It is estimated that worldwide there are nearly 12.7 million people who inject drugs. Approximately 1.7 million, or 13%, are also living with HIV. Injecting drug use is found in nearly every country. Typically, when heroin injection reaches a new community, there is an exponential increase in HIV transmission. People who inject drugs continue to face punitive legal environments, a variety of human rights abuses and have poor access to services; these and other factors combine to exacerbate their risks of acquiring HIV.

There are approximately 231.5 million international migrants. Combined with some 740 million internal migrants, this means that there are about 1 billion people on the move at any given time. Migration can place people in situations of heightened vulnerability to HIV, and has been identified in certain regions as an independent risk factor for HIV (3–5). In a majority of countries, undocumented migrants face complex obstacles, such as a lack of access to health-care services or social protection. Social exclusion also leaves migrants highly vulnerable to HIV.

Every year, 30 million people spend time in prisons or closed settings and 10 million are incarcerated at any given point in time. Virtually all will return to their communities, many within a few months to a year. Health in prisons and other closed settings is thus closely connected to the health of the wider society. Prisons are often overcrowded due to inappropriate, ineffective and excessive criminal laws. People who are already more likely to be exposed to HIV, including people who use drugs, sex workers, and gay men and other men who have sex with men, are overrepresented in prisons and other closed settings. Overcrowding increases vulnerability to infections such as HIV, tuberculosis and hepatitis. Prisoners are also at risk of violence and disruption in HIV prevention and treatment services, including access to harm reduction measures.

Worldwide, there are approximately 880 million adolescent girls and young women aged 15–24 years. Despite making up 12% of the world’s population, this population is often left without a voice or control of their own bodies. Gender-based violence and limited access to health care and education, coupled with systems and policies that do not address the needs of young people, are obstacles that block adolescent girls and young women from being able to protect themselves against HIV, particularly as they transition into adulthood.

After more than 30 years of the HIV epidemic—and an unprecedented medical and social response—discrimination, violence, harmful gender norms and related stigma continue to pose challenges to an effective HIV response. The findings of these assessments indicate that gender-related barriers pose significant obstacles to the uptake of services that prevent new HIV infections among children and keep mothers alive—obstacles that require urgent attention. Without dedicated attempts to overcome these gender-related barriers, current efforts will meet with limited success, and the needs and rights of both women and children will remain compromised.

Since the start of the AIDS epidemic, more than 78 million people have been infected with HIV and 39 million have died. Acquiring HIV no longer means certain death. A person on HIV treatment in a high-income setting now has nearly the same life expectancy as a person who does not have the virus. However, only two out of five people living with HIV have access to antiretroviral therapy. Among people who do have access, great inequities exist. People living with HIV are being left behind because they are not benefitting from health care, employment, education or social protection. This is often due to stigma, discrimination, prohibitive laws and policies or a lack of services.

We are encouraged by the progress made by countries in reducing the number of children newly infected with HIV. Two years have passed since the launch of the Global Plan, when countries embraced the goal of moving towards eliminating new HIV infections among children and keeping their mothers alive. Since then, there has been momentum in scaling up access to HIV prevention and treatment services for women and children – especially in the 21 Global Plan priority countries in sub-Saharan Africa. Ghana and South Africa have led the way, with the largest decreases in the numbers of new HIV infections among children from 2009 to 2012.

It is time for the international community to face the fact that we have a crisis in education. We must be clear that if children are forced out of school, their governments and communities are also failing. As we approach 2015, we must have unwavering support for achieving and exceeding the global education goals we have set for ourselves.