The urgency 
of now

AIDS at a 
crossroads

2024 Global AIDS Update

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Foreword

Winnie Byanyima

UNAIDS Executive Director

This report shows that world leaders can fulfil their promise to end AIDS as a public health threat by 2030, and in so doing prevent millions of AIDS-related deaths, prevent millions of new HIV infections, and ensure the almost 40 million people living with HIV have healthy, full lives. Through powerful case studies and new data, the report shows how some countries are already on the right path—and how all countries can get on it.

 

The report also shows that, right now, the world is not on track to succeed, and the inequalities that drive the HIV pandemic are not being addressed sufficiently. It shows that due to the lack of progress on prevention, global numbers of new HIV infections are not declining fast enough, and in three regions of the world numbers of HIV infections are rising. It shows that almost a quarter of people living with HIV are not receiving lifesaving treatment, and consequently a person dies from AIDS-related causes every minute.

 

We know what enables success. Progress against HIV has been strongest in the countries that have invested as required in their responses and reformed their policies to enable people to access the services they need. To accelerate the end of AIDS as a public health threat, and to ensure services and systems are in place to meet the needs of the millions of people living with HIV for decades to come, resourcing needs to be both sufficient and sustainable. Building a legal environment that facilitates access to effective, equitable and person-centred HIV services—including removing harmful criminalizing laws and tackling discrimination—is key to advancing and sustaining progress on prevention and treatment.

 

We know, too, what obstructs success. Progress is imperilled by the fraying of solidarity between and within countries. When political commitment to full financing and human rights is put at risk, progress in the HIV response is put at risk too.

 

A widening funding gap is holding back the HIV response in low- and middle-income countries, with fiscal space being tightened even further by the debt crisis. The recent surge in the promotion of anti-rights, anti-gender and anti-democracy policies is generating justified fear among people from marginalized communities who most need HIV prevention, testing, treatment and care services, and among the heroic frontline workers who provide them.

 

Advances in technology, in particular in the development of long-acting treatment and prevention options, can protect the health of everyone living with or at risk of HIV—but only if these technologies are shared with all low- and middle- income countries, and are produced by multiple manufacturers across the world at scale. Currently, patent-holders are not opening up access broadly enough to enable this breakthrough.

 

The HIV response is at a crossroads. Whether the world ends AIDS depends on the path that leaders take. The path that ends AIDS is not a mystery. It is a political and financial choice.

 

Some are reluctant to provide the scale of resourcing needed for ending AIDS. But, as the report demonstrates, the costs of not ending AIDS would be exponentially higher.

 

Some might like to walk away from the HIV response because the end is now in reach. But, as this report sets out, we cannot partly end a pandemic. Leaders can end AIDS as a public health threat only by overcoming it everywhere, for everyone.

 

Some imply that investments and reforms to end AIDS would detract from addressing other challenges. But, as the report illustrates, the actions needed to end AIDS will help advance the achievement of all the Sustainable Development Goals, ensure countries are prepared to overcome the pandemics of the future, and help secure a safer, fairer world for everyone.

 

I am sometimes asked whether I am an optimist about the HIV response, because the progress we have made shows the path that ends AIDS—or whether I am a pessimist, because restrictions on resourcing and rights are putting progress in danger. The answer is that I am neither an optimist nor a pessimist—I am an activist, because success depends on rising to the moment, on recognizing the urgency of now.

 

We can end AIDS, but only if leaders choose the right path now. We the people will ensure they do.

Chapter 1

Progress at the halfway mark to the 2025 milestones

Mixed results at the halfway mark to the 2025 impact targets with some progress on HIV treatment and poor results for prevention and societal enablers. The world is off track to meet the 2025 targets for new infections and AIDS related deaths.

 

The urgency of now is that significant gaps remain in access to HIV prevention and treatment services that need to be filled.

 

Unfair laws, discrimination and violence must be stopped to ensure access to treatment and prevention for all.

 

Integration has the potential to improve outcomes for other health and social services; however, financing and resources overall are insufficient.

Chapter 2

Taking a sustainable HIV response to 2030 and beyond

Now is the time to invest in 2025 targets and build a sustainable response for 2030 and beyond.

 

If the 2025 targets are met, UNAIDS projects potentially 29 million people living with HIV in 2050. Countries must ensure services and systems are in place for people living with HIV to be able to lead quality and healthy lives.

 

If the 2025 targets are not met, UNAIDS project that there will still be 1.4 million new HIV infections in 2030, far from the target of 200,000.

 

UNAIDS projects potentially 46 million people living with HIV in 2050 if further efforts are not made to ensure people living with, at risk of or affected by HIV can access HIV prevention and treatment.

Additional resources

Annex 1

Download annex 1 to learn more about the progress made towards the 2025 targets

Download annex 1
Annex 2

Download information on the methods used to source the data provided in the 2024 Global AIDS Update.

Download annex 2
Thematic Briefing Notes

Find out more about the AIDS epidemic among specific population groups.

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Stories

Read personal stories from people making a difference in the response to AIDS.

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Regional Fact Sheets

Find out more about the challenges and the progress made in the response to AIDS in specific regions.

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External resources