Global HIV targets: a roadmap to 2030 and beyond

A decade ago, the global community established the goal to end AIDS as a public health threat by 2030 through reducing new HIV infections and AIDS-related deaths by 90% from 2010 levels. Progress has been substantial, particularly in the most affected eastern and southern Africa region, where new infections and AIDS-related deaths have each declined by almost 60% between 2010 and 2024. Globally, more than 77% of people living with HIV received antiretroviral therapy in 2024. In a subset of countries that achieved targeted 90% treatment coverage by 2024, new HIV infections have declined by 72%, putting 90% reductions by 2030 within reach. Progress has, however, been uneven. New HIV infections have plateaued or increased in Asia, eastern Europe and central Asia, Latin America, and the Middle East and North Africa regions.1 Additionally, there are persistent gaps in HIV services for children, adolescent girls and young women, and men in low-income and middle-income countries (LMICs). Key populations at increased risk of HIV—including men who have sex with men, transgender people, people who inject drugs, and sex workers and their clients—continue to be disproportionately affected, with lower treatment coverage and higher HIV incidence.

In the high-burden settings with the most progress, ongoing and proposed budget reductions to the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria by multiple donor governments would upend HIV treatment and prevention programmes. Rapid withdrawal of financial and technical resources threatens to reverse previous gains by increasing pressure on health systems to sustain effective services and jeopardising support for civil society and community-led HIV programmes, which have been crucial for catalysing effective action and accountability through the history of the HIV response.

Over the past two decades, the global goals to reduce new HIV infections and AIDS-related deaths by 90% between 2010 and 2030 have anchored the global HIV response. Specific targets, such as the 90–90–90 targets—to achieve 90% of people living with HIV knowing their HIV-positive status, 90% of people who know their status on treatment, and 90% of people on treatment having a suppressed viral load by 2020—and then 95–95–95 by 2025, galvanised political commitment, aligned programming, and guided investments in national HIV responses. This unifying framework helped drive measurable declines in HIV-related mortality and incidence through expanding access to HIV treatment and prevention.

The emergent challenges to continuing progress towards 2030 goals amid a more constrained funding environment reinforce the need to further prioritise global targets to address the remaining gaps, particularly for disproportionately affected populations. This accompanies recognition that effective HIV care, treatment, and prevention services must be available for decades beyond the Sustainable Development Goal of ending AIDS as a public health threat by 2030.

Access the full comment, published in The Lancet, here.