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Report of the Executive Director of the Joint United Nations Programme on HIV/AIDS (E/2015/8)

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Summary

The present report was prepared in response to Economic and Social Council resolution 2013/11, in which the Council requested the Secretary-General to transmit, at the substantive session of 2015, a report prepared by the Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) on progress made in implementing a coordinated response by the United Nations system to the HIV/AIDS epidemic.

The global community has been presented with an historic opportunity. Dramatic scientific advances, combined with more than three decades of experience in scaling up HIV programmes, have cleared a way forward to end AIDS as a public health threat once and for all. In 2013 and 2014, UNAIDS focused its efforts on accelerating progress towards the 2015 targets set out in the 2011 Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS, in support of the achievement of Millennium Development Goals 3 to 6 and 8, and on galvanizing global action towards ending the AIDS epidemic by 2030. Its efforts built on major gains in the HIV/AIDS response, including substantial declines in new HIV infections and AIDS-related deaths.

Uniting and synergizing the efforts of 11 co-sponsors and the secretariat, the Joint Programme has helped to lead and coordinate the global AIDS effort. Advocacy by UNAIDS has kept AIDS high on the global political agenda and inspired a growing roster of low- and middle-income countries to increase domestic funding for the response. Normative guidance by the Joint Programme has assisted countries in implementing evidence-based programmes and in leveraging rapidly evolving scientific knowledge. UNAIDS has remained the central provider of strategic information on the epidemic and the response at the global, regional and country levels. It has also served as a consistent and vocal advocate for an inclusive response grounded in human rights and gender equality and for equitable service access for key populations and vulnerable groups. UNAIDS-supported innovation at the country level has helped to overcome service barriers and roll out new scientific advances, and the Joint Programme is a global leader in galvanizing and supporting the mobilization of communities affected by the epidemic. By leveraging the comparative advantages of diverse United Nations bodies and partners, UNAIDS plays a unique role in strengthening multisectoral responses.

Encouraging progress notwithstanding, the AIDS epidemic is not over. A majority of people living with HIV are still not receiving antiretroviral therapy, in part because more than 50 per cent of people living with HIV do not know their serostatus. While declining globally, new HIV infections are rising in some countries, in particular where services are not prioritized for most-affected populations. Although there are increasing domestic resources for the response, donor assistance for AIDS declined in 2013.

Modelling led by the Joint Programme shows that accelerated action and frontloaded investments over the next five years can bring the AIDS epidemic to an end. In response, the Joint Programme is assisting countries in developing and implementing ambitious fast-track targets for 2020, including a new HIV treatment target to maximize the proportion of people living with HIV who achieve viral suppression, and complementary prevention and non-discrimination targets beyond 2015. New resources will be needed to reach these targets, and smart investments will be required, in line with the principles of shared responsibility and global solidarity. A fast-track response will necessitate an inclusive, people-centred approach that effectively reaches those being left behind. As part of this population - and location-focused response, in 2014, the Joint Programme launched a new initiative to catalyse action by cities to mobilize municipal resources towards the goal of ending the epidemic.

To ensure its readiness to successfully navigate a rapidly evolving global landscape and to lay the foundation to end the epidemic by 2030, the Joint Programme is working to develop a new UNAIDS strategy for the period 2016 -2021, with the aim of ensuring that it is “fit for purpose” for the post-2015 era. Consistent with the multidimensional nature of the AIDS challenge, steps to end AIDS as a public health threat need to be mainstreamed across the sustainable development goals. UNAIDS and the broader AIDS response also offer important lessons that can strengthen and sustain global health and development efforts more generally. In 2016, the General Assembly will convene a high-level meeting on HIV/AIDS, which will offer a potentially transformative opportunity to strengthen global resolve and redouble strategic efforts to bring the epidemic to an end.