The United Nations (UN) General Assembly gave some bad news Monday – the 2015 global HIV/AIDS targets will not be met unless there is significant scale up in several areas. The targets were set by the 2011 Political Declaration on HIV and AIDS: Intensifying our Efforts to Eliminate HIV and AIDS. The declaration was adopted by the assembly last June after the UN High-Level Meeting on AIDS in New York City, which set a shared vision of achieving a world with zero new infections, zero discrimination and zero AIDS-related deaths. The declaration pledged to put 15 million people on treatment, eliminate new infections in children and achieve 50 percent reductions in sexual transmission, maternal deaths and tuberculosis (TB)-related deaths among people living with HIV.
A new report outlining the progress toward reaching the 2015 targets, and the challenges to overcome in order to reach them on time, is outlined in a report the General Assembly released Monday.
Although a notable flaw in the report is that the numbers used to assess progress are from 2010 or earlier, and scale up headway could be significantly different now, the report does give updates on progress in several key areas worth noting:
- 2015 Goal: Reduce HIV transmission among injection drug users (IDUs) by 50 percent.
In 2010 only 43 of 109 countries reported that they had any needle or syringe exchange program in place, only 58 countries provided opioid substation therapy, and approximately 240,000 IDUs were newly infected with HIV.
That means, new infections must fall by at least 120,000 per year to meet the 2015 target.
- 2015 Goal: Put 15 million people living with HIV on antiretroviral therapy (ART).
In 2010 coverage for ART reached 47 percent in low- and middle-income countries.
That means, to reach the goal, 8.4 million additional people in low- and middle-income countries need to be receiving treatment.
- 2015 Goal: To reduce tuberculosis deaths among people living with HIV by 50 percent.
In 2010 There were approximately 350,000 TB deaths among people living with HIV.
That means TB deaths must decline by 180,000 annually to reach the 2015 target.
- 2015 Goal: To virtually eliminate new HIV infections among children.
In 2010 48 percent of HIV-infected pregnant women in low- and middle-income countries received an effective combination antiretroviral prophylaxis to prevent transmission to their newborns. And in 2009, approximately 420,000 vertical HIV transmissions (mother-to-child) occurred.
That means new child infections need to drop by 390,000 (350,000 in sub-Saharan Africa alone) to meet the 2015 target.
The report notes that a lack of funding is a key component of the sputtering AIDS response. Despite substantial gains in the past decade, the authors contend the current response is unlikely to result in the achievement of the ambitious 2015 targets, “underscoring the urgent need for all stakeholders to redouble their efforts to strengthen the HIV response,” according to the report. “International donors, emerging economies, affected countries and additional stakeholders must all actively contribute, in accordance with their respective capacities.”
Some specific suggestions for how to change course and meet the targets made in the report include scaling up non-discriminatory/non-stigmatizing social protection for IDUs’ access to health services; expanding testing services beyond stand-alone voluntary counseling and testing centers to increase testing rates; marked efforts to increase rates of TB detection among people living with HIV; and eliminating the use of suboptimal drug regimens for HIV-infected pregnant women.