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.

UNAIDS welcomes the passing into law by the President of Benin Patrice Talon of Law 2026-02 on 9 February 2026. The law focuses on HIV prevention and management of care and will accelerate progress towards ending AIDS in the Republic of Benin.

The new law is the culmination of a process first initiated in 2013 and which resumed in 2020 under the leadership of the Health Program for the Fight against AIDS (PSLS). This revision was made due to the significant limitations of the 2006 law, namely that it was based on a punitive, coercive and stigmatizing approach.

The previous law was incompatible with human rights standards, allowed for numerous violations of confidentiality, criminalized HIV-related behaviors and reinforced the marginalization of key populations. The law was out of step with good public health practices which should be based on prevention, inclusion and respect for human rights.

The 2026 law is now aligned with international human rights standards and more specifically reaffirms the right to non-stigma and non-discrimination. It enhances privacy and data protection, ensures access to HIV care and prevention and services and recognizes key populations including sex workers, men who have sex with men, people who inject drugs, transgender people, migrants and prisoners among others. It improves prisoners’ rights significantly and reduces criminal provisions against people living with HIV by recognizing the strictly voluntary nature of disclosing HIV status.

“The journey to validating Benin’s HIV Law was powered by strong country leadership, exceptional UNAIDS–UNDP collaboration, unwavering support from the UN Regional Coordinator, close technical follow-up with the Ministry of Health, catalytic funding from UNAIDS, UNDP and Expertise France, and close involvement of parliamentarians — turning evidence into political will and political will into transformative legislation’’ said Yayé Diallo, outgoing UNAIDS Country Director for Togo and Benin.

The progress is the result of coordinated advocacy and collaborative partnership actions at all levels involving the UNAIDS Executive Director Winnie Byanyima, who made it a priority of her visit to Benin in September 2024.

UNAIDS Regional Office, the global HIV Legal Network and UNDP provided technical support. The Global Fund and Expertise France provided financial support and the combination of the efforts of various stakeholders at the local level, namely the PSLS, the CNLS-TP(Conseil National de Lutte contre le VIH/Sida, la Tuberculose, le Paludisme, les Hépatites, les Infections Sexuellement Transmissibles et les Épidémie), the parliament and its institutions (IPaB - Institut Parlementaire du Bénin), the caucus of women parliamentarians and parliamentary committees), civil society organizations including networks of people living with HIV and key populations. With this new law and rigorous monitoring of its application, Benin is resolutely committed to its march towards the ending AIDS by 2030.

"UNAIDS, the UN Country Team, and partners including Expertise France applaud Benin’s political resolve and its new, pioneering HIV legislation. By centering the law on vulnerable groups and youth who account for 35% of new infections, Benin is taking a giant leap towards universal access to HIV treatment and the ultimate goal of ending AIDS as a public health threat by 2030." said Christian Mouala, Representative and Director of the UNAIDS Multi-Country Office for Côte d’Ivoire, Togo, and Benin.

“We’re closely watching developments in both infection rates and funding in Eastern Europe and Central Asia. The challenges are great,” said Anne von Fallois, CEO of Deutsche AIDS-Stiftung (DAS), during a meeting with Eamonn Murphy, UNAIDS Regional Director, in Bonn. “We’re united on the importance of the region—especially Ukraine.”

This is a critical moment for the AIDS response in Eastern Europe and Central Asia (EECA). As global attention shifts to new crises, there is growing concern that the region—where both new HIV infections and AIDS-related deaths are still rising—could be left behind.

Since 2010, AIDS-related deaths in EECA have increased by 34%. Only about half of people living with HIV are on treatment, and viral suppression—at just 42%—is the lowest globally. More than half of new HIV diagnoses occur late, when risks of transmission and mortality are significantly higher.

War, displacement, economic hardship, and migration may be contributing to a more challenging HIV response, with potential implications beyond national borders, including the European Union. While the full impact is still emerging, these pressures could place additional demands on health systems and underscore the importance of sustained, coordinated action.

Access to services remains fragile in all countries of the region. While antiretroviral therapy is officially free in most countries, too many people are still unable to access it. Prevention coverage is even lower: opioid agonist maintenance therapy reaches only a fraction of those who need it, and pre-exposure prophylaxis remains limited. Key populations account for most new infections, yet continue to face stigma, discrimination, and legal barriers rooted in outdated policies.

