— eliminate inequalities faced by communities affected by HIV

UNITED Nations Member States have adopted a set of new and ambitious targets in a political declaration at the United Nations General Assembly High-Level Meeting on AIDS, in New York.
According to a UNAIDS release, the political declaration calls on countries to provide 95 per cent of all people at risk of acquiring HIV within all epidemiologically relevant groups, age groups and geographic settings with access to people-centred and effective HIV combination prevention options. It also calls on countries to ensure that 95 per cent of people living with HIV know their HIV status, 95 per cent of diagnosed people are on HIV treatment and 95 per cent of people on HIV treatment are virally suppressed by 2025.
“To end AIDS, we need to end the intersecting injustices that drive new HIV infections and prevent people from accessing services,” said Amina Mohammed, Deputy Secretary-General of the United Nations.

The political declaration notes with concern that key populations—gay men and other men who have sex with men, sex workers, people who use drugs, transgender people and people in prisons and closed settings—are more likely to be exposed to HIV and face violence, stigma, discrimination and laws that restrict their access to services, the release stated.
It added that Member States agreed to a target of ensuring that less than 10 per cent of countries have restrictive legal and policy frameworks that lead to the denial or limitation of access to services by 2025. They also committed to ensure that less than 10 per cent of people living with, at risk of or affected by HIV face stigma and discrimination by 2025, including by leveraging the concept of undetectable = untransmittable. (This means that people living with HIV who have achieved viral suppression do not transmit HIV).

Member States also committed to eliminate all forms of sexual and gender-based violence, including intimate partner violence, by adopting and enforcing laws that address the multiple and intersecting forms of discrimination and violence faced by women living with, at risk of and affected by HIV. They pledged to reduce to no more than 10 per cent the proportion of women, girls and people affected by HIV who experience gender-based inequalities and sexual and gender-based violence by 2025.

In addition, commitments were made to ensure that all women can exercise their right to sexuality, including their sexual and reproductive health, free of coercion, discrimination and violence. Countries were also urged to use national epidemiological data to identify other priority populations who are at higher risk of exposure to HIV, which may include people with disabilities, ethnic and racial minorities, indigenous peoples, local communities, people living in poverty, migrants and refugees. Countries also committed to ensure that 95 per cent of people living with, at risk of and affected by HIV are protected against pandemics, including COVID-19.

WAKE-UP CALL
“The stark inequalities exposed by the colliding pandemics of HIV and COVID-19 are a wake-up call for the world to prioritise and invest fully in realising the human right to health for all without discrimination,” said UNAIDS Executive Director, Winnie Byanyima.
The release also noted that Member States committed to increase and fully fund the AIDS response. They agreed to invest US$29 billion annually by 2025 in low- and middle-income countries. This includes investing at least US$3.1 billion towards societal enablers, including the protection of human rights, reduction of stigma and discrimination and law reform. They also committed to include peer-led HIV service delivery, including through social contracting and other public funding mechanisms.

Calling for expanding access to the latest technologies for tuberculosis (TB) prevention, screening, diagnosis, treatment and vaccination, Member States agreed to ensure that 90 per cent of people living with HIV receive preventive treatment for TB and reduce AIDS-related TB deaths by 80 per cent by 2025.
Countries also committed to ensure the global accessibility, availability and affordability of safe, effective and quality-assured medicines, including generics, vaccines, diagnostics and other health technologies to prevent, diagnose and treat HIV infection, its coinfections and other co-morbidities through the use of existing flexibilities under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and ensure that intellectual property rights provisions in trade agreements do not undermine the existing flexibilities as outlined in the Doha Declaration on the TRIPS Agreement and Public Health.

Member States also committed to support and leverage the 25 years of experience and expertise of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and committed to fully fund the programme so that it can continue to lead global efforts against AIDS and support efforts for pandemic preparedness and global health.
In accordance with the Global AIDS Strategy 2021–2026: End Inequalities, End AIDS, adopted by consensus on 25 March 2021 by the UNAIDS Programme Coordinating Board, as well as the report of the United Nations Secretary-General, Addressing Inequalities and Getting Back on Track to End AIDS by 2030, issued on 31 March 2021, UNAIDS would have welcomed even stronger commitments on comprehensive sexuality education, sexual and reproductive health and rights, and sexual orientation and gender identity, unqualified acceptance of evidence-based HIV prevention options, such as harm reduction, a call for the decriminalisation of the transmission of HIV, sex work, drug use and laws that criminalise same-sex sexual relationships and further flexibilisation of intellectual property rules for access to life-saving medicines, vaccines and technologies.