The AIDS pandemic seemed unstoppable two decades ago, with over 2.5 million acquiring HIV and two million lives lost a year. Today, 29.8 million of the 39 million people living with HIV globally receive life-saving treatment according to a recent report by Joint United Nations Programme on HIV/AIDS (UNAIDS), entitled The Path That Ends AIDS.
“The path to ending AIDS is clear. We have a solution if we follow the leadership of countries that have forged a strong political commitment to put people first and invest in evidence-based HIV prevention and treatment programmes,” read the report.
Since the peak in 2004, the number of AIDS-related deaths has reduced by 69 per cent.
Botswana, Eswatini, Rwanda, Tanzania and Zimbabwe have already achieved the 95–95–95 targets.
This means 95 per cent of the people who are living with HIV know their HIV status, 95 per cent of the people who are living with HIV are on treatment, and 95 per cent of people who are on treatment are virally suppressed.
At least 16 other countries are also close to doing so.
Viral suppression is a primary marker of HIV treatment success. Treatment reduces the amount of HIV in the body (viral load) to a very low level, which keeps the immune system working and prevents illness.
“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders,” said Executive Director of UNAIDS Winnie Byanyima.
“Future generations could remember them as those who stopped the world’s deadliest pandemic. They could save millions of lives and protect the health of everyone. They could show what leadership can do.”
The report highlighted that new HIV infections have declined over the years.
In 2022, an estimated 1.3 million people became newly infected with HIV, 38 per cent less than in 2010. Regions that recorded the biggest decline in this period are Eastern and Southern Africa (57 per cent reduction) and Western and Central Africa (49 per cent reduction).
Despite the drop in new HIV infections, Eastern and Southern Africa recorded the most cases in 2022, with 500,000 infections. Asia and the Pacific came in second (300,000), followed by Western and Central Africa (160,000), and eastern Europe and Central Asia (160,000).
Globally, almost three-quarters of people living with HIV in 2022 had suppressed viral loads, enabling them to live long, healthy lives without the risk of transmitting HIV.
Despite the progress, particularly in the absence of a vaccine, over nine million missed out on treatment globally in 2022.
Meanwhile, 2.1 million were getting treatment but were not virally suppressed.
Among the 1.5 million children living with HIV, about 660,000 were not receiving treatment in 2022. The number of AID-related deaths among children had dropped by two-thirds since 2010.
However, the HIV pandemic still claimed the lives of approximately 84,000 children in 2022.
Treatment progress is especially slow in Eastern Europe, Central Asia, the Middle East, and North Africa. Only about half of the over two million people living with HIV received antiretroviral therapy in 2022.
The report also highlights the widening funding gap for the global HIV response.
In 2022, a total of USD20.8 billion was available for HIV programmes in low- and middle-income countries, which was 2.6 per cent less than in 2021 and well short of the USD29.3 billion needed by 2025. HIV funding has fallen back to the same level as in 2013.
UNAIDS analysis shows that regions with increased HIV prevention funding record declining HIV incidence. Regions with the biggest funding gaps – Eastern Europe, Central Asia, the Middle East, and North Africa – are making the least progress.
Conversely, progress against AIDS has been strongest in regions with sufficient investment in their HIV responses, notably in Eastern and Southern Africa.
The report highlights that HIV responses succeed when they are anchored in strong political leadership, have adequate resources, follow the evidence, use inclusive and rights-based approaches, and pursue equity.
Countries putting people first in their policies and programmes are already leading the world to ending AIDS by 2030.
“We are hopeful, but it is not the relaxed optimism that might come if all was heading as it should be. It is, instead, a hope rooted in seeing the opportunity for success. This opportunity is dependent on action,” said Byanyima.
“The facts and figures shared in this report do not show that, as a world we are already on the path, they show that we can be. The way is clear.” – Aqilah Rahman