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Phenomenal Progress and Enduring Emergency: 4 Decades of Fighting AIDS 

Connie Mudenda smiles alongside her daughter Lubona | Photo by Jonx Pillemer, (RED)

Jennifer Lotito

President and COO, (RED)

Connie Mudenda will never forget her 36th birthday.

In the 1980s and 1990s, the Zambian mother lost three children to AIDS. Testing, treatment, and care were only available in the world’s wealthiest countries. Discrimination and injustice prevented Connie and millions of Africans from accessing life-saving medicine.

But on October 13, 2004, Connie finally gained free access to antiretroviral treatment (ART). “On my birthday, I was born again, and it’s because of the medication,” she told (RED), the organization co-founded by Bono and Bobby Shriver to fight AIDS and the injustices that enable pandemics to thrive, in a recent interview.

Where are we now?

The AIDS fight has experienced unimaginable progress in recent decades. In 2000, just 685,000 people had access to antiretroviral therapy. In 2022, 29.8 million people were living with HIV and accessing antiretroviral therapy. Medication has gone from costing roughly $27 a day in 2000 to as little as 11 cents a day. AIDS-related deaths have been slashed by nearly 70% since their peak in 2004.

That’s the good news. The bad news is that AIDS – especially in low- and middle-income countries – remains a deadly crisis. The days of AIDS dominating newspaper headlines and leading nightly newscasts are long over. But the threat persists, and it’s as real as ever.

Every minute, someone dies of AIDS-related causes. Every five minutes, a child dies from the disease. And roughly 4,000 girls and young women contract HIV every week.

It appears we’ve gotten so good at touting the phenomenal progress against AIDS that the world has forgotten the enduring emergency.

Battling stigma

Stigma and discrimination have plagued the AIDS fight since its inception. Misinformation, fear, and hysteria were fueled by media headlines like “The Man Who Gave Us AIDS” and “Britain Threatened by Gay Virus Plague,” which shaped societal attitudes.

A recent report from the Gay & Lesbian Alliance Against Defamation found that Americans are becoming more intolerant of certain people living with HIV. More education, empathy, and outreach are needed to dismantle the walls that keep too many people living with HIV, especially in key populations like the LGBTQIA+ community, sex workers, and people who inject drugs, from obtaining the critical care they need and deserve.

These attitudes have produced punitive policies and dangerous laws that have further fueled the crisis. “Stigma and discrimination obstruct HIV prevention, testing, treatment, and care, and hold back progress toward ending AIDS by 2030,” said UNAIDS Executive Director Winnie Byanyima in a recent statement. Ninety-four countries and 34 American states have laws that criminalize HIV exposure.

The path to ending AIDS

The medical solutions for ending the AIDS threat exist. Testing and treatment have been available for decades. What’s missing is the will to get those life-saving tools from wealthy countries to people and communities in places where systemic injustice has enabled AIDS to thrive.

When AIDS dominated headlines in the early 2000s, the money followed. As public attention drifted elsewhere, government resources did, too. The world is spending about as much fighting AIDS now as it was in 2013. This funding amounted to around $20.8 billion in 2022, which is significant, but also far short of the $29.3 billion experts say is needed by 2025.

Along with wealthy countries, beneficiary countries must also step up and do more. In the early 2000s, many low- and middle-income countries increased domestic spending to combat AIDS. However, 2022 marked the third year in a row where domestic HIV funding decreased. We must create a pathway that enables domestic countries to spend more on healthcare, and less on repaying old debts and mitigating the impacts of a climate crisis they did not cause.

Beyond governments, there’s a real opportunity for philanthropy and the private sector to change the trajectory of the fight. The COVID-19 pandemic demonstrated how a health crisis in one corner of the world can quickly impact every philanthropist and CEO in another. The time to invest in global health is before, not during a pandemic. Philanthropy and the private sector can make a difference by supporting proven global health initiatives like the Global Fund, medical research, and investments in innovative community health programs that can be scaled by governments.

All investors want a good bet, and global health investments are among the best around. Every dollar invested in tackling AIDS, tuberculosis, and malaria yields a return of $31 in health gains and economic returns. When governments, philanthropy, and the private sector unite to strengthen global health systems, increase capacity, and recruit and train more community health workers, they not only fight current epidemics, but also limit the risk of future debilitating pandemics.

A hopeful future

Ending the threat of AIDS will not be easy. Making preventable and treatable disease actually preventable and treatable for everyone, everywhere, will not happen quickly. But we’ve come so far already and cannot turn back.

I recently got an update from Connie, who is healthy and well thanks to her life-saving ART. She’s now a mother to a beautiful HIV-free daughter, Lubona, who celebrated her 11th birthday. Like any proud mom, Connie couldn’t resist sharing a video of her daughter’s classmates singing a rousing rendition of “Happy Birthday” as Lubona smiled as bright as the sun.

Birthdays are still cherished in the Mudenda household. Like the AIDS fight, they hold the hopeful promise of a brighter tomorrow.

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