Four Albanian cities—Kolonja, Durrës, Pogradec, and Shkodra—have signed the Paris Declaration on AIDS committing to ending AIDS as a public health threatby 2030. By signing the declaration, the Mayors committed to achieving the 95-95-95 targets by 2025 and called on other municipalities in Albania, including the capital Tirana, to join this effort. 

The Albanian cities are the latest additions to the list of more than 550 other cities around the world that are part of the Fast-Track Cities initiative which aims to fast-track action at local level to improve the quality of life of people living with and affected by HIV. 

In order to fulfill their commitments, the cities have developed different plans of action based on their local circumstances. For instance, the Municipality of Durrës plans to increase investments in methadone maintenance therapy, aiming to expand the number of people benefiting from such services by 10% each year.  

The Municipalities of Pogradec and Kolonja are focused on raising awareness among migrant populations to increase HIV testing rates in these regions. As border cities with a significant male population migrating for work, ensuring these communities are well-informed and have access to necessary health services is crucial.  

Finally, the Municipality of Shkoder aims to foster a partnership with Podgorica in Montenegro to exchange experiences and best practices in developing the "Healthy Houses" model, which has been successful in the neighboring country. The "Healthy Houses" initiative is a free social service providing psychosocial support to citizens. It focuses on improving the quality of life, reducing risks, and offering support to socially vulnerable groups. The service addresses a range of issues, including HIV, domestic violence, addiction, services for LGBTQ+ peopleand others.  

Olimbi Hoxhaj, Executive Director of the Albanian Association of People Living with HIV, hopes that signing the Declaration and the follow-up actions will not only help prevent new HIV infectionsbut will also significantly reduce AIDS-related mortality.  

Albania has a low HIV-prevalence epidemic but faces an increasing number of new HIV cases. From 1993 to 2023, 1,716 cases were diagnosed, with 113 new cases in 2023 alone. Most HIV testing occurs in the late stages of infection (about 60% of new cases), meaning official figures do not fully represent the actual infection rate. 

The Minister of Health and Social Protection of Albania, Ogerta Manastirliu, emphasized that rapid diagnosis and treatment are key. “The whole fight in this aspect is timely diagnosis so that the treatment can start as soon as possible, and the infection is under control.” 

“While the European region continues to face political, economic, and healthcare challenges due to regional conflicts, migration, and other complexities, it is important to secure commitment from municipalities to advance progress towards the crucial HIV targets,” said Eamonn Murphy, UNAIDS Regional Director for Asia-Pacific and Eastern Europe and Central Asia. 

Technical assistance to all municipalities in developing their local programs was provided through the cooperation between the International Association of AIDS Care Providers (IAPAC), the Fast-Track Cities Institute (FTCI), UNAIDS and the Global Fund’s regional #SoS 2.0 project, which aims to ensure the sustainability of HIV services in 15 countries in Eastern Europe. "Since 2019, with our support, 21 municipalities from Southeast Europe have joined the Fast-Track Cities initiative," said Tetiana Deshko, Director of the International Programs Department at the Alliance for Public Health.

Propping up her round thick-framed glasses, Carole Perrette readjusted a painting in the art exhibit at UNAIDS headquarters in Geneva, Switzerland. For one month, more than twenty paintings crafted by her art therapy group will grace the sun-smacked lobby.

Ms Perrette, a painter and art therapist, has been leading workshops at the Geneva Association of People Living with HIV/AIDS (PVA) for its members since 2005 (minus a short break to focus on her career.)

She is thrilled UNAIDS is welcoming a selection of her “students’” pastels and vibrant watercolors.

"Completing a piece of artwork is such an accomplishment that this exhibit is an even greater honor,” Ms Perette said.

For painter and PVA member May* the art and painting therapy sessions allow her to feel free.

“We paint, we talk, we express ourselves and it is very liberating...I forget my daily troubles,” she said.

PVA-Geneva offers art therapy sessions weekly to all of its members. For the Director of PVA, the workshops are a key component of the mental health outreach the association does.

“As you can see from the variety of the paintings on display, people express themselves differently... from glorious sunsets to two fish kissing to renditions of blood cells,” said Rocco Senatore.

