Events

NEW YORK/GENEVA, 27 September 2024—At the 79^th United Nations General Assembly (UNGA79) and the Summit of the Future in New York, global leaders called for the revitalization of multilateralism to address pressing global crises, drawing on the success of the global AIDS response as a model of hope and global solidarity.

"Multilateralism is not a theory – it is the way we save lives and keep the world secure,” Winnie Byanyima, Executive Director of UNAIDS, told the General Assembly. “When leaders work together for a common mission – anything is possible.”

At a special event convened by UNAIDS, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and the Global Fund to Fight AIDS, Tuberculosis, and Malaria on 24 September 2024, leaders from governments, communities, business, and international organizations all testified to how multilateralism had driven the extraordinary gains made in the fight against AIDS, and how the path to addressing other global challenges had been illuminated by the global HIV response.

“The AIDS response shows what is achievable when leaders unite, when communities are empowered, when inequalities are tackled, when human rights are protected and when science-based policy is backed by political will,” said United Nations Deputy General-Secretary, Amina Mohammed.

UNAIDS data shows that at the end of 2023, more than 30 million people were accessing life-saving HIV treatment, compared to just 7.7 million in 2010. The data also show that since 2010, AIDS-related deaths have been halved, and new HIV infections among children have been reduced by 62%.

Across the week of the UN General Assembly, leaders set out concrete commitments to ending AIDS by 2030. These include closing gaps in access to HIV prevention, treatment and care, ending stigma and discrimination, accelerating innovation and access to new HIV technologies, and mobilizing domestic and donor resources for the HIV response.

UNAIDS set out how ensuring the end of AIDS as a public health threat, and enabling the success of the Sustainable Development Goals, require bold action to tackle global inequalities. Ms Byanyima shone a light on the financing crisis which is choking sub-Saharan Africa, leaving health and HIV services chronically underfunded. "Public debt needs to be urgently reduced and domestic resource mobilization strengthened to fully fund the global HIV response and end AIDS by 2030," said Ms. Byanyima.

Two young HIV activists, Ibanomonde Ngema from South Africa and Jerop Limo from Kenya, supported by UNAIDS to meet leaders at the UN General Assembly, called on governments to work with young people as partners. "Young people are key to ending AIDS. Leaders need to listen to us and include us in policy-making to ensure the progress made is sustained," said Jerop Limo.

Watch Special Event: Revitalized Multilateralism: Recommitting to Ending AIDS 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.

Global leaders unite to recommit to ending AIDS during the 79^th United Nations General Assembly in New York

NEW YORK/GENEVA, 24 September 2024—The extraordinary advances made in the global HIV response are a success story of multilateralism. At the end of 2023, 30.7 million people out of a total of 39.9 million people living with HIV worldwide were on life-saving treatment — four times higher than the 7.7 million who were on treatment in 2010. Since 2010, AIDS-related deaths have been halved and new HIV infections among children have been reduced by 62%.

At a special event at the UN General Assembly, co-convened by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria, leaders pledged to sustain and accelerate investments, political leadership and policy reforms that will continue the momentum needed to end AIDS and sustain progress beyond 2030.

UNAIDS data shows that the end of AIDS as a public health threat is achievable by 2030, if countries, communities and partners close the gaps holding back progress.

The United Nations Deputy General-Secretary, Amina Mohammed, said the AIDS movement stood out as a beacon of hope and resilience and thanked leaders for committing to end AIDS by 2030: “The AIDS response has been a powerful testament to what is achievable when leaders unite, when communities are empowered, when inequalities are tackled, human rights are protected and when science-based policy is backed by political will.”

UNAIDS Executive Director Winnie Byanyima told the leaders making commitments, “you have proven the power of global solidarity, you have shown that multilateralism is not a theory – it is the way we save lives and keep the world secure. Ending AIDS is a political and financial choice. Today I am confident that you will make it a reality.”

Jerop Limo, a young Kenyan activist living with HIV, reminded leaders about the life-changing impact of progress in the HIV response: “As world leaders, your achievement in the HIV response is not only measured in numbers. Those numbers are me.”

Countries, communities and partners from around the world shared renewed commitments, include ensuring HIV prevention and treatment reaches everyone in need; ending HIV-related stigma and discrimination; accelerating research and innovation; and mobilizing additional domestic resources for HIV to sustain the progress in the HIV response.

A selection of quotes from leaders

President George W. Bush, in a video message recorded for the event, emphasized the need for steadfast commitment to reach global goals:

“In 2003, my administration launched PEPFAR with bipartisan support from Congress. Nearly 22 years later, PEPFAR has saved more than 25 million lives, and more than 5 million babies have been born HIV free. We are on the verge of an AIDS-free generation but at this critical moment the people of Africa still need our support. We should be proud of PEPFAR’s tremendous successes, and we should keep going until the job is done.”

William Ruto, President of Kenya:

“The undeniable success and impact of Kenya’s response to HIV demonstrates the potential of strong partnership. I must emphasize that our steadfast commitment to multilateralism has been the cornerstone of these achievements, enabling us to implement high impact interventions that have saved lives.”

Russell Dlamini, Prime Minister of Eswatini:

“The HIV response is our collective responsibility. Our journey is far from over and HIV/AIDS remains unfinished business. The 2030 target of ending AIDS as a public health threat may not be achieved unless we revitalize multilateralism and multisectoral approaches. Predictable and sustained funding for HIV/AIDS must be increased. Today I would like to take this opportunity to ask all stakeholders to recommit to supporting the HIV response.”

