The warning from UNAIDS released in July 2022 features an alarming front cover, with the words “in danger” repeated across the page. This might seem dramatic to some, until one opens the document and examines the startling statistics presented by Winnie Byanyima, UNAIDS Executive Director. She reports the sobering fact that a life was lost to AIDS each minute in 2021. Although the number of people with access to HIV treatment increased throughout the year, she insists that it grew more slowly in 2021 than previous years. ¼ of people with HIV have access to antiretroviral treatment, and only 52% of children with HIV have access to medicine. 

“The global AIDS response is under threat”.

Thus begins the introduction, reflecting that a series of global crises disrupted and distracted from the global HIV response. Resources available to lower income countries continues to decline consequently; it is estimated that current HIV responses will be $8 billion below the target by 2025. Official development assistance from bilateral donors excluding the US has dropped by 57% in a decade, making the 2022 replenishment of the Global Fund to Fight AIDS, Tuberculosis, and Malaria (the Global Fund) “more critical than ever”. UNAIDS describes how “indifference has slid towards neglect” and a “morally wrong and harmful” absence of solidarity ignores the lesson we should be taking from the Covid-19 pandemic: “pandemics can’t be ended anywhere until they are ended everywhere”. This is reflected in the HPV statistics: 9/10 girls in higher income countries are vaccinated, whereas only 3/10 girls in lower income countries are vaccinated.  

What is lacking, then according to UNAIDS?

“Shared science, strong services, and social solidarity”

The pamphlet offers advice as well as sibilant criticism, with suggested “key actions” to get back on track for 2030 eradication: 

  • Make a new push for HIV prevention. 
  • Realise human rights and gender equality. 
  • Support and effectively resource community-led responses. 
  • Ensure sufficient and sustainable financing.  
  • Address inequalities in HIV prevention, testing, and treatment access and outcomes, and close the gaps that exist in specific localities and for certain groups.  

The key message from the publication is of an urgent need to increase intellectual and financial investment to resume progress in the fight against AIDS. With targets set for as soon as 2025 and 2030, we will need to see immediate action to realise the goals.