Yobe State Agency for the Control of Aids

62% Drop in Child HIV Infections Since 2010, but Funding Cuts Threaten to Reverse Gains

For the first time since the 1980s, the number of children acquiring HIV has fallen to its lowest point in decades. According to recent data, new infections among children have dropped by 62% since 2010—a milestone that public health experts are calling “real progress” in the long fight against the AIDS epidemic.

Yet, behind that headline figure lies a sobering reality. In 2024 alone, an estimated 120,000 children still acquired HIV. That is roughly one new infection every four minutes. And now, that hard-won progress is hanging in the balance as funding cuts dismantle the very prevention programs that made the decline possible.

A Historic Low

The 62% reduction since 2010 translates to millions of children spared from a lifetime of antiretroviral therapy, stigma, and the chronic health challenges of living with HIV. The success has been driven largely by expanded access to prevention of mother-to-child transmission (PMTCT) services. These include routine HIV testing for pregnant women, immediate antiretroviral treatment for those who test positive, and safe breastfeeding guidance.

In many high-resource settings, vertical transmission rates have fallen below 5%. Even in some of the highest-burden countries, concerted efforts have brought rates down significantly from the peaks of the early 2000s.

120,000 Children: The Unfinished Agenda

But the global community is far from crossing the finish line. The fact that 120,000 children still acquired HIV in 2024 highlights persistent gaps—in remote rural areas, in conflict zones, and among marginalized populations where antenatal care and HIV testing remain out of reach.

Without these children acquiring infection, they would have been born HIV-free. Their infections represent not just a health statistic, but a failure of systems to reach every mother and child.

A Fragile Progress

The most urgent warning now comes from the funding front. Prevention programs—community health worker networks, mobile clinics, drug supply chains, and laboratory systems—are expensive to build but relatively cheap to maintain. However, major donors (including PEPFAR and the Global Fund) and national health budgets are facing cuts, reallocations, or political headwinds.

If those programs are dismantled, experts fear a backslide. In settings where PMTCT coverage has already plateaued, a loss of funding could disrupt drug supplies for pregnant women, reduce antenatal HIV testing, and break the trust built between communities and health workers. Some modeling suggests that funding cuts of just 20–30% in high-burden countries could lead to tens of thousands of additional pediatric infections within a few years.

"We Can't Afford to Slow Down Now"

Advocates are clear-eyed about the stakes. The same interventions that drove the 62% decline are still needed to drive the remaining infections to zero. But without sustained, predictable investment, the world risks not only stalling but reversing.

“We’ve proven that we know how to prevent children from acquiring HIV,” said one public health official. “The science is there. The delivery models are there. What’s in question now is the political and financial will to keep them running.”

The choice, as they see it, is stark: protect the progress of the last decade and finish the job, or watch a preventable tragedy grow again—all because the world looked away when success was finally within reach.

What Happens Next?

In the short term, global health agencies are calling for emergency bridge funding to maintain PMTCT services in the most affected countries. Longer term, advocates argue that ending pediatric HIV will require integrating PMTCT into stronger primary health care systems, not relying on vertical, donor-funded programs that can disappear overnight.

But for the 120,000 children who acquired HIV in 2024—and for the next child who will acquire it while this article is being read—progress is not a given. It is a choice. And right now, that choice is being made in budget meetings far from the clinics where mothers and babies wait for care.

Executive Director

Yobe State Agency for Control of AIDS

Hope in Action: New Study Confirms Life-Saving Liver Transplants Are Safe for People Living With HIV.

For decades, a diagnosis of HIV was effectively a death sentence for patients suffering from end-stage liver disease. Despite the life-saving potential of a transplant, these patients were routinely turned away from transplant lists. The medical establishment’s long-standing assumption was that the combination of HIV and the powerful immunosuppressive drugs required post-transplant would be too dangerous, likely leading to uncontrollable infections or rapid progression of the virus.

Now, a growing body of evidence, culminating in a pivotal new multicenter study, suggests that doctors may have been wrong. Not only is the procedure feasible, but recent data indicates that HIV-positive patients can achieve excellent outcomes, with some studies even showing 100% graft survival rates when using organs from donors who also had HIV .

