10年間の進歩を経て、エイズ終結の野心的目標に向け対応の再活性化を 国連事務総長報告2019


 2020年ターゲットの達成に向けた政治の意思を再び強く持ち、行動を強化し、必要な勢いを生み出すために、加盟国は以下の勧告の採択を求められている:(a)HIV感染の一次予防に力を入れる;(b)90-90-90ターゲット達成に向けたHIV検査の多様化と患者に合わせた保健医療ケアの提供 ;(c)社会から疎外され弱い立場にある人たちの権利を尊重する法的、政策的な環境の確立;(d)追加的資金の確保、および最も必要なところへのその資金の配分;(e)コミュニティが重要な役割を担えるようにするための支援;(f)包括的なHIV対策のユニバーサル・ヘルス・カバレッジへの合流。

Galvanizing global ambition to end the AIDS epidemic after a decade of progress
Report of the Secretary-General

A world without AIDS was almost unimaginable when the General Assembly held its first special session on the epidemic 18 years ago. Since then, the global determination to defeat one of history’s greatest health crises has produced remarkable progress. Over the past decade, the number of people living with HIV on treatment has increased 5.5 times, behaviour change communications and condom distribution programmes have successfully reduced the incidence of HIV infection in a variety of settings and a growing number of countries have eliminated mother-to-child transmission of HIV. Globally, deaths from AIDS-related illnesses among people of all ages and HIV infections among children have been cut nearly in half, and new infections among adults have declined by 19 per cent.
Strong gains against the epidemic inspired a commitment within the 2030 Agenda for Sustainable Development to end the AIDS epidemic by 2030. The General Assembly agreed in 2016 that achieving this target required rapid expansion of HIV prevention, testing and treatment services.
There are many challenges, including stigma and discrimination faced by people living with HIV and harmful gender norms. Laws and policies in many countries prevent young people, women, key populations (people who inject drugs, sex workers, transgender people, prisoners, and gay men and other men who have sex with men), indigenous peoples, migrants and refugees from accessing health and HIV services. Funding for HIV responses in low- and middle-income countries globally has also been flat for most of the past five years.
However, there is a window of opportunity for more countries, across all regions and income levels, to get on track to meet the 2020 targets agreed by the General Assembly. The United Nations system, including the Joint United Nations Programme on HIV/AIDS (UNAIDS), is enhancing its support to countries through the United Nations reform initiative.
An important opportunity is the growing movement to achieve universal health coverage. A core principle of universal health coverage is to leave no one behind. Within the context of HIV, leaving no one behind requires a health benefit package that includes a comprehensive set of health facility-based HIV services, additional public health and social protection services provided through dedicated government funding streams and structural changes to ensure that vulnerable and marginalized people can access the services they need.
Member States are urged to adopt the following recommendations to galvanize political will, accelerate action and build the momentum necessary to reach 2020 targets: (a) reinvigorate primary HIV prevention; (b) diversify HIV testing and differentiate the delivery of health care to reach the 90–90–90 targets; (c) establish enabling legal and policy environments in order to reach marginalized and vulnerable populations; (d) mobilize additional resources and allocate them where they are most needed; (e) support communities to enable them to play their critical roles; and (f) incorporate a comprehensive HIV response into universal health coverage.

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