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Sustainable and just economies
Although the HIV response in Brazil is 100% financed domestically, prevention and human rights programmes are the first to be reduced or cut when there is health crisis or need to reprioritize budgets. Innovative programmes such as penalties and fines applied to private sector companies that do not comply with regulations are being implemented by the government in Brazil. The funds collected from the penalties/fines are used to respond to populations and programmes impacted by the non-compliance. UNAIDS has entered into a partnership with ILO to use some of these funds for HIV prevention and address mental health among indigenous populations that have been displaced from their homes due to illegal mining. The use of this funds is using fiscal systems to ensure a fair redistribution of funds to populations affected by economic sector and providing an additional source of funding direct to HIV prevention from sectors beyond health. It is creating awareness among the private sector of the impact their actions and reaching populations that have a growing HIV epidemic and have been difficult to reach.

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Fardad UCD Iran: Development of ethical framework for the national response and the first Anti-Discrimination bylaw are structural changes enabling HIV response thru a people centered approach. Integration of HIV in PHC, improving well being of children and mothers by PMTCT which crossing PHC, ANC and HIV intervention are other examples. 

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Fardad UCD Iran: Development of ethical framework for the national response and the first Anti-Discrimination bylaw are structural changes enabling HIV response thru a people centered approach. Integration of HIV in PHC, improving well being of children and mothers by PMTCT which crossing PHC, ANC and HIV intervention are other examples. 

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Removing legal barrier, a crucial lever - Lassaad

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Removing legal barrier, a crucial lever - Lassaad

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Removing legal barriers will automatically create a safe space to key populations and will largely enhance access to testing and combination prevention services. It will also help stakeholders, including communities, refocus on other levers.

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Removing legal barriers to eliminate stigma, discrimination and violence against key populations will be a key game changer to advance the HIV response. Same-sex sexual relationships are criminalized in Ghana since many years ago by law, and currently the Parliament in Ghana is discussing an anti-LGBTIQ+ bill which is close to pass to the third and final reading in Parliament. This context generates violence, stigma and discrimination against key ppulations and many other´s human right violations at community level, family context and also in health care services, putting key populatios far away from the basic services (health including HIV related prevention and treatment services, education, work).

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Tharcisse Barihuta /Zambia : Strenghen human well being and Capabilities: 

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Tharcisse Barihuta /Zambia : Strenghen human well being and Capabilities: 

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Ensure universal access to services particularly Education and Health will advance HIV response in Zambia. Despite reaching 90-90-90 Fast Targets end 2020 , Zambia still have a lot of new HIV infections (33,000 in 2022) , most of them are in young people particularly adolescents' girls and young women. Allowing them to access and complete Secondary Education and reducing age of Access to SRH/HIV services will also reduce teenage pregnancy and HIV/ISTs infections. The recent policy change by the new Government by declaring Free Education at primary and secondary level with more allocation of National Budget to Education and Health will contribute to the wellbeing of the people and advance HIV/AIDS response in Zambia. Increase of Domestic resource to Health will reduce progressively Donnor dependency of HIV/AIDS response for sustainability of the achievements. The other Pathways must be utilized for better acceleration of the implementation of the SDGs and HIV/AIDS response to reach 2030 Goals.

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Cities remain a melting pot of cultures  and socio-economic challenges. increased urbanization and development of slums in Sierra Leone, like most part of Africa continue to increase HIV related vulnerabilities, which calls for multi-sectoral transformative actions in urban and peri-urban centres. The high new HIV infections in urban centers is partially attributable to high rates of drug use, limited access to quality health and social service, high rates of unemployment, sex work and inadequate safety nets, which heightens vulnerable populations risk of HIV infection. Addressing Urban and peri-urban

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Economy and finance and Sustainable and just economies:

The fight against inequality in all areas - economic, financial, social, health, education, technology, and sustainable and stable employment - is essential for the eradication of HIV and other long-term diseases. By promoting equality and equity, we create a society where every individual has equal access to essential resources and services, including healthcare and education. This reduces vulnerabilities to diseases like HIV and improves everyone's quality of life. Furthermore, a stable economic environment and sustainable jobs can help mitigate certain risk factors associated with these diseases. Finally, by bridging the technology gap, we ensure that health innovations are accessible to all, which is crucial for the prevention and treatment of long-term diseases. The eradication of HIV and other long-term diseases therefore requires a holistic approach that takes into account all these interconnected aspects of our society.

