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

Yeah, but where is the moderator? Shawin, where is he? What the later? He's at the end of this room. So we can start. Oh, okay. Can we settle down please? Those who are sitting, may you settle down. Those who are standing, rather, may you settle down, get seated. We're starting right now. We starting in 30 seconds. 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 quote, "Country-led, people-centered, integrated, and sustainable national HIV response: resilient systems and financing," close quote. Let me take this opportunity Khob khun khun. 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 AIDS 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 antiretroviral 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 Guinean 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 handoff. 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 healthcare system. In South Africa, we are moving away from treating a disease and moving towards treating the whole person through a patient-centered life course approach with specific focus on primary healthcare 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 integrating screening and care for non-communicable diseases with mental health and broader primary healthcare. 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 for 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, Dr. Tia Palla, Vice Chair of the National AIDS Authority of Cambodia. I thank you. Over to you, Co-Chair.

Thank you.

Thanks.

Excellency Mo Tsoalady, Co-Chair, and distinguished panelists, colleagues, and friends. 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 thematic panel, let us be entirely honest to ourselves. We stand at a critical crossroad. We must protect our 4 decades of monumental hard-won gains at a time when donor transitions were is 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 reversed a serious epidemic against all odds. We stand here today as a living proof that country-led sustainable response works and it delivers even in resource-limited setting. Cambodia achieved 95-95-95 target. But let me be clear, reaching 95-95-95 does not mean our mission is complete. As Samdai Prime Minister Hun Manet of the Royal Government of Cambodia has pointedly warned us, the hardest part of the journey lies 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 infections. We are newly concentrated among key populations and our youth by expanding innovative, localised services. Every single individual must be able to access prevention and care with absolute dignity. No exception, no one left behind. The UNAIDS Global AIDS Brief, just released on June 26th, sounds a stark and unavoidable alarm. It warns us financing cuts, underinvestment in prevention, and restrictions 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 got— we get to where we are today. This is not something we want to see happen to all— to us and other any country across Asia and Africa. The region carrying the highest HIV burden. The lesson is clear: sustainability depends on ownership, integration, partnership, never on donor dependence. This is a transformational demand, a deeply shared responsibility. Let us state 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 shared mandate. This week we adopt the New Political Declaration guided by the Global AIDS 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 words at home. Our goal is clear: prevent new infection and meet the core target to fewer than 250 cases 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, sell, sustain legacy to 4 generations to come. Thank you very much. So I would like to hand over the floor to the Distinguished moderator, uh, Shervin Brice, please, to officially open the panel. Shervin, the floor is yours.

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. So 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, right, 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 4 decades of progress, millions of lives saved, new infections have been reduced, treatment 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 AIDS 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. And yes, it is always worth reiterating the very clear goals we seek to address today. So, to embellish on this endeavour, allow me to introduce our panellists, and when you hear your name, I encourage you to join me on the podium when you hear your name. His Excellency Victor Elias Attalah Layam, Minister of Health of the Dominican Republic; His Excellency Javier Padilla Bernaldez, Secretary of State of Health of the country of Spain; Ms. Florence Riakoannam of the Global Network of People Living with HIV; and Dr. Claude Kamenga, Chief of Staff of the Africa Centre for Disease Control and Prevention. I will wait for them to join me on stage and then we will begin. Good afternoon. Good afternoon. Good afternoon. So without further ado, let's start with Dr. Victor Elias Attala Layam, 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 when you need them the most? And let me ask you this as well: what role should donors play in this responsible transition? You have the floor.

Muito obrigado.

Thank you very much, Moderator, Excellencies, 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 and 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 probably 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. And 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. And our experience in the Dominican Republic is not— 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 operational, 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 particularly with the most vulnerable populations. And all of that was trying to do one essential thing, and that was in the question, to reestablish the trust of the people. Otherwise, if we didn't gain that trust, everything would be rejected. So 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 and their point of view transition is a threat as they see it. They fear not being protected. And what made the difference for us? Well, we— 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 Fonds Sapé with innovative methods for co-funding between Social Security and the state. And we were able to progressively include all of the HIV responses within the current financing structure and today we are financing 100% of antiretroviral antiretroviral medicines from the national budget and ensuring that the patients have ongoing treatment for all that need it in our country. But around $4 million extra 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 Fonds Sap 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. So what we've done 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. The— certain things are temporary, but institutions remain. That's why it's so important to build them. And 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 a financial system. It's going to come about when a person understands that the system cares for them and looks after them. And currently, international donors and international cooperation must understand that this transition can't be can't happen too quickly, otherwise we'll be losing out on 4 years of— 4 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, the aim of the work over the last 4 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 and 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— Voy a hablar en español todavía otra vez.

