South Africa scaled up its provision of state-sponsored antiretroviral therapy by 75% in the last two years, ensuring that 1.7-million people had access to the life-saving treatment, according to a new report released on Tuesday ahead of World Aids Day by the Joint United Nations Programme on HIV/Aids (UNAids).
The report found that South Africa had taken the lead by increasing its domestic public investment in combating HIV/Aids to US$1.9-billion in 2011 - a five-fold increase since 2006, and the highest investment by any low- or middle-income country.
"Exceptional leadership is coming from the world's fastest-growing emerging economies: Brazil, Russia, India, China and South Africa (BRICS)," the report states.
"Together, they contribute to more than half of all domestic spending on Aids in low- and middle-income countries. Their momentum is unparalleled, having increased domestic public spending by more than 122% between 2006 and 2011."
Cut in new infections, Aids-related deaths
In South Africa's case, the increases in investment and treatment had contributed to a dramatic 41% cut in the country's rate of new HIV infections since 2001, with new HIV infections in falling by more than 50 000 in the last two years.
They had also slashed the number of Aids-related deaths - showing that antiretroviral therapy has emerged as a powerful force for saving lives - with South Africa seeing 100 000 fewer Aids-related deaths in 2011 than in 2005.
The area where the country had made perhaps the most progress, according to UNAids, was in reducing new HIV infections in children, with the number of children newly infected with HIV falling by at least 40% between 2009 and 2011.
Successes across sub-Saharan Africa
According to the report, these improvements in HIV prevention and treatment were echoed across sub-Saharan Africa, the part of the world most affected by HIV.
Since 2001, rates of new HIV infections have been cut by 73% in Malawi, 71% in Botswana, 68% in Namibia, 58% in Zambia, 50% in Zimbabwe and 41% in Swaziland.
At the same time, sub-Saharan Africa has reduced its Aids-related deaths by one-third in the last six years and increased the number of people on antiretroviral treatment by 59% in the last two years alone.
Impressive gains were also made in cutting deaths from tuberculosis (TB) in people living with HIV, the report found, with TB-related Aids deaths in sub-Saharan Africa falling by 28% in the last two years.
"This accomplishment is due to record numbers of people with HIV/TB coinfection accessing antiretroviral treatment - a 45% increase between 2009 and 2011. India, Kenya, South Africa, Zambia and Zimbabwe accounted for two-thirds of all new people with HIV/TB co-infection being treated."
Pace of progress 'quickening'
According to UNAids, the latest data, from countries in sub-Saharan Africa and around the world, "tell a story of clear success", with record numbers of lives being saved in the past six years, and more than half-a-million fewer people dying from Aids-related illnesses in 2011 than six years earlier.
"The national declines in HIV incidence in populations shows that sustained investments and increased political leadership for the Aids response are paying dividends. In particular, countries with a concurrent scale-up of HIV prevention and treatment programmes are seeing a drop in new HIV infections to record lows."
UNAids executive director Michel Sidibé said the pace of progress was quickening. "What used to take a decade is now being achieved in 24 months. We are scaling up faster and smarter than ever before. It is the proof that, with political will and follow-through, we can reach our shared goals by 2015."
Global Aids targets for 2015
A thousand days remain for the world to achieve its 2015 global Aids targets of reducing sexual transmission of HIV and new HIV infections among people who inject drugs by 50%, eliminating new HIV infections among children, providing antiretroviral treatment to 15-million people, and reducing TB-related Aids deaths by 50%.
These targets form part of the UN Millennium Development Goals agreed upon by all UN member countries in 2000. To enable the targets to be reached, countries committed to investing up to $24-billion annually on combating HIV/Aids by 2015.
The UNAids report shows that countries are increasing their Aids response investments despite a difficult economic climate, with the global gap in resources needed annually by 2015 now at 30% - $16.8-billion was available in 2011.
"In 2011, for the first time ever, domestic investments from low- and middle-income countries surpassed global giving for HIV," the report states.
"However, international assistance, which has been stable in the past few years, remains a critical lifeline for many countries. In 26 of 33 countries in sub-Saharan Africa, donor support accounts for more than half of HIV investments."
At the same time, UNAids said, countries had to take steps to reduce their dependency on international assistance for HIV treatment programmes.
The United States accounts for 48% of all international assistance for HIV and, together with the Global Fund for Aids, Tuberculosis and Malaria, provides the lion's share of investments in HIV treatment.