BRUSSELS, 1 December 2023—On World AIDS Day, UNAIDS, Spain, as President of the Council of the European Union, and other partners called for the elimination of all HIV-related stigma and discrimination as a necessary step towards ending the AIDS pandemic as a global public health threat by 2030.

Speaking at the event held at the European Parliament in Brussels, Spain’s Minister of Health, Mónica García, re-affirmed Spain’s commitment to achieve zero HIV-related stigma and discrimination.

“We hope that this leadership of Spain for the elimination of all forms of stigma and discrimination associated with HIV will be maintained over the next 7 years to meet our goals by 2030,” said Ms Garcia.

The elimination of HIV-related stigma and discrimination has been a political priority of the Spanish Presidency of the Council of the European Union since July 2023. This was reflected in a high-level meeting on "HIV and Human Rights: Political Action to Achieve Zero Stigma" hosted by the Spanish Ministry of Health in September 2023 in Seville. At the event, Spain took the important step to officially join the Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination, becoming the second EU country to join after Luxembourg.

At the event in Brussels, UNAIDS Deputy Executive Director, Christine Stegling, thanked Spain for its leadership globally and in the European Union and said the world needed to act urgently to eliminate HIV-related stigma and discrimination.

“We’ve made impressive progress against HIV, but we have much work left to do,” said Ms Stegling, “Unless we succeed in ending AIDS-related stigma and discrimination, we will not be able to reach everyone in need. Stigma and discrimination against people most affected by HIV are the biggest barriers to accessing lifesaving HIV prevention and care. We look forward to working with European Union Member States, the European Parliament and the Council of the European Union, to take this agenda forward." 

As Spain steps down from its Presidency of the Council of the European Union at the end of December 2023 and as Belgium assumes the role, Ms. Stegling also expressed hope that Belgium will follow in Spain’s footsteps and continue to lead on this critical issue. She called on the whole of the European Union to join in global efforts to abolish AIDS-related stigma and discrimination to reach people who are currently being left behind in the response.

Around the world, some 9.2 million people living with HIV still do not have access to life-saving medicines. Every minute, a life is lost to AIDS. In 2022, 1.3 million people became newly infected with HIV. Many people most affected by HIV are being left behind, including adolescent girls and young women, gay men and men who have sex with men, people who inject drugs, sex workers and migrants. These are the people who must be reached for AIDS to be ended as a public health threat by 2030.

Removing AIDS-related stigma, discrimination and criminalization will make it more possible to reach those currently being left behind. Political leadership in the European Union is key to achieving that goal.

Also critical for removing AIDS-related stigma and discrimination is community leadership. Ms. Stegling highlighted UNAIDS’ 2023 World AIDS Day report “Let Communities Lead” citing the need for governments and donors to fully empower and fund community leadership in the response to HIV.

Other speakers at the event included: Andrea Ammon, Director of the European Centre for Disease Prevention and Control; Peter Sands, the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; Hans Kluge, the World Health Organization's Regional Director for Europe and Kathleen van Brempt, MEP of the Progressive Alliance of Socialists and Democrats in the European Parliament.  

The World AIDS Day event was co-hosted and moderated by Marc Angel, MEP from Luxembourg and vice-president of the European Parliament.  He said, “Representing my country, I extend my deepest appreciation to Spain for joining the Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination. As a UNAIDS Red Ribbon Leader for the “10-10-10" targets on societal enablers, I look forward to working closely with Spain, my own country, Luxembourg and, ideally, other EU Member States to end all forms of HIV-related stigma and discrimination in the EU, across Europe and beyond.”

The 10-10-10 targets are:

• Less than 10% of countries have punitive legal and policy environments that deny access to justice
• Less than 10% of people living with HIV and key populations experience stigma and discrimination
• Less than 10% of women, girls, people living with HIV and key populations experience gender inequality and violence.

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.

As part of its ongoing support for ending AIDS in Southeast Asia and the Pacific, the Australian Government is investing up to AU$12 million in a new partnership supported by UNAIDS and Health Equity Matters. The funding will help local communities and governments in the region improve HIV prevention, testing and treatment while reducing stigma and discrimination.

"UNAIDS values Australia's long-standing partnership globally and in the Asia-Pacific region, and particularly its commitment to community leadership,” said Eamonn Murphy, UNAIDS Regional Director, Asia Pacific and Eastern Europe and Central Asia. "By both increasing service access and lowering HIV-related stigma and discrimination, we can accelerate progress toward ending AIDS as a public health threat."

