As we mark World AIDS Day, it’s crucial to confront the stark realities of the global HIV epidemic and recommit ourselves to building a more equitable response. Despite significant progress in treatment and prevention, millions remain underserved, especially among marginalized populations. This year’s theme, “Unite to Reach All”, reminds us that only by combining science, policy, and activism can we ensure no one is left behind.

In 2023, an estimated 5.4 million of the 39.9 million people living with HIV were unaware of their status. Furthermore, nearly 9.3 million people—almost one in four—lacked access to life-saving treatment. While pre-exposure prophylaxis (PrEP) has proven highly effective in preventing transmission, only 7.5 million individuals have started it globally, falling short of the target of 10 million by 2025.

Those who remain unreached are disproportionately from vulnerable and marginalized communities, including men who have sex with men, sex workers, transgender people, people who use drugs, migrants, and individuals in prisons. These groups face compounded challenges of poverty, stigma, discrimination, and restrictive legal environments, which act as formidable barriers to accessing care.

Scientific advancements, such as long-acting PrEP and HIV treatments like cabotegravir and lenacapavir, hold immense promise. However, these innovations remain inaccessible in low- and middle-income countries due to high costs, restrictive licensing, and limited manufacturing capacity. Addressing these inequities is critical to ensuring that everyone, regardless of location or income, can benefit from these breakthroughs.

For millions, structural barriers perpetuate exclusion from comprehensive care. Harmful laws criminalize behaviors associated with key populations, creating environments of fear and isolation. Alarmingly, less than 3% of global HIV prevention resources are allocated to these groups, leaving a massive investment gap that must urgently be bridged.

To end HIV as a public health threat by 2030, we must address the root causes of inequities and transform the systems that perpetuate them. Key priorities include:  

Reforming laws and policies by insisting that discriminatory and punitive laws must be replaced with inclusive frameworks that reduce vulnerability and ensure access to care for all; access to long-acting prevention and treatment be expanded;   long-acting PrEP and HIV treatments are equitable distributed. This requires addressing pricing barriers, scaling up manufacturing, and fostering global partnerships to prioritize regions hardest hit by the epidemic.

Health systems must be community-centered, adequately resourced, and stigma-free. Investments in training, infrastructure, and integration of care must ensure that services reach the most underserved populations.

People living with and affected by HIV are the experts in their own lives. Involving them in designing and implementing programs ensures that responses are effective, inclusive, and aligned with real-world needs.

World AIDS Day is a time to reflect on the progress made and the work still to be done. It is also a call to action. Here’s how you can make a difference: advocate for Key Communities; challenge stigma; demand policy change; participate in events in your community, and amplify voices on social media.

Ending HIV is possible, but only if we act together. We must commit ourselves to uniting science, policy, and community voices to reach everyone, everywhere. Let this World AIDS Day be a turning point. Whether through advocacy, storytelling, or policy reform, every contribution counts.

Together, we can create an HIV response that leaves no one behind and fulfills the promise of equity and health for all.