GENEVA, 2 June 2024—On International Sex Workers’ Day, 2nd June 2024, and every day, UNAIDS stands in solidarity with sex workers in support of their health.

Intersecting forms of structural and societal stigma and discrimination, including punitive laws, policies and practices, widen inequalities and prevent sex workers from being able to protect their health, safety and well-being. Criminalization creates barriers to enabling access to and uptake of vital HIV prevention, testing and treatment, and to sexual and reproductive health services. For sex workers who are transgender, migrants or from racial and ethnic minorities, multiple and intersecting forms of discrimination create additional barriers to services and increase risks of facing violence and harassment.

A study in sub-Saharan Africa found that the likelihood of living with HIV was seven times higher for a sex worker in a country that criminalizes sex work compared with a country that decriminalized sex work. Another review found that criminalization of any aspect of sex work was associated with reduced condom access and use and increased rates of violence. Decriminalization of sex work could avert between 33% and 46% of HIV infections among sex workers and their clients over a ten-year period.  

Among countries reporting to UNAIDS, 22% of sex workers had experienced stigma and discrimination in the past six months. 12% of sex workers had avoided accessing health-care services due to stigma and discrimination in the past 12 months. One in five sex workers experienced violence in the past 12 months.   

Currently 168 countries have punitive laws that criminalize some aspect of sex work. But a growing number of jurisdictions are recognizing the need to decriminalize sex work to protect sex workers. In May this year Queensland in Australia became the latest jurisdiction to decriminalize sex work. 

“To protect sex workers’ health, leaders need to accelerate action to tackle the stigma, discrimination and violence that sex workers face. This will require decriminalization. The evidence is clear: punitive laws hurt sex workers and need to be removed,” said Christine Stegling, Deputy Executive Director, UNAIDS.  

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, 30 May 2024— The Government of Australia and UNAIDS have today signed a new multi-million-dollar partnership to strengthen the fight against both non-communicable and communicable diseases, including HIV, to ensure better health outcomes for people in the Pacific and Southeast Asia. The signing took place at UNAIDS during the 77^th World Health Assembly.

The AU$12 million funding agreement will support governments and local communities in the region to improve HIV prevention, testing and treatment while reducing stigma and discrimination. The funds will be dedicated to advancing the HIV response in Papua New Guinea, Fiji, the Philippines, Indonesia, and Cambodia over the next four years.

“This is an important investment for the region, and a valuable partnership for UNAIDS. It will deliver multiple benefits, including tackling rising HIV infections in some countries,” said Christine Stegling, UNAIDS Deputy Executive Director. “This much-needed financial support by the Australian government will go a long way in the fight to end AIDS as a public health threat in the Pacific and Southeast Asia by 2030. More than that, it’s a demonstration of Australia’s commitment to protect people’s health and human rights beyond its own borders.”

Efforts to prevent new HIV infections in the Pacific and Southeast Asia need to be scaled up urgently as epidemics are rising in a number of countries including Papua New Guinea, Fiji and the Philippines. Stigma and discrimination are contributing to the rise, obstructing access to HIV prevention, testing and treatment services, particularly for men who have sex with men.

The financial injection, for both HIV prevention and treatment, adds to the existing AU$25 million multi-year (2022-2027) partnership between UNAIDS and the Australian Government in the Asia Pacific region, representing an expansion of the longstanding programming partnership. It’s also part of Australia’s Partnerships for a Healthy Region – an Australian Government initiative that works with governments and civil society organisations in the Pacific and Southeast Asia to build resilient, equitable and inclusive health systems that can respond to shared health challenges.

“Australia’s domestic response to HIV has always recognised that the people closest to the issue are also best placed to lead on the solutions. As policy makers and funders we must listen, support, and build genuine partnerships with affected communities and civil society organisations,” said Dr. Lucas de Toca, Australia’s Ambassador for Global Health. “Australia is proud these principles of listening and supporting are central to our new partnership with UNAIDS and Health Equity Matters. This new partnership will support locally led solutions to the HIV epidemic in our region – enabling affected communities to lead the response.”

