Information on the UNAIDS 90-90-90 Initiative and Goals

UNAIDS 90-90-90: AN AMBITIOUS TREATMENT TARGET TO HELP END THE AIDS EPIDEMIC

Ending the AIDS epidemic is more than a historic obligation to the 39 million people who have died of the disease. It also represents a momentous opportunity to lay the foundation for a healthier, more just and equitable world for future generations. Ending the AIDS epidemic will inspire broader global health and development efforts, demonstrating what can be achieved through global solidarity, evidence-based action and multisectoral partnerships.

Although many strategies will be needed to close the book on the AIDS epidemic, one thing is certain. It will be impossible to end the epidemic without bringing HIV treatment to all who need it.

As the world contemplates the way forward following the 2015 deadline for the targets and commitments in the 2011 Political Declaration on HIV and AIDS, a final target is needed to drive progress towards the concluding chapter of the AIDS epidemic, promote accountability and unite diverse stakeholders in a common effort. Whereas previous AIDS targets sought to achieve incremental progress in the response, the aim in the post-2015 era is nothing less than the end of the AIDS epidemic by 2030.

In December 2013, the UNAIDS Programme Coordinating Board called on UNAIDS to support country- and region-led efforts to establish new targets for HIV treatment scale-up beyond 2015. In response, stakeholder consultations on new targets have been held in all regions of the world. At the global level, stakeholders assembled in a variety of thematic consultations focused on civil society, laboratory medicine, paediatric HIV treatment, adolescents and other key issues.

Powerful momentum is now building towards a new narrative on HIV treatment and a new, final, ambitious, but achievable target:

• By 2020, 90% of all people living with HIV will know their HIV status.
• By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
• By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression. 

HIV Rapid Test Quality Improvement Initiative (RTQII)

Between 2004 and 2012:

• Over 159 million HTC (HIVTesting and Counseling) sessions were provided with PEPFAR (President's Emergency Plan for Aids Relief) support using HIV rapid tests (RT). Working towards the elimination of new HIV infections under PEPFAR's Combination HIV Prevention strategy will require increasing access to and uptake of HTC and emphasizing efforts to ensure the accuracy of HIV testing. 
• In support of these efforts, the Laboratory, HTC and Prevention of Mother-To-Child Transmission of HIV Technical Working Groups (PMTCT TWGs) collectively proposed an HIV Rapid Testing Quality Improvement Initiative (RTQII), which has been approved by Ambassador Goosby. The RTQII aims to ensure the quality of HIV rapid testing and expand upon current in-country HIV rapid testing quality improvement work. The RTQII is comprised of the following five key action areas:

1.      Policy Engagement: Create an enabling framework for policy development

2.      Human Resource: Increase cadres of qualified testers through training and certification

3.      Proficiency Testing Programs: Increase uptake and coverage and demonstrate impact

4.      Standardized Register: Increase uptake and coverage and demonstrate impact  

5.      Post Market Surveillance: Monitor the quality of new kit lots

All seven selected countries, like all PEPFAR-supported ones, are presently implementing to some extent the different focused areas identified by this Initiative. However, because of inadequate engagements at national levels, insufficient resource allocations, coverage and consistency in rolling out quality assurance has been challenging. To this end, the RTQII will help synergize and leverage existing country resources and ensure long-term sustainability of the quality of HIV testing. 
The seven countries participating in the RTQII Initiative are:

Kenya

Tanzania

Cameroon

Ethiopia

Uganda

Malawi

Zambia