Eleven UNAIDS’ Country Offices submitted new reports on the impact of the freeze of US foreign assistance on their country AIDS responses during the week of 24-28 February. As of 28 February, at least one status report had been received from 59 countries, including 79% of all PEPFAR-funded countries and an additional 15 countries that receive US support for their AIDS responses.

Last week, the U.S. Government issued termination letters for many agreements held by USAID. This decision is expected to significantly alter the situation reported by countries in the coming days. For example, in South Africa dozens of USAID implementing partners received termination letters on 26 February. These decisions will affect a large proportion of the 15,374 PEPFAR-funded staff working on the national HIV response in South Africa. Managers of critical programmes have said they have been given too little time to transition from U.S. funding to other sources of funding.

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New funding for the HIV project implemented by FHI360 – previously supported by U.S. funding - in Mali has been allocated. Once the funds are deployed, the project will be able to resume its activities.

This is significant as the work of associations and NGOs had nearly come to a standstill due to the suspension of U.S. funding. 

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New funding for the HIV project implemented by FHI360 – previously supported by U.S. funding - in Mali has been allocated. Once the funds are deployed, the project will be able to resume its activities.

This is significant as the work of associations and NGOs had nearly come to a standstill due to the suspension of U.S. funding. 

Following a report on the impact of the U.S. funding suspension on the community response to HIV, the Malian Government allocated 120 million CFA francs to affected associations to help them continue their activities and mitigate the negative effects of the suspension. This decision was made during a meeting on February 28, organized jointly by the UNAIDS Country Office and the Executive Secretary of the High National Council for the Fight against AIDS.

Despite the reinstatement of funding for the FHI360 project, there are still immediate risks and disruptions to HIV programmes in Mali. The suspension of U.S. funding to PEPFAR has caused disruptions in HIV treatment, testing, and prevention services. This has led to clinic closures and health workers being put on leave, which poses a significant risk to the continuity of HIV services in Mali.

At the 38th Ordinary Session of the African Union Assembly, UNAIDS congratulated H.E. Mahmoud Ali Youssouf on his election as the new Chairperson of the African Union Commission, along with the newly elected Commissioners. UNAIDS looks forward to strengthening the long lasting and fruitful cooperation with the African Union to end AIDS as a public health threat by 2030. 

At the event UNAIDS welcomed the historic adoption of the African Union Convention on Ending Violence Against Women and Girls and the endorsement of the African Union Roadmap on Sustaining AIDS, Strengthening Health Systems and Ensuring Health Security for Africa's Development. These two key policy documents represent a collective commitment to address pressing health and human rights challenges faced by women and girls and vulnerable populations across the continent.  

The African Union Convention on Ending Violence Against Women and Girls is a significant step forward in the response to gender-based violence. It underscores the urgent need for comprehensive strategies to eliminate violence against women and girls and recognizes the systemic inequalities that perpetuate such violence. UNAIDS stands ready to support African Member States in the implementation of this Convention and to ensure that health systems are equipped to provide essential services to survivors of violence.  

“This Convention, Africa’s first dedicated legal instrument to combat all forms of violence, is a strong step toward justice, equality, and protection for every woman and girl on the continent,” said Winnie Byanyima, Executive Director of UNAIDS. 

Similarly, the African Union Roadmap marks a transformative vision for health in Africa, aiming to end HIV as a public health threat by 2030 and to effectively control tuberculosis, malaria, and other communicable diseases. The roadmap is critical to strengthening health systems and achieving universal health coverage, especially for the most marginalized populations. It emphasizes the importance of community empowerment, innovative financing, and global solidarity in addressing current and future health challenges. 

"The adoption of the African Union Roadmap is a great milestone for Africa’s health,” said Winnie Byanyima, UNAIDS Executive Director. “With a bold and ambitious vision to tackle the HIV epidemic and other diseases, this roadmap reflects Africa’s commitment to end AIDS." 

UNAIDS is committed to using the African Union Roadmap as a platform for advocacy at the country and regional levels to ensure that HIV remains a priority on political agendas. This will require a holistic approach that integrates health services, human rights, and gender equality. 

The adoption of these frameworks not only sets a bold agenda for health and human rights but also reaffirms the commitment of African Union Member States to the principles of Agenda 2063 and the Sustainable Development Goals. Together, we can build resilient health systems that uphold the dignity, rights, and health of all people, especially women and girls in Africa. 

UNAIDS calls on all stakeholders, governments, civil society, and international partners—to unite in implementing these critical agreements for a future free from violence and free from HIV, where women and girls can prosper. 

