Translating Opportunity to Reality: How We Can End AIDS by 2030

This year’s World AIDS Day marked the 5 year countdown for meeting the SDG target of Ending AIDS as a public health threat by 2030. We stand at a crossroads now where there is a realistic possibility of actually achieving this target. However, this is only possible if all global partners unite to address human rights barriers and make newly available, game-changing technologies available to all who need them.

A Decade of Progress in the HIV response

Over the last decade incredible progress has been made in the global HIV response. The amount of people living with HIV who are accessing antiretroviral therapy (ART) has continued to grow reaching 30.7 million at the end of last year, a significant increase from the 7.7 million people living with HIV who were accessing ART in 2010. The number of people acquiring HIV has also reduced by 60% since its peak in 1995 and AIDS-related deaths have decreased by 51% since 2010.

These results have been achieved through effective partnerships between community-led organisations, governments and institutions such as the Global Fund to Fight AIDS, TB and Malaria, UNAIDS, Unitaid and Robert Carr Network Fund. Community-led initiatives are at the heart of the HIV response as they hold the expertise for how to effectively plan and deliver services to address stigma and discrimination and provide relevant treatment, prevention and adherence support. These critical efforts have helped to facilitate the effective and widespread delivery of ART and HIV prevention services from the Global Fund. Last year, in countries where the Global Fund invests, 25 million people were accessing ART and 17.9 million people were reached with prevention services.

Game-changing Innovations in Treatment and Prevention

Long-acting medicines have proved highly effective in treating and preventing HIV. As they are administered by injections every 6 months rather than a daily pill regimen, they could help overcome many of the barriers in accessibility and adherence that have challenged HIV services for years. Unfortunately, the price for lenacapavir (one of these new medicines), as a form of PrEP, hasn’t made it a viable alternative yet. However, the global health agency Unitaid is now supporting a group of pharmaceutical companies, the majority of which are based in lower-middle-income countries, to produce more affordable, generic versions of the medicine.

The Path Forward: Global Action to End AIDS

Key challenges remain in us reaching the SDG goal from high prices for these new treatment and preventative tools, to criminalisation and under-funding – particularly of the community response.  There were still 1.3 million new people acquiring HIV last year and 630,000 AIDS-related deaths. This is entirely unacceptable in a world where we have the tools we need and when we know the approaches that work. What do we need to do?

• Make long-acting treatment and prevention options available to all people in low-and-middle-income countries. We need to put pressure on pharmaceutical companies to make sure all low-and-middle income countries can access the affordable versions of the HIV medicine.
• Ensure the meaningful engagement of communities within the HIV response and ensure that community-led organisations are fully-funded. An effective HIV response must be led by the communities most affected but this leadership is not possible without more direct funding.  This is particularly urgent for LGBTI+ groups who are being criminalised in some countries.
• Secure increased, sustainable funding from governments and other philanthropic donors for efficient and impactful multilateral organisations that underpin the HIV response.  This includes the Global Fund, UNAIDS, Unitaid and the Robert Carr Fund, which are crucial for supporting global HIV prevention and treatment efforts, building health systems and saving millions of lives.
• Challenge punitive and criminalising laws affecting marginalised communities. A strong, equitable HIV response can serve as a key tool in combating global human rights regressions.

By taking these steps to end AIDS globally, we will also be able to strengthen global health systems, boost pandemic preparedness, and champion human rights. This is a defining moment for global partnerships, we have the opportunity to achieve one of the greatest public health victories of our time. We must not let this critical win slip from our grasp.

Authors: STOPAIDS and the Global Network of People Living with HIV (GNP+)