Ending AIDS as a public health threat by 2030: Time to reset targets for 2025

While sitting at the UNAIDS Programme Coordinating Board as the African Delegate in 2021, Wanjiku was involved in the co-creation of this paper. With the global target being to end AIDS by 2030, there was need to strategically align the ambition against the gains made and yet to be made.

As a co-author, I added to the paper ideas on why it was important to set for success and think the response and the Fast Track Strategy in 2025, almost at the finish line and yet not. Why it was important to have the person living with HIV at the center and work backwards.

Introduction

In 2015, the United Nations’ (UN) Sustainable Development Goal (SDG) 3 established that by 2030, the world would “end the epidemics of AIDS, tuberculosis, malaria …” [1]. As part of the SDG strategy, UNAIDS and partners developed the “Fast Track Response Strategy” in 2016 and, using standardized epidemiologic guidelines, defined “ending AIDS as a public health threat” as a 90% reduction in HIV incidence and mortality by the year 2030, compared to a baseline year of 2010 [2].
The “Fast Track Response Strategy” envisioned an accelerated ramping up of resources and programs with a set of intermediate targets for 2020, which, if achieved, would enable the attainment of the overall goals and top-line targets of 2030. There were 10 major targets and commitments established for 2020, which would result in a major reduction in HIV incidence to make the response sustainable. The Fast Track Strategy has fostered some major successes, especially around the 90–90–90 testing and treatment targets, i.e., for 90% of persons living with HIV (PLHIVs) to be aware of their status, 90% of those aware of their HIV–positive status to be on antiretroviral therapy and 90% of the latter to have achieved viral suppression. A number of countries achieved or nearly achieved these coverage levels [3]. However, overall, the global community has yet to fulfill the set of recommendations and goals of the Fast Track Strategy [4].