The world has committed to ending the AIDS epidemic by 2030. How to reach this bold target within the Sustainable Development Goals is the central question facing the United Nations General Assembly High-Level Meeting on Ending AIDS, to be held from 8 to 10 June 2016.
The extraordinary accomplishments of the last 15 years have inspired global confidence that this target can be achieved. UNAIDS recommends a Fast-Track approach: substantially increasing and frontloading investment over the next five years to accelerate scale-up and establish the momentum required to overcome within 15 years one of the greatest public health challenges in this generation.
The latest UNAIDS data, covering 160 countries, demonstrate both the enormous gains already made and what can be achieved in the coming years through a Fast-Track approach.
 In just the last two years the number of people living with HIV on antiretroviral therapy has increased by about a third, reaching 17.0 million people—2 million more than the 15 million by 2015 target set by the United Nations General Assembly in 2011. Since the first global treatment target was set in 2003, annual AIDS-related deaths have decreased by 43%.
 In the world’s most affected region, eastern and southern Africa, the number of people on treatment has more than doubled since 2010, reaching nearly 10.3 million people. AIDS related deaths in the region have decreased by 36% since 2010. However, huge challenges lie ahead. In 2015 there were 2.1 million [1.8 million–2.4 million] new HIV infections worldwide, adding up to a total of 36.7 million [34.0 million–39.8 million] people living with HIV.
Scale-up of antiretroviral therapy is on a Fast-Track trajectory that has surpassed expectations. Global coverage of antiretroviral therapy reached 46% [43–50%] at the end of 2015. Gains were greatest in the world’s most affected region, eastern and southern Africa.
 Coverage increased from 24% [22–25%] in 2010 to 54% [50–58%] in 2015, reaching a regional total of 10.3 million people. South Africa alone had nearly 3.4 million people on treatment, more than any other country in the world.
After South Africa, Kenya has the largest treatment programme in Africa, with nearly 900 000 people on treatment at the end of 2015. Botswana, Eritrea, Kenya, Malawi, Mozambique, Rwanda, South Africa, Swaziland, Uganda, the United Republic of Tanzania, Zambia and Zimbabwe all increased treatment coverage by more than 25 percentage points between 2010 and 2015.
Treatment coverage in Latin American and the Caribbean reached 55% [47–64%] in 2015. In the Asia and Pacific region, coverage more than doubled, from 19%[17–22%] in 2010 to 41% [35–47%] in 2015.
Western and central Africa and the Middle East and North Africa also made important gains but achieved lower levels of coverage in 2015, 28% [23–34%] and 17% [12–24%], respectively. In eastern Europe and central Asia, coverage increased by just a few percentage points in recent years to 21% [20–23%]—about one in five people living with HIV in the region.
The gains in treatment are largely responsible for a 26% decline in AIDS-related deaths globally since 2010, from an estimated 1.5 million [1.3 million–1.7 million] in 2010 to 1.1 million [940 000 –1.3 million] in 2015.
The reduction in deaths since 2010 has been greater among adult women (33% decrease) compared with adult men (15% decrease), reflecting higher treatment coverage among women than men, 52% [48–57%] and 41% [33–49%], respectively.
The gender gap for treatment among adults highlights the impact of gender norms that delay initiation of treatment among men, reduce treatment adherence, blunt the preventive effects of treatment, and lead to men accounting for 58% of adult AIDS related deaths.
Declines in new HIV infections among adults have slowed alarmingly in recent years, with the estimated annual number of new infections among adults remaining nearly static at about 1.9 million [1.7 million–2.2 million] in 2015. Beneath this global figure lie multiple disparities—across regions, within countries, between men and women and young and old, and among specific populations being left behind.
These disparities must be addressed in order to achieve the reductions required to end the AIDS epidemic as a public health threat by 2030.
Regional disparities
The largest reduction in new adult HIV infections occurred in eastern and southern
Africa. There were about 40 000 fewer new adult HIV infections in the region in 2015 than in 2010, a 4% decline. More gradual declines were achieved in the Asia and Pacific region and western and central Africa.
Rates of new adult HIV infections were relatively static in Latin America and the Caribbean, western and central Europe, North America and the Middle East and North Africa, while the annual numbers of new HIV infections in Eastern Europe and central Asia increased by 57%.
Key locations within countries
Complex and varied social, structural and economic dynamics within countries account for the uneven geographical distribution of HIV.
In many countries, HIV prevalence is higher in cities, where the vibrancy, stress and anonymity of urban life, and its bustle of encounters and interactions, provide increased opportunities for behaviours and sexual networking that may increase the risk of HIV infection. Increased efforts to collect and analyze sub-national data are revealing where HIV infections are occurring and where there are gaps in the provision of HIV services.
In Kenya, for example, an analysis in 2014 found that 65% of new HIV infections occurred in just 9 of the country’s 47 counties. This analysis contributed to a national HIV prevention “road map” that defines evidence-informed biomedical and structural interventions and targets them to specific populations and geographical zones.

The Kenya AIDS Strategic Framework aims to reduce annual new HIV infections among adults by 75% by 2019.
77% [69–86%] of all pregnant women living with HIV globally received medicines that prevent transmission to their babies in 2015.
At least 2.0 million people newly enrolled on antiretroviral treatment (ART) in 2015 – one of the largest annual increases ever.
46% [43–50%] of people living with HIV were receiving antiretroviral treatment in 2015.
Source: Global AIDS
Update 2016