01 Dec 2014
The current Ebola crisis reminds us that fighting communicable diseases requires behaviour change, engaging communities, partnerships with government and civil society, and reducing inequalities. Early diagnosis and treatment is vital too. These lessons have been learned in the fight against HIV. If the AIDS epidemic is to be ended as a public health threat by 2030, the sense of urgency and commitment to human rights which drove the early days of the response cannot be lost.
Without doubt, there have been great advances in HIV prevention and treatment. Yet there remains much to do: there were 2.1 million new HIV infections in 2013. While AIDS mortality in the general population is decreasing, it has increased in young people. AIDS is the leading cause of death among adolescents in Africa, and young women are particularly vulnerable. The coverage of life-saving antiretroviral therapy at the end of 2013 was just 37 percent for adults and 23 per cent for children aged 0-14. We continue to see disparities in health outcomes which mirror broader inequalities and inequities in societies. Populations at higher risk of acquiring HIV who often live on the margins of society, including men who have sex with men, transgender people, sex workers, and people who use drugs, are not benefiting equally from the gains of the AIDS response. In many places, punitive laws and policies still impede access to basic services, and protective laws and policies are missing in action. Stigma, discrimination, gender inequality, and sexual and gender-based violence continue to hinder evidence and rights based HIV responses.
Ending the AIDS epidemic as a public health threat by 2030 will not happen through action in the health sector alone. In addition to scaling up HIV prevention and treatment and strengthening the capacity of health systems, it is important to create enabling legal and policy environments, reduce poverty, empower women and girls, ensure children finish school, improve nutrition, and provide social protection.
As the post-2015 sustainable development goals take shape, the world has a clear choice: if we keep things as they are, HIV will continue to outrun the response, and we will not end AIDS as public health threat by 2030. If, however, defeating HIV remains a top priority and there is a rapid scale-up of evidence and right- based HIV responses which leave no one behind and contribute to eradicating poverty and reducing exclusion and inequality, we can reach our goal for 2030.
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