Press Release

Almost half (46%) of the world’s 1.7 million children living with HIV were not on treatment in 2020 and 150 000 children were newly infected with HIV, four times more than the 2020 target of 40 000

GENEVA, 21 July 2021—In the final report from the Start Free, Stay Free, AIDS Free initiative, UNAIDS and partners* warn that progress towards ending AIDS among children, adolescents and young women has stalled and none of the targets for 2020 were met.

The report shows that the total number of children on treatment declined for the first time, despite the fact that nearly 800 000 children living with HIV are not currently on treatment. It also shows that opportunities to identify infants and young children living with HIV early are being missed—more than one third of children born to mothers living with HIV were not tested. If untreated, around 50% of children living with HIV die before they reach their second birthday. 

“Over 20 years ago, initiatives for families and children to prevent vertical transmission and to eliminate children dying of AIDS truly kick-started what has now become our global AIDS response. This stemmed from an unprecedented activation of all partners, yet, despite early and dramatic progress, despite more tools and knowledge than ever before, children are falling way behind adults and way behind our goals,” said Shannon Hader, UNAIDS Deputy Executive Director, Programme. “The inequalities are striking—children are nearly 40% less likely than adults to be on life-saving treatment (54% of children versus 74% of adults), and account for a disproportionate number of deaths (just 5% of all people living with HIV are children, but children account for 15% of all AIDS-related deaths). This is about children’s right to health and healthy lives, their value in our societies.  It’s time to reactivate on all fronts—we need the leadership, activism, and investments to do what’s right for kids.”

Start Free, Stay Free, AIDS Free is a five-year framework that began in 2015, following on from the hugely successful Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. It called for a super Fast-Track approach to ensure that every child has an HIV-free beginning, that they stay HIV-free through adolescence and that every child and adolescent living with HIV has access to antiretroviral therapy. The approach intensified focus on 23 countries, 21 of which were in Africa, that accounted for 83% of the global number of pregnant women living with HIV, 80% of children living with HIV and 78% of young women aged 15–24 years newly infected with HIV.

“The HIV community has a long history of tackling unprecedented challenges, today we need that same energy and perseverance to address the needs of the most vulnerable—our children. African leaders have the power to help us change the pace of care and should act and lead until no child living with HIV is left behind,” said Ren Minghui, Assistant Director-General of the Universal Health Coverage/Communicable and Noncommunicable Diseases Division of the World Health Organization.

Although the 2020 targets were missed, the 21 focus countries in Africa made better progress than the non-focus countries. However, there were major disparities between countries, and these countries still bear the highest burden of disease: 11 countries account for nearly 70% of the “missing children”—those living with HIV but not on treatment. There was a 24% decline in new HIV infections among children from 2015 to 2020 in focus countries versus a 20% decline globally. Focus countries also achieved 89% treatment coverage for pregnant women living with HIV, compared to 85% globally, but still short of the target of 95%, and there were huge differences between countries. For example, Botswana achieved 100% treatment coverage, yet the Democratic Republic of the Congo only reached 39%.

“While we are deeply distressed by the global paediatric HIV shortfalls, we are also encouraged by the fact that we largely have the tools we need to change this,” said Angeli Achrekar, Acting United States Global AIDS Coordinator. “So, let this report be a call to action to challenge complacency and to work tirelessly to close the gap.”

The report outlines three actions necessary to end new HIV infections among children in the focus countries. First, reach pregnant women with testing and treatment as early as possible—66 000 new HIV infections occurred among children because their mothers did not receive treatment at all during pregnancy or breastfeeding. Second, ensure the continuity of treatment and viral suppression during pregnancy, breastfeeding and for life—38 000 children became newly infected with HIV because their mothers were not continued in care during pregnancy and breastfeeding. Third, prevent new HIV infections among women who are pregnant and breastfeeding—35 000 new infections among children occurred because a woman became newly infected with HIV during pregnancy or breastfeeding.

There has been some progress in preventing adolescent girls and young women from acquiring HIV. In the focus countries, the number of adolescent girls and young women acquiring HIV declined by 27% from 2015 to 2020. However, the number of adolescent girls and young women acquiring HIV in the 21 focus countries was 200 000, twice the global target for 2020 (100 000). In addition, COVID-19 and school closures are now disrupting many educational and sexual and reproductive health services for adolescent girls and young women, highlighting the urgent need to redouble HIV prevention efforts to reach young women and adolescent girls.

“The lives of the most vulnerable girls and young women hang in the balance, locked into deeply entrenched cycles of vulnerability and neglect that must urgently be interrupted. With the endorsement of United Nations Member States, the new global AIDS strategy recommits us all to address these intersecting vulnerabilities to halt and reverse the effects of HIV by 2030. We know that rapid gains can be achieved for girls and young women; what is needed is the courage to apply the solutions, and the discipline to implement these with rigor and scale,” said Chewe Luo, United Nations Children’s Fund Chief of HIV and Associate Director of Health Programmes.

UNAIDS and partners will continue to work together to develop new frameworks to address the unfinished agenda. New targets for 2025 were officially adopted by United Nations Member States in the 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030 in June this year, providing a road map for the next five years.

“It is clear that ending mother-to-child transmission requires innovative approaches that support the whole woman throughout the life course, including intensified primary prevention efforts, such as pre-exposure prophylaxis (PrEP), access to comprehensive reproductive care, and focused attention on adolescent girls and young women. The Start Free, Stay Free, AIDS Free report includes new the new targets for 2025 that, if met, will propel a new era of HIV prevention and treatment for women, children and families. This is not the time for complacency, but rather an opportunity to redouble investments to reduce and eliminate mother-to-child transmission,” said Chip Lyons, President and Chief Executive Officer of the Elizabeth Glaser Pediatric AIDS Foundation.

*The United States President’s Emergency Plan for AIDS Relief, UNAIDS, the United Nations Children’s Fund and the World Health Organization, with support from the Elizabeth Glaser Pediatric AIDS Foundation. 

UNAIDS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

PEPFAR
PEPFAR is the largest commitment by any nation to address a single disease in history. Managed and overseen by the U.S. Department of State, and supported through the compassion and generosity of the American people, PEPFAR has saved 20 million lives, prevented millions of infections, and helped transform the global AIDS response.

