Can the Caribbean achieve the global AIDS targets by 2025 to End AIDS?
United Nations Secretary General Antonio Guterres, in a sobering new year’s message for 2024, described the world as being in peril and badly hurting. He cited the immense suffering, violence and climate chaos that marked 2023, as well as the ever-increasing poverty, hunger and wars that eroded confidence and trust.
Guterres painted a gloomy picture of how the UN, founded after the Second World War, is now politically paralysed and unable to solve the world’s challenges through peaceful negotiations, multilateralism, and global solidarity. He lamented that the UN Charter has been repeatedly violated by some member states resorting to violence instead of dialogue, partnership, and respect for humanitarian law, international law, and human rights to resolve differences.
Guterres, however, offered hope to the world by stating that: “Humanity is stronger when it stands together… 2024 must be the year to restore trust and hope”. He urged the UN to deliver on its mandate to build world peace, prosperity, and sustainable development.
One of the most pressing challenges the UN faces is ending the AIDS epidemic, which has claimed millions of lives and continues to pose a threat to public health and human dignity. Forty-three years since the first cases of AIDS were reported, the world is still grappling with the pandemic. Every minute, a life is lost to AIDS-related illnesses. Outside of sub-Saharan Africa, the Caribbean region has the highest HIV prevalence of 1.2 per cent, with about 44 people getting infected with HIV and 15 people dying of AIDS every day. Other pandemics have come and gone with resolute political action and resolve by member states (COVID-19, Mpox, etc.) but the AIDS pandemic is still here without a vaccine or a cure. HIV treatment with antiretroviral drugs remain one of our greatest for HIV prevention and to keep people alive.
In the 2023 Global AIDS Report, UNAIDS stated that the world was off-track in ending the AIDS epidemic. The report highlighted the path to ending AIDS and the need to remove inequality barriers and their intersections with poverty, human rights violations, gender-based violence, stigma, and discrimination. It also stressed the importance of removing punitive and discriminatory laws and policies that prevent people living with HIV, at risk of HIV or affected by HIV from accessing HIV-related services.
Member states have committed in the 2021 Political Declaration to end AIDS as a public health threat by 2030 and to achieve the ambitious 2025 targets. These targets, known as the 95-95-95 targets, aim to ensure that 95 per cent of all people living with HIV know their status, 95 per cent of those diagnosed receive antiretroviral treatment, and 95 per cent of those on treatment achieve viral suppression by 2025. Despite the global uncertainties, the UN celebrated five countries, namely Botswana, Eswatini, Rwanda, Tanzania, and Zimbabwe, during the UN General Assembly, in 2023, for achieving these targets, demonstrating that it is possible. Other countries have been identified as getting close to attaining this target if they continue to stay on track.
Countries that have attained or are close to achieving the 95-95-95 targets have certain things in common:
a) political leadership, political will and country ownership;
b) a people-centred approach to policy making and programmatic response;
c) a focus on removing punitive and discriminatory laws and policies that prevent people living with HIV, at risk of HIV or affected by HIV from accessing HIV-related services;
d) community-led responses to ensure the full participation and engagement of civil society to create an enabling environment;
e) Leveraging data and following the science by using epidemiological and programmatic data for policy changes and making targeting resources where they are needed most; and
f) closing the funding gap, sustaining financing and prioritising transitioning to domestic resourcing of the AIDS response. These elements of success emphasise the importance of political commitment to ending AIDS.
The question arises: Can Caribbean countries reverse the tide and end the AIDS epidemic amidst global uncertainties? Policymakers must grapple with this challenge amid competing priorities such as non-communicable diseases, climate change, high debt, and social issues. UNAIDS proposes a consistent approach: Countries must continue what works, and focusing on political commitment, people-centred responses, community leadership, removal of structural barriers, data-driven strategies, and long-term investments.
Ending AIDS in a time of uncertainty is not an easy task, but it is possible. It requires a renewed commitment, a shared vision, and collective action from all stakeholders, especially the people most affected by the epidemic. It also requires a recognition that ending AIDS is not only a health issue, but a human rights, social justice, and development issue as well.
UNAIDS calls for unity and peace so that resources for war can be channelled to end pandemics for safety and global health security. The year 2024 should be one of concerted efforts to restore trust and hope in the fight against AIDS. We can alter the course of history in combating one of the world’s greatest pandemics, minimising its human cost and development toll, through political leadership, global solidarity, and shared responsibility, countries, including those in the Caribbean.
Let us stand together and end AIDS by 2030 because as the UN Secretary General Antonio Guterres said: “Humanity is stronger when it stands together”.
Dr Richard Amenyah is a medical doctor from Ghana and public-health specialist. He is the director for the UNAIDS multi-country office in the Caribbean. Send comments to the Jamaica Observer or jamaica@unaids.org.