What does the HIV response look like beyond the 2030 targets to end AIDS? For the past year, UNAIDS has been working with partners and over 30 countries to develop country-led roadmaps for the sustainability of HIV prevention, treatment and care services far into the future.

Part of the sustainability journey includes reaching the global goal of ending AIDS in the next five years. According to a recent World Bank report, despite an early COVID-19 spending peak, per capita government health spending has steadily declined in low- and lower middle-income countries. Urgent action is needed in many countries to ensure reaching the health Sustainable Development Goals remains possible by 2030.

UNAIDS’s new sustainability approach, developed jointly with the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF) in early 2024, focuses on five core areas. These are political leadership and commitment; enabling laws and policies; sustainable and equitable financing; science-driven, effective and high-impact HIV services and solutions; and systems built to deliver. The specific methods look different in each country, but all have equity and communities at the center.

“A multi-sectoral approach remains critical to the HIV response particularly in this last mile as we accelerate prevention and close gaps that require us to address the complex inequalities that persist,” said Anne Githuku-Shongwe at UNAIDS.  

As part of this initiative, UNAIDS and partners are supporting countries to create and implement sustainability roadmaps. The roadmaps identify key changes countries can take to shift towards self-reliant, efficient and impactful HIV responses both in the short- and long-term.

Representatives from 22 countries in Sub-Saharan Africa and the Dominican Republic gathered recently in Johannesburg, South Africa to hone their roadmaps during a workshop hosted in October by The South African National AIDS Council in collaboration with UNAIDS, PEPFAR and the GF.

“While it is valuable that we come together to learn and share insights, it is crucial to recognize the level of responsibility each of us carries in our respective countries. We are not here simply to exchange ideas, but to take on a leadership role in driving meaningful change,” said Thembisile Xulu  of the South African National AIDS Council as she addressed the participants.

During the workshop, countries shared experiences and learned from each other about their individual sustainability journeys. In addition, countries agreed to establish a virtual peer learning network to facilitate future cross-border partnerships and share successes and challenges in moving towards sustainability. Some of the findings so far along the journey include the necessity of high-level political support, coordinated multi-sectoral efforts and diversified funding sources.

Furthermore, countries recommended that development partners craft consistent messages about their ongoing commitment levels to fund HIV and health services. The need for transparent, responsible and inclusive conversations was emphasized by all in Johannesburg when discussing the transition from donor financed to country financed responses.

“The fiscal space for HIV is tightening, and we need to be pragmatic as we work to sustain the response with a focus on simplification and efficiency,” said Sarah Dominis from the U.S. State Department Bureau of Global Health Security and Diplomacy, Office of Financial and Programmatic Stability. “The future HIV response will be led by country governments in partnership with community and private sector partners. PEPFAR is not going away but will focus on supporting countries to sustain the HIV response, aligning to the vision they have committed to in their roadmaps.”

As the roadmaps roll out publicly, governments are recognizing the role of communities in the long-term response. For example, Tanzania’s roadmap identifies that community-led organizations play a pivotal role in community mobilisation, facilitating social and behaviour change, addressing social/cultural norms, primary HIV prevention interventions, adherence to antiretroviral treatment and retention in care. As a result, the roadmap lists actions to bolster communities, such as scaling up the network of community health workers and reinforcing community-led monitoring programs.

“When we talk about HIV sustainability we need to go back to the basics. It's about planning around the lives of PLHIV. Communities are always at the centre of service delivery, demand creation and monitoring. There is the opportunity for us all to tap into the infrastructure and willingness of communities to provide treatment and prevention services - through strong sustainable partnerships,” said Sibongile Nkosi from The Global Network of People Living with HIV.

This past World AIDS Day, ten countries launched their sustainability roadmaps, and more will follow in early 2025. To follow the process, visit: https://sustainability.unaids.org/

Progress towards ending AIDS as a public health threat has been strongest in the countries and regions with sufficient investments in their HIV responses, especially in countries from eastern and southern Africa. However, a critical part of this success lies in understanding where resources are being allocated and ensuring that investments are directed towards the most impactful interventions.