In her announcement of this partnership, marking World AIDS Day, Australian Minister for Foreign Affairs, Senator the Hon Penny Wong said, "Globally we have made remarkable progress in the fight against HIV, but there is still more to be done. It is critical that Australia supports communities in our region to end the HIV epidemic, including through sharing our own knowledge and experience."

Australia’s own national testing, treatment and viral suppression results are on track to reach the 95-95-95 targets by 2025. As of the end of 2021, 91% of people living with HIV were diagnosed, 92% of those diagnosed were on treatment and 98% of those on treatment were virally suppressed. “Among the factors contributing to Australia’s prevention, testing and treatment success is its historical bipartisan commitment to partnering with civil society in the HIV response,” Mr Murphy said. “It is this approach that we need to expand throughout the region.”

HIV infections in the region are not yet falling fast enough to meet vital targets, and there are rising epidemics in a number of countries including Papua New Guinea, Fiji and the Philippines. Stigma and discrimination are contributing to the rise in new HIV infections, obstructing access to HIV prevention, testing and treatment services for men who have sex with men. Community- and key population-led service delivery is a critical tool for reaching people, especially young people, not yet accessing services.

"The most effective way to treat and prevent HIV is to empower the people who most feel its impact,” stressed Health Equity Matters CEO, Adjunct Professor Darryl O'Donnell.

The initiative, currently still under development, reflects a new model of partnership with community organizations which UNAIDS highlighted in this year’s World AIDS Day report as critical to 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.

WASHINGTON D.C./GENEVA, 1 December 2023—UNAIDS, in partnership with the Bureau of Global Health Security and Diplomacy at the US Department of State and Members of US Congress, co-hosted a Congressional Commemoration and Ministerial Roundtable for the 35^th World AIDS Day. The event featured bipartisan Members of US Congress who pledged continued support for the reauthorization of PEPFAR, and HIV, health and development leaders, including African Ministers of Health, who recommitted to sustain progress to end AIDS.

“We have to reauthorize PEPFAR. Success must continue,” said Senator Bill Cassidy. “The challenge before us is to continue to use the science and programmatic change to reach new at-risk populations, like mothers and babies. Our goal is to end AIDS, but it is going to be one population at a time.”

Congresswoman Barbara Lee called for a renewed bipartisan effort to reauthorize PEPFAR. “We have the opportunity to see an AIDS-free generation by 2030 and we have to do everything we can do to get there. I continue to work with my Republican colleagues every day to extend PEPFAR on a bipartisan basis. The well-being of millions of people in Africa are on the line.”

Congressman Hakeem Jeffries, Minority Leader of the US House of Representatives, said, “PEPFAR is the perfect example of a life-saving, life-preserving, life-changing program. You have our commitment as the House Democrats that we will continue to work with President Biden and our colleagues on the other side of the aisle to make sure that we secure a robust, strong, lengthy reauthorization of PEPFAR.”

Other esteemed Members of Congress who addressed the event included Representative Michael Lawler, Representative Sara Jacobs, and Representative Ami Bera. They cited powerful country examples of PEPFAR’s success and committed continued bipartisan support for the reauthorization of PEPFAR, demonstrating the importance of US Congressional leadership in the global HIV response.

“PEPFAR has become the gold standard for humanity,” said John Nkengasong, Ambassador-at-Large, US Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy at the US Department of State. “We need joint responsibility and joint accountability to end AIDS by 2030. I am hopeful the US Congress will secure a clean, five-year reauthorization of PEPFAR, which will enable us end AIDS.”

“PEPFAR is an illustration of the compassion and leadership of the American people - comparable to the Marshall Plan,” said Achim Steiner, Administrator of UNDP, and UNAIDS Cosponsor. “The multisectoral approach of the global HIV response has been instrumental in helping communities lead and build resilience.”

Global leaders highlighted the life-saving impact of PEPFAR’s contributions. Martha Cameron, Executive Director of the International Community of Women Living with HIV, North America, shared her story. “Had it not been for PEPFAR, I would not be here today. I was on my death bed in Zambia and was told I had very little time to live. I was one of those first recipients. Representing my community of faith-based organizations, I hope that PEPFAR will be reauthorized.”

