Sydney Achieves Historic Global First: Near Elimination of HIV Transmission

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In parts of Sydney that were once the epicentre of the Australian AIDS epidemic, health officials have made significant progress in eliminating HIV transmission. This has raised hopes of conquering a disease that has claimed over 40 million lives.

Inner Sydney witnessed an 88% decline in HIV diagnoses compared to the 2008-2012 average, with only 11 cases reported last year. This unprecedented reduction in a former AIDS hotspot provides further evidence that existing prevention strategies, including testing and pre-exposure drugs, are highly effective when implemented correctly.

The researchers wrote, “Rapid progress towards ending AIDS is possible. If trends continue, several countries in several global regions will reach the [UN] goal of a 90% reduction in HIV incidence by 2030.”

The decline in rates was particularly remarkable in inner Sydney, where a significant proportion of men who have sex with men reside. Andrew Grulich, a professor of HIV epidemiology, labels this achievement as “extraordinary”. Darryl O’Donnell, chief executive of the HIV advocacy group Health Equity Matters, describes the prospect of eliminating transmission as “astonishing.”

The success was accredited to a community-centered approach that involved high testing rates, immediate treatment for positive cases, and increased usage of pre-exposure prophylaxis, a drug regimen with a 99% effectiveness in preventing HIV contraction.

While HIV treatment allows individuals living with the virus to lead healthy lives, complete cures are rare, and a vaccine is yet to be discovered. However, some countries have achieved significant declines, such as Zimbabwe, Nepal, Lesotho, Rwanda, Eritrea, and Malawi, while the Netherlands, England, Singapore, and cities like New York and San Francisco have witnessed a 50% decrease.

Nevertheless, no locality has reported a decline as substantial as that of inner-city Sydney. Grulich, who led the study, urges health officials to avoid complacency. He emphasizes that without a vaccine or cure, HIV elimination remains impossible, and continuous investment in testing and treatment is crucial.

Meg Doherty, head of the HIV, hepatitis, and STIs programs at the World Health Organization, acknowledges the effectiveness of the strong public health program in Sydney, which was supported by government funding.

The progress made in Australia can be traced back to the 1980s, when the government took a non-ideological approach to the epidemic and collaborated closely with the gay and bisexual community, drug users, and sex workers to tackle the crisis, reflecting the WHO’s belief that the ending of AIDS will occur gradually, starting with individual localities and eventually expanding globally until a vaccine is developed.