A report released on Monday by the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows the world is at a critical moment that will determine whether leaders meet their commitment to end AIDS as a public health threat by 2030.
The report, titled The Urgency of Now: AIDS at a Crossroads, brings together new data and case studies that demonstrate that the decisions and policy choices taken by world leaders this year will decide the fate of millions of lives and whether the world’s deadliest pandemic is overcome.
It noted, however, that currently there is a “worrying” increase of AIDS-related deaths in Belize, Cuba, Guyana and Suriname but asserts that the end of the AIDS epidemic can be achieved by 2030 if leaders take bold actions.
“While the end of AIDS is within our grasp, the data show the world is off track. Of the 39.9 million people living with HIV globally, 9.3 million, nearly a quarter, are not receiving life-saving treatment. Consequently, a person dies from AIDS-related causes every minute,” said UNAIDS in the report.
It pointed out that in the Caribbean there has been substantial progress against HIV since 2010, but the reduction in the annual number of new HIV infections slowed down over the past five years.
At the end of 2023, Cuba, the Dominican Republic, Haiti, and Jamaica, the larger countries in the region, accounted for almost 90 per cent of new infections — with Haiti alone accounting for more than one third (38 per cent) of new HIV infections.
People from key populations and their sex partners continued to account for 47 per cent of new infections in 2022.
The report argues that if leaders take the bold actions needed now to ensure sufficient and sustainable resourcing and protect everyone’s human rights, the number of people living with HIV worldwide requiring lifelong treatment will settle at around 29 million by 2050. But if they take the wrong path, the number of people who will need lifelong support will rise to 46 million (compared to 39.9 million in 2023).
“World leaders pledged to end the AIDS pandemic as a public health threat by 2030, and they can uphold their promise, but only if they ensure that the HIV response has the resources it needs and that the human rights of everyone are protected,” said UNAIDS Executive Director Winnie Byanyima.
“Leaders can save millions of lives, prevent millions of new HIV infections, and ensure that everyone living with HIV can live healthy, full lives,” added Byanyima.
The report shows treatment coverage continued to expand in the Caribbean, but significant challenges remain as it relates to late diagnosis and enrolling and keeping people living with HIV in care.
At the end of 2023, an estimated 85 per cent of people living with HIV knew their status, 70 per cent of all people living with HIV were on treatment, and 61 per cent of all people living with HIV were virally suppressed.
The percentage of people living with HIV who were on treatment and virally suppressed rose from 79 per cent in 2018 to 87 per cent in 2023.
Treatment coverage was 78 per cent among women (aged 15+ years) and 65 per cent among men (aged 15+ years).
Paediatric treatment coverage, at 39 per cent, was, however, much lower than adult treatment coverage in 2023 and late diagnosis of advanced HIV disease (AIDS) remains a significant challenge in the region.
The expansion of people accessing treatment is a landmark public health achievement that has seen AIDS-related deaths in the Caribbean fall by 57 per cent since 2010 — but a worrying increase has been reported in Belize, Cuba, Guyana, and Suriname.
“Prioritising targeted interventions, community-led responses, and integration to leave no one behind; bolstering treatment accessibility and retention in care; advocating for legal reforms; and challenging harmful gender and other social norms will go a long way to address the root causes of risk and vulnerability of people living with, and most affected by HIV,” said UNAIDS multi-country director for the Caribbean, Dr Richard Amenyah.
“There is a great need to strengthen partnerships with communities and enhance the role of civil society to reach vulnerable and at-risk groups that are hard to reach with HIV services or find it difficult, for whatever reason, to engage our health facilities,” added Amenyah.
The Urgency of Now: AIDS at a Crossroads shows that decisions made this year will determine if global targets are met, AIDS is ended as a public health threat by 2030, and a sustainable HIV response is built.
The report demonstrates that HIV prevention and treatment services will only reach people if human rights are upheld, if unfair laws against women and against marginalised communities are scrapped, and if discrimination and violence are tackled head on.
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