World AIDS Day 2016 comes a year after the community of nations committed to ending AIDS by 2030 as part of the Sustainable Development Goals and six months following a landmark Political Declaration to end AIDS. HIV prevention is central to achieving this goal. At this exciting moment in history we have at our disposal a combination of new science, evidence-based prevention strategies refined over more than 30 years, and the understanding that in order to succeed we must ensure that no one is left behind.
Some of the weapons in our arsenal are familiar. Condoms still matter. Our governments have committed to ensuring that we have strengthened national condom programmes with sufficient attention to procurement and distribution. We’ve learned over the last two decades how to use social marketing to target specific audiences and to drive demand for condom use.
Our region also knows how to prevent babies from being born with HIV. Through the widespread expansion of antiretroviral treatment for mothers living with HIV, there have been dramatic declines in HIV transmission to children. In 2015 nine of every ten pregnant women living with HIV in Latin America and the Caribbean received antiretroviral medicines (88%).
Cuba led the world by becoming the first country to be validated last year by the World Health Organization as having eliminated this form of HIV transmission. The validation process is underway now in 12 Caribbean countries and territories including Antigua and Barbuda, Barbados, Dominica, Grenada, St. Kitts and Nevis and St. Vincent and the Grenadines. The success of these countries reminds us that the elimination of new HIV infections among children is a realistic and urgent goal.
In 2008 Health and Education Ministers in Latin America and the Caribbean committed to providing young people with comprehensive sexuality education through the “Educating to Prevent” Declaration. We’ve long acknowledged our responsibility to give young people the information they need to keep them safe throughout life. We must now ramp up our efforts to ensure that adolescents have that education along with access to economic empowerment and sexual and reproductive health services.
Today, happily, we have new tools to bolster HIV prevention. Pre-exposure prophylaxis or PrEP—HIV drugs taken by an HIV negative person on a daily basis—dramatically reduces the chance of contracting the virus. The world has agreed to reach at least three million people at higher risk of HIV infection with these preventative drugs. Many Governments in our region have come onboard.
Early HIV testing and treatment can be game-changers as well. We now know that the sooner a person living with HIV finds out their status and starts treatment, the sooner the levels of the virus in their blood can be reduced, nearly eliminating the risk of infecting someone else.
It is on this basis that governments have committed to achieving the 90-90-90 targets–90% of people living with HIV aware of their status, 90% of those people on treatment and 90% of treated people virally suppressed. Overall an estimated 55% of people living with HIV in Latin America and the Caribbean were on treatment in 2015. Achieving this target will require significant investments and commitment. As governments and health ministries strategize about how to achieve scale-up, it is important to remember that these goals are feasible. Chile has already attained the treatment and viral suppression targets. Barbados is on track to achieve all three goals.
Perhaps the greatest challenge is our ongoing fight to eliminate stigma and discrimination. Even where we have combination HIV prevention services available, too many people do not feel safe or do not have the means to access them. We have to do more to ensure that poverty, homelessness, sexual orientation, gender identity, age and migrant status do not continue to be barriers to ending AIDS in Latin America and the Caribbean. That means supporting the organisations that are best positioned to reach these communities. But beyond that, every citizen of this region has a part to play in ensuring that all people are treated with dignity and respect, regardless of difference.