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Countries facing “triple funding crisis” of insufficient climate finance, insufficient HIV funding, and crippling debt

GENEVA/BAKU, 21 November 2024—The climate crisis could disrupt HIV services and lead to increasing HIV risk for some of the most vulnerable populations, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and United Nations Development Programme (UNDP) have warned at the COP29 Climate Conference in Baku, Azerbaijan.

In a new report, the UN agencies warn that eroded public health infrastructure, heightened prevalence of diseases that interact with HIV, food insecurity, water scarcity, and the mass displacement of people – all likely to intensify due to climate change – could drive new HIV infections and lead to more AIDS-related deaths.

“The progress we have made tackling AIDS is fragile – and it could be unwound by runaway climate change,” said Winnie Byanyima, Executive Director of UNAIDS. “Some of the most climate vulnerable countries also have the highest HIV burden, and are the countries in the greatest debt, compounding injustice on injustice.  We need to find ways to ease the triple funding crisis of AIDS, climate, and debt, and invest in the communities on the front lines of these intertwined crises.”

Many of the countries at the sharp end of climate change are also facing the worst impacts of the AIDS epidemic, and climate change is likely to exacerbate the inequalities of AIDS, UNAIDS says. Of the 4,000 adolescent girls and young women aged between 15 and 24 years newly infected with HIV every week, 3,100 live in Sub-Saharan Africa, where severe heatwaves and drought could leave whole regions uninhabitable.

HIV-focused institutions are responding, with 70% of financing from the Global Fund to Fight HIV, Tuberculosis and Malaria set to go to 50 of the most climate-vulnerable countries. But many of these countries are facing a triple funding crisis, with insufficient climate finance, a US$ 9.5billion gap in HIV funding, and the crushing burden of sovereign debt.

Almost half of humanity live in countries spending more on servicing debt than on healthcare. In Western and Central Africa, countries are spending seven times more on repaying debt than on health. With 71% of public climate financing coming as loans rather than grants, the climate crisis will only make this problem worse.

Last year, Malawi was hit by Cyclone Freddy amid a cholera outbreak just as the nation was recovering from COVID-19. Some of the worst hit regions were those with the highest burden of HIV. Around 37 000 people living with HIV were displaced by the storm, forced to navigate overwhelmed services and shortages of medicines – and this is just one of many examples of how climate change is already impacting the HIV response.

At the report launch on the sidelines of the COP29 Climate Conference in Baku, governments will be urged to tackle inequalities, build proper leadership and governance systems, and provide sustainable financing to prevent a climate-induced AIDS crisis.

“At COP29 we can see increasing recognition that the climate crisis is compounding existing health challenges” said Marcos Neto, Director, Bureau of Policy & Programme Support, UNDP. “The AIDS response has shown us what is possible when communities most impacted, governments and institutions unite. By embedding HIV and health considerations into climate action, we can protect hard-won progress, build resilience for the future, and leave no one behind.”

[ENDS]

Notes

On Thursday 21 November, UNAIDS and UNDP are hosting a discussion on HIV and climate change at COP29 in Baku, Azerbaijan at the Azerbaijan Pavillion from 14:00-15:00 AZT.

The Climate Crisis and HIV: A Policy Brief from UNDP and UNAIDS is available here.

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.

There are around 1.4 million people living with HIV in China and women make up around 23.7% of them, according to the latest data from Chinese health authorities. Among those living with HIV are pregnant women who are in a particularly vulnerable position due to the stigma surrounding the disease.

In order to counter such stigma and discrimination, women living with HIV and Hepatitis B came together at The Voice of Resilience event to tell their stories and to call for additional resources for community-based organizations (CBOs) working on the frontlines providing services for women living with and affected by HIV.

In 2023 alone, more than 5,000 pregnant women were diagnosed with HIV and over 400,000 with hepatitis B, and some of them were diagnosed at very late stage to be able to receive HIV services to prevent transmission to their children, according to China’s National Health Commission. Even though services are in place to prevent the transmission of HIV to their babies, discrimination, including denial of healthcare, obstructs women from accessing such services.

