HIV 40: inequalities fuel pandemics

June 5 marked 40 years since the first cases of HIV were documented in US CDC Morbidity and Mortality Weekly Report. Such a milestone offers an opportunity to reflect on progress made barriers still be overcome four decades from these reported 1981. To mark this anniversary, Lancet family journals has commissioned curated HIV-40, series reports, profiles, interviews highlighting strides research, care, prevention, impact HIV/AIDS global health advocacy. Four later, there is no vaccine cure. Despite effective prevention interventions treatments, such as pre-exposure prophylaxis (PrEP), which reduces acquisition, antiretroviral therapy that renders virus undetectable untransmissible, towards ending AIDS epidemic public threat been slow extremely uneven. Intermediate targets for 2020 have missed time running out effort reach Sustainable Development goal end by 2030. The latest UNAIDS report, published 3, estimates that, 2020, 1·5 million people newly infected with HIV, 37·5 living 690 000 died AIDS-related illnesses. Although number treatment more than tripled 2010—from 7·8 27·4 million—this leaves estimated 10 untreated. More half (62%) all new infections worldwide are so-called key populations—including men who sex men, workers, transgender people, prison, inject drugs. These individuals remain vulnerable because, many countries, they marginalised, stigmatised, or criminalised. Indeed, almost 70 countries criminalise same-sex sexual relations 90 exposure, transmission, non-disclosure. report underscores progressive policies strong systems—offering access testing services, PrEP, harm reduction approaches, quality care—were most successful fighting whereas do not take rights-based approach leave populations services. Moreover, situation young women sub-Saharan Africa should also cause concern according data: illnesses leading death among aged 15–49 Africa. Slow uneven defeating is, today, human rights social justice issue. following along lines political determinants health. Against backdrop, UN General Assembly fifth high-level meeting held 8–10, 2021, looked at through inequality lens, could crucial get world back track In declaration, Ending Inequalities Getting Track End 2030, Member States adopted set reached 2025: provide 95% risk combination options, ensure know their status, treatment. goals aspire reduce annual less 370 deaths 250 000, 34 people. Importantly, target measures discriminating against at-risk groups 10% included—despite wording disagreements—with but voting effort. “The stark inequalities exposed colliding pandemics COVID-19 wake-up call prioritize invest fully realizing right without discrimination”, said Winnie Byanyima, Executive Director. over past 18 months, pandemic added urgency fight HIV. parts world, led disruption critical services prevent, detect, treat increase violence women, exacerbated injustices, vulnerability HIV/AIDS. There clear parallels between two pandemics: fuel pandemics, inequalities. Therefore, urgent need prepare respond way addresses does deepen them. For see https://hlm2021aids.unaids.org/ prophylaxis: scaling up now futureMore decade after efficacy evidence oral (PrEP) was reported, PrEP uptake globally inadequate missed. Access highly concentrated fairly small and, even within widespread access, emerged. ambitious, high-priority required accelerate response similar success 90-90-90 targets. Full-Text PDF Open