“Despite this diversity, the art therapy sessions unite the group, and most champion each other’s work,” he said.

Many eagerly attend the workshops because they do not feel judged. Yvan, a painter and PVA member, said he had difficulties coming to terms with his HIV status. “I kept all of this bottled up for a long time. The art therapy is my support network art wise and morally too.”

During a meet and greet session with the artists and UN staff, Mahesh Mahalingam, UNAIDS Chief of Staff, said that art has been used as a longstanding bridge to raise awareness in the HIV response. “Art and artists like yourselves were instrumental in bringing the world’s attention to HIV in ways that has not happened in any other disease,” he said. “Artists have made this disease humane and out of that it led to a movement that pushed for access to treatment for millions of people.”

Nodding approvingly, Dalia, artist and PVA member, turned to the group afterwards and said, “Just like our art therapy sessions, this is what solidarity is all about.”

*Person did not want to disclose full name.

SALVADOR, BRAZIL, 6 June 2024—At the G20 preparatory meeting in Brazil, Executive Director of UNAIDS and Under-Secretary-General of the United Nations, Winnie Byanyima, today urged governments to support a new G20 Alliance, proposed by the Brazilian government, to enable life-saving medicines to be produced in every part of the world. Co-Chair of the Global Council on Inequality, AIDS, and Pandemics Sir Michael Marmot also called on G20 delegates to address the social determinants of pandemics, such as education and human rights, as a concrete part of the G20’s pandemic preparedness efforts.

The medicines initiative aims to create a global alliance of local and regional manufacturers of drugs, vaccines and other health technologies and unite a diversified network of local and regional producers to ensure an adequate supply of medicines and technologies for everyone, everywhere.

Ms Byanyima called on the G20 to ensure that the alliance takes a bold approach that strengthens efforts to fight dengue and other neglected diseases, improves global defences against future pandemics, and accelerates access to the latest technologies against HIV.

“Focusing together on neglected diseases and the major killers of vulnerable people is not only strategic, it can deliver during future pandemics,” said Ms Byanyima. “We can be thankful that, for all its devastation, COVID-19 responded to a vaccine, unlike HIV. There is no reason to believe the next pandemic will be like COVID-19.  We need to build capacity for vaccines and treatment.”

The responses to many diseases that impact vulnerable populations – from Ebola to Mpox to HIV – would benefit greatly from this initiative, Ms Byanyima told governments today.

“The alliance can supercharge the HIV response. It can supercharge the production pipeline for innovations,” said Ms Byanyima. “An alliance could also build capacity where it is not. The majority of people living with HIV, who get up every day and take that pill, live in Africa. But few of those drugs are actually made in African countries.”

“Brazil’s leadership and experience in this area has inspired this global effort. And we need the support of the whole G20 to make it a success.”

The agenda of the G20 meeting on health is helping to push global health policy towards tackling the systemic inequalities that drive ill-health.  UNAIDS is coordinating a Global Council on Inequality, AIDS and Pandemics that is gathering evidence on how inequalities deepen and prolong pandemics, including HIV and COVID-19. That evidence is being shared with policymakers at the G20 and other international forums.

On Monday, world-renowned expert Sir Michael Marmot gave a keynote address the G20 meeting on the potential of focusing concretely on the social determinants to strengthen pandemic preparedness, predict the severity of future pandemics, and  improve the efficacy of responses.

“Improving health leads to a better economy. And the way to improve health is not just to invest in healthcare, but in the social determinants of health,” Professor Marmot said. “For example, in Botswana, there is clear evidence that the longer young people remain in education, the lower the rates of HIV.”

Addressing social determinants, building manufacturing capacity, and enabling people everywhere to access the whole range of HIV prevention and treatment options, including the latest long-acting technologies, is vital for ensuring the end of AIDS as a public health threat. The G20 initiatives would play a key role in achieving that objective in a sustainable way, while also contributing to the achievement of the Sustainable Development Goals and supporting efforts to quickly respond to the next pandemic.

