AIDS 2016

Call to scale up HIV prevention


21st International AIDS Conference (AIDS 2016), Durban, South Africa. Ending AIDS with the Voices of Youth. Panel discussion (L-R) Kgomotso Matsuanyane, Elton John, HRH Prince Harry, Loyce Maturu, Brian Ssensalire, Carlo Andre Oliveras Rodriguez.


While advances in HIV treatment science must be pursued with vigour, now is the time to urgently scale up quality HIV prevention programmes for people left behind by the AIDS response. This was one of the main messages of the 21st International AIDS Conference, which closed in Durban, South Africa, on 22 July 2016.

Throughout the conference, the prevailing sentiment was that much progress had been made since the AIDS 2000 conference, which was held for the first time on Africa soil in Durban fifteen years ago. “From Durban to Durban and beyond” resonated throughout the conference programme as a call to reject complacency and ensure that action is taken to pursue the Fast-Track targets in order to make Ending AIDS as a public health threat by 2030 a reality.

Nkosi Johnson, the 11-year-old boy who spoke powerfully during the opening ceremony of AIDS 2000 conference for the dignity and acceptance of all people living with HIV was at the forefront of delegates’ minds, who remembered his quiet bravery in the face of stigma and discrimination against people living with HIV, which still persists.

One of the main themes of the conference was the urgent action that is needed to reduce new HIV infections and AIDS deaths among adolescents, especially adolescent girls and young women in Africa, who remain disproportionately affected by HIV. Young people were encouraged to take a leading role in ensuring they are no longer left behind in policy or programmes. Key populations, especially sex workers, men who have sex with men and people who inject drugs, were also high on the agenda of both the scientific and community tracks of the conference, coupled with civil society activism on the sidelines of the conference to demand the recognition of their human rights.

 

Global study shows new HIV infection stagnating at 2.5 million a year

A major new analysis from the Global Burden of Disease 2015 (GBD 2015) study, published 19 July 2016 in The Lancet HIV journal, reveals that although deaths from HIV/AIDS have been steadily declining from a peak in 2005, 2.5 million people worldwide became newly infected with HIV in 2015, a number that hasn’t changed substantially in the past 10 years.

The new GBD estimates show a slow pace of decline in new HIV infections worldwide, with a drop of just 0.7% a year between 2005 and 2015 compared to the fall of 2.7% a year between 1997 and 2005. The study was launched at the International AIDS meeting in Durban, South Africa on 19 July. Improvements and updates in GBD’s data sources and methodology indicate that the number of people living with HIV has been increasing steadily from 27.96 million in 2000 to 38.8 million in 2015. Annual deaths from HIV/AIDS have been declining at a steady pace from a peak of 1.8 million in 2005, to 1.2 million in 2015, partly due to the scale-up of antiretroviral therapy (ART). Furthermore, the proportion of people living with HIV on ART increased rapidly between 2005 and 2015, from 6.4% to 38.6% for men, and from 3.3% to 42.4% for women (figure 1D). Yet, most countries are still far from achieving the UNAIDS 90-90- 90 target of 81% by 2020. While the annual number of new infections has decreased since its peak at 3.3 million per year in 1997, it has stayed relatively constant at around an estimated 2.5 million a year worldwide for the past decade. “Although scale-up of antiretroviral therapy and measures to prevent mother-to-child transmission have had a huge impact on saving lives, our new findings present a worrying picture of slow progress in reducing new HIV infections over the past 10 years”, says lead author Dr Haidong Wang from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle, USA. “Development assistance for HIV/ AIDS is stagnating and health resources in many low-income countries are expected to plateau over the next 15 years. Therefore, a massive scale-up of efforts from governments and international agencies will be required to meet the estimated $36 billion needed every year to realise the goal of ending AIDS by 2030, along with better detection and treatment programmes and improving the affordability of antiretroviral drugs”, says the Director of IHME, Professor Christopher Murray. The findings come from a comprehensive new analysis of HIV incidence, prevalence, deaths and coverage of antiretroviral therapy (ART) at the global, regional, and national level for 195 countries between 1980 and 2015. The study was funded by the Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health, USA.

