The good news first: HIV science has made remarkable progress. While we still lack a vaccine or cure, a single dose of a new long-acting injectable drug can now offer protection against HIV for up to six months . This breakthrough could revolutionize efforts to curb a pandemic that still claims a life every minute. However, the rise of populism and regressive governance threatens to unravel many hard-won gains in HIV and public health.
The United States has suspended funding to the President’s Emergency Plan for AIDS Relief (PEPFAR), which has saved some 26 million lives over the past two decades. Even though a later waiver for “life-saving humanitarian assistance” applied to HIV testing and treatment and, narrowly, to HIV prevention for pregnant women, many PEPFAR-funded clinics had already closed, staff were sent home, and confusion remains. The future of PEPFAR is now uncertain, and more than 20 million people are in danger of losing access to life-saving medication.
Human rights restrictions continue to challenge the HIV response in regions most affected by the pandemic. In 2024, Uganda upheld one of the world’s harshest anti-gay laws. At least half of the 67 countries that still criminalize same-sex relationships are in central, eastern, southern and western Africa, where HIV burdens are highest. Anti-gay laws correlate with higher HIV rates globally. In Russia, punitive drug laws and restrictive LGBTQ+ policies continue to drive the world’s fastest-growing HIV epidemic.
Undermining science and human rights risks reversing progress and invites the next pandemics. The re-emergence of mpox and H5N1 bird flu are warning shots – HIV could be next.
But there’s a blueprint that can do the opposite and end the HIV pandemic for good:
Defend human rights Protect shrinking civil society spaces Depoliticize public health Strengthen international cooperation
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Progress happens when science, policy and civil society unite. The HIV movement is built on transformative social movements – women’s rights, LGBTQ+ rights and civil rights – which have shown that inclusive, collaborative approaches drive sustainable change.
Today, we must build on this legacy, organize, push back against anti-human rights movements, and defend science as the foundation of our societies’ progress. The alternative is a place humanity has been many times before, offering little but regression and pain.
