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Globally, fewer people acquired HIV in 2022 than at any point since the late 1980s. The estimated 1.3 million new HIV infections globally in 2022 represented a 38% reduction since 2010 and a 28% reduction since 2015.

The overall progress largely reflects achievements in the initial 28 Global HIV Prevention Coalition focus countries of which Uganda is a member.

Vincent Bagambe, the director for Planning and Strategic Information at the Uganda AIDS Commission said that Uganda is on the right track as far as attaining the 2025 HIV prevention target.

He said, Uganda had 52,000 new HIV infections as of December 2023 and certainly is not likely to attain our targets of 2025 which had been set at 15,000 new HIV infections by then.

“As members of the Global Prevention Coalition since its launch in 2017, Uganda has implemented the interventions in the road map. Uganda has implemented the interventions in the road map. We have domesticated the proposed interventions and we take note that this has had an impact on the results and taken a hard impact on the prevention indicators as set,” Bagambe explains.

Bagambe stressed that the majority of the young population between the age of 15-25 are circumcised with 42.2% % of this age group medically circumcised, but an additional 20% who had been circumcised through cultural or religious practices according to the 2020 Uganda Population HIV Impact Assessment Survey.

He acknowledged the support of the government in implementing the HIV mainstreaming approach where all government institutions must allocate 0.1% of their budget and dedicate it towards HIV prevention interventions.

Angeli Achrekar, the deputy executive director of programmes and assistant secretary general at UNAIDS, appreciated how Global HIV Prevention Coalition focus countries are handling the HIV/AIDS fight and urged every country to address the gaps highlighted in this report.

"Prevention needs to be reimagined in a world, in which HIV is no longer daily headline news, we need a new user-centered approach – position prevention as part of safe & enjoyable intimate relationships & sexuality & other aspects of life communities care about,” Achrekar explains.

AIDS Vaccine Advocacy Coalition (AVAC) executive director Mitchell Warren said the report highlights what can happen if nations can unite and pull all strengths together.

“It’s remarkable to see what has been achieved in the AIDS response in the past 20 years. But the progress to date has not been equitable and is not yet sustainable, and we must never confuse progress with being sure of success. There is progress but we must never confuse progress with success, our progress is fragile, and what we’ve achieved today could slip away even more quickly than it was achieved if we let complacency take hold.” Warren explained.

This outlines the fruits of the Global HIV Prevention Coalition

Uneven gaps in the HIV fight

The report outlined the absolute number of new HIV infections among the key population outside of sub-Saharan Africa increasing since 2010. These include sex workers, people who inject drugs, long-distance truck drivers, and fishing communities among others.

It also stresses that regular access to HIV prevention remains insufficient among key populations. On average, 49% of sex workers and 36% of people who inject drugs accessed two or more HIV prevention services in the previous three months against a target of 90%.

Uganda’s key population stands at 35% among sex workers and 23–35% among fishing communities in the country. These rates are considerably higher than the general population's rate, indicating a disproportionate impact of HIV on these key populations based on the latest (UPHIA) Uganda Population HIV Impact Assessment of 2020

Worryingly, there have been reductions in investment in both condom and VMMC programmes in countries with some of the largest HIV epidemics in the world, and breakthrough prevention options like PrEP are available to only a small fraction of the people who need them according to the report.

In sub-Saharan Africa particularly, recognition of the inordinately high risk of HIV infection among adolescent girls and young women has led to much greater emphasis on reaching them with comprehensive prevention services.

Increased investments, including from the Global Fund and PEPFAR (the United States President’s Emergency Plan for AIDS Relief), have enabled focus countries in that region to implement dedicated combination prevention programmes for young women in at least 60% of locations with high HIV incidence.

The Global Fund’s HIV prevention investments grew from US$ 705 million in the 2018–2020 period to over US$ 850 million in the 2021–2023 period.

It invested more than US$ 140 million in condom programmes in the 2021– 2023 period and doubled its investments in pre-exposure prophylaxis (PrEP) to US$ 24.1 million according to the 2023 Global HIV Prevention Coalition report.

Globally, 39.0 million [33.1–45.7 million] people were living with HIV at the end of 2022, 630,000 people died of HIV-related illnesses worldwide. Uganda has 1.4 million people with HIV/AIDS and 1.2million are on ARVs

‘62.2% of Uganda’s young population is circumcised’

Vincent Bagambe, the director for Planning and Strategic Information at the Uganda AIDS Commission said that Uganda is on the right track as far as attaining the 2025 HIV prevention target.

Vincent Bagambe, Director for Planning and Strategic Information at the Uganda AIDS Commission (File Photo)

John Musenze

Journalist @New Vision