“Global progress on HIV has been breathtaking, but the job is not yet done,” said Angeli Achrekar, Deputy Executive Director, Programme, UNAIDS. “We must continue our efforts to end AIDS as a public health threat by 2030 and sustain these gains into the future.”

Faith-based organizations have been at the forefront of the HIV response. “Working in Zambia before PEPFAR started, I remember losing friends on a weekly basis,” said Shannon Senefeld, Senior Vice President of Catholic Relief Services. “The programming implemented under PEPFAR has been pro-life. I am hard pressed to think of another example of such a life-affirming program that has been implemented by the US Government.”

The event included a high-level roundtable of leaders from across Africa, highlighting the life-saving impact of PEPFAR on progress in national HIV responses and across the African continent. “We acknowledge the remarkable leadership and collaboration between the African Union Commission, the US Congress, UNAIDS, the Global Fund and others working together to combat HIV/AIDS,” said Monique Nsanzabaganwa, Deputy Chairperson of the African Union Commission. “The African Union welcomes 20 years of US leadership in the fight against AIDS. Let me request that we finish this fight together and we continue this partnership in the next years, leading to 2030 and beyond.”

“In 2003, before PEPFAR was operational, less than 1 000 people in Tanzania were on antiretroviral therapy. Today more than 1.5 million Tanzanians are receiving this life-saving treatment for HIV, mainly because of the support we are getting from PEFPAR,” said Ummy Ally Mwalimu, Minister of Health of Tanzania. “Our appeal to the US Congress is to reauthorize PEPFAR in order to sustain the gains we have achieved.”

“We have the biggest burden of HIV and tuberculosis in the Continent and also in the world,” said Joseph Phaahla, Minister of Health of South Africa. “The partnership and support provided made it possible to roll out 5.8 million people on HIV treatment. We could not achieve this progress without the support of US Congress and ordinary American people. But the coverage of children remains a challenge which we need to close.”

“We acknowledge the support and partnership with PEPFAR, UNAIDS and the Global Fund,” said Armindo Daniel Tiago, Minister of Health of Mozambique. “We have reached the milestone of 2 million people receiving HIV treatment. We rely on the ongoing support of the US Congress, through PEPFAR, to achieve our targets and secure sustainability of the HIV response.” 

The full event can be viewed online at: World AIDS Day Congressional Commemoration and Ministerial Roundtable - YouTube

PEPFAR’s latest program results (December 2023) demonstrate the life-saving impact of the program, including:  

• Life-saving antiretroviral treatment for 20.47 million men, women, and children
• 1.95 million people to newly enrolled in PrEP to prevent HIV infection
• 327,000 health workers supported to deliver quality HIV-related prevention, treatment and supportive services, and
• 32.5 million men who received voluntary medical male circumcisions to help prevent new HIV infections since 2007.

UNAIDS latest global HIV data indicates that at the end of 2022 an estimated:

• 39.0 million people globally were living with HIV
• 29.8 million people were accessing antiretroviral therapy
• 1.3 million people became newly infected with HIV
• 630 000 people died from AIDS-related illnesses

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.

PEPFAR

The Bureau of Global Health Security and Diplomacy at the U.S. Department of State leads, manages, and oversees the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Through PEPFAR, the U.S. government has invested over $110 billion in the global HIV/AIDS response, the largest commitment by any nation to address a single disease in history, saving over 25 million lives, preventing millions of HIV infections, and accelerating progress toward controlling the global HIV/AIDS pandemic in more than 50 countries.

HIV opt-out testing will consolidate the gains towards HIV epidemic control in the UK

LONDON/GENEVA, 29 November 2023—Ahead of World AIDS Day (1 December) UNAIDS welcomes a new research project to potentially expand ‘opt-out’ HIV testing programmes across England. According to NHS figures, a pilot ‘opt-out’ HIV testing scheme, pioneered by the Elton John Foundation in England has identified more than 3,500 cases of three bloodborne infections since April 2022—HIV, Hepatitis B and Hepatitis C—including identifying more than 580 HIV cases of HIV.

Under pilot scheme in England, anyone having a blood test in selected hospital accident and emergency units has also been offered a test for HIV, Hepatitis B and Hepatitis C, and has been given the option to opt out should they not wish to have the test. The trials have been taking place in 33 hospitals in London, Greater Manchester, Sussex and Blackpool.