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 don't— 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 it tells— 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. Getting the figures down, 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 Padella-Belnadés, 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' 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. And 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. And 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, accessible affordable care across the board and funds, for example, such as for HIV, including those for removing stigma and discrimination, tuberculosis, malaria, vaccinations, for example, all of those have enormous potential, not just for financing specific interventions but to finance laboratories, epidemiological work, capacity, etc. In the question, there was a fundamental word, transition, and I think that 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. It needs to be— a transition needs has 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. And that's why when it comes to Spain, we believe that the role of donors has to proceed in 5 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. And 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. We need to— so 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 a context of growing debt service burdens and extremely limited fiscal space. And 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 kind of 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. And fifth, we must reform the international global health architecture. 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, 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, right? 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 between 2024 and 2025, you see a 23.1% decline in that. How do we stop the bleeding? It's happening already, right? 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 multilateralism 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 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 two, 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. Ms. Florence Riako Anam 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, and what would meaningful participation in financing and integration decisions actually require?

Thank you for this question, Your Excellencies, 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, and 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 have been— 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 are— 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 UNAIDS and the broader UN system, that because of the multilateralism that has gotten us to where we are at this moment, if 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. MPX, 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, GNPP+ convened a meeting to highlight the lived experience of people living with HIV and comorbidities from our global networks, coming together as the Afrocab Treatment Access, Stop TB Partnership, World Hepatitis Alliance, NCD Alliance, the Global Network of Young People Living with HIV, and the Global Network— 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 healthcare needs, addressing and expanding information around prevention for our partners, information around STI management across the various other comorbidities that we have and experience because we are aging. So this primary healthcare 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. And we are the ones walking into the health facility and facing its 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 is community engagement work that gets us to do task-shifting work, which is needed now more than ever as we integrate into primary healthcare. Task-shifting that that expands differentiated service delivery, self-care approaches that include multi-month dispensing, community pharmacy models, self-testing, cervical cancer, 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 markets 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 5 years: to end AIDS and keep people alive.

Thank you. So before I let you go, Ms. Annam, let me ask you a follow-up question, as I've done with the other panellists, right? You talk about 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 shy.

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 JIPA 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 engage 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 There is the greatest opportunity ahead of us. There are incredible tools ahead of us. Long-acting prevention is here. Long-acting treatments are 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 healthcare 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 it's not— 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 are 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. And I hope to I want 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. Dr Claude Kamenga, the Chief of Staff of the Africa CDC, which is a champion of African ownership and leadership Sir, 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 UNAIDS 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 4 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 mechanisms. Our ambition is that by 2030, at least 20 African countries should finance 50% or more of their health budgets 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 budgets, primary health care, universal health coverage, and social protection systems. International support remains essential, but it must align behind one national plan, one budget, one monitoring framework, and one shared accountability for results. 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 Pool 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 healthcare systems. The resurgence of Ebola and other outbreaks reminds us that 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, pooled procurement, local production, resilient primary healthcare system, country-owned data, and leadership. Ending AIDS by 2030 is within reach, but only, only if we shift from managing dependence to backing African leadership, African systems, and African sovereignty. Thank you, Mr.

Chair. A quick follow-up for you, Dr. Kumenga, just in terms of the CDC's work in supporting research and development, right? 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 our 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 were 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, Dr. Kumenga, for that intervention. So, 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, let the politicians come after. Alright, 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 eStatements@UN.org, eStatements, one word, @UN.org, which will be posted under eStatements of the United Nations Journal, and 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, I—

we give the floor to— there are no interventions?

All right.

We'll go straight. We do not have recorded interventions is what I'm told. I am told we will go now to our first speaker from the floor. The list keeps changing, but I believe it's Colombia.

Gracias.

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, 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 response, a dedicated response after the initial phase supported by international partners. Now Colombia is funding PrEP from national resources. 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. And Moderator, we will be providing our full statement to the Secretariat. Thank you very much.

