New UNAIDS Report Shows AIDS Pandemic Can Only Be Ended By 2030 If Leaders Boost Resources And Protect Human Rights Now

With a new HIV infection every two minutes, Asia Pacific must urgently invest in prevention and community leadership

GENEVA/MUNICH/BANGKOK, 22 July 2024—A new report released today by UNAIDS shows that the world is at a critical moment that will determine whether leaders meet their commitment to end AIDS as a public health threat by 2030. The report, ‘The Urgency of Now: AIDS at a Crossroads’, offers new data and case studies which demonstrate that the decisions taken this year will decide the fate of millions of lives.

The report finds that if leaders take the bold actions needed now to ensure sufficient and sustainable resourcing and protect everyone’s human rights, the number of people living with HIV, requiring life-long treatment, will settle at around 29 million by 2050. But if they take the wrong path, the number needing life-long support will rise to 46 million.

“World leaders pledged to end the AIDS pandemic as a public health threat by 2030, and they can uphold their promise, but only if they ensure that the HIV response has the resources it needs and that the human rights of everyone are protected,” said UNAIDS Executive Director, Winnie Byanyima.

The Asia Pacific situation

In 2023 there were an estimated six million, seven hundred thousand (6,700,000) people living with HIV in the Asia Pacific region. This is the world’s largest epidemic after eastern and southern Africa. There were 150,000 AIDS-related deaths last year. Since 2010, deaths due to AIDS have declined by half (51%).

The Asia Pacific region accounted for quarter (23%) of new HIV infections globally last year. There were 150,000 new infections in 2023 or one every two minutes. New infections have declined by just 13% since 2010. This slow reduction is largely due to rising epidemics in six countries. Since 2010, new infections have risen in Afghanistan (175%), Bangladesh (20%), Fiji (241%), Lao PDR (23%), Papua New Guinea (104%) and the Philippines (543%).

Efforts to increase access to combination HIV prevention services including harm reduction,self-testing and pre-exposure prophylaxis or PrEP, remain inadequate. (PrEP is HIV treatment used to prevent people from contracting the virus if exposed.)

The report noted that although 79% of new infections in the region are among key populations and their sexual partners, just 15% of HIV expenditure went to key population prevention programmes. (The key populations are men who have sex with men, people in prisons and other closed settings, people who use drugs, sex workers and transgender people.) Across the region new infections increased by 32% among men who have sex with men since 2010.

“We have the tools to end AIDS. We have prevention options. We just need sincere and consistent commitments from leaders around the world to support community leadership to bring these tools to the people in need of them,” said Dr Nittaya Phanuphak, Executive Director of Thailand’s Institute of HIV Research and Innovation (IHRI) at the report launch in Munich, Germany.

In 2023 78% of people living with HIV in Asia Pacific knew their status. Two-thirds of all people living with HIV were on antiretroviral treatment (67%) and had a suppressed viral load (65%). Less than half of people living with HIV were on treatment in Afghanistan (9%), Bangladesh (49%), Fiji (28%), Indonesia (31%), the Islamic Republic of Iran (43%), Mongolia (39%), Pakistan (15%) and the Philippines (43%).

The report contains evidence that most HIV transmissions occur with people who do not know their HIV positive status. There are also relatively high levels of infection linked to those who are diagnosed but not on treatment, and people who are on treatment but have not yet achieved viral suppression. As World Health Organization guidance states, when people on antiretroviral therapy achieve an undetectable viral load, there is zero chance they can transmit the virus. This concept is known as Undetectable=Untransmittable or U=U.

“We have a moral and public health imperative to help people learn their status, start them on treatment right away if they are positive, and ensure the treatment works completely,” said Eamonn Murphy, UNAIDS Regional Director for Asia Pacific and Eastern Europe Central Asia. “When people test negative they must be offered a range of prevention options so they can stay negative. With the proven prevention, testing and treatment options available, this slow progress in reducing new infections is unacceptable.”

Over the last decade external funding for HIV programmes in the region decreased by 60% while domestic resources increased by 47%. More resource mobilization is needed, especially as the number of people living with HIV in Asia and the Pacific is projected to more than double by 2050.

Through targeted investments to reach those not now accessing services and support, it is possible to dramatically reduce deaths and new infections, overcoming the world’s deadliest pandemic. Several countries in the region show that the ambitious targets to get countries on-track to end AIDS as a public health threat are attainable. Nepal is among four countries worldwide to have achieved a 75% reduction in new infections since 2010. In 2023 treatment coverage was over 80% in Cambodia, Nepal, New Zealand and Thailand. Malaysia, Maldives, Sri Lanka and Thailand have been validated for eliminating mother-to-child HIV transmission.

“Countries can choose to invest now in evidence-based prevention and treatment strategies, particularly community-led service delivery and PrEP. If not, the promise of ending AIDS by2030 will slip away,” Mr Murphy said. 

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