Notes for editors

Brazil's main proposal for the G20 Health Working Group is to establish the creation of an Alliance for Regional Production and Innovation. This initiative aims to establish a network that brings together key actors, including countries, academia, private sector, and international organizations, for research and development and production of vaccines, medicines, diagnostics, and strategic supplies to combat diseases with strong social determinants and that mainly affect vulnerable populations, such as dengue, malaria, tuberculosis, Chagas disease, and leprosy. For more information on the G20 Health Working Group, see the G20 website: https://www.g20.org/en/tracks/sherpa-track/health

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 30 May 2024— The Government of Australia and UNAIDS have today signed a new multi-million-dollar partnership to strengthen the fight against both non-communicable and communicable diseases, including HIV, to ensure better health outcomes for people in the Pacific and Southeast Asia. The signing took place at UNAIDS during the 77^th World Health Assembly.

The AU$12 million funding agreement will support governments and local communities in the region to improve HIV prevention, testing and treatment while reducing stigma and discrimination. The funds will be dedicated to advancing the HIV response in Papua New Guinea, Fiji, the Philippines, Indonesia, and Cambodia over the next four years.

“This is an important investment for the region, and a valuable partnership for UNAIDS. It will deliver multiple benefits, including tackling rising HIV infections in some countries,” said Christine Stegling, UNAIDS Deputy Executive Director. “This much-needed financial support by the Australian government will go a long way in the fight to end AIDS as a public health threat in the Pacific and Southeast Asia by 2030. More than that, it’s a demonstration of Australia’s commitment to protect people’s health and human rights beyond its own borders.”

Efforts to prevent new HIV infections in the Pacific and Southeast Asia need to be scaled up urgently as epidemics are rising in a number of countries including Papua New Guinea, Fiji and the Philippines. Stigma and discrimination are contributing to the rise, obstructing access to HIV prevention, testing and treatment services, particularly for men who have sex with men.

The financial injection, for both HIV prevention and treatment, adds to the existing AU$25 million multi-year (2022-2027) partnership between UNAIDS and the Australian Government in the Asia Pacific region, representing an expansion of the longstanding programming partnership. It’s also part of Australia’s Partnerships for a Healthy Region – an Australian Government initiative that works with governments and civil society organisations in the Pacific and Southeast Asia to build resilient, equitable and inclusive health systems that can respond to shared health challenges.

“Australia’s domestic response to HIV has always recognised that the people closest to the issue are also best placed to lead on the solutions. As policy makers and funders we must listen, support, and build genuine partnerships with affected communities and civil society organisations,” said Dr. Lucas de Toca, Australia’s Ambassador for Global Health. “Australia is proud these principles of listening and supporting are central to our new partnership with UNAIDS and Health Equity Matters. This new partnership will support locally led solutions to the HIV epidemic in our region – enabling affected communities to lead the response.”

Domestically, Australia remains committed to ending its AIDS pandemic by 2030 and recently announced a AU$43.9 million investment to boost the fight against HIV. Australia is well on the way to reaching the 95-95-95 targets by 2025.

“This commitment is a practical expression of solidarity and co-operation between the people of Australia and our near neighbours in Papua New Guinea, Fiji, the Philippines, Indonesia, and Cambodia,” said Dash Heath-Paynter, Chief Executive Officer of Health Equity Matters. “By investing in the HIV response in our region we plant the seeds for a healthier, more prosperous future, with a lighter burden of stigma and discrimination. We recognise the leadership exercised by both the Australian Government and UNAIDS in making this commitment."

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Azima has lived with HIV since childhood; she was abandoned by her parents and raised by her grandmother.

Today she is recognized as an inspirational community leader in the HIV response, including for the vital role she has played in tackling stigma as the first young woman in Uzbekistan to disclose her HIV-positive status.

"I am strong. I have a bright future ahead. And I will achieve my goals,” says Azima.

She has faced both positive and negative reactions since her disclosure. Throughout, Azima has remained a committed activist. She is especially thankful to her community of peer support, a group of children and young people living with HIV supported by UNICEF.

“In the end, the energy of the people who supported me was so strong that it helped me rise above other people's criticism,” she said.

As a peer educator, Azima works tirelessly to raise awareness about HIV.

Today, Azima is studying psychology at Fergana State University. This choice of future career was encouraged by her grandmother and inspired by a psychologist who worked in her support group.

