As the 23rd conference of the International AIDS Society (IAS) opened on Monday July 6, in virtual format due to COVID-19, UNAIDS published its annual report, in which it notes the failure to achieve the global targets set for 2020. The risk of going back ten years is envisaged if the coronavirus pandemic interrupts the fight against HIV.
The new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) highlights the disparity in progress from one region or country to another, a consequence of the uneven roll-out of access to antiretroviral therapy. Entitled "Act Now" the document stresses the urgency of redoubling efforts and acting without delay to treat the millions of people left behind. It notes that since 2015, an additional 3.5 million HIV infections and 820,000 AIDS-related deaths are attributable to unmet targets.
"Effective action must be taken every day of the coming decade to put the world back on track for the 2030 goals and end the AIDS epidemic." Winnie Byanyima, UNAIDS Executive Director
World situation New HIV infections have soared by 72% since 2010 in Eastern Europe and Central Asia. They have also jumped by 22% in the Middle East and North Africa, and by 21% in Latin America. Some 62% of new HIV infections concern key populations and their sexual partners, such as gays and other men who have sex with men, sex workers, drug users and the incarcerated population, even though they represent a very small proportion of the overall population.
Recorded advances
Fourteen countries have achieved the 90-90-90 triple objective for HIV treatment, including seven in Africa (Botswana, Eswatini, Namibia, Rwanda, Uganda, Zambia and Zimbabwe). Three countries are close to the target: Kenya, Malawi and Tanzania. This means that 90% of people living with HIV know their serostatus; 90% of people who know they are HIV-positive are on antiretroviral treatment; and 90% of people on antiretroviral treatment have an undetectable viral load. Particular progress has been made in Eastern and Southern Africa, where new HIV infections have fallen by 38% since 2010. The roll-out of antiretroviral therapy has saved millions of lives, particularly those of women, and prevented millions of new infections.
Obstacles
The world is lagging far behind in preventing new HIV infections. Nearly 1.7 million people have contracted the virus, more than triple the global target. Stigma, discrimination, other social inequalities and exclusion are all strategic obstacles. Marginalized populations who fear judgment, violence or arrest find it difficult to access sexual and reproductive health services, particularly in relation to contraception and prevention. Of the 38 million people living with HIV, 12.6 million did not have access to life-saving treatment. When services are accessible, the rate of transmission drops dramatically. Effective coverage has reduced inequality and the incidence of new HIV infections in Eswatini, Lesotho and South Africa.
"We cannot dip into the funding of one disease to treat another. HIV and COVID-19 must be comprehensively funded to avoid massive loss of life." Winnie Byanyima, UNAIDS Executive Director
HIV & COVID-19
To combat the combined epidemics of HIV and COVID-19, UNAIDS and its partners are leading a global campaign for a universal vaccine against the coronavirus. It is also urging countries to increase their investments to combat these two diseases. Investments to fight HIV fell by 7% between 2017 and 2019. Currently, 30% of the $26.2 billion needed to respond effectively to HIV by 2020 is missing.