A new report suggests doubling the number of people on HIV treatment in the next 5 years could break the AIDS epidemic.
The report estimates there are now 15.8 million people with HIV receiving antiretroviral therapy, double the number from 5 years ago.
In 2010, 7.5 million people were receiving HIV treatment, compared with 2.2 million in 2005. Also, by the end of 2014, new HIV infections dropped to 35% below the peak reached in 2000, while AIDS-related deaths fell by 42% since the peak in 2004.
Michel Sidibé, executive director of UNAIDS, says:
"Every 5 years we have more than doubled the number of people on life-saving treatment. We need to do it just one more time to break the AIDS epidemic and keep it from rebounding."
The report outlines how the Fast-Track approach with a focus on "location, population and programmes," will help attain specific targets for 2030, such as averting 21 million AIDS-related deaths, 28 million new HIV infections and 5.9 million new infections among children.
Long way from goal of 'every HIV-infected person in treatment'
The report states that the Fast-Track approach will also be instrumental in attaining the UNAIDS 90-90-90 treatment target. This says that by 2020, 90% of people living with HIV should know their HIV status, 90% of them should be receiving treatment and 90% of those on treatment should have suppressed viral loads (very low levels of HIV in the body).
The challenge that remains is daunting. The report notes that of the estimated 36.9 million people in the world living with HIV, only 41% of adults and 32% of children are receiving treatment.
Also, in sub-Saharan Africa, where 70% of people with HIV live, an estimated 49% of adults do not know their HIV status, approximately 57% living with HIV are not receiving antiretroviral therapy and an estimated 68% are not virally suppressed.
These figures highlight how far we are from the World Health Organization (WHO) guideline issued in September that calls for every HIV-infected person to be receiving treatment.
Lack of legal and cultural reform remains a significant barrier
The report details how some high-impact prevention and treatment programs - such as pre-exposure treatments, voluntary medical male circumcision and sexual and reproductive health services - have succeeded in reaching different groups in various locations. These include young women and their partners, pregnant women with HIV, people who inject drugs, sex workers, transgender people, gay men and other men who have sex with men.
However, it also emphasizes the importance of delivering services in a way that is consistent with human rights and applies safeguards to ensure that reaching out to people living with HIV does no harm. The report authors add:
"Otherwise, an effort to make services more acceptable and accessible could be misappropriated, becoming an effort to track, discriminate and punish the very people it was meant to help."
They comment that in some countries, progress in eliminating HIV/AIDS is hampered by "pervasive punitive laws and strongly held cultural values against key populations," and reforming them "remains one of the single most important elements of efforts to increase access and uptake of HIV programmes and services."
The report also shows that areas with fewer people living with HIV are more likely to have discriminatory attitudes than areas where HIV is more prevalent. Education and understanding about HIV tends to be more widespread in countries with higher rates of HIV and more people in receipt of treatment.
Meanwhile, Medical News Today has recently learned that on another battlefront, the world could be losing the fight against tuberculosis or TB, which is now the biggest infectious killer globally, claiming 1.5 million lives a year. Without a clear investment plan and a complete overhaul in how the disease is tackled, the world is unlikely to eliminate TB before the end of the 22nd century, says the Stop TB Partnership.