“We know what works: community-led services are essential to reach people who are otherwise excluded, and partnership with communities is vital in these challenging times,” said Eamonn Murphy. “With continued UNAIDS engagement in the region, sustained, coordinated investment—alongside government commitment and community engagement—is essential to protect progress and prevent further loss of life.”

Through its partnership with UNAIDS, Deutsche AIDS-Stiftung supports HIV work in Germany and internationally, advancing stigma reduction, prevention, social support, and assistance for vulnerable groups.

As funding uncertainties grow, partners stressed the need to strengthen joint resource mobilization and encourage more active engagement from the European Union. Emergency measures can only go so far. The investments required are modest, but the stakes—for the region and for Europe as a whole—could not be higher.

For 24-year-old Rakhants’a Lehloibi, growing up in the rural village of Maphutseng, in Lesotho, meant navigating life with a secret he didn’t fully understand. Born with HIV, he spent his earliest years believing the antiretroviral (ARV) treatment he took daily was simply to stop frequent nosebleeds—a story his grandmother told to shield him from the stigma surrounding HIV.

“Life was tough, but my grandmother gave me all the love in the world,” he recalled. “I never felt like I lacked anything—except answers.”

Rakhants’a’s mother died when he was very young, leaving his grandmother to raise him. In 2007, when he was just 4 years old, he became severely ill. Traditional healers were consulted, but their remedies failed. It was only when he was taken to a local clinic that he was tested and diagnosed with HIV.

“Back then, I didn’t even know what HIV was,” he said. “My grandmother told me the pills I was taking were to stop nosebleeds. I believed her.”

In Lesotho—as in much of sub-Saharan Africa—stigma against people living with HIV remains widespread. Many conceal their status to avoid rejection by family and community.

“For years, I took pills but I didn’t understand why. I missed school for clinic visits. I watched my grandmother struggle just to make sure I got my medication,” Rakhants’a said. Eventually, doubting the need for treatment since his nosebleeds stopped, he began skipping doses. “I didn’t know I was putting my life at risk.”

The stigma he faced only deepened his struggle. “Kids at school whispered that I had AIDS. I felt isolated, ashamed and angry. I even thought about running away just to escape the pain. But I kept going. I passed my exams and later moved to the country’s capital Maseru to live with my sister and attend high school.”

UNAIDS country Director for Lesotho, Pepukai Chikukwa, agrees that "Though HIV stigma has reduced over the years, it is still a critical barrier to the AIDS epidemic, obstructing access to life-saving HIV prevention and treatment." Ms Chikukwa adds that it pushes people away from care and increases their risk of infection. Ms Chikukwa noted that “Addressing HIV-related stigma and discrimination requires a coordinated, multi-level, and multi-setting approach involving individuals, communities, organizations and policymakers.”

It was in Maseru that Rakhants’a’s life began to change. At Baylor Clinic, he finally learned the truth about his diagnosis and joined the Teen Club, a support network for young people living with HIV.

“For the first time, I met others like me. I realized I had been born with HIV, passed on from my late mother. That was a turning point.”

Still, the journey was not easy. Poor adherence to HIV treatment meant that Rakhants’a’s viral load was dangerously high. One health worker bluntly told him he was “as good as dead.” Placed on second-line treatment—five pills a day instead of one—he felt overwhelmed.

“At first, it was hard. But instead of giving up, I prayed every day and asked my mother to watch over me. Slowly, things changed. I gained strength, I took my medication properly, and within three months, my viral load was suppressed.”

Today, Rakhants’a uses his voice to fight stigma and inspire others. Through social media and community platforms, he spreads a message of hope and resilience.

“Being HIV positive doesn’t mean your life is over,” he said. “With proper treatment and support, we can live full, healthy lives.”

According to UNAIDS, there are 260,000 people living with HIV in Lesotho and 3200 people became newly infected with HIV in 2024. There were 6,400 children aged between 0 to 14 years, living with HIV. Nonetheless, 97% of people living with HIV know their status, of those, 97% are receiving HIV treatment and 99% of those are virally suppressed. In 2023, 11.3% of women and 18.5% of men aged 15 – 49 years old reported discriminatory attitudes toward people living with HIV.

The United Nations Deputy Secretary-General, Amina Mohammed, joined the 57th meeting of the UNAIDS Programme Coordinating Board (PCB) in Brasilia, bringing a clear message: the UN will stand with governments and communities until AIDS is ended as a public health threat.

