WASHINGTON — In a new report published on World AIDS Day, the ONE Campaign sounded the alarm about a growing complacency in the global fight against HIV/AIDS and warned that the fight will be unwinnable if especially vulnerable populations, including men who have sex with men and transgender women, continue to be underserved.
Compared with the general population, men who have sex with men are 19 times more likely to be living with HIV and people who inject drugs are 28 times more likely. Transgender women are 49 times more likely to be living with HIV than other adults of reproductive age.
"The progress we've made against HIV/AIDS is so powerful that it's easy to get lulled into a false sense of security about the size of the fight in front of us," ONE Director of Global Health Policy Erin Hohlfelder said. "Social and legal barriers for men who have sex with men and transgender persons in many countries increase their vulnerability to contracting HIV and make it less likely that they can access the testing and treatment they need. In many instances, we don't even do a good enough job measuring basic disease indicators among these groups, making it hard to tailor and deliver effective services. These barriers will need to be addressed if the world is to turn the tide against the AIDS epidemic."
To better serve men who have sex with men and the transgender community, and to prevent the world from losing ground in the fight against the epidemic, the report recommends that governments, implementers, and advocates do three key things:
- Ensure that marginalized and most at-risk populations are better measured so we understand where these populations are and what levels of disease burden they carry and face.
- Better tailor programs and investments — with focused marginalized and most at-risk populations or gender strategies where possible — to ensure that specialists are able to design appropriate outreach approaches and that affected groups can weigh in and meaningfully advise throughout the process.
-Track how well programs and mechanisms are delivering services for these populations, holding countries and implementers accountable for greater impact.
Among the other toplines of the 2015 ONE AIDS Report, which is available for download at www.one.org/aidsreport :
- We're starting to see a dangerous level of complacency in the global fight against HIV/AIDS, and it could undo the real progress made in recent years. The plateauing of many donor governments' spending puts a premium on increased domestic spending from high-burden countries; on finding new sources of money; and on more effective spending of existing resources.
- The next five years will be a unique window in the trajectory of the AIDS epidemic. If we can aggressively scale-up our investments and programs over the next five years — closing a $12 billion per year funding gap — we could prevent nearly 8 million new infections by 2020 and bend the curve of the disease toward the end of the epidemic. If service levels remain where they are, the epidemic will outpace response measures and, by 2030, threaten to undo the progress we've made.
- While the leaders of 46 sub-Saharan African countries promised to increase their domestic spending on health programs to 15 percent of their overall budget, in the 14 years since, only six have followed through. If the other African governments were to spend just 1 percent more on their health programs, and then spent only one-fifth of that increase on AIDS programs, it would be enough to buy ARVs for more than 7 million more people.
- Seventy-four percent of adolescents in Africa who contract HIV are girls, making AIDS a leading cause of death for young women there. Adolescent women and girls face unique social and economic pressures that increase their likelihood of becoming infected, yet they are often left behind in many of today's AIDS programs. Their needs must be addressed if we are going to stop the AIDS epidemic.
- Whether world leaders step up to fully replenish the Global Fund to Fight AIDS, Tuberculosis, and Malaria in 2016 will be the first real test of whether we'll win this fight. Amid difficult budget environments and pressing global challenges, not only will the biggest donor governments need to increase their investments, but new and emerging global health donors will need to step forward.
"The world is still nearly $12 billion short annually of what it will take to end this disease, and those missing dollars, euros, pounds, naira, and yen won't grow on trees," Hohlfelder said. "This World AIDS Day — with the trajectory of the epidemic and millions of lives at stake — we need governments, companies, and philanthropists to step up and provide the resources needed to stop AIDS in its tracks. It's time we think differently about the way we finance the fight against HIV/AIDS."
"It's one thing to deliver a speech calling for the end of AIDS in our lifetimes," Hohlfelder continued. "It's another thing entirely to deliver the funding necessary to make that goal a reality. We know how to beat this disease, and we're in a moment where if we go all-in, we can do it. But this fight cannot be bankrolled solely by just a few governments. We need to find new ways to fund this fight. Leaders of affected countries need to do more for their own citizens. We need private sector innovation to help improve the way we deliver treatment. Millions of lives depend on whether or not the world steps up now."
ONE is a policy and advocacy organization of more than 7 million people taking action to end extreme poverty and preventable disease, particularly in Africa. Not politically partisan, ONE was founded by Bono and Bobby Shriver to raise public awareness and presses political leaders to combat AIDS and other preventable diseases, increase investments in agriculture and nutrition, and demand greater transparency in poverty-fighting programs.