“I received a call from the doctor telling me that I couldn’t receive services from their hospital because I was HIV positive,” explained Xia Jing, one of the mothers, after she went to a general hospital in Beijing for a routine maternal exam. She still cannot hold her tears when she remembers her traumatic experience. She challenged back and told the doctor r that under the law they had no right to reject her.

She was eventually referred to Beijing’s You’an Hospital, a designated hospital for infectious diseases and people living with HIV where she delivered her baby. Now she is a happy mother of a four-year-old boy. Doctor Zhu Yunxia was the doctor who helped Jing deliver her baby. Dedicated to her job for more than 30 years, she is proud of having helped so many women deliver healthy babies. She calls for empathy with people facing discrimination and unfair treatment and urges all people to look at women living with HIV without prejudice.

“Stigma undermines public health objectives by creating barriers to accessing health and social services and can reduce the quality of the services that members of affected communities receive,” said Mark Vcislo, the First Secretary at Canadian Embassy to China, which has supported the work to tackle stigma. He called for breaking down “the prejudices that can prevent and deter marginalized communities, including persons living with HIV, from accessing the health and social services they need and deserve.”

Community-based organizations (CBO) are vital support for women living with HIV. Sister Xin, for instance, who herself received help from community volunteers when she was first diagnosed with HIV, created Firefly, a community-based organization that has help more than 20,000 women living with HIV in the last 20 years. Zhang Yu whose CBO supports women living with HIV in rural areas of China’s southwestern Yunnan Province, called for more resources for CBO’s work. “CBOs are struggling with their survival due to lack of resources,” she said. “I sincerely hope the government, the charity organizations and everybody can support us to continue our work.”

China has developed a strong and ambitious plan to significantly reduce the transmission rates of HIV, syphilis, and hepatitis B by 2025 outlined in China Women’s Development Plan and Healthy China 2030. China has achieved around 99 percent national screening rates among pregnant women living with HIV over the past five years. In 2023 alone, more than 9 million pregnant women have received HIV testing services. 

The Chinese government has partnered with UN agencies for the “last mile” by building a patient-centred and family-centred community service model to enable a holistic set of services and help break the barriers for both mothers and infants.

“Thanks to the combination of development of technology and social progress, women living with HIV can today give birth to healthy babies,” said Sister Xin.

Read the profile of the storytellers and more unsung community heroes committed to  helping mothers and babies: http://www.unaids.org.cn/page122?_l=en&article_id=1233.

GENEVA, 19 August 2024—UNAIDS is calling on the international community to respond swiftly and decisively to the World Health Organization’s declaration of the mpox outbreak in several African countries as a public health emergency of international concern. The move came after the Africa Centres for Disease Control and Prevention (Africa CDC) made a similar declaration for the region.

“The emergence of a new and more contagious variant of mpox, and the devastating impact it is having on communities, across Africa, especially those most vulnerable including from HIV and AIDS, is alarming,” said Angeli Achrekar, UNAIDS Deputy Executive Director, Programme. “We must call on international efforts to focus on ensuring vaccines and treatments are accessible and available to all who need them and draw on the experience of the AIDS movement to ensure a response rooted in solidarity, compassion, inclusion, and equity.”

Many communities affected by mpox face discrimination, similar to people who are affected by HIV and AIDS. Stigma and discrimination undermine epidemic responses, driving people with symptoms underground and hindering efforts to protect public health. UNAIDS urges people to show compassion and solidarity to people affected, not intolerance and discrimination. We at UNAIDS, across the entire Joint Programme, also emphasize the crucial role of involving communities in every stage of the response—from development to implementation and monitoring.

The emergence of the 2024 mpox variant once again demonstrates the need for international, multisectoral coordination and solidarity to end pandemics. The Joint United Nations Programme on HIV/AIDS, is committed to bring its expertise and support to countries to help.  UNAIDS urges all media covering the crisis to follow the regular updates being issued by WHO and Africa CDC.

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.

Despite significant gains in many countries, critical gaps continue to undermine efforts to end AIDS in children

GENEVA/MUNICH, 22 July 2024—Despite progress made in reducing HIV infections and AIDS-related deaths among children, a new report released today by the Global Alliance for Ending AIDS in Children by 2030 shows that an urgent scale up of HIV services in countries worst affected by the pandemic is required to end AIDS by 2030.