UNICEF
UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. Follow UNICEF on Twitter, Facebook, Instagram and YouTube

WHO
Dedicated to the well-being of all people and guided by science, the World Health Organization (WHO) leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for heath that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable. www.who.int

Elizabeth Glaser Pediatric AIDS Foundation
EGPAF is a proven leader in the fight for an AIDS-free generation and has reached over 31 million pregnant women with services to prevent transmission of HIV to their babies. Founded in 1988, EGPAF has supported over 15,000 sites and currently works in 17 countries to offer HIV counseling, prevention, diagnosis, and treatment services alongside high-quality family health care. Each stage of life—from infancy to adulthood—brings new and different challenges, and EGPAF is driven to see a world where no other mother, child, or family is devastated by this disease. For more information, visit www.pedaids.org.

People living with HIV are at a higher risk of severe COVID-19 illness and death, yet the vast majority are denied access to COVID-19 vaccines. Key populations and their sexual partners account for 65% of new HIV infections but are largely left out of both HIV and COVID-19 responses—800 000 children living with HIV are not on the treatment they need to keep them alive

GENEVA, 14 July 2021—The UNAIDS Global AIDS Update 2021, launched today, highlights evidence that people living with HIV are more vulnerable to COVID-19, but that widening inequalities are preventing them from accessing COVID-19 vaccines and HIV services.

Studies from England and South Africa have found that the risk of dying from COVID-19 among people living with HIV was double that of the general population. In sub-Saharan Africa, which is home to two thirds (67%) of people living with HIV, less than 3% had received at least one dose of a COVID-19 vaccine by July 2021. At the same time, HIV prevention and treatment services are eluding key populations, as well as children and adolescents.

COVID-19 vaccines could save millions of lives in the developing world but are being kept out of reach as rich countries and corporations hold on tightly to the monopoly of production and delivery of supplies for profit. This is having a severe impact around the world as health systems in developing countries become overwhelmed, such as in Uganda, where football stadiums are being turned into makeshift hospitals.

“Rich countries in Europe are preparing to enjoy the summer as their populations have easy access to COVID-19 vaccines, while the global South is in crisis,” said Winnie Byanyima, Executive Director of UNAIDS. “We have failed to learn the lessons of HIV, when millions were denied life-saving medicines and died because of inequalities in access. This is totally unacceptable.”

The new UNAIDS report shows how COVID-19 lockdowns and other restrictions have badly disrupted HIV testing—in many countries this has led to steep drops in HIV diagnoses, referrals to care services and HIV treatment initiations. In KwaZulu-Natal, South Africa, for example, there was a 48% drop in HIV testing after the first national lockdown was imposed in April 2020. There were also fewer new HIV diagnoses and a marked drop in treatment initiation. This occurred as 28 000 HIV community health-care workers were shifted from HIV testing to COVID-19 symptom screening.

The report, Confronting inequalities, shows that in 2020 the 1.5 million new HIV infections were predominantly among key populations and their sexual partners. People who inject drugs, transgender women, sex workers and gay men and other men who have sex with men, and the sexual partners of these key populations, accounted for 65% of HIV infections globally in 2020. Key populations accounted for 93% of new HIV infections outside of sub-Saharan Africa, and 35% within sub-Saharan Africa. However, they remain marginalized and largely out of reach of HIV services in most countries.

The report shows that many of the 19 countries that achieved the 90–90–90 targets by 2020 have been leaders in differentiated service delivery, where facility-based services are complimented by community-led services. Most have also included key populations as central to their responses. In Estonia, for example, the expansion of comprehensive harm reduction services was followed by a 61% countrywide reduction in HIV infections and a 97% reduction in new HIV infections among people who inject drugs.

HIV testing and treatment has been scaled up massively over the past 20 years. Some 27.4 million of the 37.7 million people living with HIV were on treatment in 2020. However, gaps in service provision are much larger for children than for adults. In 2020, around 800 000 children aged 0–14 years who were living with HIV were not on HIV treatment. Treatment coverage was 74% for adults but just 54% for children in 2020. Many children were not tested for HIV at birth and remain unaware of their HIV status, making finding them and bringing them into care a major challenge.

Confronting inequalities also shows that women and girls in sub-Saharan Africa continue to be at a higher risk of HIV infection, with gender inequality and gender-based violence at the centre of that risk. Gender inequalities and gender-based violence rob women and girls of their fundamental human rights, including the right to education, health and economic opportunities. This increases their risk of HIV infection and blocks access to services. In sub-Saharan Africa, adolescent girls and young women account for 25% of all new HIV infections despite representing just 10% of the population.

Poverty and lack of schooling are also formidable barriers to health and HIV services. The report shows how family planning services for women and voluntary medical male circumcision for men and boys are much less likely to be accessed by people living in poverty. In 2020, the number of voluntary medical male circumcisions dropped by more than 30% in 15 priority countries in eastern and southern Africa.

Poverty is also a driver of migration, which has been shown to severely impact access to HIV services and puts lives in danger as migrants flee conflict and poverty in the hope of safety and economic security.

“Billionaires are sailing their yachts in the same Mediterranean waters that migrants are drowning in,” said Winnie Byanyima. “How can we stand by and let this be the “new normal”. We must confront these horrific inequalities and put the emphasis back on respect for basic, fundamental human rights.”

Inequalities are not naturally occurring. They are the result of policy and programmatic actions that divide rather than include. For example, key populations are marginalized and criminalized for their gender identities and expression, sexual orientation and livelihoods. New analysis included in the report shows a positive correlation between better HIV outcomes and the adoption of laws that advance non-discrimination. A study from sub-Saharan Africa found that HIV prevalence among sex workers was 39% in countries that criminalized sex work, compared to 12% in countries where sex work was partially legalized.

“We are 40 years into the fight against HIV. Both the successes and the failures have taught us that we cannot prepare for or defeat a pandemic unless we tear down inequalities, promote people-centred, rights-based approaches and work together with communities to reach everyone in need,” said Ms Byanyima.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Unequal gender power dynamics continue to put women and girls at higher risk of acquiring HIV. Six out of seven new HIV infections among adolescents aged between 15 and 19 years in sub-Saharan Africa are among girls and 4200 adolescent girls and young women between 15 and 24 years became infected with HIV every week in 2020

GENEVA, 6 July 2021—Five United Nations organizations have joined forces to launch a new initiative to ensure that all girls and boys in sub-Saharan Africa have equal access to free secondary education by 2025 and to contribute towards preventing HIV. Education Plus, launched at the Generation Equality Forum in Paris, France, is an ambitious five-year high-level drive to accelerate action and investments to expand access to secondary education for all young people and to advance adolescent girls’ and young women’s health, education and rights in sub-Saharan Africa.

