General Assembly: 2026 high-level meeting on HIV/AIDS: thematic panel discussions 1 and 2 - Informal meeting of the plenary, 80th session

Excellencies, ladies and gentlemen, I call to order the first thematic panel discussion of the 2026 high level meeting on HIV AIDS on the theme.
I code country led, people centered, integrated and sustainable national HIV response, resilient systems and financing close codes.
Let me take this opportunity to warmly welcome all of you.
I'm honored to serve you as a co chair, together with Dr.
Tia Phalla, Vice Chair of the National Aids Authority in Cambodia.
Distinguished co chair, excellencies panel members, and global partners.
We gather here at a critical juncture as we prepare to adopt a new political declaration this week, guided by the Global Aid Strategy 2026-2031, we must face an uncomfortable truth that the true test of our commitment is not the lofty ambitions we sign here in New York, but whether resources Whether we resource rather and deliver it at home.
For South Africa, sustainability is not a future projection.
It is a lived deliberate political choice.
South African government finances its antraviral drug procurement at 90% with 10% supported by the global fund.
But we understand that true sustainability is built on national ownership, deep integration and gaining partnership, not donor dependence.
As donor transitions accelerate globally, our absolute priority must be to protect the most vulnerable.
This transition cannot be a sudden hand off.
It must be a managed, predictable partnership.
Domestic resource mobilization and donor commitment are partners, not alternatives.
The anchor for this transition is the deliberate strength of our primary health care system.
In South Africa, we're moving away from treating a disease and moving towards treating the whole person through a patient centered life cost approach with specific focus on primary health care and strengthening the building blocks of the healthcare system.
We are actively using our massive HIV platforms to anchor and strengthen wider health system integrating screening and care for non communicable diseases with mental health and broader primary health care.
We are backing this vision with tangible systemic interventions.
We have integrated over 22,000 community health workers into our formal health system to ensure that care will reach the very doorstep of our people.
Furthermore, we are driving rigorous investments into our health infrastructure, reinforcing our procurement and supply chain systems, and robustly strengthening clinical governance across every level of care.
The ultimate vehicle for this transformation is universal health coverage embedded in our national health insurance NHI Act.
The NHI holds immense promise to radically reshape our financing and service delivery.
It will enable us to build an equitable integrated health system, organized around people, ensuring that comprehensive quality care is accessible to all, free from the silos and fragmented health system.
We have an extraordinary panel before us today representing governments, communities, and civil society from across the globe.
I look forward to a frank and forward looking exchange on how we turn these tangible strategies into sustainable realities.
It is now my distinct honor to invite my esteemed co chair, doctor Tia Pala, Vice Chair of the National Aids Authority of Cambodia.
I thank you.
Over to you, co chair.
Thank you.
Thank you.
Thanks.
Excellency Mosa Leedy, co chair, and distinguished panelists, colleague and friend.
Good morning.
It is a profound honor to stand before you today as a co chair representing the Kingdom of Cambodia.
As we open this first system thematic panel, let us be entirely honest to ourselves.
We stand at the critical crossroad.
We must protect our four decades of monumental heart borne gain at a time when donor transition were rapidly accelerating.
Most our most urgent and yielding task today is to look at the political and financial moment without illusion.
In Cambodia, we see this reality very starkly.
Cambodia reverse a serious epidemic against all odds.
We stand here today as a living proof that country led sustainable response work and it deliver even in resource limited setting.
Cambodia achieved 905-90-5905 target.
But let me be clear reaching 905-90-5905 does not mean our mission is complete.
As Sai Prime Minister Hou Manet of the Royal government of Cambodia has point repeatedly warned us the hardest part of their journey lie immediately ahead.
We cannot close the final gap by doing more of the same.
We need to be aggressive, highly targeted, people centered approach.
We must track down new infection.
We are newly concentrated among key population in our use by expanding innovative, localized services.
Every single endurer must be able to access to prevention and care with absolute dignity.
No exception, no one left behind.
The UNA Global AIDS brief just released on June 26th, sounds a stark unavoidable alarm.
It warned us financing cap under investment in prevention and restriction on human rights could roll back a generation of progress.
After all hard work by the government, civil society, community, and partner in Cambodia, we get to where we are today.
This is not something we want to see happen to all to us and all any country across Asia and Africa, the region carrying the highest HIV burden.
The lesson is clear.
Sustainability depend on ownership, integration, partnership, never on donor dependence.
This is a transformational demand, deeply shared responsibility.
Let us state that this clearly to the world, domestic resources and donor commitment are not alternative to one another.
They are partner in exact same effort.
Our global partner must ensure that donor transition are gradual, predictable, responsible, never abrupt, and never disruptive.
Excellency, this is our share mandate.
This week we adopt the new political declaration guided by the global Aid strategy 2026 2031.
The ultimate test of our leadership is not the ambition of the work we sign here today in New York, but whether we resource and deliver those work at home.
Our goal is clear, prevent new infeliction and meet the core target to fewer than 250 by 2030.
This is a Cambodian case.
Let us be clear Actionable pathway today to secure financing needed, step boldly into our true ownership and secure sale sustain legacy for generations to come.
Thank you very much.
So I would like to hand over of f to the distinguished moderator Chevin this to officially open the panel.
Chevis, the floor is yours.
Yes.
Okay.
Thank you.
Good afternoon, everybody and I thank the co chairs from South Africa and Cambodia for setting the stage for our panel discussion and a bit later for your interventions from the floor.
Please be primed and ready when we open this up to a more interactive discussion a bit later in our program.
So to recap, our objective today is clear to forge a shared vision of pathways to sustainable financing for the HIV response through increased domestic resources, that is absolutely central right now, given the context we are living through.
Then resilient and integrated health systems, community leadership, right, the bottom up approach, sustainable in that way rather than a top down, and anchored in political commitment and shared responsibility.
And we look forward to that political commitment in the political declaration that will be adopted in the next 24 hours.
The concept note for today's discussions frames it in this way.
HIV response stands at a defining moment.
After four decades of progress, millions of lives saved, new infections have been reduced, treatments scaled across the world's hardest hit regions, we now confront a financing reality and competing health and social development priorities that could unravel those gains.
So the question then becomes, how do we then translate the global AID strategy 2026 to 2031 in ensuring that we actually end AIDS as a public health threat by 2030, but then also to transform the multi sectoral response for sustained impact beyond 2030? Asked another way, how do we finance an integrated people centered HIV response that sustains impact through stronger domestic resources, resilient health systems, and community leadership anchored in that shared responsibility? Yes, it is always worth reiterating the very clear goals we seek to address today.
To embellish on this endeavor, allow me to introduce our panelists and when you hear your name, I encourage you to join me on the podium when you hear your name.
His Excellency, Victor Elis Atta Layam, Minister of Health of the Dominican Republic.
His Excellency, Javier Padilla Bernalz, Secretary of State of Health of the country of Spain, Miss Florence Riakco Annem of the Global Network of People living with HIV, and doctor Claude Kmenga, Chief of Staff of the Africa Center for Disease Control and Prevention.
I will wait for them to join me on stage and then we will begin.
Good afternoon.
Good afternoon.
Without further ado, let's start with doctor Victor Elias Atalla Lea, Minister of Public Health and Social Assistance in the Democratic Republic, a country moving, sir, from external financing towards domestic ownership.
What has been the hardest part of that journey, and what proved decisive in protecting services and equitable access for those who need them the most? Let me ask you this as well.
What role should donors play in this responsible transition? You have the floor.
Thank you very much, moderator, Excellency' delegates.
Well, allow me to begin with a quotation a few months ago We were meeting in the Dominican Republic in the interior of the country with some of the groups affected by this disease.
A person came up to us and said, I'm not concerned about the disease.
I'm not afraid of the disease.
There are treatments for the disease.
What I'm concerned about, they said, is that I'm protected, that I have treatment, that I have follow up.
And that not just probably is, but it is the biggest challenge that we face in these times.
We're in a transition from providing a response depending historically on foreign assistance to a response that's based on a national response.
In my country, that means we've had to enlarge our services without backtracking in any way, continue to make progress on the results we'd already been achieving.
Our experience in the Dominican Republic was that it wasn't just a financial problem, it was an issue of trust and of uncertainty and that it wasn't just a problem of resources.
What we needed to do was create an institutional financial and programmatic solution.
And we had a few big challenges at the beginning, obviously, resources to guarantee those resources, and we tried to find a way to bring about those resources.
And also, we wanted to mobilize the response, not just treatment, but also diagnosis, follow up, adherence to treatment, and of course, community programs, particularly with the most vulnerable populations.
All of that was trying to Do one essential thing and that was in the question to re establish the trust of the people.
Otherwise, if we didn't gain that trust, everything would be rejected.
We began working intensively on creating a system that would guarantee this national ownership of resources.
Because for governments in transition, it might be a public policy, but when it comes to the patients from their point of view, transition is a threat as they see it, they fear not being protected.
What made the difference for us? Well, all the leadership got together and we decided to turn this challenge into an important opportunity.
We created a special fund for priority health programs called FOSAP with innovative methods for co funding between Social Security and the state.
We were able to progressively include all of the HIV responses within the current financing structure and today we are financing 100% of antiretroviral medicines from the national budget and ensuring that the patients have ongoing treatment.
For all that needed in our country.
But around 4 million extra dollars annually has been invested and that enables us to invest in prevention, treatment adherence and various other community interventions.
Obviously, this was part of a broader vision to include HIV care in primary care, and we managed to include in this FSAp fund hepatitis and tuberculosis as well in order to increase efficiency, coordination, and sustainability of response, particularly since very often these infections go together with each other, co infection.
What we've Do shows that when the president gets together with the various ministries and integrates these national responses, this is what can be done.
Obviously, we still have a lot to do together with other international institutions.
I certain things are temporary, but institutions remain.
That's why it's so important to build them.
Then what role should donors play was in the question as well in transition? Well, one of the important things about transition is that donors themselves have to develop.
We have to move from strategic partners to sustainability.
We're at a key moment with HIV and We can't, by speeding up financial transition, lose the achievements that we've made.
Things have to be done bit by bit, and we have to maintain support so that all of this can be maintained.
We mustn't abandon anyone.
We must work together and cooperate.
Sustainability will not come about if a person changes if we change our financial system, it's going to come about when a person understands that the system cares for them and looks after them.
Currently, international donors and international corporation must understand that this transition can't happen too quickly.
Otherwise, we'll be losing out on four decades rather of intense work, and we're in the final home stretch now and that's the most decisive period to bring about sustainability and continuity for the whole program because at the end of the day, ladies and gentlemen, um The aim of the work over the last four decades is to protect people, not just fund programs.
Thank you.
Before I move on to the next panelist, you talked about this trust deficit in the country.
You talked about owning it in terms of domestic resources, in terms of the funding in the future of funding and a slow transition.
But how did you address the trust deficit in particular? What is it that people were not trusting in this process? Usually, I'm going to I'll carry on in Spanish.
Well, normally developing countries and those that live in developing countries, very often have lost trust in programs that depend on state financing because that depends on the politics of the day.
We are not allowing that to happen.
What we are doing is creating an institution and a program which guarantees that the resources will be provided by social security together with the help of the state and that it doesn't depend on the government of the day.
So When that gets down to the Congress of the country and it's put into laws and decrees, then demonstrates to the whole community that they will be receiving the medicines.
We are including new strategies and we are improving the treatment and adherence to treatment and getting the figures down.
I People start to understand that we're working for them.
That is the change to not depend on politicians, it's to depend on institutions.
Thank you.
Stability matters, sustainability matters.
Javier Padilla Bernardez, Secretary of State for Health of Spain, a committed donor partner that Spain is, how does your country see the donor role evolving from financing programs towards backing countries transitions into sustainable nationally owned systems.
You have the floor, sir.
Thank you very much.
Well, I think it's a very timely question and it can be extrapolated to other challenges that we've seen internationally when it comes to international cooperation.
I think that we have to complement this with another issue, and that is if we are financing responses that countries are able to sustain over time or whether we are creating dependency that could become vulnerabilities.
For Spain, the response is clear.
The role of donors has to change.
It has to move from financing isolated programs and to building solid national systems that have national ownership.
