Fight against AIDS: Need of Renewed Political Commitment, Finance and Engagement

The member nations of the United Nations adopted the Sustainable Development Goals (SDG) in 2015, set an audacious goal of ending the AIDS epidemic, along with Tuberculosis and Malaria, by the year 2030. In the fight against HIV-AIDS the key indicator selected to track progress in achieving the target for HIV-AIDS is “the number of new HIV infections per 1,000 uninfected population, by age, sex and key populations.

The phrase “key populations” mentioned in this context refers to men who have sex with men, people who use injected drugs, prison population and other closed settings like sex workers, and their clients, and transgender population.

UNAIDS, the lead UN agency coordinating the battle against HIV, set up an ambitious “90-90-90” target stated that is to be achieved by 2020, 90% of people infected with HIV will know their HIV status, 90% of all people diagnosed with HIV will receive sustained antiretroviral therapy and 90% of all people on such therapy will have achieved viral suppression.

The world so far has managed to achieve a reduction in new HIV infections by around 37% between 2000 and 2018. HIV-related deaths fell by 45%, with 13.6 million lives saved due to Antiretroviral Therapy (ART). Generic drugs for AIDS made cheaply by Indian generic drug manufacturers along with massive public and private financing have played a critical role in this battle. Compared to before around 24 million people infected with HIV are receiving ART, as compared to only 7 million nine years ago.

While some success has been achieved in the global battle against AIDS, recently there has been a slowdown in progress which has resulted in previous achievable targets becoming seems to place the targets out of reach.

At the end of 2018, only 19 countries are on track to reach the 2030 target. While improvements have been noted in eastern and southern Africa, central Asia and eastern European nations have had a setback, with more than 95% of the new infections in those regions occurring among the ‘key populations’.

The slowdown in progress is because of factors like -complacency as a result of rapid success achieved earlier this led to a complacent assumption that victory is imminent, an expanded health agenda included in the SDGs stretching the resources of national health systems, other more important diseases gaining priority, improved survival rates leading to perception that the disease is not all that fatal. 

To achieve the goals related to AIDS outlined in SDG, there has to be a fresh surge of high-level political commitment, financial support, health system thrust, public education, civil society engagement and advocacy by affected groups as all of these were part of the recipe because of which rapid progress in the early part of this century was made.