At the 69th session of the Commission on Narcotic Drugs (CND), UNAIDS, the United Nations Development Programme (UNDP) and the International Network of People who Use Drugs (INPUD), together with partners, launched a new joint guidance note titled Decriminalization of drug use in the context of HIV. 

The new guidance note provides governments with practical, evidence-based recommendations on how to align drug policies with human rights standards, public health principles and the lived realities of people who use drugs. 

People who use drugs are disproportionately impacted by the HIV epidemic. Globally, people who inject drugs are 14 times more at risk of contracting HIV than the general adult (15-49) population and 8% of all new HIV infections were among people who inject drugs, according to 2025 data.  

More than four decades of the HIV response have shown that public health approaches are the most effective way to support people who use drugs and keep them connected to essential services, including HIV prevention, testing and treatment. Harm reduction services, including needle and syringe programmes and opioid agonist maintenance treatment, have been proven time and again to be effective in significantly reducing the risk of acquiring HIV, viral hepatitis and other blood-borne viruses. In addition, access to HIV testing and treatment can enable people living with HIV to reduce their viral load to undetectable, preventing sexual transmission of HIV.  

The decriminalization of people who use drugs, combined with investments in harm reduction services, can expand access to care and enable people to seek support without fear of arrest, harassment or discrimination. However, existing punitive drug laws continue to drive millions of people who use drugs away from lifesaving HIV services, fueling stigma and discrimination and undermining progress towards global HIV targets. 

“Punitive laws undermine the HIV response. Criminalization drives stigma, pushes people away from services, and weakens community-led responses. The evidence is clear,” said Eamonn Murphy, UNAIDS Regional Director for Easter Europe and Central Asia and Asia and the Pacific. “What we need now is political leadership to translate evidence into legal, policy, and financing reforms.“ 

The guidance note comes at a critical time for the global HIV response. As no country currently fully meets global harm reduction coverage targets, the document highlights the urgent need for legal and policy reform particularly amid financial instability in the AIDS response. This funding crunch makes it increasingly important to invest limited resources where they are most effective. 

The new guidance note does not prescribe a single approach. Instead, it draws on decades of global experience and presents a range of evidence-informed approaches that countries can adapt to their national contexts including the development of clear criteria for distinguishing between drug possession for personal use and possession for supply for profit and the removal of criminal penalties for minor non-violent drug offences. It also helps policymakers work through key policy questions such as which alternative sanctions are appropriate; how not to recreate the harms of criminalization through the introduction of fines; how to ensure that referrals to treatment are voluntary and increase access to evidence‑based care; how to anticipate the potential impacts of legal and policy changes on HIV outcomes; and how to meaningfully engage communities of people who use drugs in answering these complex questions. 

Communities of people who use drugs helped develop the guidelines ensuring that it responds to realities on the ground. The document outlines steps countries can take to review and reform punitive laws, expand harm reduction services, reduce stigma, and embed community leadership in national HIV responses. 

“This guidance recognizes that people who use drugs must be at the centre of decisions affecting our health and rights so when lived expertise is included, HIV responses become more humane and effective,” said Anton Basenko of International Network of People who Use Drugs. The current Global AIDS Strategy for 2026-2031 calls for removing legal and policy barriers for key populations, scaling up harm reduction, and ensuring that community leadership is fully recognized and resourced. Ending AIDS as a public health threat by 2030 will not be possible without addressing criminalization and the inequalities that drive HIV vulnerability among people who use drugs. 

UNAIDS has convened a Regional Dialogue on the Status of the Epidemic and the AIDS Response in West and Central Africa as part of efforts to strengthen strategic engagement for a more effective, sustainable and integrated response to HIV across the region. Addressing the meeting in her opening remarks, UNAIDS Deputy Executive Director, Angeli Achrekar highlighted the unique opportunity the year presents for global partners in the HIV response. 

