International guidance for a national response
Australia’s response to HIV is influenced by international agreements and commitments, including the UN Political Declaration on HIV/AIDS and UNAIDS targets. Domestic targets and advocacy are developed in accordance with the over-arching goals of the international response.
The United Nations Political Declaration on HIV/AIDS 2011
In June 2011, all United Nations member states agreed upon the Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS (The UN Political Declaration on HIV/AIDS).
The Declaration outlines governments' responsibilities to address the HIV pandemic. Among these are several key targets, including commitments to work towards:
- Reducing sexual transmission of HIV by 50% by 2015
- Reducing transmission among people who inject drugs by 50% by 2015
- Eliminating mother-to-child transmission of HIV and substantially reducing AIDS-related maternal deaths by 2015.
- Scaling up access to treatment.
Considerable progress has been made towards meeting these goals and in 2014 the United Nations Programme on AIDS set even stronger targets for 2020.
UNAIDS ’90-90-90’ targets
Turning Political Will into Action
In 2012, AFAO and its member organisations developed a discussion paper, Turning Political Will into Action, that considered how the UN Political Declaration intersected with Australia's Sixth National HIV Strategy 2010-2013, and how it could be leveraged to ensure that Australia's HIV partnership would continue to deliver a best practice model of HIV prevention, and initiatives to improve the quality of care and support for all people with HIV.
The Melbourne Declaration
At the Australasian HIV/AIDS Conference in 2012 held in Melbourne, national HIV community and research organisations launched the Melbourne Declaration 2012 - Action on HIV.
The Declaration was a road-map for short to medium-term actions toward Australia meeting the UN Political Declaration on HIV/AIDS goals. It identified 4 priority action areas:
- Substantially increase access to and uptake of voluntary HIV testing in Australia
- Enhance access to and uptake of antiretroviral treatment for HIV
- Make HIV pre-exposure prophylaxis (PrEP) available, and
- Strengthen the partnership response and the enabling environment.
Progress on goals
Over subsequent years there have been significant moves towards achieving these goals, including:
- A 2014 commitment by all Australian Health Ministers to reduce sexual transmission of HIV by 50% and HIV treatment uptake by people with HIV to 90%, both by 2015 (the COAG AIDS 2014 Legacy Statement)
- Approval of three rapid tests and roll out of community-based rapid test sites in most jurisdictions
- Since 1 April 2014, all Australians with HIV can begin treatment as early as they choose due to changes to Pharmaceutical Benefits Scheme (PBS) prescribing rules
- Trials in Victoria, NSW and Queensland have enhanced access to PrEP and manufacturer Gilead has made an application to license Truvada, the drug used for PrEP
- An Australian commentary on guidelines for the use of PrEP was approved by the Australasian Society for HIV Medicine (ASHM) in February 2015.
Australia’s Seventh National Strategy 2014-17 builds on the goals of the UN and Melbourne Declarations, setting ambitious targets to:
- end new HIV infections in Australia by 2020 – with a 50% reduction by 2017; and
- increase treatment uptake by people with HIV to 90 per cent.
National HIV Strategy