 percent between 2000 and 2015, while mortality rate has dropped by 58 percent in the same period. Consequently, the global MDG malaria target has been achieved.
Increased universal attention, combined with considerable expansion of anti-malaria efforts have helped avert more than 6.2 million malaria deaths in the 15 year period, especially in children under five in sub-Saharan Africa. The estimated 69 percent reduction in malaria mortality for children under five in this region helped improve child survival rates, directly contributing to MDG4 – reduction of child mortality by two-thirds.
The massive gains since 2000 have been attributed to the tenfold increase in international funding for malaria, with stronger political commitment and the availability of new, more effective tools. This has increased access to malaria prevention and treatment interventions, including indoor residual spraying, long-lasting insecticide-treated mosquito nets, diagnostic testing, and artemisinin-based combination therapies.
In 2013, there were an estimated 35 million people living with HIV in the world. This number is increasing as more people gain access to antiretroviral therapy (ART). And while ART has averted 7.6 million deaths worldwide, including 4.8 million in sub-Saharan Africa, this is only 36 percent of the 31.5 million people living with HIV in developing regions.
And while 98 malaria-endemic nations have reversed malaria incidence nationally in 2015 compared to 2000, malaria continues to pose a huge public health challenge with an estimated 214 million cases and 472,000 deaths worldwide in 2015. 97 countries and territories across the globe, or 3.3 billion people, are still at risk of malaria infection, so more still needs to be done.
For patients diagnosed with tuberculosis in 2012, 86 percent were successfully treated globally, hitting the target of 85 percent set in 1991.