Before COVID-19 struck, around 34 million secondary school-aged girls in sub-Saharan Africa were being denied a full education and an estimated 24% of adolescent girls and young women (15–24 years) in the region were not in education, training or employed, compared to 14.6% of young men. One in four young people in sub-Saharan Africa aged 15–24 years are illiterate and the United Nations Children’s Fund (UNICEF) estimates that in 2020 school closures due to COVID-19 impacted around 250 million students in the region, millions of whom may never return to the classroom.

“We know that keeping girls in secondary school can reduce their risk of HIV infection by a third or more in places where HIV is common. It reduces their risk of child marriage, teenage pregnancy and gender-based and sexual violence and it can provide girls with the important skills and competencies for their economic empowerment,” said Winnie Byanyima, Executive Director of UNAIDS. “Bold and consistent political leadership is needed to ensure all children can complete a full round of secondary education in sub-Saharan Africa.”

The co-founders of Education Plus, UNAIDS, UN Women, the United Nations Educational, Scientific and Cultural Organization, the United Nations Population Fund and UNICEF, are urging countries to use education systems as an entry point to provide a holistic “plus” package of essential elements that adolescent girls and young women need as they become adults. These include comprehensive sexuality education, sexual and reproductive health and rights, including HIV prevention, freedom from gender-based violence and economic empowerment through school-to-work transitions.

Anita Myriam Emma Kouassi, a young activist from Benin, called on leaders to go beyond promises and act to end inequalities and gender discrimination against girls and young women in Africa. “Inequalities and illiteracy leave girls without the ability to take charge of their lives early on and without control over choices around their own bodies and health. We are thus left vulnerable without knowing how to defend ourselves or make our voices heard,” she said. “This is the reason why we cannot do without girls’ education; it is the bedrock and pillar of a strong nation with and for girls.”

To date, five countries—Benin, Cameroon, Gabon, Lesotho and Sierra Leone—have signed on to champion the initiative with a wide range of commitments that will tackle the urgency of effectively addressing the alarming numbers of adolescent girls and young women acquiring HIV and dying from AIDS-related illnesses, among other threats to their survival, well-being, human rights and freedoms, including sexual and gender-based violence and teenage pregnancy.  

“Over the next three years, we will work to intensify awareness of sex education through training and the development of dedicated pedagogical material. We will support pregnant girls and young mothers in the case of early pregnancy. We will provide quality sanitary facilities and promote easy access to sanitary towels in schools,” pledged Rose Christiane Ossouka Raponda, the Prime Minister of Gabon. “The new Labour Code, which is currently before Parliament, will enrich our legal framework, particularly with regard to harassment in the workplace. Adolescent girls, young women and women as a whole will be even better protected to promote their social and professional development and their empowerment.”

Education has become an urgent concern amidst the COVID-19 pandemic and its socioeconomic impacts, which have increased girls’ and young women’s exposure to gender-based violence, child marriage and unintended pregnancies, increased the risks of maternal mortality and heightened vulnerabilities to acquiring HIV. Girls in sub-Saharan Africa are especially at risk of never returning to school.

David Moinina Sengeh, the Sierra Leone Minister of Basic and Senior Secondary Education, emphasized that countries must make decisions based on evidence and “Stop at nothing to make sure girls, including pregnant girls, are not left out of education,” adding that secondary education should include sexual and reproductive health in educational curricula. “People say it costs money, but it is going to be more expensive to us when we have high illiteracy in the future,” he argued. “It is already expensive to us when we have maternal mortality, it is already expensive to us when we have major parts of our adult population, women, excluded from the economy.”

The President of Sierra Leone, Julius Maada Bio, pledged that the country’s radical new inclusion policy would expand access to previously marginalized populations, including pregnant girls, parent learners, girls from poor backgrounds and those in hard-to-reach areas. “The governmental of Sierra Leone is committed to empowering adolescent girls, promoting and protecting their rights, accelerating progress on gender equality and social inclusion, reducing teenage pregnancy and new HIV infections.”

The initiative places emphasis on ensuring the meaningful participation and leadership of adolescent girls and young women in all their diversity, with attention to ensuring inclusiveness of those in especially excluded and vulnerable situations. Engaging men and boys with a focus on changing harmful gender norms and masculinities, and as allies and agents of change, is a cross-cutting aspect for Education Plus.

In presenting the Prime Minister of Lesotho’s Education Plus commitment, Dira Khama, the Permanent Secretary for Education, pledged that the country would expand secondary education, with a focus on rural areas, strengthen the implementation of comprehensive sexuality education, introduce vocational and technical streams to strengthen school-to-work transitions and work with parents and communities to reduce sexual and gender-based violence against adolescent girls and young women. The Prime Minister also committed, “To review and implement secondary school fees rationalization policy to reduce the amounts of school fees paid by individual households,” within the next six months to a year.

Education Plus will advocate for gender-responsive reforms in policies, laws and practices to guarantee the education, health and other social and economic rights of adolescents and young people. This includes changes in parental consent requirements and eliminating user fees for adolescents to access basic HIV and other sexual and reproductive health services, supporting pregnant adolescents and young mothers to complete their education and tackling gender-based violence, menstrual hygiene management and mental health, among others.

“It is important to look at HIV prevention systematically and not underestimate the special role of mental health when it comes to safe sex practices,” said Shudufhadzo Musida, Miss South Africa 2020. “In order to bring about mental health awareness, HIV prevention, economic empowerment and gender equality, we need to empower the minds of adolescent girls and young women now more than ever.”

Education Plus was launched as a joint commitment to the Generation Equality Forum. At the high-level virtual launch, Ms Byanyima was joined by Sierra Leone’s Minister of Basic and Senior Secondary Education, David Moinina Sengeh, the Tunisian diplomat and former African Union Youth Envoy, Aya Chebbi, a representative of the Education Plus Young Women’s leadership hub, Anita Myriam Emma Kouassi, and Miss South Africa 2020, Shudufhadzo Musida.

