The 2016 World Aids Day special report focuses on what it will take to reach the 90-90-90 targets to end the Aids epidemic by 2030. (Reuters)

What will it take to end Aids by 2030?

Mia Malan
Scientific advances mean nothing if people are too ashamed and feel too judged to seek them out.

Experts around the world believe we've got what it takes to end the Aids epidemic by 2030. Big scientific breakthroughs and lessons that have been learned over the years are the backbone of this confidence.

But "ending" Aids doesn't mean there will be no new HIV infections. Rather, it suggests that the Aids epidemic can be ended as a global health threat. To achieve this by 2030, countries would need to reduce the number of new HIV infections by 90% compared with 2010, the Joint United Nations Programme on HIV and Aids (UNAids) says.

This translates into no more than 200 000 new annual infections among adults worldwide by 2030.

Where are we?

Every year since 2010, about 1.9-million adults have become newly infected with HIV.

In South Africa alone, the health department estimates that there would have been 270 000 new HIV infections this year. The department wants to more than half that number to 100 000 new annual infections by 2022.

That's a long way to go.

So, as a road map to end Aids by 2030, UNAids decided on shorter-term goals, particularly for countries with high HIV infection rates such as South Africa. They're known as the 90-90-90 targets and have to be achieved by 2020. By then, 90% of all people should know their HIV status, 90% of HIV-infected people should be on antiretroviral treatment (ART) and 90% of those on treatment, should be virologically suppressed.

How will this help?

Well, science has shown us that ART doesn't only keep people with HIV healthy, it also helps to prevent HIV from spreading. When HIV-positive people take their treatment correctly, the amount of HIV in their bodies become so small, that it becomes virtually impossible for them to infect others. This is known as viral suppression. So, the rate of new HIV infections will drastically decline if most people with HIV are on treatment.

The World Health Organisation says only 60% of people worldwide know their HIV status. South Africa is ahead of that: health department figures show that 76% of adults in South Africa know their HIV status.

In 2015, 46% of people with HIV had access to treatment globally, according to UNAids. Again, South Africa's figure is higher with 65% of HIV-positive adults accessing treatment, health department data reveal.

But we're behind with monitoring whether people on ART are virologically suppressed: figures from the health department's Tier.net system show that we've only measured the amount of virus in about 50% of people on treatment's blood. Those we have tested, do well, but for the rest, we have simply no idea, as their test results are either not recorded or the tests have not been done.

This special report focuses on what we can do to achieve the 90-90-90 targets to eventually end the Aids epidemic by 2030. There have been many scientific discoveries – antiretroviral drugs can be used by HIV-negative people to reduce their risk of infection, medical male circumcision makes heterosexual men 60% less likely to get infected, we now have kits that allow you to test for HIV at home and South Africa is on the verge of an HIV vaccine breakthrough.

But we also look at what would stand in our way of ending Aids. One of the 2030 UNAids targets is to get rid entirely of discrimination against people with HIV. In South Africa, HIV-related stigma is still rife. It prevents people from getting tested for HIV and from collecting treatment at clinics. Stigma literally spreads the virus.

Scientific advances mean nothing if people are too ashamed and feel too judged to seek them out.

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