90 90 90 is an ambitious strategy to “End” Aids by UNAIDS. The Fast Track consist in:
By 2020 (in 5 years):
- 90% of all people living with HIV will know their HIV status.
- 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
- 90% of all people receiving antiretroviral therapy will have viral suppression.
- In addition, no more than 500,000 new infections among adults.
- Finally, zero discrimination is expected.
- 95% of people with HIV are aware of their HIV status.
- 95% of them will be in HIV treatment.
- 95% of people exposed to the treatment of HIV show viral suppression.
- In addition, no more than 200,000 new infections among adults.
- Again, zero discrimination is expected.
Can we really achieve the 90-90-90 in the first place? First of all, this goal is mostly about treatment, and how we can be avoid infecting others. If you want to deal with the HIV, you need to deal with us first. It’s should be human rights based, and also, have the prevention targeted. There’s actually a couple of things we should keep in mind while talking about how realistic and prepared our governments are.
On the first “90” we must recognize that in many countries if you are not more than 18 you can’t have an HIV test without your parental consent, and in some countries even with your parent’s consent you just can’t. Also, we prioritize the “Key Populations” on this, however we see that in a lot of Eastern Africans countries the higher rate is on young women, so we may want to shift and redefine which the key populations are.
On the second “90”, I don’t really have much, just the concern about having second and third line medications available, and regarding the evidence based information, leave the option to the person about when they want to start treatment.
On the last “90”, well we know that many countries don’t have the viral load testing, so I’m not sure how we will measure this. Also, it’s quite important to have the conversation on not taking medication, because there are people that don’t want to be on treatment yet or are having a treatment vacations. And even when it would be better if this doesn’t happen, it does, we need to face it, respect it, and stop judging it.
Now, about “no more than 500,000 new infections among adults”, I really hope that young people are included here, because the incidence among this population is getting higher. And on “Zero discrimination”, what does zero discrimination means? And how do we measure it? It’s not only about having zero discrimination on the society, but in a more politic and systematic way. Maybe, and just maybe, we can achieve the “Zero Discrimination” by eliminating the HIV criminalization, along as the homosexuality, sex work and drug use criminalization. We need to end forced and coerced sterilization on women living with HIV. HIV testing for adolescents without their parental consent and the access to health care for migrant people.
Isn’t only about how many pills we deliver, is about engaging people with holistic, supportive and comprehensive health programs. It’s about having the UN system taking stronger positions with the countries, and being inclusive not only with civil society but also with other territories like Puerto Rico, American Samoa, Virgin Island where there’s any data yet on UNAIDS. It’s about the intersection of our agendas with others, like climate change, technology and peace and reconciliation.
Remember, we are humans, we yes we don’t want to infect anyone else (must of us), but we want to live a dignified life, be more than numbers, and be treated because our life matters.
Bring us to the table!