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90-90-90 Targets: Beyond treatment towards prevention

26 January 2018

In 2015 global health achieved a seemingly ambitious task of providing antiretroviral therapy (ART) to 15 million people – a global health history first. Following this success, UNAIDS began to develop a workable model to reach the 2030 target for ending the AIDS epidemic.

The 90-90-90 targets are new research-based targets set for 2020 to endeavour to end the AIDS epidemic by 2030. It stands for:

  • 90% of all people living with HIV will know their HIV status by 2020;
  • 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy by 2020; and
  • 90% of all people receiving antiretroviral therapy will have viral suppression by 2020.

The key to this target is viral suppression. Viral suppression refers to a condition where an HIV-positive individual with strong adherence to ART suppresses the viral load to undetectable levels. Studies have shown that viral suppression is a key element in limiting the spread of HIV.

“Interim findings from the PARTNER study indicate that among 767 serodiscordant couples, no case of HIV transmission occurred when the person living with HIV had suppressed virus – after an estimated 40 000 instances of sexual intercourse.”

In order to reach the targets, the global community must address the key barriers that are currently preventing treatment adoption, access to treatment and treatment adherence. These include:

  • The elimination of stigma, discrimination and social exclusion;
  • addressing current poor coverage in priority countries that require catch-up;
  • building capacity in local healthcare systems; and
  • accurately funding the model.

It’s a tall order, requiring long-term flexibility and responsiveness of health systems, sustainable financing, innovations in pharmaceuticals, early detection and a significant shift in perspectives.

For more info on this insightful study click here: http://www.unaids.org/sites/default/files/media_asset/90-90-90_en.pdf

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