It's not doing less cooperation, it's about doing better cooperation.
That is the first of the strategic goals of Spain's foreign health policy to help strengthen health systems in other countries.
There's a first essential condition there, we have to align our cooperation with national and regional priorities of the partner countries.
For a long time, international cooperation and the role of donors has happened vertically with specific programs organized on a disease by disease basis that was useful and it was essential in many cases, but we also have to recognize that at times it's created parallel structures that haven't always helped to strengthen the national health systems or the local and community capacities.
The challenge now is not to abandon verticality, but to take a second look at it and try to integrate it in a better way.
The vertical programs also have to meet horizontal objectives uh, affordable care across the board and funds, for example, such as for HIV, including those for removing stigma and discrimination, tuberculosis, malaria, um, vaccinations, for example, all of those have enormous potential, not just for financing specific interventions, but to finance laboratories, epidemiological work, capacity, et cetera In the question, there was a fundamental word transition, and I think that is key.
It was also indicated by the minister from the Dominican Republic.
Transition is a process.
It's not an abrupt withdrawal overnight.
It's not just passing on responsibility to a body that doesn't yet have the ability to carry those out, a transition needs to be properly designed and I agree with what the minister said.
Otherwise, it could endanger the progress that has been made over very many years.
That's why when it comes to Spain, we believe that the role of donors has to proceed in five fundamental directions.
First of all, we have to improve the quality, not just quantity.
It's very important how we finance things.
There has to be predictable funding, flexible, aligned with national plans and oriented toward health outcomes.
It must enable medium term planning, not merely short term responses, and it must support priorities defined by countries themselves, not imported from other places.
But ensuring that human rights and the care of groups that are habitually excluded are at the center.
Also, if we want countries to invest more and better in health, we must ensure that social investment is not penalized in tax terms.
Secondly, we must diversify the donor base.
We can't depend on a small number of funders because otherwise, we'll see things happen as we've seen in recent years.
Diversifying is not just financial diversifying, it's also an issue of legitimacy independence, and the neutrality of the multilateral system.
Then the third aspect is that we must take an honest look at external debt.
Many countries want to invest more in health, but they do so in the context of growing debt service burdens and extremely limited fiscal space.
In this regard, Spain wants to continue to look into innovative possibilities such as debt canceling, for example, when it comes to health.
These are instruments that have to be very well designed with transparency, but we think that this thinking is essential.
Fourth, we must support strong national public capacity.
Spain can share its experience, for example, in regulatory areas with those countries who aspire to consolidate their health systems into a universal health system.
I think we can provide some lessons that we've learned there.
And share relevant experiences.
Fifth, we must reform the international global health architecture.
The donors are asking for reform from countries, then we also need to be prepared to reform our organizations, our funds, and our initiatives.
Today's ecosystem is excessively fragmented and we have to be prepared to make that better.
We also need a properly financed WHO capable of exercising its normative and coordinating role at the center of the global health system, and we need greater complementarity and sensitivity when it comes to national and regional priorities.
Also, the strongest national systems must realize that they're going to continue to need international cooperation because no country on its own can face the challenges that we see today when it comes to global health emergencies, the impact of climate change, migratory movements, for example, these are all global issues that affect all countries, wherever they may be.
In conclusion, for Spain, the future role of donors means supporting responsible transitions, strengthening national capacities, and building a global health system that is less dependent on donors less fragmented and above all, of course, more just.
Secretary Bernaldez, let me just follow up with this question.
In the context of a responsible withdrawal or decline in ODA, we see numbers that ODA has declined at the fastest rate in the history of ODA.
I think 2024-2025, you see a 23.1% decline in that fund.
How do we stop the bleeding? It's happening already? What does that timeline look like and what does the pushback look like in the context of people not being able to get the financing now? Well, I think there are two things we absolutely need here.
First of all, we need to be fully committed to multilaterlism and the relevance of organizations when it comes to development cooperation.
We need to take a step forward, increase our commitments in terms of financing and above all, in terms of sustainability.
We have to create certainties.
But also, as the minister was saying just now, with regard to the trust of the population, we need to create trust amongst the People and the donors.
I think the whole reform process we're seeing in global health is aiming to generate trust that all resources will lead to the best possible result.
Having said that, we also need to bring in other players as well.
Um, and the distribution of roles in this play as it were, is not the same as the cast was 20 years ago.
There are countries that have not only financial capacities, but very particularly political abilities, capabilities to address new challenges.
I could mention too.
For example, South Africa or Brazil, they are developing leadership regional capacity that really is to be commended and I think we also have to look towards those countries and what they are doing, they are leading in a new way within the new system that we are creating.
Thank you.
Thank you, Secretary, for that informative response.
Miss Florence Riakco Anne of the Global Network of people living with HIV.
Here's your question.
Communities have been central to every major advance.
As financing models change and HIV services fold into broader systems, what are communities seeing on the ground? What would meaningful participation in financing and integration decisions actually require? Thank you for this question.
Your Excellency's distinguished delegates and to you, our moderator today.
I think to begin by answering your question with what communities are seeing on the ground, it's severe pressure.
There is a response to a disruption that caught everyone unawares.
Communities with no capacity to understand how to respond to it and no infrastructure capacity to engage with leadership in how to respond to it even though are central to the response have been playing catch up.
I will speak, I think for many organizations represented here, civil society, community organization, people living with HIV networks, key population networks, patient groups.
Many of us are sitting in this room worried and concerned and wondering if the political commitment to continuously engage, fund, and support our work will exist beyond tomorrow in the political Declaration.
What we have realized in the UNAIDS report that was released last week is we have not met our targets.
Financing is indeed under pressure.
But I think at the back end of why we are sitting in this room is the fact that we have complete belief in the continued partnership between our governments, communities, donors, the UN aids, and the broader UN system, that because of the multlateralsm that has gotten us to where we are at this moment, we keep at it, if we keep reminding you of the work that we collectively do together, that we will get to the ambition of ending AIDS, keeping people alive, and achieve HIV epidemic control.
But the HIV response started with communities.
Since time immemorial, networks of people living with HIV, key populations, communities, and civil society have been your essential partners.
Thanks to the multilateralism, we moved and we evolved, and we have been instrumental in also supporting and working with you to address other pandemics, Epox, COVID 19, Ebola.
We have celebrated our progress jointly, but also to mark the reality of the fact that we have also grown, our engagement has grown.
We moved from meeting with you to share our stories to sitting with you and doing work around governance, planning for resources.
We have engaged in fundraising for the response during the global fund replenishment, making a case with our governments for why they need to prioritize HIV and give domestic financing for HIV.
As this financing model evolves and services are integrating, our work becomes expanded, yet important to collaborate together.
This is the moment to go deeper in our collaboration, and we bring forward different perspectives, different strengths, and infrastructure that was built with funding from the very people in this room and beyond.
Yesterday, GNP Plus convened a meeting to highlight the lived experience of people living with HIV and comorbidities from our global networks, coming together as the AfroCb Treatment Access, Stop TB Partnership, World Hepatitis Alliance, NCD Alliance, the global network of young people living with HIV, and the global network of women living with HIV.
We understand that in integration of HIV services, a person living with HIV navigates multiple overlapping health challenges of TB, viral hepatitis, STIs, non communicable diseases, and mental health conditions.
We are excited in the progress of science that has gotten us to the point where we are affirmed and assured that if a person living with HIV is on treatment now and they are virally suppressed, they cannot pass this virus to a sexual partner and we sing this message, U equals U undetectable equals untransmittable.
However, this brings to us the need to embody a different mindset in addressing our health care needs, addressing and expanding information around prevention for our partners, information around STI management across the various other comobities that we have and experience because we are aging.
This primary health care integration presents a critical opportunity.
We can provide person centered care, but it must be guided by evidence of what we experience and strengthen.
We are the ones sitting at the health facility now.
It's shifting and changing in real time, not with plans that were discussed for years, but in a disrupted environment that is trying to survive and reorganize.
We are the ones walking into the health facility and facing its challenges.
We see the tired health professionals, we see the confusion, we see how we are reacting and the policies follow us.
We can do this work together.
I think what is needed moving forward is a critical commitment to going back to working with communities, to investing in community leadership and engagement.
I would like to clarify as I close that community leadership is the work that gets us to doing governance, to sitting in rooms like this.
Then there's community engagement work that gets us to do task shifting work, which is needed now more than ever as we integrate into primary health care.
Task shifting that expands differentiated service delivery, self care approaches that include multi month dispensing, community pharmacy models, self testing, survival cancers, STI screening, and various digital tools that are available for our use will only be able to bridge innovation and access if community is involved in their development, in shaping its market so that we do not lose the attention to innovation, and to restore the energy needed to get us to the last mile of the HIV response.
We possess the science, we have the tools, we have the innovation.
We just need to come together on this trusted collaboration we all have had all this time, as it remains essential to sustain the financing needed now, ensure it's predictable, ensure the structures are stronger now more than ever, as we need to work closely at community level and we are all coming together to that one dream that has put us all in this room every five years to end AIDS and keep people alive.
Thank you.
So before I let you go, Anna, let me ask you a follow up question and as I've done with the other panelists, you talk about the importance of community engagement, community leadership.
You also mentioned the political declaration.
What must this political declaration do for the things you've laid out in terms of the centrality of community ownership of this process? What is the language you'd like to see in that declaration? They're all sitting here, let them listen.
Don't be.
Because I'm not supposed to be shy, I will not read a scripted answer to this.
I think one of the biggest principles that have demonstrated the uniqueness of the HIV response has been the greater involvement of people living with HIV principles, the deeper principles.
It's why we have institutionalized how people living with HIV, people impacted by HIV, have always engaged with you.
We have adapted how we do policy.
We have adapted how we do research and created community advisory cabs and created mechanisms from which community engaged not just as recipients, but working with you from design to the actual end result.
What would be needed moving forward is that affirmation, reaffirming it strongly that it is still central and critical now more than ever.
We have the greatest opportunity ahead of us.
There are incredible tools ahead of us.
Long acting prevention is here, long acting treatments in the pipeline.
These are tools that will enable people living with HIV, people impacted by HIV, to stay and be able to embody stronger agency for our own health care at community level.
It's an opportunity to build structures at community level and it would be good to understand that this political declaration is following our needs towards wanting to work closely with you, but also strengthen our work at community level to ensure everyone who needs to access services reaches them without having to navigate the difficulties.
As I close that question, HIV is integrated into broader public health and it feels good on paper to say that.
But HIV is not your normal disease, it's not malaria, it's not hepatitis or I think hepatitis is equally stigmatized.
It's not diabetes.
There is high levels of stigma that come with HIV that are not even impacting people living with HIV alone.
They are impacting and barriers to even the prevention tools we have available now.
If we want to end AIDS and prevent new infections, we have to address stigma.
We have to understand that people living with HIV are not a homogeneous group.
There are significant barriers from our communities, from our institutions, and we have to embody rights based approaches.
I hope to see that this political declaration is able to be very strong on its commitment to keeping this going because they got us here and they can get us to where we are going.
Thanks.
So just to reiterate, I want to see stigma in the political Declaration and how you're going to address it.
I think that's a key point.
Thank you for that intervention.
Doctor Claude Kmenga the chief of staff of the Africa CDC, which is a champion of African ownership and leadership.
So as countries mobilize domestic resources and defend hard won gains, what is the Africa CDC doing to help them finance, lead, and deliver while building systems that both respond to outbreaks and sustain long term impact? You have the floor.
Thank you, Chair.
Let me begin by thanking UN AIDS and the organizers for convening us for this very important discussion at such a decisive moment for Africa and for the global HIV response.
Ending AIDS is possible, but not through business as usual.
Africa must end aids on its own terms.
The question before us is not only how Africa sustains hard won gains, but how African countries finance, lead and deliver their own health priorities while building systems that can resist future shocks.
This is at the heart of Africa health security and sovereignty.
For Africa CDC, health security is not about emergency response only.
It's about the capacity of member states to prevent, detect, and respond to epidemics while sustaining essential services such as HIV prevention, treatment and care.
It's also about reducing dependency, strengthening national systems, and ensuring that African priorities are financed, governed, and delivered through African leadership.
