In a new report, UNAIDS shows that there is a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals (SDG).
The report, ‘The Path that Ends AIDS’, contains data and case studies which highlight that ending AIDS is a political and financial choice, and that the countries and leaders who are already following the path are achieving extraordinary results.
Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the “95-95-95” targets. That means 95% of the people who are living with HIV are aware of their HIV status, 95% of those who know their status are on lifesaving antiretroviral treatment, and 95% of people on treatment have a suppressed viral load.
A further 16 countries are also close to reaching the targets including Cambodia and Thailand, from Asia and the Pacific, which have achieved 86->98-98 and 90-90-97, respectively.
“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders,” said Winnie Byanyima, Executive Director of UNAIDS. “They could be remembered by future generations as those who put a stop to the world’s deadliest pandemic. They could save millions of lives and protect the health of everyone. They could show what leadership can do.”
HIV responses succeed when they are anchored in strong political leadership. This means following the data, science, and evidence; tackling the inequalities holding back progress; enabling communities and civil society organizations in their vital role in the response; and ensuring equitable and sustainable funding.
The number of people on antiretroviral treatment worldwide rose almost fourfold, from 7.7 million in 2010 to 29.8 million in 2022. However, the report also sets out that AIDS claimed a life every minute in 2022. Around 9.2 million people still miss out on treatment, including 660 000 children living with HIV.
Asia and the Pacific situation
In 2022 there were an estimated six million, five hundred thousand (6 500 000) people living with HIV in the Asia Pacific region. Among all UNAIDS regions this is the second highest number of people living with HIV. There were an estimated 300 000 new infections and 150 000 AIDS-related deaths last year.
In 2022, 78% of people living with HIV in Asia Pacific knew their status. Almost two-thirds (65%) of all people living with HIV were on antiretroviral treatment and 62% of all people living with HIV had a suppressed viral load. The region did not experience an increase in treatment coverage since 2021 and lags behind the global treatment average of 76%. Key priorities for many countries are increasing the number of people living with HIV who know their status; ensuring early treatment initiation; and retaining people on treatment to achieve viral suppression and undetectable viral load. When people on antiretroviral therapy achieve an undetectable viral load, they are unable to transmit the virus. This concept is known as Undetectable=Untransmittable or U=U.
The HIV epidemic in Asia and the Pacific disproportionately affects people from key populations and their sexual partners. Compared to the general population, median HIV prevalence in the region is 25 times higher for men who have sex with men, 20 times higher for people who inject drugs and transgender people and five times higher for people in prisons and sex workers.
Between 2010 and 2022 new HIV infections in the region declined by 14%. Altogether, the Asia Pacific region accounted for almost one quarter (23%) of new HIV infections globally last year. There are significant variations between nations. While the new HIV infections are declining in several Asia Pacific countries, there are rebounds in others, namely Afghanistan, Bangladesh, Fiji, Papua New Guinea and the Philippines. Another challenge for the region is that 26% of new infections are among young key populations between ages 15 and 24.
According to the report, this slow progress is due primarily to a lack of full-scale HIV prevention services tailored to the needs of key populations and the barriers posed by punitive laws, stigma and discrimination.
“To end the AIDS epidemic, we must significantly slow the stream of new infections. If we do not take decisive action, we are at risk of seeing a reversal of prevention gains,” said UNAIDS Asia Pacific Regional Director, Eamonn Murphy.
Key priorities for the AIDS response in Asia and the Pacific include modernizing and scaling up HIV prevention, testing, treatment and care services; leveraging innovative solutions such as pre-exposure prophylaxis (PrEP) and virtual interventions; removing barriers to access services; prioritizing key populations; pursuing equitable and sustainable HIV financing; implementing legal and policy reforms to create a more enabling environment, reducing stigma and discrimination and empowering community leadership.
“Our governments made a commitment through the 2021 Political Declaration on HIV and AIDS to prioritize community leadership,” said Harry Prabowo, Programme Manager of the Asia Pacific Network of People Living with HIV. “It’s time to translate these promises into action. Not just in a few countries… everywhere!”