UNAIDS Gap Report: Need Smarter Scale-Up, Focus On People Left Behind

According to a report released today by the United Nations programme on HIV and AIDS (UNAIDS), around 19 million of the 35 million people living with HIV do not know that they have the virus. But if the right steps are taken, the epidemic could be ended by 2030, it says.

The UNAIDS Gap Report was launched today in Geneva with the aim to provide best possible data but also to give information and analysis on the people being left behind, UNAIDS Executive Director Michel Sidibé says in the report.

The UNAIDS report comes on the eve of the 20th international AIDS conference to be held next week in Melbourne, Australia.

What is done over next five years will determine the next fifteen, and if done right, the epidemic could be over by then, Sidibé said.

“If we are smart and scale-up by 2020, we will be on track to end the epidemic by 2030, so that AIDS is no longer a public health threat” Sidibé said during a press briefing at the launch. “The world has to commit to new targets: reducing new HIV infections by 90 percent, reducing discrimination by 90 percent and reducing AIDS related deaths by 90 percent.”

The report details progress in the fight against HIV. It cites a decrease in new HIV infections in 2013 (2.1 million people infected), while new HIV infections among children dropped below 200,000 in the 21 most affected countries in Africa, and an overall decrease was seen in AIDS-related deaths. Furthermore, there were 12.9 million people receiving antiretroviral therapy globally at the end of 2013.

The report mentions intellectual property rights in the context of research and innovation efforts to find a cure or a vaccine.

“As vaccine, cure or new treatment and prevention options emerge, issues related to intellectual property, prices or human resource capacity must not inhibit access,” it states.

But the report also analyses current gaps. For instance, it notes that some 19 million people living with HIV do not even know they have the virus.

“Whether you live or die should not depend on access to an HIV test,” Sidibé said in the press release.

Fifteen countries account for 75 percent of new HIV contamination, the report states. Entire countries are being left behind, as they face a triple threat: high HIV burden, low treatment coverage, and little or no decline in new HIV infections, according to press release.

Focus on populations that are underserved and at higher risk of HIV will be key to ending the AIDS epidemic, the press release states. The report contains chapters related to twelve populations considered to be left behind.

It also underlines that there is still stigma and discrimination against people living with HIV, including “punitive legal environments, barriers to civil society engagement and lack of investment in tailored programmes,” according to the press release. “There is no space in the world for discrimination and unfair criminalisation, everyone deserves equal access to quality HIV services,” Sidibé told the press briefing.

It is important to ensure the approach is not just globalised, but tailored, Sidibé said. Countries and regions have multiple and varying epidemics, so cities and communities will play an increasing role in effective scale-up, the press release states.

Another challenge in coming year will be to push on research and innovation. Sidibé emphasised gaps remaining notably on care for children, as less than 22 percent of them are covered. Moreover, treatments for children are not well adapted, having a bad taste and a high percentage of alcohol.

Médecins Sans Frontières (MSF, Doctors without Borders) said in its response to the launch: “Providing life-saving HIV treatment to nearly 12 million people in the developing world is a significant achievement, but more than half of people in need still do not have access.”