The report, Transforming Vision Into Reality, shows that programmes targeting vertical transmission of HIV have averted 4 million infections among children aged 0-14 years old since 2000. Globally, new HIV infections among children aged 0-14 years old have declined by 38% since 2015 and AIDS-related deaths have fallen by 43%.     

Among the 12 Global Alliance countries, several have achieved strong coverage of lifelong antiretroviral therapy among pregnant and breastfeeding women living with HIV, with Uganda nearing 100%, United Republic of Tanzania at 98%, and South Africa at 97%. Mozambique has achieved 90% coverage, with Zambia at 90%, Angola at 89%, Kenya at 89%, Zimbabwe at 88%, and Cote d'Ivoire at 84%.

“I applaud the progress that many countries are making in rolling out HIV services to keep young women healthy and to protect babies and children from HIV,” said UNAIDS Executive Director, Winnie Byanyima. “With the medicines and science available today, we can ensure that all babies are born – and remain – HIV-free, and that all children who are living with HIV get on and stay on treatment. Services for treatment and prevention must be ramped up immediately to ensure that they reach all children everywhere. We cannot rest on our laurels. The death of any child from AIDS related causes is not only a tragedy, but also an outrage. Where I come from, all children are our children. The world can and must keep its promise to end AIDS in children by 2030.”

Global Alliance countries are innovating to overcome barriers and accelerate progress towards ending AIDS in children. However, despite advances neither the world nor Global Alliance countries are currently on track to reach HIV-related commitments for children and adolescents and the pace of progress in preventing new HIV infections and AIDS-related deaths among children has slowed in recent years.

“Accelerating the delivery and uptake of HIV services for children and adolescents is a moral obligation, and a political choice,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “Twelve countries are demonstrating they have made that choice, but significant challenges remain. While we have made progress in increasing access for pregnant women to testing and treatment to prevent vertical transmission of HIV, we are still far from closing the paediatric treatment gap. We need to further strengthen the collaboration and reach of the Global Alliance, and we must do this work with focus, purpose and in solidarity with all affected mothers, children, and adolescents.”

Around 120 000 children aged 0-14 years old became infected with HIV in 2023, with around 77 000 of these new infections occurring in the Global Alliance countries. AIDS-related deaths among children aged 0-14 years old numbered 76 000 globally with Global Alliance countries accounting for 49 000 of these unnecessary deaths. Vertical transmission rates remain extremely high in some locations, particularly in Western and Central Africa, with rates exceeding 20% in countries including Nigeria and the Democratic Republic of the Congo.

“In the fight against HIV, we must do a much better job for children,” said Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which provides funding for HIV programmes in over 100 countries through a country-led partnership model. “In support of national programmes, we have been procuring the latest dolutegravir-based paediatric treatment regimens at negotiated prices. Our investments in laboratory systems are helping ensure exposed infants are rapidly tested and that those that test positive are quickly initiated on age-appropriate antiretroviral treatment. Differentiated testing and treatment approaches are helping close the diagnostic gap and ensuring more child-centred service delivery.”

It is concerning that the treatment gap between adults and children continues to widen.

“Just 57 per cent of children living with HIV receive life-saving treatment, compared to 77 per cent of adults,” said UNICEF Associate Director HIV/AIDS, Anurita Bains. “Without early and effective testing and treatment, HIV remains a persistent threat to the health and well-being of children and adolescents and puts them at risk of death. To close the treatment gap, we must support governments to scale up innovative testing approaches and ensure children and adolescents living with HIV receive the treatment and support they need.”

In 2023, there were 210 000 new infections globally among young women and girls aged 15—24 years old (130 000 in Global Alliance countries), four times higher than the 2025 goal set at 50 000. Preventing new infections among this age group is critical both to protect the health and wellbeing of young women and to reduce the risk of new infections among children.

Gender inequalities and human rights violations are increasing women’s vulnerability to HIV and diminishing their ability to access essential services. Globally, nearly one in three women have encountered some form of violence during their lifetime, with adolescent girls and young women disproportionately affected by intimate partner violence. In the four Global Alliance countries with available data, countries are not currently on track to achieve the target of ensuring that by 2025 less than 10% of women, key populations and people living with HIV experience gender-based inequalities and gender violence.

