amfAR, The Foundation for AIDS Research

UNAIDS Warns 2020 Targets Out of Reach

 Unequal access to treatment, COVID-19 pandemic hindering HIV response


UNAIDS has issued a report showing highly unequal progress in the global fight against AIDS, and warning that service disruptions due to the COVID-19 pandemic could set the response back by at least ten years.

According to the new report, Seizing the Moment, only 14 countries have achieved 2020 targets—missed targets have resulted in 3.5 million more HIV infections and 820,000 more AIDS-related deaths since 2015 than if the global response was on track.

The “90-90-90” targets call for 90% of all people living with HIV to know their status, 90% of all diagnosed individuals to be on treatment, and 90% of those on treatment to be virally suppressed.

“Every day in the next decade decisive action is needed to get the world back on track to end the AIDS epidemic by 2030,” said Winnie Byanyima, executive director of UNAIDS. “Millions of lives have been saved, particularly the lives of women in Africa. The progress made by many needs to be shared by all communities in all countries.”

Among the report’s findings:

  • In 2019, there were 1.7 million new HIV infections—more than three times the global target.
  • There is some cause for optimism: in eastern and southern Africa, the number of new infections decreased by 38% since 2010.
  • But eastern Europe and central Asia saw an increase of 72% in new infections during that same period.
  • HIV testing and treatment has been an area of progress. Of the 38 million people globally living with HIV at the end of 2019, 81% knew their status.
  • More than 2 in 3 people living with HIV (25.4 million) were on antiretroviral therapy (ART)—three times as many people accessing lifesaving treatment as in 2010. Increased access to ART has averted an estimated 12.1 million AIDS-related deaths since 2010.
  • The total number of AIDS-related deaths (690,000) has continued to decline—39% since 2010—but not fast enough to reach the 2020 target of fewer than 500,000 AIDS-related deaths.
  • In 2019, nearly 59% of people living with HIV worldwide had suppressed viral loads. While this marked a 44% increase since 2015, it is well below the target.
  • Although they make up a small percentage of the general population, key populations and their sexual partners accounted for more than 60% of new adult HIV infections worldwide in 2019.
  • Gay men and other men who have sex with men, people who inject drugs, and other marginalized populations such as sex workers were among those at highest risk of acquiring HIV.
  • Women and girls in sub-Saharan Africa accounted for 59% of new HIV infections in the region in 2019. Despite making up 10% of the population, young women accounted for about 1 in 4 new infections.
  • Stigma and discrimination continue to prevent young people, people living with HIV, and key populations from accessing HIV prevention, treatment, and other sexual and reproductive health services.
  • From 2017 to 2019, funding for HIV decreased 7% to $18.6 billion—30% below the $26.2 billion needed for an effective global response.
  • The COVID-19 pandemic has begun to impact the response to HIV, and may cause massive disruptions in treatment and services. A six-month disruption in HIV treatment could lead to more than 500,000 additional deaths in sub-Saharan Africa in the next year—setting the region back to a 2008 level of AIDS-related deaths.

The report and supporting materials are available on the UNAIDS website.