Africa CDC is acting to support countries in four practical ways.
First, we are supporting countries to strengthen domestic health financing.
This means helping member states update national health financing plans, increase domestic investment, and explore context specific revenue mechanism.
Our ambition is that by 2030, at least 20 African countries should finance 50% or more of their health budget from sustainable domestic sources.
Second, we are helping countries move from fragmented programs to country led budget and accountability frameworks.
Sustainable HIV responses must be embedded in national budget, primary health care, universal health coverage, and social protection system.
International support remains essential, but it must align behind one national plan, one budget, one monitoring framework, and one shared accountability for result.
Third, Africa CDC is advancing pooled procurement and local manufacturing.
Africa cannot lead its HIV response if medicines, diagnostics, and prevention tools remain unaffordable, delayed, or dependent on distant supply chains.
Through the African P procurement mechanism, we are helping turn fragmented demand into market power, improving affordability, supply security, and predictable markets for African manufacturers.
Fourth, we are supporting the integration of HIV services into resilient primary health care systems.
The resurgence of Ebola and other outbreaks reminds us that fragile systems cannot manage multiple emergencies without disrupting essential services.
HIV services must therefore be protected and strengthened within systems that can respond to epidemics and sustain long term impact.
So Mr.
Chair, to respond briefly to your question, Africa CDC is helping countries finance, lead and deliver by advancing domestic financing, African ownership, pool procurement, local production, resilient primary health care system, country owned data, and leadership.
Ending AIDS by 2030 is within reach, but only if we shift from managing dependence to backing African leadership, African systems, and African sovereignty.
Thank you, Mr.
Chair.
A quick follow up to you, doctor Kumana, just in terms of the CDC's work in supporting research and development.
The long term goal here is either a vaccine or a cure.
I wonder what that looks like where you are sitting.
From where we sit clearly, the area of research and development is that area where we need collective engagement.
This is actually where member states want that intersection with the big research institutions of developed world, where we see quick transfer of technology, quick transfer of knowledge so that When discoveries are made through research that was initiated in our continent, we don't find ourselves at the back of the line, but we are in front to benefit from the result of that research.
I think COVID 19 taught us that lesson.
While vaccines We already available in the West.
Africa found itself at the back of the queue and we wouldn't want to see that again.
Thank you.
Lessons learned from the COVID 19 pandemic.
Thank you, doctor Kamega for that intervention.
Just to recap this part of the discussion, domestic resources coupled with maintaining donor financing for effective transitions, we need an integrated multi sectoral response into stronger, resilient systems protecting the most vulnerable through transition.
What does that safety net tangibly look like to prevent the most vulnerable falling through the transitional cracks that are likely to emerge? That is the question we have before us.
Communities must shape the next steps or choices and what the end result looks like is that we cannot have a top down effect or approach, but rather a bottom up approach.
Let the communities lead and let the politicians come after.
Let's open up now to the floor an interactive discussion.
For your comments and statements, I would like to remind delegations that there is no established list of speakers for this meeting.
Delegations wishing to speak are requested to press the microphone button to ensure that we hear as many speakers as possible.
Delegations are requested to limit their statements to 3 minutes when speaking in their national capacity and 5 minutes when speaking on behalf of a group of states.
Once again, time limits will be strictly enforced through an automatic microphone cutoff.
Don't we all know that too well.
A timer will be projected on the screen.
Delegations may also submit their full length written statements through the email address estates atun.org, estates one word at un.org, which will be posted under ets of the United Nations Journal.
I thank you for your cooperation in that regard.
My understanding is we have two recorded interventions from the floor.
First, let's roll the tape.
All right.
If we do not have those interventions, All right.
We'll go straight.
We do not have recorded interventions is what I'm told.
We will go now to our first speaker from the fourth floor.
The list keeps changing, but I believe it's Columbia.
Thank you moderator.
Cordial greetings to the panelists, ministers.
It's an honor to be with you here today and hear your experience on this important issue.
When it comes to reduction of international funding for health and protecting achievements in response to HIV, we need to strengthen national leadership to consolidate resilient health systems and maintain international solidarity.
Colombia's experience with prep is a specific example of how you can move towards a more sustainable, a dedicated response after the initial phase supported by international partners.
Now, Colombia is funding prep from national resources.
Um, this has made it possible to move from pilot projects to an integrated public policy that is sustainable, strengthening the national situation and ensuring progressive fair access for Colombia.
The combination of domestic financing, integration of services, community leadership, and the strategic use of data constitute an effective roadmap for accelerating towards putting an end to HIV AIDS as a public health threat by 2030.
Modero We will be providing full statement to the Secretariat.
Thank you very much.
Distinguished delegates.
I thank the Distinguished Delegate of Columbia for that intervention, and I now call on the delegate from Mali.
Pres, Mr.
Chair delegates to optimize and streamline our resources and efforts, we decided to create a hub in charge of developing policies and procedures and coordinating the implementation of HIV response.
The strategic plan was developed, implemented, and evaluated for 2025, 2025.
To keep the accomplishments and meet the challenges, we are trying to increase the effectiveness of our work by better use of the data, integrate HIV with other public health priorities such as viral hepatitis, maternal health, nutrition, and vaccination, and the elimination of vertical transmission from mother to child of HIV ephilis and hepatitis B.
It's an inclusive national response involving the sectoral ministries, civil society, the private sector, and strengthening multi party cooperation, mobilizing resources and advocacy is also a major goal.
The government is also working to ensure that equal access to health care is extended to everyone in rural areas, including conflict areas as well.
I thank you.
Thank the distinguished delegate from Mali and I now give the floor to the delegate from Brazil.
Thank you very much, Mr.
Moderator and good afternoon to all colleagues.
Brazil constitutionally recognizes health as a universal right and a duty of the state.
We are internationally acknowledged for the self sufficiency and sustainability of our HIV response built over decades on the basis of universal and free access to prevention, diagnosis, and treatment, fully funded through our unified health system, the Sus.
This financing and management capacity, combined with the state's large scale purchasing power, has allowed the country to negotiate and incorporate innovative technologies, maintain a robust response to the epidemic, and reduce its dependence on external resources.
Even so, we are increasingly facing financial sustainability challenges for our model.
More recently, for example, high prices for long duration pre exposure prophylaxis.
Brazil has consistently upheld health sovereignty and promoted international mechanisms to allow countries to achieve it.
Back in the beginning of this century, Brazil, together with colleagues from South Africa and India, discussions at the WTO that culminated in the adoption of the 2001 Doha Declaration on the Trips Agreement and public health.
More recently, during our G 20 presidency, we have promoted discussions within the group about debt relief to allow developing countries more fiscal space to invest in health, and we have also established the global for local regional production, innovation, and equitable access.
This is to say dear colleagues, it is not enough to simply tell countries, especially those furthest behind that they have to commit more financially to HIV and other health demands.
Donor countries and international organizations also have to commit to foster initiatives and uphold regimes that will help.
Other nations do their share to echo what the delegate from Brazil was saying.
I apologize, but your time is up, sir, but I thank you for your intervention.
Now we move to the United Nations Development Program, wherever you are, you have the floor.
Thank you.
Excellent UDP.
UDP works on HIV with communities and governments of 100 member states.
Today, we know firsthand that we have powerful tools, including long acting prevention and treatment to end AIDS as a public health threat.
Progress, however, depends on collective political will to remove structural barriers and ensure countries and communities can lead and sustainably finance the response.
From UNDP's experience, allow me to expand on three key points.
First, sustainability cannot become code for doing less with less.
It must mean financing smarter, building resilient systems, advancing health sovereignty, and backing community led and rights based approaches that ensure this response works for everyone.
Sustainability will require making choices on what can be integrated into broader health systems, what still needs dedicated HIV financing, and where international support remains essential, especially for prevention and community led responses.
Second, enabling legal and policy environments are not optional add ons when stigma and discrimination, and punitive laws push people away from services, investments underperform.
Building on the Global Commission on HIV and the Law, UNDP has supported more than 90 countries to review and reform HIV related laws and policies, including work with judiciaries, governments, and civil society.
This work needs greater urgency with people and communities most affected at the center.
Third, financing only delivers results when economists and health and community experts work together, releasing funds on time, keeping services running, identifying gaps, and reaching people reliably.
Thank you.
I thank the delegate from the United Nations Development Program, and I now give the floor to stakeholder one slash Medical Impact.
Chair, D delegates and colleagues, on behalf of medical I an organization working on frontlines of healthcare delivery vulnerable communities and population affected by humanitarian crisis across Latin America and Africa, we witnessed firsthand the challenge countries facing HIV prevention, diagnosis, treatment, and harm reduction services.
As we look towards implementation of the global AI strategy, it is essential to establish sustainable financing pathways that combine increase domestic resource mobilization.
Continuous support from donors and leadership of civil society and communities.
Ensuring long term sustainability requires that HIV responses remind people centered, gender focused, evidence based and response to local realities, including harm reduction and risk reduction strategies to help address stigma, discrimination, and prevention, which continue to limit access to health services.
We recognize that financing HIV efforts alone is not enough.
The response requires integrative community efforts that while tackling TB, HIV, hepatitis, and other STs together to achieve a more resilient health system.
Straining access to diagnosis, treatment, prevention, and harm reduction must go hand in hand by integrating HIV attention into frontline and last mile intervention, primary health care, and broader social protection system in order to achieve universal health coverage.
At that time a profound change in global health architecture and financing landscape.
We must ensure that no transition leaves communities behind.
The future must always come first and prevention is fundamental strategy for both the present and the future.
Thank you.
I thank the delegate from Medical Impact for that intervention and we go back to a member state and the delegation from Malawi, please.
Thank you.
Excellency's distinguished guests.
I would like to share some of the strategies that my country, Malawi is implementing to protect and sustain the country's progress in HIV epidemic control.
One of the strategies is increased domestic financing.
Malawi budget is strained with competing priorities, yet government has taken bold steps to incrementally boost domestic health funding, aligning with the Abuja de relation.
Government is investing in health, infrastructure, recruiting more workers, and increasing co financing for ART.
Malawi is committed to expanding domestic financing beyond ART.
Malawi's Beyond ART, driving broader HIV response.
We therefore appeal to the international community to sustain the support helping Malawians to transition into sustainable financing as we aspire to reach 2030 targets.
A sudden funding drop would undo the progress and success achieved over the years.
Another strategy we're using is decentralized and integrated approach, moving away from parallel donor operated structures to integrating HIV care into universal primary health care and strengthening subnational structures to ensure district based planning and implementation of integrated HIV services.
We're also digitizing the data in Malawi strengthening electronic medical records and digital data systems to improve efficiency, track drug supplies, and prevent stockouts, including harmonization of all electric medical records.
Unfortunately, your time has run out, but I thank the delegate from Malawi.
The next speaker will go back to Civil Society stakeholder two Strong minds.
Good afternoon, distinguished delegates.
I'm here today on behalf of Strong Minds, a mental health organization based in Uganda and working across sectors in East and Southern Africa to treat over 2 million people, including many living with at risk of or affected by HIV AIDS for depression using a scalable, low cost community based model delivered by non specialist lay providers.
Not only is mental health a universal human right, one that all people living with at risk of or affected by HIV AIDS deserve to enjoy, but it is also a critical component of an effective person centered HIV response.
We know the link between HIV AIDS and mental health is strong and bidirectional.
Integrating community based mental health care into HIV programming can improve the prevention of new infections and strengthen treatment outcomes.
People with untreated mental health conditions are more likely to acquire new HIV infections and those living with HIV who also have depression have lower ART adherence and less viral suppression.
Physical health is not separate from mental health, but rather they are intrinsically linked in individuals' lives and therefore must be intrinsically linked in this political declaration.
Integration of services, including mental health care across sectors is critical for ending HIV as a public health threat.
Today, we urgently call on member states to adopt measurable commitments, including adequate financing for integrating mental health across the HIV prevention, treatment and care continuum.
By embedding mental health within the HIV response, we can accelerate progress on global HIV targets and create person centered rights based systems that meet the full needs of people living with at risk of and affected by HIV.
Thank you.
I thank the delegates from Strong Minds and now I give the floor to the Stop TB Partnership.
