Ending the epidemic of HIV/AIDS by 2030: Will there be an endgame to HIV, or an endemic HIV requiring an integrated health systems response in many countries?

• The third Sustainable Development Goal (SDG-3) aims to end the epidemic of HIV/AIDS by 2030 (Project 2030) based on the lessons during the last two decades. • The progress towards ending the epidemic of AIDS is on the right track; however, the progress to end HIV transmission is off track though the number of new HIV infections has continued to decline. • There is no endgame for HIV prevention and control beyond 2030; HIV would be transitioning from an epidemic state to an endemic public health problem in many countries. • Endemic HIV requires a paradigm shift, from a vertical response to an integrated health systems response, to provide services according to need. • Unrelenting political commitment, and increased and sustainable funding is required from both national and global sources, towards health systems strengthening. The third Sustainable Development Goal (SDG-3) has a target to end the epidemic of HIV/AIDS by 2030 (Project 2030). This will be achieved when the number of new HIV infections and 'AIDS-related deaths' decline by 90% between 2010 and 2030. So far, the rate of drop in AIDS-related deaths is on track, whereas the rate of drop in new HIV infections is off track to achieve Project 2030. Even if Project 2030 was achieved, HIV would be an endemic health problem. Hence, HIV prevention and control programmes cannot close down for the foreseeable future. This rather demands a paradigm shift from a fully vertical to an integrated health systems response that provides services according to disease burden towards universal health coverage. This will ensure the sustainability of HIV services in the post-2030 era. These all entail unrelenting political commitment, and increased and sustainable funding from both national and global sources. [ABSTRACT FROM AUTHOR]