The momentum is set to continue. By the end of 2016, WHO had prequalified more than 250 finished pharmaceutical products for treating HIV-related conditions, 29 active pharmaceutical ingredients, and two male circumcision devices. Since 2013, more than 100 countries have drawn on WHO technical support to develop concept notes for their Global Fund grant applications. The quality of funding applications improved, resulting in grants totalling $2 billion for country HIV programmes.
By 2017, WHO estimated that more than 18 million poor people now had access to antiretroviral therapy. In a remarkable achievement for a global health initiative, treatment coverage in eastern and southern Africa surpassed the global average.
Further expanding access to treatment is now at the heart of new “fast track” treatment targets for 2020, with the aim of ending the AIDS epidemic as a public health threat by 2030. WHO estimates that meeting the fast-track targets could prevent 1.6 million new infections and 600,000 deaths per year.
"By 2017, WHO estimated that more than 18 million poor people now had access to antiretroviral therapy." Dr Chan, WHO Director-General
Inspired by past achievements, optimism is great that sufficient momentum can be built to push the HIV epidemic into an irreversible decline, though the road ahead is not an easy one. The encouraging global outlook conceals the many countries with a major HIV burden yet low treatment coverage. Stark inequalities mar the landscape of service access. Stigma stifles the health-seeking behaviour of marginalized groups. The yearly number of new infections, stuck at more than 2 million, is way too high for a disease that can be prevented as well as treated. In some places, the number of new cases shows a stubborn upward trend.
The fact that HIV claimed more than a million lives in 2015 is a sobering reminder of the struggle ahead. The availability of affordable and highly effective medicines makes that figure stand out even more as an ethically compelling reason to do more.