Bill & Melinda Gates Foundation

Actions Speak Louder: Tracking Global Progress toward the Beginning of the End of AIDS

November 26, 2013

From President Reagan’s “Mr. Gorbachev, tear down this wall” to President Kennedy’s “We choose to go to the moon in this decade,” our history is marked by speeches that have had a bold and lasting impact on the world.  These particular quotations are cemented in our memories, not just because they were good turns of phrase, but because the leaders who delivered them followed through on their words—ultimately making what seemed impossible possible.

In many ways, when scientists, activists, and leaders from around the world began coalescing around the audacious vision of “the beginning of the end of AIDS” in 2011, their proclamations inspired a similar mix of hope and skepticism.  Of course, getting to a turning point in this devastating, decades-long epidemic would be an incredible feat—but was it actually possible?

Beginning in 2012, ONE set out to write an annual accountability report, tracking just how much (or how little) progress was being made toward that vision.  And in this year’s report, out today, we find encouraging news: if current rates of acceleration are sustained, we will achieve the beginning of the end of AIDS by 2015.  In other words, for the first time, we will finally get ahead of this disease, adding more people to life-saving antiretroviral treatment than those who are becoming newly infected with HIV.  Not just within our lifetimes, but within a matter of years.

So what’s behind all this progress?  You might be surprised to know that it’s not just a Western, donor-driven effort (though their investments are still really important).  In fact, for the second year in a row, low- and middle-income countries are now providing more than half of all global AIDS financing.  And this progress is arguably most visible across sub-Saharan Africa: our new analysis shows that 16 African countries have already achieved the beginning of the end of AIDS, ahead of global trends. Our report analyzes how countries like Ghana, Zambia, and Malawi are leading the charge, combining donor resources with their own domestic spending on health and political will to turn the tide on their national AIDS epidemics.

In spite all of this progress, achieving the beginning of the end of AIDS by 2015 is not a foregone conclusion.  In fact, we outline in this report a number of key obstacles that stand in the way of achieving this important vision.  Just at a time when the world is poised to make historic gains on this disease, donor funding has flat-lined and only six African governments are meeting their health spending commitments, leaving the AIDS fight at least $3-5 billion underfunded annually.  Meanwhile, marginalized populations are all too often still unable to access treatment and prevention services, and a lack of transparency in the AIDS financing system makes it difficult to assess if the right resources are being spent on the most effective interventions.

The world has been at the fight against this disease for a long time, and it is perhaps inevitable that some sense of AIDS fatigue has set in. But making the beginning of the end of AIDS a reality requires new resources, new political commitment, and new energy.  We hope that the findings of this report call attention to where the world has collectively fallen short, but that it also provides a source of encouragement and inspiration.  If 16 African countries have already reached this AIDS tipping point, we must work harder to ensure that all countries around the world reach and surpass this milestone.  To borrow from President Kennedy’s moon shot speech, may the challenge of ending AIDS be “one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win.”

Please take a few minutes to read and share the report with your friends and colleagues—maybe even sparing a Facebook status or a tweet in support of the cause if you like what you see.  Let us know what you think about the findings, and thanks for helping us keep the momentum going as we approach World AIDS Day on December 1st.

 
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