1 December 2017 – The world will not achieve the Sustainable Development Goals (SDGs) – which include the target of ending AIDS by 2030 – without people attaining their right to health, the United Nations said Friday, marking World AIDS Day with a strong appeal for the full realization of this fundamental right by everyone, everywhere.
“The right to health is a fundamental human right – everybody has the right to the enjoyment of the highest attainable standard of physical and mental health, as enshrined in the International Covenant on Economic, Social and Cultural Rights,” Michel Sidibé, Executive Director of the Joint UN Programme on HIV/AIDS (UNAIDS) said in his message on the Day.
Indeed, the right to health is linked to all the SDGs and “is interrelated with a range of other rights, including the rights to sanitation, food, decent housing, healthy working conditions and a clean environment.”
He explained that it includes: equal access to health care; adequate health-care infrastructure; respectful and non-discriminatory health-care services; and that healthcare must be medically appropriate and of good quality.
“But the right to health is more than that,” he continued, saying that with it, “people’s dreams and promises can be fulfilled.”
Mr. Sidibé pointed out the most marginalized and affected still face challenges in accessing urgently-needed health and social services, asserting “we all must continue to stand shoulder-to-shoulder with the people being left behind and demand that no one is denied their human rights.”
“For all the successes, AIDS is not yet over. But by ensuring that everyone, everywhere accesses their right to health, it can be,” he concluded.
In her message, Audrey Azoulay, the Director-General of the UN Educational, Scientific and Cultural Organization (UNESCO), stressed the right to quality education for all, because the two goals – health and education – go hand in hand. “This linkage stands at the heart of the 2030 Agenda for Sustainable Development and the UNAIDS 2016-2021 Strategy, she explained.
As outlined in UNESCO’s Strategy on Education for Health and Well-Being: Contributing to the Sustainable Development Goals, health and education are mutually reinforcing: healthy learners learn better, and better-educated learners are healthier.
“They are also mutually dependent – without the right to education we cannot truly fulfill the right to health,” Ms. Azoulay continued, stressing that in a world where young people – especially girls and young women – bear a disproportionate burden of HIV and AIDS, “we all must recognize that comprehensive sexuality education is central to their right to health, and to the health of all societies.”
Picking up that thread in her message, Phumzile Mlambo-Ngcuka, the Executive Director of UN Women, said that according to UNAIDS, every four minutes, three young women become infected with HIV.
“They are clearly not enjoying their right to health, nor will they, until we are able to reverse the inequalities and discrimination that fuel HIV spread. Those whose health and future are currently least prioritized must become our focus, if we are to achieve the changes we seek,” she said.
As such, leaving no woman or girl behind in the HIV response means ensuring their meaningful participation and engagement in designing that response, improving access to services and demanding their right to health.
“To do that, we foster women’s voices and leadership and support their place at decision-making tables,” Ms. Mlambo-Ngcuka continued, adding that in 2016, UN Women supported networks of women living with HIV in 31 countries to increase their engagement in the national HIV responses. “This World AIDS Day, UN Women calls for a commitment to prioritize and reach all the women and girls being left behind in the HIV response: every last woman and girl.”
Threat of complacency
Meanwhile, according to the UN Children’s Fund (UNICEF), in 2016, 120,000 children under age 14 died of AIDS-related causes while hourly, 18 were newly infected.
The 2017 UNICEF Statistical Update on Children and AIDS, launched Friday, projects that if current trends persist, there will be 3.5 million new adolescent HIV infections by 2030.
“It is unacceptable that we continue to see so many children dying from AIDS and so little progress made to protect adolescents from new HIV infections,” said Dr. Chewe Luo, Chief of HIV for UNICEF.
“The AIDS epidemic is not over; it remains a threat to the lives of children and young people and more can and should be done to prevent it,” he added.
A UNICEF analysis of demographic trends and new HIV data reveals that targets set in the 2020 Super-Fast-Track framework developed in 2016 to end AIDS among children, will not be achieved.
While noting that mother-to-child HIV transmissions have declined and two million new infections in children have been averted, UNICEF warns that such progress must not lead to complacency, saying that progress in preventing, testing and treating HIV infections among adolescents has been unacceptably slow.
“To continue at this slow rate of progress is to gamble with the lives of children and commit future generations to a preventable life of HIV and AIDS,” Dr. Luo added. “We must act urgently in order to sustain any gains we have made in the past decade.”
To address HIV-response gaps, UNICEF proposes utilising emerging innovations; scaling-up the response for children; and strengthening governments’ capacity to collect of comprehensive, disaggregated testing and treatment data.
Innovative solutions must be adopted to speed up progress in preventing HIV infection of children and ensuring those living with HIV get the treatment they need.