A Historical Shift Fueled by the HOPE Act

The turning point for this field came with the HIV Organ Policy Equity (HOPE) Act, which lifted a ban on research involving organ transplants between HIV-positive donors and recipients. Before this, organs from HIV-positive donors were discarded, even as thousands of HIV-positive recipients waited for lifesaving transplants .

A recent study published in the American Journal of Transplantation highlights the success of this approach. The research, a prospective multicenter pilot study comparing HIV-positive recipients who received organs from HIV-positive donors (HIV D+/R+) against those who received organs from HIV-negative donors (HIV D-/R+), found that graft survival was remarkably high.

Specifically, while there was a slight difference in one-year patient survival (83.3% for D+ vs. 100% for D-), there were no significant differences in one-year graft survival (96.0% vs. 100.0%) or rates of rejection between the two groups .

Addressing the "Risky" Label

Earlier research in the early 2000s laid the groundwork for this shift. A landmark study published in Transplantation in 2003 was among the first to suggest that HIV infection should no longer be an automatic exclusion criterion. In that pilot study involving 14 recipients (10 kidney, 4 liver), researchers found "no evidence of significant HIV progression and no adverse effect of HIV on allograft function" .

However, lingering fears remained regarding co-infections, particularly Hepatitis C (HCV), which is common in this patient population. A 2011 Italian study confirmed that while outcomes were comparable to HIV-negative patients, those co-infected with HCV faced unique challenges, though overall, "under specific, well-determined conditions, OLT can be a safe, efficacious procedure in HIV patients" .

Superior Outcomes: The Unexpected Finding

Perhaps the most striking data comes from a more recent retrospective study presented in 2025 comparing outcomes in Modena, Italy. In that analysis, recipients who received livers from HIV-positive donors (D+/R+) had a graft survival rate of 100% at the last follow-up, compared to 67% in those who received organs from HIV-negative donors.

Furthermore, this study noted that the HIV D+/R+ group had a lower MELD-Na score (indicating they received transplants at an earlier, less critical stage of disease) and experienced no graft rejection events, suggesting that expanding the donor pool allows patients to undergo surgery sooner and healthier .

Improving Access and Efficiency

The benefits extend beyond medical outcomes to logistics and equity. Because the HOPE Act allows the use of organs from donors with HIV, the pool of available organs has expanded significantly. An analysis of registry data published in 2025 found that candidates willing to accept a liver from an HIV-positive donor had a median wait time of just 2.3 months, compared to 1.1 years for those who were not. Willingness to accept these organs was associated with a 3.11-fold higher rate of deceased donor liver transplantation .

The Reality of Risks

While the news is overwhelmingly positive, the studies do not suggest the procedure is risk-free. The 2022 multicenter pilot study noted that the HIV D+/R+ group experienced more opportunistic infections, infectious hospitalizations, and cancer compared to the control group, warranting further investigation . Additionally, a 2025 Italian nationwide survey of 365 HIV-positive transplant recipients estimated 5-year survival rates at 64.4% , slightly reduced compared to the general population, though 1- and 3-year rates aligned with HIV-negative patients .

Conclusion

The narrative surrounding HIV and liver transplantation has undergone a complete reversal. What was once considered an absolute contraindication is now becoming a standard of care for those with well-controlled HIV. The passage of legislation like the HOPE Act has not only corrected a historical injustice—the discarding of potentially life-saving organs—but has revealed that these patients can have excellent, and in some metrics superior, post-transplant outcomes.

For the thousands of people living with HIV and end-stage liver disease, the message from the latest evidence is clear: hope is no longer just an acronym; it is a reality.

References

1. Duration, F., et al. (2022). HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV. American Journal of Transplantation, 22(3), 853-864.
2. Stock, P. G., et al. (2003). Kidney and liver transplantation in human immunodeficiency virus-infected patients: a pilot safety and efficacy study. Transplantation, 76(2), 370.
3. Baccarani, U., et al. (2011). Long-term outcomes of orthotopic liver transplantation in human immunodeficiency virus-infected patients. Transplantation Proceedings, 43, 1119-1122.
4. Cervo, A., et al. (2025). OC61 HIV-to-HIV organ transplantation: a comparative analysis of liver and kidney transplant outcomes. Sexually Transmitted Infections, 101(Suppl 1), A60.
5. (2025). Increased rate of deceased donor liver transplantation for candidates willing to receive organs from donors with human immunodeficiency virus. American Journal of Transplantation (Online ahead of print).
6. Visco-Comandini, U., et al. (2025). Liver transplantation in people living with HIV: An Italian nationwide survey. Digestive and Liver Disease, 57(8), 1639-1645.