Because of her HIV treatment, Azima cannot transmit HIV to her husband. Several months ago, she gave birth to an HIV-free baby girl.

She is thankful for her family. “My husband has always supported me,” says Azima.

Azima’s story exemplifies the progress made in Uzbekistan’s HIV response. Antiretroviral therapy is provided free of charge to all in need in Uzbekistan. The country is also making efforts to ensure all women living with HIV receive timely treatment, so that all babies will be born HIV-free. Coverage of pregnant women who receive antiretroviral treatment to prevent vertical transmission of HIV has been around 98% since 2016, according to the Uzbekistan Republican Center to fight AIDS.

“The rate of vertical HIV transmission in 2023 was 0.2%. We aim to reduce this figure to 0%. The Republic of Uzbekistan is on the verge of receiving an international certificate for the elimination of mother-to-child HIV transmission,” said Bahrom Igamberdiyev, Director of the Republican AIDS Center in Uzbekistan.

The country has approved a "Roadmap for Implementing Measures to Achieve the Validation of the Elimination of Mother-to-Child Transmission of HIV for 2024-2026". This roadmap will be implemented with the participation of all partners, allowing Uzbekistan to reach its goal and obtain validation for the elimination of vertical transmission of HIV. An effective HIV response is a priority for both the government and civil society in Uzbekistan.

However, some critical challenges in the HIV response in Uzbekistan, particularly concerning HIV prevention, which are deeply rooted in societal norms and systemic inequalities.

These, according to the recently released Gender Assessment Report for Uzbekistan, include limits on women's decision-making power, leaving many women dependent on male relatives for important life choices, including healthcare decisions.

Despite the Government’s commitment and legislative efforts to address gender-based violence, underreporting remains a significant issue. The prevalence of early and arranged marriages also contributes to the limited autonomy of women, depriving many of them of educational and economic opportunities and impeding access to comprehensive sexual education. Cultural norms limit open discussions on reproductive health and prevention in many social contexts including family and educational settings.

As a result, the latest survey found that only 14% of women between 15 and 49 years old have comprehensive knowledge about HIV. This reduces to 10% for young women between 15 and 25 years old.  “Addressing these systemic issues requires comprehensive efforts to promote gender equality, ensure access to sexual and reproductive health and rights, and empower women economically. UNAIDS is working with partners to improve access to education and create an enabling environment for women to realize their full potential,” said Eamonn Murphy, UNAIDS Regional Director for Asia-Pacific and Eastern Europe and Central Asia.

Azima is stepping up her advocacy role, pointing out that openness and education are crucial in fighting stigma and advancing access to prevention, testing and treatment. She advises young women to disclose their HIV status to partners early in relationships and emphasizes the importance of adherence to treatment and of mutual support within families.

Azima will continue breaking stereotypes, promoting awareness, and embracing her journey with courage and determination. Azima exemplifies the learning that HIV responses succeed when we let communities lead.

GENEVA, 30 April 2024—The Joint United Nations Programme on HIV/AIDS (UNAIDS) is deeply concerned about the impact of the harmful new legislation in Iraq amending the 1988 anti-sex work law to criminalize LGBTQ+ people. The legislation imposes a prison sentence of between 10 and 15 years for same-sex sexual relations. Transgender people face up to three years imprisonment for expressing their gender or receiving gender affirmation care.   Individuals also face up to seven years for promoting homosexuality. And up to three years for providing gender affirmation care.

Criminalizing consensual same-sex relationships and gender expression not only violates fundamental human rights but also undermines efforts to end AIDS by driving marginalized populations underground and away from essential health services, including life-saving HIV prevention, treatment and care services.

Globally, the movement for human rights has made progress in the past 40 years. At the start of the AIDS pandemic in the early 1980s, most countries criminalized same-sex sexual activity between men, now two thirds do not. An increasing number of countries have also recognized the rights of trans and other gender diverse people. However, this new legislation in Iraq represents a significant setback and is part of a wave of punitive and restrictive laws being passed that undermine the rights of LGBTQ+ people.  

