To reduce new HIV infections globally to fewer than 500 000 by 2020, a step towards ending the HIV epidemic as a public health threat by 2030, we need to Fast-Track the response, including renewed commitment to, sustained funding for and scaled-up implementation of HIV prevention programmes.

Evidence supports the need for a shift in the global approach to drug use. In this report, Do no harm: health, human rights and people who use drugs, UNAIDS shows what works to reduce the impact of HIV and other harms related to drug use. Countries that have moved away from laws and policies that are harmful to people who use drugs and that have increased investment in harm reduction have reduced new HIV infections and improved health outcomes. These policies also deliver broader social benefits, such as lower levels of drug-related crime and reduced pressure on health-care and criminal justice systems.

The world has pledged within the Sustainable Development Goals to end the AIDS epidemic as a public health threat by 2030. Such an extraordinary achievement will require an extraordinary and urgent effort—fully funding and front-loading investment in comprehensive HIV responses and intensifying the focus on the populations and locations in greatest need. The UNAIDS 2016–2021 Strategy elaborates this Fast-Track approach. Adopted by the UNAIDS Programme Coordinating Board in October 2015, the Strategy contains HIV service coverage targets that need to be achieved by 2020 to establish the momentum necessary to overcome one of the largest public health threats in human history by 2030.

This is the fourth annual report of the Global Plan, and it summarizes the progress made through December 2014. The final accountability report of the Global Plan will be issued in 2016 when data for the end of 2015 will be available. The Global Plan was developed during 2010 by a Global Task Team (GTT) co-chaired by UNAIDS and the Government of the United States. The GTT consisted of a consortium of stakeholders from 25 countries and 30 civil society groups, private sector partners, networks of people living with HIV and international organizations. The Global Plan was launched as a major new global initiative in 2011, but it uses 2009 as the baseline year against which to measure progress.

Ending AIDS by 2030 is an integral part of the Sustainable Development Goals, which United Nations Member States adopted unanimously in 2015. The lessons learned in responding to HIV will play an instrumental role in the success in achieving many of the Sustainable Development Goals, notably Sustainable Development Goal 3, good health and well-being, and the goals on gender equality and women’s empowerment, reduced inequalities, global partnerships and just, peaceful and inclusive societies.

Implementing PrEP poses new challenges in planning, managing and funding combination prevention. Realizing the promise of PrEP will require governments, funders, civil society and other stakeholders to join forces to systematically address them–licensing antiretroviral medicines for PrEP use, setting priorities for locations and populations for implementation, making services user-friendly and ensuring adherence. These efforts are worthwhile based on their contribution to achieving the global targets of less than 500 000 people annually acquiring HIV in 2020 and the end of AIDS as a public health threat by 2030.

To end the AIDS epidemic by 2030, specific—yet flexible—strategies are needed for different age groups, populations and geographical locations. Ending the epidemic among adolescents requires amplifying investments where they can make the most difference and fostering innovation by adolescents and youth themselves, as well as governments, international organizations, civil society and the private sector.

Achieving the Fast-Track milestones by 2020 will put the world on a trajectory to end the AIDS epidemic by 2030. The gains will be massive. UNAIDS calculations show that reaching the 2020 milestones will produce multiple major benefits compared to maintaining the current approach.