Antiretroviral Therapy (ART) is now being given to people living with HIV, irrespective of the CD4 count.

Reasons for the slowdown in progress:

• The success achieved in the early part of this century, through a determined global thrust against the global threat, led to a complacent assumption of a conclusive victory.
• The expanded health agenda in the SDGs stretched the resources of national health systems, even as global funding streams started identifying other priorities.
• Improved survival rates reduced the fear of what was seen earlier as dreaded death and pushed the disease out of the headlines.
• The information dissemination blitz that successfully elevated public awareness on HIV prevention did not continue to pass on the risk-related knowledge and strong messaging on prevention-oriented behaviours to a new generation of young persons.
• Vulnerability of adolescent girls to sexual exploitation by older men and domineering male behaviours inflicting HIV infection on unprotected women have been seen as factors contributing to new infections in Africa.
• Risk factors for cardiovascular disease are high among survivors as they age, with anti-retroviral drugs increasing the risk of atherosclerosis.
• Other infectious diseases, such as tuberculosis can co-exist and cannot be addressed by a siloed programme.
• Mental health disorders are a challenge in persons who are on lifelong therapy for a serious disease that requires constant monitoring and often carries stigma.

There are worryingly high rates of new infection in several parts of the World. Only 19 countries are on track to reach the 2030 target.

Conclusion:

Drug treatment of HIV is now well founded with an array of established and new anti-viral drugs.

The success of drug treatment to prevent mother-to-child transmission, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), and male circumcision, especially among MSM population, is well-documented.

Success in our efforts to reach the 2030 target calls for resurrecting the combination of political will, professional skill and wide ranging pan-society partnerships that characterised the high tide of the global response in the early part of this century.

The theme of the World AIDS day this year (“Ending the HIV/AIDS Epidemic: Community by Community), which is communities make the difference, is a timely reminder that community wide coalitions are needed even as highly vulnerable sections of the community are targeted for protection in the next phase of the global response.