"HIV opt-out testing will consolidate the gains towards HIV epidemic control in the UK," said Winnie Byanyima, Executive Director of UNAIDS. "Normalization of HIV testing will not only enable timely access to HIV treatment, allowing people with HIV to live healthy lives—it will also stop new HIV infections and reduce the stigma around getting an HIV test. It will save and change lives and help ensure that no one is left behind."

People living with HIV who are on effective HIV treatment cannot transmit the virus. In the UNAIDS Global AIDS Strategy, UNAIDS has set “95-95-95” targets. Aiming for 95% of people who are living with HIV to know their HIV status, 95% of people who know that they are living with HIV to be on lifesaving antiretroviral treatment, and 95% of people who are on treatment to be virally suppressed.

At least five countries, Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe have already achieved the “95-95-95” targets. A further 16 other countries, eight of them in sub-Saharan Africa, the region which accounts for 65% of all people living with HIV, are also close to doing so.

On 28 November, UNAIDS released its World AIDS Day report in London, UK urging governments to Let Communities Lead across the world to in ending AIDS. The report shows that AIDS can be ended as a public health threat by 2030, but only if communities on the frontlines get the full support they need from governments and donors. The Elton John Foundation is one of the many organizations supporting community action.

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.

1 December 2023 

World AIDS Day arrives at a defining moment.

AIDS-related deaths have fallen by almost 70 per cent since their peak in 2004, and new HIV infections are at the lowest point since the 1980s.

But AIDS still takes a life every minute.

We can — and must — end AIDS as a public health threat by 2030. 

Reaching this goal means heeding this year’s theme: Let Communities Lead.

The path to ending AIDS runs through communities.

From connecting people to the treatment, services and support they need — to the grassroots activism pushing for action so all people can realize their right to health.

Supporting those on the frontlines of the battle against AIDS is how we win.

That means placing community leadership at the centre of HIV plans, programmes, budgets and monitoring efforts. 

We must also remove barriers to community leadership, and ensure space for local civil society groups to take forward their vital work.

Above all, we need funding.

The AIDS response in low and middle-income countries needs over 8 billion dollars more per year to be fully funded.

This must include scaled-up funding for local programmes led by people living with HIV, and prevention initiatives led by communities.

AIDS is beatable.

Let’s finish the job by supporting communities to end this scourge in their neighbourhoods, their countries and around the world.

UNAIDS Statement on the International Day to End Violence Against Women and the Launch of 16 Days of Activism to End Gender-Based Violence: Unite! Invest to Prevent Violence Against Women and Girls

What will it take for the world to end gender-based violence?

The answer is crystal clear: governments must empower and fund women-led organizations worldwide. We must let communities lead.

One in three women worldwide has experienced violence, often from someone she knows. Women who experience violence are also more at risk for HIV. As Ayu Oktariani of the Indonesian Positive Women Network says, “The perception that women living with HIV are ‘bad women’ makes people normalize violence against them.”

Gender-based violence has indeed become normalized across the globe. Yet it is a gross violation of human rights on an epic scale. As such, it requires an epic response.

But today, a staggering one in five countries worldwide has no laws providing enforceable penalties against gender-based violence.  And only 1 percent of gender-focused government aid is directed to women-led organizations.   

It is time for governments to recognize violence against women for the crime it is and increase funding for those who know best how to tackle it at its roots – women-led organizations.  

Across the globe, women-led organizations are on the ground, providing support to women at risk, advocating for policy change, and shifting societal attitudes toward marginalized groups of women such as sex workers, trans women, lesbians, and women with HIV. Research shows that the single most critical factor driving both global and domestic policy change in ending violence against women and girls is the presence of a strong and autonomous feminist movement.  

Millions of women worldwide are actively engaged in ending gender-based violence. For example, in Haiti, Refuge des Femmes d'Haiti supports women and girls affected by gang violence in Port-au-Prince. In Peru, Miluska Vida y Dignidad and Trans Organizacion Feminista help cis and transgender sex workers by training police and providing legal aid and other services. In Zimbabwe, SASA! mobilizes communities to respond to HIV-related violence towards women.    

Many of these women work as volunteers or for low pay in organizations that are often under-funded and with insecure financial futures. It is time to stop our reliance on the good will of women to make change happen in the face of violence against them. 

UNAIDS calls upon governments and international agencies to support and invest in women’s rights and service organizations – the unsung heroes of the movement to end gender-based violence – at levels that reflect the enormity of this pandemic of violence.