Thank you very much.
I'm standing here on behalf of Stop TB Partnership, but as well to our 2,300 formal partners and the 10 million people with TB.
TB remains the biggest infectious disease killer and it's also the one that kills the most people living with HIV AIDS.
That's why if we want to end HIV, we have to end TB.
Now that we established that, I just want to say three things.
One is from Stop TB and from the TB community at large, we learned the hard way, but in a in a more sustainable way that when resources are limited, you can produce things that are more sustainable.
I have a call on all of us to be very smart in investing in tools that are useful not just for a single disease, but for several as we have now miniaturized tools that ensure access much quicker, the mobile X ray with artificial intelligence, the rapid molecular tests, even sequencing that can be used to ensure that all people with vulnerabilities have access to the tools.
We are offering also our help in leading and supporting the communities, not only of the people with TB or survivors, but anyone because I have a plea to all to make in making sure that we drop this language on communities for HIV, for TB for malaria, because the diseases will not work in buckets, will work across.
Let's come together and push for agendas that are inclusive and for everyone.
Thank you very much.
You, you can applaud.
Thanks to the delegate from the STOP TB Partnership, back to member states, and I give the floor to the delegation of Zimbabwe.
Thank you.
Thank you, Mr.
Moderator.
I would like to thank the panelists for their insightful presentations.
Zimbabwe's experience in achieving the 1995 95 targets ahead of schedule so that country responses can deliver results when they are incurred on sustainable national commitment, manifesting through sound policies, strong institutions, and domestic resource mobilization.
At the policy level, Zimbabwe has pursued a mod sector and people centered HIV response with HIV services increasingly integrated to primary health care and community systems.
Our approach priors differentiated services delivering prevention of mother to child transmission attention to adolescent girls and young women.
And service for people living with HIV and populations most affected.
At the institutional level, the National Aids Council has played a central coordinating role supported by provincial and district aids committees.
These strategies have helped translate national policy into local action, strengthen accountability, mobilize communities, and ensure that the response reaches people to most in need.
The National Aids Trust Fund supported by AIDS LA is a homegrown sustainable financing mechanism that contributes national resources to the HIV responses.
Despite these gains, challenges remain, funding and reductions will negatively impact prevention testing and treatment, continue to viral monitoring availability of prep, community led interventions and supply chains.
At the international level, the proposed sunset of UN AD including the future of the global HIV AIDS response is of significant concern to us.
Zimbabwe therefore calls for sustainable funding strategies that combine stronger domestic financing and international support as well as resilient institutions, affordable access to medicines and technologies and investment in data community led monitoring, primary health care, and community systems.
We also call for adequate post sunset mechanisms to minimize disruptions to the global response, Zimbe remains committed to a country led adaptable cross sector HIV response that protects.
I do thank the Delegate of Zimbabwe, and I apologize that your time is up.
We now go to the Delegation of Sweden.
Please you have the floor.
Thank you.
Excellencies, distinguished delegates.
Global health is facing a paradigm shift.
A reform is necessary.
The current global health system has delivered historic results, but is not adapted to today's and tomorrow's challenges.
Declining development assistance, shifting demographics, Disease burdens and emergency security threats require a fundamental transformation of the global health architecture.
The future of global health must be country led, coordinated, and sustainably financed.
A legitimate and effective system is built on strengthened national and regional ownership, reduced fragmentation among actors, and financing models that go beyond traditional aid.
The current system has built in weaknesses, earmarked funding, vertical programs, and parallel structures have created lock in effects, inefficiencies, and power balances between the global north and south.
Many low and middle income countries want to lead and finance their own health development, focusing on regional production, innovation, and capacity building.
Reforms must be based on countries' own priorities, budget cycles and institutions, with external actors playing a supporting but not steering role.
The fight against HIV and AIDS cannot be won and present achievement could not have been made without the active contribution of civil society, research institutions, and the private sector.
National and regional ownership, including civil society, academia, and the private sector, is a prerequisite for effectiveness and a rights based and people centered approach.
Thank you.
I do thank the delegate from Sweden and we go back to civil, actually to UN agency, the World Health Organization, please.
Chair, Excellencies colleagues, the World Health Organization welcomes the remarkable progress achieved in the global HIV response.
Expanded access to prevention, testing, treatment and care has saved millions of lives while scientific advances continue to create new opportunities to reduce infections and improve health outcomes.
Sustaining and accelerating the response requires renewed political commitment, sustainable financing, and continued investment in resilient health systems, community led and multi sectoral responses as well as research.
Integrated primary health care based approaches and people centered services that address HIV alongside other major epidemics such as tuberculosis, viral hepatitis, and sexually transmitted infections are essential, recognizing that these conditions often affect the same key and vulnerable populations.
These include efforts to accelerate progress toward the elimination of vertical transmission of HIV, syphilis, and hepatitis B.
Science and innovation, including digital technologies, remain critical to accelerate the development and scale up of new tools such as multi disease testing platforms, next generation prevention tools, including vaccines and curity therapies that can transform the response and bring an end the AIDS epidemic.
WHO affirms its commitment to providing global strategic and technical leadership in close collaboration with the UN co sponsors and Secretariat of the Joint UNA program.
As the global health architecture evolves, WHO stands ready together with fellow UN co sponsors and partners to support the smooth transition of UNAs core functions, helping to preserve continuity, protect hard won gains, sustain community engagement, and maintain momentum towards ending AIDS as a public health threat.
I thank you.
We are grateful for that intervention from the World Health Organization.
We have two more speakers from the floor and then I'm going to allow our panelists to wrap up in 1 minute each.
That's a message to all of you sitting on this side of the dice.
You'll have 1 minute at the conclusion of this event.
We now go to Back to Civil Society, the International Planned Parenthood Federation.
Thank you afternoon.
In the middle of economy of war and violations of international law, we really need to combine an approach.
Health systems funding is not only responsible of domestic governments, we need to talk about common but differentiated responsibilities, and we need to talk the mindset and the way we address health.
We need to move out of the voluntary based donations model to a predictable modality of finance.
But elephant in the room is that we don't like funds to aids.
We lack an economic and cooperation systems designed to end aIDS.
Let's remember that the financial market alone operates now in the figure of quadrillions of dollars.
We need a tax on financial transactions for health urgently.
We need alignment of multilateral regional banks.
Ear market funds for health and AIDS.
As said by Spain, we need a radical transforming of the international financial architectures.
At the national level, we need to address health as an investment rather than an expense and the health gender and responsible fiscal policies with progressive taxation, including taxic wealth rather than consumptions.
Finally, without transforming how health is financed, we cannot talk about ending AIDS by 2030.
A fully funded community and response in AIDS will only happen when we change the mindseting on economic field and the power relations among countries, recognizing that the work that sustains life must be elevated to become the foundation of every global financial decision we make.
Thank you.
We do appreciate that intervention from the International Planned Parenthood Federation and our final speaker from the floor is from the delegation of the coalition Indigenous America Latina El Caribe.
I hope I did a good job there.
Will you tell me about that? Thank you very much.
On behalf of the indigenous peoples of Latin America and the Caribbean, we also join in with these global goals, looking for an end to these new infections for our peoples.
We would invite all funds, programs, and states to apply the ILO Convention, which asks for free previous and informed consent so that together we can build relevant actions that are respectful of indigenous health and um so that we can have human differentiated interventions after 40 years of existence of HIV amongst our peoples.
There have been omissions in the treatment.
We haven't been consulted or included in these programs.
I'd like to share with you some of the concerns that we have in proposals that we have.
We ask for the recognition that we are recognized as strategic partners in treating the disease in Latin America and the Caribbean in all programs that involve indigenous peoples from self determination, inclusion in data, and recognizes key populations to overcome this and that we be part of that our shamans and traditional doctors and that wives be included in all these programs so that we can create integrated health systems that are nuanced to our needs so that we can treat our peoples with human dignity and have a holistic approach to this treatment, National prevention programs for HIV AIDS, That concludes our interventions from the floor and we thank you very much for being part of this discussion.
We really do appreciate it.
Let me give a final word a minute each, 1 minute, 60 seconds each to our panelists, and we start with the Minister of Public Health and Social Assistance of the Dominican Republic, doctor Victor Elias Atala.
Thank you.
Well, leadership should always be about thinking about people.
We're at a decisive juncture.
We've moved from curing the disease and treating the disease to making progress in prevention and integrating networks and diagnostics and very many other things.
We've taken great steps forward over the last 40 years, but we're still lacking essential steps.
They're not final steps, but they are the steps of sustainability, steps that will guarantee that the 40 years that we've been working are not lost and that progress will continue.
Countries that have the opportunity to exercise leadership should do so.
And countries that are receiving help should always work towards international cooperation.
I'd like to send out a message to everyone, particularly international partners.
No health institution, particularly not when it comes to communicable diseases, heals one person or a nation, no health solution Just cures the people it deals with.
We're in an interconnected world and every health solution is a solution for everyone, and therefore, everyone must work together and understand that this is a commitment by everyone for everyone.
Thank you.
I certainly thank doctor Lam for that intervention.
The Secretary of State for Health of Spain, Javier, Padilla Bernalz.
Thank you very much.
Well, I'd like to thank everyone for their contributions.
From the perspective of a donor country.
I'd like to point out two key things.
I think the first of these would be that one of the tasks that donor countries have before us is to be able to think beyond our current position in the world.
We need courage to understand that the position that we currently occupy in the health system is not going to be the position in the future.
All of the rules need to be fair and adapt for the future.
Technologies, for example, are not always going to be going from the north to the south and that has to be made clear in the rules that are established.
Another thing is that we've heard a lot about the centrality of communities and civil society in the response to HIV.
Well, that's The reality is you can only place communities at the heart of things if in global terms, the receiving countries are also part of that response.
You can't move from the donor countries to institutions down to the lowest civilian level.
You have to have a combination of the two.
Thank you.
I thank the Spanish Secretary of State for Health and I give the floor to Florence Ralco Am.
In my 1 minute, I would like us to zoom in on this reality.
There are 40 million people living with HIV.
Maybe 1% of us have the honor and the privilege to serve in spaces where policy and advocacy creates the policies that turn into different opportunities that get to the service delivery.
For many of these 40 million people living with HIV, who go about their day, the only time they engage with HIV is at two points.
When they are engaging with their health provider or when we have to take our treatment every day, every week, every month.
I urge all leaders in this room to understand that the work we do as communities is to support the very many people who don't make it to these rooms, to be able to have an understanding of the shifts and the changes, but for us to use the experiences they share with us, package those into data that can be useful for the transformation that we seek to have now.
In the context specific realities that we are moving towards, this work is more critical now more than ever.
I still urge that we make a strong commitment for the centrality of community, both in this political declaration but in the resources as well that we put forth.
Thank you.
I thank the co Executive Director of GNP plus, and finally, give the floor to the Chief of Staff of Africa CDC, doctor Claude Kamega for your 60 seconds.
With my 60 seconds, I would like to reiterate Africa CDC commitment to continue working with member states, UN aids, communities, and partners to support nationally owned transitions that are realistic, financed, and resilient.
I would like to call on all of us to align behind a strong political declaration that recognizes UN aids critical role for the years to come and the need for an African led, country owned and community centered transition that allows Africa to protect the gains made in the HIV response while accelerating progress toward ending AIDS by 2030.
Thank you, Chair.
How about you help me thank our panelists up here for the interventions this afternoon? All that's left for me to do is to summarize and give you the bottom line.
These are the key takeaways from this discussion.
We want to end AIDS as a public health threat by 2030.
We want funding, and we want to fund the HIV response adequately be that through multilateralism or domestic resources, expand prevention and treatment, protect human rights and reduce discrimination, empower communities, and create accountable, resilient health systems capable of sustaining progress.
Thank you for your intervention today.
Thank you for your collaboration today, and I now hand back to our co chairs who will introduce the next panel discussion.
Thank you all.
Thank you.
I Thank you so much for this entire spatic sessions to the letters of invitation.
Yes.
Excuse me.
Can we settle down, please? Can I call the meeting to order? Excellencies, I would like to call the meeting to order, please.
