The world has a plan and the tools needed to end AIDS as a public health threat by 2030. But achieving this is not a foregone conclusion.
In the more than three decades since HIV/AIDS was first discovered, the disease has taken the lives of 35 million people around the world. In 2016 alone, AIDS killed 1 million people, 730,000 of whom were living in sub-Saharan Africa. These deaths have an impact on the countries and communities hardest hit, including the over 16 million children around the world who have become orphans because of AIDS. Life-saving antiretroviral treatment is available, though millions of people still do not have access.
People often become infected with HIV during their most productive years (15-49 years old) making the disease – if untreated – a threat to development progress in the poorest and hardest hit countries. Within countries, HIV is increasingly concentrated among vulnerable populations, including men who have sex with men, female sex workers, injection drug users and adolescent girls – and in many countries, political dynamics and legislation have made it increasingly difficult to reach them.
Young women aged 15 – 24 are also at particularly high risk of infection. An average of 986 young women were infected with HIV every day last year, the majority of which live in sub-Saharan Africa. AIDS remains the leading cause of death for women aged 15–44 globally, and young women are twice as likely to be infected as young men.
Worryingly, funding available for the global fight against AIDS has started to flat line. For the first time in five years, funding disbursed by donor governments for HIV fell for the second year in a row. This happened at a time when there is still over a $7 billion gap in funding to reach the UNAIDS estimated $26.2 billion needed annually by 2020 to end AIDS as a global public health threat by 2030.
In 2016, world leaders pledged to end the AIDS epidemic by 2030, but more and better funding is needed to deliver on this commitment.
Thanks to investments and innovation over the last 15 years, we have made remarkable progress against AIDS and we know what works to accelerate efforts in the decade to come. Today, 20.9 million people are on lifesaving AIDS treatment, up from just 685,000 in 2000. Since 2000, new HIV infections have fallen by more than one third, with infections among children dropping by 65%, and AIDS-related deaths have decreased by nearly half since their peak.
As we continue to improve access to treatment, we must also deploy existing and new tools more effectively to improve prevention. For example, we know that treatment is an effective form of prevention; if a person living with AIDS takes their treatment regularly they can reduce the likelihood of passing HIV on to others by up to 96%. And voluntary medical male circumcision, another powerful tool, was shown to reduce the likelihood of HIV infection in men by up to 60%.
We also know that funding for HIV works. Investments in the fight against AIDS – channelled through governments and programs such as The Global Fund and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) – have helped save millions of lives and started to bend the curve of the pandemic. Global Fund grants currently support more than half the world’s people on treatment – 11 million people – and since its inception, the Global Fund has provided 579 million HIV counselling and testing sessions. And PEPFAR is providing treatment support for 11.5 million people, including 1.1 million children – a 97% increase since 2014. In 2016, PEPFAR reached more than 74.3 million people with HIV testing and counselling and 1 million adolescent girls and young women with comprehensive HIV prevention interventions through the DREAMS Partnership.
The world must build on this progress and accelerate the response in the next four years – particularly among women and girls, and the world’s most marginalised and difficult-to-reach populations. We have the tools to finish the job of virtual elimination of mother-to-child transmission, to dramatically scale up treatment, and to deploy smarter preventions strategies. To be effective, these goals cannot be achieved in isolation from one another, or be the sole responsibility of a small number of donor countries. Only when donors, African governments, international organisations and the private sector work together will the path towards the end of AIDS become a reality.
ONE’s Policy Position
ONE is calling for strong funding and smart investments to accelerate the fight against HIV over the next four years. In particular:
- Increase ambition and diversify sources of external funding, including through strong donor support for PEPFAR and the Global Fund
- Increase the share of domestic financing for HIV
- Keep health systems at the center of the HIV response