I thank the distinguished delegate of Colombia for that intervention, and I now call on the delegate from Mali.

Mr. President, 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, syphilis, and hepatitis B. So it's an inclusive national response involving the sectoral ministries, civil society, the private sector, and strengthening multiparty cooperation. Mobilizing resources and advocacy is also a major goal. The government is also working to ensure that equal access to healthcare is extended to everyone in rural areas, including conflict areas as well. I thank you.

Thank you, 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 led, 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 G20 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 Coalition 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. And now we move to the United Nations Development Programme. Wherever you are, you have the floor.

Thank you, Moderator.

Excellent.

I'm honored to join you at UNDP. UNDP works on HIV with communities and governments of 100 member states, and 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 3 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, 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. And 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 Programme, and I now give the floor to Stakeholder 1, /medicalimpact.

Chair, distinguished delegates and colleagues, on behalf of Medical Impact, an organization working on front lines of healthcare delivery, vulnerable communities and populations affected by humanitarian crisis across Latin America and Africa, we witness firsthand the challenge countries face in HIV prevention, diagnosis, treatment, and harm reduction services.

As we look towards implementation of the Global AIDS Strategy, it is essential to establish sustainable financing pathways that combine increased domestic resource mobilization, continued support from donors, and leadership of civil society and communities. Ensuring long-term sustainability requires that HIV response remain people-centered, gender-focused, evidence-based, and responds to local realities, including harm reduction and risk reduction strategies to help others, 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 toward 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 healthcare, and broader social protection system in order to achieve universal health coverage. At a time of 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, Excellencies, 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 Declaration. Government is investing in health infrastructure, infrastructure, recruiting more workers, and increasing cofinancing for ARRT. Malawi is committed to expanding domestic financing beyond ARRT. Malawi's beyond ARRT 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 healthcare. And strengthening subnational structures to ensure district-based planning and implementation of integrated HIV services. We're also digitalizing the data, and Malawi is strengthening electronic medical records and digital data systems to improve efficiency, track drug supplies, and prevent stockouts, including harmonization of all electronic medical records.

Unfortunately, your time has run out, but I thank the delegate from Malawi. The next speaker, we go back to civil society stakeholder 2, 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/AIDS 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. 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 delegate 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 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. And that's why if we want to end HIV, we have to end TB. And now that we establish that, I just want to say 3 things. One is from Stop TB and from the TB community at large, we learned the hard way but in a way, in a more sustainable way, that when resources are limited, you can produce things that are more sustainable. So 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 that 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. So let's come together and push for agendas that are inclusive and for everyone. Thank you very much.

You can applaud, 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 targets ahead of schedule shows that country-led responses can deliver results when they are anchored on sustainable national commitment manifesting through sound policies, strong institutions, and domestic resource mobilization. At the policy level, Zimbabwe has pursued a multi-sectoral and people-centered HIV response, with HIV services increasingly integrated to primary healthcare and community systems. Our approach prioritizes differentiated services delivery, 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 structures have helped translate national policy into local action, strengthen accountability, mobilize communities, and ensure that the response reaches people most in need. The National AIDS Trust Fund, supported by AIDS Life, is a homegrown sustainable financing mechanism that contributes national resources to the HIV responses. Despite these gains, challenges remain. Funding reductions will negatively impact prevention, testing, treatment continuity, viral load monitoring, availability of PrEP, community-led interventions, and supply chains. At the international level, the proposed sunset of UNAIDS, 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 healthcare, and community systems. We also call for adequate post-sunset mechanisms to minimize disruptions to the global response, Zimbabwe 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 society— well, actually, to UN agency, the World Health Organization, please.

Thank you.

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 and continued investment in resilient health systems, community-led and multi-sectoral responses, as well as research. Integrated primary healthcare-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. This includes 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 curative therapies that can transform the response and bring an end to the AIDS— epidemic. WHO reaffirms its commitment to providing global strategic and technical leadership in close collaboration with the UN co-sponsors and Secretariat of the joint UNAIDS program. As the global health architecture evolves, WHO stands ready, together with fellow UN co-sponsors and partners, to support the smooth transition of UNAIDS 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 panellists to wrap up in one minute each, so that's a message to all of you sitting on this side of the dais: you'll have one minute at the conclusion of this event. We now go to— back to civil society, the International Planned Parenthood Federation.