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Enhancing well being and capabilities. (Hege) Current social protection does not sufficiently address population groups most vulnerable and at risk of HIV, and people living with HIV in addition to ignore gender inequalities. A recent cut in current fuel subsidies will partially be used to invest in scaling up social protection and the UN is engaged in enhancing the policy, promoting better criteria for inclusion. 

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Enhancing well being and capabilities. (Hege) Current social protection does not sufficiently address population groups most vulnerable and at risk of HIV, and people living with HIV in addition to ignore gender inequalities. A recent cut in current fuel subsidies will partially be used to invest in scaling up social protection and the UN is engaged in enhancing the policy, promoting better criteria for inclusion. 

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Science and technology – through applying new technologies to service delivery that improves care. (David)

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Science and technology – through applying new technologies to service delivery that improves care. (David)

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For me this is about jumping over barriers that are/will take too long to address. Using technology driven innovations like PrEP and self-testing to help those most marginalized understand their HIV status and get linked to care – moving around services that may still discriminate – at the same time addressing stigma and discrimination!

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Decriminalization of HIV transmission and same sex relations, removing other legal barriers to access HIV related services would assets the national HIV response and reduce the number of new HIV cases, which in most cases are diagnosed at late stages

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Lord.  Ensure universal access to education

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Lord.  Ensure universal access to education

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In South Sudan, there are high levels of illiteracy and low educational attainment beyond primary levels, with females much more affected in this regard than men. Only 26% of the adult population is considered to be functionally literate (16% for females compared to 40% for males) with only 33% of the adult population having at least some secondary level education.

Education is one of the most important factors in helping to reduce people’s vulnerability to HIV. A study in Botswana, for example, found that additional years of secondary school (grades 8-12) were linked with significantly lower risk of HIV, particularly for women, whose HIV risk dropped by 12 percentage points with each added year of secondary school. No effect was however found for people with less than nine years of schooling. It is therefore important to target policies that will lead to enrollment and retention of young people at least through secondary school. It is important to note that secondary schooling has large benefits beyond the reduction of HIV transmission. Education is a powerful agent of change, and improves health and livelihoods, contributes to social stability and drives long-term economic growth.

Therefore, ensuring universal access to education and taking measure to ensure pupils stay through secondary school in South Sudan will be a smart investment.

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Ensure universal access to services - Pakistan & Afghanistan

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Ensure universal access to services - Pakistan & Afghanistan

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A significant portion of the population faces limited access to basic services. Addressing underlying inequalities is critical and provides an entry point to tackle the challenges and needs of people living with and most affected by HIV – not just in the area of health but also education, clean water, sanitation, etc. Focusing on access to basic services allows us to highlight the challenges and obstacles faced by these people toward ensuring access to these services that each person needs and deserves for their wellbeing.

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Rapid digital transformation already taking place prior to the COVID-19 crisis has accelerated during the pandemic, leading to the expansion of opportunities for digital inclusion. The exponential increase in e-commerce has created new jobs and income earning opportunities, which have the potential to spur household income, lift people out of poverty, and increase resilience of rural communities.

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Hind Hassan, Rwanda - Strengthening Human well being and capabilities

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Hind Hassan, Rwanda - Strengthening Human well being and capabilities

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Rwanda has 65% of its population below 30 years of age. It is a young country and the focus is on harnessing this demographic dividend. rates of completion of secondary and higher levels education are low in the country. Investing in universal access to quality education would be critical especially for AGYW which would eventually address current problems such as teen pregnancy and new infections among young people especially girls. Having a people's centered and holistic approach through the overall well-being of human capital lens is important to achieve the full potential of the people in the country.