Delighted to launch the #EducationPlus initiative at today’s #GenerationEquality Forum - joint programme with @UNICEF, @UNFPA, @UN_Women, @UNESCO.

We must ensure all girls in Africa and beyond can complete secondary education.

It’s time to #ActForEqual! https://t.co/5JE6axsPMC pic.twitter.com/myRdhKQF6E

— Winnie Byanyima (@Winnie_Byanyima) July 1, 2021

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 6 July 2021—The 48th meeting of the UNAIDS Programme Coordinating Board (PCB), which commenced on 29 June 2021, closed on 2 July.

In her opening remarks to the meeting, the UNAIDS Executive Director, Winnie Byanyima, updated the PCB on the progress made in the priority areas she committed to focus on at her first PCB, in December 2019: developing the next UNAIDS strategy, transforming the internal culture of the UNAIDS Secretariat, increasing and optimizing the use of resources for the Joint Programme and emerging programmatic priorities for action.

Reflecting on the recent adoption of the new Global AIDS Strategy 2021–2026: End Inequalities, End AIDS and the United Nations General Assembly Political Declaration: Ending Inequalities and Getting on Track to End AIDS by 2030, Ms Byanyima urged countries not to forget HIV during the COVID-19 pandemic. “AIDS is not over. It is still one of the deadliest pandemics of our times. We have lost nearly 35 million people to AIDS. And last year, there were 1.5 million new HIV infections, all preventable, and 690 000 deaths, all treatable,” she said.

Ms Byanyima spoke about how UNAIDS had responded rapidly to the COVID-19 pandemic, setting out how around 70 UNAIDS country offices worldwide had supported COVID-19 response plans and are engaged in rapid responses to COVID-19 and HIV. She also spoke about how UNAIDS is responding to a range of pressing human rights concerns unleashed by COVID-19 and lockdowns that are adversely impacting access to HIV services.

In her update on building a safe, equal and empowering workplace for everyone, the Executive Director set out the practical actions that had been taken to mitigate COVID-19’s impact on staff well-being, the progress made on the Management Action Plan for a Healthy, Equitable and Enabling Workplace for all UNAIDS Staff, improvements to the internal justice system and how the culture transformation is progressing.

During the PCB meeting, a number of important areas related to the work of UNAIDS were discussed. The UNAIDS financial report and audited financial statements for 2020 and an update on strategic human resources management issues were examined. The PCB received, for the first time, a report of the ethics office and a management response to the annual organizational oversight reports, including the reports of the internal and external auditors.

The PCB also followed up on the last PCB meeting’s thematic segment on cervical cancer and HIV and was updated on the HIV response for migrant and mobile populations.

A zero draft of the UNAIDS Unified Budget, Results and Accountability Framework (UBRAF) 2022–2026 was presented to the PCB during the meeting. The final version of the UBRAF, which maximizes the coherence, coordination and impact of the United Nations’ response to HIV by combining the efforts of the UNAIDS Cosponsors and Secretariat from 2022 to 2026, will be submitted to the PCB at a special session in October this year.

“With the PCB’s guidance and support, we can shape our new UBRAF to be a solid and meaningful framework that will allow us to translate our reinvigorated commitment and best value for investment into action for results in support of countries and communities and to continue to demonstrate strong accountability to the PCB and the wider AIDS community,” Ms Byanyima said.

Ms Byanyima thanked Meryame Kitir, Minister of Development Cooperation of Belgium, for her political leadership and the announcement of a new multiyear agreement in support of UNAIDS, modelling good donorship and demonstrating true international solidarity.  

John Nkengasong, the Director of the Africa Centres for Disease Control and Prevention, addressed the PCB in its session on leadership in the HIV response.

The PCB concluded with a thematic segment on COVID-19 and HIV, which explored the epidemiology of the colliding pandemics, how COVID-19 is impacting HIV programming and inequalities and the vital role that communities have played in mitigating the impacts and how to sustain the gains made in the response to HIV and build back a better and fairer HIV response.

The meeting was chaired by Namibia, with Thailand serving as the Vice-Chair and the United States of America as the Rapporteur. The report to the Board by the UNAIDS Executive Director and the PCB’s decisions can be found at unaids.org/en/whoweare/pcb/48.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Celebrities and supporters of the global HIV response take part in a new UNAIDS film and social media campaign calling on world leaders to address the inequalities driving the HIV epidemic to end AIDS by 2030

GENEVA/NEW YORK, 1 July 2021—In the 40th year since the first AIDS cases were reported, a group of celebrities and high-profile supporters of the HIV response have appeared in a new film as part of a campaign to hold world leaders to their commitment to end the AIDS epidemic by 2030. The film, A Message to World Leaders on Ending AIDS, shows how the HIV epidemic remains a global health emergency and that too many people are being left behind in the response because the underlying inequalities driving the epidemic are not being addressed.

Alongside the UNAIDS Executive Director, Winnie Byanyima, the film features celebrities and long-standing supporters of the global HIV movement, including Kenneth Cole, Toumani Diabaté, Youri Djorkaeff, David Furnish, Sir Elton John, Princess Stéphanie of Monaco, Sheryl Lee Ralph, Stéphanie Seydoux, Charlize Theron, Brigitte Touadera, Yousra and others.

People are invited to join the campaign by sending their own messages to world leaders on social media using the #EndInequalitiesEndAIDS hashtag and by signing a Dear World Leader letter that lays out the progress made against the HIV epidemic to date while urging stronger action to reduce inequalities, mobilize resources and empower communities living with and affected by HIV to end the AIDS epidemic for good. The letter also expresses concern about the impact of COVID-19 on HIV services and how the pandemic has increased vulnerability to HIV infection among certain groups of people, such as young women and girls because of interruptions to schooling, child marriage and gender-based violence.  

The campaign reflects the recently adopted UNAIDS Global AIDS Strategy 2021–2026: End Inequalities, End AIDS and supports the outcomes of the 2021 United Nations High-Level Meeting on AIDS. At the meeting, Member States supported the 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, which set new targets for HIV prevention and treatment and the reduction of HIV-related stigma and discrimination. If those targets are met by 2025, the world will be on course to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals. If reached, the targets will deliver HIV services to 95% of all people who need them, reduce the number of new HIV infections annually to fewer than 370 000 and reduce AIDS-related deaths to fewer than 250 000.

