A/76/PV.80 General Assembly

We are gathered here today to assess our progress in the implementation of the Political Declaration on HIV and AIDS, which aims to end the epidemic by 2030. Since the first reported cases, more than 79 million people have contracted HIV and more than 36 million people have died from AIDS- related illnesses. To this day, AIDS continues to take 13,000 lives every week. I would therefore like to start by expressing my most heartfelt condolences  — and extending my sincere sympathy  — to the millions whose lives have been lost or impacted by the crisis over the past four decades. We are brought together today as the world works to recover from the coronavirus disease (COVID-19) pandemic, which has exacerbated pre-existing inequalities and profoundly hindered our efforts not only to fight the spread of HIV/AIDS but, more broadly, to achieve the Sustainable Development Goals. The COVID-19 pandemic has shown us how critical pandemic and epidemic preparedness and equitable access to health services are to alleviating public health crises and bolstering future pandemic resilience. Striving to achieve the 2025 AIDS targets is an opportunity to work together to increase investments in public health systems and pandemic response and draw on the hard-learned lessons from the HIV/AIDS crisis for our recovery from the COVID-19 pandemic, and vice versa. Ten million people living with HIV are currently unable to access antiretroviral treatments, a particularly prominent issue among the already vulnerable populations who bear a disproportionate impact of HIV. Negative attitudes and beliefs about people with HIV, ignorance, prejudice and unfounded fears of contagion often result in social stigma, discrimination and even refusal of health-care services. We must ensure not only their safety and well-being but also their access to treatment and legal protections. As I have emphasized throughout my presidency, I firmly believe that equal access to health-care service is an essential human right. Public health must be guaranteed for each and every one. No one is safe until we are all safe. I am saddened to share that data from the Joint United Nations Programme on HIV/AIDS shows that AIDS-related deaths are not declining fast enough for the epidemic to end by 2030, as was originally envisioned. Failing to reach that target will result in the loss of 7.7 million lives over the current decade. The COVID-19 pandemic has put significant pressure on the HIV response, health-care systems and people, exacerbating the AIDS epidemic. Ensuring equitable access to life-saving services is an absolute priority for both COVID-19 vaccinations and HIV retroviral treatment. The intersection of the two crises is an opportunity to tackle those issues together. The sense of urgency and the multilateral consensus built around the Political Declaration on HIV/AIDS, I believe, clearly demonstrates our capacity for unity in times of crisis. I am therefore confident in our ability to meet, and even surpass, the benchmarks set for the next four years. Let us take the necessary steps to close the funding gap in AIDS response and public health systems so that they serve all of us. As such, in the power of our unity, I call upon on each and every Member State to act urgently to end inequalities, which is critical to ending AIDS by 2030. In accordance with rule 30 of the rules of procedure of the General Assembly, I now give the floor to His Excellency Mr. Courtenay Rattray, Chef de Cabinet of the Executive Office of the Secretary-General, to make a statement on behalf of the Secretary-General. Mr. Rattray: The long-running HIV pandemic takes one life every minute. It remains the deadliest pandemic of our time, having killed some 36 million people in the past four decades. Last year saw 1.5 million new HIV infections, against a global pledge to bring the figure below 500,000 by this time, and scientists remain concerned about the evolution of more transmissible variants. Progress was already lacking when the coronavirus disease (COVID-19) pandemic began. The war in Ukraine has now knocked that progress further off track. It is both encouraging and frustrating that we know what works in response to the pandemic. We have an agreed road map  — the bold Political Declaration on HIV/AIDS, adopted at the high-level meeting of the General Assembly on HIV/AIDS held last June (see A/75/PV.74), with ambitious new targets for 2025. We can end AIDS, but only if we work together with laser focus on tackling inequalities. I see three immediate steps to reverse current trends and get us back on track. First, we need to address inequalities, discrimination and the marginalization of entire communities, which are often exacerbated by punitive policies and laws. Gender inequality and gender-based violence contribute to the high risk of HIV infection that is faced by women and girls. In sub-Saharan Africa, more than 6 in 10 new HIV infections in 2020 were among women and girls. Girls’ education and empowerment are key to preventing new infections. As Member States just heard from the President of the General Assembly, Governments and their partners also need to tackle the stigmatization and marginalization of specific communities. That includes sex workers, people who inject drugs, prisoners, transgender people and gay men, who are all at increased risk of HIV and other life-threatening infections. Let me therefore put it bluntly — stigmatization hurts each and every one of us; social solidarity protects everyone. Secondly, to end AIDS, beat the COVID-19 pandemic and stop the pandemics of the future, we need to ensure global access to life-saving, pandemic-ending health technologies. New long-acting antiretroviral therapies must be made available to the global South. We must not repeat the deadly mistake made when the first treatments for HIV became available in the global North. We now know that 12 million people died because those therapies were not made