As Tuesday marks World AIDS Day in 2020, a new epidemic has taken center stage and has shed light on global health in a way that an international day of commemoration never could.
COVID-19 has wreaked havoc on health systems and economies, and has even divided the world politically, further highlighting inequalities around the world — and unfortunately, the impact can be seen when it comes to progress toward the elimination of HIV/AIDS.
“In many countries, HIV services have been disrupted, and supply chains for key commodities have been stretched," UNAIDS Executive Director Winnie Byanyima wrote in the organization's World AIDS Day report. "Around the world, fewer people are being diagnosed with HIV and fewer people living with HIV are starting HIV treatment."
There are still 38 million people living with HIV, 1.7 million people became infected in 2019 alone, and 690,000 people died from AIDS-related illnesses, according to the report.
But the year that has passed between World AIDS Day 2019 and today has not only seen loss.
There have been monumental wins in the fight against HIV/AIDS, and while we haven't met the targets initially set for 2020, UNAIDS has set new targets to be achieved by 2025 that would put the world back on track to success by 2030.
And despite the pain seen over the last year, there are still big wins to be celebrated today.
1. An HIV Vaccine Is on Its Way
While there is currently no approved vaccine that protects against HIV, there are currently two clinical trials in place — the Imbokodo and Mosaico trials — and both marked important milestones in 2019.
The National Institutes of Health and its partners launched phase 3 HIV vaccine efficacy trials in North America, South America, and Europe as part of the Mosaico trial. The study’s participants are men who have sex with men and transgender populations in San Francisco and other cities. Its first participant received an injection in November 2019.
All experimental vaccines were officially administered to participants of the Imbokodo trial in July 2020. Ongoing since 2017, this trial is looking to determine if its vaccine can safely and successfully prevent HIV in more than 2,600 HIV-negative women between 18 and 25 years old in South Africa, Zimbabwe, Mozambique, Malawi, and Zambia.
2. More Than 20 Countries Are on Track to Achieve 2030 Reductions Targets
By the end of 2019, 23 countries saw a decrease of more than 45% in new HIV infections and were on track to reaching 90% reduction by 2030, according to the UNAIDS report.
But the report highlights that some of the most significant progress made in the last decade is in the reduction of AIDS-related mortalities — 26 countries were on track to meeting a 90% reduction in AIDS-related deaths by 2030, including nine countries in eastern and southern Africa, areas that account for more than 55% of all people living with HIV.
From 2010 to 2019, the number of AIDS-related deaths decreased by 39%. While the total number of deaths falls short of achieving the 2020 target of reducing mortality to less than 500,000 (as the number sits at 690,000), it shows great progress as the world moves closer to 2030.
3. There’s Been Great Advancement Toward the 90-90-90 Goals
The 90-90-90 strategy consists of a global plan that would see 90% of all people living with HIV knowing their status; 90% of all people with HIV receiving sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy reaching viral suppression.
These targets were intended to be hit by 2020, and while that goal will not be met, there's still good news. At the end of 2019, 81% of people living with HIV knew their HIV status; among those who knew their status, 82% were receiving treatment, and 88% of those on treatment had achieved viral suppression, according to UNAIDS.
Just as the COVID-19 pandemic has shown, the key to achieving the United Nations' Global Goal 3 is to truly secure good health and well-being for all people, no matter where they live.
“Ending AIDS means closing gaps and ensuring that no one is left behind,” Byanyima said. “The HIV response is fundamentally about inequality — to end AIDS, we must end inequality.”