Domestically, Australia remains committed to ending its AIDS pandemic by 2030 and recently announced a AU$43.9 million investment to boost the fight against HIV. Australia is well on the way to reaching the 95-95-95 targets by 2025.

“This commitment is a practical expression of solidarity and co-operation between the people of Australia and our near neighbours in Papua New Guinea, Fiji, the Philippines, Indonesia, and Cambodia,” said Dash Heath-Paynter, Chief Executive Officer of Health Equity Matters. “By investing in the HIV response in our region we plant the seeds for a healthier, more prosperous future, with a lighter burden of stigma and discrimination. We recognise the leadership exercised by both the Australian Government and UNAIDS in making this commitment."

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.

Resolution on ‘Women, the Girl Child and HIV and AIDS’ updated, strengthened and adopted by consensus at the 68^th session of the Commission on the Status of Women

GENEVA/NEW YORK, 25 March 2024—On 22 March, governments attending the 68^th session of the Commission on the Status of Women (CSW) adopted, by consensus, a resolution focused on advancing the rights and empowerment of women and girls as part of efforts to end AIDS.

The updated resolution 60/2, Women, the Girl Child and HIV and AIDS, underscores the urgent need to prioritize the health and rights of adolescent girls and young women in the context of the ongoing global AIDS pandemic. It recognizes that adolescent girls and young women are still disproportionately affected by HIV due to various socio-economic factors, including gender inequalities, poverty, and lack of access to education and healthcare.

The resolution underscores the imperative of advancing gender equality as central to ending AIDS, and reaffirms the commitments made in the 2021 United Nations General Assembly Political Declaration on HIV and AIDS. The resolution calls for all governments to enact and intensify the implementation of laws and policies to eliminate all forms of gender-based violence, as well as end HIV-related stigma and discrimination against women and girls. It also calls for promoting active and meaningful participation and leadership of women and girls living with HIV in the AIDS response.

Winnie Byanyima, Executive Director of UNAIDS, expressed optimism and her profound appreciation for the adoption of the resolution, stating, "By committing to prioritizing the health and rights of women and girls in all their diversity and addressing HIV comprehensively, leaders have helped safeguard the health of women and girls, which will result in a more equitable and resilient future.”

Nyaradzayi Gumbonzvanda, Deputy Executive Director of UN Women, a cosponsoring organization of UNAIDS which was instrumental in organizing and ensuring a successful outcome of CSW said, “Empowering women, securing rights and achieving equality is an imperative.”

UNAIDS applauds the leadership of Southern African Development Community (SADC) and Angola as its current chair for successfully championing the update of the resolution which was initially adopted in 2016. The updated resolution will continue to serve as a guiding framework for governments, communities and civil society groups, and all stakeholders as they collaborate to safeguard the rights of women and girls living with, at risk of and affected by HIV.

Crucially, UNAIDS emphasizes the importance of translating the commitments outlined in the resolution into concrete actions at the national, regional, and global levels. Efforts must focus on closing the gender gap in HIV prevention, treatment, care and support, while also addressing the underlying social, economic, and structural factors that perpetuate gender-based discrimination, violence, and inequalities and increase the vulnerability of women and girls to HIV.

UNAIDS remains steadfast in its commitment to working collaboratively with governments, civil society, and other partners to create a world where the rights and dignity of all women and girls are respected, protected, and fulfilled, including women and girls living with, at risk of and affected by HIV.

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.

UN Plus, the association of United Nations (UN) staff members living with HIV has been re-established. 

Originally created in 2005 to advocate for the rights and well-being of UN staff members living with HIV around the world, the association paused its operations in 2021 due to global changes and funding challenges. Now, a newly established nine-member advisory committee from various UN entities and regions around the world is working again to ensure that UN staff members living with HIV have access to medications, health insurance benefits, and mental health support, as well as to actively combat HIV-related stigma and discrimination within the UN system.

