By 2025, the annual number of new HIV infections is expected to shrink to 370,000 and AIDS-related deaths to 250,000. New HIV infections among children and pediatric AIDS should cease to exist. All forms of HIV-related discrimination should disappear, and 34 million people should receive life-saving HIV treatment. These commitments were made by the UN member states under the Political Declaration adopted at the High-level Meeting of the UN General Assembly on AIDS, which is taking place in New York.
If the international community achieves these goals, 3.6 million new HIV infections and 1.7 million AIDS-related deaths will be averted by 2030.
The political declaration calls on countries to give access to people-centered and effective options of HIV combined prevention for 95% of all people at risk of HIV infection, in all epidemiologically significant groups, age groups and geographic regions. The declaration also calls on countries to ensure that 95% of people living with HIV know their HIV status, 95% of people who know their status, receive HIV treatment, and 95% of people receiving HIV treatment achieve suppressed viral load.
“If we want to implement the 2030 Agenda for Sustainable Development in this Decade of Action, all Member States must renew their commitment to ending the AIDS epidemic by 2030,” said Volkan Bozkır, President of the UN General Assembly.
“To end AIDS, we need to address the intersecting injustices causing new HIV infections and denying people access to services,” said Amina J. Mohammed, Deputy Secretary General of the United Nations.
The concern of the political declaration is that key populations — gay and other men who have sex with men, sex workers, people who inject drugs, transgender people, and people in prisons and closed facilities — are more likely to find themselves at risk of HIV infection and violence, stigma, discrimination, and laws that restrict their movement or access to services. Member states agreed on the goal of ensuring that less than 10% of countries have restrictive legal and policy frameworks causing the denial or restriction of access to services by 2025. They also committed themselves to ensure that less than 10% of people at risk of infection or affected by HIV face stigma and discrimination by 2025, including through the concept of an undetectable (= non-transmitting) person (people living with HIV who have achieved suppressed viral load, do not transmit HIV).
“I would like to thank the Member States. They adopted an ambitious political declaration to return the world back on the path to end the AIDS pandemic that has devastated communities for 40 years”, said Winnie Byanyima, Executive Director, UNAIDS.
Expressing concern about the number of new HIV infections among adolescents, especially in sub-Saharan Africa, a commitment was made to reduce the number of new HIV infections among adolescent girls and young women to less than 50,000 by 2025. Member States have committed to eliminating all forms of sexual and gender-based violence, including intimate partner violence, by enacting and enforcing laws to address the multiple and intersecting forms of discrimination and violence faced by women who live with HIV, who are at risk of infection or affected by HIV. They committed to cutting to less than 10% the number of women, girls, and people affected by HIV who face gender inequality and sexual and gender-based violence by 2025. In addition, commitments were made to ensure that women enjoy their right to sexuality, including sexual and reproductive health, free from coercion, discrimination, and violence.
Countries were also encouraged to use national epidemiological data to identify other priority populations that are at higher risk of HIV infection, which may include people with disabilities, ethnic and racial minorities, indigenous peoples, local communities, people living in poverty, migrants, refugees, internally displaced persons, men and women of the military and people in humanitarian emergencies, as well as in conflict and post-conflict situations. Countries also committed to ensuring that 95% of people who live with HIV, who are at risk of infection or affected by HIV are protected from pandemics, including COVID-19.
“The stark inequalities revealed by the collision of the HIV and COVID-19 pandemics are a wake-up call for the whole world to do its best and invest fully in realizing the human right to health for all without discrimination,” said Ms Byanyima.
Member States have also pledged to increase and fully fund the responses to AIDS. They agreed to invest US $ 29 billion annually by 2025 in low- and middle-income countries. This includes investing at least US $ 3.1 billion in social delivery instruments, including human rights protection, stigma and discrimination reduction, and legislative reform. They also committed to including peer-to-peer HIV service delivery, including through social media.
Calling for increased access to the latest technologies for the prevention, screening, diagnosis, treatment, and vaccination of tuberculosis (TB), Member States agreed to ensure that 90% of people living with HIV receive preventive TB treatment and reduce deaths of AIDS-related TB by 80% by 2025. Countries also committed to ensuring global access, presence, and availability of safe, effective, and quality medicines, including generics, vaccines, diagnostics remedies, and other medical technologies for the prevention, diagnosis, and treatment of HIV infection, its co-infections, and other associated diseases. By using the existing flexibility under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and ensuring that the provisions on intellectual property rights in trade agreements do not undermine the existing flexibilities set out in the Doha Declaration on the TRIPS Agreement and Public Health.
“The responses to AIDS continue to leave millions behind – LGBTI people, sex workers, people who use drugs, migrants and prisoners, adolescents, young people, women, and children – who also deserve an ordinary life with the same rights and dignity, that most people in this room enjoy”, said Yana Panfilova, a woman living with HIV and a member of the Global Network of People Living with HIV.
Heads of State and Government, ministers and delegates in New York, people living with HIV, civil society organizations, representatives of key populations and communities affected by HIV, international organizations, scientists and researchers, the private sector attend the high-level meeting personally and virtually. UNAIDS supported regional consultations and civil society participation in the High-level Meeting. Civil society organizations have called on the Member States to adopt a stronger resolution.
“Despite the fact that we have made significant progress as a global community, we are still not reaching the goal, and people are paying for it with their lives. There is one single reason that we cannot meet our goal: it is inequality”, said Charlize Theron, founder of the Charlize Theron Africa Outreach Project and United Nations Messenger of Peace.
Member States have also committed to maintain and use 25-years-experience and expertise from the Joint United Nations Program on HIV/AIDS (UNAIDS) and have committed to fully fund this program so that it can continue to lead the global responses to AIDS and support the responses to AIDS and pandemic preparedness and global health.
In line with the Global AIDS Strategy for 2021–2026: to end Inequality, to end AIDS, adopted by consensus on March 25, 2021, by the UNAIDS Program Coordinating Board, as well as with the UN Secretary-General’s report “Addressing inequalities and getting back on track to end AIDS by 2030 ”, released on 31 March 2021, UNAIDS advocates for an even stronger commitment to comprehensive sexuality education, sexual and reproductive health and rights, sexual orientation and gender identity, unconditional acceptance of evidence-based HIV prevention options such as harm reduction, a call for the decriminalization of HIV transmission, sex work, drug use and laws that criminalize same-sex relations, and further flexibility in intellectual property rules for access to life-saving drugs, vaccines, and technologies.
In 2020, 27.4 million of the 37.6 million people living with HIV were receiving treatment, up from 7.8 million in 2010. An estimated 16.2 million deaths have been prevented by providing affordable, quality treatment since 2001, a 43% decline from 2010 to 690,000 in 2020. Progress in reducing new HIV infections has also been made, but it has been markedly slower – a 30% decline since 2010, with 1.5 million people newly infected with the virus in 2020, compared with 2.1 million in 2010 year.