Communities are essential to the sustainability of the HIV response

GENEVA, 26 February 2025—On Zero Discrimination Day, 1 March, everyone’s right to live a full and productive life with dignity is celebrated. Zero Discrimination Day highlights how people can become informed and promote inclusion, compassion, peace and, above all, it is a movement for positive change.

This Zero Discrimination Day, UNAIDS is Standing Together with communities. Communities are essential to the sustainability of the HIV response and to broader global health efforts. They must be financed and supported in their steadfast commitment to ensuring that all people living with and affected by HIV have access to the services they need and are treated with dignity and respect.

"The only way to end AIDS is by working together with communities. They build trust and reach people which many traditional health facilities find hard to reach—the most marginalized, and people who face stigma and discrimination,” said Christine Stegling, UNAIDS Deputy Executive Director. “To end AIDS by 2030, sustained investment and support for community-led responses is crucial.”

Community healthcare and support providers are too often faced with challenges—stigma, discrimination, criminalization, funding cuts, and political backlash—despite their primary role in ensuring that health services reach everyone in need, including the most vulnerable.

Compounding this, the current crisis caused by the shift in U.S. government funding has resulted in deep anxiety and pain for many community organizations as the future of life-saving community-led HIV prevention, treatment, care, and support programmes are at risk, despite the clear evidence of the positive impact of community-led services.

Community led services are essential to the sustainability of the AIDS response up to and beyond 2030, yet community-led responses are too often unrecognized, under-resourced and in some places even under attack. Crackdowns on civil society and on the human rights of marginalized communities are obstructing communities from providing HIV prevention and treatment services. The underfunding of community-led initiatives is leaving them struggling to continue operating as well as holding them back from expanding. If these obstacles are removed, community-led organizations can add even greater impetus to end AIDS as a public health threat by 2030.

“No society can thrive where discrimination exists,” said Marc Angel, Vice President of the European Parliament and a long-time HIV activist. “Every right denied, every barrier imposed weakens us all. On Zero Discrimination Day, let’s make it clear: equality is not an option—it’s a necessity. We stand together.”

On this year’s Zero Discrimination Day, UNAIDS calls on countries, donors and partners to fulfill their commitments and Stand Together to support communities as they work to build sustainable HIV responses by ensuring that:

• Community-led organizations are able to deliver life-saving services and advocate without discrimination or harassment.
• Community-led organizations can legally be registered in the country they are working in and receive sustainable funding.
• Communities are supported in providing health services to vulnerable and marginalized groups.
• Communities are supported and funded in work to monitor respect for human rights including ending the criminalization of key populations, stigma and discrimination and gender inequalities.
• Government health services include community representatives within their structures as partners in the development, implementation and monitoring of health programmes to ensure they are accessible and acceptable to people living with HIV and marginalized populations.

The sustainability of the AIDS response now and into the future is critical with communities at the centre. Now is the time to reaffirm global commitment to their leadership.

Adrian Lindayag, a Philippines actor, learned he was living with HIV in 2017. But even before then, he’d felt the weight of the disease.

“I’ve lost friends to AIDS, and that is because of the shame and stigma surrounding the virus… the lack of education because they were afraid to get tested. Or, if they did get tested, they just gave up on their dreams, gave up on their lives.”

At first, he only discussed his diagnosis with his family and medical team. But last year he made the decision to go public, becoming a LoveYourself U=U Ambassador.

U=U is short for Undetectable = Untransmittable. It means that when a person living with HIV, adheres to effective antiretroviral treatment, the virus in their blood reduces to a level that is undectable, bringing the chance of passing the virus on to zero.

“I honestly didn't know about the concept of U=U before learning about my HIV status. It was my doctor who told me about it, and it changed my life radically. It gave me hope that I'll be able to still live a normal and healthy life,” Mr. Lindayag explained.

Dr. Jakkrapatara Fair Boonruang is a research physician at the Institute of HIV Research and Innovation (IHRI) in Bangkok, Thailand. He reflects that U=U has transformed the way he counsels newly diagnosed patients.

“U=U changed my clients’ lives,” he said. “Before, providers would advise them that antiretroviral treatment will keep them alive and healthy. But there was no sense of returning to who they were before the infections. U=U actually changes that. It means they can fully enjoy sexual intimacy, and mothers can deliver their babies without the fear of transmitting the virus. It has been a mantle of hope and empowerment.”

