Innovation, Equity, and Partnership: The Path to Ending the HIV/AIDS Epidemic

The fight against HIV/AIDS has been a long and arduous journey, spanning several decades and affecting millions of lives worldwide. Since the 1980s, approximately 86 million people have been infected with HIV, a virus that once seemed insurmountable. Over the years, biomedical innovations have transformed HIV from a death sentence into a manageable condition for many. However, despite these advancements, the epidemic persists as a significant public health challenge. Dr. Jared Baeten from Gilead Sciences emphasizes the need to go beyond a purely biomedical approach to end the HIV epidemic. He argues that integrating social determinants of health into the collective response is crucial to achieving the United Nations’ goal of ending the epidemic by 2030.

One of the most pressing issues in the fight against HIV/AIDS is the need for person-centered research and development. This involves collaborating with diverse and inclusive communities to ensure that the solutions developed are effective and accessible to all. A new report titled “Going the Extra Mile to End the HIV Epidemic” provides a framework for individual countries to take actionable steps toward the UN’s 2030 goals. This report highlights the importance of multiple strategies to overcome HIV, emphasizing that bringing treatment to all who need it is essential. While science has made significant progress in developing effective HIV treatments, not everyone is achieving long-term treatment success. Closing the HIV treatment gap must be a top global priority to eradicate the virus.

The landscape of HIV treatment is evolving as people with HIV are living longer and healthier lives. However, this progress has led to the emergence of drug resistance, complicating the treatment landscape. Different individuals have varying day-to-day treatment needs and preferences, making a one-size-fits-all approach ineffective. Person-centered innovations are necessary to address the complexities of HIV care and offer options for all those living with HIV. To achieve successful long-term health outcomes, a holistic approach to care is needed. This includes addressing systemic discrimination based on race, gender, class, and sexuality, which is crucial to ending the HIV epidemic.

Community partnerships and collaboration are indispensable in achieving health equity and reducing disparities in HIV care. Organizations like Gilead Sciences are dedicated to addressing the diverse needs of individuals and communities affected by HIV through research, innovation, and collaboration on a global, national, and local level. These efforts are critical in ensuring that the progress made in HIV treatment reaches all corners of the world. Statista, a leading provider of market and consumer data, has recognized the strides made in HIV treatment through its exclusive rankings and top lists. Their charts showcase the number of people globally who have HIV and are receiving antiretroviral treatment (ART), categorized by world region.

Despite the progress, the fight against HIV/AIDS is far from over. Over 40 million people globally were living with HIV in 2023, with over 9 million not receiving treatment. Every minute, someone dies from AIDS-related causes. Progress in ending the AIDS pandemic has slowed, funding is decreasing, and new infections are rising in specific regions. In 2023, around 630,000 people died from AIDS-related illnesses, a significant decrease from 2.1 million deaths in 2004. However, this figure is more than double the target of fewer than 250,000 deaths by 2025. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has released a report highlighting these challenges and urging world leaders to uphold their promise to end the AIDS pandemic by 2030.

Gender inequality puts girls and women at higher risk, especially in Africa. Approximately 55% of new HIV infections globally are among marginalized communities, such as sex workers and drug users. UNAIDS Executive Director Winnie Byanyima has called for urgent action to reduce new HIV infections to below 370,000 by 2025. In 2023, there were 1.3 million new infections, far exceeding this target. Out of 39.9 million people living with HIV globally, 86% knew they were infected, 77% were receiving treatment, and 72% had the virus suppressed. Innovations in HIV treatments, such as injectable options that last for six months, offer hope but are often accessible only to the wealthy due to high costs.

