A new report from UNAIDS, issued to coincide with the International AIDS Conference in Amsterdam (23-27 July), states that three in five people living with HIV now have access to the drugs they need – a marked contrast to when the epidemic first took hold.
However, UNAIDS warned at a press conference yesterday that the global response to HIV is at a precarious point. At the halfway point to the 2020 targets, the report Miles to go – closing gaps, breaking barriers, righting injustices, warns that the pace of progress is not matching global ambition. It calls for immediate action to put the world on course to reach critical 2020 targets.
The report further states that due to the impact of antiretroviral therapy roll-out, the number of AIDS-related deaths is the lowest this century (940,000), having dropped below one million for the first time in 2016. Yet, the current pace of decline is not fast enough to reach the 2020 target of fewer than 500,000 AIDS-related deaths.
In just one year, an additional 2.3 million people were newly accessing treatment. This is the largest annual increase to date, bringing the total number of people on treatment to 21.7 million. Almost 60 percent of the 36.9 million people living with HIV were on treatment in 2017, an important achievement, but to reach the 30 million target there needs to be an annual increase of 2.8 million people, and there are indications that the rate of scale-up is slowing down.
To meet the challenges we face, The Union advocates for an integrated approach, recognising the impossibility of winning the battle against HIV if we do not also fight TB. The Union has developed an integrated model of care – people who come for treatment for one disease, are also screened and tested for the other. Treatment and/or preventative measures can then be provided.
In Myanmar this approach has resulted in 2017 in 29,562 people receiving ART through The Union’s Integrated HIV Care (IHC) Programme. The Union began to treat people co-infected with TB-HIV in Myanmar and 2005, the year that Myanmar’s HIV epidemic was recognised as one of the most serious in Asia. This became the IHC Programme treating 190 people in 2005 but growing to now be a key component of Myanmar’s national HIV strategy. In 2017, an average of 394 patients per month were enrolled in the IHC programme.
The Union’s integrated, patient-centred approach can also be seen to be effective in Zimbabwe where the Ministry of Health has adopted our TB-HIV care model. The number of TB-HIV patients on antiretroviral therapy (ART) increased to 93 percent in 2017, up from 74 percent in 2013.
The report signifies an important achievement by the global health community. Access – or the lack of – to appropriate drugs, preventative treatments and care, is one of the critical public health issues of our time. But there is still much work to do in order to ensure that HIV targets for 2020 are met, let alone exceeded. When the pace of progress is not matching targets, it is clearly time for urgent action.