How Many People Have Died of HIV?

Expanded access to antiretroviral therapy has profoundly lowered the rate of HIV-related deaths, both in the U.S. and globally. Some of the greatest reversal have been seen in sub-Saharan Africa, the region of which accounts for 75 percent of all HIV infections.

According to the World Health Organization (WHO), this downward trend points us in the right direction toward reaching the goals of placing the majority of the world's HIV population on treatment by 2030.

According to the WHO, 39 million people have died of HIV since the beginning of the epidemic out of the 76.3 million who have been infected (roughly 52 percent). Moreover, of the 36.9 million people living with HIV today, just over 940,000 died in 2017, a drop of 40 percent from 2013.

All told, AIDS-related deaths have been reduced by more than 51 percent since the peak in 2004.

With regards to per-country estimates, here is how AIDS-related mortality was distributed among the top 35 affected countries:

1. Nigeria: 160,000
2. South Africa: 110,000
3. India: 62,000
4. Mozambique: 62,000
5. Indonesia: 38,000
6. Kenya: 36,000
7. Tanzania: 33,000
8. Zimbabwe: 30,000
9. Cameroon: 29,000
10. Uganda: 25,000
11. Cote d'Ivoire: 25,000
12. Malawi: 24,000
13. Zambia: 21,000
14. Ethiopia: 20,000
15. Democratic Republic of Congo: 19,000
16. Thailand: 16,000
17. Ghana: 14,000
18. Brazil: 14,000
19. South Sudan: 13,000
20. Angola: 11,000
21. Lesotho: 9,900
22. Ukraine: 8,500
23. Vietnam: 8,000
24. Burma: 7,800
25. Central African Republic: 7,300
26. Malaysia: 7,000
27. Mali: 7,000
28. United States: 6,700
29. Guinea: 5,800
30. Pakistan: 5,500
31. Togo: 5,100
32. Haiti: 4,600
33. Namibia: 4,600
34. Mexico: 4,200
35. Iran: 4,000

The reduction in HIV deaths is closely aligned with regional reductions in new infection rates. The decreases are greatest in the regions most affected by HIV, East Africa and Southern Africa, where new infections have been on the decline since 2010.

The same has not been in seen in 50 other countries where the new infection rate continues to climb. This includes is Eastern Europe, Central Asia, and Russia where the new HIV infection rate has doubled. Similarly, in the Middle East and North Africa, the new infection rate has increased by 25 percent over the past 20 years.

According to the WHO, 20.9 million people living with HIV are today treatment globally, up from 17 million in 2015. Newly expanded guidelines now recommend treatment all people living with HIV at the time of diagnosis, irrespective of age, immune status, income, or region. That's more than 22 million more than had been previously targeted for treatment.

While challenges remain to ending the epidemic, the WHO and United Nation Programme on HIV/AIDS (UNAIDS) have decided the fast-track those goals with their ambitious 90-90-90 strategy which aim to achieve the following goals by 2030:

• Diagnosing 90 percent of people living with HIV worldwide
• Placing 90 percent of the diagnosed population on antiretroviral therapy
• Achieving an undetectable viral load in 90 percent of people on therapy

However, challenges remain as infection rates continue to soar in Russia and Central Asia, due mainly to injecting drug use. Even in countries like South Africa, which has seen a reversal in HIV-related deaths, new infection rates were seen to have increased from 370,000 to 470,000 in the country's latest surveillance report.

While that's down from 1995 when it was the leading cause of death, the country's ongoing failure to reduce the new infection rates suggest that little will change in the next decade.

To that end, the U.S. has the unfortunate distinction of having the highest HIV incidence and prevalence of all developed, industrialized nations.