Excellencies, ladies and gentlemen, I call to order the second thematic panel discussion of the 2026, the high level meeting on HIV AIDS on the theme, equitable access to science, technology and innovation, accelerating HIV prevention, testing, treatment and care.
Let me take this opportunity to welcome you all.
I'm honored to serve as your co chair together with doctor Joan Ruiz Mosca of Mexico.
Today is an important day of the people of our countries.
We have made tremendous progress in the HIV response, but the epidemic is not over yet, and gains may be lost if we do not sustain the response.
Science gave us innovative tools like long acting medicines that can make 2030 targets more achievable if we can make these innovations equitably available.
This is the topic of today's session.
My own country, Malawi, is among the countries most affected by HIV, but we built a strong response.
Of the 1 million people living with HIV in Malawi, more than 95% know their status, and more than 95% of those are on HIV treatment.
Thanks to the treatment and prevention, new HIV infections in Malawi declined by more than 75% since 2010.
This shows the power of common vision.
Targets like these, 905-90-5905 for HIV treatment and reducing new HIV infections by 90%, they inspired our way.
Malawi was the first country to roll out option B plus for the prevention of mother to child transmission of HIV.
We also rolled out Kbla, a bi monthly long acting injectable HIV pre exposure prophylaxis with the support of the Gates Foundation and Georgetown University.
Building on this experience, we will be launching the implementation of La Capervel one injection in six months, long acting pre exposure prophylaxis on July one, 2026.
Thank you, with the support of the US government and the global fund to fight HIV AIDS, TB, and marilia.
Our success also shows the power of coming together.
Our success was enabled by global solidarity and financing.
But our success is also a result of strong country leadership by government, our national AIDS program, and our communities.
We need to sustain the gains and build on them, and as a country, we are fully committed to take strong leadership in pursuing 2030 HIV response goals.
The new political declaration and global aid strategy set out a clear way to achieve these goals.
This vision includes enabling access to scientific innovation.
Innovations can change lives of our communities, but only if it can make them available, afford, and sustain them.
Epidemics cannot be ended in one country or community alone.
They require collective action.
Our decision today will decide about people's health and people's lives in all countries.
This is why even in challenging global financial environment, sustained global commitment to HIV prevention and treatment are so essential.
I now hand over the floor to my fellow co chair.
Thank you.
Excellency's, distinguished delegates, colleagues and friends.
I would like to thank Her Excellency Madelizzo Chidumu Bali, Minister of Health of Malawi, for co chairing this session with me, and I join her in extending a warm welcome to this thematic panel on equitable access to science, technology and innovation to accelerate HIV prevention, testing, treatment, and care.
I think.
I would also like to thank my co chair for the excellent framework presented by her with a reflection from the perspective of those who work every day in implementing national HIV responses.
We find ourselves at an extraordinary stage in the history of public health.
Today, we have tools whose effectiveness would have seemed unimaginable only a few years ago.
We know that early access to treatment enables people to live long and healthy lives.
And that a person with an undetectable viral load cannot transmit the virus.
We have highly effective prevention strategies such as pre exposure prophylaxis, and we are entering a new era marked by long acting medicines, which have the potential to benefit those who need them.
However, Experience also teaches us that innovation only fully delivers on its promise when it reaches the people who need it most.
The history of communicable diseases offers a constant lesson.
A scientific breakthrough that is shared too late or shared unequally produces fewer benefits for everyone.
When certain communities or regions gain access to available tools years later, inequalities deepen.
Opportunities for prevention are lost, and collective goals become more difficult to achieve.
For this reason, equitable access must be understood not only as a moral imperative, but as an essential condition for the success of the global HIV response.
From our experience in Mexico and throughout Latin America, we are well aware of the challenges many countries face in incorporating new prevention and treatment technologies at the pace required by the epidemic.
We know that the sustainability of the response requires innovative solutions in financing, regulation, procurement, and international cooperation.
But we also know that the most effective health systems are those that work hand in hand with communities and place people at the center of decision making.
In this regard, it is important to recall that no innovation can achieve its full potential without the leadership, trust, and active participation of communities.
Community organizations are the ones that bring services closer to people, build trust, combat stigma, and help translate scientific advances into tangible improvements in people's lives.
Because innovation without equitable access risks becoming a new form of inequality.
The true measure of progress is not merely the existence of new tools, but our collective ability to ensure that their benefits reach everyone, especially those facing the greatest barriers and vulnerabilities.
And perhaps this is the most important reflection for our discussion today.
The challenge is not to choose between innovation and access.
Our shared challenge is to build models that advance both goals simultaneously, namely to encourage the development of new tools, while at the same time, ensuring that their benefits reach all those who need them in a timely, affordable, and sustainable manner.
That is precisely the spirit of this panel and the reason why we have brought together such diverse and complimentary voices today.
I look forward to hearing the valuable perspectives of our distinguished panelists and of all of you present here.
Thank you very much.
I give the floor to Mr.
James Chao, President of China United States Exchange Foundation, and WHO Goodwill Ambassador to moderate the panel.
Thank you very much.
Good afternoon.
Thank you very much to the co chairs for the kind introduction.
I'm James Chan, the president of the China United States Exchange Foundation and AWO Goodwill Ambassador for Sustainable Development Goals and Health.
We've heard so much about promises, people, progress in this extraordinary opening this morning of this high level meeting.
But I think it's good to take a quick pause over here to remind us that whatever incredible achievements we have made over the past decades, a lot of that is still very fragile and what we choose to do here over these 48 hours here in New York will help determine whether we move forward or whether we take a real step backwards.
We've heard so much that this is a pivotal point in the HIV response.
But the last decades have seen progress.
They have helped restore hope in the millions of lives saved and the treatment expanded.
But progress has slowed.
I said, it's fragile.
It's too many people still being left behind.
The gap is no longer about what we know works.
It's about who can access it and who simply can't.
New tools are changing the landscape, long acting prevention and treatment, smarter testing, more responsive models of care are all up there.
We know the potential is really very real.
Potential does not change outcomes alone.
As does, equity does, leadership does.
The challenge now facing us is delivery, fast, fair, and at scale.
That's what brings us on to the 40 20 target, which gives us a practical political framework, 40 million people living with HIV on sustained treatment.
Where we reminded of those 40 million people when we heard Karen Dunaway speaking here on behalf of those 40 million people at the opening of the high level, but also 20 million more people at substantial risk of HIV with access to effective prevention options by the year 2013.
We keep on talking about 20:30, it's a magical figure up in the air without acknowledging that 2030 is about four years away from now.
Science and tech are giving us new opportunities, including long acting prevention and treatment options, improved testing approaches, digital tools, and differentiated models of care, but innovation alone will not change the trajectory of the epidemic.
Its impact will instead depend on very quick and equitable access, affordable pricing, regulatory readiness, sustainable financing, reliable supply, integrated service delivery, community leadership, and of course, it was brought up again and again so many of those powerful interventions by member states this morning the removal of stigma, discrimination, gender equality, and of course, human rights barriers.
Our discussion today will thus focus on one central question, one question where we can really try to craft answers to.
What will it take to move from innovation and take that forward to equitable impact? We're going to begin with a moderated panel and each of our speakers will have 4 minutes to respond to one guiding question from their institutional perspective.
I'll keep us strictly to time so that we can preserve substantial space for the interventions and questions that we'll invite from the floor.
I'm pleased to introduce our panelists, Her Excellency, doctor Fancy Tu, ambassador and Permanent representative of the Republic of Kenya to the United Nations Office and other international organizations in Geneva.
Miss Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition, doctor Alexei Mass, Chief Specialist in HIV at the Ministry of Health of the Russian Federation, and doctor Jared Beaton, Senior Vice President at Gilead Sciences.
We move now to the moderated panel to Ambassador two beside me.
Kenya ambassador has made really, really important progress in its HIV response, including in expanding treatment and prevention.
But from where you sit over in Kenya, what's needed to build demand, implementation readiness, and sustainable delivery systems.
So that new HIV prevention and treatment innovations can reach the people that we're here to serve, can reach the communities that we're here to serve, where they can really have the deep, powerful, punchy impact.
Thank you so much, Moderator, for that question and perhaps permit me just to start by appreciating the co chairs for the work they've already done.
Kenya's perspective, the challenge before us is no longer only about developing HIV prevention and treatment tools.
I think even the previous presentations have shown us that.
It's about ensuring that scientific innovation translates into equitable access, sustained uptake, and measurable impact in the communities that need it most.
Kenya has made significant progress in expanding HIV prevention and treatment services through strong political commitment, community engagement, and partnerships.
Yet emergence of new technologies, including the long acting prevention options such as aka Fed presents an opportunity to accelerate progress even further provided we are prepared to deliver them effectively and at scale.
We believe four priorities are very critical.
The first one is that we need to build demand through community leadership and trust.
Communities are not simply beneficiaries of innovation.
They're essential partners in its success.
Young people, women, adults, and girls, key populations, and people living with HIV must be epped with accurate information, meaningful choices, and a voice in decision making.
When communities are empowered to lead awareness, advocacy and accountability efforts, upt improves and innovations are more likely to reach those who stand to benefit the most.
Secondly, we must strengthen implementation readiness.
Scientific breakthroughs can only achieve impact if countries are ready to introduce them rapidly and efficiently.
This requires regulatory preparedness, trained health workers, resilient supply chains, strong procurement systems, robust data platforms, and effective service delivery models.
It also requires integrating HIP prevention and treatment services within the product primary health care systems so that innovations are accessible, person centered, and sustainable.
The third is that we need and must ensure equitable access.
No innovation can be transformative if it remains beyond the reach of the people who need it the most.
New prevention and treatment technologies must be affordable, available and accessible across low and middle income countries.
This requires continued domestic investment, strengthen regional manufacturing and procurement mechanisms, and coordinated support from global partners to address the barriers related to cost, intellectual property and market access.
The last point, we must secure sustainable financing for innovation.
As the global health financing landscape evolves, countries need predictable and sustained resources to introduce, scale, and maintain access to new technologies.
Innovation must be accompanied by investment in delivery systems, workforce capacity, procurement and community led programs.
Sustainable financing is essential to ensure that advances in s do not become advances for only a few, but benefits shared by all who need them.
The emergency and capper Fit and other next generation prevention of technologies represents one of the most promising opportunities we have seen in decades.
Innovation alone will not end AIDS.
Success will depend on whether we can ensure that access keeps pace with scientific progress.
Our collective responsibility is to move from innovation to implementation.
From prevention choices to prevention access and from scientific promise to real protection for the people in the communities most affected by HIV.
KATE remains committed to working with communities, regional institutions, development partners, and the global HIV response to ensure that these innovations reach everyone who needs them and contribute meaningfully to ending HIDS as a public health by 2030.
Thank you.
Thank you very much, Ambassador, for highlighting the importance of country leadership, demand creation, implementation, readiness, and sustainable delivery systems.
I think what also stuck out for me is hearing a country speak so powerfully about community as an innovation, about community as a bridge, when it's empowered, when it's given the agency to really deliver on the overall good.
But that brings us very nicely onto the pivot to community and civil society perspective, Executive Director Solange Baptist, let's draw on your experience at ITPC in treatment and prevention access.
When you think about that, what role should civil society and community led organizations like yours play in turning HIV innovation into real access for people, especially those most often, as we said, left behind, left on the margins, fell right off, and what support is needed to actually turn that from a vision into a working practical reality? Thank you, Mr.
Chao, Excellencies, distinguished delegates, colleagues and friends.
Thank you for still being in the room.
Let's start with that.
Every single major gain in the HIV response from treatment access to lower medicine prices to prevention to human rights protections was hard fought and won by communities.
None of it was handed to us.
25 years ago, HIV treatment costs more than $10,000 per person per year.
Millions of people were effectively locked out of access.
But communities organized, communities challenged the status quo.
Communities are the ones that pushed for competition and versus monopoly.
Communities demanded that access become part of the conversation.
We did not simply respond to the market, we helped to shape the market.
Prices fell from 10,000 per person per patient per year to less than $100 in many countries.
Access expanded and millions of lives were saved.
Communities, however, are not naive.
We understand that innovation requires investment and that discovery involves risk and that companies should earn a fair return for developing lifesaving technologies.