Thank you.

Good 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 lack funds to aid; we lack an economic and a cooperation system designed to end AIDS. Let's remember that the financial market alone operates now in the figure of quadrillions of dollars, so we need a tax on financial transactions for health, urgently. We need alignment of multilateral regional banks. 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 taxing wealth rather than consumption. Finally, without transforming how health is financed, we cannot talk about ending AIDS by 2030. A fully funded community and response-led, uh, in AIDS will only happen when we change the mind-setting 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 Coalición de Organizaciones Indígenas de América Latina y el Caribe. I hope I did a good job there.

Muchas gracias.

Thank you very much. On behalf of the indigenous peoples of Latin America and the Caribbean, we also to join in with these good 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, private, previous, and informed consent so that together we can build relevant actions that are respectful of indigenous health and so that we can have human differentiated interventions. After 40 years of existence of HIV amongst our peoples, there has been— there have been omissions in the treatment. We haven't been consulted or included in these programs, and I'd like to share with you some of the concerns that we have and proposals that we have. We ask for the recognition of— 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 recognized as key populations to overcome this and that we be part of the that our shamans and traditional doctors and midwives 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, Dr. Victor Elias Attala León.

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 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 should always— 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, solves— 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 Dr. Layam for that intervention. The Secretary of State for Health of Spain, Javier Padilla Bernardes.

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. So 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 now give the floor to Florence Riako Anam.

In my one 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 used 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, and 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+ and finally give the floor to the Chief of Staff of Africa CDC, Dr. Claude Kamenga, for your 60 seconds.

With my 60 seconds, I would like to reiterate Africa CDC commitment to continue working with member states, UNAIDS 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 UNAIDS' 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 panellists up here for their 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. 2030. We want funding, 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 so much for being here.

Thank you.

Thank you. Thank you.

Let me introduce Forte Semaoui.

He's the one from UNAIDS that has prepared this entire thematic session, all the scripts and the support and the letters of invitation.

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. 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 Dr. Joan Ruiz Mosqueda 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. And science gave us innovative tools like long-acting medicines innovations 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—95, 95, 95—for HIV treatment and reducing new HIV infections by 90%, they inspired our way. Malawi was the first country to roll out Option B+ for the prevention of mother-to-child transmission of HIV. We also rolled out Kabla, a bimonthly 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 Lenacapavir, one injection in 6 months, long-acting pre-exposure prophylaxis on July 1, 2026. Thank you. With the support of the U.S. government and the Global Fund to fight HIV/AIDS, TB, and malaria. 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 AIDS 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, to 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 environments, sustained global commitment to HIV prevention and treatment are so essential. I now hand over the floor to my fellow co-chair.

Thank you. Excellencies, distinguished delegates, colleagues and friends, I would like to thank Her Excellency Madalizo Chidumu Baloyi 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 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, 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 axis, 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. 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 complementary 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. And I give the floor to Mr. James Chow, President, 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 a WHO 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 help 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, so we know the potential is really very real. But potential does not change outcomes alone. Access does. Equity does. Leadership does. And 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. And where were 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 2030. And we keep on talking about 2030 like it's a magical figure up in the air without acknowledging that 2030 is about 4 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 in 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 that 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 Dr. Fancy Tu, Ambassador and Permanent Representative of the Republic of Kenya to the United Nations Office and other international organizations in Geneva; Ms. Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition; Dr. Alexi Mazouz, Chief Specialist in HIV at the Ministry of Health of the Russian Federation, and Dr. Jared Bateman, Senior Vice President at Gilead Sciences. We move now to the moderated panel and to Ambassador Tu 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 have already done From 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 commitments, community engagement, and partnerships. Yet, emerging— emergence of new technologies, including long-acting prevention options such as Lendakapafil, presents an opportunity to accelerate progress even further, provided we are prepared to deliver them effectively and at scale. We believe 4 priorities are very critical. The first one is that we need to build demand through community leadership. Partnership and trust. Communities are not simply beneficiaries of innovation, they are essential partners in its success. Young people, women, adolescent girls, key populations, and people living with HIV must be equipped with accurate information, meaningful choices, and a voice in decision-making. When communities are empowered to lead awareness, advocacy, and accountability efforts, uptake improves and innovations are more likely to 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 HIV prevention and treatment services within the broader primary healthcare 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 investments, 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 investments in delivery systems, workforce capacity, procurement, and community-led programs. Sustainable financing is essential to ensure that advances in tents do not become advances for only a few, but benefits shared by all who need them. The emergence of Lend-a-Cup-of-Fear and other next-generation prevention technologies represents one of the most promising opportunities we have seen in decades. But 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 and the communities most affected by HIV. Kenya 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 HIV/AIDS as a public health threat by 2030. I thank you.