Terrance Michael Drew, Prime Minister of St Kitts and Nevis:

“It will be challenging for the Caribbean to maintain the gains we have made without the continued relationship with the international community. We have gained much but if we take our eyes off the ball we can lose much and what we have gained we should try not to lose. We cannot take our foot off the pedal but must continue to press until we get to the point where HIV/AIDS is no longer a public health crisis.”        

John Nkengasong, Ambassador-at-Large and Coordinator of United States Government Activities to Combat HIV/AIDS Globally:

“We cannot be tired in the fight against HIV/AIDS. HIV/AIDS will not be tired with us. It is here with us. On behalf of PEPFAR we are committed to sustaining people on life saving treatment. Second, we are committed to working in partnership with everyone here to ensure we close the inequity gaps.”

Peter Sands, Executive Director of the Global Fund to fight AIDS, TB and Malaria:

“Two decades ago, AIDS was claiming millions of lives with devastating consequences for families and communities around the world. Together, we joined forces and rejected this injustice, forcing this disease into retreat. That remarkable progress we have made can be an inspiration for ending AIDS as a public health threat for good. It is a goal within our grasp. That requires reaching all people in need of HIV prevention and treatment services and breaking down all barriers to health services.”

Ms. Minata Cessouma Samate, African Union Commissioner for Health, Humanitarian Affairs & Social Development:

“There has been major progress in the last four decades of the AIDS response but to end AIDS this commitment must continue. On the African continent we need continued engagement and funding—for primary healthcare and to end AIDS. The AU commission is engaged but we need international support to ensure that everyone has access to quality HIV treatment and healthcare services and we need the transfer of technologies to be able to produce quality treatments on the continent. It is multilateralism that will allow us to end AIDS in Africa.”

Dr. Aaron Motsoaledi, Minister of Health of South Africa:

“South Africa has the largest burden of HIV in the world with 7.8 million people living with HIV and 5.8 million are on antiretroviral treatment, and we are in the process of putting 2 million more people on treatment. With domestic financing and with solidarity from multilateralism we are very confident that we can end AIDS by 2030.”

Dr. Shrimati Anupriya Patel, Minister of State for Health of India:

“This platform emphasizes the multilateralism needed to achieve the SDG goal of ending AIDS as a public health threat by 2030. Breaking the silence and building synergies is the mantra of the government of India and we are committed to achieving the target of ending AIDS as a public health threat by 2030. It is imperative to consolidate the gains made in this journey. I’m confident that with our collective efforts and genuine partnerships, we can build a future towards a healthier world.”

Mr. Pierre Dimba Minister of Health of Côte d’ Ivoire, Public Hygiene and Universal Health Coverage:

“Today’s focus on multilateralism is critical, because multilateralism has enabled important progress in the fight against AIDS. But the last few miles will be difficult because the challenges are many. We have put in place a plan, including a financing plan and have strengthened our surveillance systems and integrated health services which allows us to work more globally in our approach to HIV prevention, testing and treatment. But we need support from partners to strengthen our capacities and to allow us to benefit from new innovations so that our country isn’t left behind.”

Dame Emma Walmsley, Chief Executive Officer, GSK: 

“Our commitment to get ahead of HIV together and ending the AIDS epidemic by 2030 is underpinned by three simple priorities. First, we believe in innovation, inspired by what matters most to the people that we serve. We are developing longer acting options exploring new types of innovative drugs that offer the option to treat at home and our focus on finding a cure is relentless. Secondly, we are committed to enabling access to our medicines, there is no point in innovation without it, regardless of who you are or where you live.  Lastly, and that is what this is all about here today, we get ahead of disease together with the power of partnership. Working across sectors we enable the fastest rollout of a child friendly treatment now available in 90 countries and our commitment to communities is unwavering.”

Daniel O'Day, Chief Executive Officer, Gilead Sciences:

“Upon approval our intention is to make Lenacapavir available at no profit to Gilead in the countries where the need is greatest and until voluntary licensing partners can supply high-quality low-cost versions. We are working around the clock to finalize the direct voluntary licensing costs agreements that will facilitate rapid transfer of technology, allow Gilead to support licensees and getting up to speed quickly and help provide a robust network of manufacturers that is able to produce high volumes at competitive costs. It is my great hope and belief that we are on the brink of the next great advancement in the global fight to end HIV/AIDS.” 

Silas Holland, Executive Director, Infectious Disease and Neuroscience Policy, Merck:

"Since 1985, Merck has been engaged in research and development efforts that have led to significant discoveries transforming the way that HIV is treated. The company is committed to continuing to invest in all stages of R&D to discover, develop and enhance access to innovative HIV treatments and prevention options, as well as developing novel agents for a cure, aiming to improve the lives of people living with HIV. Merck remains committed to collaborative efforts to end AIDS as a public health threat by 2030."

Rev. Gibstar Makangila, Executive Director, Circle of Hope, and Faith Representative, Zambia: 

“Our commitment in the faith community and faith-based organizations is that by 2050 we expect 1 billion young people to be living in Africa. What are we going to do about that? What we propose is a new energy, a new engagement that is based on equity, love, tolerance and inclusiveness. As faith-community we are cognizant of the changing dynamics on the ground and therefore our commitment is that we will support all programmes based on an inescapable responsibility and also empathy, compassion, integrity, passion and ethics.” 

Ms. Youk Sambath, Secretary of State, Ministry of Health, Cambodia:  

“Cambodia has made huge progress in its national AIDS response. New HIV infections have been reduced by 46% and AIDS deaths by 36% from 2010 to 2023. Cambodia is one of seven countries worldwide to first reach the targets of 90-90-90 in 2017. I thank PEPFAR, the Global Fund, UN agencies and UNAIDS, without whom these results would not have been possible.” 

