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In 2015 the Millennium Development Goals (MDGs) were replaced by 17 Sustainable Development Goals (SDGs), each with specific targets to be achieved by 2030.1 Under the SDG framework, the three MDGs relating to health were replaced by the following, overarching health goal:2 Launched in 2014, the UNAIDS Fast-Track strategy 5outlined plans to step up the HIV response in low- and middle-income countries to meet the SDG 3 target to end AIDS by 2030.
The strategy acknowledges that, without rapid scale-up, the HIV epidemic will continue to outrun the response.
Groups that are less likely to access treatment, in particular men from high HIV prevalence settings and key populations, must also be prioritised.
Tackling prevention holds the key to ending AIDS as public health threat.
To go with these headline targets, there are a number of expanded commitments, including regional targets.9 The Fast-Track strategy emphasises the need for the global response to be ‘front-loaded’ to prevent the epidemic from rebounding.To prevent this, it outlines the need to reduce new HIV infections and AIDS related deaths by 90% by 2030, compared to 2010 levels.To achieve this, the Fast Track strategy sets out targets for prevention and treatment, known as the 90-90-90 targets 6.HIV prevention targets encourage countries to promote access to tailored comprehensive prevention services for key populations, especially in locations with high levels of HIV transmission.14 However, at the time of the Declaration key population-led organisations raised concerns about the lack of explicit language in relation to those most affected by HIV or explicit recognition of why these groups are at heightened risk (such as the criminalisation of same-sex practices, drug use and sex work).In a joint statement, the Global Forum on MSM & HIV and the Global Network of Sex Work Projects said: In a 14,000-word document that includes over 76 discrete points, men who have sex with men; sex workers are only mentioned; people who use and/or inject drugs; and transgender people are only mentioned twice 15 The Declaration also commits to achieving gender equality and highlights the importance of male involvement in achieving this.