21 July 2019 (Mexico City, Mexico) – More than 5,000 people from 140 counties have gathered in Mexico City for the
opening of the 10th IAS Conference on HIV Science (IAS 2019), where global experts called for urgent action to address
the health needs of millions of people affected by humanitarian crises.
Experts grappled with the question, “Is the global HIV response in crisis?” They focused on challenges that threaten the
roll out of universal healthcare, including HIV services, to all people. They range from migration to conflict to the
difficulties of reaching specific populations, including women and girls and people who inject drugs.
More than 135 million people around the world are in need of humanitarian assistance mostly due to conflict, with
natural disasters driving the need for emergency assistance.
“From Syria to Venezuela, the challenge of providing HIV services in humanitarian crises threatens global progress in
confronting the epidemic,” Anton Pozniak, President of the International AIDS Society (IAS) and International Scientific
Chair of IAS 2019, said. “People in emergency settings are especially vulnerable to new infections. We must work to
ensure that HIV prevention and treatment are an integral part of global relief efforts.”
In Central America and Venezuela, political instability has driven mass migration and strained local health systems. Of
the 120,000 people living with HIV in Venezuela, only half were accessing antiretroviral treatment and less than 7% had
achieved viral suppression in 2017. In Chile, migrants from Venezuela and Haiti accounted for nearly half of new
diagnoses in 2018.
“Latin America is one of the most unequal regions of the world. Efforts to control the HIV epidemic will only succeed
when the enormous differences in income distribution and well-being are addressed,” Brenda Crabtree Ramirez, IAS 2019
Local Scientific Chair, said. “And of course, all eyes are on the crisis in Venezuela, where people with HIV are dying
due to a shortage of antiretroviral treatment. These needless deaths will end only with a comprehensive regional
Globally, women and girls face structural and societal barriers to accessing healthcare, including stigma and
discrimination and health providers’ lack of specific knowledge around women’s healthcare. What’s more, 29 countries
require the consent of a husband or partner for women to access sexual and reproductive health services. These
inequities are exacerbated during humanitarian crises and natural disasters.
UNAIDS estimates that in sub-Saharan Africa, three in five new HIV infections among 15–19-year-olds are among girls.
“Crises and emergency settings put women and girls at increased risk of violence and heightened risk of both HIV and
unintended pregnancy,” Quarraisha Abdool Karim, Columbia University Professor and Centre for the AIDS Programme of
Research in South Africa (CAPRISA) Associate Scientific Director, said. “Any successful HIV programme should cover
comprehensive care, including family planning and pregnancy prevention.”
Pakistan has witnessed a recent paediatric outbreak of HIV, with nearly 500 diagnoses of children in a single city.
“Strengthening weak health systems must be at the core of a global humanitarian response,” Fatima Mir, Assistant
Professor, Paediatrics, at The Aga Khan University Karachi, said. “In Pakistan, we are experiencing a devastating
outbreak of HIV among very young children infected from reused syringes and a compromised blood supply. The solutions
are clear and simple; we need to invest in basic training and resources for rural health centres providing primary- and
secondary-level care to women and children.”
Despite some successful needle exchange programmes in Eastern Europe, access to harm reduction across the region remains
low and the epidemic remains concentrated among people who inject drugs.
“We have the science and technology we need to address the epidemic, and it’s time to eliminate stigma and
discrimination to reach all people,” Momchil Baev, Sexual Health Program Manager at SingleStep said. “Eastern Europe and
Central Asia is the only region where rates of new HIV infections are on the rise, with Russia alone contributing
100,000 new infections every year. To reverse this trend, we need interventions that address the needs of those most
vulnerable to HIV. And with the Global Fund withdrawing from some East European countries, it is critical to have
community organizations to take charge and lead the way in the fight against HIV.”
According to Ambassador Deborah L. Birx, U.S. Global AIDS Coordinator and U.S Special Representative for Global Health
Diplomacy, “Over the past 16 years, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has saved more than 17
million lives and helped transform the global HIV response. We are proud of the remarkable progress being made by many
of the countries we support, and remain committed to accelerating efforts toward achieving epidemic control everywhere
that we work -- country by country, community by community.”
IAS 2019 will feature the latest science on innovations in treatment, cure and prevention and the latest on-the-ground
strategies to address inequities in the HIV response. More than 1,000 abstract presentations were selected from more
than 3,000 submissions from researchers around the world. Women represent half of all abstract presenters, and one-third
of the presenters are under 35 years old.