According to a recent report, more than four million people living in low- to middle-income countries are now receiving antiretroviral therapy.

The report, released by the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), and the Joint United Nations Programme on HIV/AIDS (UNAIDS), details other improvements in HIV/AIDS care as well, including figures related to treatment, testing and counseling, women and children, and at-risk populations.

Forty two percent of the estimated 9.5 million people in need of antiretroviral therapy (ART) in low- to middle-income countries are receiving care. The greatest increase in the number of people receiving ART was seen in sub-Saharan Africa.

Prices for first-line treatment regimens have also decreased 30 to 68 percent from 2004 to 2008, again in low- and middle-income countries. However, costs for second-line treatments continue to increase.

“This report shows tremendous progress in the global HIV/AIDS response,” said Dr. Margaret Chan, Director-General of the WHO in a press release. “But we need to do more. At least 5 million people living with HIV still do not have access to life-prolonging treatment and care.”

Despite increased efforts to test and counsel patients, surveys conducted in 2007 and 2008 revealed that less than 40 percent of respondents knew their HIV status. As a result, patients often reach later stages of the disease before initiating antiretroviral therapy, leading to higher mortality rates.

HIV testing and counseling for pregnant women has improved, increasing to 21 percent in 2008 from 15 percent in 2007. Women and children represent an especially important group for HIV care; since pregnant women risk transmitting HIV to their newborns, prevention efforts within this group are critical.

Women have also been receiving antiretroviral treatment in greater numbers to prevent transmission to their babies. Specifically, 45 percent of HIV-positive pregnant women received antiretroviral treatment in 2008, an increase of 10 percent from 2007.

Since the majority of pregnant women requiring antiretroviral therapy are from sub-Saharan Africa and South-East Asia, concentrating prevention efforts in these parts of the world can significantly impact global rates of mother-to-child HIV transmission.

Although nations have made long strides in their efforts to increase HIV prevention efforts, the report shows much remains to be done.

“Prevention services fail to reach many in need,” said Dr. Chan. “Governments and international partners must accelerate their efforts to achieve universal access to treatment.”

For more information, please see the joint press release from WHO, UNAIDS and UNICEF, and the original report, Towards Universal Access: Scaling Up Priority HIV/AIDS Interventions in the Health Sector, Progress Report 2009 (pdf).