Incredible progress has been made against HIV over the past four decades, with the number of people on life-saving medicines more than tripling since 2010. But the campaign draws attention to those being left behind, such as young women and girls, gay men and other men who have sex with men, sex workers, transgender people and people who use drugs. A recently released UNAIDS report, Global commitments, local action, shows that 10.2 million of 37.6 million people living with HIV globally are still waiting for treatment. Last year alone, 690 000 people died of AIDS-related illnesses and there were 1.5 million new HIV infections worldwide.

The film was launched during the 48th meeting of the UNAIDS Programme Coordinating Board. It can be found, with the letter to world leaders, at endinequalitiesendaids.unaids.org.

QUOTES: 

“We need governments to do their part, we need communities to mobilize and organize, we need civil society to advocate … Those who understand the need for global solidarity, those whose hearts tell them that the right thing to do is to care for humanity, must organize and win the public debate.”

Winnie Byanyima, UNAIDS Executive Director and Under-Secretary-General of the United Nations
 

“The stigma associated [with AIDS] was arguably worse than the disease itself … If we work together toward these common goals [on HIV prevention and treatment] and if they are achieved by 2025 it will put the world back on track to end AIDS as a public health crisis by 2030.”

Kenneth Cole, designer, activist and UNAIDS International Goodwill Ambassador
 

“It’s important that we continue this fight and redouble our efforts. It is urgent.”

Toumani Diabaté, musician and UNAIDS International Goodwill Ambassador
 

“The virus has not gone away. Access to prevention, treatment and care remains a vital priority.”

Youri Djorkaeff, Chief Executive Officer, FIFA Foundation
 

“People who feel disenfranchised and cut off from society … that’s where HIV tends to come in and root down most. [We need] to ensure that everybody who’s at risk of contracting HIV feels safe, feels loved and feels they have access to the testing and treatment that they need.”

David Furnish, Chairman, the Elton John AIDS Foundation
 

“Young children from Indonesia were expelled from their schools when teachers and parents found out that they are HIV-positive.”

Atiqah Hasiholan, actress, model and UNAIDS Goodwill Ambassador for Indonesia
 

“We’ve made a lot of progress scientifically and medically, but we still have a long way to go. [Ending AIDS] is an achievable dream but what we have to do is end the stigma. We must continue to give people hope throughout the world that AIDS is on the agenda. We can’t leave these people behind. We are all born equal, we all should be treated the same.”

Sir Elton John, musician and founder of the Elton John AIDS Foundation

“Today, people living with HIV can enjoy long, healthy lives with one pill a day. We need a recommitment to ending the ignorance, the stigma and, yes, sometimes the silence that stands between us and the end of the AIDS epidemic.”

Sheryl Lee Ralph, actress, singer, author and activist
 

“We know how to end AIDS and we have the tools to do so.”

Stéphanie Seydoux, France’s Ambassador for Global Health
 

“We can encourage our leaders to provide the means to stop this pandemic.”

Princess Stéphanie of Monaco, UNAIDS International Goodwill Ambassador
 

“There’s one simple reason we’re missing our goal: inequality. Key populations most likely to become HIV-positive are least likely to have access to the services they need to survive. Whether you live or die from AIDS is still too often determined by who you are, who you love and where you live.”

Charlize Theron, actress, founder of the Charlize Theron Africa Outreach Project and United Nations Messenger of Peace
 

“Unfortunately, complacency is setting in and inequalities are growing. I call on leaders around the world to commit to a world without AIDS.”

Brigitte Touadera, First Lady of the Central African Republic
 

“Many people are not accessing services out of fear of being recognized or judged or out of personal safety and security.”

Pia Wurtzbach, Miss Universe 2015 and UNAIDS Goodwill Ambassador for Asia and the Pacific
 

“To end AIDS, we need to talk about it. HIV does not discriminate. We do.”

Yousra, actress, singer and UNAIDS Goodwill Ambassador for the Middle East and North Africa

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

NEW YORK/GENEVA, 14 June 2021—After weeks of robust discussions, the 2021 United Nations General Assembly High-Level Meeting on AIDS is drawing to a close with the adoption of a new, ambitious and achievable Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. The declaration is based on evidence, grounded in human rights and will serve as an important road map to advance the global HIV response over the next five years.

“I would like to thank all Member States,” said Winnie Byanyima, Executive Director of UNAIDS. “Over the past two months they have drafted, negotiated and delivered a bold political declaration that will guide global efforts to end a pandemic that has ravaged countries and communities for 40 years.”

Important advances have been achieved in the 2021 political declaration, including new targets to ensure that 95% of people at risk of HIV use combination HIV prevention services, a greater emphasis on community-led provision of services—including a target to ensure that 80% of prevention services for key populations are provided by communities—and a commitment to end inequalities, going far beyond Sustainable Development Goal 10, reduce inequalities.

The High-Level Meeting on AIDS was convened by the President of the General Assembly, with the co-facilitators—the ambassadors of Australia and Namibia—leading negotiations on the political declaration; 193 Member States were represented and the speakers included 14 presidents, five vice-presidents and four prime ministers, with many high-level dignitaries also participating in the thematic panels and 30 supporting events. The events covered issues from how to increase treatment coverage for children to how to scale up harm reduction and empower young people and adolescents.

The five thematic panels were:

• Addressing Inequalities to End AIDS: 10 Years to 2030.
• Putting People and Communities at the Centre of the Response to AIDS.
• Resources and Funding for an Effective AIDS Response.
• Advancing Gender Equality and Empowering Women and Girls in the AIDS Response.
• Addressing the Impact of the COVID-19 Pandemic on the AIDS Response and Building Back Better for Pandemic Preparedness.

The High-Level Meeting on AIDS featured the participation of people living with HIV, senior United Nations officials, representatives of international organizations, the private sector, civil society and academia and other stakeholders, who discussed practical ways of translating the new political declaration into action and results.

