This document outlines the Joint United Nations Programme on HIV/AIDS (UNAIDS) 2016-2021 strategy to end the AIDS epidemic as a public health threat by 2030. The strategy maps out the UNAIDS Fast-Track approach to accelerating the AIDS response over the next five years with the aim of reaching the following goals or milestones by 2020: fewer than 500,000 people newly infected with HIV, fewer than 500,000 people dying from AIDS-related causes, and elimination of HIV-related discrimination. By reaching these targets, the strategy hopes to be on track towards ending the epidemic by 2030, when the target is Zero new HIV infections, Zero discimination, and Zero AIDS-related deaths.
As stated in the document, "The UNAIDS 2016–2021 Strategy comes at a critical moment in the history of the HIV epidemic and response. Evidence demonstrates that if the current, unprecedented level of HIV service coverage is simply maintained, progress will slip backwards, with rising numbers of people newly infected and more people dying from AIDS-related causes. Nevertheless, we have never had more opportunities to leverage our momentum to accelerate the response over the next five years: a new sustainable development agenda; fresh, innovative solutions; and the rise of regional, national and local leadership and institutions—including strong political commitment to the 90–90–90 treatment target."
The UNAIDS 2016–2021 Strategy is one of the first in the United Nations system to be aligned to the Sustainable Development Goals (SDGs), which set the framework for global development policy over the next 15 years, including ending the AIDS epidemic by 2030. The strategy is organised around five SDGs most relevant to the AIDS response: good health and wellbeing (SDG 1), reduce inequalities (SDG 10), achieve gender equality (SDG 5), promote just and inclusive societies (SDG 16), and revitalise global partnerships (SDG 17).
The strategy has set ten critical targets to ensure that the Fast-Track goals will be met by 2020:
Target 1 - 90% of people (children, adolescents, and adults) living with HIV know their status; 90% of people living with HIV who know their status are receiving treatment; and 90% of people on treatment have suppressed viral loads.
Target 2 - Zero new HIV infections among children, and mothers are alive and well.
Target 3 - 90% of young people are empowered with the skills, knowledge, and capability to protect themselves from HIV.
Target 4 - 90% of women and men, especially young people and those in high-prevalence settings, have access to HIV combination prevention and sexual and reproductive health services.
Target 5 - 27 million additional men in high-prevalence settings are voluntarily medically circumcised, as part of integrated sexual and reproductive health services for men.
Target 6 - 90% of key populations, including sex workers, men who have sex with men, people who inject drugs, transgender people, and prisoners, as well as migrants, have access to HIV combination prevention services.
Target 7 - 90% of women and girls live free from gender inequality and gender-based violence to mitigate the risk and impact of HIV.
Target 8 - 90% of people living with, at risk of, and affected by HIV report no discrimination, especially in health, education, and workplace settings.
Target 9 - Overall financial investments for the AIDS response in low- and middle-income countries reach at least US$ 30 billion, with continued increase from the current levels of domestic public sources.
Target 10 - 75% of people living with, at risk of and affected by HIV, who are in need, benefit from HIV-sensitive social protection.
To achieve all the targets, the strategy outlines a list of eight result areas. These constitute core dynamic and cross-cutting programmes of work. The result areas are aligned with some of the key SDGs which have the most relevance to HIV/AIDS.
Good health and well-being for all at all ages (SDG 3)
- Children, adolescents and adults living with HIV access testing, know their status, and are immediately offered and sustained on affordable quality treatment.
- New HIV infections among children are eliminated, and their mother's health and well-being is sustained.
Reduced inequalities in access to services and commodities (SDG 10)
- Young people, particularly young women and adolescent girls, access combination prevention services and are empowered to protect themselves from HIV.
- Tailored HIV combination prevention services are accessible to key populations, including sex workers, men who have sex with men, people who inject drugs, transgender people, and prisoners, as well as migrants.
Achieve gender equality and empower women and girls (SDG 5)
- Women and men practice and promote healthy gender norms and work together to end gender-based, sexual, and intimate partner violence to mitigate risk and impact of HIV.
Promote just, peaceful and and inclusive societies (SDG 16)
- Punitive laws, policies, practices, stigma, and discrimination that block effective responses to HIV are removed.
Partnerships for the goals (SDG 17)
- AIDS response is fully funded and efficiently implemented based on reliable strategic information.
- People-centred HIV and health services are integrated in the context of stronger systems for health.
In terms of how these targets and result areas are going to be achieved, the document states that "Fast-Tracking the response will require working closely with communities, countries and partners to undertake a series of transformative shifts at all levels: (1) front-loading an increasingly diverse bundle of investments; (2) laser-like focusing on the locations, populations and interventions that will deliver the greatest impact; (3) catalysing innovation for people who need it most; (4) leveraging regional leadership and political institutions for more targeted, sustainable and accountable responses; (5) launching a new era of intersectoral partnerships to address the determinants of vulnerability, including discrimination and gender inequality; and (6) committing to the GIPA principle (greater involvement of people living with HIV) and people-centred accountability under the 2030 Agenda for Sustainable Development."
UNAIDS, in particular, intends to deliver on the strategy by relying on the strength of "the diversity of its Cosponsors, the added value of the UNAIDS Secretariat in supporting multisectoral responses, and its unique governance body, which comprises Member States, UNAIDS Cosponsors and regional nongovernmental organizations. In implementing this Strategy, especially in the context of the 2030 Agenda for Sustainable Development, the role of the Joint Programme must continue to evolve. UNAIDS will strengthen its political advocacy, strategic policy advice and technical leadership, continue to convene and extend the scope of its partnerships, and improve support to countries to make optimal use of domestic and international resources, including from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the United States President's Emergency Plan for AIDS Relief (PEFPAR). UNAIDS will focus on five core aspects of the response: information, investment, inclusion, integration and innovation. As a convener and coordinator, UNAIDS will continue to create new spaces for discussion and new models of collaboration that acknowledge and work within our increasingly complex environment."
UNAIDS website on November 24 2015.