“HIV financial data is essential for decision-making”, said Jaime Atienza, Director of Equitable Finance at UNAIDS. “This is especially important when we can see constraints, now and around the corner.”

To reflect on the current use and future potential of HIV financial data, UNAIDS and the Global Fund to Fight AIDS, TB and Malaria brought together representatives from 10 African countries to Cape Town, South Africa. During the event, countries shared how they are using HIV financial data to transform their national HIV responses.

In the case of Kenya, for example, the 2022 National AIDS Spending Assessment (NASA) revealed that approximately 84% of the funds for care and treatment programmes came from external sources. This heavy reliance on external funding prompted the development of a cabinet advisory note on local commodity manufacturing, aimed at addressing commodity security risks. In response, the Office of the Presidency issued a statement on Worlds AIDS day 2022 directing that the government would support the pharmaceutical sector to strengthen its local manufacturing capacity and review relevant regulations and tax policies to create an enabling environment.

In Mozambique another NASA study showed how the country spent 26% less on HIV treatment than the National Strategic Plan required, while still surpassing the antiretroviral (ART) coverage target. ART unit costs have fallen from US$ 208 in 2017 to US$ 137 in 2022—well below most countries in the region. Economies of scale and differentiated service delivery likely contributed to this outcome. “We are using this data to inform multi-sectoral plans and state budgets” said Francisco Mbofana, Executive Secretary of Mozambique's National AIDS Council.  

HIV financial data is also seen by countries as an effective tool for mobilizing resources. Ethiopia’s NASA and National Health Accounts (NHA) informed a Domestic Resource Mobilization Strategy. The Strategy aims to boost domestic investment from US$ 27.9 million in 2020 to US$ 68.5 million by 2025 through government revenues, AIDS fund(s), targeted mainstreaming, community care coalitions, and earmarked taxes. In addition, South Africa demonstrated to the Global Fund that of the US$ 6.3 billion the government committed to invest in HIV from 2022-2025, US$ 6.2 billion (98.99%) is likely to be realized. This, in turn, unlocks the US$ 92.7 million co-financing incentive from the Global Fund grant for 2025-2028.

Financial data has also stressed the major underinvestment in HIV prevention. “The de-prioritization of HIV prevention is among the top sustainability threats,” said Thembisile Xulu, Chief Executive Officer of the South African National AIDS Council. While prevention will require a third (32.8%) of total HIV resources by 2025, NASA data shows current HIV prevention spending is at 9.4% in Kenya, 9% in Namibia, 11% in South Africa, and 13% in Uganda.

Nonetheless, several strategies to boost HIV prevention investments are being developed following evidence provided by HIV financial data. Kenya used its NASA data to develop guidelines for harnessing resources from construction projects to support HIV prevention. Zimbabwe’s resource tracking influenced a new policy to implement social contracting with a least one civil society organization per province, to channel domestic resources to community-led HIV responses. Zimbabwe has committed to invest 21% of domestic funds in HIV prevention, with a focus on key populations.

In the current environment of dwindling resources for HIV—2023 recorded the lowest amount of resources available for HIV in low-and-middle income countries in a decade—strengthening HIV resource tracking is key to ensure effective and sustainable HIV responses. “We need to plan for sustainability,” said Nertila Tavanxhi, Senior Manager for Health Financing Country Support at the Global Fund. “To do this, we really need to understand who is funding what, where and whom. This will show us the gaps, and where we must focus.”

“We are in a time of transformations towards sustainability,” said Mr Azcona. The National HIV Response Sustainability Roadmaps are an essential part of the work that the Global Fund, UNAIDS, PEFPAR and country partners are undergoing in 2024 and 2025. “This makes it even more important to have the right data to make the best possible choices on what these transformations must be.” 

Marouane Abouzid, a 25-year-old from Casablanca, grew up in an environment where social challenges and gender stereotypes were pervasive. However, his perspective changed the day he joined "The Ball is Your Protection" program, an initiative by Tibu Africa in partnership with UNAIDS, which uses sports to raise awareness about HIV, gender equality, and gender-based violence. 

