New prevention tools and investment in services essential in the fight against AIDS – World Health Organization (WHO)

Global HIV Response: Challenges and Innovations in Achieving Sustainable Development Goal 3

Introduction: A Critical Juncture for Global Health

On World AIDS Day, the World Health Organization (WHO) has issued a report on the state of the global HIV response, highlighting a critical intersection of significant challenges and transformative opportunities. The report underscores the urgent need to align global efforts with Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all, including the target to end the AIDS epidemic by 2030. Recent disruptions caused by reductions in international funding threaten to reverse decades of progress. However, the introduction of new prevention tools offers a pathway to accelerate efforts and achieve these global health targets.

Impact of Funding Disruptions on SDG 3 and SDG 10

Setbacks in HIV Prevention and Treatment Services

Sharp reductions in international funding in 2025 have led to significant disruptions in essential HIV services, directly impeding progress towards SDG 3. Community-led programmes, which are crucial for reaching vulnerable populations, have been scaled back or closed in several countries. The consequences of these funding cuts include:

• Stagnation in HIV prevention efforts, with 1.3 million new infections recorded in 2024.
• An estimated 40.8 million people globally living with HIV.
• 630,000 deaths from HIV-related causes in 2024.
• A dramatic decline in access to pre-exposure prophylaxis (PrEP), with an estimated 2.5 million users losing access in 2025 due to funding cuts alone.

Exacerbating Inequalities and Hindering SDG 10

The HIV epidemic continues to disproportionately affect key and vulnerable populations, highlighting a significant challenge to achieving SDG 10 (Reduced Inequalities). Stigma, discrimination, and structural barriers prevent these groups from accessing essential care. Data from 2024 reveals that these populations and their partners accounted for 49% of all new HIV infections. The elevated risk factors for these groups are stark:

1. People who inject drugs face a 34-fold higher risk of acquiring HIV.
2. Men who have sex with men face an 18-fold higher risk.
3. Sex workers and transgender women face a 17-fold higher risk.

Addressing these disparities is fundamental to creating an equitable health response and fulfilling the promise of leaving no one behind, a core principle of the SDGs.

Strategic Innovations and Partnerships to Advance Health Goals (SDG 3 & SDG 17)

The Role of Lenacapavir in Accelerating HIV Prevention

A major advancement in the HIV response is the WHO’s approval and recommendation of twice-yearly injectable lenacapavir (LEN) for HIV prevention. This long-acting PrEP option is a transformative tool for individuals who face challenges with adherence to daily oral medication. By providing a highly effective alternative, LEN has the potential to significantly drive down new infections and change the trajectory of the epidemic, directly contributing to the targets of SDG 3.

Collaborative Efforts to Expand Access (SDG 17)

In line with SDG 17 (Partnerships for the Goals), WHO is collaborating with multiple stakeholders to ensure affordable and widespread access to new innovations like LEN. This multi-sectoral approach is crucial for overcoming financial and regulatory barriers. Key actions include:

• WHO prequalification of LEN for HIV prevention on October 6, 2025.
• Support for national regulatory approvals in South Africa, Zimbabwe, and Zambia through WHO’s Collaborative Registration Procedure (CRP).
• Partnerships with organizations such as CIFF, the Gates Foundation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and Unitaid to facilitate affordable access in priority countries.

A Rights-Based Approach to End the AIDS Epidemic by 2030

Integrating HIV Services into Primary Health Care

WHO emphasizes that achieving the goal of ending the AIDS epidemic requires a fully integrated, evidence-based, and rights-driven approach within the framework of primary health care and universal health coverage (a key target of SDG 3). This strategy involves placing the most affected communities at the center of the HIV response, ensuring their needs and rights are prioritized.

