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Calling the Prevention Community: The UNAIDS targeting process needs all hands on deck

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Thursday, November 13, 2014

Today UNAIDS hosted a webinar to describe and discuss its proposed prevention targets. These have been developed to complement the 90-90-90 target which seeks to have 90 percent of people with HIV know their status, access antiretroviral therapy (ART) and achieve virologic suppression by 2020. 90-90-90 is, of course, a combination treatment and prevention target since virologic suppression reduces the risk of HIV transmission. But AIDS advocates have been asking for targets with similar specificity and ambition for non-ART prevention—including attention to stigma, discrimination and criminalization, since rights-based delivery of services is absolutely essential.

UNAIDS has released both a prevention target draft and a draft of non-discrimination targets. Together, these two documents are the beginning of what a comprehensive response, complementing 90-90-90 could look like. But, as we describe below, there is still a pressing need to review and clearly articulate the rationale for the specific targets being laid out—particularly in the HIV prevention target draft. This is because the prevention target draft has a narrower set of possible objective than the non-discrimination target draft, which lays out two broad approaches to setting these targets—and invites input on the overall strategy.

AVAC and partners have reviewed both draft documents; you can read the composite feedback from Stop AIDS Now and the International HIV/AIDS Alliance on the draft non-discrimination target here. In this post, we focus on the prevention target draft.

The overall prevention goal is to reduce the number of new HIV infections to below 500,000 per year by 2020. There are two population specific sub-goals:

  1. By 2020, new infections in key populations will be reduced by 75%
  2. By 2020, new infections in young women and girls will be reduced by 75%

As UNAIDS’ Karl Dehne presented on today’s webinar, the over-arching target was selected for the following reasons.

These overarching goals are ambitious, and it is both necessary and exciting to envision how they could be achieved. The prevention targets document begins to map out what Dehne calls the “programmatic targets” that could contribute to these overarching objectives. The proposed “results” framework for these programmatic targets as presented today looks like this:

AVAC and partners who have reviewed the document and the results framework feel that urgent attention and discussion is warranted to ensure that the eventual finished product has the impact that’s needed. We have submitted a letter and a mark-up of the targets document itself that articulate a range of concerns. UNAIDS has also posted shared Google documents of both the prevention and non-discrimination target drafts, and they can be viewed here:

The comment period for both documents closed yesterday (November 12, 2014). However, on today’s webinar, UNAIDS’ Chris Collins said that there was still a narrow window for weighing in—but that feedback did need to come in “as soon as possible.” The above Google Docs remain available. You may also reach out to advocacy@unaids.org.

We will be working with partners to amplify questions and priorities in the coming days—and welcome feedback and input on the documents, our analysis and the overall process for developing these goals. Please be in touch and watch this blog for more updates!