LAUSR

As the global HIV response approaches 40, we can trace 3 phases in its evolution. The first phase, from the early 1980s to the late 1990s, is characterized as an era of despair, as the virus raged unchecked through communities and political commitment and resources were scarce. The second phase from the early 2000s to about 2012 represents one of hope, with effective treatments developed and political commitment and international resources surging. HIV financing grew 30% annually a decade, an unprecedented increase. After 2012, the HIV response entered a period of uncertainty. Development assistance for HIV fell for the first time. International financing for HIV has grown perilously reliant on one funder - the US. Political commitment has fallen globally and nationally. In the epicenter of HIV, Eastern and Southern Africa, concerted international support has underpinned a sustained response, but domestic resource mobilization is uneven and inadequate. Outside Eastern and Southern Africa, the response is faltering in great swathes of the world. Stigma against key populations remains widespread. Advocacy-based claims that we can end the HIV epidemic are premature and have contributed to a perception that the crisis is largely over. Competing disease priorities - including TB, malaria and hepatitis - are pressing their claims for a share of a pie that isn’t growing. The HIV movement has an equivocal relationship with the Universal Health Coverage (UHC) movement - concerned that its profile and financing may be diluted by integration. This presentation discusses these challenges and presents 2 scenarios - a high road to success and a low road to failure - based on choices we are making today. Disclosure No significant relationships.