Eminent person and long-time AIDS activist Sir Elton John, founder of the Elton John AIDS Foundation, made a strong call to action by video message, saying, “With your leadership, we can defeat AIDS and COVID-19 and be better prepared for other pandemics that will follow. You can and will make the difference. And you have an army of supporters standing behind you, including the 38 million people living with HIV around the world. Together, we can bring an end to fear and inequality—and, by the end of this decade, end the AIDS pandemic, once and for all! The world is watching and we don’t have a moment to waste.”

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

World leaders agree to reduce the annual number of new HIV infections to under 370 000 and AIDS-related deaths to 250 000, eliminate new HIV infections among children, end paediatric AIDS and eliminate all forms of HIV-related discrimination by 2025. They also committed to providing life-saving HIV treatment to 34 million people by 2025.

NEW YORK, 8 June 2021—United Nations Member States adopted a set of new and ambitious targets in a political declaration at the United Nations General Assembly High-Level Meeting on AIDS, taking place in New York, United States of America. If the international community reaches the targets, 3.6 million new HIV-infections and 1.7 million AIDS-related deaths will be prevented by 2030.

The political declaration calls on countries to provide 95% of all people at risk of acquiring HIV within all epidemiologically relevant groups, age groups and geographic settings with access to people-centred and effective HIV combination prevention options. It also calls on countries to ensure that 95% of people living with HIV know their HIV status, 95% of people who know their status to be on HIV treatment and 95% of people on HIV treatment to be virally suppressed.

“In this Decade of Action, if we are to deliver the 2030 Agenda for Sustainable Development all Member States must recommit to ending the AIDS epidemic by 2030,” said Volkan Bozkir, the President of the United Nations General Assembly.

“To end AIDS, we need to end the intersecting injustices that drive new HIV infections and prevent people from accessing services,” said Amina J. Mohammed, Deputy Secretary-General of the United Nations.

The political declaration notes with concern that key populations—gay men and other men who have sex with men, sex workers, people who inject drugs, transgender people and people in prisons and closed settings—are more likely to be exposed to HIV and face violence, stigma, discrimination and laws that restrict their movement or access to services. Member States agreed to a target of ensuring that less than 10% of countries have restrictive legal and policy frameworks that lead to the denial or limitation of access to services by 2025. They also committed to ensure that less than 10% of people living with, at risk of or affected by HIV face stigma and discrimination by 2025, including by leveraging the concept of undetectable = untransmittable (people living with HIV who have achieved viral suppression do not transmit HIV).

“I would like to thank Member States. They have adopted an ambitious political declaration to get the world back on track to ending the AIDS pandemic that has ravaged communities for 40 years,” said Winnie Byanyima, the UNAIDS Executive Director.

Expressing concern at the number of new HIV infections among adolescents, especially in sub-Saharan Africa, a commitment was made to reduce the number of new HIV infections among adolescent girls and young women to below 50 000 by 2025. Member States committed to eliminate all forms of sexual and gender-based violence, including intimate partner violence, by adopting and enforcing laws that address the multiple and intersecting forms of discrimination and violence faced by women living with, at risk of and affected by HIV. They pledged to reduce to no more than 10% the number of women, girls and people affected by HIV who experience gender-based inequalities and sexual and gender-based violence by 2025. In addition, commitments were made to ensure that all women can exercise their right to sexuality, including their sexual and reproductive health, free of coercion, discrimination and violence.

Countries were also urged to use national epidemiological data to identify other priority populations who are at higher risk of exposure to HIV, which may include people with disabilities, ethnic and racial minorities, indigenous peoples, local communities, people living in poverty, migrants, refugees, internally displaced people, men and women in uniform and people in humanitarian emergencies and in conflict and post-conflict situations. Countries also committed to ensure that 95% of people living with, at risk of and affected by HIV are protected against pandemics, including COVID-19.

“The stark inequalities exposed by the colliding pandemics of HIV and COVID-19 are a wake-up call for the world to prioritize and invest fully in realizing the human right to health for all without discrimination,” said Ms Byanyima.

Member States also committed to increase and fully fund the AIDS response. They agreed to invest US$ 29 billion annually by 2025 in low- and middle-income countries. This includes investing at least US$ 3.1 billion towards societal enablers, including the protection of human rights, reduction of stigma and discrimination and law reform. They also committed to include peer-led HIV service delivery, including through social contracting and other public funding mechanisms.

Calling for expanding access to the latest technologies for tuberculosis (TB) prevention, screening, diagnosis, treatment and vaccination, Member States agreed to ensure that 90% of people living with HIV receive preventive treatment for TB and reduce AIDS-related TB deaths by 80% by 2025. Countries also committed to ensure the global accessibility, availability and affordability of safe, effective and quality-assured medicines, including generics, vaccines, diagnostics and other health technologies to prevent, diagnose and treat HIV infection, its coinfections and other comorbidities through the use of existing flexibilities under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and ensure that intellectual property rights provisions in trade agreements do not undermine the existing flexibilities as outlined in the Doha Declaration on the TRIPS Agreement and Public Health.

“The AIDS response is still leaving millions behind—LGBTI people, sex workers, people who use drugs, migrants and prisoners, teenagers, young people, women and children—who also deserve an ordinary life, with the same rights and dignity enjoyed by most people in this room,” said Yana Panfilova, a woman living with HIV and member of the Global Network of People Living with HIV.

The high-level meeting is being attended in-person and virtually by heads of state and government, ministers and delegates in New York, people living with HIV, civil society organizations, key populations and communities affected by HIV, international organizations, scientists and researchers and the private sector. UNAIDS supported regional consultations and the participation of civil society in the high-level meeting. Civil society organizations called on Member States to adopt a stronger resolution.

“While we have made some significant progress as a global community, we are still missing the mark and people are paying the price with their lives. There’s one single reason we are missing our goal: it’s inequality,” said Charlize Theron, Founder of the Charlize Theron Africa Outreach Project and a United Nations Messenger of Peace.

Member States also committed to support and leverage the 25 years of experience and expertise of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and committed to fully fund the programme so that it can continue to lead global efforts against AIDS and support efforts for pandemic preparedness and global health.

