24th session of the United Nations Permanent Forum on indigenous issues, Agenda item 4: Discussion on the six mandated areas of the Permanent Forum (economic and social development, culture, environment, education, health and human rights), with reference to the United Nations Declaration on the Rights of Indigenous Peoples and the 2030 Agenda for Sustainable Development.

NEW YORK, 25 April 2025 — Indigenous Peoples often face higher rates of health risks, greater unmet needs for health and social services and poorer health outcomes than non-Indigenous populations. Indigenous Peoples in some contexts are more vulnerable to and disproportionately affected by HIV, tuberculosis and Hepatitis C due to multiple and intersecting inequalities that they face, including racism, poverty, discrimination and marginalization.

Through various initiatives, UNAIDS ensures that the rights and health needs of Indigenous Peoples, including Indigenous women and two spirit people, are part of its efforts. We remain committed to promoting intercultural sensitivity and inclusivity in planning and delivery, addressing the root causes of the HIV disparities faced by Indigenous communities.

UNAIDS is dedicated to addressing the significant disparities in HIV prevalence among Indigenous Peoples, particularly in Latin America, where, in some areas, rates can be up to six times higher than in the general population. This alarming situation arises from systemic challenges, including the lack of decentralized, differentiated, and interculturally sensitive health approaches tailored to the specific HIV needs of Indigenous communities.

To combat these inequalities, UNAIDS, together with other partners, facilitated the launch of an Indigenous-led Coalition on HIV in Latin America. This Coalition promotes a regionally coordinated approach, emphasizing the design and implementation of culturally appropriate strategies to tackle HIV within Indigenous populations.

The Global AIDS Strategy for 2021–2026 and the 2021 UNGA Political Declaration on HIV/AIDS have, for the first time, recognized Indigenous Peoples as a priority population for HIV response. UNAIDS defines priority populations as groups of people who in a specific geographical context (country or location) are important for the HIV response because they are at increased risk of acquiring HIV or disadvantaged when living with HIV, due to a range of societal, structural or personal circumstances. Both documents set bold targets to be met by 2025 among all demographic groups and geographic settings.

Work is under way to develop the next Global AIDS Strategy for 2026-2031. It will inform deliberations of the 2026 High-Level Meeting of the UN General Assembly on HIV/AIDS and its expected Political Declaration.

It is important to make sure that the progress and challenges in addressing the AIDS epidemic among Indigenous Peoples are adequately considered in the development of the new Global AIDS Strategy. Meaningful participation and contribution of Indigenous Peoples will be essential. The current representation of Indigenous Peoples —through the membership of National Native American AIDS Prevention Center (NNAAPC), representing the geographic region of North America— in the NGO Delegation of the UNAIDS’ Programme Coordinating Board (PCB) is an important avenue for effectively including community voices in the development of the new Strategy. Indigenous Peoples’ organizations have also been invited to participate in the global consultations on community leadership, and regional and country consultations in Latin America and Caribbean.

UNAIDS calls on Member States, UN and other stakeholders and partners to strengthen efforts for the empowerment and participation of the Indigenous Peoples in the decision making related to their health, including HIV.

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.

GENEVA, 21 March 2025–Tuberculosis (TB) and HIV are intricately linked, and they present profound challenges for global health. In 2023, 1.25 million people lost their lives to TB, including 161 000 people living with HIV. As the leading life threating comorbidity of HIV infection, TB accounted for nearly one third of all deaths among people living with HIV in 2023. Despite the progress made in the TB and HIV responses, antiretroviral treatment coverage for people with HIV/TB co-infection was only at 58% in 2023. Between 2005 and the end of 2023, 19 million people living with HIV were initiated on tuberculosis preventive treatment. 

These numbers are not just statistics – they represent real lives, especially those of the most marginalized people who face the compounding impacts of poverty, discrimination and social inequality. 

UNAIDS is advancing the targets set at the 2023 UN High-Level Meeting on TB, where global leaders committed to addressing these issues. UNAIDS is working to incorporate these targets into the next Global AIDS Strategy, advocating for the global community to commit to ensuring that 90% of people living with HIV access HIV and TB testing and treatment services as needed, and that 95% of people living with HIV receive preventive TB therapy.