“I want to express my gratitude for the admirable work that you are doing to revitalize the UN Plus mission,” said Winnie Byanyima, UNAIDS Executive Director. “Together we can make a difference, let’s ensure a safe, supportive UN environment for all, which must include people living with HIV,” she added.

As part of its revitalization efforts, UN Plus members conducted a global survey in late 2023 to understand the experiences and challenges of their colleagues living with HIV. 74 respondents from diverse backgrounds shared their experiences with stigma, discrimination, and health-related issues.   

The survey findings underscored that many UN workforce living with HIV still face workplace stigma and discrimination, which negatively affects their professional opportunities and personal well-being. Mental health concerns were also prominent, often stemming from issues related to their HIV status.

UN Plus will work closely with UN agencies, to develop and implement policies that specifically protect the rights of its staff living with HIV. This includes advocating for non-discriminatory hiring practices and career advancement opportunities.

John (JB) Bryant Collier, Chair of UN Plus Advisory Group stated that UN Plus will address those issues through a comprehensive plan informed by the survey findings. “UN Plus is committed to making UN workforce members living with HIV feel supported and empowered wherever they are in the world,” he said.

UN Plus plans to introduce training programs for UN staff members to raise awareness about HIV and HIV-related stigma and discrimination and mental health issues, as well as the importance of supportive workplace environments.

In addition, UN Plus will work to ensure that UN staff members living with HIV have access to the latest treatments and medications and will set up mechanisms for regular monitoring and reporting on their status and well-being, including periodic surveys and feedback sessions to continually adapt and improve the provision of support services.

The relaunch of UN Plus signifies a strong commitment to improving the work environment and overall well-being of UN workforce members living with HIV, and to ensuring they receive the support and resources necessary to thrive professionally and personally.

Azima has lived with HIV since childhood; she was abandoned by her parents and raised by her grandmother.

Today she is recognized as an inspirational community leader in the HIV response, including for the vital role she has played in tackling stigma as the first young woman in Uzbekistan to disclose her HIV-positive status.

"I am strong. I have a bright future ahead. And I will achieve my goals,” says Azima.

She has faced both positive and negative reactions since her disclosure. Throughout, Azima has remained a committed activist. She is especially thankful to her community of peer support, a group of children and young people living with HIV supported by UNICEF.

“In the end, the energy of the people who supported me was so strong that it helped me rise above other people's criticism,” she said.

As a peer educator, Azima works tirelessly to raise awareness about HIV.

Today, Azima is studying psychology at Fergana State University. This choice of future career was encouraged by her grandmother and inspired by a psychologist who worked in her support group.

Because of her HIV treatment, Azima cannot transmit HIV to her husband. Several months ago, she gave birth to an HIV-free baby girl.

She is thankful for her family. “My husband has always supported me,” says Azima.

Azima’s story exemplifies the progress made in Uzbekistan’s HIV response. Antiretroviral therapy is provided free of charge to all in need in Uzbekistan. The country is also making efforts to ensure all women living with HIV receive timely treatment, so that all babies will be born HIV-free. Coverage of pregnant women who receive antiretroviral treatment to prevent vertical transmission of HIV has been around 98% since 2016, according to the Uzbekistan Republican Center to fight AIDS.

“The rate of vertical HIV transmission in 2023 was 0.2%. We aim to reduce this figure to 0%. The Republic of Uzbekistan is on the verge of receiving an international certificate for the elimination of mother-to-child HIV transmission,” said Bahrom Igamberdiyev, Director of the Republican AIDS Center in Uzbekistan.

The country has approved a "Roadmap for Implementing Measures to Achieve the Validation of the Elimination of Mother-to-Child Transmission of HIV for 2024-2026". This roadmap will be implemented with the participation of all partners, allowing Uzbekistan to reach its goal and obtain validation for the elimination of vertical transmission of HIV. An effective HIV response is a priority for both the government and civil society in Uzbekistan.