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Generation of disaggregated and longitudinal data to inform can help policy makers to take the right policies based on evidence. Data are also critical for better resources allocation addressing the needs of populations. Data are also essential to build strong advocacy for AIDS repositioning. Evidence based data can help to focus HIV interventions which lead to greater impact and good governance.

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Strengthening human well-being and capabilities through ensuring universal access to education is a transformative pathway to advancing the HIV response in South Africa. Keeping girls who are more susceptible to HIV than men and boys in secondary school is crucial and a means to protect girls against HIV. Evidence confirms that girls—and their communities and countries—reap multiple social and economic benefits from their completion of secondary school including reduced vulnerability to acquiring HIV, child marriage and teenage pregnancy, while increasing their prospects for securing jobs and higher incomes as adult women, among others. Ensuring universal access to education is a solution pathway to strengthen the human capabilities and well-being of adolescent girls and young women which in turn advances the HIV response.

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Sustainable food and Healthy Nutrition-Pathway to ending AIDS-Nuha Ceesay, Malawi  

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Sustainable food and Healthy Nutrition-Pathway to ending AIDS-Nuha Ceesay, Malawi  

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Many countries are struggling for food security and nutrition. Conflicts such was the war in Ukraine have exposed the fragility of many countries in Africa resulting in high cost of food, and shortages . Similarly, civil unrests, humanitarian challenges, COVID19 had have high impact on women, children including PLHIV. The effects of food insecurity and poor nutrition poses challenges on treatment adherence and efficacy. The recent Cyclone Freddy in Malawi resulted in many people losing their fields due to the high level of water. The people in the camps yearn for good quality food yet this is not always possible when the need is more than what is available. PLHIV, women and children are being disproportionally affected. This clearly demonstrates that better HIV response outcomes can only be achieved with holistic approaches on ending inequalities, and that includes ensuring sustainable food and healthy nutrition.

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The adoption of a social protection system in health sector will advance the AIDS response as despite that ARV are free of charge since 2007 other opportunistic infections treatments and biological exams are not free of charge. This situation constitutes a barrier to care.

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Eliminating discrimination in laws and norms- Martin Odiit, UCO Tanzania

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Eliminating discrimination in laws and norms- Martin Odiit, UCO Tanzania

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This pathway can advance the response to HIV by removing structural and legal barriers such as criminalization of sex work and same sex relationships and thereby increase access to HIV prevention and treatment services with outcomes of reduced HIV incidence among Key Populations and better coverage of ART.

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The legal framework on HIV as a contribution to move the agenda towards the universality of human rights - Alberto A Stella, MCO Southern Cone

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The legal framework on HIV as a contribution to move the agenda towards the universality of human rights - Alberto A Stella, MCO Southern Cone

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The recent launch of the new law for comprehensive care for HIV, viral hepatitis, other STIs and TB in Argentina, with a solid human rights and gender perspective and a broad framework of social protection, is a good example of a pathway to move forward. the human rights agenda, focusing on the most vulnerable so that no one is left behind. The law is currently being regulated and implemented and is a gateway to strengthen health systems towards universal health coverage. It is also a good example of a context that favors vertical and horizontal coherence in the development of policies for sustainable development. Updating HIV laws following this perspective could be an important contribution to advancing the HIV response and contributing to progress in achieving the objectives of the 2030 Agenda.

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Deploy new technologies that reduce inequalities - Guatemala

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Deploy new technologies that reduce inequalities - Guatemala

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Similarly as in the case highlighted by Richard, in Guatemala, getting the country to scale up Prep and HIV self testing access is a key game changer to prevent new infections among people most at risk, and diagnose people that we are currently not reaching through existing testing services.

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Richard AMENYAH (The Caribbean): ViiV and PrEP access

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Richard AMENYAH (The Caribbean): ViiV and PrEP access

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The recent announcement by ViiV Pharmaceutical to make the medical technology and innovation available to other countries with high HIV burden and the manufacturing capacity to produce Cabotegravir long acting (Cab-LA) as part of medicine patent pool for Pre-Exposure Prophylaxis is transformation lever and a game changer for HIV prevention for people who are substantially at risk of HIV. Access to the medical innovation in Latin American and Caribbean region will be transformational for our HIV response.