World AIDS Day 2024: Still too many HIV infections

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 ‘Take the rights path: My health, my right!’ underlines the need to ensure that everyone, everywhere, has the right to quality healthcare services in the fight against HIV and AIDS.

Background

Attacking the body’s immune system (the white blood cells or ‘CD4 cells’), HIV weakens its defence against other infections and diseases. 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 2024’s theme ‘Take the rights path: My health, my right!’ the WHO is calling on global leaders and citizens to champion the right to health by addressing the inequalities that hinder progress in ending AIDS. In its report published on 26 November 2024, UNAIDS underlines the urgent need to remove laws, policies and practices which harm people’s rights by punishing, discriminating against or stigmatising people and obstructing access to HIV prevention, testing, treatment and care, as well as laws, policies and practices that hinder the work of people who are providing vital HIV services for affected communities or who are advocating for reforms.

Facts and figures

UNAIDS data show that, in 2023, 1.3 million people contracted HIV, 39 million people were living with HIV (38 million adults (15 years or older) and 1 million children (0–14 years) and 630 000 people died of AIDS-related illnesses. Stigma and discrimination hinder individuals from seeking and obtaining HIV-related care:  across countries with available data, people living with HIV who perceive high levels of stigma are 2.4 times more likely to delay care until they are very ill.

According to the 2024 report  on ‘HIV/AIDS surveillance in Europe’ (2023 data), published on 28 November 2024 jointly by the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe, HIV affects over 2.6 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 650 000 people in the EU/European Economic Area (EEA).

In the EU/EEA specifically, 24 731 people were newly diagnosed with HIV in 2023 (22 995 in 2022).

In addition, 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. EU4Health projects aim to provide support to vulnerable groups, including access to information, testing, and community-based services. 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. The Horizon Europe programme for research and innovation supports projects ranging from basic research to the development and testing of new treatments and vaccines.

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. Its 2023 progress report published in February 2024 summarises the progress towards UN SDG 3.3 to eliminate the AIDS epidemic in Europe 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.

On the world stage, as underlined in its 2022 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 driving the AIDS epidemic and puts people at its centre, involving communities and prioritising human rights 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 calls 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.

In November 2022, at the request of the Committee on Environment, Public Health and Food Safety (ENVI), the 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 was presented at the European Parliament’s Subcommittee meeting on Public Health (SANT) of 28 November 2023.

In its December 2023 resolution on non-communicable diseases, Parliament supports further research on the development of vaccines and innovative treatment options against HIV. It calls on the Member States to step up their support to ensure that all citizens, including vulnerable communities more at risk, can be tested, diagnosed and have rapid access to the best innovative care options. It encourages the Member States to invest in and support high-impact innovative combination prevention approaches.

This updates an ‘At a glance’ note from November 2023.

Read this ‘at a glance’ note on ‘World AIDS Day 2024: Still too many HIV infections‘ in the Think Tank pages of the European Parliament.