In her remarks to the Board, the Deputy Secretary-General commended the inclusive and constructive nature of the deliberations and reaffirmed that the ongoing UN80 reform process will strengthen – not diminish – the global AIDS response. She stressed that reform must be deliberate and protect what works. “There is a sense of urgency, but let me underscore here, we are not in a hurry to fail... We must achieve common ground around all the concerns that the PCB and civil society have aired over the last few weeks in particular,” she said.

Ms. Mohammed warned of growing financial pressures on countries and donors, highlighting the strain on domestic resources in low- and middle-income countries, driven by debt and the cost of debt servicing. “Governments, even if they wanted to prioritize HIV and AIDS as a budget spend, quite frankly are taking away from education, taking away from health, because they cannot meet that [cost],” she said. “Part of what we have to do today with this strategy and with the transitions that we offer in UN80 – and UNAIDS is one of them – is how to convince the international community to come back.”

The UN80 initiative aims to make the UN development system more coherent, integrated, and fit for purpose in a rapidly changing world. For UNAIDS, this means a two-phase transition that preserves its core functions and highest-value contributions to the global AIDS response – leadership and advocacy, convening and coordination, accountability and data, and community engagement.

During its meeting, the PCB adopted landmark decisions that will shape the next phase of the HIV response:

• Global AIDS Strategy 2026–2031: A bold, evidence-informed roadmap grounded in human rights, gender equality, and community leadership. The strategy will guide preparations for the 2026 UN General Assembly High-Level Meeting on AIDS and negotiations for the political declaration.
• UNAIDS and UN80 transition: The Board reaffirmed its commitment to a responsible, inclusive transition of the UNAIDS Joint Programme within the wider UN development system. A PCB Working Group will be established in early 2026 to ensure the process is orderly, transparent, and safeguards UNAIDS’ core functions.

“I have seen many across the agencies that I chair in the UN Sustainable Development Group … This is a really good one. Why? Because it has so much clarity, it has so much of a division of labour, but I think that in this particular case, what has helped it is this nature of inclusion that you have had, and demonstrated, in the PCB, with civil society having such a strong voice,” said Ms Mohammed.

The PCB meeting also featured a one-day thematic discussion on long-acting antiretrovirals, highlighting their potential to transform HIV prevention and treatment. With political will, financing, and partnerships, these innovations can dramatically reduce new infections and accelerate progress toward ending AIDS.

“Ending AIDS remains achievable,” she concluded. “But only if resources match our ambition.”

This story first appeared in the recently released World AIDS Day report 2025.

In 2025, cuts in international support for the HIV response in Guatemala and a reduced HIV allocation from the Global Fund caused immediate challenges for the HIV response. Some services were curtailed or discontinued altogether in clinics affected by the cuts, and remaining service providers struggled to absorb clients who had lost their service access. Furthermore, a substantial portion of the personnel at HIV comprehensive care units and community outreach workers that help facilitate and maintain access to services for people from key populations were also affected as their work had long been funded by external donors.

In response to these cuts in external funding, the Ministry of Health stepped in to ensure continuity of care by covering the salaries of 81 staff members, thereby sustaining the operation of numerous comprehensive care units and guaranteeing service delivery to thousands to clients across the country. This intervention was critical to maintain access to lifesaving HIV treatment and preserve the integrity of the national HIV response.

The Government also intervened to fill the gap when a key implementer and PrEP provider lost its financing. In 2025, Guatemala moved to quantify PrEP needs, develop targets for scale-up and launch access to PrEP in three departments. However, gaps persist with respect to HIV prevention programmes for people from key populations.

Community-led responses have also stepped into the breach created by the loss of international assistance. Colectivo Amigos contra el Sida (CAS), an organization focused on HIV prevention among gay men and other men who have sex with men and transgender women, moved to assume responsibility for supporting PrEP delivery to clients of a large PrEP programme that lost its funding. CAS collects voluntary donations for services from clients who can afford to pay, which helps to co-finance operational costs that are no longer covered by international donors.

Community-led responses play a critical role in the efforts to end AIDS as a public health threat. For that reason, Guatemala, with the support of UNAIDS, is working to ensure communities have access to financial and technical support. UNAIDS is collaborating with the Global Fund to help build the knowledge and capacity of civil society organizations to lobby more effectively for greater domestic resources.

Planning for the sustainability of the HIV responses is an urgent priority for many countries including Guatemala. Now that the Global Fund is set to phase out its support given Guatemala’s status as an upper-middle-income country, UNAIDS is collaborating with the Ministry of Health and the national AIDS programme to roll out the UNAIDS Rapid AIDS Financing Tool, aimed at facilitating decision-making and actions to effectively respond to the AIDS epidemic amidst a resource-limited environment.

