2020 was meant to be the year that we, as a global community, achieved the 90-90-90 HIV treatment targets set out by UNAIDS. Unbeknownst to us, a public health crisis was lurking in the shadows and surreptitiously exploded onto the scene, derailing a lot of plans and efforts in the fight against HIV.
Global 2020 targets of reducing AIDS-related deaths to fewer than 500,000 and new HIV infections to fewer than 500,000 will be missed. There were still 690,000 AIDS-related deaths in 2019 and 1.7 million new infections across the world.
The latest UNAIDS report highlights that missed targets have already resulted in 3.5 million more HIV infections and 820,000 more AIDS-related deaths since 2015 than if the world was on track. The response could be set back by 10 years or more due to severe disruptions caused by COVID-19.
Humanity has enormous capacity to make things happen as long as we put our minds to it and work together.—
There is an urgency for action, and the report asks for countries to double down on efforts to reach the “millions still left behind.” As we come to grips with the COVID-19 pandemic, we must now refocus our energies in tackling the HIV epidemic, making up for lost time and getting back on track to achieve the Sustainable Development Goals, whose 2030 deadline is also fast approaching.
In fact, now is the time to work closer together than before and to look beyond our own backyards to share solutions, closing the widening chasms in the HIV epidemic.
Partnerships to multiply impact
The power of partnerships to close the gap on the HIV epidemic is now more crucial than ever.
Successful models of multicountry collaboration and partnerships include excellent examples such as The Global Fund To Fight AIDS, Tuberculosis and Malaria; the Fast-Track Cities initiative by the International Association of Providers of AIDS Care; DREAMS, the U.S. President’s Emergency Plan For AIDS Relief partnership platform; and UNAIDS.
The sharing of ideas, resources, labor, and capacity can have a multiplying effect on the impact of efforts much greater than if each organization acted alone.
As an illustration, data from PEPFAR showed that for the first time in 2017, there were significant declines in new HIV diagnoses among adolescent girls and young women in Africa where DREAMS programs were implemented.
The conversation on existing and emerging HIV technology is shifting toward how to ensure products and services are accessible to all.
“In the 10 African countries implementing PEPFAR’s DREAMS partnership, the majority of the highest HIV-burden communities or districts achieved greater than a 25 percent–40 percent decline in new HIV diagnoses among young women. Significantly, new diagnoses declined in nearly all DREAMS intervention districts,” according to PEPFAR.
This ambitious public-private partnership goes beyond typical health initiatives to address associated factors through multisector partnership, resulting in accelerated efforts to control the HIV/AIDS epidemic in the region.
This is the reason why Gilead has spearheaded multisector collaboration programs such as RADIAN — a partnership with the Elton John AIDS Foundation — as well as TRANScend and the COMPASS Initiative, among others, to elevate best practices and community-led solutions to combat the HIV/AIDS epidemic.
Though each of these programs is designed to meet the unique needs of HIV communities in different parts of the world, the similarities are that all these efforts require close collaboration among key stakeholders and partners across many sectors. When proven successful, these best practices and learnings from the local implementation will be used as a blueprint toward helping end the HIV epidemic across a region and other neighboring nations.
In Asia, we recognize that inadequate financing for community responses threatens the ongoing provision and scale-up of quality services, including services and action by the community. As with all regions and countries, we believe that community engagement, guidance, and responses are the backbone of any HIV/AIDS response.
Hence, in 2018 we introduced the Asia Pacific Rainbow Grant to empower grassroots community advocates working to provide access, improve education, and reduce stigma around HIV treatment and care. In the spirit of fostering the sharing of best practices and building bridges across borders, we also organized learning sessions on best practices with community-based organizations in Asia and San Francisco.
With coordinated encouragement and investment, the private sector’s health workforce can make a significant contribution to sustaining HIV services, write Abt Associates' Sarah Dominis and Emma Golub.
Coalitions such as these are the way forward in strengthening health systems, creating access to care, and removing obstacles to care. The success stories and evidence-based interventions from countries such as Cambodia and Thailand, which have achieved the 90-90-90 HIV treatment targets, should be looked at when addressing some of the key barriers in our region.
I say this all the time: The HIV/AIDS epidemic is unfinished business, but if there is anything that this COVID-19 pandemic has shown us, it is that humanity has enormous capacity to make things happen as long as we put our minds to it and work together.
We have been able to unlock incredible innovations by pulling our efforts together, and tackling the HIV epidemic is no different. The world needs to come together as one to fight the pandemic, and we need to do the same with HIV.
We have the tools in our toolbox to address the epidemic; what we now need to do is pool our collective will and resources. Reach out to one another, learn from each other, and fight this together.