Urgent action is needed as global crises undermine the HIV/AIDS response

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In its annual report, UNAIDS said urgent action was needed to get the fight against HIV/AIDS back on track after it was derailed by “overlapping crises”, leaving up to 4,000 people with new HIV infections every day.

“The data we are sharing today brings painful but important news,” UNAIDS Executive Director Winnie Byanyima said at a press briefing.

UNAIDS.

Byanyima said the response was pushed back by the collisions of the HIV and COVID-19 pandemics, the war in Ukraine and the resulting economic crises.

“Progress has been halted, inequalities have widened and millions of lives are at risk,” she added.

Key findings

New UNAIDS figures released as part of the International AIDS Conference show that progress in the fight against HIV has slowed, with the number of new infections falling by just 3.6% between 2020 and 2021. This is the most -the smallest annual decline since 2016, Byanyima said.

A total of 38.4 million people were living with HIV globally in 2021—36.7 million adults aged 15 or older and 1.7 million children—of whom 85% knew their status, leaving an estimated 5.9 million who did not know they were living with HIV.

There were 1.5 million new HIV infections, roughly 4,000 a day and 1 million more than the UNAIDS target of 500,000.

By the end of 2021, most people with HIV (75%) had access to treatment, including 76% of people aged 15 or older and 52% of children. However, in 2021 there were 650,000 AIDS-related deaths.

“Last year, in 2021, we lost one person every minute to an AIDS-related illness, even though we have the drugs needed to save those lives,” Byanyima said.

“Let me be clear, this report is not a call for despair; it’s a call to action,” she added. “This report shows us how to have an effective response – by tackling inequalities head on.”

Disproportionate burden

The report highlights the disparity in the burden of HIV among people aged 15 to 24 – particularly young women.

According to the report, a new infection occurs in a teenage girl or young woman every 2 minutes. In sub-Saharan Africa, teenage girls and young women account for 63% of all new cases.

“This is an area where we need to redouble our efforts and do more,” said Keren Dunaway, gender equality officer at the International Community of Women Living with HIV.

Similarly, in 2021, other key population groups, including sex workers, men who have sex with men, people who inject drugs and transgender women, account for a large number of new HIV infections — 70%. These populations face a 30-, 28-, 35-, and 14-fold increased risk of HIV infection, respectively.

Financing the fight

A crucial element in combating these obstacles is funding. However, the report showed that available HIV resources in low- and middle-income countries have declined, leaving their HIV responses $8 billion short of the amount needed by 2025.

According to the report, overseas HIV development aid from donors – excluding the US – has fallen by 57% over the past decade. Unlike what was seen in previous years, domestic HIV investment is not replacing lost international funding. In fact, the report showed that domestic financing in low- and middle-income countries has fallen for 2 consecutive years, including by 2% in 2021. Low- and middle-income countries will need about $29 billion to bounce back on track in 2025 to end AIDS as a global health threat.

“It is still possible for leaders to put the answer back on track to end AIDS by 2030,” Byanyima said. “Ending AIDS will cost a lot less money than not ending AIDS.”

Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, who also participated in the press conference, said the report served as a reminder that HIV continues to “run rampant” even as attention turns to COVID-19 and monkeypox.

Anthony S. Fauci

“There has definitely been a backsliding in the response to HIV,” he said, adding that this has been seen in many countries, including the U.S.

“Together, we must redouble our efforts to implement existing treatments and prevention strategies, strive for better ones to reach vulnerable communities, and renew our commitment to equity, education and outreach,” he said. “We can do better.”

References:

UNAIDS. Global HIV and AIDS Statistics – Fact Sheet. Published July 27, 2022. Accessed July 27, 2022.

UNAIDS Global AIDS Update 2022. Published 27 July 2022. Accessed 27 July 2022.

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