"It has been remarkable to see how many more children's lives can be saved when all stakeholders and partners come together to commit to end AIDS in children. While much progress has been made, notably through the successful introduction of pediatric dolutegravir, large gaps still remain across the pediatric cascade and we must recommit ourselves with purpose and innovation to fulfill the promises we have made by 2025 and beyond,” said Ambassador John N. Nkengasong, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy.

The Global Alliance for Ending AIDS in Children by 2030 was launched in 2022 by WHO, UNICEF and WHO to reinvigorate the paediatric HIV agenda. It has now grown, and in addition to the United Nations agencies, the alliance includes civil society movements, including the Global Network of People living with HIV, national governments in the most affected countries, and international partners, including PEPFAR and the Global Fund. Twelve countries are members: Angola, Cameroon, Côte d'Ivoire, The Democratic Republic of the Congo (DRC), Kenya, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe.

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.

In April, at the United Nations Headquarters in New York, governments renewed their commitment and determination to accelerate the implementation of the Programme of Action of the 1994 International Conference on Population and Development (ICPD), the principles of which are embedded in the United Nations Sustainable Development Goals (SDGs), including commitments to ensure universal access to sexual and reproductive health-care services and to advance reproductive rights.1

Significant progress has been made over the past three decades. Since 1990, the number of women using modern contraception has doubled. Since 2000, maternal mortality has declined by 34 per cent. By 2022, access to HIV treatment had averted an estimated 20.8 million deaths globally. More recently, however, this progress has stalled and in some instances is reversing. Looking forward, the prospect of continued progress is far from guaranteed. The ongoing effects of the COVID-19 pandemic, persistent and increasing conflict, climate change, rising inequalities and deepening polarization are all undermining access to quality, essential health services. These setbacks demand urgent action.

Women and girls are disproportionately affected by these challenges, hindering their right to make informed decisions and exercise full bodily autonomy without coercion, violence or discrimination – fundamental human rights. Equitable and sustainable access to human rights–based sexual and reproductive health interventions and information remains beyond the reach of many – especially marginalized women, adolescent girls and those living in humanitarian crises and conflict zones. The latest data show that close to half of women of reproductive age cannot make their own informed decisions about whether or when to become pregnant, and many still lack the autonomy and agency to fully exercise their reproductive rights.

On World Population Day, as UN agencies mandated to advance the health and rights of all people and ensure no one is left behind, we call upon the global community, including governments, donors, civil society organizations, and the private sector to strengthen access to a comprehensive package of sexual and reproductive health services as part of universal health coverage, delivered through resilient health systems including at the primary healthcare level. We underscore the need to implement evidence-based, normative guidance to strengthen access to affordable, high quality and rights-based care. To ensure services are acceptable to all, efforts are needed to eliminate stigma and discrimination and dismantle harmful social and gender norms.

We also call for accelerated access to comprehensive sexuality education and strengthened action across social sectors, such as education and gender, to enhance the health and well-being of girls and women throughout their lives. Promoting comprehensive sexual and reproductive health and rights is not only the right thing to do – it is also the smart thing to do. Investing in women’s and girls’ reproductive rights and agency and expanding access to services is proven to have remarkable returns, including in terms of social wellbeing, economic prosperity and peace, which our world so desperately needs. Additional financing from all sources – domestic, international, public, private – is essential to create long-term positive outcomes for women and girls.

We must also urgently support the increasing efforts of young people, women and communities to speak up about sexual and reproductive health concerns and to design and deliver solutions that respond to their needs and to the realities of a changing world, where climate change in particular, affects sexual and reproductive health and rights. An inclusive, bottom-up approach to designing and delivering health interventions with and for communities can deliver more sustainable results and reach those who are furthest left behind.

We urge the public and private sectors to collaborate in exploring cutting-edge technologies like telemedicine, artificial intelligence, big data analytics and predictive modeling to bridge geospatial gaps and expand access to essential services, particularly in remote and underserved areas. At the same time, we call on innovators to address the risks inherent in these new technologies, including gender gaps in access, technology-facilitated gender-based violence, and systematic biases embedded in tech design.

