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From New York to Durban
Politics and strategies

From New York to Durban

On 8 June this year the new 2016 United Nations General Assembly Political Declaration “On the Fast-Track to Accelerate the Fight against HIV and to End the AIDS Epidemic by 2030” was adopted in New York. It was the first formal high-level meeting in the fight against HIV/AIDS following the announcement of Agenda 2030 in September 2015.

(Photo: 21st International AIDS Conference, 18-22 July 2016 GovernmentZA/flickr)

Why was this meeting important?

Governments from around the world met on 8 June at the UNO Headquarters to sign a political declaration on the global fight against HIV/AIDS for the next five to ten years. The document contained important targets in regard to HIV treatment and prevention as well as to the implementation of human rights and further essential funding.

The political declaration is not legally binding. However, it is an excellent instrument which can be used particularly by people in developing countries, the affected and civil society activists to remind their governments of their duties and pledges with regards to the promised HIV/AIDS interventions. All governments in the world acknowledge that the HIV epidemic remains a global emergency and presents an immense challenge.

Every government has committed itself to achieving the following goals by 2020: new HIV infections must fall below 500,000; fewer than 500,000 people must die of AIDS-related illnesses; nobody should be discriminated against or stigmatised because of an HIV infection (Paragraph 56).

These goals are linked to the UNAIDS fast-track approach 90-90-90: 90% of people living with HIV (children, adolescents and adults) will be aware of their HIV status, 90% of people who are aware of their status will have access to treatment and 90% of these people will have a suppressed viral load.

At the same time the global community has committed itself to do everything to make sure that by 2030 AIDS will no longer pose a risk to public health. That means very few HIV infections because those who are infected are in treatment and therefore do not spread the infection further. Scientists agree that if we strengthen the effort in the fight against HIV/AIDS during the next five years (in accordance with “Fast-Track”), these targets can be achieved.

The targets are clear but so ambitious that the global community is not in agreement as to how these goals can be achieved. This was also discussed during the largest scientific conference on HIV and AIDS in Durban, South Africa. The 21st International AIDS Conference, taking place for the second time in Durban from 18 to 22 July 2016, highlighted the target of ending AIDS by 2030.

Video: Opening Speech by Charlize Theron

We have undoubtedly achieved a great deal in the fight against AIDS. A cure, however, is still far from being reached.

We now know that people are no longer infectious when they correctly follow HIV therapy. More and more countries are implementing the “Test and Treat” – also known as the “Treat All” – recommendation made by the World Health Organisation. This means that everyone who is diagnosed as HIV-positive has the right to receive treatment.

Embarking on a therapy is not simple because the medication merely suppresses the virus rather than destroying it. This poses a huge challenge to the global community because, whilst 17 million people currently have access to the therapy, an estimated further 20 million do not. Around 2 million new people are infected each year.

Research into medication with a long-term effect which only needs to be taken every two or three months is underway and very encouraging. A vaccination is unfortunately not yet in sight.

PreP (pre-exposure prophylaxis) programmes received a great amount of attention during the conference and are recognised as an effective form of prevention. African representatives were, however, sceptical about their feasibility in the African context.

The high infection rate in adolescents, particularly in young women, was another important topic. Everyone agreed: interventions must not only be undertaken amongst school children because many young women unable to attend school are infected and WHO is infecting them? Interventions must more effectively reach the so-called „sugar daddies“ or “blessers”.

The infection rate amongst children has fallen sharply, thanks to better care for pregnant women and the PMTCT programme. Worldwide almost half of HIV-infected children are now receiving treatment.

If we want to achieve the intermediary targets by 2020 which are so decisive for the end of AIDS, then world health must be invested in today!

The call for full financing of the Global Fund during the Replenishment Conference in Canada this September was loud and clear. It is the fifth Replenishment Conference and the Global Fund expects a minimum of 13 billion US dollars in order to achieve its goals in the coming years.

UNAIDS is also feeling the effect of diminished contributions from some countries. The organisation is lacking 80 of the 240 billion dollars required for the coming year. Unfavourable exchange rates are posing further problems.

“Keep the Promise 2016”

Activists everywhere joined the “Keep the Promise 2016” march on 16 July. The HIV/AIDS epidemic presents us with new challenges and it is essential to continue to fulfil the promises in future. Sufficient funding is required to safeguard the vast amount of medication that is needed, to fight against upcoming viral resistance, to remove stigmatisation and discrimination, and to empower women to guard themselves better against unprotected sex. Especially in this area men must learn to develop more respect for themselves and their fellow human beings.

AIDS activists attend the "Keep the Promise 2016" march through the streets of Durban. (AFP)

 

References

HLM 2016

AIDS conference 2016