UNAIDS spells out the costs of missing global AIDS goals

Amid evidence that funding for the HIV response is on the decline both globally — including reports that the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, will have its funding cut — and within domestic budgets, the Joint United Nations Programme on HIV/AIDS, or UNAIDS, has figured out what it would cost in terms of lives and livelihoods if HIV services stagnated at 2020 levels. The price would be 17.7 million AIDS-related deaths and 34.9 million new infections between 2021 and 2050 if services are simply maintained during that period, compared to making the investments UNAIDS has called for to achieve ambitious targets for testing, treating, and keeping people’s infection suppressed. “Every life lost is a tragedy, every new infection is a failure,” Erik Lamontagne, one of the authors of the study, said at a press conference this week detailing the findings. The UNAIDS targets spell out a scenario where 95% of all people living with HIV in each country know their status, 95% of those people are on treatment, and 95% of the people on treatment have a suppressed viral load, meaning they are unable to transmit the virus. Countries are supposed to hit the targets, known as 95-95-95, by the end of 2025. Five countries — Botswana, Eswatini, Rwanda, Tanzania, and Zimbabwe — have already reached the goals and it appears possible that 16 other countries, including eight in sub-Saharan Africa, will, according to UNAIDS. But that still leaves much of the world off track. At the same time, UNAIDS has previously warned that HIV funding in 2022, both from international and domestic sources, fell back to the same level as in 2013. And that was before news broke that the Biden administration is planning to cut 6% of PEPFAR’s budget during the 2025 fiscal year. The new findings from UNAIDS were released ahead of the 25th International AIDS Conference, scheduled to launch next week in Munich, Germany, where one of the key themes will be how to sustain a global HIV response that appears to be flagging. The impact of not reaching the 95-95-95 goals can be measured in more than just lives and new infections, Lamontagne said. It will also rob every person living in low- and middle-income countries of $8,291 over the 30-year period, according to the agency’s estimates. Alternatively, making the investments now toward the targets “enables those treated to live a normal life in comfort economically and socially,” he said. UNAIDS is set to release updated data on progress toward the 95-95-95 targets at the conference in Munich.