However, some critical challenges in the HIV response in Uzbekistan, particularly concerning HIV prevention, which are deeply rooted in societal norms and systemic inequalities.

These, according to the recently released Gender Assessment Report for Uzbekistan, include limits on women's decision-making power, leaving many women dependent on male relatives for important life choices, including healthcare decisions.

Despite the Government’s commitment and legislative efforts to address gender-based violence, underreporting remains a significant issue. The prevalence of early and arranged marriages also contributes to the limited autonomy of women, depriving many of them of educational and economic opportunities and impeding access to comprehensive sexual education. Cultural norms limit open discussions on reproductive health and prevention in many social contexts including family and educational settings.

As a result, the latest survey found that only 14% of women between 15 and 49 years old have comprehensive knowledge about HIV. This reduces to 10% for young women between 15 and 25 years old.  “Addressing these systemic issues requires comprehensive efforts to promote gender equality, ensure access to sexual and reproductive health and rights, and empower women economically. UNAIDS is working with partners to improve access to education and create an enabling environment for women to realize their full potential,” said Eamonn Murphy, UNAIDS Regional Director for Asia-Pacific and Eastern Europe and Central Asia.

Azima is stepping up her advocacy role, pointing out that openness and education are crucial in fighting stigma and advancing access to prevention, testing and treatment. She advises young women to disclose their HIV status to partners early in relationships and emphasizes the importance of adherence to treatment and of mutual support within families.

Azima will continue breaking stereotypes, promoting awareness, and embracing her journey with courage and determination. Azima exemplifies the learning that HIV responses succeed when we let communities lead.

GENEVA, 29 May 2024—As LGBTQ+ communities and allies take to the streets to mark PRIDE month, UNAIDS is speaking out in solidarity, rejecting the criminalization, discrimination and stigmatization of LGBTQ+ people and insisting on respect for all.

“The PRIDE celebrations are a demonstration of the power of inclusivity,” said UNAIDS Executive Director, Winnie Byanyima. “PRIDE has brought the world a long way in the struggle to protect the human rights of LGBTQ+ people. So much has been won. But the progress that has been made is under threat. The world needs the spirit of PRIDE more than ever today: to protect everyone’s health, we need to protect everyone’s rights.”

There is much to celebrate. UNAIDS data shows that 123 countries do not penalize same-sex relations. This represents the highest number of countries rejecting criminalization ever.

More and more countries have been scrapping the harmful punitive anti-LGBTQ+ laws which are often leftovers of colonial rule. Since 2019 alone, Botswana, Gabon, Angola, Bhutan, Antigua and Barbuda, Barbados, Singapore, Saint Kitts and Nevis, Cook Islands, Mauritius and Dominica have all repealed laws that had criminalized LGBTQ+ people.

However, the human rights of the LGBTQ+ community are threatened by a globally coordinated and well-funded extremist anti-rights network who are spending millions promoting hate and social division and are proposing ever more draconian laws to punish LGBTQ+ people. Attacks on LGBTQ+ people violate human rights and undermine public health.

This perilous time calls for courage and solidarity from everyone. PRIDE has always been as much about protest and commemoration as celebration. The first marchers in New York more than 50 years ago knew that PRIDE was the antidote to stigma and discrimination – a rejection of the shame that others sought to impose on them.

Movements spearheaded by LGBTQ+ activists have driven much of the progress that has been made in protecting everyone’s human rights and protecting everyone’s health.

Today we are at a hinge moment: the end of AIDS as a public health threat is realisable in this decade, but progress is imperiled by the pushback on human rights.

At a time when support for human rights defenders is vital and urgent, funding support for civil society organizations is shrinking, as donor countries cut their budgets.

The evidence is crystal clear: stigma kills, solidarity saves lives.

This is a moment for solidarity. This is a moment for PRIDE.

