Infectious Disease

Urgent action needed as global crises undermine HIV/AIDS response

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Byanyima, Dunaway and Fauci report no relevant financial disclosures.

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In its annual report, UNAIDS said urgent action is needed to get the fight against HIV/AIDS back on track after it was derailed by “overlapping crises,” leaving up to 4,000 people with new HIV infections every day.

“The data we are sharing today brings painful but important news,” UNAIDS Executive Director Winnie Byanyima said during a press briefing.

IDN0722UNAIDSReport_Graphic_01_WEB

UNAIDS.

Byanyima said the response has been thrown off by the colliding pandemics of HIV and COVID-19, the war in the Ukraine and resulting economic crises.

“Progress has been stalled, inequalities have widened, and millions of lives are at risk,” she added.

Key Findings

New UNAIDS data released as part of the International AIDS Conference showed that progress in combating HIV has slowed, with the number of new infections dropping by only 3.6% between 2020 and 2021. This was the smallest annual decline since 2016, Byanyima said.

In total, 38.4 million people were living with HIV globally in 2021 — 36.7 million adults aged 15 years or older and 1.7 million children — of whom 85% knew their status, leaving approximately 5.9 million who did not know that they were living with HIV.

There were 1.5 million new HIV infections, which translates to roughly 4,000 per day and is 1 million more cases than the UNAIDS goal of 500,000.

By the end of 2021, most people with HIV (75%) were accessing treatment, including 76% of people aged 15 years or older and 52% of children. Despite this, there were 650,000 AIDS-related deaths in 2021.

“Last year, in 2021, we lost one person every minute to AIDS-related illness even though we have the medicines needed to save those lives,” Byanyima said.

“Let me clarify, this report is not a call to despair; this is a call to action,” she added. “This report shows us how to have an effective response — by addressing inequalities head on.”

A disproportionate burden

The report highlighted inequalities in the HIV burden seen among people aged 15 to 24 years — particularly young women.

According to the report, a new infection occurred in an adolescent girl or young woman every 2 minutes. In Sub-Saharan Africa, teenage girls and young women accounted for 63% of all new cases.

“This is an area where we need to double down and do more,” said Keren Dunawaygender equality officer at the International Community of Women Living with HIV.

Similarly, in 2021, other key populations including sex workers, men who have sex with men, people who inject drugs and transgender women accounted for a large number of new HIV infections — 70%. These populations faced a 30, 28, 35 and 14 times higher risk for acquiring HIV, respectively.

Funding the fight

A crucial element in combating these setbacks is funding. However, the report showed that resources available for HIV in low- and middle-income countries declined, leaving their HIV responses $8 billion short of the amount needed by 2025.

According to the report, overseas development assistance for HIV from country donors — with the exception of the US — has dropped by 57% over the last decade. Unlike what was seen in previous years, domestic HIV investments are not replacing lost international funding. In fact, the report showed that domestic funding in low- and middle-income countries has fallen for 2 consecutive years, including by 2% in 2021. Low- and middle-income countries will need an estimated $29 billion to get back on track in 2025 to end AIDS as a global health threat.

“It is still possible for leaders to get the response back on track to end AIDS by 2030,” Byanyima said. “Ending AIDS will cost much less money than not ending AIDS.”

Anthony S Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, who also took part in the press conference, said the report serves as a reminder that HIV continues to “rage,” even as attention has turned to COVID-19 and monkeypox.

Anthony S Fauci

“There has without a doubt been a backslide in the HIV response,” he said, adding that this was observed in many countries, including the US

“Collectively, we must double down on our efforts to implement existing treatments and strategies for preventions, to strive for better ones to reach vulnerable communities and to renew our commitment to equity, education and outreach,” he said. “We can do better.”

References:

UNAIDS. Global HIV & AIDS statistics – Fact sheet. https://www.unaids.org/en/resources/fact-sheet. Published July 27, 2022. Accessed July 27, 2022.

UNAIDS Global AIDS Update 2022. https://www.unaids.org/sites/default/files/media_asset/2022-global-aids-update-summary_en.pdf. Published July 27, 2022. Accessed July 27, 2022.

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