A study published by The Lancet this week brings welcome news of significant reductions in maternal deaths and cites access to HIV antiretroviral therapy as a major contributor to reduced death rates among women. It is among the most compelling evidence to date that HV services do not compete with other health priorities in the developing world, they support them.

Photo: WHO/UNAIDS/E. Miller

The study shows once again that access to HIV prevention, treatment and care are essential to a comprehensive approach to improving developing world health because they:

• reduce all-cause mortality
• improve maternal health
• improve child health by preventing and treating HIV disease in children and reducing diarrheal and other diseases through safe breastfeeding
• reduce tuberculosis and other infectious diseases that exploit HIV-weakened immune systems
• support health worker training and strengthen developing world health systems.

Looking at maternal health in 181 countries over a span of almost 30 years, the study offers yet more proof that concerted, evidence-based action to improve the health of vulnerable populations works.

Improving the health of women demands sustained commitment to addressing HIV, the leading global killer of women of reproductive age and one of the leading causes of adult and child deaths in low- and middle-income countries. According to UNAIDS, women comprise about half of all people living with HIV worldwide and three quarters of people ages 15-24 living with HIV in sub-Saharan Africa. Broad access to ART has reduced morbidity and mortality among women, reduced vertical transmission of HIV and improved the health of infants and children.

Leaders of the G8 nations and every United Nations member state pledged in 2005 to achieve universal access to HIV prevention, treatment, care and support by 2010. The publication of The Lancet study is another powerful reminder of why it is so crucial to meet this pledge as quickly as possible. While the number of people receiving ART in low- and middle-income countries grew from 400,000 in 2003 to 4 million in 2008, only about one-third of the people who need HIV therapy today receive it. That proportion drops further when figuring in the World Health Organization’s new guidelines urging earlier treatment with ART for better health outcomes. 

Unfortunately, at this critical moment, as evidence about the broad and multiple b enefits of universal access is pouring in, donor nations are falling billions of dollars short in their pledges to global HIV programmes. These ill-timed and shortsighted cutbacks threaten to reduce access to HIV prevention and treatment just as increased action is needed to build on progress cited in The Lancet study and elsewhere.

As we note the significant, but partial, victory of a decrease in maternal mortality, the global community must increase its voice to demand that all nations meet the pledge to achieve universal access to HIV prevention, treatment, care and support, and fund other vital health interventions to reduce the overwhelming toll of unnecessary illness and death that still impoverishes the entire world. 

I urge you to visit the IAS’s Universal Access Now campaign and urge world leaders to renew their commitment to universal access. We need no more evidence than we have today that universal access is both achievable and essential to the health of the world’s most vulnerable citizens. It’s time to get it done.