As we mark World AIDS Day, we stand at a crossroads in the response to the epidemic. Hard work, political commitment, community engagement and financial investment over the past 15 years have provided us with a golden opportunity to end the AIDS epidemic—we must not squander it.

Since 2000, the global response to HIV has averted 30 million new HIV infections and nearly eight million AIDS-related deaths. Back then, fewer than 700 000 people were accessing antiretroviral therapy. Today, more than 15 million people are accessing the life-saving medicines. A historic and ambitious treatment target—to ensure that 15 million people have access to HIV treatment by 2015—has not only been met but exceeded. That’s great news.

But now we have to take the AIDS response to another level. AIDS is unfinished business and it will require renewed energy and dedication from all of us to reach the goal of ending the epidemic by 2030 as part of the Sustainable Development Goals. Of the 36.9 million people living with HIV today, almost half remain unaware that they are HIV-positive. There are 22 million people not accessing the treatment that would keep them alive and healthy and prevent the virus being transmitted to other people.

Fast-Tracking the AIDS response

UNAIDS has a plan to end the AIDS epidemic by 2030: the Fast-Track approach. This means front-loading investment over the next five years to reach an ambitious 90–90–90 treatment target by 2020. Reaching this target would see 90 per cent of people living with HIV knowing their HIV status, 90 per cent of people who know their HIV-positive status accessing treatment and 90 per cent of people on treatment having suppressed viral loads. The Fast-Track approach will also reduce new HIV infections by 75 per cent and realize our vision of zero discrimination.

Reaching the Fast-Track Targets by 2020 means we will have broken the epidemic and from 2021 less money will be necessary each year to end the epidemic by 2030. Increasing current investments by US$ 12 billion a year would produce benefits of more than US$ 3.2 trillion that extend well beyond 2030—a return on investment of nearly US$ 17 for every US$ 1 invested.

Leaving no one behind

To be successful, the Fast-Track approach must be grounded in human rights and put people-centred policies and programmes at the forefront. Until now, progress made against the AIDS epidemic has not been shared equally. This is a social injustice. People are being left behind because they continue to face stigma and discrimination, human rights violations, gender inequality, violence and punitive laws.

Ensuring that women and girls are empowered to protect themselves from HIV is crucial. AIDS-related causes are still the leading cause of death among women of reproductive age globally, while around one in five new adult HIV infections occur among young women aged 15 to 24. The human rights of women and girls must be respected. These include the right to make decisions about their own health and the right to assume control over matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence.

AIDS is also the primary cause of death among adolescents in Africa and the secondary cause of death among young people worldwide. Many young people are still unaware of their risk of HIV exposure or how to protect themselves. It is essential that they have unimpeded access to HIV testing and treatment services as part of quality sexual and reproductive health care. Sex workers, gay men and other men who have sex with men, transgender people, people who inject drugs, prisoners and migrants must be able to access appropriate services and targeted programmes that keep them healthy.

A commitment to ending the AIDS epidemic    

In September, world leaders signed up to ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. The science and tools are at hand. The UNAIDS Fast-Track approach provides a clear road map: front-loading investment, respecting human rights and promoting people-centred programmes and service delivery.

How the world responds over the next five years will determine whether another generation of young people grows up with the epidemic or whether the AIDS epidemic is ended as a public health threat within 15 years. By following the Fast-Track approach, we can avert 21 million AIDS-related deaths and 28 million new HIV infections by 2030.

On this World AIDS Day, let’s make sure we choose the right path – let’s break the AIDS epidemic.