This landscape report is part of an ongoing UNITAID initiative to describe and monitor the landscape for human immunodeficiency virus (HIV) commodities. It provides a broad overview of key HIV prevention tools, describing the market dynamics around prevention technologies and the primary factors that affect commodity access in HIV-endemic countries. Specifically, the report describes and analyses the market and technology landscapes for (i) male circumcision devices, (ii) barrier methods, (iii) microbicides, (iv) methods based on antiretroviral (ARV) drugs and (v) commodities needed in harm reduction programmes for people who inject drugs. The report also explores market-based interventions that could alleviate current market shortcomings in order to improve access, focusing on key emerging products and rapidly evolving product areas. The report focuses exclusively on commodities for HIV prevention and not on the behavioural and structural issues that must also be considered when developing comprehensive approaches to HIV prevention. Information in this report was collected through a variety of methods, including desk research, literature reviews and expert interviews. The material presented in this report is current as of July 2014.
Public health problem
The HIV epidemic remains one of the world’s most serious health challenges. Substantial progress has been achieved in preventing new HIV infections—which declined globally by 38% between 2001 and 2013 and by more than 75% in 10 countries. However, 2.1 million people were newly infected with HIV in 2013, underscoring the continued importance of HIV prevention. Acquired immunodeficiency syndrome (AIDS) is still the sixth leading cause of death globally and the number one cause of death in Eastern and Southern Africa. New HIV infections are on the rise in certain regions, including Eastern Europe, Central Asia, the Middle East and North Africa.
Unless the number of new infections falls sharply, long-term costs associated with the provision of lifelong antiretroviral therapy (ART) in low- and middle-income countries (LMICs) could soon become prohibitive, potentially threatening advances achieved to date by the global AIDS response.