This is key to ending violence against women and girls in all their diversity. It is also key to ending AIDS.

This will speed up progress to end the AIDS pandemic and save lives.

GENEVA, 4 October 2023—The United Nations in Mauritius—which includes UNAIDS, UNFPA, OHCHR, UNDP and WHO—welcome today’s ruling by the Supreme Court of Mauritius that a discriminatory law criminalizing consensual same sex relations is unconstitutional and will be immediately struck from the legal code. Previously, under Section 250 of the Mauritian Criminal Code (which dated back to 1898) anyone convicted could have faced up to five years in prison.

“The Supreme Court today overturned an obsolete colonial law and demonstrated its commitment to non-discrimination and leaving no-one behind,” said Lisa Singh, United Nations Resident Coordinator in Mauritius. “The UN in Mauritius and internationally welcomes the decision of Mauritius to join the growing list of African countries protecting the human rights of everyone, including LGBTQI+ people.”

The ruling noted that “Section 250 was not introduced in Mauritius to reflect any indigenous Mauritian values but was inherited as part of our colonial history from Britain. Its enactment was not the expression of domestic democratic will, but was a course imposed on Mauritius and other colonies by British rule.” It also noted that a growing number of countries have decriminalized consensual same sex sexual relations, including the United Kingdom which overturned its law in 1967. 

“Mauritius' decision to decriminalize homosexuality is an important step forward for public health and a step towards equal rights, respect and dignity for the LGBTQI community,” said Anne Githuku-Shongwe, Director of UNAIDS’ Regional Support Team for Eastern and Southern Africa. “UNAIDS applauds Mauritius for today’s decision which will mean that men who have sex with men will have much easier access to the health and social services they need without fear of arrest or criminalization. Work will need to continue to break down the barriers of stigma and discrimination towards the LGBTQI community, but today’s ruling is a positive step in the right direction. It will save lives.”

Mauritius becomes the latest in a growing list of countries to declare that laws which have criminalized LGBTQI people are unconstitutional. However, UNAIDS estimates that 66 countries still have laws which criminalize consensual same sex relations. In addition to contravening the human rights of LGBTQI people, these laws impede access to health and social services, including HIV services. Such laws fuel stigma and discrimination against LGBTQI people and put them under constant fear of being punished or detained.

The case was brought forward by Abdool Ridwan Firaas Ah Seek, President of Arc-en-Ciel, the largest and longest-standing organisation in Mauritius championing the human rights of LGBTQI people, and was supported by partners including the Human Dignity Trust.

Civil society organizations, especially community-led organizations, are at the forefront of a global wave of progress that advances access to health for all. UNAIDS urges all countries to decriminalise same sex sexual relations. Decriminalization saves and changes lives.

Maneesh Gobin, Attorney General and Minister of Foreign Affairs and Regional Integration in Mauritius said, “In keeping with its internationally acclaimed respect for the rule of law, Mauritius will indeed report to United Nations Member States at the next cycle of the Universal Periodic Review.” The Universal Periodic Review is a unique mechanism of the Human Rights Council that calls for each UN Member State to undergo a peer review of its human rights records every 4.5 years.

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.

Colombia makes landmark decision to declare the HIV medicine dolutegravir of public interest, allowing the country to purchase or manufacture more affordable, generic versions of the live-saving HIV medicine

BOGOTÁ/GENEVA, 4 October 2023—UNAIDS applauds the government of Colombia for declaring the HIV medicine dolutegravir of public interest. This important breakthrough in public health measures will allow the government to issue a compulsory license, breaking the monopoly, and making it much more affordable for the Colombian government to purchase or manufacture. The new decision could mean that the price of the life-saving medicine is reduced by as much as 80%.

“When the power to produce health technologies is held by a few companies, the result all too often is that countries can’t afford the high prices and people who need newer products cannot access them,” said Luisa Cabal, UNAIDS Regional Director for Latin America and the Caribbean. “We are confident that this decision will have an impact across the whole region and beyond, as many middle-income countries are struggling to access generic markets of key health products to prevent and treat HIV infection.” 

The World Health Organization recommends dolutegravir as the preferred first-line and second-line HIV treatment for all populations. As well as being effective, treatments incorporating dolutegravir-based regimens have demonstrated greater adherence, due to fewer side effects, while presenting enhanced, safety, and reduced likelihood of drug resistance.

