Is the UN Goal of Ending AIDS by 2030 Unrealistic?

More than four decades after the outbreak of the global AIDS epidemic, the light at the end of the tunnel appears increasingly to be a runaway train, as both funding and the efficiency of medicines to combat the disease ebbs. Health experts fear that not only might they fail to lower the number of people diagnosed with the virus that causes AIDS, but that in some regions, most notably Africa, the numbers might actually increase.

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The United Nations had designated 2030 as the “end of AIDS,” while UNAIDS has set “fast-tracked” targets aimed at meeting the ambitious goal. But UNAIDS Executive Director and Director of the London School of Hygiene and Tropical Medicine Peter Piot told The Guardian that the 2030 goals could be unrealistic.

Indeed, UNAIDS wrote in 2014 that “if the world does not rapidly scale up in the next five years, the epidemic is likely to spring back with a higher rate of new HIV infections than today.”

And the status quo is nothing to boast about. According to U.N. statistics, an estimated 37 million people are living with HIV around the globe, and less than half—17 million—have access to essential antiretroviral drugs to manage the disease. That is a far cry from the UNAIDS goal of 90 percent of HIV-positive people receiving treatment by 2020, and 95 percent by 2030.

In 2015, 1.1 million people died from AIDS-related deaths after HIV/AIDS held a spot in the World Health Organization’s 2000 to 2012 list of the top 10 leading causes of death in the world along with heart disease, stroke, lung disease, and other serious health problems. According to UNICEF, AIDS was the leading cause of death of teenagers in Africa in 2015 and the second cause of death of adolescents around the world.

While the rate of infection has dropped somewhat over the years, 2.1 million people, or roughly 5,500 per day, contracted HIV in 2015. To meet the UNAIDS “fast-tracked” targets aimed at eliminating AIDS by 2030, the number of new HIV-positive people will have to be reduced to less than a quarter of the current rate to hit the goal of just 500,000 new infections among adults by 2020.

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Beyond the sheer scale of the crisis, campaigns to tackle AIDS could be further frustrated by research showing that the disease is strengthening its resistance to anti-AIDs drugs, prohibitive pharmaceutical costs, and, in some cases, persistent levels of chronic poverty.

In sub-Saharan Africa—and particularly in the southernmost countries such as Swaziland, Botswana, Lesotho, South Africa, and Zimbabwe where the disease is most prevalent—HIV/AIDS is exasperated by systemic, extreme poverty. Not only is the lack of resources a barrier to health care, but researchers have found that food insecurity in sub-Saharan Africa also negatively impacts access to and the ability to adhere to an antiretroviral therapy regimen.

What’s more, much-needed funds are declining. As the International Aids Conference in South Africa kicked off earlier this month, the Kaiser Family Foundation announced that global donations for AIDS-related causes had fallen by more than US$1 billion from US$8.6 billion in 2014 to US$7.5 billion in 2015. UNAIDS estimates that an effective response to AIDS calls for US$26.2 billion in 2020 and US$23.9 billion in 2030.

HIV weakens the immune system, increasing an HIV-positive person’s susceptibility to viruses. AIDS, on the other hand, is more severe and completely compromises the ability of the body to defend itself against infections, illnesses, and diseases.

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