CESIDA—an organization that coordinates the civil society response to HIV in Spain—and the Fernando Pombo Foundation have won an important ruling that, for the first time, recognizes discrimination based on the serological status of a person living with HIV.
The significance of this case lies in the frequency in which similar situations occur to people living with HIV, who continue to face constant stigma and discrimination despite advances in HIV treatment and prevention. 

"This ruling represents a significant achievement in the protection of the rights of people living with HIV against discrimination.  It also marks progress within the framework of the Social Pact for Non-Discrimination and Equal Treatment in relation to HIV, as well as the Global Partnership for Action to Eliminate all Forms of HIV-related Stigma and Discrimination” said Julia del Amo, Director of the Division for the Control of HIV, STIs, Viral Hepatitis, and Tuberculosis at the Ministry of Health.

On 24 October 2022, the Directorate General of Traffic (DGT) informed a person living with HIV that their driving license renewal was reduced to half the usual duration (5 years instead of 10). The only apparent reason for this decision was that the person disclosed their HIV status and treatment during the medical examination, despite this having no impact on their ability to drive.

In response to the DGT's decision, the person living with HIV authorized CESIDA—an organization that coordinates the civil society response to HIV in Spain—to file an administrative appeal. This was possible due to the provision in Article 29 of Act 15/2022, which grants active standing to social entities under certain requirements.

After hearing evidence and arguments by the pro bono legal team from Gómez-Acebo & Pombo, who represented CESIDA, the Administrative Court ruled in favor of CESIDA and annulled the DGT’s decision, finding it discriminatory. This ruling is a groundbreaking decision in Spain.

"This ruling is a crucial step in defending the rights of people with HIV. There is still much to be done, but we are firmly committed to continuing the fight against the stigmatization and discrimination that people living with HIV face in our society," said Oliver Marcos, Secretary General of CESIDA.

The ruling is one of the first cases in which, under Act 15/2022, the standing of an association established to defend human rights is recognized to combat a situation of discrimination within the realm of Public Law.

"This case sets an important precedent in Spain as it is a pioneering ruling against discrimination based on serological status, as well as for the recognition of the active standing of social entities," said Miguel Ángel Ramiro, coordinator of the Legal Clinic at the University of Alcalá. "The admission of the claim by CESIDA, without the need for individual visibility of the person with HIV, represents a key advance in the legal approach to prevent discriminations that, although not always visible, are real,” added Ana Higuera, director of the Fundación Fernando Pombo.

“This ruling in Spain represents a significant step forward in the fight against HIV-related discrimination. It highlights the importance of protecting the rights of people living with HIV and ensuring they are not subjected to unfair treatment based on their HIV status” said Umunyana Rugege, Head of Human Rights at UNAIDS.

Immediate risks and disruptions

1. Access to Kenya electronic medical records system: There are media reports indicating that aggregate health data are not accessible through the Kenya health information system (DHIS2).
2. Commodity availability: Short-term commodity availability has improved, with HIV commodities now being available at facilities. However, human resources for health remains impacted.
3. Service impact: Services for HIV, TB, malaria, immunization, nutrition, and family planning programmes are still affected. HIV prevention programmes have been paused or scaled down.  

Politically relevant updates

1. Impact of US Government funding cuts: The Kenyan Government released a comprehensive report on 24 March detailing the impact of the US Government funding cuts. Key recommendations include:
   • Immediate actions:
     • Establish an emergency health contingency fund.
     • Mobilize domestic resources and reallocate the national budget.
     • Begin high-level diplomatic negotiations with the United States.
   • Medium-to-long-term actions:
     • Strengthen public-private partnerships.
     • Expand universal health coverage and implement health insurance reforms.
     • Develop local pharmaceutical manufacturing.
     • Set up a donor coordination platform with real-time monitoring and mapping.
     • Create a structured contractual and legal framework to ensure resilience.
2. Government convening and mitigation measures: The National AIDS & STI Control Programme and the National Syndemic Diseases Control Council are planning to take an in-depth account of the situation at the county level on HIV treatment for adults and children.

Impact highlights

1. Civil society impact: Kenyan civil societies, led by the Kenya Legal and Ethical Issues Network, have demanded clarification from the Office of Data Protection Commission on measures taken to safeguard health data and ensure compliance with relevant data protection laws.
2. Community-led initiatives: ISHTAR, a key populations-led organization, received funding from other donors to continue with community-led monitoring work until the end of March.
3. UN response: The UNAIDS country office, in partnership with the National AIDS & STI Control Programme and the National Syndemic Diseases Control Council is developing a proposal to mobilize resources from the China International Development Cooperation Agency for HIV and other sexually transmitted infections prevention activities.

Documented impact on services

All facilities/service points providing antiretroviral treatment are working at a reduced capacity. The UNAIDS country office has received reports from the field that HIV commodities are now available at the facilities. The country has currently adequate HIV commodities and those that were running low at health facility level were flagged on 14 March 2025 by the Cabinet Secretary Ministry of Health for distribution by the US supported procurement agency. No stockouts are foreseen in the next 3-6 months. However, human resources for health remains impacted. 

Immediate risks and disruptions 

1. Documented impact on services:

• Reduced availability of PrEP; suspension of HIV prevention education and awareness campaigns, and decreased access to HIV testing and counselling services for key populations.
• Disruption of the distribution of condoms, lubricating gel, antiretroviral drugs.
• All programmes on stigma and discrimination funded by the US Government have stopped. 

2. Disruption of HIV data collection:

• Cessation of data entry at PEPFAR sites, leading to a disruption in HIV data collection.

3. Decrease in viral load testing:

• Viral load testing has decreased due to the slowdown in services at PEPFAR-funded sites.

4. Stock concerns:

• Concerns about stock-out of HIV test kits within 3-6 months.
• Condom stocks are sufficient for 1-3 months; but there is a need for 800,000 condoms per month, with funding for procurement being a concern.

5. International NGO-run services:

• All services run by international NGOs funded by US Government/PEPFAR have stopped. 

Politically relevant updates 

1. Government actions:

• The National Programme for the Fight against HIV/AIDS and Sexually Transmitted Infections has conducted an analysis of service provision, commodity availability, and human resources.
• The National Council for the Fight against AIDS sent an information note to the President and the Ministry of Health.
• Advocacy efforts with other technical and financial partners to mobilize resources to fill gaps.
• Integration of HIV services into other health services is being worked on by the government.
• The government is funding 55 operational sites and 142 mediators.

2. Civil society impact:

• Civil society has assessed financial, programmatic, and human resources gaps.
• Consultation meetings with the National Program for the Fight against HIV/AIDS and Sexually Transmitted Infections and implementation of a roadmap. 

Impact 

1. Impact of USAID funding suspension:

• 11,000 people living with HIV will lose access to antiretroviral treatment.
• 24,769 people living with HIV will no longer have access to viral load testing.
• 10,000 individuals, including pregnant women and their children, will miss out on testing.
• 203 project staff are facing technical unemployment since January 2025.

2. Current financial gaps:

• Togo faces a financial gap of 2.1 billion FCFA (West African CFA franc) for 2025, with 1.6 billion FCFA needed for antiretroviral medications and reagents.

3. Proposed solutions:

• Increase the state budget line for health from 2.5 billion FCFA to 5 billion FCFA.
• Include HIV as a chronic disease in the universal health insurance mechanism to ensure sustainable domestic funding. 

UN response 

• The UNAIDS Country Office is meeting with networks of people living with HIV and key populations, and a country-level task team is in place, including representatives from people living with HIV and key population networks.