amfAR, The Foundation for AIDS Research

A “Dangerous Complacency” Is Threatening the Global HIV Response

Reports from UNAIDS and Lancet Commission are a “stark wake-up call”

Both UNAIDS and a Lancet Commission led by the International AIDS Society (IAS) have issued reports demonstrating that the current global HIV response is insufficient to meet critical targets and that immediate corrective action is necessary. The 2020 “90-90-90” targets set by UNAIDS 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. These targets have been identified as an essential milestone toward the ultimate goal of ending the HIV pandemic by 2030.

From left, Nicole Tsague, AIDES (France); Yves Yomb, Global Network Alliance of Communities for Health and Rights (Cameroon); Michel Sidibé, executive director, UNAIDS; Stéphanie Seydoux, French ambassador for global health; Aurélien Beaucamp, president, AIDES, and administrator, Coalition PLUS; Revanta Dharmarajah,
International HIV/AIDS Alliance

The UNAIDS report, Miles to go—closing gaps, breaking barriers, righting injustices, warns that new HIV infections are increasing in some 50 countries, AIDS-related deaths are not falling fast enough, and resources are not keeping pace with what is needed to sustain progress.

“We are sounding the alarm,” said Michel Sidibé, executive director of UNAIDS. “Entire regions are falling behind, the huge gains we made for children are not being sustained, women are still most affected and key populations continue to be ignored. All these elements are halting progress and urgently need to be addressed head on.”

Among the report’s findings are that only half of all children living with HIV are getting treatment (compared to almost 60% of people overall), about 58% of new infections in adults over 15 years of age occur in women, and key populations and their sexual partners account for nearly half of new HIV infections. Discrimination by health-care workers, law enforcement, teachers, employers, parents, religious leaders, and community members often prevents young people, people living with HIV, and key populations from accessing HIV prevention, treatment, and other sexual and reproductive health services.

“It is the responsibility of political leaders, national governments and the international community to make sufficient financial investments and establish the legal and policy environments needed to bring the work of innovators to the global scale,” said Mr. Sidibé.


The Lancet report also shows that the HIV pandemic is not on track to end by 2030 and current approaches are not enough to control it. The authors state that HIV researchers and health care professionals need to work more closely with their counterparts in global health; HIV services need to be included in wider health services; and global health policies need to incorporate HIV.

amfAR Vice President and Director of Public Policy Greg Millett was one of the 40 international leaders in HIV research, policy and public health who authored the Lancet report, which was presented at the International AIDS Conference in Amsterdam.

HIV funding has remained flat in recent years, at about US$19.1 billion, roughly US$7 billion short of the estimated amount needed to achieve the UNAIDS 90-90-90 targets. This is happening as a growing number of people are receiving antiretroviral therapy (ART) and will require sustained access for decades to come. In June 2017 approximately 21 million people worldwide were receiving ART.

The Lancet report also points to wider issues in global health that add to the funding problems. “Global health is beginning to falter as democracy, civil society, and human rights deteriorate in many countries, and as development assistance for health has stalled,” said lead Lancet Commissioner and IAS President Dr. Linda-Gail Bekker. “This loss of momentum comes as health systems need to become stronger to contend with the growing numbers of non-communicable diseases.”