There are significant opportunities to further integrate TB and HIV services, particularly in the initiation and management of antiretroviral therapy, as well as TB preventive and curative treatment. This can be achieved at all levels of health systems, especially by leveraging community support systems to close existing gaps and ensure integrated, people-centered care.   

However, the situation has recently worsened due to funding cuts from major donors, which have disrupted TB /HIV services, including health worker layoffs, drug shortages and broken supply chains. If not addressed urgently, they will likely lead to a resurgence in TB cases. 

On World Tuberculosis Day (24 March) and in this critical moment, UNAIDS urges the donor community to maintain their support for the global TB and HIV response. This is not just an act of international solidarity, but also an investment in the health and well-being of people everywhere, including in donor countries. UNAIDS also calls on national leaders to re-double their commitment to increase domestic investment in health and ensure that health services are integrated, people-centered, rights-based, and sustainable. 

Ending HIV and TB is not merely a health goal - it is a fight for justice, dignity, and a healthier and fairer world for all. When we unite, invest, and act with purpose, we save lives.

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.

GENEVA, 6 March 2025– Ahead of International Women’s Day, 8 March, UNAIDS  calls for renewed efforts in support of gender equality  to facilitate increased and accelerated access to HIV services for women and girls.

Great progress has been made in preventing new HIV infections among women and girls in the past two decades. The rate of new HIV infections declined by 63% among adolescent girls and young women between 2010 to 2023. However, women and girls remain most vulnerable to HIV. In sub-Saharan Africa, adolescent girls and young women aged between 15-24 years are three times more likely to be newly infected with HIV than men and boys the same age. Every week 4000 young women and girls become infected with HIV globally; 3100 of them are in sub-Saharan Africa.

UNAIDS urges continued funding to support women and girls to prevent new HIV infections, to stop gender-based violence - which heightens women’s and girls’ risk for HIV infection - and to ensure access to treatment, if prevention fails.

“There is a deep injustice faced by women and girls - their vulnerability to HIV,” said Winnie Byanyima, Executive Director of UNAIDS. “But when we work with countries to support girls and enable them to complete secondary school, we keep them safer from HIV, from teenage pregnancy, from violence and child marriage. That means HIV programmes for women and girls need to be fully funded and expanded and that women and girls must be able to access the prevention and treatment tools that meet their specific needs. This includes new prevention tools - such as the new long-acting injectable HIV prevention technologies. HIV is a feminist issue, and we cannot wait any longer for gender equality.

This year marks the 30^th anniversary of the Beijing Declaration and Platform for Action. Adopted in 1995 in China’s capital city by 189 governments, the declaration remains a fundamental blueprint for women and girls’ rights worldwide. Rooted in the experiences and demands of women and girls, the Beijing Declaration outlined 12 critical areas for action and affirmed women’s right to live free from violence. ‘Human rights are women’s rights and women’s rights are human rights,’ was the rallying cry for feminists at that conference. It still is.

The world cannot wait for another 30 years to fulfill the promise of gender equality. It is key to continue advancing women’s and girls’ rights, promote gender equality, foster empowerment; and ensure that young women and girls can access the life-saving HIV services they need – and deserve.

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.

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.

Despite proven effectiveness, UNAIDS is alarmed by a decrease in condom use in several countries

Geneva, 13 February 2025– On International Condom Day, UNAIDS and partners are calling for HIV prevention efforts to be stepped up. In 2023, around 3,500 people became newly infected with HIV every day, bringing the total number of people newly infected in 2023 to 1.3 million.

One of the most effective, low-cost HIV prevention tools available today are condoms which are 98% effective when used correctly and consistently. Condom use has averted an estimated 117 million new HIV infections globally from 1990 to 2019 however, new data reveal that there has been a decline of 6-15% in condom use in a number of countries, according to the Demographic and Health Surveys (DHS), a Condom Landscape Analysis, and the World Health Organization (WHO.)

For the past few years, the estimated global public sector and subsidized condom procurement declined by an average of 30% from peak procurement in 2011. This decline occurred despite the population in Africa growing to an estimated 400 million since 2010.  As a consequence, fewer free or subsidized condoms are available per capita in Africa now than a decade ago.

"Condoms are a critical part of a comprehensive approach to HIV prevention and public health.. We also want to make sure medical breakthroughs like long-acting HIV medicines are affordable and accessible to all to give people most at risk additional HIV prevention options,” said Angeli Achrekar, UNAIDS Deputy Executive Director for Programmes.

