During AIDS 2026 and as part of the Rethink. Rebuild. Rise. campaign, VirusOFF is launching Rio Briefs — a series of stories from Rio exploring how HIV prevention is changing today and what these changes mean for people in Central and Eastern Europe and Central Asia.
AIDS 2026 officially opened in Rio de Janeiro on 27 July. One of the central questions on the first day of the conference was clear: if science has already created tools capable of changing the course of the epidemic, why do they remain out of reach for millions of people?
The world has made enormous progress over recent decades. Since the peak of the epidemic, new HIV acquisitions have declined by 65%, while AIDS-related deaths have fallen by 73%. Antiretroviral treatment has saved more than 28.5 million lives. Today, 32.1 million people are receiving treatment — the highest number ever.
But progress is not the same as victory.
In 2025, 1.2 million people acquired HIV, 570,000 people died from AIDS-related illnesses, and almost 9 million people living with HIV were still not receiving life-saving treatment. Every day, around 3,400 people acquire HIV and approximately 1,600 people die from AIDS-related illnesses.
Behind every one of these figures is not simply a data point in a report, but a human life.
At the same time, we are living through one of the most important moments in the history of HIV prevention. Long-acting options can provide protection for several months. Monthly and six-monthly injections are beginning to reach the market, while monthly pills are in late-stage trials.
“Scientific breakthroughs are giving us tools that previous generations could only dream of.” — Winnie Byanyima, Executive Director of UNAIDS.
For some people, these options mean no longer having to take a tablet every day. For others, they offer greater privacy and a lower risk of stigma. For a person on the move, living through war, frequently changing their place of residence or lacking continuous access to a health facility, a long-acting option can help maintain continuity of prevention.
Yet a scientific breakthrough matters only when it becomes available to everyone — not only to those who can afford it.
“However, innovation without access is not innovation, it is injustice. The test of success is not whether medicines exist—it is whether the people who need them can get them, and at an affordable price.” — Winnie Byanyima, Executive Director of UNAIDS.
UNAIDS estimates that approximately 20 million people need access to antiretroviral-based prevention if long-acting options are to change the course of the epidemic.
Registering a new medicine is not enough. Affordable prices, rapid voluntary licensing, competition among generic manufacturers, technology transfer, regional production and swift inclusion in national health programmes are all essential.
Otherwise, a scientific achievement risks becoming another dividing line of inequality: some countries and communities will benefit from modern prevention, while others wait years for their turn.
This risk is becoming even more acute amid sharp reductions in international financing. In 2025, global development assistance fell by 23% — the steepest decline on record. International financing for HIV decreased by more than US$1.5 billion and reached its lowest level in almost two decades.
People are already experiencing the consequences. Community-led organizations are being forced to reduce or close services, prevention programmes are shrinking, health and social workers are losing their jobs, and people are losing access to care.
When prevention disappears, new HIV acquisitions rise. When treatment is interrupted, people die. This is neither a natural disaster nor an inevitability. It is the consequence of political choices.
Access to prevention cannot be separated from human rights. Criminalization, stigma, discrimination and restrictions on community-led organizations push people away from health services. If a person fears judgement, humiliation, violence or prosecution, even the most effective medicine may remain beyond their reach.
“You cannot end AIDS while criminalizing people living with and most at risk of HIV. When people fear arrest, violence or discrimination, they stay away from HIV services.” — Winnie Byanyima, Executive Director of UNAIDS.
Human rights are not a separate component of the HIV response. Without them, the response does not work.
Communities must therefore be more than symbolic participants in discussions. They must be equal partners in decision-making: identifying which options people need, determining how and where they should be provided, monitoring access and showing where systems are leaving people without support.
This is particularly important for Central and Eastern Europe and Central Asia. New prevention options must not be limited to countries with the largest markets or strongest health systems. They must reach people in smaller cities, migrants and refugees, trans* people, gay and bisexual men and other men who have sex with men, people who use drugs, sex workers, young people, and everyone who still faces judgement and barriers when seeking prevention.
Science has already taken an enormous step forward. The next decisions belong to governments, manufacturers, funders and international institutions.
The question is no longer whether we can stop the HIV epidemic. The question is whether we will make the political choices required to do so.
“The choice before us is clear: retreat and risk resurgence, or rethink, rebuild and rise to end AIDS as a public health threat by 2030.” — Winnie Byanyima, Executive Director of UNAIDS.