Finally, we call upon governments, communities, civil society organizations and the private sector to unite to prioritize universal access to comprehensive sexual and reproductive health, in ways that advance gender equality and promote the full realization of human rights, in line with the groundbreaking vision of the ICPD Programme of Action. We ask for more than a commitment, more than business as usual — this is an appeal to collaborate and innovate in ways that ensure everyone can realize their rights to health, dignity and security. As we head towards the Summit of the Future at the United Nations General Assembly in September, now is the time to act boldly and decisively, forging a path towards a more just, equitable and sustainable world for all.

Thirty years ago in Cairo, 179 governments adopted a framework that recognized sexual and reproductive health and reproductive rights and the empowerment of women and girls as foundational pillars of sustainable development – the landmark Programme of Action of the International Conference on Population and Development. As UN agencies, we stand together committed to advancing comprehensive sexual and reproductive health and rights, which are integral to everyone’s right to the enjoyment of the highest attainable standard of physical and mental health and essential for the achievement of gender equality.

[1] https://www.un.org/development/desa/pd/content/regional-reviews-icpd-programme-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.

Girls’ education as a tool to prevent HIV infection has been centered at the 1st African Union Pan-African Conference on Girls’ and Women’s Education in Africa. This followed African leaders designating education as the 2024 African Union theme of the year.

At a high-level side event hosted by the Education Plus Initiative on the first day of conference held at the African Union Commission in Addis Ababa, Ethiopia, leaders, girls’ and women’s networks and advocates called for greater investments in girls’ education.

“Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them,” said UNAIDS Executive Director, Winnie Byanyima. “We can get all our girls and boys to complete secondary education; that should be our legacy."

UNICEF calculates that 34 million girls in sub-Saharan Africa are out of secondary school. According to the Global Education Monitoring (GEM) Report 2023, in all regions in Africa, there are more girls out of school at the secondary level than boys, with gender disparities worsening as children move up to higher levels of education in favour of boys over girls. In sub-Saharan Africa, less than half of adolescent girls complete secondary education, their percentage standing at 42% and there has been no progress at all in closing this gap in the past 20 years.  Sub-Saharan Africa is the region furthest from parity at the expense of girls, with no progress since 2011 at the lower secondary level and since 2014 in upper secondary.

Gender is a key factor linked to disparities in enrolment, retention, completion, and learning outcomes through social conditioning, gender-based differences in parental expectations and education-related investments, child marriages and early childbearing, female genital mutilation, child labour, gender-based violence, period poverty and discrimination.

More than forty years into the HIV response, Africa remains an epicenter of the AIDS epidemic with adolescent girls and young women being disproportionately affected. Every week 3100 adolescent girls and young women acquired HIV in sub-Saharan Africa. Every three minutes, an adolescent girl or young woman aged 15-24 years acquired HIV in 2022 in sub-Saharan Africa.  Adolescent girls and young women aged 15-24 years in the region were more than three times as likely to acquire HIV than their male peers in 2022.

UN agencies, African Union representatives, government ministers, and young women leaders called for accelerated actions to translate commitments to action through leveraging girls' education for gender equality and preventing HIV, child marriage, teenage pregnancies, violence, gender-related stigma and discrimination in Africa.

Speakers emphasized the connection between health and education. Ministers spoke about key policy reforms and best practices aimed at promoting girls' education, including creating safe and inclusive school environments, strategies to get girls into secondary school, and the readmission policy that addresses high dropout rates due to pregnancy.  UN co-leads emphasised the need for improved collection of data disaggregated by sex and other relevant population characteristics to better understand educational participation, progression, and learning, and using gender-sensitive data for policymaking and planning. 

Other issues highlighted included the integration of digital literacy programs into the secondary education and vocational training curriculum to facilitate smooth transitions from school to employment; integrate gender equality into all aspects of the education system, including curriculum-based comprehensive sexuality education  and life skills, address gender-based violence  within schools and discriminatory laws and practices, and access to information, non-discriminatory HIV and sexual and reproductive health services access.

Young women leaders spoke on the role of partnerships and young women's leadership. Participants highlighted the upcoming 30th anniversary of the Beijing Declaration as an opportunity moment to accelerate accountability and commitments, as well as the CSW Resolution 60/2, Women, the Girl Child and HIV and AIDS as significant mechanisms to address political and resource gaps so no woman or girl is behind in the HIV response.

