GENEVA, 13 July 2023—A new report released today by UNAIDS shows that there is a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals. The report, ‘The Path that Ends AIDS’, contains data and case studies which highlight that ending AIDS is a political and financial choice, and that the countries and leaders who are already following the path are achieving extraordinary results.

Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe have already achieved the “95-95-95” targets. That means 95% of the people who are living with HIV knowing their HIV status, 95% of the people who know that they are living with HIV being on lifesaving antiretroviral treatment, and 95% of people who are on treatment being virally suppressed. A further 16 other countries, eight of them in sub-Saharan Africa, the region which accounts for 65% of all people living with HIV, are also close to doing so.

“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders,” said Winnie Byanyima, Executive Director of UNAIDS. “They could be remembered by future generations as those who put a stop to the world’s deadliest pandemic. They could save millions of lives and protect the health of everyone. They could show what leadership can do.”

The report highlights that HIV responses succeed when they are anchored in strong political leadership. This means following the data, science, and evidence; tackling the inequalities holding back progress; enabling communities and civil society organizations in their vital role in the response; and ensuring sufficient and sustainable funding.

Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa where new HIV infections have been reduced by 57% since 2010.

Thanks to support for and investment in ending AIDS among children, 82% of pregnant and breastfeeding women living with HIV globally were accessing antiretroviral treatment in 2022, up from 46% in 2010. This has led to a 58% reduction in new HIV infections among children from 2010 to 2022, the lowest number since the 1980’s.

Progress in the HIV response has been strengthened by ensuring that legal and policy frameworks do not undermine human rights, but enable and protect them. Several countries removed harmful laws in 2022 and 2023, including five (Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis, and Singapore) that have decriminalized same-sex sexual relations.

The number of people on antiretroviral treatment worldwide rose almost fourfold, from 7.7 million in 2010 to 29.8 million in 2022.

However, the report also sets out that ending AIDS will not come automatically. AIDS claimed a life every minute in 2022. Around 9.2 million people still miss out on treatment, including 660 000 children living with HIV.

Women and girls are still disproportionately affected, particularly in sub-Saharan Africa. Globally, 4,000 young women and girls became infected with HIV every week in 2022. Only 42% of districts with HIV incidence over 0.3% in sub-Saharan Africa are currently covered with dedicated HIV prevention programmes for adolescent girls and young women.

Almost one quarter (23%) of new HIV infections were in Asia and the Pacific where new infections are rising alarmingly in some countries. Steep increases in new infections are continuing in eastern Europe and central Asia (a rise of 49% since 2010) and in the Middle East and North Africa (a rise of 61% since 2010). These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination.

Funding for HIV also declined in 2022 from both international and domestic sources, falling back to the same level as in 2013. Funding amounted to US$ 20.8 billion in 2022, far short of the US$ 29.3 billion needed by 2025.

There is an opportunity now to end AIDS by increasing political will by investing in a sustainable response to HIV through financing what matters most: evidence-based HIV prevention and treatment, health systems integration, non- discriminatory laws, gender equality, and empowered community networks.

“We are hopeful, but it is not the relaxed optimism that might come if all was heading as it should be. It is, instead, a hope rooted in seeing the opportunity for success, an opportunity that is dependent on action,” said Ms Byanyima. “The facts and figures shared in this report do not show that as a world we are already on the path, they show that we can be. The way is clear.”

In 2022, an estimated:

• 39.0 million people globally were living with HIV
• 29.8 million people were accessing antiretroviral therapy
• 1.3 million people became newly infected with HIV
• 630 000 people died from AIDS-related illnesses

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

During a regional UNAIDS HIV estimates workshop in Bangkok, Thailand, groups gathered around laptops to discuss national insights, including the growing HIV infections among gay men and men who have sex with men (MSM) in the Philippines, the high mother-to-child transmission rate in India, and the expansion of the epidemic among some more at-risk groups.

After months of collecting raw data in their home country throughout the year, the teams were now entering those data into specific software to analyze the results.

“Countries use the results to describe what's happening in terms of HIV incidence, prevalence, AIDS-related deaths and other indicators that are difficult, if not impossible, to directly measure,” said Mary Mahy, UNAIDS Data For Impact Director, a.i.

Since 2003, UNAIDS has supported countries to generate such uniform epidemiological measures based on data from antenatal clinics, surveys among key populations or among the entire population, antiretroviral therapy use, and more recently, HIV case reporting and vital registration systems.

At the regional workshops, country representatives, UNAIDS staff, and partners use modelling software to produce HIV estimates. “The benefit in using a model,” Dr Mahy explained, “is that it allows users to combine their best programme and surveillance data to understand what's happening with their HIV epidemic.”

Over time the HIV estimates have become increasingly granular. Since 2020, 39 countries globally can generate sub-national HIV estimates at the district level.

This year the teams put additional emphasis on developing a more complete picture of HIV among key populations (MSM, sex workers, transgender people, prisoners and people who inject drugs) to identify inequalities in the epidemiological outcomes of these different populations.  That means ensuring that countries have data that looks at sex, age, whether a certain population group is more impacted than another by HIV or AIDS-related deaths for example. For UNAIDS Regional Strategic Information Officer Dr. Ye Yu Shwe this added analysis is more than just producing numbers.  “It is about identifying the unequal impact of the epidemic on those who are most affected and the unequal access to services,” he explained. That is then followed by the data teams looking at what the social, and structural systems in place driving or perpetuating various results.

Charlene Tinaja from the Philippines Department of Health’s Epidemiology Bureau said that the workshop allowed her to see how the epidemic is evolving.

“Where are the new infections coming from, what are the specific age groups impacted and from what area in the country… and finally where should we strategically place interventions,” she said.

Nine separate regional workshops were held covering Eastern and southern Africa, Asia Pacific, Western and central Africa, Caribbean, Latin America Middle East and North Africa and Eastern Europe and Central Asia reaching more than 600 participants from 120 countries.

The UNAIDS estimates will be used to summarize the status of the HIV pandemic, which will be released in a July report as part of the Global AIDS update. The granularity helps to identify who is being left behind, which in turn informs efforts to adapt HIV responses to close key gaps and address persistent inequalities and more importantly advocate governments and donors.

It will also be used to measure each country’s progress in relation to their national strategic plans.

In addition, the Global Fund gauges the impact of their grants based on UNAIDS-generated HIV estimates.  The estimates also enable annual reporting on progress towards the UN Sustainable Development Goal (SDG 3) of ending AIDS as a public health threat by 2030 and against time-bound targets for HIV testing, treatment and prevention services.

The UNAIDS estimates are also used to determine how the USD$ 8.7 billion dollars will be distributed among the 54 countries receiving PEPFAR support over the coming two years.  

As Angeli Achrekar, UNAIDS Deputy Executive Director, said, “The HIV epidemiological estimates are the North Star for how we need to move forward.”