The legislation passed in parliament is an amendment to an existing 1988 anti-sex work law which continues to criminalize both the selling and buying of sexual services. The amendments passed on Saturday 27 April 2024 increase the penalties in relation to sex work. These laws, which countries committed to removing under the 2021 United Nations General Assembly Political Declaration on HIV and AIDS, likewise undermine the human rights and public health of sex workers.

UNAIDS calls upon the authorities of Iraq to overturn this discriminatory legislation and fulfill its obligations under international human rights law to protect the rights of all people, regardless of sexual orientation or gender identity. UNAIDS stands in solidarity with LGBTQ+ people and communities and reaffirms its commitment to work with partners to promote equality, end stigma and discrimination, uphold human rights—including the right to health, and ensure access to comprehensive HIV services for everyone, everywhere.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

This story was first published by News24.com

Eswatini is one of the countries which has been most affected by HIV. At the peak of the epidemic in 2015, almost one out of three people were living with HIV. In 1995, when there was no antiretroviral treatment for people living with HIV, 73 000 people were living with HIV. 2400 people died of AIDS that year. Worried about the rising number of infections and deaths, communities of people living with HIV mobilized to press that antiretroviral treatment be made available for people living with HIV.

One of the key campaigners for access was Hannie Dlamini. Dlamini is now 50 years old and has been living with HIV for 32 years, after finding out about his HIV positive status at the age of 18. He was one of the first people in Eswatini to publicly declare his positive HIV status in 1995 at a time when the stigma and misinformation around HIV was rife.

Dlamini rallied together other people living with HIV as well as non-governmental organizations working to end AIDS in Eswatini, to ensure that everyone living with HIV and in need of treatment had access to it. They formed a community-led organization called Swaziland AIDS Support Organization (SASO) as a support group for people living with HIV. SASO also provided healthy living information for people living with HIV.

“When we asked the government [in 2002] for ARVs in Eswatini we did a pilot project with NECHA [National Emergency Response Council on HIV/AIDS], to see if people would use the drugs.” Dlamini says the response was overwhelming, with many people keen to start the lifesaving treatment. “We initially planned to enrol 200 people on treatment but the demand was 630.” said Dlamini.

Today, Eswatini is one of the countries which has achieved the ambitious 95-95-95 targets (95% of people living with HIV who know their HIV status, 95% of people who know that they are living with HIV are on life-saving antiretroviral treatment, and 95% of people who are on treatment are virally suppressed). This achievement has put the country a step closer to ending AIDS as a public health threat, thanks to the work of community-led organizations, authorities and global partners like UNAIDS, the United States President's Emergency Plan For AIDS Relief (PEPFAR) and the Global Fund to fight AIDS, TB and Malaria who are working with the government and local communities to end AIDS.

Eswatini’s HIV response strategy includes ongoing nationwide testing and treatment campaigns, use of self-testing kits to encourage more people to take up testing at the comfort of their homes, antiretroviral treatment, male circumcision and pre-exposure prophylaxis (medicine to prevent HIV) and other prevention measures. Community organizations such as Kwakha Indvodza are also key in encouraging men to take full responsibility for their wellbeing and reducing toxic masculinity and gender-based violence which are some of the drivers of HIV.

The driving role of communities in Eswatini to end AIDS is acknowledged by the health authorities. According to Dr. Michel Morisho, HIV management specialist at Mbabane Government Hospital, the government “could not have achieved the 95-95-95 without communities.”

Dr. Morisho says as part of the country’s strategy to end AIDS, HIV testing and treatment are part of disease management for every patient who presents at health facilities for any illness. “When people come to the hospital for whatever, or check up, we offer an HIV test to allow them to know their HIV status,” he said. Dr. Morisho added that treatment is important to bring down viral load and is helping people living with HIV to stay healthy. Eswatini is striving to achieve 100-100-100 [in the number of people who know their HIV status, are on treatment and are virally suppressed].” People who are virally suppressed cannot transmit HIV, thus helping in HIV prevention efforts.

Young women living with HIV have also stepped up to fight the spread of HIV in the country, volunteering their time as peer educators to educate young people about HIV and supporting people newly infected to stay on treatment to live healthily and long lives. Ntsiki Shabangu is a 28-year-old young woman living with HIV. She was diagnosed with HIV in 2015, at the age of 19. She opened up about her status in 2017 and is now working with the Eswatini Network of Young Positives, a local non-governmental organisation working to end AIDS among young people providing counselling and HIV awareness training . Ntsiki believes that: “When you share your story, you bring hope to young people.”

