UNAIDS in action

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.

Now 43 years old, Ariadne Ribeiro Ferreira, a trans woman working for UNAIDS in Brazil, advocates to leaders and speaks to media around the world. As she is an inspiration to colleagues, many are keen to learn more about Ariadne’s story.

From a young age, Ariadne sensed that she was different from those around her. “When my sister arrived, I understood, as a child, that I was like her,” Ariadne recalls.

Ariadne's situation, already challenging, became dangerous when her mother remarried. “My stepfather would beat me almost every day, berating me for my lifestyle,”  she recalls.

At just 13, Ariadne was forced to flee her home. "I had no choice," she remembers. Despite these difficulties, she was fortunate to have a caring grandmother who took her in and provided support. “My grandmother was different from the rest of the family. She was like a teacher to me,” Ariadne reflects. Her grandma had a transgender friend named Zeze, an activist who also inspired her.

At the age of eighteen while living with her grandmother, Ariadne’s life took a turn when she heard on the radio that a local hospital would begin offering sex change surgeries with state support. “My grandma was overjoyed at the news and danced for me,” Ariadne recalls with a smile. Shortly after Ariadne began her transition.

However, that same year she experienced a traumatic event when she contracted HIV after being raped. Despite this devastating ordeal, she refused to give up. She began treatment and continued her life with determination and resilience.

By the age of 24, she had completed all her surgeries, and she had been legally registered a woman. Ariadne officially changed her name on all her documents.

She pursued education to open up opportunities. “I had the chance to specialize at UNIFESP, the second-best university in Brazil. Since then, I have continued my education, earning a specialization, a master’s degree, and recently a Ph.D.”

Ariadne began her healthcare career in Itanhaém, where she worked in a peer education program at a health facility and contributed to a cooperation agreement with the State Government. “I focused on HIV prevention programs, gaining visibility as one of the few transgender professionals at the time,” she explains. “This recognition opened up new opportunities for me.”

Reflecting on her proudest achievements, Ariadne highlights her work with homeless individuals in São Paulo, Brazil and her role in establishing the state’s first shelter for homeless transgender people. Following these accomplishments, she joined UNAIDS in 2019, where she continues to advocate for transgender rights and supports people living with and affected by HIV, using her voice to uplift and empower others.

Ariadne's makes use of her extensive experience to champion the rights and well-being of everyone living with HIV, including UN staff. Working with UN Plus, she is pioneering innovative strategies to uphold dignity in every workplace.  Building a future free from stigma and discrimination, say Ariadne and UN Plus, is how to enable everyone to perform at their best, and to thrive.

After Evelyn Siula’s husband died, she knew she had to get tested for HIV. The result came back as positive.

"I had prepared myself mentally for either outcome, but it was still a shock."

She was jobless and with three children to care for.

The stigma and discrimination surrounding the virus meant that many people were scared to disclose their status. "I had three friends whose families rejected them because their HIV status became known,” Evelyn shares.

But Evelyn chose to break the silence early, starting by telling her young daughter. Family support played a crucial role in Evelyn’s journey. Her family stood by her, offering constant encouragement and strength, vital for getting through the many challenges.

Stigma followed Evelyn. She recalls a particularly painful moment: “At a community gathering, someone pointed at me and asked, ‘Can you believe she’s HIV-positive?’ It was one of the worst experiences being talked about like that.”

Evelyn became a strong advocate for people living with HIV, standing up to stigma everywhere, including in her church. At a gathering in a church, when a speaker criticized people living with HIV, she shared her own status as HIV-positive and as a church elder. Her openness has helped challenge stigma and gain support. Through her work she  learned that many fellow church members were struggling in silence, and so helped create the Livingstonia Synod Positive Christians group, known as LISAP+.

Despite her bold advocacy, Evelyn acknowledges how mental health challenges, particularly fear and anxiety, have affected her. “I have thoughts like: ‘What if something happens to me? What if I die?’ I worry about my children and how they would manage without me. These are the fears that raise my blood pressure.”

But over time, Evelyn’s diagnosis has become not just a challenge but also a source of strength.

Today, Evelyn works for UNAIDS and is the vice chair of the UN Plus Advisory Group. She is proud to show that people living with HIV are leading healthy and productive lives.

She has completed  Bachelor’s and Master’s degrees in business administration. “The day I graduated with my Master’s degree was extra special because I graduated alongside my eldest son. It’s rare for a mother and son to share such a moment.”

Evelyn encourages everyone to ensure they know their HIV status as the first step to taking control of their health: “Please get tested. It's just a status. If you're positive, follow the advice of your doctors. There is full life after testing HIV positive. Take your medication religiously, eat well, and live a healthy life.”

“Never stigmatize anyone,” says Eveyln, “because we are all one.”

