The UNAIDS Programme Coordinating Board has rejected the option of winding down the Joint United Nations Programme on HIV/AIDS and backed its transformation. The decision resolves one major question about the future of the international HIV response, but leaves others unanswered: how will UNAIDS operate at country level, who will be responsible for supporting communities, and can hard-won progress be protected amid funding cuts? These questions are particularly important for Eastern Europe and Central Asia.
On 26 October 2026, the UNAIDS Programme Coordinating Board (PCB) met in a special session in Geneva and made a pivotal decision: UNAIDS will continue.
The option of *sunsetting* — an orderly closure of the programme — was rejected. Instead, the Board endorsed a strategic direction for reform, including a leaner structure, a redistribution of responsibilities across UN entities and a stronger focus on work at country level.
The decision forms part of the wider UN80 reform initiative. For UNAIDS, however, the stakes go far beyond administrative efficiency. The Joint Programme brings together international institutions, governments and civil society in the HIV response, and its future is closely tied to the sustainability of national efforts.
Keeping UNAIDS is only the first step
Addressing the Board, UNAIDS Executive Director Winnie Byanyima thanked countries, donors, civil society and activists who had advocated for the programme’s continuation.
“You have rejected the sunsetting of UNAIDS and chosen instead to transform and strengthen this unique Joint Programme,” she said.
Byanyima stressed that preserving UNAIDS was only the beginning. The next challenge is to get the transformation right.
Under the strategic direction endorsed by the Board, the UNAIDS Secretariat is expected to become leaner and focus on four core functions. The UN cosponsoring organizations will assume greater leadership in technical areas, in line with the agreed division of labour.
The UN mandate on HIV and inclusive governance through the PCB will remain in place. The transition is intended to be phased and adapted to each country’s circumstances and readiness.
The practical arrangements, however, have yet to be developed. The central question is therefore how the new model will work in practice — and whether it can avoid weakening support for the countries and communities that need it most.
Communities must be partners in decisions, not observers
One of the most significant elements of the Board’s decision is its reaffirmation that communities must remain at the centre of UNAIDS.
The Board endorsed a shift towards *co-creation* and *co-leadership*. Rather than bringing community representatives into discussions mainly as consultees, this approach envisages their direct involvement in setting priorities and making decisions.
For organizations of people living with HIV and representatives of key populations, the distinction is fundamental.
Community-led organizations are often the first to identify barriers that formal systems overlook: discrimination in health facilities, limited access to prevention, fears around disclosure of HIV status and gaps in services for criminalized and socially excluded groups.
Yet recognizing the importance of communities in a strategy does not automatically give them influence in practice.
It remains to be seen how these principles will be reflected in funding, planning, accountability and the assessment of results.
Notably, the Transition Task Team charged with developing a practical reform plan will include two community representatives nominated by the PCB NGO delegation, alongside representatives of the Secretariat and cosponsors.
This creates a formal channel for civil society to take part in shaping the changes. The significance of that participation will become clearer as the team’s work progresses.
Funding: preserving the programme does not resolve the crisis
Discussions about the future of UNAIDS are taking place against a backdrop of cuts in international assistance and increasing uncertainty over financing for the global HIV response.
UNAIDS faces the challenge of reducing costs and redesigning its operating model while continuing to support countries that rely on international coordination and technical assistance.
At the Board meeting, several countries reaffirmed their financial support. Algeria, for example, announced a voluntary contribution of US$40,000 for its UNAIDS country office in 2027. Other contributing countries include Kazakhstan, Brazil, China, South Africa, Thailand and countries across Asia and Africa.
The Board also approved the 2027 Work Plan and Budget and urged governments to release their contributions promptly and, where possible, make multi-year commitments.
Political agreement to preserve UNAIDS, however, is not the same as ensuring the financial sustainability of its future model.
If resources shrink while expectations remain high, a gap may emerge between what the programme is expected to deliver and what it can realistically achieve.
The next stages of reform must therefore establish which functions will be adequately funded and how country-level support will be maintained.
What is at stake for Eastern Europe and Central Asia?
For Eastern Europe and Central Asia (EECA), the future of UNAIDS matters particularly for the continuity of services, protection of human rights and meaningful participation of communities in national HIV responses.
In several countries across the region, community organizations work with people who face barriers to accessing public health services because of stigma, discrimination, criminalization or a lack of services tailored to their needs.
russia’s war against Ukraine, forced displacement and differences between national health systems create additional challenges to maintaining uninterrupted access to prevention, testing and treatment.
In this context, UNAIDS matters beyond its technical role. It can provide space for dialogue between governments and civil society, help sustain international commitments and support the inclusion of key populations’ needs in national strategies.
For EECA, it is therefore important that UNAIDS reform does not become simply an exercise in reducing its administrative presence.
Several practical questions now need answers:
- Will countries in the region retain the technical and advocacy support they need?
- How will community organizations help set priorities for the transformed programme?
- Will co-leadership mechanisms be backed by real authority and resources?
- How will cooperation with national programmes and civil society continue under financial constraints?
The strategic directions approved so far do not provide definitive answers.
At the same time, the commitment to a phased transition that takes country contexts into account offers an opportunity to adapt reform to local needs rather than apply a single model everywhere.
This is especially relevant in a region where health systems face markedly different needs and constraints.
A new chapter for UNAIDS — and new leadership
The transformation will coincide with a change in leadership.
Winnie Byanyima has announced that she will complete her service as UNAIDS Executive Director on 31 December 2026. From 1 January 2027, the UN Secretary-General will appoint an interim Executive Director while the Board begins the selection process for her successor.
The year ahead will therefore bring several changes at once: a new operating model, a revised division of responsibilities, the search for sustainable financing and a leadership transition.
The Transition Task Team is expected to develop a fully costed implementation plan. That document will provide a clearer picture of whether the Board’s strategic commitments are matched by workable arrangements.
The goal is not merely to preserve a structure — but to protect results
The PCB decision means that UNAIDS will continue as a Joint United Nations Programme. It sends an important signal at a time of serious concern about the future of international coordination on HIV.
But keeping an institution in place does not, by itself, safeguard the progress it has helped achieve.
For people living with HIV and key populations, the significance of reform will not be measured by the number of offices or changes to an organizational chart. What matters more is whether prevention and treatment remain accessible, whether community-led organizations can continue their work and whether their voices shape decisions about the future of the HIV response.
For EECA, that means looking beyond the reform announcement itself to the resources, powers and opportunities for participation that will be available to countries and communities across the region.
UNAIDS has been preserved. The next test is whether its transformation strengthens the HIV response rather than weakening support for those who need it most.