In 2014, Thai researchers joined peers in Australia and Brazil for the Opposites Attract Study. That research tracked couples in which one person was HIV-negative and the other was living with HIV but had achieved an undetectable viral load through successful treatment.  It confirmed that after two years of unprotected sex, there were no cases of HIV transmission between more than 300 couples. 

Although the U=U concept has been established as scientific fact for over a decade, the word has not gotten out to the wider world. Even some people living with HIV weren’t informed during counselling. Bella Aubree, an Indonesian activist, is one of them. When she learned her HIV status at age 16, she wondered whether she would die soon. She learned about U=U online and the message gave her hope.

“At the time I felt bored with taking ARVs (antiretroviral therapy) every day. But my motivation came from knowing at some point I will be undetectable, which means untransmittable,” she explained.

For Shan Ali, a Dostana Society peer counsellor from Pakistan, while the U=U concept has transformed his health and outlook, the knowledge hasn’t shifted attitudes among his family members.

“In Pakistan right now there are only two sets of people who know about U=U. One is the service providers and the other is people living with HIV. The general public has no idea,” Mr Ali explained. “I have tried bringing my family in for counseling, but they still discriminate towards me. They even make me eat with separate utensils. I feel very isolated and stigmatized. But in my work with community, I feel a sense of purpose.”

Karun Lama, a communications specialist for the Seven Alliance, is HIV-negative but lost both her parents to AIDS. For her, U=U holds the promise of a regular life and family with her boyfriend who is living with HIV.

“In India, where family and relatives' consent is very important, it was very difficult for us at first to make them understand because my partner's family and relatives were scared and concerned for me. They thought that my partner is putting my life at risk and he should get married to a person living with HIV only. But we've sensitized them about U=U and they have begun to understand that we can also live a life together happily and he won't transmit HIV if his viral load is undetectable,” Ms Lama said.

Eamonn Murphy, Regional Director of UNAIDS Asia Pacific and Eastern Europe Central Asia, saluted the courage of these and other community leaders working to raise awareness about the power of the U=U concept.

“Treatment saves lives. But it can also prevent new infections and transform the way we think about people living with HIV and how they see themselves,” said Mr Murphy. “This Zero Discrimination Day, we recognize the critical role of communities in spreading awareness, supporting adherence and challenging stigma and discrimination. We must ensure this essential work is facilitated and financed.”

With support from communities, researchers and UNAIDS Goodwill Ambassador for Asia and the Pacific, Miss Universe 2015, Pia Alonzo Wurtzbach, UNAIDS is leveraging the U=U message to help end HIV stigma and discrimination. On Zero Discrimination Day (1 March). UNAIDS welcomes everyone to join by sharing these messages and joining the U=U song and dance challenge on social media. #UequalsUDance #EndHIVstigma

Honduras' HIV response is experiencing critical disruptions due to the U.S. funding pause for many HIV services. Approximately 100 healthcare workers had stopped providing lifesaving services following the initial U.S. stop-work-order last month, reducing access to essential HIV services like testing, prevention, and treatment for people living with HIV. These interruptions in access to HIV services create great individual – and public - health risks. While some affected healthcare workers were instructed that they could resume work on 24 February, it is not clear how many of them returned to work.  It is estimated that approximately 20 000 people live with HIV in Honduras. The country’s HIV response relies on external financial support for prevention among key populations. The Global Fund, PEPFAR and USAID have been supporting the country’s efforts to end AIDS as a public health threat.

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Sixteen new reports on the impact of the freeze of US foreign assistance on the global AIDS response were received from UNAIDS’ Country Offices during the week of 17-21 February. As of 21 February, at least one status report had been received from 55 countries, including 42 PEPFAR-supported and 13 that receive some US support.

Reports received over the past week show that waivers have led to the resumption of select clinical services, such as HIV treatment and prevention of vertical transmission, in many countries that are highly dependent on US funding. However, the durability of this resumption is unclear amid multiple reports that key US government systems and staff responsible for paying implementing partners are either offline or working at greatly reduced capacity.

Critical layers of national AIDS responses are ineligible for waivers, including many HIV prevention and community-led services for key populations and adolescent girls and young women. In addition, data collection and analysis services have been disrupted in numerous countries. Reports from UNAIDS’ Country Offices note that these interruptions have eroded the overall quantity and quality of HIV prevention, testing and treatment services. Human resources for health at health facilities are facing increased workloads, and patients are experiencing increased waiting times to receive life-saving services. US government statements to UN system organizations suggest US-funded programmes focused on gender equality and transgender populations may not resume.

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