TEN WHO Member States were presented certificates of achievement on 19th May at the 79th World Health Assembly, for the elimination of mother-to-child transmission of HIV, HBV, and syphilis.
Anguilla, Bahamas, Brazil, Cuba, Denmark, Maldives, Montserrat, Oman, Sri Lanka, and Turks and Caicos were recognised by WHO Director-General, Dr Tedros Adhanom Ghebreyesus, for outstanding public health achievements under the discussion theme: ‘Reshaping global health: a shared responsibility’.
Including the ongoing rollout of lenacapavir, a uniquely affordable HIV prevention drug, there have been promising developments in global HIV elimination.
Addressing Member States at the summit, Dr Ghebreyesus said that, in the past year: “On HIV, we took an important step forward by prequalifying lenacapavir in tandem with guidelines on its use, supporting the first 14 countries to roll it out.
“Lenacapavir is one of the most powerful and promising tools in the history of HIV: a long-acting injectable given every six months, it’s the next best thing to an HIV vaccine.”
Yet, barriers to prevention persist, a WHO expert told EMJ at the Assembly.
Vulnerable Groups and Social Stigma
Dr Tereza Kasaeva, Director, WHO Department on HIV, Tuberculosis, Hepatitis, and Sexually Transmitted Infections, Geneva, Switzerland, said: “From the very beginning, there have been key vulnerable groups of populations: men who have sex with men, young women, children, transgender people, as well as drug users.
“The fact that they require a special focus and access to essential services is absolutely well known, recognised, and is a priority everywhere.”
Dr Kasaeva reported that WHO is cautious about trends seen particularly in vulnerable groups in the African region, as well as in Western and Central Asia, the North American region, and some Asian and Pacific regions, where incidence and mortality is declining slower than in other areas and groups.
She continued: “We are alerting and negotiating with governments.
“[The trend] clearly shows that these groups require more focus, more prioritisation, and more access to timely diagnosis, treatment, and prevention.”
The expert said there has also been concern around the historic lack of understanding, evidence, and information around HIV, adding: “From the very beginning, it was driven by the community’s concerns, by their leadership, by their strong advocacy.
“At the time, research and availability of effective tools were not there – this advocacy was driving overall progress, and now we can see the impact of all these efforts.
“While, unfortunately, stigma and discrimination are real barriers for the implementation of new tools – breakthroughs – the advancing research agenda is quite inspiring.”
Lenacapavir
Lenacapavir rollout for HIV prevention was unique in that it prioritised the needs of low-income countries with the highest HIV burden, through collaboration between key stakeholders and agreement on affordability and prioritisation goals, Dr Kasaeva told EMJ, calling for replication of the development model.
Dr Kasaeva said: “Partners are working together on the rapid introduction of generics and we hope that, in 2027, another 122 countries will have affordable access to generics.”
The cost for one year of treatment is reportedly no more than 60 USD.
Outcomes of the World Health Assembly
Special agenda items, with a focus on strategies for HIV, hepatitis, and sexually transmitted infections were brought forward at the Assembly.
WHO is “cautiously positive” about the Sustainable Development Goal (Target 3.3) to end the HIV epidemic as a public health threat by 2030.
Dr Kasaeva explained: “Progress to date is really impressive, with a more than 40% reduction of HIV incidence since 2010 and more than 50% reduction of HIV-related death.
“But we have to keep in mind the target for 2030 is 90% for both and we are far from that.
“At the same time, we have a whole spectrum of highly effective tools for diagnostics, prevention, and treatment.”
The expert called for increased domestic funding, paired with heightened attention around prevention.
She said: “We are working closely with UNAIDS and other co-sponsors or organisations, like UNICEF, UNDP, UNFPA, to consolidate our efforts and not allow HIV progress to be affected by current political, social, and economic issues, keeping communities and civil society organsiation at the heart of the response.”
Winnie Byanyima, Executive Director of UNAIDS and Under-Secretary of the United Nations, commented: “Funding cuts and the pushback on rights are already costing lives — shutting clinics and halting prevention.
“This is the moment to choose solidarity: sustained investment and shared responsibility to protect everyone, everywhere.”
Featured image: francovolpato on Adobe Stock
