In just about 24 months, the world will arrive at the deadline for the UNAIDS "Fast Track" goals for ending the epidemic. The primary fast-track goal for HIV prevention is reduction in new diagnoses from roughly 2,000,000 a year, to less than 500,000. There's no chance this goal will be achieved.
That's the bad news. The good news, such as it is, is that the reasons why the world is going to miss the target are obvious and can be tackled. This year's AVAC Report is dedicated to diagnosing the problem, and proposing actionable solutions.
The future of new and existing biomedical prevention options depends on investment in "demand creation", a term that has been around for a long time and is increasingly becoming a buzzword. The problem with buzzwords is that they can mean everything and nothing.
Demand creation encompasses many things, and always will. But there's a minimum set of pieces that should be considered, if not in place, and often isn't. We think the future depends on defining and doing demand creation right. Download this section from the Report.
Choice is a dangerous word in public health these days. It's been that way since the Trump administration implemented a vastly expanded version of the Global Gag Rule, restricing foreign NGO recipients of US funding from speaking about, referring or advocating for expanded access to abortion.
At AIDS 2018 in Amsterdam, a range of presentations showed the pernicious effects of this rule: it is causing much-needed services to a close, sowing such confusion about allowable activities that reproductive health coalitions are faltering, and costing women's health and lives, as unsafe abortions and poor outcomes from unplanned pregnancies take their toll. Download this section from the Report.
An end to epidemic levels of new HIV infections — a situation that occurs when the rates of new diagnoses is lower than the rate of deaths from AIDS — is possible. Profoundly, achingly possible. It will take a major course correction in approaches to primary HIV prevention, but it can happen — and there are signs that it is already underway. Download this section from the Report.