UNAIDS 2025 targets
UNAIDS’ current targets set out what needs to be achieved by 2025 to end AIDS as a public health threat by 2030. The 2025 targets replace the 2020 Fast-Track targets.
UNAIDS 2025 targets state that, by 2025:
These first three targets mirror the Fast Track 90-90-90 targets, which countries were aiming to meet by 2020, only the coverage for each target is now 95% instead of 90%.
The other 2025 targets are:
95% of women of reproductive age will have their sexual reproductive health needs met
95% of people will be able to access services to eliminate parent to child transmission of HIV
90% of people with HIV and most at risk of HIV have access to services to support their overall health, such as for sexual and gender-based violence, mental health, tuberculosis and other health conditions.
fewer than 10% of countries will have punitive laws and policies that deny people access to justice
fewer than 10% of people with HIV and most at risk of HIV will experience stigma and discrimination
UNAIDS’ current strategy (2021-2026) provides a framework to support countries to reach the 2025 targets. In it, UNAIDS is clear that at-risk communities and people with HIV must be prioritised. UNAIDS’ targets are designed to meet the HIV-related targets in the Sustainable Development Goals (SDGs).
The Sustainable Development Goals
The Sustainable Development Goals (SDGs), also known as the Global Goals, are a broad range of goals which countries in the United Nations (called UN Member States) have committed to reaching by 2030. There are 17 goals, and each is made up of a set of targets.
The goal that includes HIV targets is SDG 3: Ensure healthy lives and promote wellbeing for all at all ages.
SDG 3 contains the following targets:
Target 3.8: achieve universal health coverage, access to quality healthcare services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all. This includes HIV services, sexual and reproductive health services and harm reduction services.
The other SDGs that relate to HIV are:
SDG 4: Quality education: includes targets on comprehensive sexual and reproductive health education and life-skills.
SDG 5: Gender equality: includes targets on sexual and reproductive health and rights, and the elimination of violence, harmful gender norms and practices.
SDG 10: Reduced inequalities: includes targets on protecting people from discrimination, empowering people to claim their rights, and enhancing access to HIV services.
The Political Declaration on HIV and AIDS is adopted by UN Member States to commit to reaching the global HIV targets. The declarations are made around every five years. The most recent declaration – the fifth – happened in 2021.
By 2025, UN Member States have agreed to:
reach the UNAIDS 2025 targets
provide life-saving HIV treatment to 34 million people
reduce the annual number of new HIV infections to below 370,000, including fewer than 50,000 new HIV infections among adolescent girls and young women
reduce the annual number of AIDS-related deaths to 250,000
end AIDS among children and stop any children getting HIV
eliminate all forms of HIV-related discrimination
ensure that 90% of people with HIV receive preventive treatment for tuberculosis
reduce AIDS-related TB deaths by 80%
ensure that 95% of people with HIV and people most at risk of HIV are protected against other pandemics, including COVID-19
invest US$ 29 billion annually to respond to HIV in low- and middle-income countries. This includes investing at least US$ 3.1 billion towards ‘societal enablers’, which seek to protect human rights, reduce stigma and discrimination, and reform unjust laws.
Reaching these targets by 2030 will prevent 3.6 million people from getting HIV and 1.7 million people from dying due to an AIDS-related illness.
How can we achieve these targets?
Globally, in 2020, 84% of people with HIV were diagnosed, and 87% of these people were on treatment. Of those on HIV treatment, 90% were virally suppressed. This is an impressive achievement. It reflects the way HIV services have rapidly expanded in the past decade, particularly treatment and care.
But, despite this progress, the 90-90-90 target have not been met. And although some individual countries did reach them, the majority did not. So, what is needed to ensure the 95-95-95 goals are reached so that AIDS is no longer a public health threat by 2030?
Around six out of ten people who get HIV are from marginalised groups, including gay men and other men who have sex with men, transgender people, people who inject drugs, sex workers and their clients. Yet it is these people who find it hardest to access HIV prevention, testing, treatment and care services. Stigma and discrimination make it hard for them to access services.
UNAIDS’ latest strategy makes it clear that enabling marginalised communities to access effective HIV services is fundamental to ending AIDS. This means more community-led HIV services are needed. It also means additional services, support, programmes and advocacy are needed to address stigma, discrimination, criminalisation, poverty, social exclusion and gender-based violence – or these groups’ vulnerability to HIV will continue.
Closely linked to the importance of focusing on marginalised communities is the need to provide resources and support for community-led organisations so that they can deliver services and support, advocate for their rights, participate in research and data collection and respond to emerging needs.
Huge progress has been made on expanding access to HIV testing in recent years, mainly due to new testing technologies that enable people to take HIV tests in community spaces or at home, rather than in clinics. But still around 15% of people with HIV are unaware they have it. Addressing this is crucial because people with HIV will not access treatment until they are diagnosed – and the more people who remain undiagnosed and off treatment, the more likely HIV is to spread.
The HIV treatment cascade has been a key focus in the last five years, but there is a need for a renewed focus on HIV prevention. UNAIDS is calling for a US$ 9.5 billion to strengthen and scale-up of HIV combination prevention services by 2025. Resources should be spent on the most effective, evidence-based HIV prevention approaches and tools, such as PrEP and condoms, and the people who most need HIV prevention should be prioritised.
Having national systems in place to track who is and who is not accessing HIV services, and who needs them, is vital for making programmes and services more effective. But ensuring data on most-at-risk communities is collected can be challenging. This is why at-risk communities must be involved in data collection and research. Data is also vital for monitoring whether governments are on track to reach the targets set out in their national strategic HIV plans, which feed into global targets.