Before joining the program, Marouane had limited knowledge about HIV and gender equality. “The training on HIV awareness led by UNAIDS and Tibu Africa was a transformative experience,” he says. “It equipped me with essential skills like effective communication and active listening.” Thanks to the program, Marouane discovered how sports can be a powerful tool to engage young people on often-overlooked topics, such as HIV prevention and breaking gender stereotypes. 

Now, trained to be a change ambassador in his community, Marouane leads sports activities and participates in educational sessions, becoming a role model for his peers. “I talk openly about what I’ve learned. I encourage my friends to get tested for HIV and respect the rights of others,” he shares. 

For Marouane, this program was more than just training. “Today, I feel ready to take action and share what I’ve learned with my community,” he says. 

During the closing ceremony of the "The Ball is Your Protection” project, Marouane facilitated workshops and sports activities with other young participants. “I saw how sports could become a tool for awareness and social mobilization,” he explains. These activities created a safe space for young people to discuss issues related to HIV and gender equality, free from societal judgment. 

In Morocco, approximately 23,000 people live with HIV, nearly 50% of whom are women. Although the prevalence rate is relatively low, vulnerable groups such as sex workers, men who have sex with men, and people who inject drugs are particularly at risk. “Before, I thought HIV didn’t have a real impact on those around me. Now, I understand that we all have a role to play,” Marouane adds. 

Marouane is not alone on this journey. Assia Ezzahraoui, 25, a participant in Tibu Africa’s Sports Vocational School program, reflects: “HIV awareness was a profoundly enriching experience. It gave me new insights into symptoms, prevention methods, and available treatments.” For Assia, taking part in the educational event deepened her understanding of HIV and reinforced the importance of protecting her health and that of those around her. 

“I want to thank everyone who contributed to this initiative. Their commitment to young athletes in Morocco is truly inspiring,” says Assia, emphasizing the value of such events in educating youth about HIV. 

Thanks to initiatives like "The Ball is Your Protection," young people like Marouane and Assia are playing an active role in addressing gender inequalities and HIV-related stigma. These young leaders are helping to build a healthier and more equitable future, proving that change can start with something as simple as a ball. 

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

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

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

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

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

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

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

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

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

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

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

UNAIDS

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

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

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

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

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

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

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

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

UNAIDS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

UNAIDS

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

ABUJA, NIGERIA, 3 December 2024 — The Joint United Nations Programme on HIV/AIDS (UNAIDS) is pleased to announce the appointment of Funke Akindele, a multiple award-winning actress, movie producer and director, as its new National Goodwill Ambassador (GWA) for Nigeria. This prestigious nomination recognizes Funke Akindele’s outstanding contributions to the fight against HIV and her unwavering commitment to advocacy, raising awareness, and driving efforts to end AIDS as a public health threat by 2030.

Funke Akindele’s career took off with her role in the United Nations Population Fund (UNFPA)-sponsored television series “I Need to Know”, which focused on adolescent reproductive health and rights, including HIV. Since then, she has captivated audiences worldwide, earning millions of fans and accolades for her unforgettable roles. Known as the “Queen of Box Office” in Nollywood, Funke holds the top three slots on the list of highest-grossing Nollywood films of all time, reflecting her prominence and influence in the industry.

Over the past two decades, Funke Akindele has consistently broken barriers and used her platform to amplify social impact issues, influence positive change, and champion causes that matter. As UNAIDS’ National Goodwill Ambassador, she will contribute to efforts aimed at eliminating vertical transmission of HIV, ending HIV-related stigma and discrimination, and promoting HIV prevention across Nigeria.

Nigeria has made significant strides in the fight against HIV over the past two decades. As of 2023, approximately 2 million people are living with HIV in the country, with an adult prevalence rate of 1.3% among individuals aged 15–49. Nigeria recorded approximately 130,000 new HIV infections in 2010. By 2023, this number had declined to about 75,000 new infections, representing a reduction of approximately 55,000 cases, or a 42.3% decrease over the 13-year period. . The country has also achieved notable progress in treatment access, with 1.6 million out of the 2 million people living with HIV in Nigeria currently on treatment.

Despite these advancements, challenges remain, including addressing stigma and discrimination, and ensuring equitable access to prevention and treatment services across all regions.