“This decision represents a milestone for public health in Colombia. Since the Ministry of Health initiated the administrative procedures earlier this year, over 120 civil society organizations, other government agencies, academia and international organizations including UNAIDS supported this process,” said Andrea Boccardi Vidarte, UNAIDS Director for the Andean Countries. "Through our local, regional and global offices, UNAIDS will continue supporting the government on the implementation of this landmark decision.” 

With this decision, the Colombian government estimates that it will be able to put 28 people on dolutegravir for the same price that it is allocated today to treat just one person. The implementation of the measure will allow the country to access less expensive, but just as effective, generic versions. A huge increase in reach with quality medicines which will save lives.

Colombia had already issued national guidelines in 2021 to prioritize dolutegravir as the recommended first-line antiretroviral treatment, in line with WHO recommendations. However, the high price of dolutegravir has remained an obstacle to expanding access and making it widely available to people living with HIV in the country.

This ruling will save lives in Colombia and across the region. The country hosts the largest number of Venezuelan migrants in the world (2.9 million as of October 2022). Recent studies have shown a 0.9% HIV prevalence among this migrant population, almost double the 0.5% HIV prevalence among the country’s adult population. 

“This decision provides the government with the legal conditions to manufacture or purchase more affordable versions of this essential first-line antiretroviral treatment for all people living with HIV in Colombia, including Venezuelan migrants”, said Ms Cabal.

Compulsory licensing is a provision in the World Trade Organization (WTO) Agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS Agreement). It enables governments to supply its citizens with generic versions of patented treatments either through domestic production or imports, ensuring health products’ prices are affordable.

The 2001 WTO Declaration on the TRIPS agreement and public health reaffirmed the rights of member states to make use of all flexibilities in the TRIPS agreement to protect public health, including compulsory licenses. More recently, in the 2021 Political Declaration on HIV/AIDS, countries committed to make use of TRIPS flexibilities, specifically geared to promoting access to medicines.

UNAIDS

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

UNAIDS

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

UNAIDS offers lessons from the AIDS pandemic on the Intergovernmental Negotiating Body Pandemic Accord Bureau text

GENEVA, 24 July 2023—The Joint United Nations Programme on HIV/AIDS (UNAIDS) offers lessons learnt from the HIV/AIDS pandemic to strengthen and sharpen the bureau text of the Pandemic Accord to ensure a truly robust response to current pandemics, and to prevent, prepare for and respond to pandemics of the future.

UNAIDS and the global response to AIDS have unique experience and insight over the past forty years in responding to pandemics. The global AIDS response has shown how effective a pandemic response can be which it outlined recently in its Global AIDS Update 2023 – The Path that Ends AIDS.

While COVID-19 increased HIV vulnerability and disrupted HIV service access for millions of people around the world, the AIDS response, systems, infrastructure and governance model also helped countries respond to both HIV and COVID-19. UNAIDS has a critical interest in protecting the gains in the HIV response, preventing future pandemics and health emergencies which impact people living with and affected by HIV and which could set back efforts to end AIDS by 2030.

Drawing on the more than a quarter-century as a global leader of the fight to end AIDS as a public health threat, UNAIDS offers the following lessons learned for strengthening the current bureau text of the Pandemic Accord:

General language

The current draft could be amended to incorporate much clearer, stronger language on the obligations of high-income countries (HICs) to ensure worldwide access to pandemic products and to proactively provide financial and technical support to enable pandemic responses in low- and middle-income countries (LMICs). The frequent use of “as appropriate” language could be replaced by clear language that conveys the obligation of states to act. In the current draft, much of the burden for prevention and surveillance falls on LMICs, without communicating clear obligations of HICs to assist and support LMICs. It could also have text that commits all countries to prioritise health and medical research.

