Dear Colleagues,

We hope you are enjoying a joyful and safe holiday. We are deeply thankful for your support and collaboration as we work to end the AIDS pandemic in the face of the tragically still burgeoning COVID-19 pandemic. We wanted to share a few key documents in advance of World AIDS Day: UNAIDS' World AIDS Day report (including new 2025 targets) and the annotated outline for the Global AIDS Strategy 2021-2026 which will be considered at UNAIDS'  Programme Coordinating Board meeting Dec. 15-18 (at which the United States will serve as Chair). We want to highlight that the strategy under development is a strategy intended to guide the world to the end of AIDS--and not a strategy focused only on UNAIDS/its role in that work. As detailed below, the intention is to develop a final draft version of this new strategy for consideration by UNAIDS' Programme Coordinating Board at a special meeting in March 2021 with the hope that the strategy will be finalized in advance of a special High-Level meeting focused on HIV/AIDS at the United Nations General Assembly next summer (likely in June). These special meetings on HIV have been held every five years at the UNGA since 2001. 

We would be delighted to answer any questions you have or brief you more fulsomely if desired. 

2020 World AIDS Day Report/2025 Targets

Today, UNAIDS launched our 2020 World AIDS Day report--Prevailing Against Pandemics by Putting People at the Centre--which shows that five years after a global commitment to fast-track the HIV response and end AIDS by 2030, the world is off track. A promise to build on the momentum created in the first decade of the twenty-first century by front-loading investment and accelerating HIV service provision has been fulfilled by too few countries.

Although some countries in sub-Saharan Africa, such as Botswana and Eswatini, have done remarkably well and have achieved or even exceeded the targets set for 2020, many more countries are falling way behind. The high-performing countries have created a path for others to follow. UNAIDS has worked with its partners to distil those lessons into a set of proposed targets for 2025 that take a people-centred approach.

As COVID-19 pushes the AIDS response even further off track and the 2020 targets are missed, UNAIDS is urging countries to learn from the lessons of underinvesting in health. With this report, UNAIDS calls on countries to step up global action to end AIDS and other pandemics and proposes bold new HIV targets for 2025 to put the world back on track to end AIDS as a public health threat by 2030.  

“The collective failure to invest sufficiently in comprehensive, rights-based, people-centred HIV responses has come at a terrible price,” said Winnie Byanyima, Executive Director of UNAIDS. “Implementing just the most politically palatable programmes will not turn the tide against COVID-19 or end AIDS. To get the global response back on track will require putting people first and tackling the inequalities on which epidemics thrive.”

Modelling of the COVID-19 pandemic’s long-term impact on the HIV response shows that there could be an estimated 123 000 to 293 000 additional new HIV infections and 69 000 to 148 000 additional AIDS-related deaths between 2020 and 2022. Of the 38 million people living with HIV in 2019, 25.4 million people are now on HIV treatment, with 12.6 million people still waiting. In 2019 there were 690,000 AIDS-related deaths. Failure to act immediately will cost lives, diminish health and lead to further increases in the costs of treatment—all of which will burden future generations as resources will be needed for HIV treatment and care programmes well beyond 2030.

“No country can defeat these pandemics on its own,” said Ms Byanyima. “A challenge of this magnitude can only be defeated by forging global solidarity, accepting a shared responsibility and mobilizing a response that leaves no one behind. We can do this by sharing the load and working together.”

There are bright spots: the leadership, infrastructure and lessons of the HIV response are being leveraged to fight COVID-19. The HIV response has helped to ensure the continuity of services in the face of extraordinary challenges. The response by communities against COVID-19 has shown what can be achieved by working together.

In addition, the world must learn from the mistakes of the HIV response, when millions in developing countries died waiting for treatment. Even today, as mentioned, more than 12 million people still do not have access to HIV treatment and 1.7 million people became infected with HIV in 2019 because they did not have access to essential HIV services.

Everyone has a right to health, which is why UNAIDS has been a leading advocate for a People’s Vaccine against COVID-19. Promising COVID-19 vaccines are emerging, but we must ensure that they are not the privilege of the rich. Therefore, UNAIDS and partners are calling on pharmaceutical companies to openly share their technology and know-how and to wave their intellectual property rights so that the world can produce successful vaccines at the huge scale and speed required to protect everyone.

UNAIDS Executive Director Winnie Byanyima's message for World AIDS Day:

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2020/november/world-aids-day-2020-message-from-executive-director-winnie-byanyima

UNAIDS 2020 World AIDS Day Report press release: 

https://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2020/november/20201126_bold-new-aids-targets-for-2025

UNAIDS 2020 World AIDS report:

https://www.unaids.org/sites/default/files/media_asset/prevailing-against-pandemics_en.pdf?