Takhmina Haidarova and Pulod Jamalov are among the very few HIV activists in Tajikistan living openly with HIV. For years, they have been the public faces of courage—challenging stigma, supporting others and ensuring no one faces HIV alone. Through their organizations, the Tajikistan Network of Women Living with HIV and Spin Plus, they have built lifelines for people living with HIV and people from key populations, including people who use drugs.

Now, those lifelines are at risk of disappearing. Recent funding freezes and cuts to international HIV assistance threaten to close community-led programmes across the country. “People are panicking,” says Takhmina. “If our support services shut down, women affected by HIV, families with children living with HIV, and people from key populations will have nowhere to turn.”

Tajikistan is a small, mountainous, landlocked country in central Asia, bordered by Afghanistan, China, Kyrgyzstan and Uzbekistan. Despite economic growth, it remains the poorest country in the region, with nearly a third of its gross domestic product coming from remittances. It faces deep social and structural challenges—a fragile health system, restrictive laws, gender inequality, and powerful traditional and religious norms that fuel stigma and discrimination.

For people living with HIV, these challenges can be overwhelming. Nearly 97% of women living with HIV in Tajikistan conceal their HIV status, even from family members, and 64% report discrimination, including from health-care providers.

For Takhmina, the fight is personal. She acquired HIV from her husband, a labour migrant in the Russian Federation, and was rejected by the family after his death. “I did not even know HIV existed in Tajikistan,” she says. “I had no knowledge, no support, no one to turn to.” Now, through the Tajikistan Network of Women Living with HIV, she helps other women navigate the isolation she once faced.

“Community groups like ours are the only ones people trust,” says Pulod Jamalov, Director of Spin Plus. “We go where the system does not reach—into prisons, remote villages and migrant families. Without us, many people will simply be left behind.”

Until now, international partnerships have made real progress possible. HIV-related mortality has halved since 2020 in Tajikistan, and vertical transmission dropped to 0.8% in 2024, with only one such case recorded that year.

But this progress is fragile. About 60% of the HIV response in Tajikistan depends on international donors, of which about 20% was funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) until January 2025. Around 37% of the national programme is now financed domestically, marking a step towards sustainability. The Government covers all costs for prevention of vertical HIV transmission, including HIV testing for pregnant women. In 2025, for the first time, the Government of Tajikistan allocated national funds to procure 10% of the country’s antiretroviral (ARV) medicines.

National authorities estimate that even a 10–20% reduction in funding could trigger a 135% increase in the number of new HIV infections and a 5% increase in mortality, erasing years of gains.

In January 2025, two major community health centres providing stigma-free care were closed, and outreach, testing and counselling stopped altogether. When these centres temporarily resumed their operations, they recorded a noticeable decline in the number of clients seeking or referred for services. Community-led monitoring, once a key accountability tool, has been completely discontinued.

Tajikistan has shown what is possible with targeted support. But unless donors, governments and international partners act quickly to protect community-led services, those gains will be reversed.

This story first appeared in the recently released World AIDS Day report 2025

Across eastern and southern Africa, men and boys are less likely to test for HIV, initiate antiretroviral therapy or remain engaged in care. As a result, although HIV prevalence is higher among women and girls, the number of AIDS-related deaths is higher among men and boys in the region.

One leader recognized the challenge and decided to use his influence to create positive change. In the traditional kingdom of the Buganda people within present-day Uganda, the King, His Majesty Mutebi II, has championed health and well-being over the course of his reign, including through a series of campaigns that aim to instil healthy social norms and health-seeking behaviours. Previous campaigns have focused on promoting polio immunization, blood donation, maternal and child health and physical exercise. Buganda is home to 12 million of the 49 million people living in Uganda.

Beginning in 2016, Uganda decided to harness the influence of traditional leadership to encourage men and boys to test for HIV, and for those who test positive to start and stay on treatment. This national effort, which the King carried forward in Buganda, is premised on the conviction that social influencers such as the King are uniquely well positioned to change the attitudes and social norms of men and boys. In 2017, UNAIDS appointed the King as a UNAIDS Goodwill Ambassador on ending AIDS in eastern and southern Africa to support and highlight the King’s leadership to improve HIV outcomes among men and boys in the kingdom.

