worried, international experts call for intensifying the effort

Watch out for the rebound effect! This is essentially the message that has just been delivered, with force, a commission led by the International Society on AIDS (IAS), in a special issue of the prestigious journal The Lancet published Friday, July 19. The international NGO, composed of health professionals involved in the fight against AIDS, brocarde the speech on the possible end of the epidemic and proposes ways for a more integrated prevention.

In ten years, the number of dead AIDS has declined dramatically, from 1.9 million in 2005 to 1 million in 2016. Advances in prevention and improved access to antiretroviral therapy have helped to stem the global epidemic. To the point that in 2015, UNAIDS, the UN body in charge of the global fight against the disease, set the goal of seeing the disease disappear by 2030. A goal severely challenged by the AIS , who fears a relaxation of efforts.

"A dangerous complacency"

"The global HIV epidemic is not nearing completion and the dominant discourse on the end of AIDS, feeding a dangerous complacency , possibly precipitated the decline of the determination to fight the virus in the world, "say the authors. The international commission responsible for this work includes some 50 members, including Linda-Gail Bekker, president of the IAS, but also a former executive director of UNAIDS and two former directors of the Global Fund to fight AIDS , Tuberculosis and Malaria

Despite generally encouraging results, some populations remain highly exposed to HIV infection. This is the case of men who have bad with men, injecting drug users (Russia, Eastern Europe, Central Asia), young girls at the beginning of their badual life (sub-Saharan Africa), and more generally women. people with limited access to health systems – migrants, displaced persons, people with very low socio-economic status

For integrated prevention

To continue to stop the epidemic, the authors advocate better integrating HIV / AIDS to other health services. An experiment in Russia shows, for example, that badociating AIDS prevention with the fight against drug addiction gives good results. Other examples include integrating prevention with family planning services (Nigeria), or even screening for AIDS along with cardiovascular diseases (South Africa, Kenya).

In reverse of an organization in silo, it is It would therefore be important to integrate prevention with other health programs (contraception, maternity, addiction, infectious diseases, etc.) in order to target at-risk groups. "The challenge is to achieve greater integration without diluting the success of the fight against HIV," warns Peter Sands, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria ( FMLSTP ), in a joint editorial

In 2019, Paris will host the GFATM conference, which will collect public and private funding for the period 2020-2022. A prime political opportunity, say Pamela Das and Richard Horton, of Lancet who call on Emmanuel Macron to "lead the debate" in favor of an integrated approach to the fight against AIDS.