washington — Thousands of policymakers, health care professionals and advocates gathered this week in Munich, Germany, to take stock of the global fight against HIV as they try to meet the 2030 deadline set by world leaders for eliminating AIDS as a public health threat.

Advocates hailed sub-Saharan Africa’s progress in the global HIV response, with tens of millions of people now on lifesaving drugs.

A new UNAIDS survey released during the conference reported that “approximately 30.7 million of the estimated 39.9 million people living with HIV globally were receiving antiretroviral therapy in 2023.”

The report called that result a “landmark public health achievement,” and health officials at the conference said it would not be possible without the “immense political will” of regional leaders and NGOs.

Anne Githuku-Shongwe, the UNAIDS regional director for eastern and southern Africa, told VOA from Johannesburg that recently there has been a “huge focus” on ensuring that anyone living with HIV in sub-Saharan Africa gets access to testing and treatment to ensure virus suppression, so the virus becomes untransmissible.

“The data is telling us that 84% of people living with HIV in our region have access to treatment. And 94% of those on treatment have been able to keep [the virus] suppressed so it is untransmissible,” she said.

However, Githuku-Shongwe pointed out that despite the progress that has been made, some countries in Africa are lagging behind in the battle against HIV/AIDS, partly because of civil wars, humanitarian setbacks and sheer negligence. She mentioned South Sudan, Angola, Madagascar, Mauritius, Seychelles and the Comoros as examples.

“[Countries] like Mauritius are barely at 50% of the treatment target,” she said, adding that another critical challenge being faced is the lack of attention to children living with the virus.

The report said children aged 0-14 years are still contracting HIV. An estimated 120,000 children got the virus in 2023, bringing the number of children living with HIV globally to 1.4 million, 86% of whom are in sub-Saharan Africa, according to the UNAIDS report.

Worries about donor funding

Githuku-Shongwe said there have been major investments from partners – particularly from PEPFAR, a U.S.-funded initiative to tackle the HIV/AIDS crisis, and the Global Fund to Fight AIDS, Tuberculosis and Malaria. She noted that in some countries, up to 99% of the HIV response is externally funded.

“But with time we are seeing that dwindling,” she said.

Nearly $19.8 billion was available in 2023 for HIV programs in low- and middle-income countries, almost $9.5 billion short of the amount needed by 2025, the report said.

Catherine Connor, vice president in charge of public policy and advocacy at the Elizabeth Glaser Pediatric AIDS Foundation, a Washington nonprofit, told VOA from Munich that the data on infections in children were “troubling” and pointed to a lackadaisical approach toward pediatric HIV.

“The report clearly shows that children are one out of every 10 new infections, which is really high,” she said. “But there’s also an outsized mortality issue around children. Children make up 3% of the HIV-infected population, but they represent 12% of deaths.”

Connor said there’s inequity in treatment, particularly for children living with HIV.

“Children can’t take themselves to clinics. They often don’t even know they’ve been exposed to HIV,” she said. “So they really rely on caregivers, the community around them, to ensure not just that they can be identified as being HIV-exposed or potentially HIV-positive, but also get the needed support to maintain their health, even if they are on treatment.”

Connor concluded that world leaders and policymakers should be made aware how significant it is to act on HIV prevention, because if the world fails to take steps to curtail the virus, then “we will not end AIDS.”

“It’s almost like having a dam holding back a river of water,” she said.

“HIV is preventable and treatable, but it is not curable. And so, if we let cracks in that dam get so bad, it’s going to break, and we are going to see a reemergence of the HIV/AIDS pandemic in ways we have never seen,” Connor said.
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