City efforts to end Fast Track Cities AIDS epidemic

3 / 23 / 2023

Fast Track Cities Workshop Japan 2022 was held in Tokyo in November 2022. Fast Track Cities(FTC) workshop will be held in Japan for the second time following the last year. In this workshop, physicians and researchers at home and abroad report on the status of the most recent HIV/AIDS and the current issues, and they can also listen to the voices of the parties involved and their support groups. FTC characteristic is that the healthcare providers, the parties involved, and the supporters meet together. What is FTC in the first place?

What is Fast Track Cities (Fast Track Cities)?

On World AIDS Day (World AIDS Day) on December 1, 2014, many mayors from around the world gathered in Paris, France. A declaration was issued that "They will be united to end the AIDS epidemicby 2030 ", and the 27 city mayors who were attending signed it. This is called the Paris Declaration.

The Joint United Nations Programme on HIV/AIDS (Joint United Nations Programme on HIV/AIDS:UNAIDS) has emphasized the need to accelerate measures against AIDS in cities. Because more than half of the population worldwide is concentrated in urban areas, and many people living with HIV also live in urban areas. In cities, it is easy to connect people with others, but because of the large community and economic disparities, it is difficult to provide support to all people. It is believed that by taking measures based on these characteristics and problems, it will be easier to provide services to more people.

Fast-Track Cities(FTC) was launched there. In FTC framework, partners from cities and municipalities around the world, including UNAIDS, and the International Society of AIDS Care Providers (International Association of Providers of AIDS Care:IAPAC), will collaborate to develop activities. The number of participating cities and municipalities has increased over the years and has grown into large projects.
HIV policies and strategies implemented in FTC member cities will be compiled and shared with the member cities. Better sharing of best practices for other urban efforts is considered one of the benefits of FTC membership.

95-95-95 for the end of the AIDS epidemic

If the viral load in the blood is suppressed by anti HIV treatment, even if the person is infected with HIV, there is no possibility of infecting the sexual partner. Therefore, in 2014, UNAIDS advocated three world targets by 2020: "more than 90% of infected persons are diagnosed and aware of infection," "more than 90% of infected persons are treated with HIV therapy," and "suppress blood viral load in more than 90% of infected persons under treatment." By 2030, it is estimated that 28 million new HIV infections and 21 million deaths will be prevented. The Slogan of achieving 90-90-90 achieved certain results, but unfortunately did not reach the target. To ensure the end of the AIDS epidemic, the next target has been set to be more ambitious, from 90% to 95%.

[Target by 2025]
1. More than 95% of infected persons should be diagnosed and aware of infection.
2. More than 95% of diagnosed infected persons receive anti HIV therapy.
3. Suppression of viral load in blood in > 95% of infected persons on treatment.

Urban Initiatives for HIV.

However, with targets alone, realization is far from being achieved, and efforts are required not only in the medical community but also in various fields. Following the Paris Declaration in 2014, the press release issued by UNAIDS pointed out that there are discrimination and stigma towards people living with HIV as barriers to achieving the above goals. If HIV is found to be infected and is feared to be discriminated or stigmatized from the surroundings and the feet are far from the test, the initial goal of "more than 90% of infected people are diagnosed and aware of infection" cannot be achieved. It is important to have the right knowledge and interest in HIV/AIDS not only among the parties and healthcare professionals, but also across the community.

In order to achieve the goal of the end of AIDS, IAPAC director José M. Zuniga said it is required to eliminate disparities in HIV prevention, testing, and treatment. "To that end, we need to consider this issue on a global scale, act regionally, and take community-driven interventions while utilizing programs and resources that have been present in different cities."

In October 2022, FAST-TRACK CITIES 2022 was held in Seville, Spain. A number of cities, including remote participants, brought together the municipalities and others involved. Here, the Seville Declaration was issued as a supplement to the Paris Declaration in 2014. It contains ten commitments. These include the unreasonable elimination of regulations and legislation on HIV. It also included support for building connected care from testing to treatment and for continuing treatment, and efforts to collect, analyze, and use HIV data from different cities on a community-based basis.

FTC aims to focus on the communities that support HIV actors and their peoples, and to spread efforts in different cities worldwide to end the AIDS epidemic.

・Fast-Track Cities