This Give a Day: Understanding 90-90-90, The three-pronged goal of UNAids to combat HIV
We know how far a day’s pay can go for ourselves – imagine the difference it can make for a person living with HIV in a resource-limited country. I first heard of Give a Day several years ago when my friend and fellow Dignitas Board member Jennifer Keenan invited me to an event. That night I met the founder of Give a Day, Dr Jane Philpott. I subsequently organized my own event with Dr. Eleanor Colledge at Toronto East General Hospital. The simple premise of the campaign is to donate a day’s pay to Dignitas International and/or the Stephen Lewis Foundation in an effort to combat the scourge of HIV/AIDS in the developing world. The current crisis with Ebola highlights that it is in all of our interests to ensure that people everywhere have access to decent medical care.
Recently, UNAIDS and WHO estimated that there were 35 million people living with HIV/AIDS. A staggering 22 million people, 63% of those infected, are still without access to anti-retroviral treatment. While significant strides have been made since 2003, we are not even remotely close to the end of the epidemic.
As we look ahead, new strategies are being adopted to prevent new transmission of HIV/AIDS and improve the health and lifespans of those living with the disease. In September, UNAIDS announced 90-90-90: a threefold attack on HIV/AIDS. This strategy sets to meet three goals by 2020.
First, 90% of all people living with HIV must know their status – this means more HIV tests, particularly in sub-Saharan Africa, where only about half of all people living with HIV are aware of their positive status. This along with better public education could have a profound effect on disease transmission.
Secondly, 90% of HIV-positive people will start and sustain anti-retroviral treatment.
Finally, of those on anti-retroviral treatment, 90% will have viral load suppression. In other words, the virus will be sufficiently suppressed in order for them to lead healthy and productive lives while also reducing the probability of transmission to others.
If we make these targets a reality by 2020, UNAIDS predicts 73% of those living with HIV/AIDS will be virally suppressed. Nevertheless many hurdles remain. Stigma and discrimination, persistent in the social structure of sub-Saharan Africa still deters many people from HIV testing and treatment. Accessibility to treatment, particularly in rural communities, also remains a profound obstacle. Finally, funding for HIV treatment and programs must be strong and consistent. Robust international assistance is essential to keep building momentum towards the end of AIDS. The health of the developed world is ultimately linked to the health of the most vulnerable.
Every day, we make positive strides towards the end of HIV/AIDS, but on Give a Day, we have an opportunity to impact further. An AIDS-free generation is in sight, but only if we work for it. We must not let this opportunity slip away.