In accordance with the Global AIDS Strategy 2021–2026: End Inequalities, End AIDS, adopted by consensus on 25 March 2021 by the UNAIDS Programme Coordinating Board, as well as the report of the United Nations Secretary-General, Addressing Inequalities and Getting Back on Track to End AIDS by 2030, issued on 31 March 2021, UNAIDS would have welcomed even stronger commitments on comprehensive sexuality education, sexual and reproductive health and rights, and sexual orientation and gender identity, unqualified acceptance of evidence-based HIV prevention options, such as harm reduction, a call for the decriminalization of the transmission of HIV, sex work, drug use and laws that criminalize same-sex sexual relationships and further flexibilization of intellectual property rules for access to life-saving medicines, vaccines and technologies.

In 2020, 27.4 million of the 37.6 million people living with HIV were on treatment, up from just 7.8 million in 2010. The roll-out of affordable, quality treatment is estimated to have averted 16.2 million deaths since 2001. AIDS-related deaths have fallen by 43% since 2010, to 690 000 in 2020. Progress in reducing new HIV infections has also been made, but has been markedly slower—a 30% reduction since 2010, with 1.5 million people newly infected with the virus in 2020, compared to 2.1 million in 2010.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS urges world leaders to adopt a bold political declaration on HIV at the United Nations General Assembly High-Level Meeting on AIDS, being held in New York and online next week, and to commit to achieving a new set of targets for 2025 to end AIDS by 2030

NEW YORK/GENEVA, 3 June 2021—Four decades after the first cases of AIDS were reported, new data from UNAIDS show that dozens of countries achieved or exceed the 2020 targets set by the United Nations General Assembly in 2016—evidence that the targets were not just aspirational but achievable.

The report shows that countries with progressive laws and policies and strong and inclusive health systems have had the best outcomes against HIV. In those countries, people living with and affected by HIV are more likely to have access to effective HIV services, including HIV testing, pre-exposure prophylaxis (medicine to prevent HIV), harm reduction, multimonth supplies of HIV treatment and consistent, quality follow-up and care.

“High-performing countries have provided paths for others to follow,” said Winnie Byanyima, the Executive Director of UNAIDS. “Their adequate funding, genuine community engagement, rights-based and multisectoral approaches and the use of scientific evidence to guide focused strategies have reversed their epidemics and saved lives. These elements are invaluable for pandemic preparedness and responses against HIV, COVID-19 and many other diseases.”  

Globally, the report shows that the number of people on treatment has more than tripled since 2010. In 2020, 27.4 million of the 37.6 million people living with HIV were on treatment, up from just 7.8 million in 2010. The roll-out of affordable, quality treatment is estimated to have averted 16.2 million deaths since 2001.

Deaths have fallen in large part due to the roll-out of antiretroviral therapy. AIDS-related deaths have fallen by 43% since 2010, to 690 000 in 2020. Progress in reducing new HIV infections has also been made, but has been markedly slower—a 30% reduction since 2010, with 1.5 million people newly infected with the virus in 2020 compared to 2.1 million in 2010.

The report underscores that countries with punitive laws and that do not take a rights-based approach to health punish, ignore, stigmatize and leave key populations—which make up 62% of new HIV infections worldwide—on the margins and out of reach of HIV services. For example, almost 70 countries worldwide criminalize same-sex sexual relationships. Gay men and other men who have sex with men, sex workers, transgender people, people in prison and people who inject drugs are left with little or no access to health or social services, allowing HIV to spread among the most vulnerable in society.

Young women in sub-Saharan Africa also continue to be left behind. Six out of seven new HIV infections among adolescents aged 15–19 years in the region are among girls. AIDS-related illnesses remain the leading cause of death among women aged 15–49 years in sub-Saharan Africa.

COVID-19 has shown the fragility of the health and development gains made over the past decades and has exposed glaring inequalities. To get the world on track to end AIDS by 2030, the global AIDS community and UNAIDS have used an inequalities lens to develop an ambitious and achievable strategy with new targets to reach by 2025. Ending inequalities requires HIV responses that can reach the populations currently being left behind.

If reached, the targets will bring HIV services to 95% of the people who need them, reduce annual HIV infections to fewer than 370 000 and AIDS-related deaths to fewer than 250 000 by 2025. This will require an investment of US$ 29 billion a year by 2025. Each additional US$ 1 of investment in implementing the global AIDS strategy will bring a return of more than US$ 7 in health benefits.

UNAIDS urges the United Nations General Assembly to commit to the targets in a new political declaration on HIV at the fifth United Nations General Assembly High-Level Meeting on AIDS, taking place from 8 to 10 June 2021.

“The world cannot afford to underinvest in pandemic preparedness and responses,” said Ms Byanyima. “I strongly urge the United Nations General Assembly to seize the moment and commit to taking the actions needed to end AIDS.”

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 30 April 2021—Norman Fowler, the pioneering United Kingdom Secretary of State for Health, human rights campaigner and respected Lords Speaker, will champion law reform, health for all and girls’ education worldwide to help end HIV as an ambassador for UNAIDS. 

Lord Fowler, who steps down as Lord Speaker at the end of April, will take up his new role as an advocate on AIDS in May 2021. 

In his new role, he will focus on engaging leaders across the world in advancing three transformational shifts that are central to ending AIDS: ending punitive laws against and stigmatization of lesbian, gay, bisexual, transgender and intersex (LGBTI) people; ensuring universal access to health care; and ensuring the empowerment and education of all girls so that they finish secondary school and benefit from a dramatically reduced risk of acquiring HIV. 

Lord Fowler served as the United Kingdom’s Secretary of State for Health from the beginning of the HIV epidemic. He has decades of service at the highest levels of government and has been a champion for people affected by HIV and for the human rights of LGBTI people. 

The UNAIDS Executive Director, Winnie Byanyima, said, “We can beat AIDS, but only through bold action by leaders. Lord Fowler is respected as a great parliamentarian and courageous leader across the world. He has delivered bold change to fight AIDS, and can help other leaders to do the same. We are so grateful to Lord Fowler for supporting us in this way.” 

Lord Fowler said, “As I said when I announced that I was stepping down as Lord Speaker, I am not retiring, only resigning. I am determined to see the end of AIDS, and to see the end of the inequalities that stand in the way of the end of AIDS. We have come so far but this last mile is the most challenging one. The COVID-19 crisis is not a reason to step back but a reason to step up and beat AIDS.”