Ms. Laura Rissanen, State Secretary, Ministry of Social Security, Finland:

“Today we are still facing many challenges—the global HIV response is at a crossroads and there is no time to waste. The ambitious goal to end AIDS by 2030 as a public health threat can only be achieved by putting human rights and gender equality at the core of HIV response efforts. Finland is strongly committed to enhancing human rights, in particular the rights of women and girls, LGBTQI people, and people living with HIV. We therefore value and support the human rights advocacy efforts of UNAIDS. We must all continue to pull together in these difficult times to ensure that we will reach the finish line leaving no-one behind.”

Mr. George Ternes, Director General for Development Cooperation and Humanitarian Aid, Ministry of Foreign Affairs, Luxembourg:

“We have all the tools and knowledge. We have everything we need to end AIDS by 2030. The message is that Luxembourg will be there. You can count on our continued support. It is normal that at the end of a fight, you confront the most difficult task. Now there are some really critical ones and the stigma that keeps you from living a normal life in society because you are under treatment for HIV/AIDS – it’s still existing, it’s a major obstacle.” 

Ms. Carina Connellan, Director of the Multilateral Unit in the Development Cooperation and Africa Division, Department of Foreign Affairs of Ireland:

“UNAIDS is a longstanding and highly valued partner of Ireland. Ireland is committed to HIV prevention, especially for those at risk including adolescent girls and young women. Health systems strengthening is a priority for Ireland and we know that effective collaboration among global health actors is vital for strong and resilient health systems. It is very important to acknowledge successes, but we know that significant challenges remain. Ireland’s focus will be very much on reaching those who are furthest behind first. Ireland will continue to be a close partner of UNAIDS, and we will work together with affected communities and all stakeholders to end AIDS.”

Mr. Jean Bernard Parenteau, DG for Health and Nutrition, Global Affairs Canada: 

“What really concerns us is the increased vulnerability of women and girls due to the stigma of accessing sexual and reproductive health services, which continues to threaten progress. This is one of the reasons that motivates Canada to commit to making the Global Fund replenishment a success. This also motives Canada to continue its 10-year commitment to global health and rights in the fight against AIDS. Comprehensive sexual and reproductive health and rights are key to the AIDS response. With a feminist approach, a rights-based approach, Canada is committed to 2030 and beyond.”

Mr. Haoliang Xu, Associate Administrator, UNDP, on behalf of UNAIDS co-sponsors:

“The Summit of the Future is about the future of multilateralism, so this is the first concrete step to follow up on the implementation of the pact for the future. For HIV we know the job is not done. Every minute someone dies of AIDS and 1.3 million new HIV infections occur every year so there is a lot still to be done. The co-sponsors of UNAIDS commit to multilateralism and to ending HIV as a public health threat by 2030 and to sustain progress beyond 2030. We are committed to scaling up programmes to achieve results because HIV is about livelihoods, it’s about rights and it’s about dignity. We are committed to working effectively to achieve the task we set out to achieve.”  

The quotes shared above are only a sample from an event which featured commitments by dozens of leaders which are being compiled. UNAIDS will continue to update and share details.

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.

NEW YORK/GENEVA, 19 September 2024—With support from UNAIDS, two young social media influencers living with HIV are on their way to the United Nations General Assembly and the Summit of the Future in New York to urge world leaders to partner with them in the response to HIV. Ibanomonde Ngema from South Africa and Jerop Limo from Kenya will call on leaders to invest in youth-friendly health systems, provide holistic services for young people living with HIV, and to partner with young people and communities, allowing them to lead in the response to HIV.

“Young people’s powerful and vibrant activism has driven so much of the progress made in the HIV response,” said Winnie Byanyima, Executive Director of UNAIDS. “They know what works for them. It is essential for leaders to listen to them to understand the specific challenges that young people face and how those challenges can be overcome. Leaders can only successfully plan how to end AIDS and sustain the advances made by partnering with young people living with HIV.”

“I am representing not only the voices of 1.5 million Kenyans living with HIV but all people living with HIV,” said Jerop Limo, a young Kenyan HIV activist. “I want leaders to leave New York knowing that we are not beneficiaries, we are equal rights holders. We have a voice, we have skills and expertise and we need an equal playing field where our data is valued, where our input is valued and where our voices are heard. We want meaningful and ethical engagement of adolescents and young people in all spaces of the AIDS response.”

Young people, especially adolescent girls and young women, are disproportionately affected by HIV. Globally, 44% of all new HIV infections were among women and girls (all ages) in 2023 and every week 4000 young women and girls around the world are infected with HIV—3100 are in sub-Saharan Africa. In 2023, some 3.1 million adolescents and young people (15-24 yrs) were living with HIV—1.9 million were adolescent girls and young women.

“Governments meeting here in New York cannot end AIDS alone. They need to involve us to find solutions. We have lived experiences of HIV, from treatment to mental health, because we navigate life with HIV every day. We need to be included in policymaking so that we can take full ownership of ending end AIDS as a public threat,” said Ibanomonde Ngema, a young South African AIDS activist. “The world can only benefit when young people are included in the global HIV response. No conversation about HIV should take place without us, from policy to practice in communities.”

Too often young people report facing stigma and discrimination, including from doctors and healthcare workers, when they access sexual and reproductive health and HIV services. This discourages them from seeking support and crucial information about their health, putting them at risk of HIV infection or of defaulting on treatment for those who are living with HIV.

