Over the past three decades, the global HIV response has achieved remarkable progress. Mortality has fallen, treatment options have expanded, and millions of people are now living healthier lives. Today, an estimated 40.8 million people are living with HIV worldwide, a reminder of how far we have come and how much is at stake.
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With just five years left to the 2030 target of ending AIDS as a public health threat, this is a moment that calls for reflection. If we take stock of where we stand, one message is clear: the target remains within reach, but only if we strengthen the foundations that have driven progress so far.
Progress has not been uniform, but the overall trajectory is positive. Many countries have expanded testing, improved access to antiretroviral therapy, and invested in community awareness. At the same time, persistent gaps remind us that scientific advancements alone are not enough. Ending AIDS depends on the strength of our health systems, how well they reach people consistently, deliver high-quality services, and adapt to changing needs.
Innovation is creating new opportunities
A most encouraging development is the arrival of long-acting therapies such as lenacapavir. This twice-yearly injectable offers an option for individuals who face challenges with daily regimens, whether due to work schedules, stigma, mobility, or other barriers. Fewer clinic visits and simpler pathways can make a real difference for many.
This is part of a broader wave of innovation. Advances in injectable PrEP, digital adherence tools, and AI-enabled platforms are reshaping the HIV response in many countries. While these tools will never replace the human elements of healthcare, they can help systems respond more effectively and bridge access gaps.
However, innovation alone will not be enough to change outcomes at scale. Its impact depends on how effectively these tools reach the people who need them. This will require attention to how newer solutions are manufactured, priced, and distributed. For treatments such as lenacapavir, timely access across regions depends on stronger supply systems, coordinated regulatory pathways, and a commitment to avoid repeating past mistakes that left many communities waiting years for essential medicines. The past three decades have shown that access relies on timely, affordable supply and distribution models that reach all regions fairly.
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Innovation gives us momentum, but ensuring equitable access to these tools will determine whether progress continues at the pace required to meet the 2030 goal.
A challenging moment for global health financing
While scientific progress has accelerated, global health financing has become more constrained. Economic pressures have slowed investment in long-standing programmes, and competing health priorities – from pandemic preparedness to NCDs – risk diverting attention from HIV. This places real pressure on treatment continuity, and even short disruptions can reverse gains that took decades to build, especially in settings with higher burdens of disease.
This is where resilient health systems matter most. Recent years have shown how essential it is to have reliable supply chains, well-supported health workers, and integrated primary care services. These elements help maintain continuity of care during periods of uncertainty, and they remain central to the long-term HIV response.
Service disruptions have already affected millions, particularly in prevention and community-level initiatives, which have long been central to progress. Some groups continue to face higher risks due to social, economic, or demographic factors, including adolescents, young women, and communities with limited access to services. Addressing these disparities requires practical, locally grounded approaches that make prevention, testing, and treatment as accessible as possible.
What it will take to stay on course
Reaching the 2030 target is still possible, but will require sustained commitment to the approaches that have been effective for decades:
- Invest in global and national health financing.
Stable, predictable funding is a prerequisite to sustain prevention, treatment, and community-level services. - Strengthen primary healthcare systems.
HIV programmes thrive when integrated into broader, resilient systems that support continuity of care and respond to evolving needs.
- Ensure equitable access to new tools.
Long-acting therapies and digital innovations must be accessible to all communities, not only to those easiest to reach.
- Work closely with communities and healthcare providers.
Local engagement continues to play a central role in raising awareness, improving uptake, and sustaining progress.
- Use digital and AI tools responsibly.
When applied thoughtfully, these technologies can improve surveillance, streamline service delivery, and support better outcomes.
The world is closer than ever to ending AIDS. The science is strong, the tools exist, and the solutions are well understood. What is needed now is steadiness, a clear focus on equity, innovation, and the health system foundations that make lasting progress possible.
Ending AIDS is within reach, but we will only get there by ensuring no one is left behind.
Dubai-based Public Health Consultant