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, 15 May 2024—Ahead of IDAHOBIT, commemorated worldwide on 17 May, UNAIDS is calling on governments everywhere to protect the human rights of LGBTQ+ people. Protecting the human rights of every person, UNAIDS research shows, is essential for protecting public health, because it enables inclusive and equitable access to health services without discrimination.

The movement for human rights for all has made important progress. For example, whereas, at the start of the AIDS pandemic, most countries criminalized LGBTQ+ people, now two thirds of countries do not.

However, more than 60 countries still do while another 20 countries criminalize gender expression and identity.

“Stigma, discrimination and criminalization can be lethal,” said Winnie Byanyima, Executive Director of UNAIDS. “In the response to HIV, we have learned that a human rights-based approach is critical in responding to a health crisis and leaving no-one behind. Countries must remove these discriminatory criminal laws and introduce legislation which protects rights if we are to end AIDS as a public health threat for everyone.”

Discrimination, violence and criminalization force many LGBTQ+ people underground and away from health services; as a result, gay men and other men who have sex with men, and transgender people, are more affected by HIV. Globally, in 2022, men who have sex with men were 23 times more likely to acquire HIV, and transgender women 20 times more likely to acquire HIV than other adults aged 15–49.

Criminalization of LGBTQ+ people in particular causes significant harm to health. In sub-Saharan Africa, men who have sex with men in countries where they are criminalized, are five times more likely to be living with HIV than in countries that do not criminalize same-sex sexual behavior.

As a recent IAS - Lancet report demonstrated, violations of human rights have multiple damaging impacts on public health. Treating people as criminals drives people away from vital services for fear of arrest and discrimination, resulting in them not accessing HIV prevention, treatment and care.  In addition, strict anti-LGBTQ+ laws have been associated with a lack of knowledge about HIV testing and HIV status.

“For far too many people in our LGBTQ+ communities and beyond, the most basic things are still too far from reach, because of the discrimination, stigma, and violence they face every day,” said the international lesbian, gay, bisexual, trans and intersex association, ILGA World, co-Secretaries General Luz Elena Aranda and Tuisina Ymania Brown.  “This is why they are rallying behind an urgent cry: ‘No one left behind: equality, freedom and justice for all,’ reminding us of the importance of rejecting discriminatory laws, policies, and attitudes.”  

Criminal laws that discriminate on the basis of sexual orientation and gender identity are a breach of the right to privacy and non-discrimination and impede the HIV response. UNAIDS calls on all states to repeal such laws and to introduce legal protections against discrimination on the basis of sexual orientation.

UNAIDS, the World Health Organization, the United Nations Development Programme, and the Global Commission on HIV and the Law have made the same recommendations, as have the Office of the United Nations High Commissioner for Human Rights and several other United Nations agencies.

UNAIDS stands with LGBTQ+ people everywhere who are facing hate, discrimination and marginalization, and calls for an end to their criminalization.

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, 30 April 2024—The Joint United Nations Programme on HIV/AIDS (UNAIDS) is deeply concerned about the impact of the harmful new legislation in Iraq amending the 1988 anti-sex work law to criminalize LGBTQ+ people. The legislation imposes a prison sentence of between 10 and 15 years for same-sex sexual relations. Transgender people face up to three years imprisonment for expressing their gender or receiving gender affirmation care.   Individuals also face up to seven years for promoting homosexuality. And up to three years for providing gender affirmation care.

Criminalizing consensual same-sex relationships and gender expression not only violates fundamental human rights but also undermines efforts to end AIDS by driving marginalized populations underground and away from essential health services, including life-saving HIV prevention, treatment and care services.

Globally, the movement for human rights has made progress in the past 40 years. At the start of the AIDS pandemic in the early 1980s, most countries criminalized same-sex sexual activity between men, now two thirds do not. An increasing number of countries have also recognized the rights of trans and other gender diverse people. However, this new legislation in Iraq represents a significant setback and is part of a wave of punitive and restrictive laws being passed that undermine the rights of LGBTQ+ people.  