While Eswatini is on the path to end AIDS, the country is facing other health burdens associated with aging, including non-communicable diseases such as diabetes and cancer. People living with HIV are not often more affected by these illnesses. Some people living with HIV in Eswatini have developed these comorbidities, which presents the need for the strengthening of the healthcare system to provide easily accessible holistic disease management and treatment along with HIV services to improve the quality of life for people living with HIV. As Thembi Nkambule, a woman who has been on HIV treatment for more than 20 years said: “Most of us are sick. Most of us are presenting with kidney issues. We are presenting with hypertension; we are presenting with sugar diabetes. We have a lot of issues.”

To protect the gains that have been made against HIV in Eswatini, the government should invest more resources in building a resilient healthcare infrastructure to strengthen the system to better meet the health needs of people living with HIV and to prepare for future pandemics. Community-led organisations should also be placed at the centre of HIV response and supported, both financially and politically, to reach more people who need HIV services to end the epidemic by 2030 as a public health threat.

22 April 2024 – UNAIDS welcomes the decision of the High Court of Dominica to protect the rights of LGBTQ people in Dominica.

Today the Court ruled that sections 14 and 16 of the Sexual Offences Act (SOA), which had criminalised consensual same sex activity between adults, are unconstitutional under the Constitution of the Commonwealth of Dominica. The Court ruled that the former provisions violated the right to liberty which is guaranteed by section 1(a) of the Constitution, freedom of expression which is guaranteed by sections 1 (b) and section 10 (1) and protection of personal privacy which guaranteed by section 1 (c).  

In a decision by Justice Kimberly Cenac-Phulgence on a claim brought by a gay man, the Court found that:

“criminalising sexual relations between consenting adults of the same sex as effected by sections 14 and 16 of SOA is an unjustifiable restriction on the constitutionally guaranteed right to freedom of expression in a free and democratic society”.

Equally powerfully, the court accepted that the right to protection of privacy of the home encompasses:

“private and family life and the personal sphere which includes one’s sexual identity and orientation as well as intimate activity with a partner of a person’s choice. Therefore Sections 14 and 16 of the SOA contravene the Constitution in so far as they intrude on the private home life of an individual by proscribing the choice of consenting adults as to whom to engage in intimate sexual activity with,  and are therefore, void.”

Dominica is the sixth country in the Caribbean in which powerful community action has resulted in the removal of the criminalisation of same-sex relations. As well as advancing human rights for everyone including LGBTQ people, this legal progress will also advance public health for everyone. The series of rulings made across the Caribbean are helping the region to speed up its progress towards zero new HIV infections, zero AIDS-related deaths and zero discrimination for affected people.

Winnie Byanyima, Executive Director of UNAIDS, said:

“Today another Caribbean Court has struck down the harmful old colonial punitive law which had criminalised LGBTQ people. Dominica’s ruling is a win for public health as well as for human rights. Protecting the human rights of all people is essential to protect the health of all people. Courts, as the guardians of written Constitutions which enshrine fundamental rights, are vital pathways for the realisation of everyone’s rights.”

UNAIDS congratulates Dominica and especially honours the fortitude of frontline communities in Dominica for leading the movement for the human rights of all people.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Countries affected by the migration crisis in Eastern Europe and Central Asia, prompted by the war in Ukraine and other turmoil in the region, have had to put in place measures so that all displaced people have access to essential HIV services. 

 Key Figures: 

• In 2022, Europe was confronted by the largest refugee crisis since World War II. 
• As of February 2024, nearly one-third of Ukraine’s population remains displaced, with 6.3 million Ukrainian refugees globally, primarily concentrated in Europe, 62% of them are women. 
• In 2022, around one million Russian citizens emigrated, with many choosing prolonged stays abroad.
• Central Asian countries witnessed the biggest influx of international migrants since their independence.
• Up to 300,000 Belarusians left their country since May 2020.
• Migration from Central Asia to Russia surged in 2023, with notable increases in Uzbek, Kyrgyz, and Tajik nationals entering for work purposes. (ICMPD Migration Outlook Eastern Europe and Central Asia 2024)
• The HIV epidemic is growing in Eastern Europe and Central Asia, with Russia, Ukraine, Uzbekistan, and Kazakhstan accounting for 93% of new infections in the region combined. 

