UNAIDS’ recent report finds that worldwide goals for 2020 have not been reached, despite past years’ efforts. More people know their HIV-status, more people have access to medicines and more people have an undetectable viral load thanks to treatment. Yet, the efforts to prevent new infections have been less successful. The number of new infections among adults has hardly dropped in the past 4 years. Not a single region reached the goal to decrease new infections by 75% compared to 2016.  

Reducing inequalities lies at the heart of UNAIDS’ 2021-2026 new Global AIDS Strategy. It aims to assist and guide every country and community in reaching UNAIDS goals of zero new HIV-infections, zero discrimination and zero AIDS-related deaths. A comprehensive framework of actions has been outlined to tackle inequalities and protect human rights in the HIV response. The gaps for HIV prevention, testing, treatment and support can be closed by reducing inequalities. The Strategy’s vision for reducing inequalities and laying the foundation to reach the 2030 targets builds on its three Strategic Priorities: (1) Maximise equitable and equal access to HIV services and solutions; (2) Break down barriers to achieving HIV outcomes;(3) Fully resource efficient HIV responses and integrate HIV in systems for health, social protection, and humanitarian and pandemic responses.

Sensoa International's annual audit of the expenditures by the Belgian Directorate General for Development Cooperation and Humanitarian Aid (DGD) shows that spending on health and reproductive health in 2019 was at its lowest level in four years. DGD spent a total of 11.08% of its budget on health and reproductive health in 2019, whereas support halted at 13.29% in 2017 and 12.84% in 2016. 

Particularly worrying is DGD's declining support for HIV prevention and treatment, for which the budget was cut in half during the previous government term. Support has been falling since 2017, with substantially less attention for HIV in Belgium’s bilateral cooperation and less support for multilateral organisations that take the lead in the global 'HIV response', such as UNAIDS and the Global Fund to Fight Aids, Tuberculosis and Malaria (GFATM). Multilateral support did increase in 2019, but not enough to turn the tide. 

Gains made in preventing mother-to-child transmission of HIV could be reversed, with new HIV infections among children up by as much as 162% and setting the clock on AIDS-related deaths back to 2008, a modelling group convened by the World Health Organization and UNAIDS estimated. If no efforts are made to mitigate and overcome interruptions in health services and supplies during the COVID-19 pandemic, a six-month disruption of antiretroviral therapy could lead to more than 500,000 extra deaths from AIDS-related illnesses in sub-Saharan Africa in 2020–2021.

• The 'community' which is fighting for sexual and reproductive rights has years of experience in the fight against that other pandemic, hiv. Important lessons can be drawn from this.

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​UNAIDS broke it down:

• The response to the crisis must always be based on a Human Rights approach. 
• More vulnerable groups should be identified in a non-stigmatising way
• Efforts should focus on those groups that would otherwise easily be excluded from care.
• Health workers should thus be equipped with information and knowledge about the needs of the most vulnerable sections, such as women, people living in poverty, people living with an illness, people in rural areas, people with disabilities, people in detention, people living in slums or other informal settlements and the homeless.
• Vulnerable sections of the population should be recognized themselves as health workers as they care family members, peer outreach, etc. In other words, they are also on the frontline of the epidemic. Their security and protection must therefore also be a priority.

For World Aids Day, the ‘Parliamentarians for the 2030 Agenda’ invited UNAIDS Brussels Representative Dr. Jantine Jacobi, Burundian youth representative Fabien Ndikuriyo, Stéphanie Drèze of MSF and Dr. Gert Scheerder of Sensoa to discuss the HIV epidemic worldwide, in Belgium and in Belgium’s partner countries. 

This year Belgium will preside the UNAIDS constituency with Portugal, Luxemburg and the Netherlands in the Programme Coordination Board (PCB) of UNAIDS, the governing board of the Joint United Nations Programme on HIV. The UNAIDS PCB sets the overall policies and priorities for UNAIDS and decides on the organisation’s planning and execution. Challenges discussed within the board include how to keep up international support for HIV response, but can also include discussions on the impact of big donor countries’ policies on the HIV/AIDS response, think of the detrimental effect of the reinstatement of the Mexico City Policy (or Global Gag Rule) by the US on integrated SRHR-HIV service delivery in countries in the Global South.

75%  of all people living with HIV know their HIV status, but increased efforts are needed to reach the 9.4 million people living with HIV who are not aware that they are living with the virus, UNAIDS 2018 reports shows.