Written by Laurence Amand Eeckhout.
World AIDS Day, proclaimed by the United Nations in 1988, takes place each year on 1 December. The aim is to raise awareness, fight prejudice, encourage progress in prevention, and improve treatment around the world. Although infection with the human immunodeficiency virus (HIV) is preventable, significant HIV transmission remains a challenge to EU Member States’ health systems. This year’s theme ‘Let communities lead!’ underlines the importance of communities living with, at risk of, or affected by HIV in shaping the HIV response.
Background
Attacking the body’s immune system (the white blood cells or ‘CD4 cells’), HIV weakens its defence against other infections and diseases, including tuberculosis and some types of cancer. The most advanced stage of HIV infection is AIDS (with a CD4 count below 200). Found in a variety of body fluids, such as blood, semen, vaginal secretions and breast milk, HIV can be transmitted through sex, blood transfusion, the sharing of contaminated needles, and between mother and child during pregnancy, delivery and breastfeeding.
People who are at high risk of getting HIV can take pre-exposure prophylaxis (PrEP) medicine to reduce the risk of infection.
People diagnosed with HIV and treated early can now expect to live a normal lifespan. Infections can be treated to prevent progression to AIDS by decreasing viral load in an infected body (antiretroviral therapy, ‘ART’). However ART does not cure HIV infection, and there is no vaccine.
The United Nations (UN) Programme on HIV/AIDS (UNAIDS) is leading the global effort to end the AIDS epidemic by 2030, as part of the Sustainable Development Goals (SDGs) adopted by the UN in 2015 (Goal 3.3). UNAIDS unites the efforts of 11 UN organisations, including the World Health Organization (WHO).
| With World AIDS Day 2023’s theme ‘Let communities lead!‘ the WHO wishes to mark the pivotal impact that communities have had in shaping the HIV response, as well as global health at large. UNAIDS underlines that organisations of communities living with, at risk of, or affected by HIV are the frontline of progress in the HIV response. Communities connect people with person-centred public health services, build trust, innovate, and monitor implementation of policies and services. However, funding shortages, policy and regulatory hurdles, capacity constraints, and crackdowns on civil society and on the human rights of marginalised communities are obstructing the progress of HIV prevention and treatment services. |
Facts and figures
UNAIDS data show that, in 2022, 1.3 million people contracted HIV, 39 million people were living with HIV, and 630 000 people died of AIDS-related causes.
According to the 2023 report on ‘HIV/AIDS surveillance in Europe’ (2022 data), published jointly by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, HIV affects over 2.4 million people in the WHO European region (made up of 53 countries covering a vast geographical region from the Atlantic to the Pacific Ocean), including over 766 000 people in the EU/European Economic Area (EEA).
In the EU/EEA specifically, 22 995 people were newly diagnosed with HIV in 2022 (17 000 in 2021). Factors contributing to the 2022 increase in diagnoses include the resumption of normal testing services after the COVID-19 pandemic, expanded and targeted HIV testing services, and the implementation of new testing strategies. However more than 1 in 10 people living with HIV in the EU/EEA are still unaware of their status, which contributes to late diagnoses, worse outcomes and the continued spread of HIV.
EU action on HIV/AIDS
EU Member States are responsible for their own healthcare policies and systems. However, according to Article 168 of the Treaty on the Functioning of the European Union, the EU complements national policies while also fostering cooperation between Member States.
In the EU, HIV/AIDS policy focuses on prevention and on supporting people living with the disease. The European Commission has mobilised measures and instruments across several policy areas in the fight against HIV/AIDS. This includes support for Member States to help them achieve the global target under Goal 3.3 of the UN SDGs, to end the AIDS epidemic by 2030. In that context, the Commission facilitates the exchange of best practices through the Health Security Committee, as well as dedicated networks on the EU Health Policy Platform. The EU drugs strategy for 2021-2025 aims to ensure a high level of health promotion, including measures to reduce the prevalence and incidence of drug-related infectious diseases, such as viral hepatitis and HIV.
Since the early years of the AIDS epidemic in the 1980s, the EU has invested significantly in HIV/AIDS research. Both the Horizon 2020 and Horizon Europe (2021‑2027) programmes for research and innovation support projects ranging from basic research to the development and testing of new treatments and vaccine.
The European Medicines Agency (EMA) supports the global HIV response through scientific evaluation, supervision and safety monitoring of medicines. The ECDC is a key partner of the Commission in relation to HIV/AIDS and provides guidance to Member States in terms of controlling the disease. Its September 2023 progress report summarises the progress towards UN SDG 3.3 to eliminate the epidemic of AIDS in Europe and Central Asia by 2030. It provides an update on the progress in relation to HIV prevention, testing and treatment, AIDS-related deaths and HIV-related stigma and discrimination. HIV-related stigma and eliminating discrimination was the subject of a high-level meeting in Sevilla on 15 September 2023, under the Spanish Presidency of the Council, in view of a high-level declaration from the European institutions.
On the world stage, as underlined in its EU global health strategy, the EU supports the Global Fund against AIDS, malaria and tuberculosis. In 2022, the EU pledged €715 million for the 2023-2025 period, a 30 % increase over its pledge of €550 million covering the 2020-2022 period. The UNAIDS 2021‑2026 global AIDS strategy highlights the need for a new approach that reduces the inequalities that drive the AIDS epidemic and puts people at its centre, involving communities and prioritising human rights, respect and dignity.
| In its May 2021 resolution on accelerating progress and tackling inequalities towards ending AIDS as a public health threat by 2030, the European Parliament called on the European Commission to address AIDS as a global public health crisis, to prioritise health as part of the EU-Africa strategy, to work with Member States and partners to invest in community engagement and community-led responses as key components in the fight against HIV/AIDS-related stigma and discrimination, and to integrate HIV prevention and care with other local healthcare service offers, as an entry point for HIV information, education, communication and training. In November 2022, at the request of the Committee on Environment, Public Health and Food Safety (ENVI), the European Parliament’s Policy Department for Economic, Scientific and Quality of Life Policies provided a study on ‘Health-related quality of life in people living with HIV’. The study suggests accelerated action in several areas to reduce the incidence of HIV and to improve quality of life for people living with HIV, notably: a combined approach to HIV prevention (including access to condoms, PrEP, and harm reduction services such as needle exchange and drug treatment); expanded accessibility to HIV testing and, for those who test positive, rapid linkage to care; development of integrated, patient-centred services; and monitoring and addressing HIV-related stigma, particularly in healthcare systems. This study, based on the ECDC report on HIV/AIDS surveillance and monitoring data, was presented at the European Parliament’s SANT committee meeting of 28 November 2023 by Teymur Noori, expert on infectious diseases at the ECDC. |
Read this ‘at a glance’ note on ‘World AIDS Day 2023: 1 December‘ in the Think Tank pages of the European Parliament.
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