Recommendations for Future Action

To overcome current disruptions and transform the AIDS response, a dual-track approach of solidarity and investment in innovation is required. The report calls on governments and partners to prioritize the expansion of access to new tools for all at-risk populations. The path forward relies on strengthening health systems, increasing domestic investment, and protecting human rights to safeguard progress and ensure that the global community remains on track to end the AIDS epidemic by 2030.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on the global HIV response connects to several Sustainable Development Goals, primarily focusing on health, equality, and global partnerships. The main SDGs addressed are:

• SDG 3: Good Health and Well-being: The entire article is centered on combating the HIV/AIDS epidemic, a key public health target under this goal. It discusses prevention, treatment, new medical technologies (lenacapavir), and the overall goal of ending the AIDS epidemic.
• SDG 10: Reduced Inequalities: The article explicitly highlights the disproportionate impact of HIV on “key and vulnerable populations,” such as sex workers, men who have sex with men, transgender women, and people who inject drugs. It points to “stigma, discrimination, and legal, social and structural barriers” as drivers of these inequalities, directly linking the issue to SDG 10.
• SDG 17: Partnerships for the Goals: The text emphasizes the critical role of global collaboration and funding. It details how “cuts to foreign aid” and “reductions in international funding” disrupt essential services, while also mentioning partnerships with organizations like the Gates Foundation, the Global Fund, and Unitaid to improve access to new treatments.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s discussion, the following specific SDG targets can be identified:

1. Target 3.3: End the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases.
   • The article directly references this goal by stating that disruptions from funding cuts are “jeopardizing efforts to end AIDS by 2030.” The entire focus on reducing new infections and expanding access to prevention tools like PrEP and lenacapavir is aimed at achieving this target.
2. Target 3.8: Achieve universal health coverage, including access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines.
   • The call to “rapidly expand access to new WHO-approved tools including lenacapavir” and the concern over “2.5 million people who used PrEP… lost access to their medications” directly relate to ensuring universal access to essential medicines and healthcare services for HIV prevention. The emphasis on integrating HIV services into primary health care also supports this target.
3. Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of… sex… or other status.
   • The article identifies that “almost half (49%) of new HIV infections occurred among key populations” and that these groups face “stigma, discrimination, and legal, social and structural barriers.” The call to put “those most affected at the centre of the HIV response” is a call for their inclusion and empowerment in health systems, which is central to this target.
4. Target 17.2: Developed countries to implement fully their official development assistance commitments.
   • The article’s central problem revolves around the “sharp and sudden reductions in international funding” and “cuts to foreign aid.” This directly points to a failure in meeting development assistance commitments, which are crucial for funding the global HIV response in many countries.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article contains several explicit and implicit indicators that can be used to measure progress:

• For Target 3.3 (End AIDS):
  • Indicator 3.3.1 (New HIV infections): The article explicitly states there were “1.3 million new infections” in 2024. Tracking this number annually is a direct measure of progress. It also provides disaggregated data, noting that “49% of new HIV infections occurred among key populations,” which is a crucial part of this indicator.
  • AIDS-related deaths: The article mentions that “630 000 people died from HIV-related causes” in 2024. This figure is a key indicator for measuring the success of treatment and care programs.
• For Target 3.8 (Universal Health Coverage):
  • Access to essential medicines: The statistic that “2.5 million people who used PrEP in 2024 lost access to their medications in 2025” serves as a direct, albeit negative, indicator of access. Conversely, the number of people gaining access to PrEP and lenacapavir would be a positive indicator of progress.
• For Target 10.2 (Reduce Inequalities):
  • Disproportionate risk ratios: The article provides specific data points that serve as indicators of inequality: “sex workers and transgender women face a 17-fold higher risk of acquiring HIV, men who have sex with men face an 18-fold higher risk, and people who inject drugs – a 34-fold higher risk.” These ratios measure the inequality of health outcomes among different population groups.
• For Target 17.2 (Official Development Assistance):
  • Funding levels for HIV programs: While not providing a specific monetary value, the article’s repeated references to “dramatic funding setbacks,” “cuts to international funding,” and “donor funding cuts” imply that the flow of official development assistance for HIV is a critical indicator being monitored. A decrease in this funding indicates a regression from the target.

4. Summary Table of SDGs, Targets, and Indicators

Source: who.int