Education Plus is a rights-based, gender-responsive action agenda to ensure adolescent girls and young women have equal access to quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.  Co-led by five UN agencies, the initiative builds on existing frameworks like the Transforming Education Summit, the Continental Education Strategy for Africa (CESA) and the Dakar Education for All (EFA) Declaration to push for access and completion of education for women and girls in Africa.

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.

Debt restructuring and reforms to the global tax system are urgently required to finance health systems and other essential services

WASHINGTON/GENEVA, 16 April 2024—As financial leaders meet in Washington for the annual Spring Meetings of the World Bank and the International Monetary Fund, UNAIDS is calling for increased and sustainable investments in the global response to HIV and other health threats.

“At a time of multiple geo-political and economic crises, the need to tackle the financial constraints threatening the global fight against HIV and other health threats has never been greater,” said UNAIDS Executive Director Winnie Byanyima, “At their Spring Meetings in Washington, global financial leaders must find the courage to reject calls for more fiscal restraint and embrace measures that can release the necessary investments to save millions of people and transform the lives of the most vulnerable all over the world, including women and girls.”

As the world struggles to achieve many of the health goals set out in the United Nations Sustainable Development Agenda, investments in the HIV response have returned extraordinary gains for humanity. Since 2010, AIDS-related deaths have declined by 51% worldwide and new HIV infections have fallen by 38%.

But more than 9 million people are still waiting to receive HIV medication that will stop them dying from AIDS and there were still 1.3 million new HIV infections in 2022. Increased investments in the HIV response today are crucial to reach everyone who needs treatment and to prevent new infections that will only increase future treatment costs.      

However, there is a huge shortfall in the global investments required to end AIDS as a global health threat by 2030. A total of US$ 20.8 billion (constant 2019 US$) was available for HIV programmes in low- and middle-income countries in 2022––2.6% less than in 2021 and well short of the US$ 29.3 billion needed by 2025.

In many countries with the most serious HIV pandemics, debt service is consuming increasingly large shares of government revenue and constraining public spending.

In Angola, Kenya, Malawi, Rwanda, Uganda, and Zambia, debt service obligations exceed 50% of government revenues. Last year, in GDP terms, Sierra Leone spent 15 times more on public debt servicing than on health, 7 times more on public debt servicing than on education and 37 times more on debt servicing than on social protection. For Angola, debt servicing was 7 times more than investments on health, 6 times more than on education and 14 times more than on social protection.

UNAIDS maintains that reform to the global financial system including the cancellation of debt, the introduction of fairer and affordable financing mechanisms and global taxation reform is key to releasing transformative funding for health, education and social protection also required to end AIDS as a public health threat by 2030.

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/GENEVA, 15 April 2024—A new report released today by UNAIDS and Friends of the Global Fight Against AIDS, Tuberculosis and Malaria shows how countries are leveraging their HIV responses to both ensure impact on the HIV response and also to improve broader national health and well-being. The report finds that investing now to end AIDS as a public health threat by 2030 will not only follow through on the commitment to end the pandemic but also magnify the broader health benefits of HIV specific investments.

The report, Expanding the HIV response to drive broad-based health gains, profiles country examples from Colombia, Côte D’Ivoire, Jamaica, South Africa, Thailand and Uganda. Experiences in these six countries indicate that strengthened HIV responses have contributed to broader health benefits. Far from being in isolation, HIV treatment, prevention and care programmes are also helping to build more robust health systems that enhance access to people-centred care and bolster pandemic preparedness.

For example, the integration of HIV and non-HIV specific services is increasing access to holistic, comprehensive health services needed for people living with and affected by HIV. In Côte d’Ivoire, Jamaica, South Africa and other countries, service platforms originally developed to respond to HIV are leveraged to provide a broad range of health services, including prevention, screening and treatment of noncommunicable diseases.

HIV care is inspiring models of care in other areas. In Colombia, a model of care specifically developed for HIV is now being used for the provision of comprehensive, coordinated care for other chronic diseases, including diabetes, cancer and cardiovascular diseases.

Health system components strengthened through HIV investments are also improving a wide array of health outcomes in addition to those related to HIV and AIDS. In Côte D’Ivoire, laboratory systems strengthened through HIV investments are contributing to diagnostic services for multiple health issues, including maternal and child health, tuberculosis, viral hepatitis and COVID-19.

