31 May 2016: Global coverage of antiretroviral (ARV) therapy reached 46% by the end of 2015, with the number of HIV-positive people taking ARV medicine more than doubling between 2010 and 2015, according to the ‘Global AIDS Update 2016.’ The UN released the report in advance of the UN General Assembly’s (UNGA) High-Level Meeting (HLM) on Ending AIDS, which is expected to agree on a Political Declaration on Ending AIDS.
The UN is urging continued momentum to reach the UNAIDS 90-90-90 treatment by 2020, where 90% of people living with HIV know their status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads. Achieving this target by 2020 will position the world to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals (SDGs), the UN says. SDG 3 (Ensure healthy lives and promote well-being for all at all ages) includes target 3.3, which aims to, by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
Two million people gained access to life-saving drugs in 2015 alone, according to the Joint UN Programme on HIV/AIDS (UNAIDS), which published the report. The UN reports that this increase in treatment has reduced AIDS-related deaths from 1.5 million in 2010 to 1.1 million in 2015.
Eastern and southern Africa recorded the highest increase in coverage of ARV therapy, with treatment coverage increasing from 24% in 2010 to 54% in 2015, for a total of 10.3 million people reached. Botswana, Eritrea, Kenya, Malawi, Mozambique, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia and Zimbabwe increased coverage by over 25% between 2010 and 2015.
New HIV infections among adults have slowed significantly in recent years, the report finds, pointing to a static number of new infections at 1.9 million annually. The report highlights regional disparities in new HIV infections among adults, with the largest reductions in eastern and southern Africa and more gradual declines in western and central Africa and the Asia-Pacific region. In eastern Europe and central Asia, the annual number of new HIV infections increased by 57%. The infection rate is relatively stable in Latin America and the Caribbean, western and central Europe, North America, the Middle East and North Africa. The report recommends addressing such regional disparities to achieve SDG target 3.3.
The report further recommends, inter alia: scaling up HIV prevention efforts; continuing to roll out treatment; ensuring that no one is left behind in the AIDS response; and ensuring that countries have the right services in the right places. The report observes that inequalities combined with obstacles to education, sexual and reproductive health services, poverty, food insecurity and violence, contribute to increased vulnerability for some populations, such as adolescent girls and young women, particularly in sub-Saharan Africa.
In advance of the HLM on Ending AIDS, the UN has underscored the importance of tackling discrimination and stigma in preventing new HIV infections, and UN leaders have called for inclusivity at the meeting, which will convene from 8-10 June 2016, in New York, US. UNAIDS has stressed that the HLM “should be guided by the principles on which the successes of the AIDS response are built – inclusion, participation and dignity. As enshrined in the UN Charter, the doors of the UN should be open to all.” UNAIDS states it is crucial that the voices and perspectives of individuals and organizations, including those living with HIV and most affected by the epidemic, must be heard at the meeting to ensure that no one is left behind.
UN Secretary-General Ban Ki-moon expressed his opposition to the exclusion of lesbian, gay, bisexual and transgender (LGBT) organizations from the HLM. On 31 May, his spokesperson said, “These NGOs are close to communities affected by the epidemic and they must be part of the response,” and the UN should be a “big tent” that allows for freedom of movement and inclusion, including of NGOs, saying such an approach is crucial to achieve the SDGs. World religious leaders have also pointed out that some communities are being left behind in the AIDS response, and delegates at the 69th session of the World Health Assembly (WHA 69) highlighted gender inequality in the HIV response, stressing the need to address gender equality and women’s empowerment as part of efforts to achieve the SDGs, particularly Target 3.3. [UN Press Release, 31 May] [UN Press Release, 30 May] [UNAIDS Press Release, 18 May] [UNAIDS Press Release, 31 May] [UNAIDS Press Release, 1 June] [UNAIDS Press Release, 23 May] [Publication Website] [UN Secretary-General Spokesperson Daily Briefing, 31 May]