available simultaneously in the global South. Pandemic-ending technologies must be shared if they are to benefit all of us, North and South alike. That is in everyone’s interests. We can end AIDS only by ending it everywhere. Thirdly, we need to increase the resources made available to tackle AIDS. Investments in AIDS are investments in global health security and in the world economy. They save lives, and they save money. Policies that end AIDS will go far beyond one disease, helping to manage the risks of future pandemics of all kinds. The General Assembly has called for $29 billion in annual investments in the AIDS responses of low- and middle-income countries by 2025. Therefore, we have a way to go to meet that target. Contributing to other causes, including support for those who are fleeing the war in Ukraine, cannot come at the expense of the global AIDS response. The most important message today is that, if we work together to tackle the inequalities that perpetuate HIV/AIDS, we can still end it as a public health threat by 2030. In doing so, we can save millions of lives, help prevent further global pandemics and contribute to the 2030 Agenda for Sustainable Development. In short, we have no time to lose.

I now give the floor to the representative of the European Union, in its capacity as observer.

I have the honour to speak on behalf of the European Union (EU) and its member States. The candidate countries North Macedonia, Serbia and Albania; the country of the Stabilization and Association Process Bosnia and Herzegovina; as well as Ukraine, the Republic of Moldova, Georgia, Andorra, Monaco and San Marino, align themselves with this statement. With the coronavirus disease pandemic still keeping a firm grip on large parts of the world and Russia’s brutal, unprovoked and unjustified war against Ukraine, which is affecting people in all corners of the world  — the world clearly focuses on immediate emergencies. Against that backdrop, the HIV/AIDS epidemic and pandemic seems a forgotten or a solved issue — but it clearly is not. The report of the Secretary-General (A/76/783) offers evidence and analysis of the situation and urges action with concrete recommendations. Reducing inequalities that drive the HIV/AIDS epidemic is the key to getting back on track. If we fail, we will not only miss Target 3.3 of the Sustainable Development Goals but also be responsible for the prolonged suffering of the 13,000 people who die from HIV/AIDS-related illnesses every week. We know what needs to be done, and we must fully implement the commitments we made in the Political Declaration on HIV/AIDS. We clearly see that, in order to have an effective HIV/AIDS response, we first need to keep key populations in focus, as they are particularly vulnerable to HIV and frequently lack sufficient access to adequate services, including HIV prevention, treatment and care. Secondly, we need to work against stigmatization, which is often linked to sexual orientation and gender identity and punitive laws. Thirdly, we further need to improve universal access to quality and affordable, evidence-based, comprehensive sexual and reproductive health information and education in order to address discrimination and ensure equitable access to diagnostics and treatment, as well as preventive measures. Fourthly, we need a stronger focus on the overall prevention agenda, since too many new infections are still occurring. To ensure the implementation of the targets, there must be a rigorous set of indicators to measure and monitor progress and investments, especially with regard to community leadership and the 10-10-10 societal enablers. In line with the Political Declaration and the Global AIDS Strategy  — which has our full support  — the EU is fully committed to getting on track to end AIDS by 2030. We will continue working towards ending inequalities that drive the AIDS epidemic, ensuring gender equality and protecting human rights. We will also continue to prioritize people who are not yet accessing life-saving HIV services, particularly girls and young women — as adolescent girls and young women continue to be disproportionately affected by HIV. We will do so by putting people at the centre of our efforts, supporting community-led initiatives, in particular by building sustainable and resilient health systems, including community health  — which is a major objective of the health sector in the EU — with a view to reaching universal health coverage. However, we note with concern that, at the recent World Health Assembly, the World Health Organization Global Health Sector Strategy on HIV was adopted not by consensus but, for the first time, by vote. In addition, important approaches that are at the core of addressing those diseases have been removed from the strategy or were moved to an annex, such as approaches on information and education, including on sexuality, gender identity, gender-responsive approaches, intimate partner violence and gender-based violence. HIV seemed unbeatable 40 years ago, but global solidarity has turned the tide against the virus. With extraordinary multi-stakeholder engagement, the world has come a long way in the fight against HIV/ AIDS. From the start, communities have been leaders in shaping the response. In 1994, the United Nations combined forces in the establishment of the Joint United Nations Programme on HIV/AIDS (UNAIDS), and, 20 years ago, the Global Fund to Fight AIDS, Tuberculosis and Malaria was established, of which the EU and many EU member States are proud supporters. Today people with HIV can lead long, fulfilling lives. The Global Fund is heading towards its replenishment in the fourth quarter of this year, and we will need every contribution to continue its qualified and important work. In addition, as a technical partner to the Global Fund, UNAIDS needs to be adequately resourced to lead the global response on HIV/AIDS. Let us continue our efforts together so that, by 2030, we can declare victory over AIDS.