Executive Director

Yobe State Agency for Control of AIDS (YOSACA )

The Old Diabetes Drug with a New Mission: Could Metformin Help Cure HIV?

For decades, a cheap and common diabetes pill has helped millions control their blood sugar. Now, researchers believe it might hold the key to one of modern medicine’s most elusive goals: a functional cure for HIV.

Scientists from the University of Montreal and the Gladstone Institutes have independently discovered that Metformin—a drug used by an estimated 150 million people worldwide—can target the root cause of incurable HIV: the silent "reservoirs" hiding deep within the immune system.

The Problem: The Sleeping Virus

Modern antiretroviral therapy (ART) is a miracle of science. It suppresses HIV to undetectable levels, allowing people to live long, healthy lives without transmitting the virus. However, ART is not a cure.

The virus integrates its genetic code into a small pool of immune cells (CD4+ T cells), creating latent "reservoirs". These cells lie dormant. If a person stops taking their daily ART pills, these reservoirs typically reactivate within weeks, flooding the body with new virus.

"The treatment is not curative," explains Dr. Petronela Ancuta, a lead researcher at the CRCHUM at the University of Montreal. "New therapeutic strategies are needed to accelerate the decay of viral reservoirs."

Two Pathways, One Goal

Remarkably, recent research published in high-impact journals like Immunity and iScience shows that Metformin attacks this problem from two distinct angles.

1. The "Block and Lock" Strategy (Keeping the Virus Asleep)

At the Gladstone Institutes, Dr. Nadia Roan's team studied "elite controllers"—rare individuals whose immune systems naturally suppress HIV even without drugs.

They discovered that these individuals have high levels of a specific gene called DDIT4, which acts like a "security lock" to keep the virus asleep. Metformin effectively activates this gene.

In laboratory experiments, treating infected cells with Metformin blocked their ability to reactivate. Data suggests the drug reduced HIV infection rates by 37% and viral reactivation by 51%. This supports a "block and lock" cure strategy, where the virus is forced into permanent hibernation.

"Our data suggest metformin might be able to delay, or possibly even prevent HIV rebound in some individuals," says Dr. Roan, calling the drug "very safe and affordable".

2. The "Shock and Kill" Strategy (Exposing Hidden Cells)

Dr. Ancuta’s team at the University of Montreal, publishing in iScience, found a different, almost paradoxical effect.

Metformin increases the frequency of cells showing HIV markers (a "proviral" effect) but crucially, it prevents new viruses from escaping. It over-expresses a protein called BST2 that literally "glues" viral particles to the surface of infected cells.

By holding the virus on the outside of the cell, Metformin acts like a flare in the dark, marking the hidden reservoir for destruction. When researchers added anti-HIV antibodies, the immune system could easily spot and kill these exposed cells.

"We could resort to metformin to reactivate the reservoir cells, in combination with antibodies, to detect the rare infected cells and eliminate them," Dr. Ancuta proposes.

A Two-Pronged Future Treatment

Taken together, the two studies suggest a powerful synergy.

· Metformin inhibits mTOR, the molecule HIV uses to replicate, reinforcing the "block" effect.
· Metformin also upregulates BST2, exposing the reservoir for the immune system to "kill".

In 2021, a clinical trial had already shown that adding Metformin to ART for three months improved immune function and reduced chronic inflammation. Now, researchers are eager to launch new trials specifically to test viral rebound.

From the Lab to the Pharmacy

The excitement surrounding Metformin comes from its availability. It is off-patent, cheap, and has a well-established safety profile.

While patients should not rush to self-medicate, the pathway to a cure is now clearer. The META Trial is already assessing the drug's impact on preventing diabetes in people living with HIV in Africa. Expanding those trials to include viral remission endpoints is the logical next step.

As Dr. Ancuta notes, these advances allow scientists to "envision the 'shock and kill' strategy in a different light". For the 39 million people living with HIV worldwide, that new light looks promising.

