World AIDS Day – Ending the HIV/AIDS Epidemic: Community by Community

The Human Immunodeficiency Virus (HIV) targets the immune system weakening the defence system against infections and diseases. As the virus destroys and impairs the function of immune system cells, infected individuals gradually become immunodeficient.
Immunodeficiency results in increased susceptibility to a wide range of infections, cancers and other diseases that people with healthy immune systems can fight off. The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take from 2 to 15 years to develop depending on the individual. AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.
To raise awareness to tackle AIDS, December 1 was designated World AIDS Day since 1988. It is an international day dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection and to mourning those who have died of the disease. Government and health officials, Non-Governmental Organisations, and individuals around the world observe the day, often with education on AIDS prevention and control.
World AIDS Day is one of the eight official global public health campaigns marked by the World Health Organisation (WHO), along with World Health Day, World Blood Donor Day, World Immunisation Week, World Tuberculosis Day, World No Tobacco Day, World Malaria Day and World Hepatitis Day.
This year World AIDS Day is observed under the theme “Ending the HIV/AIDS Epidemic: Community by Community”.
World AIDS Day was first conceived in August 1987 by James W Bunn and Thomas Netter, two public information officers for the Global Programme on AIDS at the WHO in Geneva, Switzerland. Bunn and Netter took their idea to Dr Jonathan Mann, Director of the Global Programme on AIDS (now known as UNAIDS). Dr Mann liked the concept, approved it, and agreed with the recommendation that the first observance of World AIDS Day should be on December 1, 1988. Bunn, a former television broadcast Journalist from San Francisco, had recommended the date of December 1 believing it would maximise coverage of World AIDS Day by Western news media, as that date was sufficiently long after the US elections but before the Christmas holidays.
In its first two years, the theme of World AIDS Day focused on children and young people. While the choice theme was criticised at the time by some for ignoring the fact that people of all ages may become infected with HIV, the theme helped alleviate some of the stigma surrounding the disease and boost recognition of the problem as a family disease.
Key facts
HIV continues to be a major global public health issue, having claimed more than 32 million lives so far. However, with increasing access to effective HIV prevention, diagnosis, treatment and care, including for opportunistic infections, HIV infection has become a manageable chronic health condition, enabling people living with HIV to lead long and healthy lives.
There were approximately 37.9 million people living with HIV at the end of 2018. As a result of concerted international efforts to respond to HIV, coverage of services has been steadily increasing. In 2018, 62 per cent of adults and 54 per cent of children living with HIV in low- and middle-income countries were receiving lifelong antiretroviral therapy (ART).
A great majority (82 per cent) of pregnant and breastfeeding women living with HIV also received ART, which not only protects their health, but also ensures prevention of HIV transmission to their newborns.
However, not everyone is able to access HIV testing, treatment and care. Notably, the 2018 Super-Fast-Track targets for reducing new paediatric HIV infections to 40 000 was not achieved. Global targets for 2020 are at risk of being missed unless rapid action is taken.
Due to gaps in HIV services, 770 000 people died from HIV-related causes in 2018 and 1.7 million people were newly infected. In 2018, for the first time, individuals from key population groups and their sexual partners accounted for over half of all new HIV infections globally (an estimated 54 per cent) in 2018. For eastern European, central Asian, Middle Eastern and North African regions, these groups accounted for around 95 per cent of new HIV infections.
Key populations include: men who have sex with men; people who inject drugs; people in prisons and other closed settings; sex workers and their clients; and transgender people.
In addition, given their life circumstances, a range of other populations may be particularly vulnerable, and at increased risk of HIV infection, such as adolescent girls and young women in southern and eastern Africa and indigenous peoples in some communities.
Increased HIV vulnerability is often associated with legal and social factors, which increases exposure to risk situations and creates barriers to accessing effective, quality and affordable HIV prevention, testing and treatment services.
Over two thirds of all people living with HIV live in the WHO African Region (25.7 million). While HIV is prevalent among the general population in this region, an increasing number of new infections occur among key population groups.
HIV can be diagnosed through rapid diagnostic tests that can provide same-day results. This greatly facilitates diagnosis and linkage with treatment and care.
There is no cure for HIV infection. However, effective antiretroviral drugs (ARVs) can control the virus and help prevent onward transmission to other people.
At the end of 2018, an estimated 79 per cent of people living with HIV knew their status. An estimated 23.3 million (or 62 per cent of all) people living with HIV were receiving antiretroviral therapy (ART) and 53 per cent had achieved suppression of the HIV virus with no risk of infecting others.
Between 2000 and 2018, new HIV infections fell by 37 per cent and HIV-related deaths fell by 45 per cent, with 13.6 million lives saved due to ART. This achievement was the result of great efforts by national HIV programmes supported by civil society and international development partners. (WHO, UNAIDS)