{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T18:33:23Z","timestamp":1790188403037,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T00:00:00Z","timestamp":1537315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The 90\u201090\u201090 target states that by 2020, 90% of people living with HIV should be diagnosed, 90% of those diagnosed treated, and 90% of those treated virally suppressed. We assessed the actions needed in each country of sub\u2010Saharan Africa to achieve the 90\u201090\u201090 target.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We developed a mathematical model to assess the number of patients needing to start antiretroviral therapy (ART) between 2017 and 2020 to achieve 81% coverage by 2020 in each country, and the proportion of treated patients who are virally suppressed in four scenarios, combining two scenarios of retention (current\u2010level or perfect), and routine viral load monitoring (current or universal coverage). We performed two separate simulations, one using observed failure rates from cohort studies, and one with considerably lower failure rates to set a theoretical lower limit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our model projected that 2.9 million people started ART in 2017 in sub\u2010Saharan Africa. If, depending on scenario, at least 2.2\u20132.7 million patients continue to start ART annually, 81% ART coverage will be reached in 2020 in sub\u2010Saharan Africa on average. In 37% of the countries, a multiple\u2010fold increase in annual number of patients starting ART is needed. Virological suppression &gt;90% in 2020 could be reached only in the best\u2010case scenario assuming low probability of treatment failure, elimination of treatment interruptions, and universal routine viral load monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The 90\u201090\u201090 target is realistic in sub\u2010Saharan Africa on average, but not necessarily in all individual countries. Each country should identify and focus on the specific gaps needing attention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13145","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T07:56:44Z","timestamp":1535615804000},"page":"1223-1230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["How to achieve the global 90\u201090\u201090 target by 2020 in sub\u2010Saharan Africa? A mathematical modelling study"],"prefix":"10.1111","volume":"23","author":[{"given":"Janne","family":"Estill","sequence":"first","affiliation":[{"name":"Institute of Global Health University of Geneva Geneva Switzerland"},{"name":"Institute of Mathematical Statistics and Actuarial Science University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Marsh","sequence":"additional","affiliation":[{"name":"Joint United Nations Programme on HIV\/AIDS Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Autenrieth","sequence":"additional","affiliation":[{"name":"Joint United Nations Programme on HIV\/AIDS Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of HIV\/AIDS World Health Organization Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,9,19]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"90\u201090\u201090.An Ambitious Treatment Target to Help End the AIDS Epidemic. 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