A new report released today, highlights achievements and gaps in the implementation of the global health sector strategies for HIV, viral hepatitis and sexually transmitted infections (STIs) from 2016-2021 and outlines key steps needed to eliminate these diseases as a public health threat by 2030.
The report contains new estimates for viral hepatitis and the four main preventable and curable STIs; and most targets had not been reached by 2020, even before the COVID-19 pandemic struck.
- HIV, viral hepatitis and sexually transmitted infections all continue to be major public health threats and account for 1 million new STIs per day, and when taken together resulted in 2.3 million deaths and 1.2 million cancers per year.
- New data show that hepatitis B and C cause 3.0 million new infections and 1.1 million deaths in 2019. Only 10% of people who have chronic infection with hepatitis B virus are diagnosed; 22% of whom receive treatment. For hepatitis C infection, 21% of people are diagnosed and 62% of whom receive treatment. Despite progress against the 2020 hepatitis targets, the gaps towards achieving 2030 goals are enormous.
- With 1.7 million people newly infected with HIV in 2019, HIV incidence has fallen to its lowest annual number since 1990. However, this remains far below the global target of less than 500 000 people newly infected by 2020.
- New data on STIs show 374 million new cases per year. Other than slow declines in congenital syphilis, the incidence of most other STIs is plateauing despite ambitious targets.
However there have been some important success stories: the reduction in the incidence of hepatitis B infection is one of the few Sustainable Development Goals health targets that is on track. In addition, new data show that 9.4 million people are receiving treatment for chronic hepatitis C virus infection, a more than nine fold increase since 2015.
There has been a large-scale expansion of HIV treatment and reduction in mother to child transmission of syphilis and HIV. Two thirds of all people living with HIV and 85% of pregnant women living with HIV are receiving antiretroviral therapy, leading to a substantial decline in mortality and fewer paediatric infections from vertical transmission.
Many more countries now have national strategic plans and updated guidelines to address STIs. Coverage of interventions such as syphilis screening of pregnant women in antenatal care and human papillomavirus vaccination, are increasing.
One key challenge is that many people are unable to access these vital interventions. In many situations, the populations most severely affected and at higher risk, young people and those stigmatized by these diseases, are missing out on services. HIV testing, prevention and STI services have also been disrupted during COVID-19. The pandemic has forced all three disease programmes to innovate to deliver and maintain essential health services.
"The accountability report would have looked very different a year ago, before COVID-19", says Dr Meg Doherty, Director of WHO's Department of Global HIV, Hepatitis and STI Programmes. "Our progress to date demonstrates that we have the interventions and approaches to make a great impact and build back stronger against COVID-19, HIV, viral hepatitis, and STIs. The report is a call to action – we have 9 years to reach our SDG targets – we need all stakeholders to accelerate action across the three diseases to achieve our ambitious yet achievable goals by 2030.''
