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圖片來源：iStock/LightFieldStudios

030 年之後，愛滋病毒應對措施將會發生什麼變化？

海絲特‧菲利普斯 / 2024 年 2 月 2 日 / 知情

聯合國愛滋病規劃署提出新方法，幫助各國保護 2030 年後愛滋病毒防治成果

照片用於說明目的。 它們並不暗示健康狀況或行為。

多年來，愛滋病毒應對措施的重點是到 2030 年消除愛滋病這項公共衛生威脅。但此後會發生什麼事？ 聯合國愛滋病規劃署的一份新「導引」探討了這個問題。

這份報告是關於什麼？

聯合國愛滋病規劃署新的愛滋病應對永續性入門讀本。 此舉旨在鼓勵有關國家的愛滋病毒應對措施未來的對話。 目標是制定針對國家具體的計畫，以維持到 2030 年在愛滋病毒防治方面上取得的進展，並長期控制該流行病。

為什麼它如此重要？

各國的愛滋病毒應對措施處於不同階段。 有些國家比其他國家更接近 2030 年消除愛滋病這一公共衛生威脅。 但每個國家現在都需要開始規劃 2030 年代及以後的有效、可持續性的愛滋病毒應對措施。 該計畫的具體內容將取決於一個國家的愛滋病毒疫情及其變化情況、愛滋病毒疫情得到控制的程度以及仍然存在哪些障礙。

它說了些什麼？

長期永續性

隨著愛滋病毒流行的變化，一些現有的計畫活動將不再需要。 愛滋病毒應對措施的其他部分需要改變才能更加有效。 例如，未來，大多數愛滋病毒感染者可能屬於老年族群。 治療和預防服務可能需要將重點轉向這些年齡組，並且可能需要更多地關注合併感染治療。 另一個例子是，擴大預防和治療服務所需的策略和服務將不同於維持這些服務所需的策略和服務。

需要當地採取應對措施

每個國家的永續發展需求都會有所不同。 聯合國愛滋病規劃署建議每個國家制定永續發展路線圖，概述實現以下目標的關鍵國家策略和行動：

• 預測、預防、檢測和應對新的愛滋病毒感染

• 維持愛滋病毒感染者的病毒量抑制（超過 86% 的愛滋病毒感染者的病毒受到抑制，所有年齡層、性別和所有重點人群均達到這一比例）

• 透過結束或減少導致愛滋病毒流行的不平等現象來實現 10-10-10 目標（註）

路線圖應列出為實現這些目標在關鍵領域所需採取的行動。 這些關鍵領域是政治領導、服務取得、系統能力、政策和法律以及國內和國際融資。

該路線圖與愛滋病毒國家策略計畫 (NSP) 不同。 NSP 傾向於關注短期和中期成果（3-5 年），而一個國家的愛滋病毒永續發展路線圖將關注 2030 年後的幾年和幾十年。

受愛滋病毒影響最嚴重的民間社會和社區需要有意義地參與制定路線圖，並應在每個開發階段進行協商。

需要基於權利和以人為本的方法

為了使愛滋病毒應對措施充分有效，並使這種影響持續下去，所有人的健康權都必須實現。

這意味著改變愛滋病毒政策、計畫和系統，使其包容社會所有成員，特別是愛滋病毒高危險群。 它也意味著努力改變法律和社會結構，使其具有非歧視性且不侵犯人權。

這對愛滋病毒服務意味著什麼？

永續發展將成為聯合國愛滋病規劃署今年及以後議程的首要議題。

要加快這項議程，重要的是要了解制定永續發展路線圖的計畫。 以下是不同的階段：

2024 年 1 月至 3 月：聯合國愛滋病規劃署與國家領導團隊合作，並舉行永續發展對話和諮詢。

2024 年 4 月至 6 月：將評估每個國家目前的愛滋病毒應對措施的可持續性。

2024 年 7 月至 12 月：將制定國家愛滋病毒應對永續性路線圖。

2025 年 1 月至 5 月：將為每個路線圖制定轉型計畫。 這將側重於使計畫和系統朝向以權利為基礎、以人為本所需的變革。

2025 年 6 月起：將實施並監督轉型計畫。

註：具有懲罰性的法律和政策環境以拒絕或限制獲得服務機會的國家應少於10%

愛滋病毒感染者和關鍵人群會遭受到恥辱和歧視者應少於10%

婦女、女孩、愛滋病毒感染者和關鍵人群會遭受到性別不平等和暴力侵害者應少於10%

What will happen to the HIV response after 2030?