Public and international investment in condom distribution, education, and social marketing has decreased in recent years. As a result, a new generation of young people has not been exposed to condom promotion.

As new drugs and injectable HIV prevention methods gain ground in the next few years, condoms as well as PrEP (pills for people who may be at risk of acquiring HIV), voluntary medical male circumcision and treatment remain essential to achieving global health targets related to HIV and sexual and reproductive health.

Your Health. Your Power. Your Choice. Your Future.

International Condom Day is a reminder of the importance of protecting one’s own health. This year's theme focuses on the importance of ensuring equitable access to condoms, combating myths and misconceptions, and encouraging open conversations about preventing new HIV infections.

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.

GENEVA, 29 January 2025— The United States Secretary of State, Marco Rubio, has approved an “Emergency Humanitarian Waiver”, which will allow people to continue accessing HIV treatment funded by the US across 55 countries worldwide. More than 20 million people living with HIV, representing two-thirds of all people living with HIV receiving treatment globally, are directly supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR) - the world’s leading HIV initiative.

“UNAIDS welcomes this waiver from the US government which ensures that millions of people living with HIV can continue to receive life-saving HIV medication during the assessment of US foreign development assistance,” said UNAIDS Executive Director, Winnie Byanyima. “This urgent decision recognizes PEPFAR’s critical role in the AIDS response and restores hope to people living with HIV.”

In recent days, the US Department of State announced an immediate 90-day funding pause for all foreign assistance, including for funding and services supported by PEPFAR. The executive order announcing a “90-day pause in United States foreign development assistance for assessment of programmatic efficiencies and consistency with United States foreign policy” was one of the first major foreign policy decisions of the new administration. This waiver approves the continuation or resumption of “life-saving humanitarian assistance” which applies to core life-saving medicine and medical services, including HIV treatment, as well as to supplies necessary to deliver such assistance.

UNAIDS will continue efforts to ensure that all people living with or affected by HIV are served and that other key components of PEPFAR’s life-saving efforts, including service delivery and services for HIV prevention, care, and support for orphans and vulnerable children are continued.

UNAIDS is serving in its essential role to mobilize and convene partners, governments, and communities across the globe at the country level to assess and mitigate the impact of the pause on the continuity of essential HIV services.   

UNAIDS has encouraged President Donald J. Trump to prioritize the U.S. Government’s leadership in the global HIV response to achieve the shared goal of ending AIDS.

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.

GENEVA, 22 January 2025—UNAIDS congratulates President Donald J. Trump as the 47th President of the United States of America.

“Under President Trump’s leadership, the United States of America has the opportunity to accelerate the global HIV response and end AIDS by 2030,” said Winnie Byanyima, Executive Director of UNAIDS. 

During President Trump’s first administration, he demonstrated strong leadership in the fight against AIDS by launching the groundbreaking initiative Ending the HIV Epidemic in the US and reaffirming the United States of America's steadfast commitment to the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund), and the Joint United Nations Programme on HIV/AIDS (UNAIDS). 

For more than two decades, the United States Government has led in the global HIV response, saving more than 26 million lives. The country's unwavering commitment to addressing HIV stands as a global gold standard of leadership.

Since the start of the AIDS pandemic, innovations led by the United States in HIV prevention and treatment technologies have saved millions of lives around the world.

Today, we are on the brink of ending AIDS thanks to advances in developing long-acting medicines which both prevent and treat HIV. These new medicines give us a real shot at ending AIDS with the United States of America at the forefront. UNAIDS is poised and ready to work side by side with the new Administration to save millions of lives by bringing these new medicines swiftly to scale.

The United States Government’s partnership with UNAIDS remains an indispensable force for progress and accountability in the global HIV response. UNAIDS looks forward to further strengthening its collaboration with the United States to achieve our shared goal of ending AIDS.

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.

NAIROBI, 13 December 2024—The 55th meeting of UNAIDS’ Programme Coordinating Board (PCB) has concluded in Nairobi, Kenya, with Board members reaffirming their commitment to end the AIDS pandemic by 2030. Taking place in Africa for the first time in 18 years, the PCB meeting came at a critical moment for the AIDS response as new scientific advances bring the hope of ending the AIDS pandemic closer than ever and as UNAIDS embarks on developing the next Global AIDS Strategy and building political support for new 2030 HIV goals.

