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The international battle to combat HIV/AIDS

As progress stalls, urgent action is needed to scale up the response and end AIDS epidemic by 2030

The most vulnerable groups and communities with the highest risk of HIV infections are being left behind as the world struggles to contain the AIDS epidemic. Globally, new HIV infections have declined by only 18% since 2010, which is far below the 75% reduction needed by 2020 – which would signal the world is on track to end AIDS epidemic by 2030.

Ahead of the 22nd International AIDS Conference, starting next week in Amsterdam, UNAIDS published the 2018 Global AIDS update report Miles to go. The report, released at the midpoint of the Fast-Track phase, shows that while progress has been made, significant barriers still remain to achieve targeted goals.

The strongest gains have been achieved in eastern and southern Africa, where more than half of the world’s HIV-infected population lives. Increases in both domestic and international funding have fuelled innovative research and new programmes combatting the disease in the region in the past decade, resulting in a 42% reduction in deaths from AIDS-related illness and 30% reduction in new HIV infections.

However, efforts to prevent new HIV infections continue to lag behind progress on reducing AIDS-related deaths. As the number of people needing treatment grows, so does the burden to healthcare systems, especially in low- and middle-income countries. Further investment, and push to change conflicting societal, legal, and policy issues, are needed to bridge the gap between HIV services and the people who need them the most.

Poor and marginalised groups often bear the brunt of HIV prevention shortcomings – they face higher risks of being infected, and are less likely to get the needed treatment. In cases where treatment is available, high costs can prevent the poorest to afford it. While universal health coverage programmes hope to prevent these crippling out-of-pocket payments, they have only been established in a few low- and middle-income countries.

Improving the effectiveness of available health resources in these countries is therefore crucial to help expand HIV services to reach all who need them. In Uganda, our Health team helped to develop an analytical framework to identify areas of improvement within the efficiency and economy of the Ugandan HIV subsector, and to track progress in achieving these savings. The video below shows why it is important to use healthcare resources efficiently.

In South Africa, The Bumb’INGOMSO HIV prevention programme challenges traditional behaviours to combat gender-based violence, strengthen health service systems, and expand access to economic opportunities for young women. Our practical recommendations helped to refine targeting and delivery of the programme.

The Maternal, Newborn, and Child Health Programme in Zimbabwe seeks to improve coverage, quality, and accessibility of health services, as well as increase the provision of HIV therapy to tackle AIDS-related illness and death. We helped to evaluate the programme, hoping to scale up its impact.

Image credit: Attila Jandi /