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IAS 2014: Ending AIDS by 2030—Finishing the Job

The 20th International Conference on AIDS opened in Melbourne, Australia on July 20, 2014. The theme of this year's conference is "Stepping Up the Pace."

Michel Sidibé, Executive Director of UNAIDS, gave the keynote address, The last climb: ending AIDS leaving no one behind," calling for an end to the AIDS epidemic by 2030 and stressed the need for a new “catch-up” plan to do that. “Now, more than ever, we must concentrate our limited resources on where most infections occur and on where most people die,” he said. “The world needs a new “catch-up” plan for the 15 countries that account for 75% of new HIV infections.”

In their press release, UNAIDS quoted Sidibé, "My friends, let us not leave Melbourne thinking that it will be easy to reach the summit. Complacency will cause us to stumble. Will future generations say that we squandered the opportunity of a lifetime? I know the path will be steep and the obstacles many. Let us do this in memory of our colleagues who died en route to Melbourne and the millions who have died of AIDS-related illnesses and of the tens of millions of people living with HIV. If every person here tonight, and everyone working to end the epidemic, acts with the same sense of urgency, the same hope and the same commitment to fight for those left behind, we will scale this mountain. But only if we go arm in arm will we reach the top and the end."

A report makes some bold statements and is worth a glance. A synopsis is below:

New HIV infections and deaths from AIDS are decreasing, the United Nations said on July 16, 2014, making it possible to control the epidemic by 2030 and eventually end it "in every region, in every country."

"More than ever before, there is hope that ending AIDS is possible. However, a business-as-usual approach or simply sustaining the AIDS response at its current pace cannot end the epidemic," the U.N. AIDS program UNAIDS said in a global report issued ahead of the 20th International Conference on AIDS in Melbourne, Australia.

It said the number of people infected with HIV was stabilizing at around 35 million worldwide. The epidemic had killed some 39 million of the 78 million people it has affected since it began in the 1980s.

"The AIDS epidemic can be ended in every region, every country, in every location, in every population and every community," Michel Sidibe, the director of UNAIDS, said in the report. "There are multiple reasons why there is hope and conviction about this goal."

UNAIDS said that at the end of 2013, some 12.9 million HIV positive people had access to antiretroviral therapy - a dramatic improvement on the 10 million who were on treatment just one year earlier and the only 5 million who were getting AIDS drugs in 2010.

Since 2001, new HIV infections have fallen by 38%, it said. AIDS deaths have fallen 35% since a peak in 2005.

"The world has witnessed extraordinary changes in the AIDS landscape. There have been more achievements in the past five years than in the preceding 23 years," the report said.

The U.N. report said ending the AIDS epidemic by 2030 would mean the spread of HIV was being controlled or contained, and that the impact of the virus in societies and in people's lives had been reduced by significant declines in ill health, stigma, deaths and the number of AIDS orphans.

"It means increased life expectancy, unconditional acceptance of people's diversity and rights, and increased productivity and reduced costs as the impact diminishes."

According to UNAIDS, $19.1 billion was available from all sources for the AIDS response in 2013, and the estimated annual need by 2015 is currently between $22 billion and $24 billion.

Sidibe said the international community should seize the opportunity to turn the epidemic around.

"We have a fragile five-year window to build on the rapid results that been made," he said. "If we accelerate all HIV scale-up by 2020, we will be on track to end the epidemic by 2030. If not, we risk significantly increasing the time it would take - adding a decade, if not more."

He said controlling the epidemic by 2030 would avert 18 million new HIV infections and 11.2 million AIDS deaths between 2013 and 2030.

In 2011, U.N. member states agreed to a target of getting HIV treatment to 15 million people by 2015. As countries scaled up treatment coverage, and evidence showed how treating HIV early also reduces its spread, the World Health Organization (WHO) set new guidelines last year, expanding the number of people needing treatment by more than 10 million.

Jennifer Cohn, medical director of the access campaign for the charity Médecins Sans Frontières (MSF), said millions of HIV positive people still do not get the drugs they needed.

"Providing life-saving HIV treatment to nearly 12 million people in the developing world is a significant achievement, but more than half of people in need still do not have access," she said. "We know that early treatment helps prevent transmission of HIV and keeps people healthy; we need to respond to HIV in all contexts and make treatment accessible to everyone in need as soon as possible."

The last climb: ending AIDS leaving no one behind," Michel Sidibé, Executive Director of UNAIDS, 20th International Conference on AIDS, Melbourne, July 20, 2014.

The Gap Report, UNAIDS.

Source: Reporting from Melbourne, Australia, for the PRN News: Bill Valenti, MD