24-July-2024-Editorial

2024 UNAIDS GLOBAL AIDS UPDATE

The 2024 UNAIDS Global AIDS Update, titled “The Urgency of Now: AIDS at a Crossroads,” provides an overview of the current state of the HIV/AIDS epidemic and the global response to it.

This report highlights the progress made in the fight against AIDS, ongoing challenges, and recommendations to achieve the goal of ending AIDS as a public health threat by 2030.

Progress and Achievements

Reduction in HIV Infections and AIDS-Related Deaths

• Global new HIV infections have dropped by 39% since 2010.
• Sub-Saharan Africa has seen the most significant decline, with a 56% reduction.
• The number of new HIV infections in 2023 is the lowest recorded since the late 1980s.
• Nearly 31 million people worldwide are currently on antiretroviral therapy (ART).
• AIDS-related deaths have reached their lowest level since 2004, mainly due to better access to ART.

Regional Disparities

• While sub-Saharan Africa shows significant progress, new HIV infections are rising in regions like Eastern Europe, Central Asia, Latin America, and the Middle East and North Africa.
• For the first time, new HIV infections outside sub-Saharan Africa have surpassed those within it.

Key Affected Groups

• High-risk groups such as sex workers, men who have sex with men, people who inject drugs, transgender individuals, and prisoners continue to face high HIV infection risks.
• These groups often lack adequate prevention programs and face stigma and discrimination.
• Community-led interventions are crucial but frequently underfunded and overlooked.

Prevention and Treatment Gaps

• Efforts in HIV prevention are insufficient, with gaps in services like pre-exposure prophylaxis (PrEP) and harm reduction for people who inject drugs.
• Around 9.3 million people living with HIV are not on ART, with children and adolescents being particularly affected.

About UNAIDS

Role and Structure

• UNAIDS is a leading organization in the global effort to end AIDS by 2030 as part of the Sustainable Development Goals (SDGs).
• Established in 1996, UNAIDS is unique in its model, integrating 11 United Nations system Cosponsors and civil society representation on its governing body.
• UNAIDS advocates for zero new HIV infections, zero discrimination, and zero AIDS-related deaths, and works to ensure no one is left behind.

About HIV/AIDS

Definition and Impact

• HIV (Human Immunodeficiency Virus) attacks the immune system, particularly CD4 cells (T cells), which are vital for fighting infections.
• Without treatment, HIV can lead to AIDS (acquired immunodeficiency syndrome), where the immune system is severely compromised.

Transmission

• HIV spreads through contact with infected bodily fluids such as blood, semen, vaginal fluids, rectal fluids, and breast milk.
• Transmission methods include sexual contact, sharing needles, mother-to-child during childbirth or breastfeeding, and, rarely, through blood transfusions or organ transplants.

Symptoms

• Clinical Latent Infection: HIV remains active but reproduces at low levels; symptoms may be mild or absent.
• Acute HIV Infection: Symptoms may resemble flu, including fever, swollen lymph nodes, sore throat, rash, muscle and joint aches, and headache.
• AIDS: Severe symptoms include rapid weight loss, persistent fever or night sweats, and extreme fatigue.

Diagnosis and Treatment

Diagnosis:

• HIV antibody/antigen tests detect antibodies or antigens in blood or oral fluids.
• Nucleic acid tests (NATs) look for the virus itself and can detect HIV earlier.

Treatment:

• Antiretroviral Therapy (ART): Combines several HIV medicines daily to manage the virus, allowing individuals to live longer, healthier lives and reducing transmission risk.
• Pre-exposure Prophylaxis (PrEP): A daily pill for at-risk individuals to lower the risk of HIV infection. Recently, a new HIV drug requiring only a few injections a year has been approved in the UK.

India’s Efforts to Combat HIV

Legislation and Initiatives

• HIV and AIDS (Prevention and Control) Act, 2017: Aims to prevent and control HIV/AIDS and reduce stigma.
• Access to ART: Increased availability of ART for those living with HIV.
• MoU between Ministries: Signed in 2019 to enhance outreach and reduce stigma related to HIV/AIDS and drug abuse.

Project Sunrise

• Launched in 2016 to address the rising HIV prevalence in India’s northeastern states, particularly among people who inject drugs.
• Aims to meet the UNAIDS 90-90-90 targets and end AIDS by 2030.

International Initiatives

UNAIDS Global Efforts

• Leading the global mission to end AIDS as a public health threat by 2030, with a focus on achieving zero new infections, zero discrimination, and zero AIDS-related deaths.
• The UN Political Declaration on Ending AIDS (2016) sets targets to end AIDS by 2030.
• WHO’s “Treat All” guidance recommends starting treatment as soon as possible after diagnosis to reduce HIV transmission.

Global AIDS Strategy 2021-2026

• Focuses on addressing inequalities to close gaps in progress and end AIDS by 2030.

Key Suggestions from the Report

Accelerating HIV Prevention

• Expand access to prevention services for key populations.
• Reinstate and fund condom programs and scale up PrEP availability, targeting 21.2 million users by 2025.

Enhancing Treatment and Care

• Ensure 95% of people living with HIV are on ART by 2025, up from the current 77%.
• Improve treatment and diagnosis for children with HIV.
• Integrate HIV services with broader health services to address related health issues.

Addressing Inequalities and Stigma

• Remove punitive laws against HIV transmission and protect key populations.
• Implement programs to reduce stigma and ensure legal protection for people living with HIV.

Community-Led Responses

• Strengthen the role of community-led organizations in delivering HIV services, aiming for them to handle 30% of testing and treatment and 80% of prevention services.

Sustainable Financing

• Address the funding gap, requiring an additional USD 9.5 billion by 2025.
• Explore new funding mechanisms, especially for low- and middle-income countries.

Conclusion

The 2024 UNAIDS Global AIDS Update stresses the urgent need to address inequalities, enhance prevention and treatment efforts, and secure sustainable funding to end AIDS as a public health threat by 2030. Through continued global cooperation and targeted interventions, significant progress can be made in combating the HIV/AIDS epidemic.