Ending AIDS by 2030: Partnerships and Linkages with SDG 2

Abstract

Several strategic shifts are occurring in the field of HIV/AIDS globally. The approach to health care in general is moving from a focus on vertical programming for individual diseases toward more integrated health systems. SDG 3, good health and well-being, includes the commitment to end the HIV, malaria and TB epidemics and address non-communicable diseases by 2030—having moved away from the disease-specific MDG goal on HIV. HIV programming is under increasing financial strain, and an increasing share of HIV funding is coming from domestic sources, while funding from global donors has been declining. With the new treatment protocol, more people are eligible for treatment and living longer, and issues of HIV as a chronic disease is further weighing down already burdened health systems. Nevertheless, the need to expand services to ‘difficult to reach’ vulnerable populations is urgently increasing. UNAIDS’ new strategy and Fast Track approach reinforces the vision of Three Zeros: Zero new infections, Zero AIDS-related deaths and Zero discrimination. Thirty-five countries have been identified by UNAIDS as ‘Fast Track’ countries. In order to sustain the progress made by the HIV/AIDS response in this new environment, partnerships and social protection will have to be effectively leveraged to support sustainable access and effectiveness of HIV prevention services, treatment, care and support (demand side) and complement health system strengthening efforts (supply side). Nutrition and food assistance will need to continue to be integrated in the HIV/AIDS response, and at the same time, an HIV-sensitive lens will need to be applied to the fields of health, education, social protection, food security and nutrition. Operationalizing these concepts should be the focus in the next 5–10 years. Setting the context of the epidemic and building on the HIV continuum of care, this chapter introduces a framework to define individual-, household-, community- and health system-level considerations that are important for each step, i.e., HIV transmission, HIV testing, pre-ART care and, lifelong, ART care. This framework is then used to systematically look at nutrition and food assistance interventions at each level while exploring links with social protection policies and programs, reproductive health programming and an emphasis on treatment adherence.