Reflections from AIDS 2026

Rethink. Rebuild. Rise. But Above All, Put Children, Youth, and Communities at the Centre of the HIV Response 

The global HIV response has reached a defining moment. At the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil, one message echoed across sessions, policy dialogues and community forums: scientific innovation alone will not end AIDS. Without equitable access, sustained investment, political leadership and meaningful community engagement, even the most groundbreaking discoveries will fail to reach the people who need them most. 

For PATA, AIDS 2026 reaffirmed what frontline healthcare providers, children, adolescents, youth, caregivers and underserved communities across Africa have long been telling us: the future of the HIV response must be person-centred, community-led and rooted in equity. 

A Funding Crisis That Demands Political Courage 

AIDS 2026 took place against one of the most uncertain periods in the history of the HIV response. International funding cuts, shrinking civic space and shifting global priorities are placing decades of hard-won progress at risk.  

Evidence presented throughout the conference showed the consequences are already being felt with healthcare facility closures, health workforce losses, disrupted prevention programmes and reduced access to treatment. For children, adolescents, youth and underserved communities, these disruptions are especially severe. 

With resources constrained, integration with primary healthcare, maternal and child health, and non-communicable diseases is no longer optional — it is the primary engine for resilient service delivery. 

However, integration cannot remain a high-level policy concept. Health systems must operationalise it at the frontline by connecting global science, national policy, district coordination, and local care delivery. To make integration work on the ground, systems must clearly define who delivers what, with what training, commodities, referral pathways, and accountability, while equipping healthcare providers with practical mentorship to deliver compassionate care. 

Innovation Without Access Is Not Justice 

One of the conference’s defining messages came from Brazil’s Minister of Health, Dr Alexandre Padilha:  

“Innovation without access is not innovation. It is an injustice.” 

From long-acting HIV prevention and treatment options to progress towards an HIV cure and vaccine research, AIDS 2026 showcased great scientific advances. Yet too often these breakthroughs reach adults first, while children, adolescents and lower-resource settings wait years for the same life-saving tools. 

Children Cannot Remain an Afterthought: Paediatric Equity and AHD 

Achieving an AIDS-free generation is possible, but only if the global response prioritises children and addresses persistent diagnostic blind spots across every stage of care: 

• Despite progress in simplified regimens and long-acting formulations, paediatric treatments continue to lag behind adult options, and children remain routinely excluded from early-stage clinical trials 

• All children living with HIV under five are clinically classified as having Advanced HIV Disease (AHD), making rapid ART initiation and complete AHD packages an urgent, non-negotiable priority 

• Eliminating vertical transmission requires bridging implementation gaps. While HIV testing and treatment in antenatal care are established, critical gaps persist around co-infections (such as syphilis and hepatitis B), care continuity, and cross-system data across pregnancy and beyond 

Communities Remain the Engine of the HIV Response 

Closing clinical, operational, and diagnostic gaps is impossible without community leadership. Evidence consistently shows that community-led responses improve health outcomes, strengthen accountability, and reduce stigma. 

From peer navigation and community-led monitoring to differentiated service delivery and youth leadership, communities are doing far more than delivering programmes — they are shaping policy and ensuring services respond to people’s realities. However, because many community-led responses rely heavily on donor support, they remain the most vulnerable to current funding cuts.  

This reflects PATA’s experience across our network of frontline healthcare providers, peer supporters and community partners. Healthcare extends far beyond healthcare facility walls, making investment in community leadership essential to resilient health systems. 

The Future Will Be Shaped by the Choices We Make Today 

The theme of AIDS 2026 — Rethink. Rebuild. Rise. — is more than a conference slogan. It is a direct call to action. 

We must rethink how the HIV response is financed, rebuild resilient and integrated health systems, and rise together by protecting science, defending human rights and ensuring every child, adolescent and family has equitable access to life-saving care. 

As PATA moves forward, we remain committed to: 

• Supporting the healthcare providers and peer navigators who deliver care every day 

• Advocating for children, adolescents, and underserved communities to sit at the centre of policy and investment decisions 

• Scaling community-led, person-centred care models that bridge the gap between healthcare facilities and communities 

Ending AIDS is not simply about developing better tools. It is about ensuring those tools reach every child, adolescent, and community without delay. Only then can we truly rethink, rebuild, and rise together.