The year 2024 and the decisions made by policymakers will determine whether or not the world reaches the goal of eliminating AIDS as a public health threat by 2030, UNAIDS said Monday.
While the 2023 figures show an overall improvement, the UN agency points out that the pandemic has killed more than 42 million people and that this progress remains fragile.
In 2023, just under 40 million people were living with the AIDS virus, HIV, the organization’s annual report reveals. About 1.3 million were newly infected last year, some 100,000 fewer than a year earlier.
That’s 60 percent less than the peak in 1995, when 3.3 million people contracted HIV.
But UNAIDS is not satisfied because the target of just 330,000 infections by 2025 seems unattainable.
AIDS also kills far fewer people: 630,000 deaths in 2023, compared to 670,000 deaths the previous year. This is also 69% less than in 2004, the dark year of the pandemic.
Access to antiretroviral therapy is the major issue, because it is very effective today.
By the end of December 2023, 30.7 million people had access to one of these therapies, compared to only 7.7 million in 2010, but this figure remains below the 2025 target of 34 million people.
And above all, almost a quarter of people infected with the virus have no treatment.
Eastern and Southern Africa remains the worst-affected region: 20.8 million people are living with HIV, 450,000 were infected last year and 260,000 died.
Stigma of infections
Winnie Byanyima, Executive Director of UNAIDS, highlights the “significant funding gap that is holding back the HIV response in low- and middle-income countries.”
She estimates it at $9.5 billion per year. Added to this is the weight of public debt, which forces many poor countries to choose between repayment and health spending, for example.
She also called for speeding up the distribution of long-acting antiretrovirals, such as lenacapavir, which requires only two injections per year. She urged the American laboratory Gilead to share its license.
A study shows that “generic manufacturers could produce lenacapavir not for $40,000 or more per year, but for less than $100 per person per year,” Mr.me Byanyima.
“One person still dies every minute from HIV-related illnesses,” she said.
Finally, the stigma and discrimination, sometimes criminalization, suffered by certain groups of people also prevents progress because they cannot get help and treatment without danger.
The figures speak for themselves: worldwide, the median HIV prevalence among adults aged 15 to 49 was 0.8%.
The prevalence is 2.3% among young women and girls aged 15–24 in eastern and southern Africa, 7.7% among gay men and other men who have sex with men, 3% among sex workers, 5% among injecting drug users, 9.2% among transgender people and 1.3% among people in prison.
Coordinated action
In an interview with AFP, Mr.me Byanyima denounced a “well-coordinated and well-funded action” against LGBT+ rights, reproductive rights and gender equality led by socially conservative countries and groups, such as the Organization of Islamic Cooperation and American Christian organizations.
And while in some sub-Saharan African countries new infections have fallen by more than half and deaths by up to 60% since 2010, “we also have regions like Eastern Europe, Central Asia and Latin America where new infections are moving in the wrong direction and increasing,” she insists.
In Eastern Europe and Central Asia, only half of people infected with HIV are treated and in North Africa and the Middle East it is only 49% compared to the global average of 77%.
“Stigma kills. Solidarity saves lives,” Ms. Byanyima and UN High Commissioner for Human Rights Volker Türk said in a joint statement.