UNAIDS is releasing an updated version of its guidelines for conducting National AIDS Spending Assessments (NASA). The guidelines are aimed at NASA implementers and HIV programme managers utilizing HIV expenditure data to influence budgetary, policy and programmatic decisions. 

NASA is a comprehensive, systematic approach to tracking HIV expenditures and analyzing financial resources dedicated to the HIV response within a country. NASA results can identify which programmes and interventions are most underfunded and require prioritization, as well as those dependent on external sources and thus most vulnerable to external shocks. By providing this granular view, NASA data supports sustainability planning and integration into broader health financing systems, while also identifying potential inefficiencies and cost-saving opportunities, increasing evidence for allocative efficiency measures and fostering a performance-based financing culture aligned with value-for-money principles. 

Importantly, the NASA approach allows for the tracking of resources being directed to, and used by, the community-led response, and for all community-based interventions. Without the detailed expenditures collected via NASA or through a similar approach, it would be difficult to monitor progress towards the global targets regarding community-leadership in the HIV response, as well as other country and global targets, including co-financing commitments. 

These detailed expenditure data are critical to sustainability planning by providing an updated picture of the financial landscape which helps countries identify future trends and potential funding gaps, to inform their resource mobilization options and measure their progress towards sustainability of their HIV responses. 

The NASA framework has been developed by UNAIDS in collaboration with partners and country stakeholders, evolving over more than two decades to provide a globally accepted, standardized and comparable approach to tracking the multisectoral resources invested in the HIV response. It aligns with the System of Health Accounts developed by the World Health Organization and is based on the triaxial framework of accounting (refer to figure below). NASA’s classification system allows for the detailed matching of the spending against the priorities outlined in countries’ national HIV strategic plans (NSPs) and the Global HIV Strategy. Since the late 2000s, over 80 countries have undertaken at least one NASA, with many countries undertaking assessments routinely, mostly in low and middle-income countries (LMICs). UNAIDS also offers an expanded range of resource tracking approaches to best suit country needs - including NASA-basic for resource constrained settings, requiring less time and fewer resources (typically 4–6 weeks) and NASA-plus for deeper dives into community-led response or TB tracking.   

UNAIDS provides capacity building, technical tools and guidance, as well as technical support to countries for their routine expenditure data collection, analysis, and dissemination. UNAIDS also continues to support the strengthening of public expenditure systems, and HIV resource tracking within these, to improve governments’ ability to track and manage all their HIV and health-related expenditures, linking these to performance indicators, to achieve optimal outcomes with their available resources.  

To promote transparency and accountability, UNAIDS and the Equitable Financing Practice synthesizes NASA and Global AIDS Monitoring (GAM) financial indicators making them publicly available and empowering stakeholders to interpret and advocate for improved resource allocation: https://hivfinancial.unaids.org/hivfinancialdashboards.html#  

The findings from NASA will be instrumental in shaping the future direction of the HIV response in any given country. They will also support the broader goals of achieving universal access to HIV prevention, treatment, care and support services, and ultimately, in ending the AIDS epidemic as a public health threat by 2030. 

A nationwide campaign in Spain is raising awareness of the labour rights of people living with HIV, while strengthening the commitment of businesses, public administrations and civil society to combat stigma and discrimination.

Led by the non-profit association Trabajando en Positivo, the #YoTrabajoPositivo initiative is marking its tenth anniversary this year. For a decade, the initiative has travelled across Spanish cities raising awareness and advocating for the labour rights of people living with HIV, connecting companies, trade unions and institutions in this effort.

Medical advances have transformed the outlook for HIV. With timely diagnosis and proper treatment, people living with the virus can enjoy life expectancies and quality of life comparable to those of the general population. Nevertheless, stigma and discrimination remain real barriers to labour inclusion.

According to Spain’s Ministry of Health, 19% of the population report feeling uncomfortable at the idea of sharing a workplace with someone living with HIV. Similarly, the International Labour Organization’s Global Survey on HIV-related Discrimination in the World of Work (2021) revealed that a significant proportion of respondents (59.6%) supported measures that violate human rights, such as mandatory HIV testing for employment, highlighting the need to strengthen training and awareness. A further study, Experience of Stigma among People Living with HIV in Spain (Social Pact for Non-Discrimination and Equal Treatment Associated with HIV, 2024), reveals that many people with HIV still fear losing their jobs or being treated differently by colleagues if their status were known.

In this context, the initiative operates on three complementary fronts: providing evidence-based information, showcasing personal testimonies, and promoting good business practices. Together, these elements aim to dispel medical myths and transform workplace attitudes and organizational cultures.