Involvement of young people in the HIV response

Young people living with HIV play a critical role in the fight against AIDS in communities. They offer support and share important information about HIV that schools or parents might not talk about. They also challenge stigma and discrimination through social media, helping to save lives and encourage young people to stay on treatment.

They drive innovation in communities, for example, a self-funded project by the Youth Empowerment Group uses e-bikes to deliver antiretroviral medicines, food and adherence support to young people who often cannot attend clinics because their schooling hours conflict with clinic opening times in Namibia.

However, their transformational work is being held back because it is not being sufficiently supported. Youth-led HIV responses often operate with little or no financial and political support. At the UNGA the two young people will call on world leaders to fully support and fund their work. They will also urge leaders to uphold the human rights of young people as key to ending AIDS as a public health threat—they will call on them to protect young people’s right to healthcare, education, freedom of speech, and to provide social support to young people living with HIV.

“Providing treatment is not enough, young people living with HIV need an education and they need a job to survive,” added Jerop Limo. “We need to be seen as equal contributors and partners, and we need investment to allow us drive change. We are the leaders of the future and we need to be included now to help shape a better future for us 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.

We do not need to accept pandemics as fate, experts gathered at the International AIDS Conference concurred. By taking specific, well-evidenced, concrete actions to tackle the inequalities driving them, today’s health threats can all be overcome.

As the latest data reveals that progress in the HIV response is stalling, putting millions of lives in danger, as the COVID-19 crisis drags on, and as Monkeypox presents new risks,  all are being held back by inequalities, and all three viruses are in turn further exacerbating those inequalities. However, a focus on tackling underlying drivers of pandemic risk can enable a successful response, scientists, economists and heads of AIDS programmes concurred.

“There are Monkeypox vaccine doses in Europe but none in Africa. Most people at risk of dying from COVID-19 in lower-income countries have still not received a COVID-19 vaccine. New game changing prevention medicines for HIV will not be widely available in lower income counties for years unless there is a dramatic course correction,” said Winnie Byanyima, Executive Director, UNAIDS, and Under-Secretary-General of the United Nations. “An effective response to disease outbreaks and pandemics means tackling inequalities. That means empowering women and girls to shift power relations between men and women. It means tackling inequalities in access to health services between rich and poor. And it means removing punitive laws that push away from life-saving services LGBTQI+ people, people who use drugs, and sex workers.” 

The application of scientific advancements is currently being undermined by inequalities, delegates at the International AIDS Conference noted.  They recalled how, at the turn of the millennium, civil society and generic manufacturers teamed up to demand access to antiretrovirals  for people living with HIV and their victory against the odds helped save millions of lives. But whilst that battle was won, delegates highlighted that the overall process of research and development, innovation and how that translates into manufacturing, pricing and distribution has remained untransparent and heavily skewed to the interests of rich countries. This played out during the COVID-19 pandemic as tests, vaccines and now antivirals are widely available in rich countries while still scarce in lower-income countries. And now this is repeating again with Monkeypox. 

Inequality is not only about differential risks but is about cycles of power, the imbalance in how laws and policies are implemented, who is empowered by these policies, and who is disempowered. 

“The AIDS movement is one of the best examples of how groups of people experiencing intersecting inequalities can unite to overcome them, leading to millions of lives being saved,” said Professor Joseph Stiglitz, Nobel laureate in economics. “But those gains were not permanent. Now a heating world combined with systemic inequalities mean that new disease outbreaks are becoming more frequent and while technological advancement is important, if there’s not a serious move to tackle inequality, the pattern of prolonged pandemics will only continue.” Professor Stiglitz was speaking at the AIDS Conference’s flagship session entitled “How Inequalities Perpetuate Pandemics: Why We Need a New Approach to End AIDS.”

New HIV infections occurred disproportionately among young women and adolescent girls, with a new infection every two minutes in this population in 2021. The gendered HIV impact, particularly for young African women and girls, occurred amidst disruption of key HIV treatment and prevention services, millions of girls out of school due to pandemics, and spikes in teenage pregnancies and gender-based violence. In sub-Saharan Africa, adolescent girls and young women are three times as likely to acquire HIV as adolescent boys and young men. 

Worldwide, only half (52%) of children living with HIV have access to life-saving medicine, and the inequality in HIV treatment coverage between children and adults is increasing rather than narrowing.​

Racial inequalities drive HIV too. In the United Kingdom and the United States, declines in new HIV diagnoses have been smaller among Black populations than among White. In Australia, Canada and the United States, HIV acquisition rates are higher in Indigenous communities than in non-Indigenous communities. 

Sbongile Nkosi, Co-Executive Director of the Global Network of PLHIV stated “Our experiences to date remind us that responding to pandemics such as HIV and COVID-19 is not just about dealing with a medical condition, it’s also about the environment in which we live and how my social status will determine the care I receive. It means centering interventions around the needs of people, listening to people. When we talk about key populations, we tend to group people. But then we misunderstand inequalities. People live intersecting lives and inequalities affect them differently.” During the disruptions of the last few years, key populations have been particularly affected in many communities – with rising prevalence in many locations. UNAIDS data have shown increasing risk of new infections faced by gay men and other men who have sex with men (MSM) globally. As of 2021, UNAIDS key populations data show MSM have 28 times the risk of acquiring HIV compared to people of the same age and gender identity while people who inject drugs have 35 times the risk, sex workers 30 times the risk, and transgender women 14 times the risk.

