Barometer 2024: HIV and AIDS

• SADC is still the most heavily HIV affected region in the world.  Even as prevalence of HIV is falling slowly, six countries still have prevalence rates that are over 10% which are the highest in the world.  Prevalence is higher in women than in men in most countries of SADC.  HIV prevalence in young women is about double that in young men in eight countries.
• SADC needs to continue urgent steps to eradicate AIDS as a public health threat by 2030.  In the absence of a cure or a vaccine for HIV, SADC must prepare to sustain huge treatment programmes for many years beyond 2030.
• Recent drastic and very sudden cuts in PEPFAR funding have underscored the urgent need to mobilise sufficient domestic funding to not depend on external funding.  Funding for condoms, which are an important component of prevention programmes, had already declined prior to the dramatic cuts.
• The surge in HIV and AIDS in Madagascar calls for continued vigilance in all countries as HIV can rapidly spread from a relatively contained epidemic in key populations into the general public.  There is urgent need for investment in control of HIV and AIDS in Madagascar where only 22% of PLHIV know their status and 22% are on ARVs[1].
• There is continued emphasis on prevention, especially of vertical transmission to children, for adolescent girls and young women, adolescent boys and young men as well as for key populations.
• Great progress has been achieved in the fight against HIV, thanks to global and domestic mobilisation of funds and human resources, for instance:
• Botswana and Namibia are the only African, and high HIV prevalence, countries to achieve the status of being on the path towards elimination of vertical transmission to children (or fewer than 750 new HIV infections per 100 000 births).[2]
• Eswatini, Botswana, Zimbabwe, Zambia and Malawi are amongst the nine countries globally that had achieved the 95 95 95 targets in 2023.  (These are 95% of all people living with HIV know their status, 95% of those diagnosed with HIV, or 90% of all PLHIV, access antiretroviral treatment, and 95% of those on ARVs, or 86% of all PLHIV, achieve viral suppression).  Lesotho and Namibia are amongst the ten countries which were on track globally to achieve the targets by 2025. Women are still more likely to have been tested, to have accessed ARV therapy and to have achieved viral suppression than men in most countries.
• These gains are threatened by the sudden PEPFAR termination of funding.
• As the numbers of people on ART is expanding exponentially, health systems are strained to provide prevention, testing, access to treatment as well as supporting adherence to treatment for large numbers of PLHIV.  Many community organizations are supporting HIV programming.  The stress on communities to provide more services, especially for those that are marginalised and stigmatised is likely to increase.
• Access to treatment continues to lag for children.

Download the Barometer 2024 HIV and AIDS chapter.
Download the full Barometer.

[1] UNAIDS 2024.  UNAIDS 2023 data, https://aidsinfo.unaids.org/   accessed 25 July, 2024

[2] UNAIDS.  2024.  The urgency of now: AIDS at a crossroads. Geneva: Joint United Nations Programme on HIV/AIDS.