Annotated Outline for the Global AIDS Strategy 2021-2026

At the 45th meeting of UNAIDS' Programme Coordinating Board in December 2019, UNAIDS Executive Director Winnie Byanyima presented her vision for the global HIV response and affirmed that the next UNAIDS Strategy would provide a bridge from 2020 to 2025 and towards the achievement of the target of ending AIDS as a public health threat by 2030 as part of the Sustainable Development Goals (SDGs). She committed to the PCB that the process to develop the next Strategy would be evidence-based, data-driven and highly consultative. She also indicated UNAIDS’ plan to present the new Strategy for the PCB’s adoption in time to inform the anticipated United Nations (UN) General Assembly High-Level Meeting on AIDS in 2021.

The "Global AIDS Strategy 2021–2026: A people-centred HIV response" is a global strategy being co-created with the participation of diverse stakeholders involved in the HIV response. It is based on data and evidence, and it draws of many impacted by, and working to end, HIV/AIDS. This is a strategy for all people and countries, with a direct focus on reducing HIV inequalities and inequities both within and between countries.

Inclusive consultations in the strategy review and development process were undertaken, with the participation of over 10,000 stakeholders globally. Participants included PCB members, government entities (including ministries of health, education and finance), national AIDS commissions, civil society advocates and implementers, people living with and affected by HIV, key populations, young people and faith-based organizations. Also participating were representatives from parliaments, science and academia, philanthropists, donors, the private sector, and global health partners such as the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund), the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), Unitaid, Stop TB, various foundations, UNAIDS Cosponsors and members of the UNAIDS Advisory Group. Reports of the consultations are available on the UNAIDS website. Strategy workshops were organized on 20 August and 6 November 2020 to analyze the inputs received and to discuss the issues needing to be addressed in the next global AIDS Strategy.

UNAIDS will continue to lead an inclusive, consultative process to finalize the Global AIDS Strategy 2021–2026 after the 47th PCB meeting in December 2020. The Executive Director proposes that the strategy be finalized in the first quarter of 2021 and be presented to the PCB for adoption at a Special Session of the PCB no later than the end of March 2021.

At the time of publication of this paper (25 November 2020), preparations for the High-Level Meeting were in their early stages. On 11 November 2020, the President of the 75th session of the UN General Assembly, H.E. Mr. Volkan Bozkir, appointed H.E. Mr. Mitchell Peter Fifield, Permanent Representative of Australia to the UN, and H.E. Mr. Neville Melvin Gertze, Permanent Representative of Namibia to the UN, to cofacilitate the process related to the convening of the High-Level Meeting on HIV and AIDS. The cofacilitators will begin consultations with Member States to negotiate a resolution to be adopted by the UN General Assembly, which will set forth the modalities for the High-Level Meeting, including the date, duration, scope, format, participation and outcome. Additional details will be provided to the PCB during its 47th meeting in December 2020.

The review of the current UNAIDS Strategy found that the policies, approaches and principles in the current Strategy are based on data, evidence and sound programmatic approaches which have delivered results. The review also found that the implementation of the current UNAIDS Strategy has been uneven. In many countries and contexts, the evidence-based approaches in the current UNAIDS Strategy have not been implemented with sufficient speed, scale, quality and resources to achieve the expected impact.

Experience shows that dramatic progress to end AIDS is necessary and possible. Recent years have provided extensive additional evidence, knowledge and experience on how best to respond to HIV, how to move from outbreaks to breakthroughs and even epidemic transition, and how to improve outcomes, health and wellbeing for people living with, most at risk and affected by HIV. The process of developing the next global AIDS Strategy capitalizes on this evidence, knowledge and experience; builds on the policies, approaches, and principles in the current UNAIDS Strategy. The AIDS pandemic continues to require a multisectoral response, combining biomedical approaches with attention to key social and structural factors. 

In 2020, the COVID-19 pandemic has tested the resilience of all health care systems and has placed the gains made in the global HIV response at risk. COVID-19 has also reminded us that AIDS remains an urgent pandemic. We have the science and tools to prevent each new HIV infection, to avoid each AIDS-related death and to eliminate HIV-related stigma and discrimination.  

Urgency is especially needed to: 

1. Ramp up HIV prevention - intensify leadership, combination prevention, community-led programmes adequately financed, and remove legal and structural barriers.

2. Reach those most affected by HIV who are still being left behind, especially people living with HIV, key populations, including young key populations and women and girls in subSaharan Africa.

3. Meaningfully address inequalities, social enablers and the integration of services.

4. Tailor the HIV responses to the needs of different population groups in different locations and context, investing in evidence-based interventions and community-led responses.

5. Close the most glaring gaps of the response (such as paediatric HIV, loss-to-follow-up, HIV prevention for key population and young people)

The Annotated Outline for the Global AIDS Strategy 2021-2026 (Part I of this paper summarizes the process to develop the next global AIDS Strategy for 2021–2026. Part II of the paper presents the annotated outline of the Strategy for consideration by the Programme Coordinating Board (PCB) at its 47th meeting in December 2020.):

https://www.unaids.org/en/resources/documents/2020/PCB47_Annotated_Outline_Strategy

Documents for UNAIDS' 47th Programme Coordinating Board meeting:

https://www.unaids.org/en/whoweare/pcb/47

Best regards,

Regan Hofmann

Director, a.i., U.S. Liaison Office

UNAIDS