What we reject is the false choice between innovation and access.
History has shown that we can have both and with efficacy and with cost effectiveness.
That history also reminds us that communities do not simply help deliver innovation, communities help make innovation accessible.
And that remains true today.
We have long acting prevention technologies, new treatment options, improved diagnostics and scientific advances that were unimaginable just a few years ago.
But innovation alone does not end epidemics.
I think we've heard that before today.
We know that breakthroughs only become public health successes when they reach the people who need them the most.
From ITPCs experienced communities play three critical roles in turning innovation into access.
First, communities create trust.
People do not adopt new technologies simply because they exist.
Build it and they will come is not a public health strategy.
Communities build treatment, prevention literacy, they address misinformation, reduce stigma, and help people understand how innovation can improve their lives.
Second, communities create accountability.
Communities are not only recipients of care, they are producers of evidence, generators of solutions, and often the first to problems long before institutions do.
Through community led monitoring, communities identify barriers, detect problems early, and generate information and strategies needed to improve implementation.
Communities, in other words, help determine whether innovation will succeed or fail.
Third, communities create equity.
Communities help to ensure that innovation reaches the people who are too often left behind.
New technologies do not automatically reach everyone equally.
Without community leadership, those who need innovation the most are often the last to benefit from it.
If we are serious about equitable access, then communities need more than recognition, they need support.
Are we not tired of hearing that communities are essential while continuing to treat community funding as optional.
Communities cannot build trust and generate evidence and drive accountability on applause and goodwill alone.
That means funding community led organizations directly and sustainably.
It means investing in community led monitoring and accountability systems.
It means ensuring that communities have meaningful seats at the decision making tables, and it means supporting policies that promote affordability and equitable access from the very beginning.
Too often we celebrate approvals and announcements as if they were the finish line.
Communities need access, not just announcements.
Communities are not the final step in the delivery chain.
They are the bridge between scientific breakthroughs and public health impact.
Innovation only matters when people can access it.
Thank you.
I think you've shaken up the room a little bit.
We need to re up.
Great.
There we will continue on that line.
But there were three words that you used there which were really important amongst many more, that when it comes to community, everything was earned, everything was earned.
Thank you very much to Executive Director Baptist reminding us that innovation only matters when people and communities can actually access it, use it, trust it.
Let's turn now to the health system and the public health perspective.
Doctor Mass, you're the leading expert in Russia's extensive government network for HIV and AIDS.
While the centralized AID Center model has provided exceptional specialized management, the future that we're talking about requires optimizing the modern continuum of care.
Bridging that gap between specialized centers on the one hand and general health systems on the other.
As Russia manages treatment and care for hundreds of thousands of people with complex HIV comorbidities, how is your Ministry of Health planning to decentralize HIV services beyond those dedicated aid centers and still ensure a personalized patient experience, avoid stigma, and ensure retention in treatment and care? What am I Distinguished moderator and colleagues, thank you for your questions.
The realities of AIDS services in Russia are as follows.
We decentralize the medical assistance for cases of HIV infection.
We create the services as accessible to the patients as possible, and this is a key condition for equitable access to services.
The key strategy for our health care system is not just creating the conditions for absolute access to free of charge HIV testing, but also creating amongst the people the understanding that HIV testing is a natural thing.
This is a basis for early detection of those with HIV infection in turn for making sure that they're put on anti retroviral therapy in time.
Russia today is a leader on covering with HIV testing.
In 2025, more than 57 million were tested.
Essentially, that's 40% of the population of our country.
The absolute success in our many years long fight against AIDS is the fact that an HIV infected mother can give birth to a healthy child.
In our country, those women who registered with health services early enough and who follow doctor's recommendations, such woman brings the risk of giving birth to an HIV infected child is minimal.
And this is a very good illustration of teamwork, teams consisting of obstetricians, gynecologists, infection disease specialists, and pre perinatal doctors.
I think that this is exactly an example of smart decentralization.
Now, is it possible to have a heart transplant or another transplant within HIV Aids Center? Now, today, because of the effectiveness of ART therapy, our patients live long enough to come down with age bracket appropriate diseases and therefore need specialized high technology medical assistance, be it cardiology, oncology, or any medical specialty? On the other hand, AD centers have not at all lost their relevance, quite to the contrary.
Our experience of combating COVID 19 has shown us how important it is to have specialized medical centers with a very powerful laboratory base behind them with highly qualified epidemiologists and clinicians.
We have come a long constructive way.
30 years ago when an anti retrovival therapy first appeared, the first patients were given hope that they will survive.
The first ART therapy regimes consist of 28 capsules per day and very serious side effects.
The reality today is for a patient to be able to find the most suitable therapy regime and one pill per day.
It's a norm from my country where we have our own original highly effective Medication which is accessible to anyone who needs it.
Very recently, literally several weeks ago, within the framework of an International Economic Forum in St.
Petersburg, we had a discussion with our outstanding colleagues and friends from the People's Republic of China, what the way forward would be new therapy regimes, truly accessible and available long action medications, wide use being made of gene editing, CRT therapy possibilities, other innovations, Of course, this includes creating a vaccine, the vaccine which would drastically change not just our approaches to understanding and countering HIV infection, but which will also make the world more equitable and just.
Thank you.
Thank you very much, doctor Mass, for bringing the health system and implementation perspective.
That brings us very nicely on to the role of industry, doctor Batten, how will Gilliad work with countries, communities, donors, and access partners to ensure that HIV innovations are introduced rapidly, affordably, and equitably without widening existing access gaps.
There are plenty of people here from civil society in this room.
I think all of us are very interested in what you and your peers and industry will have to say.
Thank you.
Thank you to the moderator, to the chairs, to excellencies and colleagues on this panel and in the room and to community partners across the room.
The A Gilead Sciences, we are deeply committed to collaborating with partners to accelerate real world impact for HIV prevention and treatment options.
In partnership, we aim to help end the HIV epidemic for everyone everywhere.
As one of my colleagues down the table said earlier, innovation and access must go hand in hand.
To that end, I bring to this table today the perspective from Gilead Sciences, which builds on three decades of making innovations in medicines along with innovations and access.
That included the first single tablet regimen for HIV, the first medicine for prep, a medicine for prep that is given once every six months that has been discussed quite some time today, and also the first voluntary licensing.
These advances in treatment prevention have simplified care, expanded choice, supported adherence, responded to real world problems, and made treatment and prevention available and impactful worldwide.
Central to these efforts has been sustained input from diverse voices and partnerships with people affected by HIV and the advocates and communities that surround them throughout our entire development process and, as my colleague earlier said, after that starting line, which is when a medicine is developed when it needs to become impactful and equitably accessible.
Our dedication to transformational innovation extends beyond medicines.
Relentless scientific discovery must be paired with relentless dedication to delivery models that help countries and communities translate new tools into public health impact.
Through partnerships, collaborations, and charitable giving, Gilead also aims to improve education, expand access, and address barriers to care.
To that end, the funders concerned about AIDS reports that Gilead remains the number one philanthropic funder for HIV worldwide.
Equitable access to innovation for all people affected by HIV, particularly those disproportionately affected by other health inequities, is essential.
I would like to talk a moment about HIV prevention.
Lana Kaver mentioned many times today is a result of nearly two decades of development by Gilead scientists.
Over those years, through trial and error, dedication, and grit, Gilead persisted with the understanding that novel long acting options could one day help meaningfully change the trajectory of the epidemic.
Years of deep engagement and partnership with advocates, clinicians, scientists, and policymakers guided us along the way, aiming to make a new prep option that could have a meaningful impact for people and communities.
In 2024, trials had unprecedented results and immediately and comprehensively reported their findings.
Immediately thereafter, Access was pursued with the same dedication and urgency.
Our access approach is anchored in partnerships with countries communities, donors, and global health partners.
Our long term strategy is to enable access through voluntary licensing to support sustainable, affordable generic supply across 120 high incidence resource limited settings.
Gilead signed royalty free licensing agreements with six generic manufacturers within two weeks of the trial results reading out and completed technology transfer within months.
Ahead of regulatory filings anywhere in the world to aim at unprecedented early access to generic and cap ofr hopefully very soon.
Until and as that generic supply scales, Gilead is working with the global fund and the US State Department through PEPFAR approach, on a bridge approach, supplying La cap ofr now for up to more than 3 million people at no profit Gilead, while these partners lead country prioritization and implementation.
This approach is designed to support immediate access while catalyzing countries for readiness and building towards long term sustainability.
Today, Lana Capvir has reached ten countries in sub Sharan Africa with plans for 24 more low and middle income countries by the end of this year through these partnerships.
This builds on an important milestone reached in 2025, which I was very proud to be able to see that for the first time a new medicine for HIV reached communities in S Saarn Africa in the very same year that it reached communities in my country, enabled by years of early and sustained access planning.
In middle income countries, outside the voluntary licensing region, we're working with governments and regional bodies, including PAH, to define and pursue the fastest paths to access, and we look forward to providing more and more updates soon as we have done for the last two years.
We cannot talk about prevention without talking about treatment because they are complementary.
Many strategies are necessary to overcome HIV and it will be impossible to end this epidemic without bringing treatment to all who need it.
When people living with HIV take treatment as they achieve and maintain an undetectable viral load resulting in a long term life and reduced and eliminated HIV transmission.
I believe greatly in what U equals U has done as a movement around the world.
I am proud to have the part that Gilead has played in the decades that have led up to treatment being available around the world.
Every person with HIV needs to be virally suppressed for their entire lives.
Each person has different needs and preferences, and there will not be one size fits all that will get us to 100100100.
The complexities of HIV require person centered innovations that put people at the center of developing new therapies.
These evolving needs propel our teams at Gilead.
As we make long acting combinations for HIV treatment that will meet the needs of people all around the world.
And bringing community voices into our research process is essential to close this treatment gap.
We do that from planning to clinical trial execution, to regulatory strategies to access so that community has direct line of sight in how treatments work and how treatments become workable in people's lives.
As member states move from the political declaration into implementation, please know that Gilead will remain a committed partner, advancing scientific innovation, access planning, and the partnerships needed to ensure that medicines reach people and communities who have been left too often behind.
The global community stands at a critical juncture in the HIV response.
Despite considerable progress, HIV is exacerbated by inequities within access to care, pervasive stigma, and emerging health threats which will require sustained leadership across sectors.
Ending HIV requires the right tools delivered in innovative ways with clear accountability.
Together with communities, person centered research care, R&D and access will transform lives and result in transformative outcomes reshaping the future of health and hopefully moving to the global goal of ending the epidemic by 2030.
Thank you.
Thank you very much, doctor Baton.
Well, before we go into the interventions, I thought we would take a quick pause to look at what the opportunity and where the challenge is.
The picture where we are now is 1.2 million new HIV infections in 2025, which is 43% fewer than in 2010.
But where we should be is around 200,000 new HIV infections in 2030, which would be 90% fewer than in 2010.
Obviously, there can be a real ramp up by the end of the epidemic by boosting access to HIV prevention options that really work, including new long acting ones.
So that by that year 2030, 20 million people access anti retroviral based prevention options alongside existing effective, lower cost prevention and harm reduction options, 20 billion condoms being distributed and 20% of domestic HIV funding going to prevention.
Well, thank you to all the speakers and for those who focused with their really thoughtful preventions.
We've heard really important perspectives from country leadership, communities, and civil society, public health implementation, and of course, industry.
Several universal messages are beginning to emerge from these discussions.
We're hearing about innovation being matched by access.
Access being equitable and affordable, delivery systems must be ready and active.
Communities must be at the heart and be central and core to all these efforts, and of course, partners being aligned behind country priorities.
We're going to throw this open now to a wider inclusive discussion.
We've got about 35 minutes for that.
We're going to begin with a few pre identified interventions, starting with Esuartini and then take brief comments, ideas, suggestions from all of you.
In line with guidance for the session, interventions will be limited to 2 minutes each, so please keep it brief and compelling.
Um, let's start off with the Minister of Health from Sati Minister Matsu Bula Eswatini, of course, has made remarkable process in his own HIV response, including strong achievements on treatment targets.