Surviving the devastating events of March 2022 in Mariupol, Ukraine, uncertain of what the future held, Svetlana fled her hometown.  

"Mariupol was a scene of utter destruction. I had a packed suitcase, but I left it behind, only taking with me a dog and a cat," recalls Svetlana. "With assistance, we managed to reach the Polish border, eventually finding refuge in Lithuania."  

Living with HIV since 2000, Svetlana relies on anti-retroviral treatment (ARV) to keep the virus at bay by taking a tablet a day. In haste, she had only taken one pill box. 

Upon her arrival in Lithuania, she connected with an online organization that within days helped her to obtain her life-saving medicine from a doctor.    

Svetlana is one of 70  participants in 6 countries in the Regional Expert Group on Migration and Health (REG) study that assessed the healthcare access for Ukrainian refugees using qualitative methods. According to Daniel Kashnitsky, the lead REG expert, “insights from specialists and service recipients revealed that all HIV-positive refugees had access to treatment across EU host countries.” 

After recovering from the initial shock, the European Union activated the Temporary Protection Directive, establishing legal guidelines for managing mass arrivals, offering humanitarian aid, and ensuring access to life-saving antiretroviral treatment and basic HIV services to those in need. 

Outside the EU, in countries like Moldova and Georgia, special regulations ensure free access to HIV services. Moldova's National AIDS Coordinator, Yuri Klimaszewski, underscored that Moldova provided HIV services to refugees like it does for its citizens. 

The study also revealed that some refugees struggled in host countries, leading to challenges maintaining treatment adherence. Tatyana (name changed) left Odessa along the Black Sea in April 2022. 

But she returned home because she could not find adequate support under the opioid maintenance therapy program in Poland. She found it complicated to reach the service point, the language barriers prevented her from communicating her needs with medical staff, and she lacked community support. 

“Despite the unprecedented support shown by European countries to Ukrainian refugees, systemic issues, particularly bureaucratic complexities, require proactive intervention by social workers, community organisations and volunteers to effectively address these challenges,” said Mr Kashnitsky. Additionally, he added, “there is a pressing need to tackle the stigma faced by people living with HIV and other key populations, such as people who use drugs.”  

Uladzimir, who left Belarus for Poland in the first days of the war in Ukraine, needed about a month to start receiving ARV treatment. First, he had to obtain "international protection", then confirm his HIV status and wait for an appointment with a doctor. But once all that was cleared, he had access to all the necessary services. For many accessing services is not as straightforward as it is for Ukrainian refugees, according to the REG study “Forced migrants with HIV status: social psychological and medical aspects of adaptation” 

Legislation in some countries makes accessing HIV prevention and treatment for migrants challenging. And in some cases, national healthcare systems may lack resources to meet the influx of people and their needs. 

As the Russian Federation continues to deport migrants living with HIV, those who remain in Russia due to the inability to return home or for family reasons are compelled to stay in the country illegally. They are deprived of HIV treatment and health services. Some have succeeded by receiving treatment remotely (ARVs sent to them with the help of countries of origin).

Recommended strategies, as outlined by the REG study, include improving the system of informing people about potential risks and available HIV services abroad, establishing health insurance protocols, and supporting community organizations that provide HIV services. 

Removing legal provisions that discriminate against migrants living with HIV will also reduce barriers to accessing antiretroviral therapy, resulting in significant improvements for public health in the region. 

Eamonn Murphy, UNAIDS Regional Director for Asia Pacific and EECA regions, praises the collaborative efforts involving various stakeholders, including governments of countries of origin and host countries, community organizations, the Joint UN Programme on AIDS, and donors.   

However, he says more needs to be done. “There is an urgent need to work on the legalization and standardization of such approaches to ensure all people on the move can access essential services and remain on treatment wherever they are.”