The era of HIV is not over — there is much more to be done

If the global goal of ending AIDS as a public health threat is to be achieved by 2030, complacency is not an option. The world needs to intensify its efforts to fight this cruel disease.

Over the last three decades, major battles have been won against HIV, says Dr Gottfried Hirnschall, Director of the HIV Department and the Global Hepatitis Programme (GHP) of the World Health Organization. There have been huge steps forward in HIV testing and diagnosis, while increased numbers of people are able to access treatment in low- and middle-income countries. And, thanks to advances in treatments, an HIV-positive diagnosis is no longer the death sentence it once was. On the 30th anniversary of World AIDS Day, that’s great news.

Yet, warns Dr Hirnschall, despite those gains, the world must not sit back, relax and think that HIV is a thing of the past.

It was important then, and it continues to be important now.

“The impression that it’s ‘done’ and ‘over with’ is totally misleading,” he insists. “We cannot allow complacency to creep in. Yes, many people have access to treatment for HIV — close to 60% of those who need it, get it, but there are still many who don’t. And over the last few years, consistently high numbers of people — 1.8 million people in 2017 — have been newly infected. Adolescent girls and young women in Africa are being hit hard. Elsewhere it is those populations most marginalized who are being infected and can’t access treatment – including sex workers, men who have sex with men, people who use drugs and transgender people. We cannot leave anybody behind in our efforts”

Intensifying efforts in the next decade

While much hard work has gone into combatting stigma and discrimination towards those with HIV, it has not been eradicated completely. “We have seen some very positive movements in this area,” agrees Dr Hirnschall. “But, overall, stigma and discrimination still exist. So, the job is not done.”

In fact, he says, the world needs to intensify its efforts over the next decade to achieve the global goal of ending AIDS as a public health threat by 2030.

“We have targets to hit by 2020. We want 90% of all people living with HIV to be diagnosed; 90% of diagnosed people to be receiving antiretroviral therapy; and 90% of people on treatment to be virally suppressed.

“We can’t continue the path we’ve been on for the last 10 or 20 years. New medicines and innovative ways to deliver prevention and treatment services will become available and, when they do, we will need to embrace them and help countries adopt them quickly.”

World AIDS Day has been a significant way to focus minds and raise awareness. “Thirty years ago, HIV was a deadly epidemic that caused fear and despair and was poorly understood,” says Dr Hirnschall. “World AIDS Day was the first disease-specific health day to generate awareness, bring partners together and mobilise the community. It was important then, and it continues to be important now.”