“This Regional Dialogue comes at a time of substantial progress towards development, for example, life expectancy has increased by 20 years in Africa since 2000. We have a unique political opportunity this year to mobilize action guided by the new 2026 – 2031 Global AIDS Strategy to end AIDS. And we have exceptional capacity for impact that can be leveraged through the power of country, regional and global partnerships,” said Ms Achrekar.

The West and Central African region has made notable progress in the AIDS response in recent years. UNAIDS data show that in 2024, 81% of people living with HIV knew their status, 76% were accessing antiretroviral therapy, and 70% had suppressed viral loads, preventing onward transmission of the virus. 

Between 2010 and 2024 there was a 55% reduction in new HIV infections across the region and a 60% decline in AIDS-related deaths. However, these gains remain insufficient to meet global targets and end AIDS as a public health threat by 2030.

“The HIV epidemic is not over. It took the lives of 124,000 people in the region last year and in at least five countries in west, central and north Africa, new HIV infections continue to grow. So even as we celebrate progress, let’s remember that the job is not yet done," said Susan Kasedde, UNAIDS Regional Director, West and Central Africa.

Data from Eastern and Southern Africa show that faster progress is possible—93% of people living with HIV in the region know their HIV status, 84% are on treatment and 80% have suppressed viral loads. These results show that reaching the 2030 targets (95% of people living with HIV knowing their status, 90% receiving treatment, and 86% being virally suppressed) is achievable. The participants underscored the importance therefore of political will and engagement to accelerate progress, close gaps and end AIDS in the region.

"Behind the figures, there are still too many vulnerabilities, too many gaps in prevention, screening, and treatment services, and too many people still lack access to essential services. An even more massive remobilization of all institutional, community, and political partners and actors is necessary to meet these challenges,” said Saffiatou Thiam, Executive Direction, National AIDS Commission of Senegal.

In West and Central Africa progress is being hindered by significant inequalities which continue to persist. Disparities exist between countries and within countries, including differences across regions, districts, sexes, age groups and population groups. These inequalities limit the overall impact of interventions and threaten progress towards ending AIDS. 

“To get to 2030, countries must take decisive action to protect the populations most vulnerable to HIV infection, illness and death and all those working with them. Countries must ensure that the fundamental rights of these people to life, inclusion, safety and health are not violated,” noted Magatte Mbodj, from the Alliance Nationale Contre le SIDA in Senegal.

The Regional Dialogue comes at a pivotal moment for the global HIV response. The Global AIDS Strategy 2026–2031 has recently been developed, outlining three strategic priorities:

• Sustaining the response through country-led, resilient and future-ready systems
• Putting people at the centre, ensuring equity, dignity and access to services
• Empowering communities to lead and shape the HIV response

The meeting also takes place ahead of the United Nations General Assembly High-Level Meeting on HIV/AIDS, scheduled for June 2026, which will mobilize global commitment and establish a new political declaration to guide the AIDS response for the next five years.

"In Africa, we must seize this opportunity, mobilize political leadership of the region and support and defend a strong common African position that transforms the way we think about public policy and integration, helps develop resilient systems and advances realistic, financed, achievable sub-regional targets," said Adama Bocar Soko, Deputy Resident Representative (Operations) at UNDP.

GENEVA, 6 March — Globally, in 2024, around 4,000 adolescent girls and young women newly acquired HIV every week—3,300 of whom live in sub-Saharan Africa, where women and girls make up around two in every three new HIV infections.

The statistics do not end there.

• Nearly one in four adolescent girls experiences physical or sexual violence before the age of 20.
• According to UNFPA, fewer than half of women globally are able to make their own decisions about sex, contraception and health care.
• Punitive laws continue to fuel the HIV epidemic and undermine sexual and reproductive health and rights.

Such inequality is not a law of nature, it is a consequence.

This is what happens when women and girls are denied rights and denied justice.

When a girl cannot stay in school because of violence, when a woman cannot negotiate safer sex, when a survivor of violence cannot access healthcare and justice—HIV risk rises.

