This year (2021) marks 40 years since AIDS was first reported. This has led to decades of global healthcare research and innovation, intergovernmental cohesion and civil society action leading to the treatment, prevention and care of a significant number of people. However, despite the strides made in the HIV/AIDS response, the AIDS pandemic remains a global crisis. While a handful of nations are on track to end AIDS by 2030, globally we have missed the mark. Many governments have failed to meet targets set out in the 2016 Political Declaration on the Fast-Track to End AIDS and in the face of the COVID pandemic, much of our momentum has been lost and we are falling further behind. New infections globally in 2019 are more than 3 times the 2020 target and are rising for the first time in nearly two decades.

A High-Level meeting is an event where all 193 UN member states get together to review progress on an issue of global importance and make new commitments and set new targets. In this case, the HLM is focused on HIV/AIDS. The Political Declaration that will emerge from the HLM is a document agreed to my all members and will be critical in creating momentum and drive politically sustainable policies, that will help member states form national strategies and set country targets.  The High-Level meeting that is taking place from 8-10 June will provide a final push, an important “last chance” to end HIV/AIDS by 2030, as declared in the United Nations third Sustainable Development Goal (SDG-3).

Select sessions of the HLM will be broadcast on http://webtv.un.org/ A detailed programme is available here.  The Informal Interactive Multi-stakeholder Hearing as part of the preparatory process for the 2021 high-level meeting on HIV/AIDS  was hosted on Friday, 23 April 2021 and can be accessed here. Full information about the HLM can be found here.

Children experience the greatest inequalities in HIV treatment coverage, with just 53% of children living with HIV accessing lifesaving medications, compared with 74% in adults. With  90% of all children living with HIV globally located in Africa, and treatment coverage and viral suppression rates lagging, our children are being left behind. Although children accounted for 5% of people living with HIV in 2019, they represented 14% of all AIDS-related deaths. Six out of seven new infections among adolescents (aged 15 to 19 years) in sub-Saharan Africa are among girls with adolescent girls and young women (aged 15 to 24 years) accounting for 25% of HIV infections, despite representing just 10% of the population. AIDS-related illness remains the leading cause of death for adult women (aged 15 to 49 years). This is unacceptable, especially as we have the tools, we have the treatment, we know what to do and what works. What we need now is leadership to deliver what works at scale, with renewed investments and action from political, national and community-level leaders. The investments and actions must prioritise paediatric HIV and provide an advocacy platform focused on resources, policies and visibility that can fully and urgently address the inequalities facing women, children, families and marginalised communities. It is also essential that governments ACT NOW to invest, protect,  improve pay and conditions, and retention strategies for  health providers and care workers if we are to save our global health system and continue to deliver HIV services, meet global HIV targets, manage COVID-19 setbacks and realize universal health care for all.

1. Close the treatment and services delivery gap for children, adolescents and young families by adopting recommended targets, providing a comprehensive package of prevention, treatment and care that is resourced fully.

2. Invest and redefine systems for health that are optimally effective, accountable, inclusive, accessible, integrated, tailored and people-centred;

3. Adopt robust laws and policies that promote and protect the rights of the most marginalised and provide all children and adolescents in all their diverisity with holistic care and support that addresses their biomedical, social and economic needs;

4. Invest in economic empowerment; maternal, child and sexual reproductive health services; HIV prevention, testing and treatment; childcare; mental health support; social protection and support for early childhood development with increased prevention and action on gender-based violence;

5. Protect and invest in health and care workers and community-based organisations as a public health good. Provide them with support, skills and tools to deliver HIV services and  accelerate COVID-19 recovery. Invest in systems that enable clinics and communities to plan, deliver and monitor services together, including sharing and using common data;

6. Stop HIV funding cuts to health services, communities, and civil society organisation who continue to be a critical and essential partner, especially in low-income countries, that are already stretched thin and continue to struggle with socioeconomic challenges and inadequate healthcare services;

7. Invest and trust in local communities and frontline health workers to lead. Support these local voices to influence and inform your conversations, in leadership and decision making.