In her opening remarks to the Board the Executive Director of UNAIDS Winnie Byanyima said, “Let us make it possible for people living with HIV today to get the best science for HIV prevention and treatment that exists wherever they are in the world. Let us do this as a matter of sustainability to end this disease, as a matter of social justice, as a matter of human rights and as a matter of public health.”

In the session on Leadership in the AIDS Response, civil society and community activists expressed how breakthrough medicines must be shared equitably to reach the people most in need to accelerate progress towards ending AIDS. Countries demonstrated appreciation and solidarity with UNAIDS with some taking the opportunity to announce funding commitments to UNAIDS during the meeting. France announced a new €1.8 million commitment, via Expertise France, its public international cooperation agency, for equitable and sustainable financing for the AIDS response in southeast Asia, while the Netherlands announced a €23 million core funding contribution to UNAIDS for 2025. Denmark also declared a multi-year financial agreement for 2024—2029, with an expected annual contribution of DKK 40 million.

The Board underscored the need for the world to accelerate toward the 2025 targets.  It also agreed to accelerate the Joint Programme’s work on sustainability and received an update on the ongoing work of the High-level panel on a resilient and fit-for-purpose UNAIDS Joint Programme in the context of the sustainability of the HIV response, with Board members confirming their expectation to consider bold and transformational recommendations at the next PCB on reforming the Joint Programme’s operating model.

A thematic segment on addressing inequalities in children and adolescents to end AIDS by 2030 was held on the last day of the PCB. Board members discussed how to close the persistent gaps and challenges in the response to AIDS in children and adolescents and explored strategies, innovations and programme successes to accelerate HIV prevention, treatment, protection, care and support for pregnant women, children and adolescents.

Sitsope Adjovi, a young HIV activist from Togo’s Network of Positive Children, Adolescents and Youth Innovating for Renewal (REAJIR+) said, “Young people are capable of doing what it takes and are ready to be engaged. it's no longer AIDS that's killing children, teenagers and young people. It's inappropriate policies, interventions and programmes that threaten our lives.” 

There were 120 000 new HIV infections among children aged 0—14 in 2023 and 1.4 million children were living with HIV, 86% of whom are in sub-Saharan Africa. Just 57% of children living with HIV were on treatment in 2023 compared with 77% of adults and every 8 minutes a child died of an AIDS-related illness.

“When we know what works, when we know it is possible to end transmission of HIV to children, every new infection is a collective policy failure. A failure that we must address at every level of the HIV response by bridging the gaps between policy and delivery.” said Ms Byanyima.

The UNAIDS PCB brings together civil society, cosponsors and United Nations member states to help chart the co-creation of the future of the response to HIV, including the development of the next Global AIDS Strategy, the vision for 2030 and beyond. 

The 55th meeting of the PCB was chaired by Kenya, with Brazil serving as the Vice-Chair and the Netherlands as Rapporteur. The 56th meeting to be held in June 2025 will be chaired by Brazil, with the Netherlands serving as Vice-Chair and Kenya as Rapporteur.

Read the Report to the Board by the UNAIDS Executive Director.

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.

GENEVA, 10 December 2024—The world can end AIDS—if the human rights of people living with or affected by HIV are respected, protected and fulfilled, to put communities in the lead and ensure equitable access to high-quality HIV services.

The HIV response has come a long way. The progress made to date on HIV prevention and treatment services has been made possible, in large part, thanks to the advocacy of people living with HIV, communities and civil society allies, demanding treatment, demanding services, demanding dignity, demanding action – demanding their rights.

Over 30 million people are now on treatment, and annual numbers of new HIV infections have declined by 39% since 2010. However we still have a long way to go. In 2023, 1.3 million people around the world newly acquired HIV—three times higher than the global target set for 2025 of no more than 370 000 new acquisitions.

“An approach grounded in human rights is vital to enable meaningful engagement of communities and access to HIV services for all without discrimination” said Christine Stegling, UNAIDS Deputy Executive Director. “HIV services will reach the people most in need only if their human rights are upheld; if communities are in the lead, discriminatory and harmful laws are removed; HIV-related stigma, discrimination and violence are effectively tackled and if access to life-saving medicines is assured.”

Fostering resilient societies where human rights are protected and communities are enabled to lead requires long-term structural and systemic changes. If we are to have a sustainable HIV response, we must have a sustainable, well-resourced, approach to human rights.

