HIV remains a major global public health issue, having claimed 40.4 million lives so far with ongoing transmission in all countries globally, with some countries reporting increasing trends in new infections when previously on the decline.
UNAIDS/WHO estimates in 2023 that approximately 39.0 million people will be living with HIV at the end of 2022, two-thirds of whom (25.6 million) are in the African region. Also, in 2022, 630,000 died from HIV-related causes and 1.3 million people acquired HIV.
There is no cure for HIV infection. However, with access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable health condition, enabling people living with HIV to lead long and healthy lives.
The world can end AIDS, with communities leading the way. Organisations of communities living with, at risk of, or affected by HIV are the frontline of progress in the HIV response.
Communities connect people with person-centred public health services, build trust, innovate, monitor the implementation of policies and services, and hold providers accountable.
But communities are being held back in their leadership. Funding shortages, policy and regulatory hurdles, capacity constraints, and crackdowns on civil society and the human rights of marginalised communities, are obstructing the progress of HIV prevention and treatment services. If these obstacles are removed, community-led organisations can add even greater impetus to the global HIV response, advancing progress towards the end of AIDS.
This World AIDS Day is more than a celebration of the achievements of communities; it is a call to action to enable and support communities in their leadership roles.
Communities’ leadership roles need to be made core in all HIV plans and programmes and their formulation, budgeting, implementation, monitoring and evaluation, because, as the catchphrase goes, “Nothing about us without us.”
Let communities lead
Communities’ leadership roles need to be fully and reliably funded to enable the required scale up, and be properly supported and remunerated, which means, “Not ending AIDS is more expensive than ending it.”
Barriers to communities’ leadership roles need to be removed. An enabling regulatory environment is needed which facilitates communities’ role in the provision of HIV services, ensures civil society space, and protects the human rights of all, including marginalised communities, to advance the global HIV response. We therefore have to “Remove laws that harm, create laws that empower.”
Communities are leading World AIDS Day, and across the world are shaping the events and tailoring the detailed calls to their specific needs.
According to the Global Data, by 2025, 95 per cent of all people living with HIV (PLHIV) should have a diagnosis; 95 per cent of those should be taking lifesaving antiretroviral treatment (ART) and 95 per cent of PLHIV of treatments should achieve a suppressed viral load for the benefit of the person’s health and for reducing onward HIV transmission. In 2022, these percentages were 86, 89, and 93 respectively.
When considering all people living with HIV, 86 per cent knew their status, 76 per cent were receiving antiretroviral therapy and 71 per cent has suppressed viral loads.
“The end of AIDS is possible; it is within our grasp,” says UNAIDS Executive Director Winnie Byanyima, “To follow the path that ends AIDS, the world needs to let communities lead.”
