TY - JOUR
T1 - What is required to end the AIDS epidemic as a public health threat by 2030? the cost and impact of the fast-track approach
AU - Stover, John
AU - Bollinger, Lori
AU - Antonio Izazola, Jose
AU - Loures, Luiz
AU - DeLay, Paul
AU - Ghys, Peter D.
AU - Dybul, Mark
AU - Bidault, Nicolas
AU - Onyekwena, Obinna
AU - Blakely, Matt
AU - Hijazi, Mai
AU - Montaner, Julio
AU - Over, Mead
AU - Vassall, Anna
AU - Brown, Timothy
AU - Diamond, Samantha
AU - Tagar, Elya
AU - Eaton, Jeffrey
AU - Williams, Brian
AU - Webb, Douglas
AU - Idele, Priscilla A.
AU - Lauer, Jeremy Addison
AU - Weiler, Gundo Aurel
AU - Benedikt, Clemens
AU - Cohen, Jennifer
AU - Izazola, Jose A.
AU - Valladares, Ricardo
AU - Zekeng, Leopold
AU - Semini, Iris
AU - Burgos-Filho, Ruy
AU - Masiye, Felix
AU - Meyer-Rath, Gesine
AU - Fast Track Modeling Working Group
PY - 2016/5/9
Y1 - 2016/5/9
N2 - In 2011 a new Investment Framework was proposed that described how the scale-up of key HIV interventions could dramatically reduce new HIV infections and AIDS-related deaths in low and middle income countries by 2015. This framework included ambitious coverage goals for prevention and treatment services for 2015, resulting in a reduction of new HIV infections by more than half, in line with the goals of the declaration of the UN High Level Meeting in June 2011. However, the approach suggested a leveling in the number of new infections at about 1 million annually - far from the UNAIDS goal of ending AIDS by 2030. In response, UNAIDS has developed the Fast-Track approach that is intended to provide a roadmap to the actions required to achieve this goal. The Fast-Track approach is predicated on a rapid scale-up of focused, effective prevention and treatment services over the next 5 years and then maintaining a high level of programme implementation until 2030. Fast-Track aims to reduce new infections and AIDS-related deaths by 90% from 2010 to 2030 and proposes a set of biomedical, behavioral and enabling intervention targets for 2020 and 2030 to achieve that goal, including the rapid scale-up initiative for antiretroviral treatment known as 90-90-90. Compared to a counterfactual scenario of constant coverage for all services at early-2015 levels, the Fast-Track approach would avert 18 million HIV infections and 11 million deaths from 2016 to 2030 globally. This paper describes the analysis that produced these targets and the estimated resources needed to achieve them in low- and middle-income countries. It indicates that it is possible to achieve these goals with a significant push to achieve rapid scale-up of key interventions between now and 2020. The annual resources required from all sources would rise to US$7.4Bn in low-income countries, US$8.2Bn in lower middle-income countries and US$10.5Bn in upper-middle-income-countries by 2020 before declining approximately 9% by 2030.
AB - In 2011 a new Investment Framework was proposed that described how the scale-up of key HIV interventions could dramatically reduce new HIV infections and AIDS-related deaths in low and middle income countries by 2015. This framework included ambitious coverage goals for prevention and treatment services for 2015, resulting in a reduction of new HIV infections by more than half, in line with the goals of the declaration of the UN High Level Meeting in June 2011. However, the approach suggested a leveling in the number of new infections at about 1 million annually - far from the UNAIDS goal of ending AIDS by 2030. In response, UNAIDS has developed the Fast-Track approach that is intended to provide a roadmap to the actions required to achieve this goal. The Fast-Track approach is predicated on a rapid scale-up of focused, effective prevention and treatment services over the next 5 years and then maintaining a high level of programme implementation until 2030. Fast-Track aims to reduce new infections and AIDS-related deaths by 90% from 2010 to 2030 and proposes a set of biomedical, behavioral and enabling intervention targets for 2020 and 2030 to achieve that goal, including the rapid scale-up initiative for antiretroviral treatment known as 90-90-90. Compared to a counterfactual scenario of constant coverage for all services at early-2015 levels, the Fast-Track approach would avert 18 million HIV infections and 11 million deaths from 2016 to 2030 globally. This paper describes the analysis that produced these targets and the estimated resources needed to achieve them in low- and middle-income countries. It indicates that it is possible to achieve these goals with a significant push to achieve rapid scale-up of key interventions between now and 2020. The annual resources required from all sources would rise to US$7.4Bn in low-income countries, US$8.2Bn in lower middle-income countries and US$10.5Bn in upper-middle-income-countries by 2020 before declining approximately 9% by 2030.
KW - HIV
KW - preexposure prophylaxis
KW - acquired immune deficiency syndrome
KW - antiviral therapy
KW - disease surveillance
KW - geographic distribution
KW - health care cost
KW - infection prevention
KW - public health
UR - http://www.scopus.com/inward/record.url?scp=84969820610&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0154893
DO - 10.1371/journal.pone.0154893
M3 - Article
C2 - 27159260
AN - SCOPUS:84969820610
SN - 1932-6203
VL - 11
SP - 1
EP - 14
JO - PLoS ONE
JF - PLoS ONE
IS - 5
M1 - e0154893
ER -