The Global HIV/AIDS epidemic

The Global HIV/AIDS epidemic

The European Parliament Research Service issued a briefing on 1 December, World Aids Day for its Members.

In the middle of the coronavirus pandemic, World Aids Day on 1 December is a timely reminder of the need for continued efforts to tackle other global health problems. Since the first cases were recorded in 1981, the disease has claimed 33 million lives worldwide. New infections and deaths are steadily declining but there are still huge disparities and challenges to meeting the UN target of ending the epidemic by 2030.

HIV (human immunodeficiency virus) is transmitted through blood, semen, as well as vaginal and other bodily secretions. Infections spread through sexual intercourse, sharing of needles by drug users, and sometimes through blood transfusions. Mothers can also infect their children during pregnancy and breastfeeding. If left untreated, HIV attacks the body’s immune system, and may lead to AIDS (acquired immunodeficiency syndrome). Due to their loss of immunity, most AIDS sufferers die within a few years due to contracting other severe diseases such as tuberculosis and cancer.

The sustainable development goals adopted by the UN in 2015 envisage ending the HIV/AIDS epidemic by 2030. In 2014, UN agency UNAIDS set three intermediate goals for 2020: at least 90 % of people with the virus should be aware of their status; of these, 90 % should receive treatment, with virus levels in 90 % of patients receiving treatment reduced to a level where no infection is possible. The combined effect of achieving these three targets would be to cut infection rates by three-quarters. Southern and eastern Africa, the worst affected region, has come close to achieving these targets (87 %; 83 %; 93%), helping to explain the dramatic drop in infection rates, while the eastern Europe/central Asia region is one of the worst performers (70 %; 63 %; 93 %), figures that again correlate with sharply rising infections.

No cure exists for HIV/AIDS, but it can be managed as a chronic disease through antiretroviral treatment (ART), which reduces concentrations of the virus in the body to a level where it no longer threatens the patient’s life or infects others. The same drugs can also be taken preventively by persons who are at high risk of exposure (such as sex workers).

Established in 1996, UNAIDS took over from the World Health Organization as the lead UN agency responsible for coordinating the fight against HIV/AIDS. It has played a key role in curbing the spread of the disease by raising awareness and mobilising resources. However, many observers question the value of having a separate body from the WHO, arguing for a more integrated approach that helps developing countries tackle health problems across the board; they also point out that HIV/AIDS receives a disproportionate amount of funding compared to threats such as diabetes, which claim far more lives.

Through its PEPFAR fund (US$6.9 billion in 2020), the US is the main foreign contributor to spending on HIV/AIDS in developing countries. The EU does not have a dedicated HIV/AIDS programme, but in 2019 it pledged €550 million over the next three years for the Global Fund, a UN-led partnership to tackle HIV/AIDS, tuberculosis and malaria. Since 2014, the EU has also allocated €220 million from the Horizon 2020 programme for HIV/AIDS-related research. In 2017, the European Parliament called for an integrated EU policy framework on HIV, tuberculosis and viral hepatitis.

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