'End of Aids' still possible by 2030: UN

GENEVA - “The end of Aids” is still possible by 2030, the United Nations insisted on Thursday, but cautioned that the world’s deadliest pandemic could be halted only if leaders grasped the opportunity.

Aids can be ended as a public health threat, the UNAids agency said, as it outlined a road map of investment, evidence-based prevention and treatment, empowering civil society, and tackling the inequalities holding back progress.

UNAids said ending the pandemic was, above all, a political and financial choice.

“We are not yet on the path that ends Aids,” said the agency’s executive director, Ms Winnie Byanyima, “(but) we can choose to get on that path.”

The UN first set out in 2015 the target of ending Aids as a public health threat by 2030.

Ms Byanyima said the greatest progress on HIV, the virus that causes Aids, was being made in the countries and regions that have invested strongly.

She cited eastern and southern Africa, where new HIV infections have dropped by 57 per cent since 2010.

Botswana, Eswatini, Rwanda, Tanzania and Zimbabwe have already achieved what are called the 95-95-95 targets.

This means that 95 per cent of those living with HIV know their status; 95 per cent of those who know they have HIV are on life-saving anti-retroviral treatment; and 95 per cent of people on treatment achieve viral suppression, and therefore are highly unlikely to infect others.

At least 16 other countries are close to achieving the target. They include eight in sub-Saharan Africa – the region where 65 per cent of HIV-positive people live – as well as Denmark, Kuwait and Thailand.

39 million living with HIV

In a report, UNAids said that two decades ago, the Aids pandemic seemed unstoppable, with more than 2.5 million people acquiring HIV each year and Aids claiming two million lives annually.

But the picture is now dramatically different.

UNAids said that in 2022, 39 million people globally were living with HIV, of whom 29.8 million were accessing anti-retroviral therapy. Those missing out included 660,000 children.

The numbers on anti-retroviral treatment have near-quadrupled from 7.7 million in 2010.

Furthermore, 82 per cent of pregnant and breastfeeding women living with HIV had access to anti-retroviral treatment in 2022, compared with 46 per cent in 2010 – which has led to a 58 per cent drop in new infections in children.

Around 1.3 million people became newly infected with HIV in 2022, down 59 per cent from the peak in 1995.

Meanwhile, 630,000 died from Aids-related illnesses, and it is still the No. 1 killer in countries including Mozambique, said Ms Byanyima.

“Overall, numbers of Aids-related deaths have been reduced by 69 per cent since the peak in 2004,” the report said.

‘Dependent on action’

The end of Aids is an opportunity for today’s leaders to be remembered as “those who put a stop to the world’s deadliest pandemic”, said Ms Byanyima.

“We are hopeful, but it is not the relaxed optimism that might come if all was heading as it should be. It is, instead, a hope rooted in seeing the opportunity.”

Funding for HIV fell back in 2022 to US$20.8 billion (S$27.5 billion) – around the same level as in 2013, and well short of the US$29.3 billion needed by 2025.

Laws that criminalise people from key populations, or their behaviours, remain in place in many nations, UNAids said, giving the example that criminalisation, and stigmatisation, of people who inject drugs prevents them from coming forward for treatment.

HIV continues to impact key populations more than the general population, it added.

In 2022, compared with adults aged 15 to 49 in the general population, HIV prevalence was 11 times higher among men who have sex with men, four times higher among sex workers, seven times higher among people who inject drugs, and 14 times higher among transgender people. AFP