“HIV thrives where gender inequality persists,” said Winnie Byanyima, Executive Director of UNAIDS. “On this International Women’s Day let us honor all those organising for justice, defending rights, and supporting healthcare in the hardest of circumstances. Let us support community leadership and community outreach and the women spearheading such movements. Let us reform unjust laws. Protect services. Defend rights. Because ending AIDS and building a just world begins with rights, justice, and action for all women and girls.”

As the world prepares for the 70th session of the Commission on the Status of Women (CSW70) and the new Political Declaration on HIV and AIDS, UNAIDS calls on governments, donors, and partners to reaffirm that justice is a right, not a privilege. Ending all forms of violence and ensuring legal empowerment and access to justice for women and girls in all their diversity, are inseparable from the fight to eliminate the inequalities within the HIV response.

Together, we can build a world where every woman and girl - including every woman and girl living with and affected by HIV - lives free from violence, fully in control of her rights, choices, and future.

Rights. Justice. Action. #ForAllWomenAndGirls.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS has published its consolidated annual information on the cost of procuring antiretroviral (ARV) treatment based on data provided by countries through the UNAIDS Global AIDS Monitoring tool.  

The consolidated evidence reveals that there is considerable cross-country price variation, particularly for second-line regimens where prices increase significantly with income level highlighting transition and sustainability risks in middle-income settings.

For first-line regimens, the reported data shows that international procurement channels achieve lower average prices than domestic channels, indicating opportunities for efficiency gains through competitive tendering, pooled procurement and strategic contracting.

The consolidated data, which can be accessed from the UNAIDS HIV Financial Dashboard, presents  average unit prices  for first- and second-line regimens, disaggregated by income group, region, country, regimen, and by domestic versus international source of procurement. This release provides strengthened financial transparency that is essential for policy dialogue and to advance global and national reforms for affordable HIV medicines. 

The procurement of ARVs is a recurring, lifelong cost for every country that represent the single largest and most non-discretionary line item in their HIV budgets. As such, the stability, affordability and predictability of ARV financing are the core determinants of treatment continuity and sustained epidemic control. In an increasingly constrained fiscal environment, procurement efficiency and equitable pricing are macro-fiscal priorities and not merely technical considerations.

The new global AIDS targets include a top-line commitment on equitable pricing of medicines and therapeutics. Monitoring progress toward that target requires reliable, comparable and routinely updated price intelligence. The publication of this global reference directly supports this objective by providing a transparent basis to assess price equity across income groups and procurement modalities.

At national level, this reinforces the need for routine monitoring of ARV procurement prices as part of broader HIV financing oversight. Strengthening digital Logistics Management Information Systems (LMIS) and Procurement and Supply Management (PSM) platforms will be essential to:

• Improve real-time visibility of procurement prices and volumes
• Enhance transparency across funding sources
• Enable systematic benchmarking
• Increase efficiency and reduce avoidable cost escalation
• Carefully develop new or strengthened channels for procurement systems at national and regional levels.

“As countries navigate donor transitions, fiscal pressures and evolving treatment guidelines, systematic price monitoring must become an integral component of sustainability planning,” notes Jaime Atienza, UNAIDS Director, Sustainability Practice.

From late 2026, this global dataset will also expand to include ARVs used for pre-exposure prophylaxis (PrEP), including long-acting innovations, further strengthening its relevance for integrated HIV prevention and treatment financing.

“By consolidating, quality assuring and publishing these country-reported data as strategic financial intelligence, UNAIDS provides an essential policy tool to allow for well-planned necessary reforms, advance equitable pricing, fiscal sustainability , uninterrupted treatment access and market shaping”  added Deepak Mattur, UNAIDS Senior advisor on Resource tracking.

