It’s still “possible” to eliminate AIDS as a public health threat by 2030, but a growing funding gap is slowing the acceleration of progress, the United Nations said on Thursday.
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The roadmap presented in the new UNAIDS report “shows that success is possible in this decade,” says the organization’s executive director, Winnie Byanyima.
According to UNAIDS, ending AIDS is primarily a political and financial decision. UNAIDS is leading global action to end the AIDS epidemic as a public health threat by 2030 as part of the 2015 Sustainable Development Goals.
The organization calls for addressing inequalities, helping communities and civil society organizations to respond, and ensuring adequate and sustainable funding.
Ms Byanyima notes that progress has been greatest in the countries and regions that have invested the most financially, citing eastern and southern Africa, where new infections have fallen by 57% since 2010.
Botswana, Eswatini, Rwanda, Tanzania and Zimbabwe have already achieved the so-called “95-95-95” targets: 95% of people living with HIV know their HIV status, 95% of these people are on life-saving antiretroviral treatment and 95% of people treated are virus-suppressed (and therefore no longer transmit the virus).
Sixteen other countries, including eight in sub-Saharan Africa – the region home to 65% of HIV-positive people – are on track to meet this goal. Thailand, Kuwait, Saudi Arabia and Denmark are also on this list.
Another death every minute
The number of people taking antiretroviral treatment worldwide has increased from 7.7 million in 2010 to 29.8 million in 2022, while new infections have fallen by 59% since their peak in 1995.
Additionally, in 2022, 82% of pregnant and breastfeeding women living with HIV worldwide had access to antiretroviral treatment, compared to 46% in 2010. These efforts have resulted in a 58% drop in new childhood infections between 2010 and 2022 lowest level since the 1980s.
“The end of AIDS is an opportunity for today’s leaders to leave a legacy of extraordinary power,” notes Ms. Byanyima in the roadmap.
“Future generations will remember them as those who implemented the policies, programs and investments that helped stop the world’s deadliest pandemic.”
In 2022, one person would still die from AIDS every minute, and around 9.2 million people are still not receiving treatment, including 660,000 HIV-positive children.
Several obstacles slow down the acceleration of progress.
funding dropped
In 2022 and 2023, five (Antigua and Barbuda, Cook Islands, Barbados, St Kitts and Nevis, and Singapore) decriminalized same-sex sexual relations.
However, according to UNAIDS, much of the world still has laws criminalizing the most vulnerable populations or their behavior.
The vast majority of countries (145) criminalize the use or possession of small amounts of drugs, 67 countries criminalize consensual same-sex sexual activity and 20 countries criminalize transgender people.
In addition, 143 countries criminalize or prosecute HIV exposure, concealment, or transmission of the virus.
When “leaders ignore, isolate and criminalize people who are living with HIV or who are at risk of infection, progress on AIDS control is hampered and more people are contracting the virus,” stresses UNAIDS.
Another formidable challenge is funding the global response. After a significant increase in the early 2010s, it fell again last year to the same level as in 2013.
In 2022, a total of US$20.8 billion was available for HIV programs in low- and middle-income countries, down 2.6% from 2021 and significantly less than the US$29.3 billion budgeted by 2025 be deemed necessary.