The UNAIDS Global AIDS Update 2023 report, released last Thursday, shows that despite the absence of an HIV/AIDS vaccine, the world is on the right path to eradicate HIV/AIDS as a public health threat by 2030.

Data shows that 29,8 million of the 39 million people living with HIV globally are currently receiving life-saving treatment. But despite the progress made over the last decades, there are areas of concern which urgently need to be addressed.

A lack of funding, millions of people not on treatment, poor treatment coverage for children, and a lack of protection for adolescent girls, young women and key populations have been cited as some of the stumbling blocks.

Some positive outcomes detailed in the report is the 69% reduction in AIDS related deaths since the peak in 2004, and achievement of the 95-95-95 targets by several  African countries. 

Botswana, Eswatini, Rwanda, Tanzania and Zimbabwehave already achieved the 95-95-95 targets, while at least 16 other countries are also close to doing so.

South Africa still lagging behind

The UNAIDS 95-95-95 targets refers to 95% of people living with HIV to know their HIV status, 95% of people with diagnosed HIV infection to receive sustained antiretroviral therapy, and 95% of all people receiving antiretroviral therapy to have viral suppression therapy by 2025. 

In South Africa, more than 7.5 million people live with the virus, but only 94-77-92 of the 95-95-95 targets have been achieved so far.

The report reveals that almost three-quarters (71%) of people living with HIV worldwide in 2022 (76% of women and 67% of men) had suppressed viral loads, which enables people living with HIV to live long, healthy lives and to have zero risk of transmitting HIV sexually.

The impact of strong political will

The biggest breakthroughs are occurring in countries that have forged and maintained strong political commitment to put people first and invest sufficiently in proven strategies to fight the spread of HIV/AIDS.

Winnie Byanyima, Executive Director of UNAIDS says that great HIV/AIDS responses are strengthened when they enable communities, societies and civil societies to play their roles.

“We see that in countries like South Africa and Thailand. The data in this report shows that the path that ends AIDS is not a mystery but it is a choice, it is a political and a financial choice. The report shows that HIV responses can succeed when they are anchored in strong political leadership,” explains Byanyima.

She says that the main message of the report is 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, an opportunity that is dependent on action. 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,” she says.

Byanyima says that the path to end AIDS is the same path that will also help societies to be prepared for future pandemics and that will also help countries to achieve the Sustainable Development Goals.

Jerome Salomon, Assistant Director-General at the World Health Organization (WHO), says the report highlights that the next seven years are critical, even though there is no vaccine and there is no cure, the tools exist for the globe to end AIDS as a public health threat.

“The task is challenging but it is achievable, as the report sets out, success depends on a strong political leadership and a fully funded response to HIV in the context of building sustainable health systems with communities at the centre,” says Salomon.

Stumbling blocks

Adolescent girls and young women still have to contend with extraordinarily high risk of HIV infection in many parts of sub-Saharan Africa, as do people from key populations everywhere.

Byanyima says that it should be our collective shame that in 2022 AIDS claimed a life every minute, as it is still a killer and sometimes the number one killer in some countries such as Mozambique.

According to the South African National AIDS Council (SANAC), in South Africa, there is a gap of about two million South Africans who are living who are HIV positive but have not yet started on treatment.

“Every week 4000 adolescent girls and young women acquire HIV. In 2022 in sub-Saharan Africa, women and girls of all ages accounted for 63% of all new HIV infections. Only about 42% of districts with very high HIV incidence in sub-Saharan Africa are currently covered with dedicated prevention programmes for adolescent girls and young women,” reads the report.

It also states that closing these gaps and making it easier for sexually active girls and women to access female-friendly biomedical prevention tools, such as oral PrEP and the dapivirine vaginal ring, would greatly reduce their risks of acquiring HIV.

Children are still missing out on HIV treatment

The other remaining challenge to ending AIDS as a public health threat is that treatment  coverage for children who are HIV positive still lags behind. Approximately 660 000 children living with HIV, (43% 1.5 million children) were not receiving treatment in 2022.

HIV claimed the lives of approximately 84 000 children in 2022.

Byanyima says that it is also concerning that funding for HIV prevention internationally and domestically declined last year.-Health-e News.