During this series, POLITICO has taken a deep dive into the landscape of HIV in Europe and considered the evolving nature of the fight against HIV, from its initial appearance into public consciousness in the 1980s through to the modern day. Today, being HIV positive in Europe is no longer the death sentence it once was. The Telescope series has highlighted the progress made in our understanding of the virus and illustrated the path that has been taken for it to become the manageable chronic condition it is today in many parts of the world. Nevertheless, the series has also highlighted that there are outstanding challenges and barriers in the field of HIV which must be tackled if we are to get to zero new infections and end the epidemic once and for all.
What does Europe need to get to zero once and for all?
2020 is going to be remembered as a year of uncertainty and unexpected crisis due to the COVID-19 pandemic which has dramatically altered our daily lives and has created a “new normal” we will all have to adjust to. Clearly, the COVID-19 pandemic has demonstrated how critical it is to be able to effectively tackle viruses and to ensure our health systems are fully prepared to address health emergencies, by acting with a sense of urgency. It is clear we need to stay vigilant and intensify efforts to work in a collaborative manner with a view to increasing the odds of successfully managing pandemics.
These factors are equally important in the fight against HIV. Additionally, there are critical elements one should consider in tackling viruses adequately: the importance of generating good data, the availability of regular and repeated testing, access to innovative treatments and implementing measures to prevent new cases, as well as the need for measures taking into account the quality of life of people affected. Indeed, people with HIV are at higher risk than the general population of experiencing co-existing medical conditions3 (co-morbidities) such as cancer (i.e. smoking related and virological cancers)4, heart conditions5, bone fractures6, kidney failure7 or mental health issues (particularly depression)8.
Let’s not forget that despite the progress achieved so far, HIV has not been defeated yet. Although many European countries, particularly in Western and Central Europe9 are on track to meet the 90-90-90 targets established by UNAIDS in December 2013, progress is not uniform across countries. While countries like Denmark, Norway, Portugal and Spain have achieved steep declines in the number of annual infections, others like Bulgaria, Czechia, Poland and Slovakia have seen annual HIV infections rise dramatically10. Additionally, late diagnosis (diagnosis at an advanced stage of the disease, so called phenomenon of “late presenters”) remains a common challenge11.
This is no time for complacency. Like in the fight against COVID-19, we can only end the HIV epidemic if we stay vigilant and intensify efforts to work together to stop HIV. This means we need to be ambitious, strive to reach the 90-90-90 targets evenly across Europe and push the bar higher, beyond the targets, aiming at zero new infections, zero discrimination and zero new AIDS-related deaths12.
We, at Gilead, are committed to playing our part in the fight against HIV. EU and national policymakers have an essential role to play too.
Initiatives like the recently launched online mapping “HIV Lens” can support policy-makers in identifying the areas where to take actions. Knowing in detail the numbers of people affected or at greatest risk of infection is indeed essential to mapping care and commissioning services accordingly. HIV Lens, a collaboration between NAM, Public Health England and Gilead Sciences, has been recently launched to improve HIV data collection in England and could be a best practice for other countries to consider in their efforts to fight HIV.
We are one decade away from 2030 and if we really want to end the epidemic and get to zero, it is vital that the EU and Member States raise their ambition beyond achieving viral suppression for people living with HIV.
The EU and Member States should:
- Renew their political commitment to sustain the scientific progress achieved to date, as innovation is vital to defeat HIV;
- Raise the ambition beyond viral suppression and define new policy approaches to address the long-term needs of people living with HIV and tackle HIV related stigma and discrimination;
- Bridge the existing gap in the fight against HIV between Eastern and Western Europe by adopting a European action plan to support the EU Member States in achieving the Sustainable Development Goal 3 (SDG3) of eliminating HIV/AIDS by 2030.
Together we can get to zero.