Sustaining Gains: Global Progress in HIV and the Road Ahead

Alison Lucas

Knowledge Management and Communications Specialist, USAID ASSIST Project/URC

On December 1st, we commemorated World AIDS Day. In 1988, when World AIDS Day was established, I had two uncles with HIV, both of whom would go on to die of complications related to AIDS. At that time, there was no concept of living with HIV; HIV led to AIDS, and AIDS was a death sentence.

Today we barely talk of AIDS in global health. We talk about people living with HIV—how can we ensure that people living with HIV know their status; receive quality care and treatment, including proper nutrition; adhere to and be retained in care; and prevent the transmission of the virus to their partners and, in the case of pregnant and breastfeeding mothers, to their babies.

It’s important to remember that this transition from death sentence to management of a chronic illness did not happen by accident—it happened because governments, organizations, and individuals dedicated an incredible amount of resources to ensuring it happened. The graph below shows the number of global HIV deaths from 1990 to present day. You can see that deaths begin to decline shortly after the launch of the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR, the President’s Emergency Plan for AIDS Relief—the largest commitment by any nation to address a single disease in human history.

We’ve made great progress. But something that sticks out to me in this graph is that—in spite of the incredible gains we’ve made—global deaths from HIV are still higher now than they were in 1990, when I lost my first uncle to AIDS.

The work is not over. There are still almost 37 million people living with HIV worldwide; of these, only 19.5 million people are receiving lifesaving antiretroviral therapy. In addition, about 5,000 new people contract HIV each day; prevention efforts must continue to reduce this number.

ASSIST has been working over the last five years applying improvement methods to identify gaps in HIV prevention, care, and treatment and making changes to the way we provide care to address these gaps and improve outcomes. You can learn more about our work preventing HIV and improving care and treatment for those living with HIV here: and in this recent newsletter.

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