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This week, we look at the fight to end AIDS and the risk that the world may snatch defeat from the jaws of victory.

Unimaginable progress

The world is at a juncture almost unimaginable 20 years ago: Ending AIDS as a public health threat is within reach. Whether the world has the collective will to seize it is another matter.

But first, a little background. 3.3 million people were newly infected with HIV in 1995. AIDS-related deaths peaked at 2.1 million in 2004. Since then, new infections have gone down 60% and deaths have plummeted by 69%. That’s remarkable progress against a disease that has killed more than 40 million people globally.

And yet, a person still dies of an AIDS-related illness every minute. An adolescent girl or young woman contracts HIV every 2.5 minutes. And the progress made over the past three decades is in jeopardy as funding and focus wanes.

The end of AIDS lies just over the horizon, but the world is taking its foot off the accelerator. Below, my colleagues take a closer look at what’s going on.

– Joe Kraus, Aftershocks Editor

“The urgency of now”

Making progress: An estimated 40 million people are living with HIV. More than three-fourths of them are accessing antiretroviral therapy, which has been incredibly successful at transforming HIV from a death sentence to a manageable disease. Further good news: 84% of pregnant women living with HIV have access to medicines to prevent transmission to their child. That’s helped drop the number of new infections in children by nearly two-thirds since 2010. But that progress has stalled in recent years (you may be noticing a theme). For the first time, more new HIV infections are occurring outside of sub-Saharan Africa. While that is a sign of progress in the region most impacted by HIV, we would prefer to see infections dropping everywhere. And with some political will, we could see that.

– Nupur Parikh, Global Health Policy Officer

AIDS-related deaths and people with HIV receiving treatment

Source: UNAIDS

Progress under pressure: Funding for the HIV response is under pressure. And it’s a trend, not a blip. Domestic HIV funding declined in 2023 for the fourth year in a row, and international resources were almost 20% lower than at their peak in 2013. These reductions would be even more severe if not for significant, steady investments from the Global Fund and the US over the past decade. Bilateral funding from donor governments not named the US fell from US$2 billion in 2011 to US$370 million in 2023. With that context, it’s frustrating – but perhaps not surprising – that the number of new HIV infections is more than three times higher than the 2025 target set by leaders back in 2021.

– Jenny Ottenhoff, Senior Policy Director for Global Health

Resource availability for HIV in low- and middle-income countries, by source, and 2025 target

Source: UNAIDS

A literal lifeline: A new HIV drug that’s “as close as we’ve ever been to an HIV vaccine” could be made for just US$40 a year for every patient and still be profitable. Why then, you might wonder, is Gilead, the US pharmaceutical company that owns the drug and made US$5.6 billion in profits last year, currently selling it for US$42,250? We refer all such questions to Gilead’s CEO and his US$22.6 million annual compensation package. The head of UNAIDS, Winnie Byanyima, and AIDS campaigners are urging Gilead to move quickly to licence the drug to generic producers to enable people living in regions most impacted by HIV/AIDS to access it. 👏

– Micaela Iveson, Policy & Projects Manager

From the ONE Team

• Jenny Ottenhoff on the state of the HIV pandemic and the global response.
• A 5-point plan for the G20 to reform the global financial system as finance ministers meet in Brazil.
• How the €1.4 billion that France spent to clean up the Seine for the 2024 Olympics could have been used to improve people’s lives.
• Ndidi Okonkwo Nwuneli spoke at the Aspen Security Forum about who will help the most vulnerable in a “flammable world.” Ndidi also laid out why it’s time for Africa to define the future.

The numbers

• 1.3 million people were newly infected with HIV globally in 2023.
• 47 emerging market and developing economies are at risk of debt insolvency in the next five years as they look to meet the SDGs and climate goals.
• US$127 billion: How much could be raised each year from a carbon levy on maritime shipping to help climate vulnerable countries.

Quote of the week

“We want this 'miracle' prevention drug to reach all those who need it, now – not in 6 years!”

—  Winnie Byanyima, Executive Director of UNAIDS

What you should read, watch, and listen to:

• Is Kenya the canary in the sovereign debt coal mine?
• Immigration is both essential and impossible.
• Is the UAE’s US$30 billion climate fund merely greenwashing?

A look ahead

26 July - 11 August: 2024 Summer Olympics

The ONE Campaign’s data.one.org provides cutting edge data and analysis on the economic, political, and social changes impacting Africa. Check it out HERE.

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