Seventieth session Agenda item 11 Implementation of the Declaration of Commitment on HIV/AIDS and the Political Declarations on HIV and AIDS
Report of the UN Secretary-General on the fast track to ending the AIDS epidemic, UN Doc. A/70/811, 2016
On the fast track to ending the AIDS epidemic Report of the Secretary-General
I. Introduction Robust progress provides a solid foundation for the fast track
1. The global commitment to ending the AIDS epidemic, as set forth in the 2030 Agenda for Sustainable Development, represents an unparalleled opportunity to end one of the most devastating modern-day health challenges and also to build on the momentum of the AIDS response in order to accelerate results across the sustainable development agenda.
2. Even when confronted with the vast scale of the global AIDS epidemic, the response to HIV has never lost sight of the value and experience of each individual affected, their hopes and frustrations and their right to health and well-being. I have had the privilege of spending time with people engaged in the AIDS response, including people living with HIV. I have learned about their difficulties in getting access to the antiretroviral medicines that keep them alive and about the fear and stigma they live with each day. Many have also expressed their unwavering belief that we can end this epidemic. Their stories of courage and hope embody the resolve of all those involved in the AIDS response. Today, we can appreciate the remarkable progress we have made together, but also how far we have to go to ensure that no one is left behind.
3. The AIDS response has delivered more than results. It has delivered the aspiration and the practical foundation, including the medical advancements, interventions and partnerships, to end the epidemic by 2030. All that truly remains, the missing link that will determine whether fast-track targets will be met or missed, is the political commitment to implement our proven tools adequately and equitably.
4. The AIDS response engages State and non-state actors, works across sectors and tackles social drivers and human rights abuses. I am proud to see investments in the AIDS response do so much to drive the development of health systems, social protection and community resilience. I believe that the approaches and mechanisms pioneered by the AIDS response can serve to overcome systemic challenges that give rise to repeated disease outbreaks and new epidemics of chronic diseases, while building towards equitable universal health coverage.
5. Yet AIDS is far from over. We cannot afford to lose in the AIDS response. The next five years present a narrow window of opportunity to radically change the trajectory of the epidemic. Despite remarkable progress, if we accept the status quo unchanged, the epidemic will rebound in several low- and middle-income countries. More people will acquire HIV and die from AIDS-related illness in 2030 than in 2015. Treatment costs will rise sharply. Failure to control the AIDS epidemic will undermine efforts to end tuberculosis and reduce rates of maternal and child mortality, hepatitis C and cervical cancer. Our tremendous investment, and the world’s most inspiring movement for the right to health, will have been in vain.
6. But that bleak future need not be ours. Today, ending the AIDS epidemic as a public health threat by 2030 is within our reach, if we fast-track the response by embracing ambitious targets for 2020 and increasing and front-loading investments. We must reinforce rights-based approaches, including those that foster gender equality and empower women. Access to services must be ensured for the people most affected, marginalized and discriminated against, including people living with HIV; young women and their sexual partners in sub-Saharan Africa; children and adolescents everywhere; gay men and other men who have sex with men; sex workers and their clients; people who inject drugs; transgender people; peopl e in prison; people with disabilities; migrants; and refugees.
7. Ending AIDS requires HIV and other health and social needs to be met throughout a lifetime, including when a person is at risk of acquiring HIV, when a person requires lifetime access to treatment and when an individual, family or community may have to care for orphans and people living with HIV. Ending AIDS demands focusing resources in the countries, districts, subdistricts and city boroughs most affected and tailoring services to populations at risk and communities living in fragile contexts. It requires people-centred innovation, from transforming and reinforcing community- and facility-based service delivery to developing more effective, affordable health products, including a vaccine and cure.
8. Punitive and discriminatory laws need to change. Stigma and discrimination and gender-based violence must finally be ended. Social and economic drivers of health, such as food and nutrition security, housing, education, employment and economic empowerment, must be addressed. Doing so will demand new kinds of partnership that capitalize on the contributions of civil society, Governments, regional political institutions, international organizations, academia, faith-based organizations and the private sector.
9. Through a fast-track, multisectoral response to AIDS, and through making more strategic use of the machinery built by the response, considerable contributions to a range of Sustainable Development Goals (see General Assembly resolution 70/1) will be made, including on poverty elimination, food and nutrition security, health, gender equality, decent work, reducing inequalities, cities, justice and inclusive institutions and partnership. With that aim in mind, I call on all partners to work together more coherently across political, cultural, religious and institutional divides. I urge the international community to support the United Nations in becoming fit to deliver on the 2030 Agenda for Sustainable Development, including by reinforcing and expanding on the unique multisector, multi-actor approach of the Joint United Nations Programme on HIV/AIDS (UNAIDS), as reaffirmed by the Economic and Social Council in 2015.
10. The year 2015 marked the target year of the Political Declaration on HIV and AIDS: Intensifying our Efforts to Eliminate HIV and AIDS, adopted by the General Assembly in 2011, as well as that of the Millennium Development Goals. The present report provides a review of the 10 targets of the Political Declaration and, in the context of several Sustainable Development Goals, looks forward, highlighting areas of urgency and opportunity.
11. The high-level meeting on HIV/AIDS, to be held in June 2016 by the General Assembly (see resolution 70/228) is a pivotal occasion to rally global commitment to the fast-track targets and core actions for ending AIDS by 2030, as outlined in the UNAIDS 2016-2021 Strategy, “On the Fast-Track to end AIDS”. It provides the opportunity to build on the lessons learned from the AIDS response and to work with the people, institutions and networks that sustain it, to truly advance a paradigm shift to the integrated development approach envisioned in the Sustainable Development Goals. Together we can achieve success, measured by the assurance of people’s health, human rights, dignity and ability to thrive in the long term.