UNAIDS has launched the 2030 target-setting process that will provide the framework for the next Global AIDS Strategy. A Global Targets Task Team (GTT) composed of 33 experts from governments, civil society and communities, donors, multilateral organizations and academic public health experts will propose the targets building on the targets set for 2025. The Global Task Team is co-chaired by Chewe Luo, former Director HIV at UNICEF and Michel Kazatchkine, former Executive Director at the Global Fund.

The targets and strategy will underpin and inform the June 2026 High Level meeting on AIDS. The 2030 HIV targets will provide milestones within the SDG 2030 targets of reducing new HIV infections and AIDS-related deaths.

As highlighted in the July 2024 Global AIDS Update – the Urgency of Now : AIDS at a crossroads, there will be millions of people living with HIV in 2030 and beyond. The next set of targets will focus on the services and systems that countries need to have in place to ensure a sustainable country-owned response after 2030. 

In defining the targets, the GTT will consider the balance of proposed thematic areas, measurability, evidence of impact of interventions, gender-sensitivity and human rights. These targets will only be successful if they are adopted by countries. Ensuring their relevance to countries and country engagement will be fundamental to this process. 

The GTT has been undertaking an initial scoping phase and will work until November 2024 to develop a set of recommended targets to UNAIDS. These targets will become the foundations of the next Global AIDS Strategy consultation process.

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.

GENEVA, 29 September 2023—The topic of the global AIDS response—including its successes and invaluable lessons for handling pandemics—permeated many discussions during last week’s United Nations General Assembly (UNGA) in New York. From three High-Level meetings on health, to the Sustainable Development Goals (SDG) Summit to remarks given to the General Assembly and at High-Level Side events, the lessons from 40 years of responding to HIV—including the principle of leaving no one behind—were repeatedly referenced in the context of a future of health and equality for all.

In his remarks to the General Assembly, United States President Joe Biden referenced success against AIDS as a platinum example of what global solidarity and shared responsibility can achieve. “HIV/AIDS infections and deaths plummeted in no small part because of PEPFAR’s work in more than 55 countries, saving more than 25 million lives,” said President Biden. “It’s a profound testament to what we can achieve when we act together when we take on tough challenges and an admonition for us to urgently accelerate our progress so that no one is left behind.”

At the opening of the SDG Summit, Irish prime minister, Leo Eric Varadkar noted that half-way to the 2030 targets we are not where we would wish to be with only 15% of the SDGs on target. He added that despite this there is progress. “More than 800 million people have been connected to electricity since 2015, 146 countries have met or are on track to achieving the under-five mortality target, and effective HIV treatment has halved global AIDS-related deaths since 2010,” said Mr Varadkar. “This progress shows that change is possible, that backsliding is not inevitable, and that poverty, pollution and gender inequality are not pre-ordained. They are trends that can be reversed, problems that can be solved and tragedies that can be averted.”

While celebrating the collective success against AIDS, UNAIDS urged leaders to keep HIV high on political agendas for three reasons. “Firstly,” said Winnie Byanyima, Executive Director of UNAIDS, “The job is not yet done—43 years into the pandemic, there are still more than 9 million people waiting for life-saving treatment, more than 1.3 million new HIV infections every year and AIDS took a life every minute in 2022. Secondly: We know how to end AIDS and, we have the path and the power to do it. And thirdly: The AIDS response is a smart investment yielding other health, social and economic impacts.”  

A number of ministers and heads of state spoke about the economic challenges they face as the result of multiple and concurrent crises, and the need for cooperation and solidarity to overcome these crises while continuing to make critical investments in development and health. Many political leaders noted that while the political will is there, there are not enough domestic resources to invest in health, education and social protection.

The UN Secretary-General Antonio Guterres reminded the international community that there is an urgent need to rethink—and reconfigure--the international financial architecture in order to achieve the SDGs. The same is true for UNAIDS's mission to end AIDS as a public health threat and ensure those gains are sustained well beyond 2030. Ending AIDS requires new and sustained resources, and a different political discourse on funding for development. UNAIDS highlighted the importance for maintaining bilateral funding for PEPFAR and multilateral funding for the Global Fund to Fight AIDS, TB and Malaria.

UNAIDS stressed that as we develop a global architecture for pandemics prevention, preparedness and response, we need to draw from over 40 years of responding to AIDS, because the AIDS response is pandemic prevention, preparedness and response.

The importance of community-led responses as essential to reaching marginalized groups and people most affected by pandemics was emphasized. UNAIDS highlighted that the Pandemic Accord must acknowledge the central role of community-led responses and commit member states to include communities and civil society in decision-making, planning, preparation, implementation and monitoring. 

The call to end inequalities was a central theme to UNAIDS’ messaging at UNGA. UNAIDS highlighted the need for equitable, affordable access to life saving medical products and how inequality drives, and prolongs, pandemics. UNAIDS advocated metrics, targets and accountability systems for focusing the response and additionally for advancing human rights to improve public health and warned that human rights violations undermine trust and drive people away from health services.

