Central to the Fast-Track commitments are three overarching Fast-Track Targets:
UNAIDS is working towards ensuring that, by 2020, 30 million people have access to treatment through meeting the 90–90–90 targets, whereby 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads.
Since UNAIDS launched the 90–90–90 initiative in 2014, it has advocated for a range of actions to achieve the targets: stepping up HIV testing services worldwide; bringing down the cost of antiretroviral therapy, so limited resources can go further; and brokering deals to bring down the price of viral load tests. More and more countries are getting on the Fast-Track, with more than half of all people living with HIV—20.9 million people—now on treatment.
At the end of 2016, the total number of people living with HIV stood at 36.7 million, with the 90–90–90 targets standing at 70% of people living with HIV knowing their HIV status, 77% of people who knew their HIV-positive status accessing treatment and 82% of people on treatment having suppressed viral loads.
UNAIDS, working with the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and other partners through the Start Free, Stay Free, AIDS Free framework, is building on the tremendous progress achieved under the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan), which saw 60% fewer children newly infected with HIV in the 21 Global Plan priority countries in just six years.
Under the Political Declaration commitments, by 2018, 1.6 million children should have access to HIV treatment, and, by 2020, new HIV infections among children should be eliminated.
UNAIDS’ support to Start Free, Stay Free, AIDS Free is focused on helping the world build towards the ambitious shared goal of ending AIDS among children. Through a Super-Fast-Track approach, children, adolescents and young women will access HIV prevention, treatment, care and support services, bringing the world one step closer to an AIDS-free generation.
UNAIDS is helping countries to meet the commitment to ensure access to the range of prevention options, including pre-exposure prophylaxis, voluntary medical male circumcision, harm reduction and condoms, to at least 90% of people, including key populations, by 2020.
The UNAIDS Quarter for HIV Prevention campaign advocates for 25% of AIDS funding to be spent on HIV prevention programmes. UNAIDS modelling on resource needs for the AIDS response shows that investing around a quarter of all the resources required for the AIDS response in HIV prevention services is sufficient to scale up services to dramatically reduce new HIV infections—a target agreed to in the Political Declaration. But Quarter for HIV Prevention is more than a call for more resources: it is a call for effectiveness, efficiencies and impact for every quarter that is invested in HIV prevention.
The Prevention Coalition, a joint initiative with the United Nations Population Fund, has launched a road map to chart the way to reducing new HIV infections by 75% by 2020—a key target towards ending AIDS by 2030.
UNAIDS has worked to ensure that no one is left behind and has championed the rights of girls and women and of key populations—gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs, prisoners and other incarcerated people and migrants—to ensure that they can access the HIV services they need.
AIDS won’t be ended without eliminating gender inequalities and ending all forms of violence and discrimination against women and girls, people living with HIV and key populations, something that countries have committed to achieve by 2020.
Working with partners, UNAIDS programmes are strengthening the empowerment of women and helping countries to stop violence in all its forms in order to meet this vital target.
UNAIDS has engaged and empowered civil society and people living with HIV in the AIDS response. It has promoted a fundamental change, from a centralized and medicalized HIV response to one that is driven and delivered by communities, extending reach and reducing costs.
The United Nations Political Declaration on Ending AIDS calls for 75% of people living with, at risk of and affected by HIV to benefit from HIV-sensitive social protection by 2020 and for at least 30% of all service delivery to be community-led by 2020.
UNAIDS is working to ensure that communities are empowered to engage, own and direct HIV programmes and promotes the full inclusion of civil society. Since social protection is acknowledged to benefit the AIDS response through increased access to HIV services for all people, including the most marginalized and excluded in society, UNAIDS assists countries to develop and implement evidence-informed programming on HIV and social protection.
UNAIDS has helped to make the resources for the AIDS response go further. Through advocacy, negotiation and collaboration with the private sector, technical partners and affected countries, UNAIDS has helped to reduce the cost of life-saving medicines for people living with HIV by 100-fold. It has helped to reduce the cost of diagnosing HIV and monitoring HIV treatment effectiveness, to reduce the time in which new medicines developed in high-income countries became available and affordable and to reduce the number of pills from 15 per day to one per day.
In the Political Declaration, countries committed to increasing HIV investments to US$ 26 billion by 2020, including a quarter for HIV prevention and 6% for social enablers. However, in 2016, there was a US$ 7 billion gap, with only US$ 19.1 billion available. With funding flatlining, the world needs to do more to get on track to meeting the US$ 26 billion commitment.
UNAIDS supports countries in determining their AIDS investment needs and supports resource mobilization from both domestic and international sources. UNAIDS will continue to make the money work for people and to mobilize and advocate for a fully funded AIDS response, where the investment made reaches the people who need it.
UNAIDS has worked towards protecting and promoting human rights since its inception. UNAIDS has stood up for and amplified the voices of the most marginalized and their human rights defenders when HIV-related rights have been denied or threatened. It has harnessed the power of the United Nations to promote stronger leadership and accountability for ending all forms of violence, discrimination and exclusion in the context of HIV. UNAIDS has advocated for the removal of travel restrictions on people living with HIV, with the list of countries with travel restrictions decreasing from 59 in 2008 to 35 in 2015.