Human rights and equity

While the draft identifies human rights and equity as core principles of pandemic preparedness, the draft could clarify language regarding the member states’ commitment to protect human rights and ensure equity in all aspects of pandemic prevention, preparedness and response (PPR). The accord could: reconsider the definition of “persons in vulnerable situations” (Art. 1); explicitly reference States obligations to protect and fulfil human rights within its “general principles” (Art. 3.1); mainstream concern for equity throughout provisions of the accord; emphasize formal and substantive equality, alongside non-discrimination, as general principles (Art. 3.1)

Equitable access

With respect to equitable access to pandemic-related products, the bureau draft uses language that suggests that recommended actions are advisory rather than obligatory. UNAIDS recommends that the draft :

• Clearly commit countries that possess pandemic-related medical technologies and knowhow to share it with LMICs in a timely and meaningful manner, including requirements in funding and purchasing agreements for institutions and companies in HICs to share intellectual property rights, technologies and knowhow with researchers and capable manufacturers in LMICs.
• Commit to provide robust financial and technical support for collaborative research between institutions in the North and South to build R&D capacity in LMICs – not only for pandemics and not only for manufacturing, but to enable LMICs to contribute to progress in science and technology for all of humanity.
• Countries to make full use of TRIPS flexibilities to address public health needs during a health emergency.
• Commit all states to waive intellectual property provisions for all pandemic-related products during pandemic and recovery periods.
• Commit Member States to provide political leadership and robust financial and technical support to build strong, flexible medical manufacturing capacity in LMICs before the next pandemic emerges. With future pandemics, surge support will be essential to adapt this capacity in LMICs to manufacture pandemic-relevant products.
• If and when demand for pandemic-relevant products outstrips supply during future pandemics, all Member States must commit to abide by WHO product allocation prioritization recommendations to ensure equitable access, with particular attention to the most vulnerable populations.

Access and benefit sharing

Although the draft specifies obligations among LMICs for actions pertaining to surveillance and the timely sharing of pathogens and data, the draft should be revised to commit Member States to ensure equitable access, including sharing the benefits and profits from the sale of these pathogens. Draw lessons from the Ebola where pathogens from Africa were shared but the medicines were stockpiled in the north leaving people in Africa waiting for charitable donations. The Accord should build on the precedence of the Pandemic Influenza Preparedness agreement (PIP) which facilitates sharing of pathogens and benefits both in terms of vaccines and profit.

Common but differentiated responsibility

While PPR is a shared responsibility of Member States, the draft could make clear that the nature and extent of responsibilities are differentiated based on each country’s financial and technological resources and capacities. As the effects of epidemics are felt most heavily in poor and vulnerable populations, countries that are home to these populations require additional assistance.

Inclusion of community and civil society

Community-led responses play critical roles in reaching marginalized communities with essential health messages and services during a pandemic – as both HIV and COVID-19 have shown – but communities remain under-resourced and inadequately integrated as key partners in national PPR efforts. The Pandemic Accord must acknowledge the central role of community-led responses and commit member states to include communities and civil society in decision-making, planning, preparation, implementation and monitoring.

Sustainable investments in health systems and infrastructure

Sustainable, resilient, well-resourced, equitable, human rights-based and people-centred health systems are essential to PPR and to efforts to achieve Universal Health Coverage. The HIV response has shown clearly how it is possible to leverage HIV investments to build stronger, inclusive, sustainable health and social service systems that respond to both HIV and other health threats. Drawing on previously recommended language on differentiated responsibilities based on national financial and technical capacity, the draft could clearly commit countries to invest major new public financing in health systems – ensuring a well-trained, well-remunerated health workforce (including community health workers); strengthening primary health care; ensuring access to health technologies (including those that are locally produced); and strengthening and effectively using health information systems.

Multisectoral governance

HIV has pioneered inclusive, accountable, participatory health governance across multiple sectors and with community, but there is a risk that PPR governance will be devised as a technocratic, top-down enterprise that does not include the central contributions of communities and civil society. The draft could insist that PPR governance mechanisms be fully inclusive of key stakeholders and integrated at national and regional levels to deal with current pandemics and future health crises. Language on whole-of-government and whole-of-society approaches should be strengthened.

Conclusion

Pandemics continue to exact enormous costs on societies across the world – an estimated 630,000 people died of AIDS-related causes in 2022, and long COVID will has lasting effects on human health and well-being and health infrastructure. In responses to HIV and COVID-19, too many countries and communities have been left to fend for themselves. Responding effectively to current and future pandemics requires the global community to summon the principles of solidarity, equity and people-centred action at the heart of the 2030 Agenda for Sustainable Development. Through learning by doing over decades, the HIV response has shown how it is possible to respond effectively to a pandemic. UNAIDS strongly encourages countries to take on board UNAIDS lessons learned when negotiating revisions to the bureau draft of the Pandemic Accord.

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.