Prevention programmes helped reduce the annual number of people acquiring HIV to 2.1 million [1.8 million–2.4 million] in 2015, a 35% decline in incidence since 2000, according to UNAIDS/WHO estimates. A massive expansion of antiretroviral therapy (ART) has reduced the global number of people dying from HIV-related causes to about 1.1 million [940 000–1.3 million] in 2015 – 45% fewer than in 2005, when HIV-related mortality peaked (1). UNAIDS/WHO estimates show that more than 18 million people were receiving ART in mid-2016.
To achieve these results, the provision of public health care is being transformed, especially in low- and middleincome countries. Life-saving health services are reaching communities that used to be off the grid to many public health systems. The prices of vital antiretroviral (ARV) drugs and diagnostics continue to be driven down, and technological innovations are being assessed and introduced more rapidly than ever. Systems for collecting and analysing vital information are stronger than at any time in the past. Countries’ HIV responses are advancing efforts towards universal health coverage and making important contributions to attaining the Sustainable Development Goals (2).
Nevertheless, there is no room for complacency. Countries need to live up to their commitment to end the AIDS epidemic as a public health threat by 2030 – a target included in the 2030 Agenda for Sustainable Development adopted by the United Nations General Assembly in September 2015. The immediate challenge is to reach the Fast-Track targets for 2020 (Box 1.1), as new infections and HIV-related deaths are still unacceptably high. The 2020 targets include reducing the number of people acquiring HIV to fewer than 500 000 and reducing the number of people dying from HIV-related causes to fewer than 500 000. Based on current estimates, this provides an opportunity to prevent over 1.6 million new infections and 600 000 deaths per year.
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