“We are thrilled to welcome Funke Akindele as our National Goodwill Ambassador for Nigeria,” said Dr Leopold Zekeng, UNAIDS Country Director for Nigeria. “Her powerful voice, vast influence, and commitment to social change make her an invaluable ally in our efforts to combat HIV and support people living with HIV in Nigeria. We look forward to working with her to drive positive impact and progress in the fight against AIDS.”

The nomination process for the National Goodwill Ambassador involved active collaboration with the National Agency for the Control of AIDS (NACA), which has expressed appreciation for UNAIDS’ role in securing such a significant partnership for Nigeria’s HIV response. Funke Akindele’s work as a National Goodwill Ambassador will be vital in mobilizing efforts for HIV prevention and ensuring that key messages reach wider audiences across the country.

The official announcement of Funke Akindele’s appointment as UNAIDS National Goodwill Ambassador was made during the World AIDS Day commemoration in Abuja on 3 December 2024, during an event led by the United Nations Resident Coordinator for Nigeria, Mr. Mohammed M. Malick Fall.

Ethiopia faces a triple crisis of conflict, climate change, and displacement that impedes the capacity to provide essential health and other humanitarian assistance to those in need, including people living with HIV.

With support from 2Gether 4 SRHR, UNAIDS and partners recently organised a joint mission to learn about the humanitarian response and to identify the challenges that persist. The findings of the mission will help update the guidelines on Addressing HIV in Humanitarian Settings, a crucial resource for all actors working on HIV in emergency settings, providing evidence-based recommendations for integrating HIV into the different sectors of humanitarian responses.

Ethiopia hosts more than 1 million refugees, predominantly from South Sudan, Somalia, Eritrea and Sudan, the majority of whom live in 24 refugee camps established across five regional states, and 80,000 of whom reside in the capital Addis Ababa. In addition, the country has 4.4 million internally displaced persons (IDPs) and over 1.5 million IDP returnees.

The team visited two of the regions hardest hit by humanitarian crises, grappling with rising HIV rates: Tigray and Gambella. In Tigray, just 5 kilometers from the capital Mekelle, lies Seba Kare (70 Kare) IDP camp—a settlement hosting over 20,000 people displaced by the conflicts in the western and eastern parts of the region. Seba Kare represents both the resilience of its inhabitants and the dire challenges of prolonged displacement. The camp, initially intended as temporary shelter for six months, has now housed many families for over four years. Cramped conditions, insufficient food, limited access to education, and inadequate healthcare services are daily realities for residents. Despite the tireless efforts of humanitarian partners on the ground, the growing needs of the displaced population far exceed the resources available.  

Among the most pressing gaps is the lack of comprehensive healthcare, particularly for people living with HIV. In humanitarian crises, critical services for HIV and sexual and reproductive health are often sidelined, overshadowed by the urgent need for food, shelter, and disease control. Healthcare is restricted to primary services. Care for chronic conditions, such as HIV, is referred to government hospitals. This means that all patients, IDP or not, must pay for transportation as well as services and purchase vital medical supplies on their own—an impossible burden for many.

Despite the continuous advocacy efforts in support of the decentralization of services and outreach interventions at camp-level, government-owned facilities outside the camp remain the only viable option for IDPs in need of health services.

The refugee camp of Jewi—in the western province of Gambella which has the highest HIV burden across Ethiopia—is equipped with its own antiretroviral therapy center. However, like in Tigray, Gambella faces significant challenges in providing HIV testing and treatment. Limited mobility within and beyond the camps, due to the costs of transport for clients and a shortage of ambulances in medical emergencies, combined with resource constraints at health centres, often results in treatment interruptions and high rates of loss to follow-up.

Adding to the crisis, the recent reduction in donor funding has severely impacted the quality of health services in the camps. The gender-based violence (GBV) center run by International Medical Corps will soon close due to funding cuts, leaving no other GBV services available outside of health services.