It is my honour to address the General Assembly this afternoon on behalf of the 14 member States of the Caribbean Community (CARICOM). At the outset, the Caribbean Community wishes to thank the Secretary-General for his report (A/76/783) on tackling inequalities to end the AIDS epidemic. We recall that, just one year ago, we convened here in the General Assembly at the high-level meeting (see A/75/ PV.74) to discuss and renew commitments to tackle the HIV/AIDS epidemic and adopt the 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. While we acknowledge that global AIDS-related deaths and HIV infection have fallen over the past 20 years, we regret that they have not been reducing at the desired rate necessary to end AIDS by 2030. However, CARICOM celebrates that the Caribbean region, along with sub-Saharan Africa, have had the strongest reductions since 2010. We reiterate that we have been able to achieve that as a result of the implementation of indigenous policies and approaches, consistent with our political, legal, social and cultural environment. Over the past year in particular, the Caribbean has, first, prioritized the strengthening of national and regional governance of the HIV response. Secondly, it has expanded HIV services, including for the HIV testing and treatment cascade. Thirdly, it has improved data collection and strengthened data surveillance. Fourthly, it has continued to work to eliminate mother- to-child HIV transmission and ensure the revalidation of countries that have already been validated in our region. At this time, we remain focused on tackling existing inequalities, including inequalities in health financing and health systems and inequalities in access to medicines and health technologies, among many others. We are committed to doing our part to end the inequalities, and we call on all countries, in global solidarity, to tackle those inequalities together.

It is an honour for me to speak on behalf of the member countries of the Central American Integration System (SICA): Belize, Costa Rica, the Dominican Republic, El Salvador, Guatemala, Honduras, Nicaragua and my own country, Panama. We reiterate our commitment to continue to step up efforts to end inequalities and bring an end to AIDS by 2030, which we committed to do here one year ago in the Political Declaration on HIV and AIDS, which was adopted at the high-level meeting of the General Assembly on HIV and AIDS (see A/75/PV.74). Putting an end to this threat to public health and accelerating progress in implementing the Sustainable Development Goals, in particular Goal 3, concerning health and well- being, is urgent. Allow me to share a few of the efforts that we have made. Our region has achieved sustained progress with respect to people knowing about their serological status  — in 2019, we reached an average of 78 per cent, with some variation from one country to another. According to the data for 2018 and 2019, it is estimated that, of the total number of people who were diagnosed, 69 per cent received treatment, a percentage that, according to reports, ranges from 58 to 87 per cent. The SICA member countries have made strides in responding to AIDS by strengthening the policy framework for the strategic orientation of our action, as well as in terms of sustainability, mobilization of resources and cost reduction through the regional mechanism for jointly negotiating prices and procuring medication, which since 2006 has made it possible to improve access to medication for health systems. We have also increased access to diagnosis and to treatment for people with HIV, which in the last five years has grown at an accelerated rate. Similarly, we have incorporated guidelines from the World Health Organization in our national regulatory frameworks. We have set up clinics to monitor and control HIV/AIDS and sexually transmitted diseases and have provided prevention packages to key populations. We have also implemented the Regional Strategy for Health, Dignity and Positive Prevention for Central America and the Dominican Republic. We know that in our region there are gaps that our countries must overcome as soon as possible. That is the case for preventing a decrease in budgets allocated for prevention, taking immediate action following diagnosis and improving investment and interventions for key populations. We think it is important to guarantee specialized care, psychological support and mental health treatment for people who live with HIV/ AIDS, while facilitating access to information and doing so in close contact with our national health- care systems. We reiterate the commitment of our States to the United Nations strategy to achieve a coverage of 95 per cent of a set of evidence-based services; eliminate legal and social barriers; improve