Thank you very much, Ambassador, for highlighting the importance of country leadership, demand creation, implementation readiness, and sustainable delivery systems. I think, you know, 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 Baptiste, let's draw on your experience at ITPC in treatment and prevention access. When you think about that, what role should the 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. Chow. 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 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 cost 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 life-saving 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. And 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 ITPC's experience, communities play 3 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, they 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 identify 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 for— 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 wake up. Great. There, we'll continue on that line. But there were 3 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 Baptiste for reminding us that innovation only matters when people in communities can actually access it, use it, trust it. So, let's turn now to the health system and the public health perspective. Dr. Mazhous, you're the leading expert in Russia's extensive government network for HIV and AIDS. While the centralized AIDS center model has provided exceptional specialized management, the future that we're talking about requires optimizing the modern continuum of care by bridging that gap between specialized centers on the one hand and general health systems on the other. So 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 AIDS centers and still ensure a personalized patient experience, avoid stigma, and ensure retention in treatment and care?

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 healthcare 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 antiretroviral 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 doctors' recommendations, such a 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 prenatal doctors. And 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 an 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, AIDS 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 in a constructive way. 30 years ago, when anti-retroviral therapy first appeared, the first patients were given hope that they will survive. And 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, uh, literally several weeks ago, we, uh, in the framework of an International Economic Forum in St. Saint Petersburg, we had a discussion with our outstanding colleagues and friends from the People's Republic of China, uh, what the way forward would be. New therapy regimes, accessible, truly accessible and available long-action medications, wide use being made of gene editing, CAR-T therapy possibilities, other innovations. And 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, Dr. Mazouz, for bringing in the health system and implementation perspective. And that brings us very nicely on to the role of industry. Dr. Baten, how will Gilead work with countries, communities, donors, and access partners to ensure that HIV innovations are introduced rapidly, affordably, and equitably without widening existing access gaps. And 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 in industry will have to say. And 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. At 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, down the table said earlier, innovation and access must go hand in hand. And to that end, I bring to this table today the perspective from Gilead Sciences, which builds on 3 decades of making innova— innovations in medicines, along with innovations in access. And that included the first single tablet regimen for HIV, the first medicine for PrEP, a medicine for PrEP that, that is given once every 6 months that has been discussed quite some time today, and also the first voluntary licensing. These advances in treatment prevention have, 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 when a medicine is developed, when it needs to be— become impactful and equitably accessible. Our dedication to transfer innovation— 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, and address barriers to care. And 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. Lenacapavir, mentioned many times today, is the 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, their findings. And 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 6 generic manufacturers within 2 weeks of the trial results reading out and completed technology transfer within months. Months ahead of regulatory filings anywhere in the world to aim at unprecedented early access to generic lenacapavir, hopefully very soon. And until and as that generic supply scales, Gilead is working with the Global Fund and the U.S. State Department through PEPFAR on bridge approach— on a bridge approach— supplying lenacapavir now for up to more than 3 million people at no profit to Gilead while these partners lead country prioritization and implementation. Implementation. This approach is designed to support immediate access while catalyzing countries for readiness and building towards long-term sustainability. Today, lenacapavir has reached 10 countries in sub-Saharan 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 sub-Saharan 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 PAHO, to define and pursue the fastest paths to access. And we look forward to providing more, more and more updates soon, as we have done for the last 2 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, they achieve and maintain an undetectable viral load, resulting in, in long-term life and reduced and eliminated HIV transmission. Transmission, and I believe greatly in what U=U has done as a movement around the world. I am proud to be a part— to have a part— 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 100-100-100. 100. And 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 lenacapavir 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. Step, and we do that from planning to clinical trial execution to regulatory strategies to access so that they have— 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 left— 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, Dr. Batson. Well, before we go into the interventions, I thought we would take 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. So 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 antiretroviral-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. And 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 Eswatini, and then take brief comments, ideas, suggestions from all of you. In line with guidance for this session, interventions will be limited to 2 minutes each, so please keep it brief and compelling. Let's start off with the Minister of Health from Eswatini, Minister Matsubuhe. Eswatini, of course, has made remarkable progress in its 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, and what are Eswatini's main prevention priorities at this Dr.