Hester Phillips / 02 February 2024 /  Be In The Know

UNAIDS is proposing a new approach to help countries protect the gains on HIV beyond 2030

Photos are used for illustrative purposes. They do not imply health status or behaviour.

 Credit: iStock/LightFieldStudios

For many years, the HIV response has focused on ending AIDS as a public health threat by 2030. But what happens after that? A new ‘primer’ from UNAIDS explores the issue.

What is this report about?

UNAIDS’ new HIV Response Sustainability Primer. This is designed to encourage conversations about the future of national HIV responses. The aim is to develop country-specific plans that will sustain the progress that has been made on HIV by 2030, and keep the epidemic under control in the long-term.

Why is it important?

Countries are at different stages in their HIV responses. Some are closer to ending AIDS as a public health threat by 2030 than others. But each country needs to start planning now for an effective, sustainable HIV response into the 2030s and beyond. What this plan looks like will depend on a country’s HIV epidemic and how it is changing, to what extent the HIV epidemic has been controlled and what barriers remain.

What does it say?

Long-term sustainability

As HIV epidemics change, some existing programme activities will no longer be needed. Other parts of the HIV response will need to change to be more effective. For instance, in the future, the majority of people with HIV are likely to be in older age groups. Treatment and prevention services may need to shift focus onto these age groups, and more focus on treating co-infections may be needed. Another example is that strategies and services needed to scale up prevention and treatment services will be different from those needed to maintain them.

The need for locally-owned responses

Each country’s sustainability needs will be different. UNAIDS is proposing that each country develops a Sustainability Roadmap to outline the key national strategies and actions to achieve the following things:

• · predicting, preventing, detecting and responding to new HIV infections
• · sustaining viral load suppression among people with HIV (more than 86% of all people with HIV are virally suppressed, with this rate reached among all age groups and genders and all key populations)
• · achieving the 10–10–10 targets by ending or reducing inequities that drive the HIV epidemic

The roadmaps should set out what needs to happen in key areas to achieve these goals. These key areas are political leadership, service access, system capacities, policies and laws, and domestic and international financing.

The roadmaps are different from HIV National Strategic Plans (NSPs). NSPs tend to focus on short and middle-term outcomes (3-5 years), whereas a country’s HIV Sustainability Roadmap will focus on the years and decades beyond 2030.

Civil society and communities most affected by HIV need to be meaningfully involved in developing the roadmaps and should be consulted at each development phase (see more on this below).

The need for rights-based and person centred approaches

For HIV responses to be fully effective, and for this impact to be sustained, all people must have their right to health fulfilled.

This means making changes to HIV policies, programmes and systems so that they are inclusive of all members of society, particularly people most at risk of HIV. It also means working to change laws and social structures so they are non-discriminatory and do not violate human rights.

What does this mean for HIV services?

Sustainability will be at the top of UNAIDS’s agenda this year and beyond.

To jump on this agenda, it is important to be aware of the plan for developing the Sustainability Roadmaps. Here are the different phases:

January to March 2024: UNAIDS engages country leadership teams, and sustainability dialogues and consultations are held.

April to June 2024: Work will be done to assess how sustainable each country’s HIV response currently is.

July to December 2024: National HIV Response Sustainability Roadmaps will be developed.

January to May 2025: A Transformation Plan for each roadmap will be developed. This will focus on the changes needed to make programmes and systems rights-based and people-centred.

June 2025 onward: Transformation Plans will be implemented and monitored.