Financing trends and making smarter investments in the HIV response

During a high-level political session at the 20th International AIDS Conference, UNAIDS executive director Michel Sidibé called for a new set of treatment targets by 2030.

During a high-level political session at the 20th International AIDS Conference, UNAIDS
executive director Michel Sidibé has called for a new set of treatment targets
by 2030.

These include that 90 percent of all people living with HIV know their
status, 90 percent of all people diagnosed with HIV receive treatment and 90
percent of all people receiving HIV treatment have durable viral suppression.

Ending the epidemic

Mark Dybul, executive director of the Global Fund, said at the plenary
session that scientific advances and years of implementing programmes have
given the global community an historic opportunity to end the HIV pandemic.

Travelling that last mile will require smarter investments, setting more
refined epidemiological targets and focusing on the most vulnerable people. He
urged partners to work together to seize the moment and use all the tools
available to have the greatest impact in a more intelligent way. “The goal we
can and must have today is ending HIV as an epidemic and turning it into
low-level endemicity,” he said.

Address people at greater risk

Twelve years ago, when the Global Fund was founded, the HIV response was
centred on stopping death and as many new infections as possible, so targets in
the fight against the disease were set with that reality in mind. Dybul argued
that to achieve the goal of ending the HIV epidemic, it is essential to have
equity and to address the people at greatest risk of becoming infected with
HIV;  women and girls, sex workers, people who use drugs, men who have sex
with men, transgender people, people in prison and migrants.

Epidemiological data shows HIV exists in hotspots. Bringing the epidemic
under control will mean moving beyond the ‘tyranny of averages’ to target instead
those specific geographic areas and marginalized populations most affected by
the disease. Dybul said: “We have to look at geographies and we have to look at
populations, those most at risk to ensure that we have equity. We have to bring
the epidemic under control in all of those sub-geographies and sub-regions and
all populations and key affected populations. Otherwise, we will continue
leaving people behind and miss an historic opportunity to bring the epidemic
under control.”

Current trends in AIDS financing

During a symposia session on AIDS financing further discussion on how to
achieve an end to the epidemic highlighted the need for sustainability of
funding in the current global economic climate. JVR Prasada Rao, UN Secretary
General’s Special Envoy for AIDS in Asia Pacific is also chair of the high
level panel on the ‘AIDS funding landscape in Asia and the Pacific’, a new
initiative to help countries and development partners decide on future funding
priorities and develop sustainable investment plans. He put the spotlight on
how global funding for AIDS is falling short of estimated global need as donor
countries are continually lowering their development aid, but added that a
number of countries are leading the way in financing the AIDS response with
domestic funds.

Rao gave examples of programmes in China, India, Myanmar and Thailand in
which clearly targeted spending on prevention among high-risk populations
substantially reduced new infections. Countries need to put greater investment
in such programmes to prevent HIV infections among key populations who are at
high risk such as sex workers, people who use drugs and men who have sex with

Continuing low level AIDS spending on key populations will not lead to the
breakthroughs needed to trigger significant decreases in HIV infection rates.
This thinking is backed up by the study ‘Spending of HIV resources
in Asia and Eastern Europe: systematic review reveals the need to shift funding
allocations towards priority populations’

Rao said: “We must do more to ensure that the money we already have is being
put to work in the most effective way to drive down the epidemic. Despite
overwhelming evidence that spending on HIV prevention focused on populations at
higher risk will drastically reduce new infections, all too often we see large
amounts of AIDS funding directed to ‘soft’ programmes that are not focused in
the areas where they can have the most impact.”

Ending HIV as an epidemic means smarter investments in the right places,
making sure no one is left behind. Donors, governments, NGOs, communities
affected by the disease, faith-based organizations, activists and community
groups and the private sector must galvanize around this historic moment.

Read more about HIV and the key players