Suresh S. Rajagopal, Minister of Science and Technology, India.

We call on the Minister, please.

Scientific progress has advanced at an unprecedented pace, yet equitable access to that progress remains uneven. From a Swatini experience, we know that this gap can be closed.

We currently stand at 98-98-98 on the UNAIDS targets, achievements made through sustained investment in HIV testing, same-day ART 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.

Eswatini's answer is concrete, Lenacapavir.

In our setting, new infections, particularly among adolescent girls and young women, remain disproportionately high.

Len 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. LANE 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/LAN introduction with strengthened monitoring systems, health worker training.

Well, thank you very much to the Minister from Eswatini, and for Eswatini reaching 98, 98, 98, I think most countries in the world would be dreaming to reach that level of 98, 98, 98, getting so close to the end of AIDS. You are a reminder that a country, no —no matter how big or small—can really make that dream into a reality. So thank you for that. A quick reminder to delegations that there is no established list of speakers for this meeting, and 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. And once again, those time limits will be strictly enforced through an automatic microphone cutoff. I'm not doing the cutoff, someone else is, but the timer will be projected on screen. Delegations may also submit their full-length written statements through email to estatements@un.org, which will be posted under the e-statements section of the United Nations Journal. Thanks for that. From Eswatini, let's go now to Georgia, please.

Hello, Chair, Excellencies, distinguished delegates. Georgia believes that science, technology, and innovation are among the most powerful tools available to end AIDS 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 receive treatment, and 94% of those on treatment have achieved viral suppression. Innovation has been central in this progress. In 2017, Georgia introduced the— the first pre-exposure prophylaxis program in our region and subsequently expanded it through 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 pioneering hepatitis C elimination program launched in 2015 has farthest tracks to strengthen 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 of 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 panellists, colleagues, South Africa thanks the panel for centering this discussion on equitable access. The gap between science, what science has achieved, and what reaches our people remains unresolved. Innovation exists but access does not yet follow. Long-acting antiretroviral medicines hold 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 learned that science 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 self-reliance. Thirdly, alternative mechanism to incentivize innovation that do not depend on final product prices, because a financing model built on high prices will always exclude the population this panel exists to serve. 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, PAHO, 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 PAHA. 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 IFPMA representing the novelty pharmaceutical industry. As member states gather at this high-level meeting to renew global commitments to HIV/AIDS. FPMA welcomes the political declaration's 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 the 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. IFMA and its members stand ready to contribute constructively through R&D, manufacturing partnerships, and practical evidence-based solutions that 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 GATE, Global Action for Trans Equality, to present the results of our research on democratic backsliding and its impact on HIV services, a crucial intersection to meet the targets of our current Global AIDS Strategy. GATE surveyed 64 member organizations across 5 global regions, and the findings are stark. 92% reported anti-gender movements have become more visible and affected HIV services. 83% report healthcare providers have changed practices due to anti-gender pressure, while 89% cite fear of discrimination as the top access barrier. This is not an anecdote. It's a pattern of systematic— systematically dismantling. We are living through a scientific revolution in HIV prevention. Long-acting antiretrovirals offer what oral regimes cannot: decoupling treatment from daily pill-taking and clinic visits, protecting privacy, and improving adherence for trans and gender-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 antiretrovirals cannot deliver on their equity promise if the infrastructure is being dismantled. 27% of surveyed organizations report that anti-gender attacks have directly disrupted long-acting medication rollout. The science exists, the medication exists. What is being dismantled is the social and political infrastructure to deliver them equitably. We call urgently for protecting civic space for trans-led organizations, ensuring HIV medication rollout strategies, and addressing that anti-gender attacks do not impose barriers on 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 GATE, the Global Action for Trans Equality, and move now to a couple of members States in the following order: Thailand, Brazil, Mali, and Spain. We now invite Thailand to speak first, please. Thank you, Moderator.