10 facts on HIV/AIDS
Fact 1: HIV (human immunodeficiency virus) infects cells of the immune system
Infection results in the progressive deterioration of the immune system, breaking down the body’s ability to fend off some infections and other diseases. AIDS (Acquired immune deficiency syndrome) refers to the most advanced stages of HIV infection, defined by the occurrence of any of more than 20 opportunistic infections or related cancers.
Fact 2: HIV can be transmitted in several ways
HIV can be transmitted through:
* unprotected sexual intercourse (vaginal or anal) or oral sex with an infected person;
* transfusions of contaminated blood or blood products ortransplantation of contaminated tissue;
* the sharing of contaminated injecting equipment and solutions (needles, syringes) or tattooing equipment;
* through the use of contaminated surgical equipment and other sharp instruments;
* the transmission between a mother and her baby during pregnancy, childbirth and breastfeeding.
Fact 3: There are several ways to prevent HIV transmission
Key ways to prevent HIV transmission:
* practice safe sexual behaviours such as using condoms;
* get tested and treated for sexually transmitted infections, including HIV to prevent onward transmission;
* avoid injecting drugs, or if you do, always use sterile needles and syringes;
* ensure that any blood or blood products that you might need are tested for HIV;
* access voluntary medical male circumcision if you live in one of the 14 countries where this intervention is promoted;
* if you have HIV start antiretroviral therapy as soon as possible for your own health and to prevent HIV transmission to your sexual or drug using partner or to your infant (if you are pregnant or breastfeeding);
* use pre-exposure prophylaxis prior to engaging in high risk behaviour;demand post-exposure prophylaxis if there is the risk that you have been exposed to HIV infection in both occupational and non-occupational settings.
Fact 4: 36.7 million people are living with HIV worldwide.
Globally, an estimated 36.7 million (34.0–39.8 million) people were living with HIV in 2015, and 1.8 million (1.5–2.0 million) of these were children. The vast majority of people living with HIV are in low- and middle-income countries. An estimated 2.1 million (1.8–2.4 million) people were newly infected with with HIV in 2015. An estimated 35 million people have died from HIV-related causes so far, including 1.1 million (940,000–1.3 million) in 2015.
Fact 5: Combination antiretroviral therapy (ART) prevents HIV from multiplying in the body
If the reproduction of HIV stops, then the body’s immune cells are able to live longer and provide the body with protection from infections. Effective ART results in a reduction in viral load, the amount of virus in the body, greatly reducing the risk of transmitting the virus sexual partners. If the HIV positive partner in a couple is on effective ART, the likelihood of sexual transmission to the HIV-negative partner can be reduced by as much as 96%. Expanding coverage of HIV treatment contributes to HIV prevention efforts.
Fact 6: As of mid-2016, 18.2 million people were receiving ART worldwide
Of these, more than 16 million lived in low- and middle-income countries. In 2016, WHO released the second edition of the “Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection.” These guidelines present several new recommendations, including the recommendation to provide lifelong ART to all children, adolescents and adults, including all pregnant and breastfeeding women living with HIV, regardless of CD4 cell count as soon as possible after diagnosis. WHO has also expanded earlier recommendations to offer pre-exposure prophylaxis of HIV (PrEP) to selected people at substantial risk of acquiring HIV. Alternative first-line treatment regimens are also recommended.
Fact 7: HIV testing can help to ensure treatment for people in need
Access to HIV testing and medicines should be dramatically accelerated in order to reach the goal of ending AIDS by 2030. HIV testing reach is still limited, as an estimated 40% of people with HIV or over 14 million people remain undiagnosed and don’t know their infection status. WHO is recommending innovative HIV-self-testing and partner notification approaches to increase HIV testing services among undiagnosed people.
Fact 8: An estimated 1.8 million children are living with HIV
According to 2015 figures most of these children live in sub-Saharan Africa and were infected through transmission from their HIV-positive mothers during pregnancy, childbirth or breastfeeding. Close to 150 000 children (110 000–190 000) became newly infected with HIV in 2015.
Fact 9: Elimination of mother-to-child-transmission is becoming a reality
Access to preventive interventions remains limited in many low- and middle-income countries. But progress has been made in some areas such as prevention of mother-to-child transmission of HIV and keeping mothers alive. In 2015, almost 8 out of 10 pregnant women living with HIV – 1.1 million women – received antiretrovirals worldwide. In 2015, Cuba was the first country declared by WHO as having eliminated mother-to-child transmission of HIV and syphilis. In June 2016, 3 other countries: Armenia, Belarus and Thailand were also validated for eliminating mother-to-child HIV.
Fact 10: HIV is the greatest risk factor for developing active TB disease
In 2015, an estimated 1.2 million (11%) of the 10.4 million people who developed TB worldwide were HIV-positive. In the same year approximately 390 000 deaths from tuberculosis occurred among people living with HIV. The WHO African Region accounted for around 75% of the estimated number of HIV-related TB deaths.
