Sustainable Development: Ending HIV/AIDS as an Epidemic by 2030
On Dec. 1, the global HIV/AIDS community will celebrate World AIDS Day and the ambitious goals and targets outlined in the United Nations’ Sustainable Development Goals. It is important that we reflect on the successes of our collective efforts to combat the disease globally, while also recognizing the challenges that lie ahead as we work on a plan to end HIV/AIDS as an epidemic by 2030.
The outbreak of HIV in rural Indiana this past spring and Charlie Sheen’s recent announcement about his HIV status demonstrate that HIV/AIDS is still affecting people domestically. Globally, the disease burden is stark, with an estimated 35 million people living with the disease around the world. Despite the challenges, the United Nations believes that an end to HIV/AIDS is within our reach. Therefore, in preparation for World AIDS Day 2015, the White House has declared that The Time to Act Is Now.
The tremendous success globally in fighting HIV/AIDS can largely be attributed to the United Nations’ Millennium Development Goals (MDGs), specifically MDG 6: Combat HIV/AIDS, Malaria, and Other Diseases. Following this bold goal and through the work of the global health community, including U.S. leadership through the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund, nearly 8 million AIDS-related deaths have been averted, 30 million HIV infections have been prevented, and 15.8 million people currently have access to lifesaving antiretroviral therapy.
As we applaud and reflect on these successes, we must look forward to the Sustainable Development Goals (SDGs), recently adopted by the United Nations, as new goals for organizations and governments worldwide. The SDGs set the bar even higher for HIV/AIDS than the previous MDGs. SDG 3 aims to “Ensure healthy lives and promote well-being for all at all ages,” setting an ambitious target to end the HIV/AIDS epidemic as a public health threat by 2030. While scientifically possible, the estimated price tag for achieving this target is $31.1 billion a year, much more than the current funding level of $20 billion annually.
As we celebrate World AIDS Day, it is important to consider how the global community will fund the fight against HIV/AIDS moving forward. Currently, the Global Fund and the United States provide almost 80 percent of global HIV/AIDS funding, but the funding needed to eliminate the disease is more than they alone can feasibly and sustainably provide. No one entity, organization, or government can tackle all global health threats or even HIV/AIDS in a vacuum.
The answer lies in a global, multi-sectoral approach that incentivizes innovative financing such as domestic resource mobilization. We must bring everyone to the table to see an end to HIV/AIDS. This means that in addition to continued, robust funding from traditional donors (e.g., countries, foundations, the private sector, etc.), implementing countries must increase their own domestic health budgets to ensure the sustainability of programs. Currently, organizations like the Global Fund and PEPFAR are working with partners to support in-country innovations and make domestic financing part of their strategic plans. For instance, PEPFAR announced that under Angola’s partnership framework, the country would finance approximately 80 percent of total expenditures for HIV, including an estimated 50 percent of expenditures targeted to HIV prevention programs. Angola’s overall health expenditures increased from 4.1 percent of the national budget in 2006 to 6.7 percent in 2008, in line with the government’s goal of 15 percent by 2015. Additionally, the Global Fund has worked with countries and partners globally and recently stated that African countries, with the support of other partners such as UNAIDS, have increased their domestic resources to respond to HIV by 150 percent in the last four years.
Multi-sectoral collaboration and increased domestic investment in health are the only ways to ensure country ownership and sustainability of HIV/AIDS programs in the future. With continued efforts like these, we can and will see an end to HIV/AIDS by 2030.