Looking ahead, how far are we from ending AIDS as a global public health threat? What are the greatest hopes and challenges?

Okay, here's the translation:

How Far Are We from Ending AIDS as a Global Public Health Threat?

First, let’s be clear: "Ending AIDS as a public health threat" is not the same thing as "eradicating HIV."

Eradication: Like smallpox, making the virus vanish from Earth with zero infected individuals. Frankly, this goal is still very, very distant.
Ending as a Public Health Threat: This is the UN’s 2030 goal. It doesn’t mean there will be no more people living with HIV. Instead, it means reducing new infections and deaths to such low levels that it no longer poses a major threat to society and healthcare systems. Essentially, imagine successfully locking a once-rampaging tiger in a cage—it’s still there, but it can no longer freely harm people.

So, how far are we from this "locked in the cage" goal?

In short: We've come a long way, the finish line is faintly visible, but this final stretch may be the hardest to run.

UNAIDS has set a key benchmark known as the “95-95-95” targets to measure progress:

95% of all people living with HIV know their HIV status.
95% of those who know their status are receiving antiretroviral therapy.
95% of those on treatment achieve viral suppression (meaning the virus is suppressed to undetectable levels in the blood).

According to 2023 data, globally we are roughly at “86-89-93”. See, numerically we're not far from the targets, right? But the closer we get to 100%, the harder the remaining challenges become to solve.

What Gives the Most Hope? (The Bright Side)

In my view, hope stems mainly from these areas:

1. The Scientific Toolkit is Getting Stronger—Our Hand is Excellent!

U=U (Undetectable = Untransmittable). This is absolutely the most significant breakthrough of the past decade! Simply put, if a person living with HIV adheres to antiretroviral treatment and successfully suppresses their viral load to undetectable levels, they cannot transmit HIV to their sexual partners. This not only dramatically improves the quality of life for people with HIV but also fundamentally breaks the chain of transmission. It's the most powerful weapon against fear and stigma.
Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP). These are powerful "defense tools."
- PrEP acts like a "bulletproof vest" for high-risk populations. Taking specific drugs daily or as-needed significantly prevents HIV infection.
- PEP is "emergency post-exposure treatment." Starting medication within 72 hours after a high-risk incident (e.g., unprotected sex) and continuing for 28 days also has a high probability of preventing infection.
Long-Acting Therapies and Potential Future Tech. We now have injectable treatments and prevention medications administered every two months. Future options might involve even longer intervals, like shots every six months. This vastly improves convenience for those who struggle with daily pills. Looking further ahead, scientists are continuously working on a vaccine and functional cure (putting the virus into long-term dormancy without needing daily medication). While the road is long, there is hope.

2. Progress in Public Awareness and Attitudes

While stigma persists, the situation is vastly better than twenty or thirty years ago. More and more people understand that HIV is a manageable chronic condition. People living with HIV can now enjoy life expectancy and quality of life almost identical to the general population. This widespread understanding is the foundation for encouraging testing and treatment.

What Are the Biggest Challenges? (The Difficult Side)

Hope is great, but the challenges are equally enormous, perhaps even more complex.

1. More Dreadful Than the Virus: The "Social Ills"—Discrimination, Stigma, and Inequality

This is the biggest stumbling block on our path to the finish line.

Discrimination & Stigma: Many people avoid testing not because they don't want to, but because they dare not. They fear losing their job, being rejected by family and friends, or being unable to date or marry normally if diagnosed. This fear forces many into the shadows, delaying their own treatment and increasing the risk of unintentional transmission. Many of the remaining 5% or 10% of undiagnosed infected individuals fall into this category.
Inequality: Progress in HIV/AIDS control is profoundly uneven globally.
- Regional Inequality: Sub-Saharan Africa, while making huge strides, remains the epicenter, with far fewer resources than developed countries.
- Population Inequality: Globally, "key populations"—such as men who have sex with men (MSM), transgender people, sex workers, and people who inject drugs—bear a disproportionate burden of infection. Yet, they are precisely the groups most likely to be marginalized by society, criminalized by law, and denied healthcare access. Failing to address the difficulties faced by these groups will prevent us from reaching the "ending" goal.
- Gender Inequality: In many regions, young women and girls, due to lower economic and cultural status, find it difficult to protect themselves within sexual relationships, leading to persistently high infection rates.

2. Waning Resources and Political Will

Funding Issues: HIV/AIDS control requires massive, sustained investment. However, global attention has been diverted by the COVID-19 pandemic, regional conflicts, and other crises in recent years, risking a reduction in international aid. Many countries also face fiscal pressures domestically.
"Victory Fever" Complacency: When a problem no longer seems like the "number one killer," public and governmental attention can wane. This "almost done" mentality could undermine the final push needed.

3. The Ultimate Scientific Hurdles

The Difficulty of a Cure: HIV is exceptionally cunning. It integrates its genetic material into the DNA of human immune cells, forming a "viral reservoir" where it lies dormant. Current drugs can only clear active virus in the bloodstream but are powerless against this "latent" reservoir. This is why lifelong treatment is needed. Finding ways to completely eliminate this reservoir is a monumental challenge confronting the scientific community.
The Vaccine Dilemma: HIV mutates extremely rapidly and exists in numerous strains, presenting unprecedented difficulties for vaccine development. Despite nearly 40 years of effort, a vaccine remains elusive.

To Summarize

So, we may be only "the last mile" away from ending AIDS as a global public health threat. But this "last mile" isn't a smooth highway; it's a rugged mountain trail strewn with social, political, and economic obstacles.

We already possess sufficiently powerful scientific tools (medicines and prevention methods)—essentially, the technical barriers have been largely overcome.

The greatest hope lies in the power of science and the illumination of human compassion; the greatest challenges, however, stem from our own ingrained prejudices, societal structural ills, and global inequality.

Ultimately, whether we meet the target by 2030 or shortly after depends not only on the ingenuity of medical experts and scientists, but on the determination, compassion, and execution of humanity as a whole.