Finally, UNAIDS called for a multisectoral/whole of society approach to effectively prevent, prepare for and respond to pandemics because pandemics are not merely health crises—they also present political, social and economic challenges which require transformative action by all.

The Executive Director of UNODC, Ms Ghada Waly, on behalf of UNAIDS’ cosponsoring organizations acknowledged that, “The multi-sectoral partnership on HIV/AIDS is as important as ever, bringing together the expertise, assets and comparative advantages of 11 Cosponsors in an exemplary partnership for the development approach of the SDGs.”

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, 13 July 2023—A new report released today by UNAIDS shows that there is a clear path that ends AIDS. This path will also help prepare for and tackle future pandemics and advance progress towards achieving the Sustainable Development Goals. The report, ‘The Path that Ends AIDS’, contains data and case studies which highlight that ending AIDS is a political and financial choice, and that the countries and leaders who are already following the path are achieving extraordinary results.

Botswana, Eswatini, Rwanda, the United Republic of Tanzania, and Zimbabwe have already achieved the “95-95-95” targets. That means 95% of the people who are living with HIV knowing their HIV status, 95% of the people who know that they are living with HIV being on lifesaving antiretroviral treatment, and 95% of people who are on treatment being virally suppressed. A further 16 other countries, eight of them in sub-Saharan Africa, the region which accounts for 65% of all people living with HIV, are also close to doing so.

“The end of AIDS is an opportunity for a uniquely powerful legacy for today’s leaders,” said Winnie Byanyima, Executive Director of UNAIDS. “They could be remembered by future generations as those who put a stop to the world’s deadliest pandemic. They could save millions of lives and protect the health of everyone. They could show what leadership can do.”

The report highlights that HIV responses succeed when they are anchored in strong political leadership. This means following the data, science, and evidence; tackling the inequalities holding back progress; enabling communities and civil society organizations in their vital role in the response; and ensuring sufficient and sustainable funding.

Progress has been strongest in the countries and regions that have the most financial investments, such as in eastern and southern Africa where new HIV infections have been reduced by 57% since 2010.

Thanks to support for and investment in ending AIDS among children, 82% of pregnant and breastfeeding women living with HIV globally were accessing antiretroviral treatment in 2022, up from 46% in 2010. This has led to a 58% reduction in new HIV infections among children from 2010 to 2022, the lowest number since the 1980’s.

Progress in the HIV response has been strengthened by ensuring that legal and policy frameworks do not undermine human rights, but enable and protect them. Several countries removed harmful laws in 2022 and 2023, including five (Antigua and Barbuda, the Cook Islands, Barbados, Saint Kitts and Nevis, and Singapore) that have decriminalized same-sex sexual relations.

The number of people on antiretroviral treatment worldwide rose almost fourfold, from 7.7 million in 2010 to 29.8 million in 2022.

However, the report also sets out that ending AIDS will not come automatically. AIDS claimed a life every minute in 2022. Around 9.2 million people still miss out on treatment, including 660 000 children living with HIV.

Women and girls are still disproportionately affected, particularly in sub-Saharan Africa. Globally, 4,000 young women and girls became infected with HIV every week in 2022. Only 42% of districts with HIV incidence over 0.3% in sub-Saharan Africa are currently covered with dedicated HIV prevention programmes for adolescent girls and young women.

Almost one quarter (23%) of new HIV infections were in Asia and the Pacific where new infections are rising alarmingly in some countries. Steep increases in new infections are continuing in eastern Europe and central Asia (a rise of 49% since 2010) and in the Middle East and North Africa (a rise of 61% since 2010). These trends are due primarily to a lack of HIV prevention services for marginalized and key populations and the barriers posed by punitive laws and social discrimination.

Funding for HIV also declined in 2022 from both international and domestic sources, falling back to the same level as in 2013. Funding amounted to US$ 20.8 billion in 2022, far short of the US$ 29.3 billion needed by 2025.

There is an opportunity now to end AIDS by increasing political will by investing in a sustainable response to HIV through financing what matters most: evidence-based HIV prevention and treatment, health systems integration, non- discriminatory laws, gender equality, and empowered community networks.

“We are hopeful, but it is not the relaxed optimism that might come if all was heading as it should be. It is, instead, a hope rooted in seeing the opportunity for success, an opportunity that is dependent on action,” said Ms Byanyima. “The facts and figures shared in this report do not show that as a world we are already on the path, they show that we can be. The way is clear.”

In 2022, an estimated:

• 39.0 million people globally were living with HIV
• 29.8 million people were accessing antiretroviral therapy
• 1.3 million people became newly infected with HIV
• 630 000 people died from AIDS-related illnesses

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.