Thailand's experience demonstrates that scientific advances can only achieve their full potential through strong public health systems, sustainable financing, and meaningful community engagement. Through our universal health coverage system, Thailand has ensured universal improved access to antiretroviral treatment and expanded access to evidence-based prevention intervention, including HIV self-tests, 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 priorities. First, we should strengthen equitable and affordable access to scientific advance and health innovations, including new prevention technologies, diagnostic 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 resilient public health system, universal health coverage, sustainable financing, and our— and human capacity development at all levels to ensure the integration of HIV intervention into primary healthcare and accessibility for all, while promoting meaningful community leadership, community-led services, and addressing stigma stigma, discrimination, and other human rights barriers. Thailand remains 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 antiretroviral 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 dependence 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. Merci, Mr. Lubombo.

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, Kapotegravir, 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, 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. And this is a tool to bridge the gap of '95. Where we are still currently at 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 to Mali. 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 most needed— where the advances are most needed, they are 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 don't— 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, 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. And finally, Spain would like to highlight our commitment to combination prevention through public funding for PrEP since 2019, and including the injectable formulation of cabotegratavir 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. And 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.

Mohana Dovbakh from Eurasian Harm Reduction Association and Rise Decriminalize 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. At the same time, there are evidence-based community interventions 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, we simply need to scale up and ensure their sustainable support.

Some of these innovations are truly transformative.

Long-acting buprenorphine as opioid agonist treatment means that one injecting per month can allow a person living with opioid dependence to lead a productive to work, study, and life without having to visit a clinic every day. Opioid agonist treatment and naloxone 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 ECA region because of persistent misconceptions and lack of trust in science evidence. PrEP is indeed as important an 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 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, women using drugs. I am 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 ACT UP. So next is AIDS Healthcare Foundation, followed by ACT UP, 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 3x5, 15x15, to 90-90-90, and 95-95-95. And now new financing targets are emerging. These goals have helped drive remarkable progress. That is true. But as goalposts continue to move, we should ask whether the resources, political commitment, and implementation capacity needed to achieve them are keeping pace. We 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 healthcare 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 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 ACT UP New York, one of the more well-known and first AIDS organizations that created lots of demonstrations, 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, who's been— I've been symptomatic since 1982, 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 deserved to live when people in the developing world, especially mothers with children, were dying in less than a year in Africa. So myself and other people fought to get generic AIDS drugs developed and funding for their distribution.

And 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 commendable.

Thank you all for doing that.

And, Jaleel, please not only do what you've been Sorry, Eric, you know, there's a default system that cut off your microphone, so we can't hear you. It's the wrong time to cut it off because it's a powerful story and testimony, but thank you.

I'll use my outside voice. Please, Gillian, reach out to your other companies and your industry, and you got them to follow your leadership.

Jared, the thank you is always followed by a powerful ask. So 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 am from— I'm Lucian Quiroz from Mexico representing those living with HIV in Latin America and the 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 new vision— we have a new vision in what Gilead is proposing. Countries must have access to new technologies. Thank you very much.

Thank you very much to people living with HIV in Latin America. We're going to close with some very, very quick reflections, just 60 seconds from each panellist. Jared, 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.

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 panellists and I realize that I began my career working on HIV prevention in Kenya. I have been a public— I have been a clinician and a public health practitioner, and I am a community member and an advocate. Innovation medicines and innovations in access must be together, 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. And on that promise, let's weave this narrative over to Ambassador Tuambastai. I've seen you listening intently throughout this discussion to the many different interventions, and 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 keep coming up again and again and 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. Implementation. And your question, Moderator, it must be affordable, readily accessible to all those that truly needs it. Thank you.

Thank you, Ambassador Tu. Dr. Mazous, 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, Dr. Mazouz. And Solange Baptiste, 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 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? It's not— 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. And I think as GNP+ 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 Solange Baptiste. 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, has 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. So 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 in communities most often left behind. And 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 impact. So 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 the 2026 to 2031 AIDS 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, and this requires all of us to come together and to build towards that, so that we have rapid, equitable, affordable, and sustained access to prevention, testing, treatment, and gender-based— gender-based— 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, but 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, very much.