But as the country looks ahead to the next phase of the response, why is HIV prevention now such a critical priority? What are Suatii's main prevention priorities at this stage? Can we call on the minister, please? I.
Scientific progress has advanced at an unprecedented pace, yet equitable access to that progress remains uneven.
From a Ses experience, we know that this gap can be closed.
We currently stand at 908-90-8908 on the UN aids targets.
Achievements made through sustained investment in HIV testing, same day at initiation, and differentiated service delivery models that meet people where they are.
As we look ahead, one reality is clear, prevention must now take a more central role in the next phase of the response.
This panel asks us to leverage scientific innovation to end AIDS by 2030.
A S his answer is concrete, La Kaavia.
In our setting, new infections, particularly among adolescent girls and young women remain disproportionately high.
LAN introduced in December 2025 has come at an opportune time to improve access to prevention technologies.
For key populations, adolescent girls and young women, and pregnant and breastfeeding women, precisely where new infections persist.
LAN removes the daily burden of oral prep, reduces frequent clinic visits, and directly addresses the adherence, stigma, and access barriers that have limited prevention impact.
But scientific breakthroughs only matter if they reach people.
We have pet AN introduction with strengthened monitoring systems, health worker training, Well, thank you very much to the minister from Esuaini and for Euatii reaching 908-90-8908, I think most countries in the world would be dreaming to reach that level of 908-90-8908, getting so close to the end of AIDS.
You are a reminder that a country, no matter how big or small, can really make that dream into a reality.
Thank you for that.
A quick reminder to delegations that there is no established list of speakers for this meeting.
Delegations wishing to speak are requested to press that microphone button to ensure that we hear as many as possible.
You're requested to limit your statements to 2 minutes when speaking in national capacity, 3 minutes when speaking on behalf of a group of states.
Once again, those timers will be strictly enforced through an automatic microphone cutoff.
I'm not doing the cutoff someone else's, but a timer will be projected on screen.
Delegations may also submit their full length written statements through email to estates at un.org, which will be posted under etment section of the United Nations Journal.
Thanks for that.
From Euatini, let's go now to Georgia, please.
Hello, Chair, Excellency, distinguished delegates.
Georgia believes that science, technology and innovation are among the most powerful tools available to end AID by 2030.
However, innovation can only achieve its full impact when it is accessible, affordable, and reaches the people who need it most.
While Georgia has not yet reversed its HIV epidemic, we have made significant progress over the past decade through sustained political commitment, evidence based policies, and investments in innovative approaches to prevention, testing and treatment.
Today, almost 90% of people diagnosed with HIV received treatment and 94% of those on treatment have achieved viral suppression.
Innovation has been central in this progress.
In 2017, Georgia introduced the first pre exposure prophylaxis program in our region and subsequently expanded it to community based delivery models.
Since 2021, prep has been available free of charge to all key populations, and we are currently preparing for the introduction of long acting HIV prevention options.
Georgia's Ponary hepatitis C elimination program launched in 2015 has further strengthened HIV prevention and case finding through integrated screening services.
Scientific advances alone are not enough.
Stigma, discrimination, and other social barriers continue to limit access to HIV services and innovations.
Our experience demonstrates that sustained political commitment, domestic investment, strong community partnerships, and evidence based innovation can accelerate progress toward ending AIDS.
Georgia remains committed to working with all partners to ensure that scientific advances benefit everyone and that no one is left behind.
Thanks.
Thank you very much to Georgia.
We'll hear next from South Africa, which will be followed by the representatives from Paho from the IFPMA and also Global Action for Trans equality.
Then we'll move to Thailand, Brazil, Mali, and Spain.
May we now hear from South Africa, please.
Chair, distinguished panelists, colleagues, South Africa, thanks the panel for centering this discussion on equitable access.
The gap between what science has achieved and what reaches our people remains unresolved.
Innovation exists.
A does not yet follow.
Long acting antiretroviral medicines holds real promise to close persistent gaps in HIV prevention, treatment and care.
Yet the declaration itself in its draft in its own words, indicates that these innovations are not equitably accessible, affordable, nor rapidly deployed.
South Africa holds significant HIV prevention and vaccine trial infrastructure and has land that signs is really the constraint.
Intellectual property frameworks, pricing, and fragmented supply chains are.
What this panel must be able to defend, South Africa calls on this panel to protect the commitments in this text.
Firstly, the balanced use of agreement on trade related aspects of intellectual property rights, flexibility through a public health lens which must not be diluted in the weeks ahead.
Second, the strengthened local regional manufacturing capacity, including support for African production and regulatory safe reliance.
Thirdly, alternative mechanism to incentivize innovation that do not depend on final product prices because a financing model built on higher prices will always exclude the population this panel exists to self.
This panel's mandate rightly treats stigma as a barrier to innovation, not separated.
Access without dignity is not access at all.
Thank you to South Africa.
We now move to Paho please.
Mr.
Chair, Excellencies, delegates, friends, on behalf of the Pan American Health Organization, today we are seeing member states in the Americas progress with concrete plans in response to their commitments to eliminating more than 30 communicable diseases by 2030 through the Pan American Health Organization Disease Elimination Initiative.
In this sense and building upon previous success and progress in the HIV response, PAH with its partners launched the Alliance for the elimination of HIV in the Americas as a platform and mechanism for joint action and coordination among governments, communities, academia, donors, and private sector, among other key partners to accelerate the elimination of HIV.
This alliance aims to foster an enabling political, institutional, and social environment that supports making new technologies such as long acting technologies more affordable and accessible.
Our goal is to demonstrate that elimination is achievable by leading by example.
To this end, we have piloted the methodology of the path to elimination framework.
The path to elimination provides a structured methodology that outlines key processes, milestones, and criteria in data, programs, lab, and human rights that countries must meet to be recognized with the attainment of silver and gold status.
This is what makes the Alliance for HIV elimination relevant beyond our region.
It is practical, measurable, adaptable, and grounded in reality.
Other regions can be guided and inspired along a similar path.
Thank you very much to Pha.
We now give the floor to IFPMA, the International Federation of Pharmaceutical Manufacturers Association, please.
Excellencies, distinguished delegates.
I'm pleased to speak on behalf of the FPMA representing the Noy pharmaceutical industry.
As member states gather at this high level meeting to renew global commitments to HIV AIDS, IPMA welcomes the political declarations continued ambition to end AIDS as a public health threat by 2030.
Meaningful progress has been made, but it remains fragile, uneven and vulnerable to reversal if political attention, funding, and implementation momentum weakens.
The priority now is implementation through country led, evidence based, and collaboration oriented access strategies that deliver outcomes for people and communities.
Biomedical innovation has transformed HIV care, enabling people living with HIV and those who could benefit from innovative prevention options to live full, active, and productive lives.
We welcome recognition of the important role played by the private sector in innovation, research and development.
The high level meeting is also an opportunity to sustain ambition for the next generation of HIV innovation and promote investments in science and technology, including R&D to accelerate progress toward the vaccine and a functional cure for HIV.
Innovation, intellectual property, and equitable access are mutually reinforcing, not competing objectives.
The response should prioritize regulatory pathways, supply security, procurement readiness, sustainable financing, and country led leadership to drive implementation and facilitate access pathways that the private sector enables through collaborations with governments and communities, global and regional institutions, and voluntary licensing.
IFA and its members stand ready to contribute constructively through R&D, manufacturing, partnerships, and practical evidence based solutions.
They strengthen country leadership and community shaped people centered implementation to sustain.
Thank you.
We now turn to the Global Action for Trans equality.
You now have the floor.
Thank you, Chair.
I speak on behalf of GAT, Global Action for Trans equality to presents the results for research on democratic backsliding and its impact on HIV services, a crucial intersection to meet the targets of our current global aid strategy.
GAT surveyed 64 member organizations across five global regions and the findings are stark.
92% reported anti gender movements have become more visible in affected HIV services.
83% report healthcare providers have changed practices due to anti gender pressure.
Why 89% cite fear of discrimination as the top access barrier.
This is not an anecdote, it's a pattern of systematically dismantling.
We are living through a scientific revolution in HIV prevention.
Long acting antiretrovirals offer what oral regimes cannot, decoupling treatment for daily pill taking and clinic visits, protecting privacy and improving adherence for transgender diverse communities.
But for our communities, the barriers to these medicines are political and structural.
Provider refusal, site closures, and criminalization of outreach workers block access.
Long acting anti retroviirs cannot deliver on their equity promise if the infrastructure is being dismantled.
27% of survey organizations report that anti gender attacks have directly disrupted long acting medication rollout.
The science exists, the medication exist.
What is being dismantled is the social and political infrastructure to deliver them actably.
We call urgently for protecting civic space for translator organizations, ensuring HIV medication rollout strategies, and addressing that anti gender attacks do not impose barriers on the implementation.
Democratic backsliding is a health emergency for our communities and for everyone and the response must match the scale of that emergency.
Thank you.
We thank the representative from GAT, the global action for Trans equality and move now to a couple of member states in the following order, Thailand, Brazil, Mali, and Spain.
We now invite Thailand to speak first, please.
Thank you, moderator.
Thailand's experience demonstrate that scientific advance can only achieve that full potential strong public health systems, sustainable financing, and meaningful community engagement through our universal health coverage system, Thailand has ensured universal access to anterior world treatment and expanded access to evidence based prevention intervention, including HIV self test, prep, and community based services.
These achievements have been made possible by our capacity to translate scientific advance into affordable and evidence based public health program.
Yet challenges remain.
Thailand wishes to share the following priorities.
First, we should strengthen equitable and affordable access to scientific advance and health innovations, in new prevention technologies, diagnosis, medicines and long acting treatment options, particularly low and middle income countries as well as strengthen national capacity to translate these innovations into affordable, scalable, and sustainable public health programs.
Second, we should strengthen Li and public health system, universal health coverage, sustainable financing, and human capacity development at all levels to ensure the integration of HIV intervention into primary health care and accessibility for all.
While promoting meaningful community leadership, community led services, and addressing stigma, discrimination, and other human right barriers.
Tyran may committed to working with our partners to ensure that scientific progress benefits everyone and everywhere.
Thank you.
Thank you, Thailand.
We now move to Brazil, please.
Thank you, moderator.
Brazil welcomes this panel and recognizes that scientific advances over the past decades have profoundly transformed the global HIV response.
However, innovation can only be considered successful when it reaches the people who need it most.
Without mechanisms to ensure for affordable access to innovation, countries are left to navigate in complex markets, negotiate prices, and introduce technologies on their own, often from a position of weakness.
Brazil's experience demonstrates that innovation delivers concrete results when combined with strong public health systems.
Through our unified health system, Brazil provides universal and free access to HIV testing and intra hetero viral and have expanded the combination of prevention strategies, including the provision of self testing, the scale up of pre exposure prophylaxis with incorporation of long acting injectable prep.
President Lula da Silva sanctioned new regulatory laws to promote clinical research, which increased Brazilian proportion in global clinical research to 30%.
I'd also like to mention the role expected from the Global Coalition for local and regional Production, innovation and equitable access in fostering innovation and production in the Global South in order to reduce dependency from the North.
Nevertheless, significant challenges remain ensuring equitable access.
For this reason, Brazil advocates for strengthening international cooperation, promoting technology transfer, developing local and regional manufacturing capacities, preserving policy space to promote public health, and implementing measures that support the sustainability of health systems.
Thank you.
Thank you, Brazil.
May we now give the floor to Mali.
Thank you, moderator.
We associate ourselves with the statement made by the African group when they denounced the gap existing in the science area.
Medical innovation is extraordinary long acting medicines, catevir and early screening.
However, for developing countries, these advances are accessible only with difficulty.
It is unacceptable that intellectual property monopoly in the therapy area exists and we call for the unimpeded Application of the flexibility we have in the agreements and in the Doha declaration to promote local and regional manufacturing of generic medications in Africa.
Technologically, we're not passively waiting for that.
We integrate digitalization so as to optimize our national response given our economic and geographical constraints, but it enables us to work across approaches in the areas of high mobility or the ones that are difficultly accessible.
This is a tool to bridge the gap of 95.
Where we are still currently at the 68% of under treatment.
We would like to make the international community make these technologies accessible to help us bridge the gap.