On World AIDS Day, 1 December, UNAIDS released a report ‘The Rights Path’ to show what can be done. It shares examples from around the world of proven policies and programmes that are succeeding in protecting health and HIV services by protecting rights.

The HIV response is at a crossroads. We can end AIDS, if we take the rights path. Let us walk it together.

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.

NAIROBI, 10 December 2024—Today, at the 55th Programme Coordinating Board for the Joint United Nations Programme on HIV/AIDS (UNAIDS), HIV leaders from across the world called for access to long-acting medicines for everyone who would benefit from them, to build toward a new era in the AIDS response.

Over the last two years, scientific breakthroughs have brought to the fore a new class of anti-HIV medicines with long-acting effects, allowing people at risk of HIV infection and those living with the virus to take medicines every few months. One is injected just twice a year. Recent studies have shown these medicines to be among the most effective ever developed. One study showed zero new infections among young African women using long-acting prevention drugs, while a study among key populations showed them more effective than oral medicines. Another study highlighted at the session showed encouraging results using long-acting HIV treatment in low- and middle-income countries.

At the “Leadership in the AIDS Response” session at the UNAIDS board, government officials, researchers, manufacturers, and civil society called for accelerating global access to use these scientific breakthroughs to interrupt the continuing AIDS pandemic. Despite existing HIV prevention tools, in 2023 an estimated 1.3 million people newly contracted HIV – two every minute. Despite HIV treatment, there is still one AIDS-related deaths every minute.

Winnie Byanyima, Executive Director of UNAIDS, said: “We can usher in a new era by connecting technological innovation with access for all. Let us act boldly together, bring down the curve of new infections, and dramatically accelerate the HIV response.

“Let us learn from the painful lessons of the past so that we write a new story now. In the late 1990s and early 2000s, even after antiretroviral medicines were proven to be effective and rolled out in high-income countries, 12 million people on this continent still died waiting for those drugs. We can - and must – do better with long-actings. We urge the companies producing these medicines to expand their generics licenses. And we support governments making use of all their legal flexibilities to get access to affordable medicines.

“The usual trajectory is that the Global South waits years before the science reaches them. What if we do not wait for years, what if we ensure that science is treated as the public good it is? What if we disrupt the far too slow trajectory we are on and shift to a trajectory that accelerates progress, ends the pandemic, enables sustainability, and can be a model for the world?"

Secretary Ethel Maciel, Secretary of Health of Brazil, said: “Brazil has a long history of making use of technology in the HIV response. The possibility of having new long-acting medicines in the global response is a great opportunity. But we have the huge challenge of the high cost of these medicines, and the difficulty for a range of countries, including ours, to access them.

“Brazil is committed to work together in the fight to ensure that this new technology is made available to all people all over the world who are at risk of and living with HIV.”

Dr Cissy Kityo, Executive Director of the Joint Clinical Research Centre, Uganda, a leading scientist working on trials of long-acting medicines said:  “We have these fantastic new tools. The technology of long-acting ARV’s antiretrovirals is remarkable. The evidence is now clear that long acting medicines will be game-changers for both prevention and treatment. The science is in, the question is how well we will use it.”

Mr Javier Padilla Bernáldez, Secretary of State for Health, Spain, said: “This new long-acting technology puts us in an exceptional situation, not an ordinary one, an opportunity that we cannot afford to miss. Long-acting medicines can change the landscape of the HIV response. But if this game-changing innovation did not reach the people it would be a nothing-changer!

“We need to remember the 2000s’ fight for universal access. We cannot repeat the same mistakes and delays of before. We need to ensure that no countries should be pressured if they choose to use the safeguards in the TRIPS agreement. The inequality gap is a global problem. We need a universal perspective, so that all countries, including middle-income countries, are included.”

Dr Sylvia Vito, Africa Head of EVA Pharma, a company in Egypt licensed to produce a generic version of lenacapavir, said: “We are a company that will not sit comfortably, but rather be in a good hurry to support the unmet HIV medical needs for our people. We intend to move fast on product development, production, and eventual registration. It is our intention that high quality long-acting generic ARV medicine will not only be available, but made accessible and affordable as well. We intend to beat the current standard of care in HIV treatment and prevention by going further to improve on the current options for patients in low and middle-income countries.”

