- Última actualización en 20 Agosto 2016
- Visitas: 1991
Cities will determine the outcome of the fight to end Aids.
Of the 35 million people living with HIV around the world, more than a quarter reside in urban hotspots affected by the pandemic. And in many major cities, over half of all people live without access to HIV prevention, testing, treatment and care.
Urban strategies and actions are central to ending the Aids epidemic by 2030. This goal is ambitious but achievable and necessary. Cities are already demonstrating leadership.
There have been seismic changes in cities like Amsterdam, Paris, London, New York, San Francisco and Vancouver – all are close to reaching the so-called 90–90–90 treatment targets: namely that by 2020, 90% of all people with HIV will know their status; 90% of those people will receive sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy will maintain viral suppression.
Working hand-in-hand with the scientific community, clinicians, civil society organizations and key population representatives, the city of Paris has created a trusting environment with local actors committed to tackling the epidemic through innovative solutions. This includes pre-exposure treatment (PrEP), a once-a-day pill for people who are at high risk of acquiring HIV, and a range of testing tools, including self-tests.
The Paris strategy hinges on combined prevention – renewed information and clear messages on testing, treatment and its preventive effectiveness; promotion of condom use and PrEP; control of sexually transmitted infections (STIs); and comprehensive care for people with HIV. Combined prevention tools serve key populations across the board.
Paris can only achieve these goals with a strong commitment to marginalized groups, including gay and bisexual men, migrants, transgender people and sex workers. And 2016 can be the year we finally end needless and harmful discrimination, ensuring the wellbeing of all people in inclusive cities.
The report from New York City, which has proudly signed the Paris Declaration, is truly remarkable. Through the rigorous testing initiative New York Knows and the media campaign #beHIVsure, New York City has leveraged community and healthcare providers to make certain that all New Yorkers know their HIV status.
With several innovative take-action programs, New York City will accelerate the significant strides it has made to end Aids. “Jumpstart” STD clinics throughout the city will also soon provide newly diagnosed individuals with immediate access to medication and navigation to high-quality HIV care. These clinics, as well as others, will be supported to rapidly start people at risk of HIV on PrEP to make sure they stay negative, and New York City will continue to promote traditional prevention with the distribution of nearly 40m condoms annually.
Because of these efforts, New York City has already achieved the first two important pillars of the 90-90-90 strategy – testing and treatment. And the third pillar – viral suppression – is right around the corner. Thanks to increased technical assistance for city HIV clinics, a vigorous social marketing campaign and our citywide commitment to assisting New Yorkers with their basic needs for shelter, food, and transportation – so that they can better focus on their health – a 90% or better result for viral suppression for those on medication in New York City will be achieved well before 2020.
In concert with these citywide strategies, accelerated funding to populations in need is a crucial aspect to creating a clear roadmap to end the HIV/Aids epidemic as a public health threat by 2030. Economic expansion means smart investments in public health are possible. The private sector has an important role to play in bridging the limits of public funds and the reality of community needs.
Public private partnerships engage key players like the Mac Aids Fund to greatly expand the scale and reach of services and are instrumental in bolstering local responses to end the epidemic. The response to HIV is a shared responsibility, and more than individual health is at stake. For example, in Paris, the Mac Aids Fund is supporting the implementation of Paris’s city plan to end Aids. In New York, the Fund and the city are working on a new program that connects newly diagnosed persons to immediate HIV care and treatment. Both demonstrate the incredible strides that can be made when public and private sectors work in tandem.
We want to create a sustainable and dynamic network of partners to share best practices and learn from each other. We believe that together we can achieve these goals. Ending the Aids epidemic by 2030 is feasible if the world’s major cities follow New York and Paris to act immediately and decisively, if donors follow the lead set by the Mac Aids Fund and step up to the challenge and if civil society and multilateral leaders provide the necessary technical support. It’s up to us to make sure we win the fight to end Aids.