amfAR, The Foundation for AIDS Research

UNAIDS Warns that Progress on HIV Is Slowing

Latest report shows that time is running out to meet the 2020 targets

unaids logoIn what it calls a “stark wake-up call,” UNAIDS has issued a report warning that the current global HIV response is insufficient to meet critical targets and that immediate action is necessary to put the world back on track. The 2020 “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.

According to the new report, Miles to go—closing gaps, breaking barriers, righting injustices, 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.”

miles to go
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

Among the report’s findings:

  • Global new HIV infections have declined by just 18% in the past seven years, from 2.2 million in 2010 to 1.8 million in 2017. This rate of decline is not quick enough to reach the target of fewer than 500,000 by 2020.
  • An additional 2.3 million people were newly accessing treatment in the past year. This is the largest annual increase to date, bringing the total number of people on treatment to 21.7 million.
  • But while almost 60% of the 36.9 million people living with HIV were on treatment in 2017, to reach the 30 million target there needs to be an annual increase of 2.8 million people, and there are indications that the rate of scale-up is slowing down.
  • The number of AIDS-related deaths is the lowest in this century (940,000), but the current pace of decline is not fast enough to reach the 2020 target of fewer than 500,000 AIDS-related deaths.
  • The greatest progress has been seen in the region most affected by HIV—eastern and southern Africa—where in 2017 59% of children and 66% of adults living with HIV had access to treatment, and since 2010 new infections have been reduced by 30% and AIDS-related deaths by 42%.
  • By contrast, in 2017 just 26% of children and 41% of adults living with HIV in Western and Central Africa had access to treatment, and since 2010 AIDS-related deaths have fallen by just 24%.
  • New HIV infections are rising in around 50 countries. In Eastern Europe and Central Asia the annual number of new HIV infections has doubled, and new infections have increased by more than a quarter in the Middle East and North Africa over the past 20 years.
  • New HIV infections among children have declined by only 8% in the past two years, only half (52%) of all children living with HIV are getting treatment, and 110,000 children died of AIDS-related illnesses in 2017.
  • Although 80% of pregnant women living with HIV had access to antiretroviral medicines to prevent transmission of HIV to their children in 2017, 180,000 children acquired HIV during birth or breastfeeding—far from the target of fewer than 40,000 by the end of 2018.
  • Key populations and their sexual partners account for 47% of new HIV infections worldwide and 97% of new HIV infections in Eastern Europe and Central Asia, where one third of new HIV infections are among people who inject drugs.
  • Discrimination by health-care workers, law enforcement, teachers, employers, parents, religious leaders, and community members is preventing young people, people living with HIV, and key populations from accessing HIV prevention, treatment, and other sexual and reproductive health services.
  • In 2017, about 58% of new HIV infections in adults over 15 years of age were among women, and 6,600 young women between the ages of 15 and 24 years became infected with HIV every week. More than one in three women worldwide have experienced physical or sexual violence, often at the hands of their intimate partners, and this violence has been linked to increased vulnerability to HIV.

“For every challenge there is a solution,” said Mr Sidibé. “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. Doing so will create the momentum needed to reach the targets by 2020.”

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