World AIDS Day on 1 December is a chance to unite against HIV, show support for people living with HIV/AIDS, and remember those who have died. This year the theme is “Hands up for HIV Prevention”. It highlights HIV prevention issues like access and the right to health, zero discrimination, testing and condoms in relation to specific groups such as adolescent girls and young women, key populations such as sex workers, and people living with HIV, to ensure no one is left behind.
Despite making considerable progress since 2000, with both new infections and deaths dropping by over 40% by 2015, Sub-Saharan Africa continues to be the region most affected in the world, with almost 26 million people living with the infection in 2015. Over 2 million are children under the age of 15, which is 90% of the global burden of HIV/AIDS among children. The region experienced nearly three-quarters more deaths due to HIV than any other; about 800 000 people died in 2015 alone.
In terms of new infections, the Sub-Saharan region bears the brunt of the burden, with nearly 1.4 million individuals - 65% of the global total - becoming infected. Adolescent girls and young women are particularly vulnerable, being infected at twice the rate of boys and men of the same age. Over 20% of new infections in 2015 were among key populations and their partners.
The full benefits of HIV interventions and services are not being realized in the Region. There are 12.5 million of the 25.5 million people living with HIV who are unaware of their HIV status. In addition, there are 13.4 million people living with HIV who are not accessing antiretroviral therapy.
Discrimination, stigma, gender inequality and gender-based violence continue to hinder access to health services, particularly for children, adolescents, young women and key populations most at risk. Conflicts and emergencies which destroy health systems and displace people obstruct access even further.
But there is hope. Now more than ever before, there is political commitment towards the HIV/AIDS response which continues to grow. In September 2015, global leaders adopted the Sustainable Development Goals, including the target of ending the AIDS epidemic by 2030. This was followed up in July 2016 when countries at the United Nations General Assembly agreed to a historic agenda to accelerate efforts to meet this goal.
Leaders around the world realize that no country has ended AIDS and no country can afford to ease up on its response to HIV. Ending the AIDS epidemic by 2030 will only be possible if countries meet the fast track targets of 2020. Within the next four years, new HIV infections need to be reduced in the African Region to fewer than 400 000; AIDS-related deaths need to be reduced to fewer than 300 000; and HIV-related sigma and discrimination needs to be eliminated by 2020.
To reduce new HIV infections in the region, adolescent girls, young women and key populations must be placed at the center of the response. Intensive focus is needed to improve their access to sexual and reproductive health services. Antiretroviral therapy and voluntary medical male circumcision need to be scaled up, along with powerful prevention strategies such as pre-exposure prophylaxis for high-risk population groups. For testing HIV, we need to explore new ways of delivering HIV testing services, including the potential of self-testing.
Prevention must remain a priority. I urge all countries and partners to address the gaps in HIV prevention and implement interventions which have the highest impact, such as making condoms available, ensuring injection and blood safety, behavior change campaigns to address risky sexual behavior and stigma.
My hand is up for HIV prevention.