The legislation passed in parliament is an amendment to an existing 1988 anti-sex work law which continues to criminalize both the selling and buying of sexual services. The amendments passed on Saturday 27 April 2024 increase the penalties in relation to sex work. These laws, which countries committed to removing under the 2021 United Nations General Assembly Political Declaration on HIV and AIDS, likewise undermine the human rights and public health of sex workers.

UNAIDS calls upon the authorities of Iraq to overturn this discriminatory legislation and fulfill its obligations under international human rights law to protect the rights of all people, regardless of sexual orientation or gender identity. UNAIDS stands in solidarity with LGBTQ+ people and communities and reaffirms its commitment to work with partners to promote equality, end stigma and discrimination, uphold human rights—including the right to health, and ensure access to comprehensive HIV services for everyone, everywhere.

UNAIDS

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

As countries work to reach the goal of ending AIDS as a public health threat by 2030, planning is urgently needed for sustaining the gains from the HIV response beyond 2030.

With that in mind, UNAIDS has released the “HIV Response Sustainability Primer” which proposes a new approach to ensure the sustainability of the HIV response. This holistic approach includes programmatic, political, policy-related and financial aspects of the HIV response. The new Primer provides the rationale, the definitions, and an in-depth explanation of this new sustainability approach.

“The moment is right, the imperative is now, the global HIV community must come together to dialogue about what is needed to sustain the HIV response by and beyond 2030,” says Jaime Atienza, Director of Equitable Financing at UNAIDS. “We are calling on leaders to initiate national conversations about the future state of a sustained HIV response, and the transformations needed to achieve and sustain impact, by and beyond 2030, including looking at the policy changes, donor commitment and investments needed to translate them into results and concrete changes at country level.”

The goal of sustainability is not to perpetuate the HIV response in its current form. Rather, it is to ensure the durability of the impact of the HIV response. This will require a shift in focus to long-term sustainability. Transformative action, starting now, will be needed to make this a reality by and beyond 2030.

For instance, the strategies and delivery modalities required for scaling up prevention and treatment services and to ensure a stable enabling environment to reach the 2030 target will differ from those that will be needed for long-term sustainability. Leveraging societal enablers will be especially critical for sustainability, including minimizing HIV vulnerability and ensuring access to services in future decades. Rather than build incrementally on what is already in place, sustainability will demand transformations in human rights based, people-centred policies, programmes and systems.

Sustainability will require different measures and approaches in diverse settings, highlighting the importance of tailoring planning and implementation for specific contexts. Therefore, this Primer outlines a new approach to planning for and implementing sustainable national HIV responses—to reach global AIDS targets and maintain the gains of the HIV response beyond 2030.

Through country driven and owned processes that leverage specific data, countries will develop HIV Response Sustainability Roadmaps which will chart the pathways for country level strategies and actions to achieve and sustain impact, leaving no one behind. The stages and ways of developing these Roadmaps are also contained in the “HIV Response Sustainability Primer”.

The Sustainability Roadmap will be distinct from, yet complimentary to, National Strategic Planning exercises (NSPs). Each country’s Roadmap should be a living document, allowing for the continual reassessment and evolution of HIV interventions, programmes and policies as contexts and circumstances change.

As a key transformation required for long term sustainability, countries are advised to prioritize the careful and effective integration of the HIV response in national systems, with appropriate attention to reforms or modifications required for key and vulnerable populations. This transformation will increase efficiency, promote equity, maximize resource utilization and contribute to the dual goal of achieving and sustaining HIV epidemic control and strengthening human rights based, people-centred systems for health.

The process for developing the HIV Response Sustainability Roadmaps is aligned with the principles, goals and targets set out in the Global AIDS Strategy 2021–2026 and in the 2021 Political Declaration on Ending AIDS. International partners will support country driven processes through the provision of technical support, including a series of resources described in this Primer.

The proposed new approach to sustainability outlined in this newly released Primer will require all participants, including international actors, to be ready to undergo transformations on the way they have been carrying forward the response to better prepare for the post 2030 world.