To undertake his health promotion campaigns, the King leverages his influence to obtain financial support for campaigns and to maximize their reach and effectiveness. The King has been able to attract financial support for the health campaigns from private-sector partners such as Airtel Uganda and DFCU Bank to contribute to the health campaign focused on men and boys.

The King’s HIV advocacy campaign, Abaami Munyenye (“Men are Stars”), focused on men and boys aged 15–49 years living in districts with a high HIV burden. The campaign used innovative means to generate resources and reach men and boys with key messages, including at major sporting events, such as a marathon to celebrate the King’s birthday, which attracted 50 000–60 000 participants (85% male), and the Malaza football cup, which attracted 20 000–30 000 fans. In addition to leveraging these events to reach tens of thousands of men and boys with health promotion messages, the fees paid by event participants raised funds to support health services for men and boys.

The advocacy campaign has had a clear positive impact on HIV outcomes in Buganda. From 2016 to 2020, the percentage of people living with HIV who knew their HIV status rose from 89% to 94%, HIV treatment coverage increased from 64% to 92%, and the number of new HIV infections declined by 52%.

The King’s previous health promotion campaigns typically ran for three years each, but there was consideration in 2025 to replace the HIV campaign. With donor cutbacks potentially jeopardizing national momentum towards HIV epidemic control, the King determined that now was not the time to move on from the HIV response. As a result, the campaign to improve HIV outcomes is now continuing across the kingdom.

UNAIDS is releasing an updated version of its guidelines for conducting National AIDS Spending Assessments (NASA). The guidelines are aimed at NASA implementers and HIV programme managers utilizing HIV expenditure data to influence budgetary, policy and programmatic decisions. 

NASA is a comprehensive, systematic approach to tracking HIV expenditures and analyzing financial resources dedicated to the HIV response within a country. NASA results can identify which programmes and interventions are most underfunded and require prioritization, as well as those dependent on external sources and thus most vulnerable to external shocks. By providing this granular view, NASA data supports sustainability planning and integration into broader health financing systems, while also identifying potential inefficiencies and cost-saving opportunities, increasing evidence for allocative efficiency measures and fostering a performance-based financing culture aligned with value-for-money principles. 

Importantly, the NASA approach allows for the tracking of resources being directed to, and used by, the community-led response, and for all community-based interventions. Without the detailed expenditures collected via NASA or through a similar approach, it would be difficult to monitor progress towards the global targets regarding community-leadership in the HIV response, as well as other country and global targets, including co-financing commitments. 

These detailed expenditure data are critical to sustainability planning by providing an updated picture of the financial landscape which helps countries identify future trends and potential funding gaps, to inform their resource mobilization options and measure their progress towards sustainability of their HIV responses. 

The NASA framework has been developed by UNAIDS in collaboration with partners and country stakeholders, evolving over more than two decades to provide a globally accepted, standardized and comparable approach to tracking the multisectoral resources invested in the HIV response. It aligns with the System of Health Accounts developed by the World Health Organization and is based on the triaxial framework of accounting (refer to figure below). NASA’s classification system allows for the detailed matching of the spending against the priorities outlined in countries’ national HIV strategic plans (NSPs) and the Global HIV Strategy. Since the late 2000s, over 80 countries have undertaken at least one NASA, with many countries undertaking assessments routinely, mostly in low and middle-income countries (LMICs). UNAIDS also offers an expanded range of resource tracking approaches to best suit country needs - including NASA-basic for resource constrained settings, requiring less time and fewer resources (typically 4–6 weeks) and NASA-plus for deeper dives into community-led response or TB tracking.   

UNAIDS provides capacity building, technical tools and guidance, as well as technical support to countries for their routine expenditure data collection, analysis, and dissemination. UNAIDS also continues to support the strengthening of public expenditure systems, and HIV resource tracking within these, to improve governments’ ability to track and manage all their HIV and health-related expenditures, linking these to performance indicators, to achieve optimal outcomes with their available resources.  

To promote transparency and accountability, UNAIDS and the Equitable Financing Practice synthesizes NASA and Global AIDS Monitoring (GAM) financial indicators making them publicly available and empowering stakeholders to interpret and advocate for improved resource allocation: https://hivfinancial.unaids.org/hivfinancialdashboards.html#  

The findings from NASA will be instrumental in shaping the future direction of the HIV response in any given country. They will also support the broader goals of achieving universal access to HIV prevention, treatment, care and support services, and ultimately, in ending the AIDS epidemic as a public health threat by 2030.