fast-track approach to ending AIDS
From June 8 to 10, the UN General Assembly held the High-Level Meeting on Ending AIDS in New York City to draft a new Political Declaration on Ending AIDS and to introduce the Fast-Track approach to ending AIDS.

The Fast-Track approach to ending AIDS plans to increase and front-load investments in fighting the AIDS epidemic. This would be done in combination with scaled up coverage of HIV services in order to reduce the rate of new infections and AIDS-related deaths.

Greater investment in human rights, advocacy, civil society and community-based services are also essential to the Fast-Track approach, according to meeting documents.

The ultimate goals of the Fast-Track approach to ending AIDs are to ensure that fewer than 500,000 people are newly infected with HIV, to ensure that fewer than 500,000 people die from AIDS-related illnesses and to eliminate HIV-related discrimination.

UNAIDS, the branch of the UN working towards “zero new HIV infections, zero discrimination and zero AIDS-related deaths” as part of the Sustainable Development Goal of ending the AIDS epidemic by 2030, said in a press statement that it wanted to hear from both individuals living with HIV and NGOs helping people on the ground during the meeting.

One such group is AIDS Outreach, an NGO located in Montana. Executive Director Bob Cruz said in an interview that most of his time is spent testing for HIV. His next biggest challenge is ensuring that those who test positive for HIV find an insurance package they can afford.

“Treatment is out there, but to get [people living with HIV] on it we need to know what insurance options are available,” Cruz said. “There are many, but they don’t know it.” According to Cruz, treatment for HIV can cost $3,000 to $4,000 per month.

In Secretary General Ban Ki-moon’s report, “On the fast track to ending the AIDS epidemic,” he noted that he has spoken with individuals about their difficulties obtaining the retroviral medicine they need.

Although past successful policies have extended access to retroviral treatment, the UN General Assembly’s zero draft political declaration states that people living with HIV “in low- and middle-income countries still remain without treatment.”

The declaration goes on to say that “a substantial proportion of people on antiretroviral therapy face social and structural barriers to good health, including lack of social protection, care and support and as a result struggle to adhere to their treatment.”

Until a recent funding cut, AIDS Outreach had offered support groups for people living with HIV and for men who have sex with men, a key population affected by HIV. Before the cut, Cruz said the groups gave people a sign of visible support. Their purpose was “to offer someone a space to talk about what is on their mind,” free of judgment.

If Cruz had more resources, he would restart AIDS Outreach’s support groups and put more time into educating people in schools and prisons. He would also want to ensure that people knew more about recent advancements in treatment, helping to reduce the fear and stigma of living with HIV.

According to Cruz, new treatments such as PrEP, a drug that people at very high risk for HIV take daily to lower their chances of getting infected, allow people to live without the constant fear of their immune system becoming compromised.

At the High Meeting, the zero draft political statement said that health needs must be addressed in a more holistic manner. The UN will not only work to ensure the health and wellbeing of people living with HIV, but also “health security, universal health coverage and health system strengthening and preparedness.”

As part of the greater investment in HIV prevention and treatment, and to provide more holistic treatment, key areas are in need of more resources.

According to meeting documents, community mobilization needs to rise to three percent of total HIV investment by 2020—three times the current amount. Investment in social enablers, such as advocacy, law and policy reform and stigma reduction, needs to rise to eight percent of total investment by that time.

In 2014, there was $19 billion available that had been invested in the prevention and treatment of HIV. Meeting documents stated that this needs to increase to $26 billion available annually by 2020.

It is hoped that this increased investment, along with better service coverage and a more efficient use of resources, will lead to the success of the fast-track approach to ending AIDS, resulting in declining annual resource needs after 2020.

Anastazia Vanisko

Photo: Flickr