To support such actions, sustainability will be at the top of UNAIDS priority agenda in 2024. Together with its co-sponsors, partners such as PEPFAR and the Global Fund, and other stakeholders of the Global HIV community, UNAIDS is resolute in its commitment to supporting countries leverage the tools and analytics, the lessons learned, the science of what works where, to foster open and honest dialogue on the future of the HIV response, the transformations needed to ensure that responses across the globe are not in danger of putting millions of lives and livelihoods at risk and the financing commitments needed for scale and impact. 

There are more people than ever before living with HIV and in need of lifelong treatment (39 million in 2022), with this number set to rise in the coming years. Ensuring long-term resourcing is vital.

However, resources for HIV are severely constrained. In 2022, US$ 20.8 billion was available for HIV programmes in low- and middle-income countries––2.6% less than in 2021 and well short of the US$ 29.3 billion estimated to be needed by 2025. In addition, UNAIDS estimates that in 2022 there was a 90% shortfall in funding for HIV prevention among key populations most affected by HIV, including men who have sex with men, sex workers and people who inject drugs.

As countries work to reach the goal of ending AIDS as a public health threat by 2030, planning is urgently needed to protect and build on the HIV gains made to date, increase efforts to reach people most affected by HIV, and to sustain the HIV response into the future.

This is why UNAIDS has developed an HIV sustainability framework which includes transformations in policy, programmes and systems to sustain the HIV response beyond 2030. To ensure success in sustaining the HIV response, UNAIDS is supporting all stakeholders on long-term planning.

“As the global community pushes towards the ambitious goal of ending AIDS as a public health threat by 2030, a crucial conversation is needed now on how to sustain the hard-won gains of the HIV response well beyond 2030,” said Winnie Byanyima, Executive Director of UNAIDS. “A paradigm shift is needed to ensure the long-term sustainability of the HIV response, a journey that demands transformative action starting today.”

To support countries and partners in implementing the Sustainability Framework as outlined in the UNAIDS HIV response sustainability primer, UNAIDS has released a new Companion Guide which includes country-specific analytical resource packages and a sustainability assessment tool. These resources will serve as tools to help countries and partners develop roadmaps and navigate the path towards sustainability.

The companion guide offers flexible stepwise methodology, allowing each country to tailor the sustainability framework to its unique context. With practical tools and insights, it serves as a compass for initiating and guiding the roadmap development process.

“Developing sustainability roadmaps is key to the HIV sustainability framework and will empower countries to navigate the complex terrain of sustainability,” said Angeli Achrekar, Deputy Executive Director for Programme, UNAIDS.

The country analytical resources package features granular data tables, graphics, and essential fiscal and macroeconomic metrics, broader health system analytics and additional qualitative information. The package serves to facilitate sustainability dialogues essential for planning that fits each country's epidemic characteristics and broader economic and health system landscape.

Central to this journey is also the sustainability assessment tool. This tool empowers stakeholders to identify and address risks across political, structural, financial, and programmatic domains. It also facilitates the discovery of new strategies to enhance the HIV response and drive continuous improvement towards 2030 and beyond.

“Through its intuitive interface, the sustainability assessment tool will help countries understand how to ensure that their HIV response is sustainable – identify the big milestones needed and to organize how to get there,” said Christine Stegling, Deputy Executive Director, Policy, Advocacy and Knowledge Branch, UNAIDS.

Sustainability to 2030 and beyond will require strong political leadership across multiple sectors, and the active engagement of people living with HIV and of key and vulnerable populations. Resources will need to be mobilized from both domestic and international sources, and flexibility and resilience will be required as epidemics evolve, and shifts occur in changing economic, political and social contexts.

UNAIDS will work side by side with countries and partners to enable them to successfully implement the new sustainability framework, so that all people living with and affected by HIV can continue accessing the lifesaving HIV services they need, have their rights protected, and be able to thrive.