Just as tackling inequalities has been key to progress in tackling HIV,  so it is in tackling COVID-19. But too many COVID-19 responses have ignored this. “We have failed to learn a lot of the lessons from HIV/AIDS in the way we responded to COVID-19. And we need to be honest about that and reflect on where we go from here,” noted Executive Director of the Global Fund, Peter Sands.

“It's time not only to know your gaps but to close those gaps,” said Ambassador John Nkengasong, US Global AIDS Coordinator and Special Representative for Global Health Diplomacy. 

Today’s inequalities are bleak. But the most important message is a hopeful one.  We know how to end AIDS by 2030 and also how to overcome Monkeypox, COVID-19 and other current and future health threats: when we tackle the inequalities which drive health risks, we can keep everyone safe.

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.

On 1 March, Marc Angel, a Member of the European Parliament and former champion for the 90–90–90 HIV targets, hosted a virtual Zero Discrimination Day parliamentary event. The event, co-organized by the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination (Global Partnership), brought together high-level speakers who are passionate about ending discrimination in the European Union (EU) and beyond.

The speakers addressed HIV-related rights violations, societal barriers, including laws and policies, and the underlying stigma and discrimination that fuels the AIDS pandemic. Reflecting on their own work and experiences, they discussed how the EU and its member states could advance the work of the Global Partnership in ending discriminatory laws, policies and practices within the EU region and partner countries.

“Stigma and discrimination hurt the fight against HIV/AIDS, as they constitute a major obstacle to seeking testing and accessing or staying on treatment,” said Helena Dalli, the EU Commissioner for Equality. “We can, and must, combat HIV stigma and discrimination, speak up, collect evidence and share facts and knowledge.”

Evidence gathered by community networks and civil society organizations reveals significant levels of stigma and discrimination and other human rights violations that impact people living with and affected by HIV in the EU, which has been exacerbated by the COVID-19 pandemic.

“When it comes to the EU, there are still growing inequalities, which are major barriers in the HIV response,” said Ferenc Bagyinszky, the Executive Coordinator of AIDS Action Europe. “The global AIDS strategy gives an excellent opportunity for the EU and its member states, together with the communities, to work towards ending these inequalities in the EU, especially in relation to the 10–10–10 targets.”

“The EU can make a critical contribution to address HIV-related stigma and discrimination by establishing linkages with its various human rights and gender equality projects,” said Mandeep Dhaliwal, Director of the HIV, Health and Development Group of the United Nations Development Programme.

“By leveraging its expertise, resources and political leadership to support communities and partner countries in ending HIV-related stigma and discrimination wherever it exists, the EU can make a huge contribution to getting the HIV response back on track,” said Matthew Kavanagh, UNAIDS Deputy Executive Director, a.i., Policy, Advocacy and Knowledge.

To date, 29 countries, none of which are EU member states, have joined the Global Partnership.

Luxembourg’s Minister for Development and Humanitarian Affairs, Franz Fayot, announced Luxembourg’s support for the Global Partnership, the first EU member state to do so. “We support the work of the Global Partnership and can only applaud its role in assisting countries in achieving the 10–10–10 targets by removing laws that harm and creating laws that empower. The Global Partnership’s strategic approach and inclusive platform to manage the diverse human rights violations faced by people living with HIV and marginalized populations will be key to addressing counterproductive discriminatory practices,” Mr Fayot said.

“The Global Partnership is a unique opportunity for the EU and its member states to end intersecting inequalities and injustices for a pandemic-resilient Europe and the world,” said Mr Angel.

Catharina Rinzema, a Member of the European Parliament, spoke about the importance of talking about HIV openly, to correct misconceptions and help the public to educate themselves. She also alluded to the stigma and discrimination that lesbian, gay, bisexual, transgender and intersex people face in the EU. “We should have a blood donation policy where it doesn’t matter with whom you have sex, but whether the sex was safe,” she said.

Maria Walsh, a Member of the European Parliament, referred to the effects that stigma and discrimination has on the mental health and well-being of people living with HIV and called for an inclusive and comprehensive EU mental health strategy. “In order to break the stigma and empower HIV-positive people, it is essential that we speak openly and honestly about their lived experience,” she said.

Mr Angel concluded by encouraging EU member states to join the Global Partnership and highlighted the need for global and concerted action to meaningfully advance towards ending HIV-related stigma, discrimination, inequalities and AIDS by 2030. 

Michael James (not his real name) was shell-shocked when he was fired. He scanned the dismissal letter. It cited his performance and tardiness as reasons for the job loss. But years of performance appraisals told a different story. He’d consistently received positive evaluations and there were no memos about late-coming or substandard work on his file. The only reason he could discern was that colleagues recently learned that he was living with HIV.

HIV-related prejudice remains rife in Jamaica. One third of people living with HIV responding to the 2020 Jamaica People Living with HIV Stigma Index reported experiencing stigma and discrimination. Verbal harassment, gossip and discriminatory remarks were the most common violations. But one in 10 said they were refused employment or lost a source of income because of their HIV status. No legislation prohibits a Jamaican employer from discriminating on the basis of HIV status.

This has marked implications for the HIV response. Twenty-one per cent of respondents were worried about mistreatment or confidentiality breaches by health-care workers. Thirty-eight per cent delayed testing and 29% delayed starting treatment because of concerns about how they would be treated.

Shelly John (not her real name) recounts hopping from one treatment site to another before landing at Jamaica AIDS Support for Life. At other facilities she overheard nurses gossiping about patients’ medical histories.

“I felt uncomfortable. If I am hearing about other clients, other clients can come inside and hear about me as well,” she reasoned.