Campaigns such as the #YoTrabajoPositivo Route play a vital role in spreading key messages that help to end stigma in workplaces including:

• HIV is not ordinarily transmitted in work environments.
• People living with HIV can perform any job with the same ability as anyone else.
• With effective treatment, people living with HIV can expect to live a normal lifespan and have full work capacity.
• There is no legal obligation to disclose HIV status in the workplace.

These messages are disseminated through public events, educational materials, and activities in public spaces, bridging the gap between scientific evidence and people's everyday experiences.

The initiative is also part of broader corporate social responsibility and equality promotion efforts in employment. Participation by companies in the Business Initiative Committed to HIV (Empresas Comprometidas con el VIH) has led to the development of internal policies that ensure HIV status does not negatively affect recruitment, retention or promotion processes. These policies also foster training and awareness among staff.

Over the past ten years, the #YoTrabajoPositivo initiative has created public spaces for dialogue on the right to work free from discrimination. It has brought scientific knowledge closer to the general public and fostered cross-sector collaboration.

Building on Spain’s commitment within the Global Partnership for Action to Eliminate All Forms of HIV-Related Stigma and Discrimination, the initiative shows how strong country leadership — combined with evidence, visibility, and collaboration — can transform attitudes and create fairer, more inclusive workplaces.

POLOKWANE, SOUTH AFRICA, 7 November 2025 — The Ministerial Statement issued from the G20 Ministerial in Polokwane has set out concrete actions to protect public health by fighting inequalities. The statement details key global and national steps to address the inequality-drivers of pandemics including AIDS and to help end TB, to advance access to medicines and to strengthen global health security.  

South Africa’s leadership of the G20 has been praised by experts including Nobel Prize Winning Economist Joseph E. Stiglitz, world-leading epidemiologist Sir Michael Marmot, and Executive Chairperson of the One Economy Foundation and former First Lady of Namibia Monica Geingos, the three Co-Chairs of the Global Council on Inequality, AIDS, and Pandemics established by UNAIDS. 

The statement reflects important alignment with the Global Council’s landmark new report, Breaking the inequality-pandemic cycle: building true health security in a global age, which revealed a vicious cycle: how inequality is making pandemics more likely, more deadly and more costly; and how pandemics are increasing inequalities. The Global Council held the international launch of the report on Monday this week in Johannesburg and then presented the report to President Cyril Ramaphosa in Cape Town on Tuesday, before heading to Polokwane to address health ministers on Thursday and Friday.  

The statement sets out key actions to be taken that were recommended by the Global Council’s report including through: 

• Promoting affordable, rapid access to pandemic medicines like long-acting HIV drugs
• Addressing the ways high levels of debt are making the world vulnerable 
• Tackling the social determinants of health  

UNAIDS Executive Director Winnie Byanyima, who convened the Global Council on Inequality, AIDS, and Pandemics, paid tribute to South Africa for its leadership in advancing access to medicines, on debt and financing, and for its drive for universal health coverage through national health insurance. “President Ramaphosa is lighting the way to a world that is both fairer and safer. Inequality is bad for public health. International action to address inequality will benefit everyone,” she remarked. 

Sir Michael Marmot said: “South Africa is right to insist that the inequality-pandemic cycle can be broken, and is right to highlight that failing to act would be dangerous and unaffordable. The world needs to move urgently from the dangerous failure of austerity to the proven effectiveness of investments in health and in the social determinants of health.” 

Joseph E. Stiglitz speaking at the Ministerial congratulated South Africa for modelling leadership in health through its national health insurance programme. He urged countries in the Global North to lift the barriers blocking access to pandemic-ending medical technology for millions of people in the Global South. “Viruses don’t know about passports and visas,” he noted. “We need everyone to be safe in order to protect all world population from future and worse pandemics. “ 

Monica Geingos stated: “We have leadership from South Africa as chair of the G20, and from other countries, and we have leadership from civil society across the world. We have the evidence of what needs to be done, set out in the Breaking the Inequality-Pandemic Cycle report. And we have shown that the actions needed to break this cycle are in the interests of every country, that breaking the inequality-pandemic cycle is not only the right thing to do but is the smart thing to do.” 

/ENDS 

Notes for editors  

The G20 Ministerial Statement will be posted by G20 chair South Africa soon here:  https://g20.org/track/health/

The Global Council on Inequality, AIDS, and Pandemics report Breaking the inequality-pandemic cycle: building true health security in a global age, is available here: https://www.inequalitycouncil.org/wp-content/uploads/2025/11/Report-2025_Global-Council-report_En.pdf