References

1. Fert, A., et al. (2024). Metformin facilitates viral reservoir reactivation and their recognition by anti-HIV-1 envelope antibodies. iScience.
2. Ma, T., George, A., et al. (2026). Multiomic analysis of ART-interruption cohorts identifies mechanisms driving control of HIV rebound. Immunity.
3. Chew, G. M., et al. (2021). Effects of Brief Adjunctive Metformin Therapy... on Anti-HIV CD8 T Cell Responses. University of Hawai'i.
4. Global Health EDCTP3. (2025). The META Trial: Preventing diabetes in people living with HIV.

Executive Director

Yobe State Agency for Control of AIDS

The Price of a Pandemic’s End: UNAIDS Estimates $21.9 Billion Annually Needed to Stop HIV

In the global fight against HIV/AIDS, one question has long overshadowed scientific progress: How much will it actually cost to end the epidemic?

According to the latest data from the Joint United Nations Programme on HIV/AIDS (UNAIDS), the answer is precise but daunting. The agency estimates that $21.9 billion annually will be required through 2030 to achieve global HIV targets in low- and middle-income countries—the regions where the burden of the disease is heaviest.

This figure represents the total investment needed to fully fund prevention, testing, treatment, and care services. It includes the cost of antiretroviral therapy for millions of people living with HIV, pre-exposure prophylaxis (PrEP) for those at high risk, widespread testing campaigns, and programs to prevent mother-to-child transmission.

Why $21.9 Billion?

UNAIDS breaks down the cost into three core pillars. First, expanding access to life-saving drugs: ensuring that the nearly 40 million people living with HIV globally receive effective treatment. Second, strengthening prevention infrastructure, particularly for key populations such as s*x workers, people who inject drugs, and young women in sub-Saharan Africa. Third, supporting community-led systems that help retain patients in care and fight stigma.

Without this annual investment, UNAIDS warns that progress could stall or reverse. New infections would likely rise, and long-term healthcare costs would balloon as delayed treatment leads to more advanced—and more expensive—stages of illness.

Is the Goal Achievable?

While $21.9 billion per year is a substantial sum, UNAIDS emphasizes that it is both achievable and cost-effective. For context, the figure is less than 0.1% of the combined GDP of low- and middle-income countries, and a fraction of what wealthy nations spend on other global health initiatives.

More importantly, the agency notes that the gap between current resources and the target has been narrowing. In recent years, domestic funding from affected countries has increased, and international donors—led by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund—have maintained significant commitment.

However, recent economic pressures and shifting political priorities have created worrying shortfalls. UNAIDS warns that if funding stagnates or declines, the world will miss the 2030 targets. The consequences would be severe: up to 7.7 million AIDS-related deaths could occur between 2021 and 2030 if the response is not fully funded.

The Return on Investment

Ending AIDS is not just a moral imperative—it is also a financial one. UNAIDS estimates that fully funding the response would avert millions of new HIV infections and save billions of dollars in long-term medical costs. Patients who start treatment early can live near-normal lifespans and remain productive members of their communities, reducing the economic drag of the disease.

“Ending AIDS is a choice,” a UNAIDS spokesperson has previously stated. “The science, the tools, and the strategies exist. What is needed now is the political and financial will to deploy them at scale.”

Looking Ahead to 2030

As the 2030 deadline approaches, the world stands at a crossroads. The $21.9 billion annual price tag is high, but it is the cost of closing the door on a pandemic that has already claimed more than 40 million lives. Whether that price is paid—and who will pay it—remains one of the defining health questions of the decade.

For now, UNAIDS continues to urge governments, philanthropies, and the private sector to step forward. Without full funding, the goal of ending AIDS will remain not only unmet but, in many regions, increasingly out of reach.

Source: Based on UNAIDS estimates and global HIV funding data.

Executive Director

Yobe State Agency for Control of AIDS

The 10-10-10 targets, part of the Global AIDS Strategy 2021–2026 (leading toward 2031 goals), directly address the social and structural barriers. They are:

1. Fewer than 10% of people living with HIV experience stigma and discrimination (in health care, education, workplace, and community settings).

2. Fewer than 10% of women, girls, and people at risk of HIV experience gender-based inequality and violence (which fuels HIV risk and limits access to services).

3. Fewer than 10% of countries have punitive laws and policies (e.g., criminalization of HIV non-disclosure, same-s*x relations, s*x work, or drug use) that block effective HIV responses.