The situation for women and youth in Gambella is especially concerning. Limited educational and employment opportunities, compounded by rising HIV infections, put them at higher risk of infection due to the adoption of negative coping mechanisms, including substance abuse. The high rates of new HIV infections exacerbate these existing challenges, underscoring the urgent need for sustained interventions to improve health services, livelihoods, and social inclusion for refugees and host communities in the region.  “There are many young and vulnerable people who need protection, shelter, food, income, education – and HIV prevention, testing, treatment and care. We must make sure to rebuild health and social services and fill the current resources gap,” said Tina Boonto, UNAIDS Ethiopia Country Director.
 
As international organisations step up their efforts to address HIV in humanitarian settings, there is a coordinated push in Ethiopia, at both the federal and regional levels, to ensure that the health needs of people living with HIV are met, even in the most challenging circumstances. The Ministry of Health, with support from UNAIDS, is developing an HIV Baseline Survey in Humanitarian Settings and a comprehensive National HIV/Sexual and Reproductive Health Guiding Document. This initiative is a substantial step towards safeguarding the rights and well-being of people living with HIV across the country.

"Ethiopia's progress in addressing HIV is inspiring,” said Maheswari P Murugayia, Public Health Officer and Global HIV Focal Point at UNHCR. “Tackling HIV in humanitarian settings is not just a priority— it’s a necessity for ensuring the health and well-being of displaced populations.”

Christoforos Mallouris' journey from humble beginnings in Cyprus to becoming a prominent global HIV advocate is a powerful story of personal transformation.

In his youth, Mallouris struggled with accepting his sexuality. "I couldn’t admit to myself that I was gay," shares Mallouris. The burden of self-stigma made it difficult for him to value his life: "In a way, I was homophobic towards myself and others."   

At 29, while studying in Chicago, he was diagnosed with HIV. The diagnosis marked a pivotal moment in his life. "It changed how I understood myself, really forcing me to learn to value my life and accept who I am."

By the time he was diagnosed, he had already developed AIDS. Fortunately, Mallouris got support from his sister, who came to take care of him during his lowest moments.

Being HIV-positive in the United States as a foreign student presented its own set of challenges. "At the time, being HIV positive in the United States as a foreigner was illegal," Mallouris recalled, "so if the authorities found out, I would be deported." The fear of deportation hung over him as he was doing his PhD in astrophysics, but that fear also catalyzed his first act of activism.

Faced with health insurance that covered only two months of his costly HIV medication, Mallouris approached the Dean of Students at the University of Chicago. He boldly stated, "What are you going to do about it? I’m sure you don’t want this to go to the press." To his surprise, the Dean took immediate action, negotiating better health insurance coverage for all students with chronic illnesses.

As Mallouris’ health improved, he began to question his career path. Although he had completed his PhD in astrophysics, he no longer felt fulfilled enough by that field. He sought something that connected directly to being able to help people.

After securing a postdoctoral position at the Institute of Astrophysics in Paris, Mallouris found himself increasingly drawn to HIV work, so he started volunteering at a local NGO focused on HIV education and prevention for non-French speakers in Paris. It wasn’t long before he realized that this work was where his heart was.

He joined the Global Network of People Living with HIV, managing community empowerment programs in the HIV response. "I changed my career because of my HIV status," he said. "I wanted to do something that truly impacts lives."

Mallouris has had to overcome stigma and discrimination throughout his journey. Dating, for instance, was difficult. "There was a lot of rejection as soon as people found out I was HIV-positive," he shared. But despite the challenges, he found strength in the support of his friends, who have stood by him unconditionally. "I am lucky to have a strong network of support."

Mallouris joined UNAIDS in 2013, first as a Community Mobilization Advisor in Geneva and later as an Equality and Rights Advisor in Johannesburg. He describes UNAIDS as a supportive and inclusive workplace, where he feels valued for his skills and experience.

Mallouris highlights that the work to help secure treatment for people living with HIV is inseparable from the work to secure the recognition of people living with HIV as equal human beings. "Success in the HIV response depends on accepting all people, especially the most marginalized members of society.”

Mallouris is proud as he looks back, and hopeful as he looks ahead. He will always speak out for the rights of communities, even when—especially when—it isn’t popular.

HIV may have started as a burden in his life, but over time, it has become his strength, guiding him towards work that makes a profound difference, advancing a world where everyone is safe, has a place, and is welcome.