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The World Health Organization (WHO) reported that the number of individuals receiving antiretroviral therapy (ART) in low- and middle-income countries (LMIC) has risen from 23.6 million in 2019 to 26.6 million in 2021.
Projections indicate a further 25 per cent increase by 2025, as outlined in a recent publication by WHO. This report offers insights into the anticipated demand for medications utilised in HIV, viral hepatitis and sexually transmitted infections (STI), potentially guiding advocacy, procurement planning and manufacturing strategies.
Of the estimated 38.4 million people living with HIV by the end of 2021, 25.6 million reside in the WHO African Region.
Dolutegravir-based ART stands as the primary treatment recommendation for HIV in LMICs, both for initial and secondary treatments.
Despite a projected decline in the number of children living with HIV in LMICs, reaching the UNAIDS target of 95 per cent treatment coverage by 2025 would necessitate an increase in the number of children receiving treatment to 1.1 million. Presently, only about half of the 1.7 million children living with HIV (as of 2021) receive ART.
The utilisation of oral pre-exposure prophylaxis (PrEP) has seen a significant increase globally, with approximately 1.8 million individuals receiving it in 2021, a five-fold rise from 2018. The African Region witnessed the most substantial growth in PrEP use between 2018 and 2021, with projections suggesting up to 5 million individuals may be using PrEP by 2023.
Chronic hepatitis B and C infections continue to pose significant burdens globally, with over 350 million affected globally as of 2019. Additionally, an estimated 3 million new infections occur each year.
An estimated 296 million people were living with chronic hepatitis B infection in 2019, with 1.5 million new infections occurring each year.
Hepatitis B caused an estimated 820,000 deaths in 2019. The burden of hepatitis B infection is highest in the WHO Western Pacific Region, with 116 million people chronically infected and African Region, with 81 million people chronically infected. Hepatitis C resulted in an estimated 290,000 deaths in 2019.
There are an estimated 374 million new infections annually with one of four curable sexually transmitted infections (STI) - chlamydia, gonorrhoea, syphilis and trichomoniasis.
WHO estimates 930,000 pregnant women annually have probable active syphilis (transmissible during pregnancy). The UN health agency targeted syphilis, along with HIV and Hepatitis B, in its initiative to eliminate mother-to-child transmission. Benzathine penicillin G is the only recommended treatment to prevent the mother-to-child transmission of syphilis.
The implementation of WHO’s global health sector strategies on HIV, viral hepatitis and STIs for the period 2022-30 has been approved by the 75th World Health Assembly.
Aligned with the UNAIDS Global AIDS Strategy 2021-26, these initiatives aim to reduce inequalities driving the AIDS epidemic and work toward ending AIDS as a public health threat by 2030.