These targets recognize that ending AIDS as a public health threat by 2030 (and sustaining progress through 2031) is impossible without dismantling discrimination, protecting human rights, and advancing gender equality. The strategy emphasizes community-led responses, legal reforms, and removing barriers to prevention, testing, and treatment.

Executive Director

Yobe State Agency for Control of AIDS

Scientists Uncover Hidden Weak Spots in HIV and Ebola, Paving the Way for Smarter Vaccines

For years, researchers hunting for vaccines against HIV and Ebola have been working with an incomplete picture. In order to study the surface proteins of these viruses—the very parts the immune system needs to recognize—scientists were forced to strip away the surrounding membrane. While this made lab work easier, it also meant they were missing critical clues about how antibodies truly attack a virus inside the human body.

Now, a team at Scripps Research has developed a breakthrough solution. They’ve created a technology called "nanodiscs"—tiny lipid particles that hold viral proteins in place, closely mimicking the virus’s natural outer layer. For the first time, scientists can observe how antibodies interact with HIV and Ebola proteins in an environment that closely resembles the real thing.

The results were unexpected. Hidden interactions at the membrane interface—interactions never visible before—suddenly came to light. These discoveries are revealing new ways that certain antibodies might completely block viruses from infecting cells.

Beyond these insights, the new platform dramatically speeds up research. Experiments that once took over a month can now be completed in about a week.

While this isn't a vaccine itself, experts say it’s nearly as valuable: a far more accurate tool for designing and testing the vaccines of the future. The technology could also be applied to influenza and COVID-19.

After 40 years of searching for an HIV vaccine, science has finally obtained a clearer map.

Source: Scripps Research Institute / Nature Communications, April 2026

Executive Director

Yobe State Agency for Control of AIDS

Major HIV Cure Trial in Durban Shows 20% of Participants Achieve Long-Term Viral Suppression Without ART

DURBAN, South Africa – In a significant breakthrough for HIV cure research, a clinical trial conducted in Durban has demonstrated that 20% of participants remained off antiretroviral therapy (ART) while maintaining viral suppression for over a year. The findings offer new hope for developing strategies to enable the immune system to control the virus without lifelong medication.

The study, led by Professor Thumbi Ndung’u of the University of KwaZulu-Natal (UKZN), was presented at the Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco. The trial tested a combination immunotherapy approach designed to empower the immune system to keep HIV in check after ART is stopped.

The trial enrolled 20 women who were started on ART soon after infection. They subsequently received immune-boosting therapies. Under close medical monitoring, their treatment was paused to assess whether their own immune systems could independently suppress the virus.

Results showed that six participants (30%) stayed off treatment for nearly a year. Notably, four of those six participants (20% of the total trial cohort) remained off ART for 55 weeks and have continued without medication for an average of 1.5 years.

Professor Ndung’u, who is also the Director for Basic & Translational Science at the African Health Research Institute (AHRI), the Victor Daltz Foundation Chair, and Director of SANTHE (Sub-Saharan African Network for TB/HIV Research Excellence), said that analyzing how this subset achieved viral control could inform future cure strategies and improve treatment approaches. He added that the trial demonstrates complex HIV cure research can be conducted successfully even in resource-limited settings.

Busisiwe Ncama, Deputy Vice-Chancellor and Head of the College of Health Science at UKZN, described the findings as a milestone for both South Africa and global HIV research.

The study was conducted by the HIV Pathogenesis Programme at UKZN in collaboration with the Ragon Institute of Mass General Brigham, MIT, Harvard, and Gilead Sciences.

Reference

The information in this article is based on the following source:

· Conference presentation at the Conference on Retroviruses and Opportunistic Infections (CROI), San Francisco. Trial led by Professor Thumbi Ndung’u, University of KwaZulu-Natal (UKZN), Durban, South Africa. Study conducted by the HIV Pathogenesis Programme at UKZN in collaboration with the Ragon Institute of Mass General Brigham, MIT, Harvard, and Gilead Sciences.

Executive Director

Yobe State Agency for Control of AIDS

FDA Approves “Teal Wand” – First At-Home Cervical Cancer Screening Tool.