As progress lags in achieving many of the health targets of the Sustainable Development Goals, efforts to end AIDS stand out as a beacon of hope. Since 2010, annual new HIV infections and AIDS-related deaths have declined globally by 38% and 51%, respectively.

Angeli Achrekar, Deputy Executive Director of Programmes at UNAIDS, said “This report highlights the need for more purposeful efforts by countries to identify and capitalize on ‘win-win’ opportunities that efficiently and effectively increase the reach of health services to accelerate progress towards ending AIDS as a public health threat by 2030 and to reach other health-related Sustainable Development Goals.”

The report concludes with a series of recommendations to further leverage the wider health benefits through increased and sustained HIV investments. It says that particular attention is required to maintain and further strengthen investments in robust, sustainable community networks of people living with HIV and key populations, including networks led by women and young people.

Chris Collins, President and CEO of Friends of the Global Fight, said: “The HIV response is a force for multistakeholder engagement, human rights-based programming, community leadership and constant innovation. These are strengths we need to bring to health services more broadly, including pandemic preparedness and Universal Health Coverage. But this catalytic role for the HIV response is only possible if governments, donors and communities invest adequately and commit to accelerated progress against HIV.”

To join the April 16 (09:00 ET/15:00 CET) webinar highlighting the report findings, please register here.

Thank you to the Elton John AIDS Foundation for its support of this project.

Friends of the Global Fight

Friends of the Global Fight Against AIDS, Tuberculosis and Malaria advocates for U.S. support of the Global Fund, and the goal to end the epidemics of AIDS, tuberculosis and malaria. For more information about Friends of the Global Fight, visit www.theglobalfight.org.

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.

The humanitarian crisis in Haiti is exacerbating the vulnerability of people living with or affected by HIV, particularly women, girls, and key populations. The situation has deepened existing inequalities, and multiplied the risks faced by marginalised communities. In the face of this adversity, UNAIDS continues to work with partners to ensure that people living with or affected by HIV have access to life-saving HIV services, including treatment and prevention services.

For example, in the West Department, over 50,000 people are receiving antiretroviral treatment and are at high risk of disruption. HIV prevention and health care services also face disruption. The recent violence continues to leave thousands of families traumatized. Thousands of people now find themselves unsafe and exposed to all types of risks. Displaced people and vulnerable populations need emergency aid and safe, protected spaces.

"Communities already at risk of HIV in Haiti have been made even more vulnerable, and people living with HIV are facing greater challenges in accessing treatment and care", said UNAIDS Regional Director for Latin America and the Caribbean, Luisa Cabal. "Together with all the United Nations agencies, and with partners, UNAIDS is advocating for safe and unhindered humanitarian access, and the protection health facilities and health workers."

The situation in Haiti is dire, with over 5.5 million people in need of assistance, including more than three million children. The World Food Programme has noted that around 1.4 million Haitians are "one step away from famine." The UN Humanitarian Coordinator for Haiti has noted that the humanitarian response plan is only six percent funded. Less than half of the health facilities in Port-au-Prince are functioning at their average capacity, and there is a pressing need for safe blood products, anesthetics, and other essential medicines.

In the face of these challenges, UNAIDS and its Cosponsors, together with the United States President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Observatory of Civil Society for HIV/TB/Malaria are supporting Haiti’s National AIDS Program.

UNAIDS has been working with the Ministry of Health and Population Unit for Management of Health Emergencies to support HIV treatment delivery. This support includes programmes to provide a broad package of support to affected communities. For example, together with the United Nations High Commissioner for Refugees (UNHCR) and in collaboration with the Organisation de Développement et de Lutte contre la Pauvreté (ODELPA), UNAIDS supports girls and women who are survivors of gender-based violence by training community leaders and granting empowerment funds for women and men's income-generating activities.

"We are working to ensure that people living with HIV have continuity of antiretroviral treatment as well as access to essential needs, especially including the most vulnerable people across the most affected areas," explains Christian Mouala, UNAIDS Country Director for Haiti. "UNAIDS remains committed to not let the humanitarian crisis disrupt the progress that has been made in the HIV response.  The United Nations stand together to support the people of Haiti."