I thank you.
Thank you very much, Tali.
We move now to Spain.
You have the floor.
Thank you very much.
We find ourselves at a decisive moment.
We have all scientific tools capable of accelerating the end of HIV as a public health threat, yet inequalities remain and so profound that in places these advances are needed, where the advances are most needed, they're not available.
We've heard innovation is only innovation if it is accessible.
Well, it also must be incorporated from the very beginning of the development process as a fundamental condition for embedding equity in policies governing access to medicines.
Also, new advances is not just about discovering a molecule.
You have to invest in a new form of innovation that pays attention to the needs of affected communities, taking into account multiple intersecting stigmas experienced by populations at risk of HIV and those living with HIV.
Also, lack of access doesn't just depend on technology.
There are two central elements to make progress in this area.
First of all, Universal health coverage, this is the approach that most strongly promotes and advances health equity and the prerequisite for achieving the goals set for 2030.
Universal health coverage is the wisest choice from a health, economic and political perspective, particularly with regard to HIV.
Secondly, the main barrier is not technological but social.
Stigma, discrimination, and certain legal barriers continue to prevent access to HIV services.
Finally, Spain would like to highlight our commitment to combination prevention through public funding for prep since 2019 and including the injectable formulation of Cbogratvia in February 2026.
These are essential prevention tools.
We are committed to combining biomedical, innovation, and public health, community participation, and epidemiological surveillance in order to accelerate the decline in new infections.
Also, we include fundamental aspects with regard to access.
Thank you.
Spain, we now move to civil society, the representative from the Eurasian Harm Reduction Network.
B from Eurasian Harm Reduction Association and rise decriminalized movement.
In Eastern Europe, Central Asia region, we are discussing a lot how science, technology, innovations can make health services truly accessible for key populations, people who use drugs, sex workers, LGBT people, women living with HIV adolescents and young people, migrants and people in prison.
The same time, there are evidence based community intervention that have not been innovations for 30 years in some countries yet are still treated as pilot projects in others.
Community led prevention and harm reduction are well known and proven approaches.
We simply need to scale up and ensure their sustainable support.
Some of these innovations are truly transformative.
Low acting buprenphen as opioid agonist treatment means that one injecting per month can allow a person living With opioid dependence to lead a productive life, to work, study and life without having to visit a clinic every day.
Opioid agonist treatment and enoxon remain one of the most effective ways to prevent HIV transmission and reduce overdose deaths.
Both remain still inaccessible to the majority of people who use drugs in eco region because of persistent misconceptions and lack of trust in science evidence.
Prep is indeed is important in intervention, but harm reduction and outreach services must be in place.
For people who use stimulants, there are also innovative approaches such as drug checking services and counseling in nightlife setting.
Harm reduction combined with a social counseling now is provided digitally and that's also very innovative.
Support of survivors of gender based violence is not innovations but need to be provided to women living with HIV, sex workers, and women using drugs.
I'm calling for states to introduce evidence based approaches which already exist in a lot of countries to make these innovations help lives.
Thank you.
Thank you.
We'll hear next from the AIDS Healthcare and then followed by AOP.
Next is the AIDS Healthcare Foundation, followed by AcOP followed by people living with HIV, Latin America.
Thank you, Chair.
I speak on behalf of AIDS Healthcare Foundation.
Over the years, the global HIV response has advanced a succession of ambitious targets from three by five, 15 by 15 to 909090 and 905-90-5905, and now new financing targets are emerging.
These goals have helped drive remarkable progress.
That is true.
But as goal posts continue to move, we should ask whether the resources, political commitment, and implementation capacity needed to achieve them are keeping pace.
Should also be careful not to narrow our focus.
Today, there is enormous attention on prep, which is an important tool in HIV prevention.
However, no single intervention will end the epidemic.
We must continue to invest in and promote the full range of prevention measures, including condoms, testing, treatment as prevention, harm reduction, prevention of mother to child transmission, and comprehensive sexuality education.
New innovations should strengthen, not overshadow established approaches that have saved millions of lives.
Finally, the budgets are moral documents.
Declarations, commitments, and political promises are important, but they do not deliver medicine, pay health care workers, or keep clinics open.
The true measure of our priorities is not what we say, but what we fund.
Every commitment made in this room must ultimately be reflected in budgets and financing decisions.
If we are serious about achieving our health and development goals, ambitions must be matched by resources.
Innovation must be matched by implementation, and promises must be matched by action.
Thank you.
Thank you.
Let's move now to Act Up.
We have a representative from Act Up here? Yes.
Thank you.
My name is Eric Sawyer and I'm one of the founders of ATM.
Act Up, New York, one of the more well known and first AIDS organizations that created lots of demonstration, civil disobedience, carried dead bodies to the lawn of the White House to force our government and did the same things to drug companies, chased them all over, trying to force them to develop drugs to save our lives.
And once there were drugs that were effective in keeping people like myself, I've been symptomatic since 1982, and I survived because I had access to the early drugs as they developed here through primarily clinical trials.
But I didn't think that I deserve to live when people in the developing world, especially mothers with children, were dying in less than a year in Africa.
Myself and other people fought to get generic AIDS drugs developed and funding for their distribution.
I want to thank Gilead for their leadership and I don't usually thank drug companies.
I usually chain myself to their doors, but I want to thank them for their leadership in what they're doing to get their newest innovations available in the developing world.
Your leadership, like the leadership of the governments in this room who are standing up talking about what they do and what they want to see happen so that more people can survive HIV around the world is commended Thank you for your.
Sorry, Eric, there's a default system that cut off your microphone so we can't hear you.
It's a wrong time to cut it off because it's a powerful story and testimony, but thank you.
I outside.
Please reach out to your other companies in.
Jared, the thank you is always followed by a powerful ask.
Let me hold on to that thought for just a moment.
Let's go first to people living with HIV Latin America and then we'll come back to some of those thoughts.
Good afternoon.
Thank you for giving me the floor.
I'm Lucia Cris from Mexico representing those living with HIV in Latin America, Caribbean.
It's very important for us to be able to guarantee that the region of the Americas will have visibility, particularly in order to guarantee that we achieve the goals that we've committed to in this declaration.
We want new technologies to also reach Latin America that the Americas are seen as part of the region to ensure that member states can guarantee these interventions.
Clearly, interactions between civil society and governments have to be complementary and they have to move from words to actions in terms of funding and We need to have a.
We have a new vision in what Gilad is proposing.
Countries must have access to new technologies.
Thank you very much.
Thank you very much to people living with HIV, Latin America.
We're going to close with some very, very quick reflections, just 60 seconds from each panelist, Jed, let's flip the script around.
Maybe you can give a very quick response to the call that was made to you in 60 seconds or less.
Thank you to the call and thank you to everyone in this room.
This is a reminder that we all play a role across sectors and many of us carry many of these roles in our own lives.
I look at my own fellow panelists and I realize that I began my career working on HIV prevention in Kenya.
I've been a clinician and a public health practitioner, and I am a community member and an advocate.
Innovative medicines and innovations and access must go together and they have transformed HIV care worldwide.
Gilead has is and will be a partner in ensuring that innovation and access continue to go hand in hand toward a goal of ending the epidemic for everyone everywhere.
Thank you.
Thank you.
On that promise, let's weave this narrative over to ambassador to ambassador.
I've seen you listening intently throughout this discussion to the many different interventions.
I was just wondering whether there is a response from you from a country's perspective, particularly on what countries need from partners to support implementation readiness, but also equitable delivery, equitable and equity are just these words that come up again and again again.
Thank you so much.
I think Kenya, like most countries in the Global South, who are dealing with this particular burden of disease cannot overemphasize the need to ensure that access must be real access, the move from policy to implementation.
And your question, moderator, it must be affordable, readily accessible to all those that truly needs it.
Thank you.
Thank you, Ambassador too.
Doctor Mazos maybe a quick word from you on the health system requirements for introducing innovation, but also at the same time, maintaining quality, safety, and continuity of care.
Thank you.
I will spend some of my seconds to express my absolute gratitude for the brilliant way this panel has been conducted by the moderator.
It's very important to say that we are on the brink of a technological victory over HIV infection.
This is obvious.
We heard this in reports and statements made by the distinguished participants.
It is clear that we need to nonetheless not lose the focus on traditional issues on prophylaxis, on creating a safe environment for the people, on educating the young people.
It is only through a comprehensive approach that we will be able to decisively deal with an HIV infection.
I thank you.
Thank you very much, doctor Mass and Solanj Baptist.
Not a question for you, but maybe a space for you instead to use your time and your 60 seconds to tell us what's really important to you, what feels really important to you sitting here in this room in New York at this high level meeting as we heard the very last one before 2030.
Thank you for the space because I don't think I was going to answer your question.
If I may leave the room with two final thoughts.
One is actually a caution.
I've been sitting here listening and I think there's a big distinction between excitement and sustainability.
They're not the same thing.
And I think if we've learned nothing from HIV, we've learned that scientific success does not automatically become public health success.
The sustainability question must be asked at the beginning, not after the rollout.
So if a technology cannot be financed, governed, and accessed equitably over the long term, then scale remains an aspiration, doesn't it? Then it's not a strategy.
It's an aspiration.
The other thought I have in mind is more of an encouragement.
I've been thinking here, why do we continue to struggle with access in HIV despite having science? It's not today we're grappling with this question.
I think as GNP plus had reminded us, HIV is not a disease like diabetes.
It is deeply moralized.
It has always been a moralized disease and when it's a moralized disease, people affected by it are often judged before they are served.
They're blamed before they are supported.
That is why community leadership means so much and why it matters in HIV.
And when you have affected communities generating intelligence and making innovation more effective and equitable and ultimately more valuable, that is not a drain on the system, that's value creation.
Thank you.
Thank you very much to Executive Director Sj Batice and thank you to everybody here.
I mean, all of you in your different wonderful ways have informed and contributed where we are, whether you've spoken today or not.
I think your presence and your participation is truly valued.
This has been a really focused and enhanced discussion.
It helped identify several priorities for action.
So political commitment, country readiness, affordability, regulatory preparedness, sustainable financing, community led demand and accountability, integrated delivery, and stronger partner alignment.
The message is clear that the 40 20 target will only be achieved if science and innovation are matched by systems, financing, community leadership, and accountability.
Let me quickly summarize some of the thoughts that we've got out of today.
Number one, the target gives us a clear practical political compact to build and preserve that progress towards 40 million people on HIV treatment while enabling 20 million people to access effective HIV prevention by 2030.
Second, innovation can help shift the trajectory of the HIV response, but only if it reaches people rapidly, affordably, and equitably.
Long acting HIV prevention and treatment options, improved testing approaches, digital tools, and differentiated models of care must be integrated into country led systems, not introduced as parallel or fragmented programs.
Third, countries need readiness, and that means regulatory preparedness, sustainable financing, procurement and supply security, trained providers, integrated service delivery, and data systems that can actually support prioritization and accountability.
Fourth, communities must remain central, community leadership, rights based delivery, demand creation, stigma reduction and accountability are essential to ensuring that new tools reach the people and communities most often left behind.
Finally, partners have a responsibility to align behind country priorities, and that means financing partners, technical agencies, access partners, regional institutions, the pharmaceutical industry, and civil society must all come together, must work together to turn scientific progress into equitable public health impacts.
Building on this discussion, the call to action is clear.
We call on heads of state and government, ministers, communities, donors, technical partners, regional institutions, access partners, the pharma industry and the scientific community to work together to advance a 2026 to 2031 aid strategy.
40 20 target, which is sustaining progress towards the 40 million we spoke of on HIV treatment while enabling that 20 million more to access effective treatment.
This requires all of us to come together to build towards that so that we have rapid, equitable, affordable and sustained access to prevention, testing, treatment, and gender gender gender responsive and community led approaches, treatment and care innovations that are delivered through that rights based gender responsive and community led approaches, which is what I meant to say that reach those most often left behind.
We started today by talking about progress that the progress has been historic.
That progress really has been proved to be really, really fragile.
We've used these 24 hours here in New York to make that first step forward.
Let's ensure that we keep moving in that direction with that momentum over the next 24 hours to the close of tomorrow.
Thank you very much.