IAPAC Calls for Re-Imagining the Global HIV Response

WASHINGTON, DC, USA (1 January 2025) – As we approach the midpoint of the timeline to achieve Sustainable Development Goal (SDG) 3.3 of ending AIDS as a public health threat by 2030, the global community stands at a critical juncture in the HIV response. Despite considerable progress, HIV remains a formidable public health challenge, exacerbated by inequities in access to care, pervasive stigma, and emerging health threats.

With five critical years to make progress towards and achieve SDG 3.3, Re-Imagining the Global HIV Response for 2030 and Beyond offers a comprehensive roadmap with 35 cross-cutting recommendations across seven policy and programmatic domains to guide clinical, public health, and public policy decision-makers and practitioners. The recommendations were released on World AIDS Day 2024 by the International Association of Providers of AIDS Care (IAPAC) and Fast-Track Health.

“On New Year’s Day 2025, we must re-commit to addressing the evolving nature of the HIV epidemic, persistent disparities in access to HIV services, and the intersection of HIV with other health and social determinants – all of which require we re-imagine the global HIV response so that it is fit for purpose,” said Dr. José M. Zuniga, President/CEO of IAPAC and Fast-Track Health. “We call on stakeholders engaged in the HIV response to action the 35 consensus-driven recommendations we propose to accelerate focused action to end AIDS as a public health threat by 2030.”

The IAPAC recommendations for 2025-2030 were published on World AIDS Day 2024 and seek to align the global HIV response with current realities, leveraging data-driven strategies, innovations in HIV prevention and treatment, digital health and health Al, integrated service delivery, community involvement, and political leadership to achieve SDG 3.3 and build a sustainable and equitable future for all.

Within the context of addressing a call for sustainability in the HIV response, IAPAC’s recommendations include:

  • DEVELOPING NATIONAL SUSTAINABILITY FRAMEWORKS: Create a national HIV sustainability framework that aligns with global best practices, emphasizing equity, social justice, and human rights, and integrating HIV services into broader health systems at all relevant jurisdictional levels, including subnational and municipal.
  • SECURING LONG-TERM FINANCING: Prioritize increased domestic and international financing dedicated to the HIV response, ensuring that resources are allocated equitably and that bilateral and multilateral funding mechanisms, including the Global Fund to Fight AIDS, Tuberculosis & Malaria, are stable and sustainable.
  • PROMOTING MULTISTAKEHOLDER ENGAGEMENT: Strengthen multistakeholder engagement mechanisms and engage in public-private partnerships that
    include government, civil society, the private sector, and communities affected by HIV, to collaboratively develop, implement, and monitor sustainability initiatives.
  • INTEGRATING HIV SERVICES INTO UNIVERSAL HEALTH COVERAGE (UHC): Ensure that HIV services are fully integrated into national UHC packages, including prevention, treatment, care, and support services, to guarantee long-term sustainability and access, within the context of person-centered care.
  • MONITORING AND EVALUATING SUSTAINABILITY EFFORTS: Implement robust monitoring and evaluation systems to track the progress of sustainability efforts, ensuring that equity-based principles are adhered to and that the impact on health outcomes is continuously assessed.

IAPAC also offers recommendations for re-defining and focusing data parameters to inform the HIV response, including:

  • STRENGTHENING DATA COLLECTION SYSTEMS: Invest in national and subnational electronic health information systems to collect disaggregated data that captures key demographic and socioeconomic variables, enabling more accurate and targeted HIV interventions, with an additional focus on related health conditions, health concerns, and cost-efficiency.
  • ENHANCING DATA QUALITY AND RELIABILITY: Implement standardized protocols across regions and healthcare facilities to improve the accuracy and consistency of HIV and other data, with a focus on resource-limited settings where data collection challenges are most pronounced.
  • INTEGRATING ADVANCED DATA ANALYTICS: Adopt and integrate advanced data analytics tools, including Al and machine learning, into national HIV data systems to enhance the predictive accuracy of models and to generate real-time insights for policymaking.
  • FOSTERING COMMUNITY-LED DATA MONITORING: Support and institutionalize community-led monitoring initiatives by providing training and resources to communities, ensuring that their data contributions are systematically included in national HIV data systems.
  • ESTABLISHING DATA-SHARING PARTNERSHIPS: Facilitate data-sharing partnerships with international organizations, research institutions, and other countries to improve the global HIV data landscape, ensuring that best practices and innovations are disseminated and adopted.

IAPAC offers recommendations for leveraging antiretroviral (ARV) drug and diagnostic technologies to optimize HIV outcomes:

  • PRIORITIZING RESEARCH AND DEVELOPMENT: Increase investment in R&D for new ARV drug and diagnostic technologies, with a focus on long-acting ARV formulations and community-based and self-testing multiplex diagnostic tools, to overcome current HIV treatment and prevention barriers, but with an equal focus on equitable access for all communities.
  • FACILITATING ACCESS TO INNOVATIVE ARV DRUGS: Work with pharmaceutical companies and international partners to accelerate the regulatory approval and distribution of innovative ARV drugs, ensuring equitable access to the latest treatments across all geographic regions, without exception.
  • EXPANDING NATIONAL DRUG PROCUREMENT PROGRAMS: Strengthen national drug procurement programs to include new ARV drug technologies, ensuring that they are available in both urban and rural settings and that supply chains are robust and reliable.
  • SUPPORTING COMMUNITY EDUCATION ON ARV DRUG INNOVATIONS: Launch awareness campaigns and training programs to educate healthcare providers and communities about new ARV drug innovations, while stressing patient choice regarding oral, injectable, and other future ARV formulations.
  • REMOVING STRUCTURAL BARRIERS TO ACCESS: Identify and address legal, policy, and logistical barriers that hinder access to innovative ARV drugs and diagnostics, including reducing regulatory delays and improving healthcare infrastructure, including person-centered innovation to improve access and utilization of HIV services.