“The fear of stigma drives some persons underground and away from much needed health services. Owing to stigma and discrimination, some persons delay accessing needed services and, as a result, some are diagnosed with HIV at an advanced stage,” acknowledged State Minister in the Health and Wellness Ministry and Chair of the Jamaica Partnership to Eliminate HIV-Related Stigma and Discrimination, Juliet Cuthbert Flynn.

Jamaica’s testing and treatment outcomes bear this out. While an estimated 86% of people living with HIV were aware of their status in 2020, just 40% of people living with HIV were on HIV treatment.

While the Jamaica Charter of Fundamental Rights and Freedom guarantees protection against discrimination, it is limited in scope. The protected grounds are race, sex, place of origin, social class, colour, religion and political opinions. There are piecemeal anti-discrimination provisions in different pieces of legislation, such as the 2014 Disabilities Act and the 1975 Employment Act. But neither the constitution nor ordinary legislation make discrimination on other grounds unlawful.

Since 2020, UNAIDS and the United Nations Development Programme have been providing technical and financial support to local nongovernmental organizations, including Jamaica AIDS Support for Life, to support the rollout of a national survey on the public’s perspectives and experiences with stigma and discrimination in Jamaica and on the need to have more adequate protections in the law. The results of the survey will be used to advocate for legislation to adequately deal with discrimination experienced by vulnerable and marginalized groups.

The proposed legislation should provide protection across areas including discrimination based on health status, pregnancy or childbirth, hiring or termination decisions and the denial of services to minority groups. It should also address discriminatory conduct based on assumptions about a person’s competence, capabilities, age, self-expression, income level, the neighbourhood in which they live or their educational background.

“Comprehensive anti-discrimination legislation will strengthen the legal framework for the protection of human rights towards achieving equality for all,” Manoela Manova, the UNAIDS Country Director for Jamaica, explained.

In real terms, this means that duty-bearers will have to consider how their policies, programmes and services will affect people with the protected characteristics. Critically, the focus on markers related to poverty would mean that for the first time public bodies will have a duty to consider socioeconomic disadvantage when making strategic decisions about how to exercise their functions and when proposing to use public funds.

“Our overarching finding has been that regardless of health status, sex, age or sexual orientation, the factor that fuels discrimination and makes people more vulnerable is poverty. Moving forward, it is critical that we don’t treat HIV as a stand-alone concern but address the full picture of what makes people marginalized and vulnerable in Jamaica,” said UNAIDS Community Support Adviser for Jamaica, Ruben Pages Ramos.

DUBLIN/GENEVA, 1 March 2022—Ireland has today announced that it is increasing its core funding for UNAIDS from €2.4 million in 2021 to €2.5 million in 2022. The announcement was made at a meeting in Dublin between Ireland’s Minister for Overseas Development Aid and Diaspora, Colm Brophy, and the Executive Director of UNAIDS, Winnie Byanyima.

Ireland has been a partner and supporter of UNAIDS for more than 20 years. It has supported programmes that reduce the impact of HIV among some of the most-at-risk groups, including gay men and other men who have sex with men and young women and girls. In addition to the €2.4 million contribution in 2021, Ireland provided €1 million in support of UNAIDS’ zero discrimination agenda.

“Ireland is a strong leader in the global AIDS response and continues to be a steadfast ally to UNAIDS,” said Ms Byanyima. “This additional financial contribution from Irish Aid is an important signal at a time when the world must step up its efforts to remove laws that harm and instead create laws that empower so that people can receive life-saving and life-changing HIV services.”  

This year on Zero Discrimination Day, which is being held under the theme “Remove laws that harm, create laws that empower”, UNAIDS is highlighting the urgent need to take action against discriminatory laws. In many countries, laws result in people being treated differently, excluded from essential services or being subject to undue restrictions on how they live their lives, simply because of who they are, what they do or who they love. Such laws are discriminatory—they deny human rights and fundamental freedoms.

On Zero Discrimination Day, 1 March, we celebrate the right of everyone to live a full and productive life—and live it with dignity and free from discrimination.

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.

Like any other regular day in Bangkok, Thailand, Pete went to work and was living a pretty normal life. He had a business that imported and exported fresh vegetables from neighbouring countries in South-East Asia, a family business that he shared with his sister. He was happy and in a serious long-term relationship with his boyfriend, and everything seemed perfect. That day, he and his partner went to get tested for HIV, and that’s when his life suddenly began to change.

“I found out about my HIV status in 2016 and soon after left my business because I didn’t know if I was going to live much longer. Without guidance and mental health support, I had many misconceptions about HIV, and I started to suffer from depression,” he said.

“I blamed myself for contracting HIV, and I couldn’t cope with this thought. I became a drug user, was engaging in chem sex, broke up with my partner and survived suicide attempts,” he continued. “But after receiving support from local organizations of people living with HIV, I decided to retake control of my life. I started to talk openly about HIV to help other young people live with a positive diagnosis. Even though this was never my plan, I knew I had to do it. That’s why I became an HIV activist,” he added.

Nowadays, Pete (famously known online as Pete Living with HIV) is a well-known HIV activist in Thailand and has come far since his diagnosis. He has spent the past few years building an online community for people living with HIV. In this safe space, people can connect and be comfortable enough to share their stories and experiences in an open environment free from stigma and discrimination. His Facebook group, which has strict membership requirements (for obvious reasons), has more than 1300 members.

“I created this space because I didn’t have a place to share my story. I wanted to create a platform where people living with HIV can be proud of themselves and be reminded they are not alone. No one deserves to be stigmatized, bullied, dehumanized or disrespected. Everyone deserves to be loved, respected and accepted,” he said.

