Each year, on the 1st of December, the World AIDS Day is an opportunity for people to fight HIV worldwide, show their support for people living with HIV and to commemorate people who have died
An estimated 24 million people are living with HIV globally and, since the virus was identified in 1984, more than 35 million people have died of AIDS, one of the most destructive pandemics in human history. AIDS represents a major global public health issue, with more than 38 million people who have become infected with the virus since 2000 and more than 25 million who have died of AIDS-related illnesses – a staggering burden placed mostly on low- and middle-income countries in sub-Saharan Africa and Asia. In 2014, there were roughly 2 million new infections, 220,000 of which were among children, the latter mostly living in Africa and having been infected during pregnancy, childbirth or breastfeeding via their HIV-positive mothers.
Over the past several decades however, researchers have learned a lot about the virus and the disease; historical medical breakthroughs have been made, and many countries have passed legislation to protect people living with HIV from discrimination and ensure access to appropriate treatments. As of March 2015, the goal of 15 million people on life-saving HIV treatment by 2015 had been met nine months ahead of schedule, according to a report released by UNAIDS in July, an achievement deemed impossible 15 years ago.
The situation has also improved dramatically for the low- and middle-income countries more particularly, with the number of people receiving appropriate antiretroviral therapy (ART) increasing rapidly from just 400,000 in 2003 to 13.5 million– although, globally, 59% of people living with HIV are still not accessing treatment.
Situation in Western and Central Europe and North America
The situation in these countries cannot compare with that of Africa or Asia, however HIV/AIDS remains a public health problem since there were roughly 88,000 new HIV infections and 27,000 AIDS related deaths in 2013, for an estimated 2.3 million people living with HIV. Although the modes of transmission vary greatly between countries, the key affected populations in this region are men who have sex with men, migrants from sub-Saharan Africa, African Americans and people who inject drugs – the latter accounting for 5% of all new HIV infections over the last decade in Western Europe.
Antiretroviral treatment coverage is very high in this region, however people can access and benefit from ART advances only if they are aware of their status and accessing testing services.
Contrary to what had been anticipated in the mid-1990s, the availability of ART did not lead to earlier testing, and worse, there are stagnant or even increasing rates of late diagnosis. The European region in particular needs to step up prevention and treatment activities if it is to reach the 90-90-90 target by 2020, i.e. 90% diagnosed, 90% of those diagnosed on treatment, and 90% of those on treatment with suppressed viral load.
Challenges for the future
In recent years, international organizations like UNAIDS and their partners have committed to end the HIV epidemic by 2030, through a series of targets and indicators by which to measure progress. According to UNAIDS, “we have today the science and tools to fast-track our response towards the end of the AIDS epidemic while striving for equality for all, the protection of human rights and zero discrimination”.
As Michel Sidibé, Director of UNAIDS put it in a 2013 press statement: “HIV has taught us that health and human rights are intricately linked and that we need to protect and respect human rights and be courageous enough to confront society’s wrongs. (…) Achieving our vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths will demand human rights. Everyone has equal dignity and value, and everyone deserves the right to health and to life.”