In a landmark move for women’s health, the U.S. Food and Drug Administration (FDA) has approved an innovative at-home cervical cancer screening device known as the Teal Wand. The approval marks a significant step toward making early cancer detection more accessible, convenient, and patient-centered.

The Teal Wand allows users to collect their own sample in the privacy of their home. The sample is then sent to a laboratory for HPV (human papillomavirus) testing, which can detect early signs of cervical cancer without the need for a traditional pelvic exam or clinic visit. This approach aligns with the latest understanding that nearly all cervical cancers are caused by persistent HPV infection, making HPV testing a reliable primary screening method.

Breaking Down Barriers to Screening

Health experts have long warned that many women delay or avoid cervical cancer screening due to barriers such as:

· Living far from healthcare facilities
· Lack of time or flexible work schedules
· Discomfort or anxiety with pelvic exams
· Past trauma or cultural concerns

By offering a private, do-it-yourself option, the Teal Wand could significantly improve screening rates among these underserved groups. According to the FDA, the device is intended for individuals aged 30 and older, following clinical data showing it performs comparably to clinician-collected samples.

Maintaining Accuracy and Follow-Up Care

While the Teal Wand prioritizes convenience, the FDA stresses that it does not compromise on laboratory rigor. Samples sent to certified labs undergo the same high-quality HPV testing as those collected in clinics. Women who test positive for high-risk HPV strains will still need follow-up care, which may include a confirmatory clinical test or colposcopy — a procedure to examine the cervix more closely.

“This approval reflects a growing shift towards more convenient, patient-centered preventive healthcare while still maintaining strong laboratory accuracy and follow-up care where needed,” FDA officials noted in their announcement.

A New Era for Preventive Health

The Teal Wand is not intended to replace all in-person gynecological care. However, it represents a powerful new tool in the fight against cervical cancer — a disease that claims over 4,000 lives annually in the U.S., despite being highly preventable with regular screening and HPV vaccination.

As the device becomes available by prescription, public health experts will be watching to see if it successfully reaches women who have never been screened or are overdue for testing. If so, the Teal Wand could help the U.S. move closer to the World Health Organization’s goal of eliminating cervical cancer as a public health problem.

Reference:
U.S. Food and Drug Administration. (2025). FDA Approves First At-Home Cervical Cancer Screening Tool.

Executive Director

Yobe State Agency for Control of AIDS

Scientists use mRNA to push hidden HIV virus out so it can be found and destroyed completely.

"SHOCK AND KILL" STRATEGY.

Researchers are using mRNA technology to flush the dormant virus out of its hiding places, making it visible so the immune system or other therapies can destroy it.

Here is how the process works:

· The "Shock" (Flushing out HIV): Scientists deliver mRNA wrapped in a specially designed fat bubble ("LNP X") into resting CD4+ T cells. This mRNA instructs the cells to produce viral proteins (like Tat or using CRISPR), essentially "waking up" the dormant virus.

· The "Kill" (Destroying the cell): Once awake, the infected cell produces viral parts, acting as a beacon. This flags the cell for destruction either by the body's own immune system or by the virus itself as it tries to replicate.

Current Status & Outlook

· A Major Hurdle Overcome: The key breakthrough was solving a delivery issue—resting T cells usually reject foreign material. The new "LNP X" carrier successfully penetrates these cells without activating them or causing toxicity.

· Early Stages Only: This research is still preclinical (lab-based on donated cells). Researchers are very hopeful but caution it will likely take years of animal and human safety trials before it reaches clinics.

Executive Director

Yobe State Agency for Control of AIDS

A Roadmap to End AIDS: Unpacking the New Global AIDS Strategy’s 8 Priority Action

As the world strives to end AIDS as a public health threat by 2030, the new Global AIDS Strategy (2021–2026) provides a critical blueprint. Moving beyond broad aspirations, the Strategy establishes three overarching priorities and eight specific result areas—each demanding tangible, practical actions. These eight pillars form the backbone of a successful and sustainable HIV response, emphasizing integration, equity, and community leadership.

The analysis of the eight actions that nations and stakeholders must now prioritize.

1. Ensure Financing for People-Centred HIV Responses.

Sustainable funding is the foundation of any health initiative. The Strategy calls for robust financing for both global and national responses, but with a crucial shift: resources must be allocated to people-centred approaches. This means moving away from siloed budgets and investing in services that address the holistic needs of individuals, including mental health and social support [1].