In 2019, the country announced the Thailand Partnership for Zero Discrimination, which calls for intensified collaboration between the government and civil society to work on stigma and discrimination beyond health-care settings, including workplaces, the education system and the legal and justice system. UNAIDS has been involved since the outset of the initiative by providing technical assistance to formulate the zero discrimination strategy and the five-year action plan, develop a monitoring and evaluation plan and operationalize the strategy as a joint effort between the government and civil society.

Pete thinks this initiative is a cornerstone to ending the AIDS epidemic, as stigma and discrimination continues to be the main barrier to HIV services. “Although it has improved a lot over the years, I still experience stigma and discrimination when I go for regular sexually transmitted infection check-ups. I still receive judgement from nurses and doctors,” he said.

Pete has also become a passionate activist for, and speaks about the importance of, U = U (undetectable = untransmittable) at international forums and conferences. “U = U changed my life. I continue to fight for and promote U = U because its messages have the power to change the lives of people living with and affected by HIV. Still, more importantly, it can change social attitudes and tackle stigma and discrimination,” he said.

With U = U, HIV treatment has transformed the HIV prevention landscape. The message is clear and life-changing: by being on HIV treatment and having an undetectable viral load, people living with HIV cannot transmit HIV to their partners. The awareness that they can no longer transmit HIV sexually can provide people living with HIV with confidence and a strong sense of agency in their approach to new or existing relationships.

Pete launched a campaign in 2020 focusing on U = U and mental health advocacy. “Through my social media channels, I raise awareness about the importance of listening to people and their experiences and respecting them. U = U is key to helping people living with HIV overcome self-stigma and negative feelings like shame, which discourage them from accessing and/or remaining on treatment. U = U is encouraging; it can help remind people living with HIV to be proud of themselves,” he said.

Pete is now strengthening partnerships with national stakeholders and allies of the HIV response to ensure that messages related to U = U, HIV prevention and zero discrimination are amplified and reach different audiences. He is also a representative on a multisectoral task force to design and implement the People Living with HIV Stigma Index in Thailand, which will be conducted this year. He has supported the United Nations in Thailand on various campaigns, including the Everybody Deserves Love Valentine's Day campaign and the zero discrimination campaign, in which he is engaging young people from across Thailand. 

Marcia John (not her real name), a Guyanese transgender woman, readied to leave a transgender support group meeting. She slipped off her black wig, replacing it with a bandana and hat. Her employer only allows her to perform her duties if she presents as a man.

“I have no choice,” she said. “I have to work.”

In 2018, the Caribbean Court of Justice ruled that an 1893 Guyana law that prohibited cross-dressing was unconstitutional. Last August, lawmakers formally removed that section from the law books. But for Ms John and other transgender women, this has not been enough to transform the way they navigate social spaces. Intolerant attitudes remain, with sometimes dire implications for transgender people’s welfare and livelihoods.

Led by the University of the West Indies Rights Advocacy Project, the cross-dressing law challenge started with a constitutional action filed in the Guyana High Court in 2010. Eight years and two appeals later, the litigants earned a historic win.

“At the heart of the right to equality and non-discrimination lies a recognition that a fundamental goal of any constitutional democracy is to develop a society in which all citizens are respected and regarded as equal,” the Caribbean’s final appellate court ruled in 2018.

Reflecting on the impact of the landmark law reform effort, Alessandra Hereman, Guyana Trans United (GTU) Project Coordinator, said that the main benefit has been more visibility.

“The community’s increased media presence in the lead-up to the case brought transgender issues into the public space. People realized that transgender Guyanese exist and are part of our society. Some thought we should be treated equally and others held on to their religious beliefs. But transgender issues were brought to the fore and were part of public discourse,” she said from GTU’s Georgetown office.

Formed in 2012, GTU has worked over the past decade to facilitate the dialogue and sensitization that are needed alongside key law and policy reforms to create a safe and empowering social context for transgender people. They contribute to the ongoing effort to shift the attitudes and perceptions of health-care providers around sexual orientation and gender identity. This work strengthens the community’s access to health services, including HIV prevention, testing and treatment. With support from UNAIDS, GTU also trained journalists on covering transgender people and issues ethically and accurately.

“Law reform is essential, but it is not a stand-alone,” said James Guwani, the Director of the UNAIDS Caribbean Sub-Regional Office. “Alongside strategies like judicial review and political advocacy, there must be ongoing community dialogue and targeted efforts to increase social inclusion.”

At present, GTU has two high law and policy reform priorities. First, Guyana’s Prevention of Discrimination Act of 1997 makes no mention of sexual orientation or gender identity.

“Employers use the lack of this protected status to discriminate against lesbian, gay, bisexual and transgender (LGBT) persons. Amending that legislation would mean that if you violate the rights of an LGBT person there would be some mechanism for redress. Having that in place will tell people you can’t discriminate because there will be consequences,” Ms Hereman explained.

The CARICOM Secretariat, through the Pan Caribbean Partnership against HIV and AIDS (PANCAP), has developed a model anti-discrimination bill to guide Caribbean countries in creating anti-discrimination laws. PANCAP continues to advocate with regional stakeholders, including policymakers, for countries to adopt the model as it provides for the protection of persons against discrimination, including discrimination involving harassment, victimisation and vilification on the grounds of HIV status, sexual orientation, etc. It is hoped that the model will lead to more access to health care for key populations with the overarching goal of a Caribbean free of AIDS and new HIV infections, in which all people are happier, healthier, productive, safe and respected. Next on GTU’s list is the revision of the Teachers’ Code of Conduct to be inclusive of the needs of LGBT students.

