A new report released by United Nations Secretary-General Ban Ki-moon warns that the AIDS epidemic could be prolonged indefinitely if urgent action is not implemented within the next five years.
On the Fast-Track to end the AIDS epidemic reveals that the extraordinary acceleration of progress made over the past 15 years could be lost and urges all partners to concentrate their efforts to increase and front-load investments to ensure that the global AIDS epidemic is ended as a public health threat by 2030.
“The AIDS response has delivered more than results. It has delivered the aspiration and the practical foundation to end the epidemic by 2030,” said Mr. Ban in the report. “But if we accept the status quo unchanged, the epidemic will rebound in several low- and middle-income countries. Our tremendous investment, and the world’s most inspiring movement for the right to health, will have been in vain.”
According to a press release issued by the Joint UN Programme on HIV/AIDS (UNAIDS), the review of progress looks at the gains made, particularly since the 2011 Political Declaration on HIV and AIDS, which accelerated action by uniting the world around a set of ambitious targets for 2015.
“The progress made has been inspiring,” said Mr. Ban. “Reaching 15 million people with antiretroviral therapy nine months before the December 2015 deadline is a major global victory.”
The report outlines that the rapid treatment scale-up has been a major contributing factor to the 42 per cent decline in AIDS-related deaths since the peak in 2004 and notes that this has caused life expectancy in the countries most affected by HIV to rise sharply in recent years.
It also underlines the critical role civil society has played in securing many of the gains made and the leadership provided by people living with HIV. Community efforts have been key to removing many of the obstacles faced in scaling up the AIDS response, including reaching people at risk of HIV infection with HIV services, helping people to adhere to treatment and reinforcing other essential health services.
In the report, however, the UN chief also calls the shortfalls in the implementation of the 2011 Political Declaration on HIV and AIDS distressing, revealing that even as new HIV prevention tools and approaches have emerged, HIV prevention programmes have weakened in recent years owing to inadequate leadership, weak accountability and declining funding. He notes that new HIV infections declined by just 8 per cent between 2010 and 2014.
The report draws attention to regions where new HIV infections are continuing to rise, such as in eastern Europe and central Asia – where new HIV infections rose by 30 per cent between 2000 and 2014, mostly among people who inject drugs – and in the Middle East and North Africa as well as in the Asia–Pacific region.
The report also emphasizes the necessity of repealing punitive laws and repressive policies that criminalize same-sex sexual relations, people who use drugs and sex workers, since they impede access to services.
“We must reinforce rights-based approaches, including those that foster gender equality and empower women,” said Mr. Ban. “Access to services must be ensured for the people most affected, marginalized and discriminated against including people living with HIV, young women and their sexual partners in sub-Saharan Africa, children and adolescents everywhere, and gay men and other men who have sex with men, sex workers and their clients, people who inject drugs, transgender people, people in prison, people with disabilities, migrants and refugees.”
The report gives strong emphasis to the links between the response to HIV and the success of the Sustainable Development Goals (SDGs).
Finally, it urges countries to embrace the UNAIDS Fast-Track approach to ending the AIDS epidemic, which will require reaching an ambitious set of goals by 2020, including reducing the numbers of people newly infected with HIV and people dying from AIDS-related causes to fewer than 500 000 per annum and eliminating HIV-related discrimination.
Targets to reach these goals include reaching the 90–90–90 treatment target for 2020, which calls for 90 per cent of people living with HIV to know their status, 90 per cent of people who know their HIV-positive status to access treatment, and 90 per cent of people on treatment to have suppressed viral loads.