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If these targets are reached, according to UNAids, 20.6-million Aids-related deaths will be averted by 2030 and 27.9-million new adult HIV infections and 5.9-million infections among children will also decrease. (Reuters)

Aids could be over by 2030 - or it could get worse than it is now

Mia Malan
The epidemic could end in 15 years if "fast-track targets" are accelerated in the next six years – if not, infection rates could continue to rise.

The Joint United Nations Programme on HIV and Aids (UNAids) announced on Tuesday that the Aids epidemic could be something of the past by 2030. “Ending the Aids epidemic as a global health threat is no longer a dream. It can be a reality within 15 years if we accelerate action today,” the agency said in a press release.

In its 2014 World Aids Day report, which reveals the latest global HIV statistics, UNAids authors reveal “this confidence is based on a combination of major scientific breakthroughs and accumulated lessons learned over more than a decade of scaling up the Aids response worldwide”.

In order to reach the end of the epidemic the following “fast-track targets” need to be achieved by 2030:

  • 95% of people with HIV need to know they’re infected with the virus;
  • 95% of people who know their HIV status need to be on treatment; and
  • 95% of HIV-positive people on treatment need to have suppressed viral loads (viral loads low enough for HIV infected people’s immune systems to remain strong and for them to stop being infectious).

If these targets are reached, according to UNAids, 20.6-million Aids-related deaths will be averted by 2030 and 27.9-million new adult HIV infections and 5.9-million infections among children will also decrease.

“The economic return on fast-track investment is expected to be 17 to one and $24-billion of additional costs for HIV treatment will be averted.”

UNAids warns that, “if we miss this opportunity”, by 2030 the epidemic “could spring to even higher levels” than today. “With business going on as usual [keeping service coverage at 2013 levels], the epidemic will have rebounded by 2030, presenting an even more serious threat to the world’s future health and wellbeing and requiring substantial resources for what would then be an uncontrolled epidemic,” the agency said.

Some good news
Nearly 90% of HIV infections occur in just 30 countries worldwide, including Brazil, South Africa, Angola, Swaziland, Zambia and Zimbabwe, among others.

As of June 2014, according to the UNAids report, only 38% of adults and 24% of children with HIV are receiving treatment.

But there is good news too: new HIV infections among adults have fallen by 38% since 2001: 2.1-million people became newly infected with HIV in 2013, down from 3.4-million in 2001.

New infections among children have declined by even more – by 58% from 580 000 in 2001 to 240 000 in 2013.

In sub-Saharan Africa, where more than 70% of the world’s new HIV infections occur, Aids-related deaths have fallen by 37% between 2005 and 2013.

Three out of four people on antiretroviral treatment live in sub-Saharan Africa. However, 67% of HIV infected men and 57% of HIV infected women in this region were not receiving antiretroviral treatment. In Nigeria, 80% of people with HIV don’t have access to antiretroviral treatment.

The fast track
To fast-track the end of the Aids epidemic, UNAids estimates that low-income countries will require $9.7-billion in funding by 2020 and lower-middle-income countries $8.7-billion. “Due to their income status and the scale of their HIV epidemics, these countries will continue to need international support to fund their Aids response,” the agency said.

Upper-middle-income countries, such as South Africa, will require Aids funding of $17.2-million, after which their needs will decline to $14.2-billion in 2030. Upper-middle-income countries are already financing most of their Aids efforts from “domestic public sources”.

Sub-Saharan Africa will require the largest share of global Aids financing, with $19.4-billion in 2020.

According to UNAids, the next six years will be crucial in determining countries’ success with fast-track targets: “If the world is to end the Aids epidemic by 2030, rapid progress must be made by 2020.”

“Quickening the pace for essential HIV prevention and treatment approaches will limit the epidemic to more manageable levels and enable countries to move towards the elimination phase. If the response is too slow, the Aids epidemic will continue to grow, with a heavy human and financial toll of increasing demand for antiretroviral treatment and expanding the costs for HIV prevention and treatment,” the agency said.

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