 

Start Free, Stay Free, AIDS Free

At the 21st International AIDS Conference in Durban, South Africa, stakeholders came together to forge ahead on the Start Free, Stay Free, AIDS Free initiative, which was launched at the United Nations General Assembly High- Level Meeting on Ending AIDS in June 2016. The initiative is designed as a followup to the remarkable success achieved by the ‘Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive’.

In a session entitled “Start Free, Stay Free, AIDS Free: finishing the job of the Global Plan,” stakeholders reviewed the progress made towards eliminating new HIV infections among children, as well as how to super Fast-Track access to paediatric treatment for mothers and children. The session was organized by a consortium comprising UNAIDS, the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO).

The Start Free, Stay Free, AIDS Free framework provides a menu of policy and programmatic actions designed to enable countries and partners to close the remaining HIV prevention and treatment gap for children, adolescents, young women and expectant mothers. Stakeholders discussed how to build a concerted and coordinated country-led action that is backed by global support, so that countries can move quickly forward. The framework recognizes that every country needs a tailor-made acceleration and implementation plan. Each plan should respond to the country context, building on successful strategies for systems strengthening and identifying critical opportunities and actions that can expand access to life-saving HIV treatment and prevention services for all children, adolescents and young women as quickly as possible.

Participants at the session discussed the need to ensure that children are at the centre of an AIDS-free generation and examined the major barriers, gaps and opportunities to achieving this goal. The session also discussed the role of public– private partnerships and women living with HIV.

The Start Free, Stay Free, AIDS Free framework establishes three blocks of programme activity that are closely interrelated and should move forwards together. The participants discussed how to ensure that the response takes into account the reality and variability of country, government and partner priorities, and how to create an implementation environment that optimizes partnerships. They discussed the role of accountability and measurement and mechanisms to ensure that countries get timely responses and support.

To support implementation, the framework also calls on industry, civil society and international partners to focus on investing in and finding new, efficient and cost-effective solutions that simplify and innovate to maximize programme outcomes.

 


Political Declaration to end AIDS

In June 2016, United Nations Member States committed to implementing a bold agenda to end the AIDS epidemic by 2030 during the United Nations General Assembly High-Level Meeting on Ending AIDS. The progressive, new and actionable Political Declaration <http://tinyurl.com/zwdj8j6> includes a set of specific, time-bound targets and actions that must be achieved by 2020 to get on the Fast-Track and end the AIDS epidemic by 2030 within the framework of the Sustainable Development Goals.

During the 21st International AIDS Conference, taking place in Durban, South Africa, participants at a session entitled “From commitments to actions: implications of the 2016 United Nations High-Level Meeting on Ending AIDS,” discussed the implications of the Political Declaration, with a focus on implementation and accountability. The need to Fast-Track the AIDS response by breaking the silos and engaging with all sectors and coalitions in a whole-of-government approach in order to achieve the goals and targets of the Political Declaration and the Sustainable Development Goals was highlighted. The participants reiterated the call for a fully funded AIDS response that was made throughout the conference, including full funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria.

 

AIDS facts for Middle East and North Africa

  • In 2014, there were 230,000 people living with HIV in the Middle East and North Africa.
  • In 2015, there were an estimated 21,000 new HIV infections in the region.
    – New HIV infections rose by 4% between 2010 and 2015.
    – Worldwide new HIV infections have fallen by 6% since 2010.
  • In the Middle East and North Africa, 12,000 people died of AIDS-related causes in 2015.
    – Between 2010 and 2015, the number of AIDSrelated deaths in the region increased by 22%.
  • Treatment coverage in 2015 was 17% among people living with HIV in the Middle East and North Africa.
  • There were 2100 new HIV infections among children in the Middle East and North Africa in 2015.
    – Worldwide new HIV infections among children have declined by 50% since 2010.

 

 
Date of upload: 15th Sep 2016

                                  
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