We failed to meet HIV treatment and family planning goals for 2020: now what?

 By Erin Rogers, MPH; Kristin Wall, PhD; Rob Stephenson, PhD

Although several international stakeholders, including the United Nations and Family Planning 2020, led the fight to end the HIV and unintended pregnancy epidemics across low and middle-income countries by 2020, we fell short of recognizing these goals.

Our recent editorial in BMJ Sexual and Reproductive Health outlines the country-level progress made towards both the UNAIDS HIV treatment cascade targets and Family Planning 2020 goals, highlighting the relatively few countries that achieved success in both sets of targets and providing a framework to guide policy and programmatic efforts to ensure future global success in achieving these goals.

What we did

Using publicly available data from both UNAIDS and Family Planning 2020, we measured the country-level progress towards achieving both these goals. The UNAIDS goals aimed to ensure that 90% of people are tested for HIV, and that 90% of those testing positive for HIV receive treatment and achieve viral suppression by 2020 (targets which have been raised to 95% for 2030). Family Planning 2020 aimed to reduce unwanted fertility by providing contraception to 120 million additional women by 2020. We measured success towards this goal based on the individual pledges countries set for themselves to reach a modern contraceptive prevalence rate (mCPR).

What we found

Of the 37 countries included in our analysis, none achieved both their UNAIDS and Family Planning 2020 goals. Vast disparities towards achieving either of these goals persists, with Rwanda being the only country to successfully reach the first 90-90-90 target, with 90% of individuals testing for HIV.  Only three countries surpassed their target modern contraceptive prevalence rate (Liberia at 179% of their target, Somalia at 154%, and Burkina Faso at 108%).

Moving Forward

These findings underscore the growing understanding that family planning and HIV services must coalesce to combat the dual epidemics of HIV and unintended pregnancy in a cost-effective way. As UNAIDS realigns towards a new goal of 95-95-95 and countries continue to aim for universal access to family planning by 2030, dedicated funding for evidence-based, integrated service delivery models is a promising strategy to recognize this success.


Read the full paper: Wall KM, Rogers E, Stephenson R. Meeting the mark by 2020: country progress toward FP2020 and UNAIDS HIV targets. BMJ Sexual & Reproductive Health Published Online First: 05 March 2020.



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