“They must know that they have a duty to create an enabling environment for all students so that LGBT pupils have an opportunity to learn without bullying,” Ms Hereman said.

Lack of gender recognition legislation and the criminalization of sex between people of the same sex remain challenges in the Guyana and wider Caribbean contexts. The United Caribbean Trans Network has mounted a campaign around gender identity recognition, while the Society against Sexual Orientation Discrimination is working to remove Sections 351 to 353 of the Criminal Law (Offences) Act, which make sex between men punishable with life imprisonment. However, GTU is first prioritizing issues that it says go to the heart of transgender’s people’s ability to get an education and access employment. Exclusion from these spaces compounds their vulnerability to poverty, violence and disease.

“We occupy the lowest socioeconomic level in society. Guyana is now an oil-producing nation. LGBT people should have opportunities as well,” Ms Hereman insisted.

Nargis was born in Dushanbe, Tajikistan, into a large family. Life was not easy, and she was sent to a boarding school for low-income families. Her favourite subject at school was physical education, excelling at basketball and swimming. She hoped that after graduating from school in 1991 with a diploma in physical education she would continue her studies at a technical school.

However, because of unrest in the country, she couldn’t carry on with her schooling. “I cried for six months, I really wanted to continue my studies, but instead of going to a technical school, my parents married me off. I was not yet 16 years old then,” said Nargis. When she was 17 years old, she gave birth to a son; five years later, while pregnant with her second child, she learned that her husband was involved in drug trafficking, and he was sent to prison.

From that time on, Nargis had to provide for herself and her family on her own. She got a job in a casino. The earnings were good, but it was there that she started taking drugs. “I was a shy girl, so to make me feel relaxed, I used drugs. From there, I became a drug addict. I didn’t even notice how it happened,” she recalled.

She was eventually fired from her job because of her drug-taking and was forced to look for other ways to survive.

Nargis injected drugs for 14 years, but she started on opioid substitution therapy when it was made available in the country. “While I was on methadone, I was hired as a peer counsellor. I worked with drug users, with people living with HIV. I worked as a consultant in several HIV prevention projects,” said Nargis.

Nargis remained on methadone until May 2021. “Last year, I had to stop methadone because I was sent to prison and there was no methadone in prison. It was very hard, I was in the prison hospital for several months, but as a result I got off methadone and, so far, I am holding on.”

Nargis was imprisoned under Article 125 of the Criminal Code of Tajikistan, under which it is a criminal offence to infect someone with HIV or to put them at risk of HIV infection. Based on this article, law enforcement agencies initiate criminal cases against people living with HIV just on the basis of the potential threat of HIV transmission or simply just based on their HIV-positive status.

“I have been taking antiretroviral therapy since 2013. I have never interrupted it. I have an undetectable viral load. No one wrote a statement against me. I did not infect anyone. The accusation was made on the basis of a note from a man I knew, because we were dating,” Nargis said.

The legislation does not take into account the informed consent of the other sexual partner, regardless of whether there was a risk of HIV infection, or whether the person living with HIV takes precautions against HIV transmission. In addition, the legislation does not define how someone living with HIV should declare their HIV status. In effect, all people living with HIV who have sex can be held criminally liable.

Nargis explained her shame, “Law enforcement agencies called everyone, doctors, my colleagues, relatives, and told them about my HIV diagnosis, asked what kind of relationship we were in, dishonoured me.”

“Article 162 of the Health Code gives doctors the right to disclose the status of HIV-infected patients at the request of the investigating authorities, and does not contain any justification for this. Some criminal cases under part 1 of Article 125 were initiated after the HIV clinic disclosed information about HIV to law enforcement agencies. During the investigation and trial, the defendants’ right to confidentiality regarding their HIV status is not ensured, since investigators, officials, court clerks and judges can request medical information in accordance with the provisions of the Health Code without any specific conditions,” said Larisa Aleksandrova, a lawyer.

Nargis is now free, but she said that she was just lucky. “I was released under an amnesty in connection with the 30th anniversary of the republic.”

She is out of prison, but there are still dozens of other people convicted under Article 125. Now that everyone knows that she is living with HIV, Nargis is ready to fearlessly fight for the right to live, work and love, despite her HIV status.

Nargis continues to work as a volunteer peer consultant on HIV prevention. She has many plans, but the main goal that she is striving for is the revision of articles criminalizing HIV in Tajikistan.

“I always say that there should be more information about HIV, about people living with HIV, so that they don’t fear us the way they do now. Now everything has changed, there is treatment, there is prevention. An HIV diagnosis should not be a guilty verdict—it’s just a diagnosis.”

Most countries in the eastern Europe and central Asia region have criminal penalties and various types of punishment, including imprisonment, for concealing a source of HIV infection, for putting someone at risk of HIV or for transmitting HIV. HIV criminalization disproportionately affects marginalized populations, especially women. Women are more likely to find out their HIV status when accessing health care, such as for pregnancy, and are more likely to be criminalized and punished.

“We know for certain that laws that criminalize HIV are counterproductive, undermining rather than supporting efforts to prevent new HIV infections. We hope that by consolidating the efforts of governments and public organizations it will be possible to revise outdated laws in the near future, taking into account the latest data on HIV, which will allow people living with HIV, or those who are most at risk of infection, to be open in their relationships with medical organizations, to disclose their HIV status and use affordable medical services,” said Eleanora Hvazdziova, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.