IAPAC proposes recommendations for integrating digital health and health AI innovations into the HIV response, including:

  • DEVELOPING NATIONAL DIGITAL HEALTH STRATEGIES: Create or update national digital health strategies that incorporate health Al-driven solutions for the HIV response, ensuring these strategies address ethical concerns and are aligned with international standards.
  • INVESTING IN DIGITAL INFRASTRUCTURE: Allocate resources to strengthen digital infrastructure, particularly in underserved regions, to support the deployment and scalability of digital health and health Al tools in the HIV response.
  • ENHANCING DATA PRIVACY AND SECURITY: Implement strict data privacy and security measures for digital health and health Al systems, including robust legal frameworks and encryption protocols, to protect sensitive health data and build public trust.
  • PROMOTING DIGITAL HEALTH LITERACY: Launch national campaigns to improve digital health literacy among healthcare providers and patients, ensuring that digital tools are accessible and usable for all populations, particularly in rural and resource-limited settings.
  • ENCOURAGING PUBLIC-PRIVATE PARTNERSHIPS: Foster public-private partnerships to drive innovation and scale in digital health and health Al, leveraging the expertise and resources of the private sector while ensuring that solutions are equitable and sustainable.

To optimize HIV outcomes, IAPAC offers recommendations for optimizing integrated HIV and other health responses:

  • SCALING UP DIFFERENTIATED SERVICE DELIVERY: Implement and scale up differentiated service delivery (DSD) models nationally, ensuring they are integrated into the broader health system and tailored to the specific needs of different populations, particularly those with high HIV burden.
  • INVESTING IN HEALTH WORKFORCE TRAINING: Provide ongoing capacity-building for healthcare workers on DSD and other health innovations, as well as HIV stigma elimination in health settings, to ensure they are equipped to deliver person­ centered, integrated care.
  • INTEGRATING HIV SERVICES WITH PRIMARY CARE: Facilitate the integration of HIV services into primary healthcare, promoting a comprehensive approach that addresses multiple health needs, including the management of comorbidities and syndemic conditions.
  • SUPPORTING TASK-SHIFTING INITIATIVES: Expand task-shifting programs to enable paraprofessional healthcare workers, such as community health workers, to take on additional responsibilities in delivering HIV services, thereby extending the health system’s reach.
  • MONITORING AND EVALUATING HEALTH SYSTEMS INNOVATIONS: Establish monitoring and evaluation frameworks to assess the impact of DSD and other health systems innovations on HIV outcomes, using this data to continuously refine and improve service delivery.

IAPAC proposes recommendations for meaningfully involving affected communities to lead the HIV response:

  • ESTABLISHING COMMUNITY LEADERSHIP PLATFORMS: Create platforms that empower communities to lead HIV response efforts at national, subnational, and municipal levels, ensuring that their voices are central to decision-making processes at all levels of government.
  • PROVIDING FUNDING FOR COMMUNITY-LED INITIATIVES: Allocate specific funding streams to support community-led HIV initiatives, including public HIV awareness campaigns, ensuring these resources are sustainably accessible to marginalized groups.
  • INTEGRATING COMMUNITY-LED MONITORING INTO NATIONAL HEALTH SYSTEMS: Institutionalize community-led monitoring as a key component of national HIV data systems, providing training and resources to communities to enable accurate data collection and reporting.
  • PROMOTING LEGAL AND POLICY REFORMS: Advocate for legal and policy reforms that remove barriers to community involvement in the HIV response, including addressing HIV and intersectional stigma, and the criminalization of key populations.
  • DEVELOPING CAPACITY-BUILDING PROGRAMS: Implement capacity-building programs for community organizations to strengthen their technical and organizational capabilities, enabling them to effectively manage and lead HIV response initiatives.

Underpinning the previous recommendations, IAPAC offers recommendations for achieving equity, equality, and justice for all in the HIV response:

  • IMPLEMENTING EQUITY-FOCUSED HEALTH POLICIES: Develop and implement national health policies that prioritize equity, equality, and justice and engage all relevant government institutions, ensuring these principles are embedded in all aspects of the HIV response.
  • ADDRESSING SOCIAL DETERMINANTS OF HEALTH: Launch initiatives that tackle the social determinants of health, such as poverty, education, and gender inequality, which contribute to disparities in HIV outcomes.
  • PROMOTINGE INCLUSIVE DECISION-MAKING: Ensure that marginalized and vulnerable populations are represented in decision-making processes related to HIV policy and program development, giving them a voice in shaping the response.
  • ENHANCING DATA COLLECTION ON HEALTH DISPARITIES: Improve data collection and analysis on health disparities within the HIV response, ensuring that data is disaggregated by key demographics and used to inform targeted interventions.
  • ADVOCATING FOR HUMAN RIGHTS PROTECTIONS: Champion human rights protections for people living with and affected by HIV, including repealing laws criminalizing key populations, reforming discriminatory laws and practices, and eliminating stigma in all its forms.

Click here to access the full recommendations, including rationale and rationales, objectives, and key points, across the document’s seven domains.