This is a key year for the HIV response, which marks the fortieth anniversary of the discovery of HIV. This year will also see the United Nations High-Level Meeting on AIDS, at which leaders will set out the steps they will take to achieve the end of AIDS by 2030.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Forty years since the first AIDS cases were reported and just weeks before the United Nations General Assembly High-Level Meeting on AIDS, the United Nations Secretary-General has released a new report with recommendations and targets to get the world back on track to end AIDS

NEW YORK, 30 April 2021—The United Nations Secretary-General, António Guterres, has warned that despite intensive action and progress made against HIV in some places and population groups, HIV epidemics continue to expand in others and issued a set of 10 key recommendations.* If followed by all countries, this will end the AIDS pandemic as a public health threat by 2030 as part of the Sustainable Development Goals. In a new report, Addressing inequalities and getting back on track to end AIDS by 2030, the United Nations Secretary-General urges the world to address the inequalities that are slowing progress. 

“It is imperative to break out of an increasingly costly and unsustainable cycle of achieving some progress against HIV but ultimately not enough to bring about an end to the pandemic,” said Mr Guterres in the report. “Inequalities are the key reason why the 2020 global targets were missed. By ending inequalities, transformative outcomes can be achieved for people living with HIV, communities and countries.”

The global targets set out in the General Assembly’s 2016 Political Declaration on Ending AIDS were missed by a long way, allowing the AIDS pandemic to grow in many regions and countries. The staggering 1.7 million new HIV infections that occurred in 2019 are more than three times higher than the 2020 target of less than 500 000 new infections. In addition, the 690 000 AIDS-related deaths in 2019 far exceed the 2020 target of reducing deaths to fewer than 500 000 a year.

“Ending AIDS as a public health threat by 2030 is still within reach—many countries are showing that rapid progress against HIV is possible when evidence-informed strategies and human rights-based approaches are adopted,” said UNAIDS Executive Director Winnie Byanyima. “But it requires bold political leadership to challenge and address the social injustices and inequalities that continue to make certain groups of people and entire communities highly vulnerable to HIV infection.”

The report notes that COVID-19 has caused additional setbacks. The United Nations Secretary-General warned that COVID-19 is not an excuse for missing AIDS targets, but rather a stark warning to the countries that they can no longer afford to underinvest in pandemic preparedness and responses.

At the same time, the COVID-19 pandemic has underscored the many spill-over benefits of HIV investments in health and development. Community-led service delivery pioneered by the HIV response is helping to overcome the extraordinary impediments created by COVID-19.

The set of 10 recommendations to get the world back on track include: addressing inequalities and reaching all people living with or at risk of HIV infection to reduce the annual new HIV infections to under 370 000 and annual AIDS-related deaths to under 250 000 by 2025; prioritizing HIV prevention to ensure that 95% of people at risk of HIV infection have access to effective HIV prevention options by 2025; and eliminating new HIV infections among children.

The report underscores that addressing social and structural factors that perpetuate inequalities is key. It highlights, for example, how gender inequality, underpinned by harmful gender norms, restricts women’s use of HIV and sexual and reproductive health services by perpetuating gender-based violence and limiting decision-making power, including the ability of women and girls to refuse unwanted sex, negotiate safer sex and mitigate HIV risk.

It also shows how vulnerable, marginalized and criminalized communities, such as gay men and other men who have sex with men, people who use drugs, sex workers, transgender people, prisoners and migrants, also remain at higher risk of HIV infection than the general population because they are not receiving essential information and HIV treatment, prevention and care services.

The United Nations Secretary-General describes how communities of people living with, at risk of and affected by HIV are the backbone of the HIV response. Initiatives led by people living with HIV, women, key populations, young people and other affected communities have identified and addressed key inequalities and service gaps, advocated for the rights of their constituents and expanded the reach, scale and quality of health services.

In the report, Mr Guterres applauds UNAIDS’ recently adopted Global AIDS Strategy 2021–2026: End Inequalities, End AIDS. “The lessons from the countries, cities and communities that successfully fast-tracked their HIV responses over the last five years are at the heart of the UNAIDS Global AIDS Strategy 2021–2026,” said Mr Guterres. “The global AIDS community and UNAIDS have used an inequalities lens to develop the strategy, with new targets that are ambitious, granular and tailored to reach the furthest behind first.”

The report comes 25 years after the creation of UNAIDS and describes how COVID-19 has exposed social inequalities and health system weaknesses. The United Nations Secretary-General says that the world should leverage the experience from responding to the AIDS pandemic to strengthen health systems across the world and improve pandemic preparedness. He also calls for enhanced global solidarity to close the HIV resource gap and increase annual HIV investments in low- and middle-income countries to US$ 29 billion by 2025. 

*The 10 recommendations in the United Nations Secretary-General’s report:

1.      Reduce and end the acute and intersecting inequalities that are obstructing progress to end AIDS.
2.      Prioritize HIV prevention and ensure that 95% of people at risk of HIV infection have access to and use appropriate, prioritized, person-centred and effective combination prevention options by 2025.
3.      Close gaps in HIV testing, treatment and viral suppression that are limiting the impact of HIV responses and achieve by 2025 the 95–95–95 testing and treatment targets within all subpopulations, age groups and geographic settings, including children living with HIV.
4.      Eliminate vertical HIV transmission and end paediatric AIDS.
5.      Put gender equality and the human rights of women and girls in all their diversity at the forefront of efforts to mitigate the risk and impact of HIV.
6.      Implement the GIPA (Greater Involvement of People Living with HIV/AIDS) principle and empower communities of people living with HIV, women, adolescents and young people and key populations to play their critical HIV response roles.
7.      Respect, protect and fulfil the human rights of people living with, at risk of and affected by HIV and ensure by 2025 that less than 10% of people living with HIV and key populations experience stigma and discrimination.
8.      Enhance global solidarity to close the HIV response resource gap and increase annual HIV investments in low- and middle-income countries to US$29 billion by 2025.
9.      Accelerate progress towards universal health coverage and strong primary health care systems, build forward better and fairer from COVID-19 and humanitarian crises, and strengthen global health security and future pandemic preparedness.
10.  Leverage the 25 years of experience, expertise and mandate of the Joint United Nations Programme on HIV/AIDS (UNAIDS) in building multisectoral, multi-stakeholder and rights-based collaborative action to end AIDS and deliver health for all as global public good.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.