2. Integrate HIV Services with Primary Health and Non-Health Sectors.

HIV cannot be fought in isolation. This action mandates the integration of HIV interventions into primary healthcare (e.g., TB, reproductive health) and broader systems such as education and social welfare. For example, linking HIV testing with non-communicable disease screenings or using community health workers to deliver both vaccines and PrEP (pre-exposure prophylaxis) increases efficiency and reach [2].

3. Invest in Essential Health Systems and Multi-Sector Data Collection.

Data saves lives, but only if it is accurate and inclusive. The Strategy urges investment in health systems (supply chains, laboratories) and data systems across multiple sectors, crucially including communities. Community-led monitoring—where local groups track service quality—helps identify gaps that official statistics often miss, ensuring accountability [3].

4. Scale Up Combined HIV Prevention Options.

No single prevention method works for everyone. The Strategy calls for scaling up a mix of biomedical (e.g., PrEP, condoms, voluntary male medical circumcision), structural (e.g., laws that enable access), community (e.g., peer outreach), and behavioral interventions (e.g., risk reduction counselling). This “combination prevention” tailors approaches to local epidemics and individual needs [4].

5. Guarantee Equitable Access to Quality Testing, Treatment, and Care.

Equity is not optional. The fifth action demands that HIV testing, treatment, and care be available, accessible, acceptable, and of high quality—especially for key populations (men who have s*x with men, s*x workers, people who inject drugs, transgender people, and people in prisons). Removing user fees, decentralizing services to community sites, and ensuring culturally competent care are practical steps [5].

6. End Stigma and Discrimination, Uphold Human Rights and Gender Equality.

Stigma remains a primary barrier to HIV services. This action explicitly links the HIV response to human rights and gender equality. It requires repealing punitive laws (e.g., criminalization of HIV non-disclosure), training healthcare workers to eliminate bias, and addressing gender-based violence—which fuels HIV risk for women and girls [6].

7. Ensure Equitable Access to Scientific and Medical Innovations.

From long-acting injectable PrEP to point-of-care viral load tests, innovation is accelerating. However, these breakthroughs often reach wealthier populations first. The Strategy calls for equitable access to all new technologies in testing, prevention, treatment, and care, emphasizing voluntary licensing, generic production, and technology transfer to low- and middle-income countries [7].

8. Empower Communities to Lead.

The final action is both a means and an end. Empowering communities to lead means funding community-led organizations as equal partners, not just beneficiaries. It includes placing people living with HIV on governing boards, supporting peer navigators, and recognizing that community leadership is the single most effective driver of sustainable HIV responses—as proven by decades of activism [8].

Conclusion

The Global AIDS Strategy’s eight actions are not isolated goals; they form an interconnected system. Financing (Action 1) enables integration (Action 2), which relies on data (Action 3). Prevention (Action 4) works only alongside equitable treatment (Action 5), an end to stigma (Action 6), and access to innovation (Action 7)—all powered by communities (Action 8). As UNAIDS notes, following this roadmap is the only way to turn the corner on AIDS, once and for all.

References

[1] UNAIDS. (2021). Global AIDS Strategy 2021–2026: End Inequalities, End AIDS. Geneva: UNAIDS. (See Priority 1: Financing for people-centred HIV responses).

[2] World Health Organization. (2019). Consolidated guidelines on HIV testing services. Geneva: WHO. (Discusses integration with primary care).

[3] International Community of Women Living with HIV (ICW) & UNAIDS. (2020). Community-led monitoring: A people-centred approach. London/ Geneva.

[4] UNAIDS. (2021). Combination HIV prevention: Tailoring programmes to local epidemics. Geneva: UNAIDS.

[5] World Health Organization. (2021). Updated recommendations on HIV prevention, testing, treatment and care. Geneva: WHO.

[6] Global Network of People Living with HIV (GNP+). (2019). Stigma and discrimination index: Key findings. Amsterdam.

[7] Medicines Patent Pool. (2022). Access to HIV technologies: Annual report 2022. Geneva: MPP.

[8] UNAIDS. (2021). Community leadership in the HIV response. Geneva: UNAIDS (Result Area 8).

Executive Director

Yobe State Agency for Control of AIDS