The importance of generic production was central to the interventions of speakers. Several speakers noted the obstacle that much of Latin America, a region of rising HIV infections, has been excluded from companies’ voluntary licenses for generic versions. This is despite Brazil, Peru, Mexico and Argentina participating in clinical trials. Speakers highlighted the importance of using TRIPS flexibilities for enabling access under World Trade Organization rules, which can enable governments to supply its citizens with generic versions of patented treatments either through domestic production or imports. In the 2021 Political Declaration on HIV/AIDS, countries committed to make use of TRIPS flexibilities, specifically geared to promoting access to medicines.

Although Gilead Sciences, the producer of lenacapavir, one of the new class of long-acting medicines, has not yet announced the price of its product for use as PrEP, it costs around $40,000 per person per year in the United States where it is used for treatment. However, experts have estimated that it could be produced and sold for $40 per person per year, in line with UNAIDS estimates for sustainable pricing in low- and middle-income countries. Speakers highlighted opportunities to bring down the price of these medicines through generics, expanded local and regional production, and the use of TRIPS flexibilities by member states.

One important opportunity for progress emphasized by speakers was to build on the progress on multilateral collaboration made by Brazil, which as chair of the G20 in 2024, successfully secured worldwide support for the Global Coalition for Local and Regional Production, Innovation and Equitable Access, laying the foundations for a greatly expanded and more equitable access to medicines.

Speakers noted also the importance of choice, and of widening access to a range of new technologies, of which lenacapavir is just one. Speakers highlighted important current innovations including 2-monthly injectable cabotegravir and a three-month dapivirine vaginal ring, as well as new technologies currently in the pipeline including a once-a-month pill may move into phase 3 trials next year.

Reinforcing the importance of accelerating access to long-acting medicines, The New England Journal of Medicine has today published an article by UNAIDS Executive Director Winnie Byanyima, Linda-Gail Becker of the Desmond Tutu HIV Centre, and Matthew Kavanagh of Georgetown University’s Center for Global Health Policy and Politics, entitled “Long-Acting HIV Medicines and the Pandemic Inequality Cycle — Rethinking Access”.

The article showed that the “pandemic inequality cycle” in HIV has usually meant a decade delay between access to breakthrough HIV technologies in the global North and the global South.

In their article the authors write: “The world may look back on 2024 as a pivotal time in the fight against AIDS — the start of a revolution in the global biomedical response to HIV using long-acting antiretroviral medicines. Whether they will do so depends on whether policymakers and pharmaceutical companies avoid repeating past mistakes.”

The authors call for “a nonlinear approach to global access to ARVs that combines far more rapid sharing of technology, decentralized global production, and research and development of products that meet the needs in Africa, Asia, Latin America, and the Caribbean.”

They highlight the need for progress on long-acting treatment as well as prevention and “to break the long-standing pattern of failing to get HIV technologies to the people who need them most, to stop playing catch-up, stop accepting that innovations must reach people in the Global South years late, and use long-acting medicines to help end the pandemic.” The article is available at https://www.nejm.org/doi/full/10.1056/NEJMms2412286

The importance of long-actings, and what is at stake in the discussions on access, was summed up by Jerop Limo, a 26 year old Kenyan activist born living with HIV who is Executive Director of the Ambassador for Youth and Adolescent Reproductive Health Program (AYARHEP):

“Taking a pill every day is not easy. It is a constant reminder of being different, and the stigmatising and shaming we experience because of it can discourage us from taking our medicines.

“This is not just about convenience. Young people living with HIV, and young people at risk of HIV, are clear: with all the pressures we face, long-acting medicines would help us stay on the medicines and help transform, and save, our lives.

“We deserve to live, and to live fully. We can’t have access on paper only. We need access for all people in all countries.

“I am inspired to see leaders coming together to centre communities and to call for access to long-acting HIV medicines. With partnership we can do this. We don’t have time to wait.”

The UNAIDS Programme Coordinating Board brings together governments, civil society and the United Nations to help guide the HIV response. UNAIDS sees the development of long-actings as a vital disruptive innovation.

“The arrival of long-acting injections is a game-changer which can help prevent millions of new HIV infections, if we ensure access to all who would benefit from them,” said Ms Byanyima. “Today, in Nairobi, leaders in the global HIV response took a bold and vital step forward on the path to access for all.”

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.