The progress made in responding to HIV over the past 15 years has given the world real hope of ending the AIDS epidemic by 2030. Earlier this year, at a special meeting at the United Nations in New York, countries agreed that the global response to the epidemic had to be accelerated to reach three Fast-Track milestones by 2020: reducing AIDS-related deaths to fewer than 500,000 a year, reducing new HIV infections to fewer than 500,000 a year and ending HIV-related stigma and discrimination. Reaching these milestones by 2020 would put the world on track to ending the AIDS epidemic by 2030. So, how are we doing?

Looking at the numbers

Owing to the growing number of people living with HIV taking antiretroviral medicines, the number of AIDS-related deaths dropped to 1.1 million in 2015, compared to 2 million in 2005, and efforts to eliminate mother-to-child transmission of HIV have achieved steep declines in the annual number of new HIV infections among children.

But progress in avoiding new HIV infections among adults is less reassuring and the failure to deliver effective HIV prevention programs to the people most in need threatens to prolong the AIDS epidemic into the second half of the century.

For at least the past five years, the number of new infections among adults aged 15 years and over has stalled, at an estimated 1.9 million every year. Achieving the benchmark of fewer than 500,000 new HIV infections by 2020 is in jeopardy — there needs to be an urgent and immediate scale-up of HIV prevention services or we could see ever-expanding numbers of people living with HIV in need of antiretroviral medicines.

“For at least the past five years, the number of new infections among adults aged 15 years and over has stalled, at an estimated 1.9 million every year.”

Increasing prevention

Fortunately, the range of methods available to prevent HIV has never been wider — we now need to ensure that people have the knowledge, information and, most importantly, the right to access them.

For example, we know that young women aged 15 to 24 years old are particularly vulnerable to HIV infection, but equally that adolescents are not being equipped with the life skills to make free and informed decisions about their sexual health.

Key populations, including sex workers, people who inject drugs, transgender people, and men who have sex with men, still aren’t getting the services and support they require, despite being at much higher risk of HIV infection than other people.

Meeting the milestones

Part of the solution lies in the development of innovative peer-led programs and services and the use of digital technologies and scientific breakthroughs that better respond to people’s individual needs.

These include self-testing kits that allow people greater control over their health, access to medicines, such as pre-exposure prophylaxis, that stop HIV infection and prevention options that increase women’s autonomy over their own sexual and reproductive health and rights. International donors and individual countries urgently need to invest more in HIV prevention and testing programs that are tailored to reach the people at the highest risk.

At the same time, governments must create legal and cultural environments in which people feel comfortable accessing those services without fear of criminalization, marginalization or discrimination.

Then we can finish what we started — we can end the AIDS epidemic.