Fifth year of war in Ukraine: deepening humanitarian needs and impact on the HIV response 

In Kryvyi Rih, war is measured not only in sirens and blackouts, but in whether people can continue getting the medicines that keep them alive. The city has become a lifeline for displaced people living with or affected by HIV arriving from frontline and temporarily occupied areas—often without documents, stable housing, or a clear route back into care.

“People come to us exhausted, carrying everything they have in one bag,” says Oleksandr Shveda, a social worker at a community-run shelter operated by the charitable organization Public Health. “Some haven’t taken antiretroviral therapy for days or weeks—not because they didn’t want to, but because they lost access, lost papers and didn’t know where to turn.”

This is what Ukraine’s fifth year of war looks like for the HIV response: care delivered through delays, danger and uncertainty, often to people who are least visible and most excluded. 

People living with HIV and other groups vulnerable to HIV can be overlooked by mainstream humanitarian and social protection programmes. Many people from key populations remain marginalized and fall outside the “typical” categories reached by humanitarian assistance and social protection programmes, even though they face some of the highest health and protection risks. In wartime, when systems are overstretched and priorities narrow, these communities can fall even further out of reach. 

“They often try to stay invisible,” explains social worker Olena Maligina. “But HIV doesn’t wait, and neither does Tuberculosis. Keeping someone in care is not just about medicine—it’s about safety and trust.”

Continuity of HIV care is not only a matter of individual survival; it is a public health necessity. Maintaining treatment, counselling and referral pathways helps prevent interruption, reduces severe illness, limits onward transmission, and supports reintegration upon release.

However, with limited staff capacity, reliance on volunteers, and close coordination with national partners, the team at the Public Health organization says it is becoming harder to reach the people most at risk—especially medically fragile people living with HIV, including palliative and bedridden patients. “We are doing everything we can,” Mr Shveda adds, “because for some people, this support is the only bridge to life and dignity.”

Across the country, the humanitarian crisis continues to deepen, with profound consequences for access to essential services, including health care.  In frontline areas, intensified hostilities have left health facilities damaged or non-functional, created severe staff shortages, and made it unsafe for ambulances to reach remote or heavily affected areas. For HIV services, the energy crisis has become an ongoing barrier to continuity. Power outages disrupt clinic operations, laboratories, health information systems, telecommunications and transport—making it harder for health workers to deliver services and for people living with HIV to access care and remain on treatment. 

The combined pressures of protracted conflict, displacement, poverty, and infrastructure damage are eroding coping capacities and increasing the risk of HIV treatment interruption. In this environment, community-led and community-based responses remain central to maintaining reach, trust and continuity, especially for people facing insecurity, displacement and social vulnerability. Yet these organizations are under growing strain: staff capacity is shrinking, burnout risks are rising, and operational constraints make every visit, delivery and follow-up more difficult.

The Government of Ukraine, through the Ministry of Health and the Ukraine Public Health Center, continues to lead the national response in close partnership with community organizations to sustain services under wartime conditions. Support from international partners and donors—especially the United States Government, the Global Fund to Fight AIDS, Tuberculosis and Malaria, Expertise France, the Government of the Netherlands, and other bilateral and multilateral partners—has been critical to maintaining essential HIV prevention, testing, treatment and care. 

“Ukraine’s resilience is visible in the remarkable courage of its people—and in the determination of health-care workers and community organizations who keep services going when conditions make it feel impossible,” says Eamonn Murphy, UNAIDS Regional Director for Easter Europe and Central Asia and Asia and the Pacific. “They keep services open, reach people on the move, and ensure no one is left without care. Their work is built on trust, and in this war, that trust can be lifesaving. We must continue supporting community-led services so people can stay on treatment safely and with dignity.”

In 2026, the AIDS response will remain heavily dependent on external support, underscoring the need for strategic, predictable funding to sustain essential services while also beginning, where it is feasible, to plan a gradual transition towards nationally owned systems and community-led structures.

The message from Kryvyi Rih is clear: continuity of care is not automatic in a war—it is built, protected and must be sustained.