The disparity in access to life-saving treatments underscores the need for global leaders to prioritize health equity. Daily treatment with pills costs $75 per person per year, allowing many countries to increase the number of people receiving treatment for HIV. However, UNAIDS continues to advocate for a vaccine to prevent AIDS, which would be a game-changer in the fight against the epidemic. In Canada, political strategists are discussing former Bank of Canada Governor Mark Carney as a potential solution to the Liberal party’s poor polling numbers. Meanwhile, Nova Scotia is suspending the licensed Cape Breton moose hunt for three years due to a significant drop in the population, highlighting the interconnectedness of health, politics, and environmental issues.

For the first time, most new HIV infections are occurring outside sub-Saharan Africa. Infections in sub-Saharan Africa have decreased by 56% since 2010, while regions like Eastern Europe, Central Asia, Latin America, the Middle East, and North Africa have seen an increase in HIV infections. UNAIDS warns that the world is at a critical point in the fight against HIV. Backlash against human rights makes it difficult for marginalized groups to access care, and services are facing funding shortages due to cuts in aid and high levels of debt. Game-changing HIV drugs are currently only available in richer countries, creating a disparity in access that must be addressed to meet the global goal of ending AIDS by 2030.

Protecting human rights is crucial in the fight against HIV. Infections are most prevalent among marginalized groups such as people who inject drugs, sex workers, and LGBTQ+ individuals. Young women in sub-Saharan Africa are particularly vulnerable to HIV, and policies must be implemented to reduce inequalities. Access to antiretroviral drugs remains low in many regions, especially among children. Immediate action and new solutions, such as long-acting drugs and debt restructuring, are necessary to end the AIDS epidemic by 2030. The International AIDS Society is encouraged by data showing that managing epidemics can lead to lower HIV infections, even in poor countries, but emphasizes the need for continued commitment and innovation.

The Global Alliance for Ending AIDS in Children has released a report showing that more efforts are needed to reach their goal of ending AIDS by 2030. While some progress has been made in several countries, more action is necessary in those most affected by the pandemic. Uganda, the United Republic of Tanzania, and South Africa have achieved high coverage of antiretroviral therapy for pregnant and breastfeeding women. Other countries, such as Mozambique, Zambia, and Kenya, have also made progress, but there is still work to be done. UNAIDS’s Executive Director, Winnie Byanyima, commends the progress made in rolling out HIV services but emphasizes the need for further action.

Keeping babies HIV-free and ensuring that children living with HIV receive proper treatment is a moral obligation and a political choice. The death of a child from AIDS-related causes is not just a tragedy but also an injustice. The global alliance countries are addressing barriers and innovating to accelerate progress towards ending AIDS in children. However, both the world and the global alliance countries are currently not on track to reach their commitments for children and adolescents with HIV. The pace of progress in preventing new infections and deaths among children has slowed down in recent years, highlighting the urgent need for renewed efforts and resources.

The World Health Organization’s Director-General, Dr. Tedros Adhanom Ghebreyesus, believes that providing for children and adolescents with HIV is a moral obligation and political choice. While some countries have made strides in preventing mother-to-child transmission, more work needs to be done to close the treatment gap. The Global Fund provides funding for HIV programs in over 100 countries and is working with governments to scale up innovations in testing and treatment. UNICEF’s Associate Director for HIV/AIDS, Anurita Bains, stresses the importance of early and effective testing and treatment for children living with HIV, emphasizing that timely intervention can save lives and improve health outcomes.

In 2023, 210,000 young women and girls aged 15-24 were infected with HIV globally, with the majority being in global alliance countries. This is four times higher than the 2025 goal set by the alliance. Gender inequality and human rights violations put women at higher risk for HIV, with one in three women globally experiencing violence in their lifetime. The four global alliance countries with available data are not on track to meet their target of less than 10% of women experiencing gender-based violence by 2025. UN Ambassador John N. Nkengasong acknowledges the progress made but stresses the need for continued commitment and innovation to fulfill their promises. The Global Alliance for Ending AIDS in Children was launched in 2022 and includes UN agencies, civil society movements, national governments, and international partners. Twelve countries are members, and their collective efforts are crucial to achieving the goal of ending AIDS in children by 2030.