New report on HIV worldwide

The enormous achievements in the response to HIV is one of the best examples of multilateralism in action.

A new report from António Guterres, the United Nations Secretary-General, Galvanising global ambition to end the AIDS epidemic after a decade of progress, has been presented to United Nations Member States.

The Member States, in New York, for the 73rd session of the United Nations General Assembly, which runs from 18 September 2018-17 September 2019, review progress and share their own progress and challenges.

The Secretary-General’s report shows that results once derided as impossible in low-income settings have now been achieved, following a decade of progress in the response to HIV.

Between 2008 and 2017, there was a 43 per cent reduction in AIDS-related deaths, a 45 per cent reduction in new HIV infections among children and a 19 per cent reduction in new HIV infections among adults globally.

The number of people living with HIV on treatment increased, by 5.5 times, reaching 21.7 million of the 36.9 million people living with HIV in 2017.

And the ongoing decline in the number of children acquiring HIV is a major public health triumph.

Globally, 1.6 million new child infections were averted between 2008 and 2017 – an achievement that stems from a steep increase in the percentage of pregnant women living with HIV who receive antiretroviral medicines to prevent mother-to-child transmission of HIV or as lifelong therapy, from 25 per cent in 2008 to 80 per cent in 2017.

Among the countries with high HIV prevalence, Eswatini, Malawi, Namibia and Zimbabwe have achieved major reductions in mother-to-child transmission. Such progress shows the potential to bring about the end of paediatric AIDS in the near future.

But high rates of HIV infection continue among adolescent girls and young women across sub-Saharan Africa, many of whom become mothers.

Adolescent girls and young women – aged 15–24 years – accounted for one in four HIV infections in the region in 2017, despite making up just 10 per cent of the population.

AIDS-related illnesses were a leading cause of death among women and girls of reproductive age –  15–49 years.

One in five pregnant women living with HIV is not diagnosed or does not access treatment, and retention on HIV treatment for pregnant and breastfeeding women is too low, with 20 per cent of women in sub-Saharan Africa who began treatment dropping out of care before delivering their babies.

In addition, a substantial number of women acquire HIV while pregnant or breastfeeding and are not diagnosed in time to prevent vertical transmission.

But most regions have experienced declines in new HIV infections.

Notable exceptions are eastern Europe and central Asia, where the annual number of new HIV infections has risen by 30 per cent since 2010, with an estimated 960,000 people newly infected over this time, and in the Middle East and North Africa, where deaths from AIDS-related illnesses increased by 11 per cent, an estimated 140,000 people newly infected, over the same period.

Many challenges remain, including the stigma and discrimination faced by people living with HIV and harmful gender norms, and the laws and policies in many countries that prevent people from accessing health and HIV services.

In the report, the United Nations Secretary-General urges Member States to adopt the following recommendations in order to galvanise political will, accelerate action and build the momentum necessary to reach the 2020 targets agreed to by the United Nations General Assembly in the 2016 United Nations Political Declaration on Ending AIDS:

(a) reinvigorate primary HIV prevention;

(b) diversify HIV testing and differentiate the delivery of health care to reach the 90–90–90 targets;

(c) establish enabling legal and policy environments in order to reach marginalized and vulnerable populations;

(d) mobilise additional resources and allocate them where they are most needed;

(e) support communities to enable them to play their critical roles; and

(f) incorporate a comprehensive HIV response into universal health coverage.

‘A world without AIDS was almost unimaginable when the General Assembly held its first special session on the epidemic 18 years ago,’ Guterres said in the report.

‘Since then, the global determination to defeat one of history’s greatest health crises has produced remarkable progress … and … inspired a commitment within the 2030 Agenda for Sustainable Development to end the AIDS epidemic by 2030.’

And María Fernanda Espinosa, President of the United Nations General Assembly, said: “The enormous achievements in the response to HIV in recent decades, under the strong leadership of UNAIDS, is one of the best examples of multilateralism in action.”

“It is most definitely an indication of what we can achieve when we work together around a common cause.”

To read the full report, click here.