results in terms of HIV; guarantee the necessary financing to the HIV response; and integrate HIV in our health systems, social protection and crisis responses, as well as in our response to the pandemic. Only in that way can we end inequality and achieve the goals for 2025 established in the 2021 Political Declaration, as a prerequisite to putting an end to AIDS by 2030. I would now like to make additional comments in my national capacity. Panama currently faces a concentrated epidemic, with about 31,000 people living with HIV/AIDS, 70 per cent of whom are men. We are very concerned that HIV is currently concentrated among young people between 20 and 29 years of age. There is significant stigma and discrimination against people with HIV. That is why we must continue to implement actions that mitigate the disease’s devastating consequences through timely prevention and diagnosis. A year ago in this very forum, we welcomed the adoption of the Political Declaration in order to put an end to AIDS by 2030. Panama made the commitment to take urgent action, and it has taken decisive action. The response to HIV/AIDS in Panama is led by the Ministry of Health, with the support of the social security fund and other key allies, such as the Joint United Nations Programme on HIV/AIDS. Panama offers universal retroviral treatment free of charge to all people who require it in the national territory, highlighting the strategy implemented to improve the connection and adherence to treatment for people with HIV/AIDS. We currently have seven clinics that provide accessible treatment. We have also set up a national plan to eliminate mother-to-child transmission of HIV and syphilis. We recently included pre-exposure prophylaxis for key populations and have migrated to new systems of treatment, which have demonstrated an improved ability to reduce the viral load, a reduced risk of treatment discontinuation and a reduced likelihood of developing resistance. In Panama, we have a coordinated mechanism working actively to implement the subsidies received from the Global Fund to Fight AIDS, Tuberculosis and Malaria. That mechanism includes the participation of the public and private sectors, as well as civil society. Panama is also updating its strategic multisectoral plans for HIV for the period 2020 to 2024, which provide a road map for our actions and the measures to be taken for the treatment and protection of people with HIV/ AIDS. Panama has included HIV/AIDS patients as a priority population in all our schemes for vaccination and other actions related to preventing and managing the coronavirus disease (COVID-19) pandemic. HIV/AIDS is much more than a health problem. This illness reveals the fragile social and economic conditions, prejudice, discrimination and marginalization that are inherent in the key challenges that our countries face. Injustice and inequality have been exacerbated by the COVID-19 pandemic, and its impact threatens progress in development and public health, including with regard to the prevention of HIV. It is imperative to include actions to put an end to stigma and discrimination as a cross-cutting principle of the entire HIV/AIDS response, including through mental health treatment with a human-rights based approach and gender perspective. Only by mounting a response based on equality can we close the many gaps that separate us and eliminate barriers to make space for prevention, timely diagnosis and universal access to treatment for HIV/AIDS without leaving anyone behind.

I have the honour to deliver this statement on behalf of the Group of African States. The African Group takes note of the report of the Secretary-General (A/76/783) entitled “Tackling inequalities to end the AIDS pandemic” and the recommendations contained therein. We are gathered here today to undertake a review of the progress achieved in realizing the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, which focuses on inequalities one year after its adoption. We are also here to share accelerated efforts for action and best practices in order to ensure that the global goal of ending AIDS as a public health threat by 2030 becomes a reality. To that end, it is important to assess the comprehensive universal and integrated response to HIV and AIDS and investments over the next eight years. We must put all people living with HIV on treatment. It is our duty to protect future generations from acquiring HIV. We must eliminate new HIV infections. And we must promote and continue advocacy and education efforts to stop people from engaging in risky behaviour. We should strengthen initiatives that prevent mother- to-child HIV transmission. We should empower young people, men and women equally, and ensure their access to the HIV-related health-care services they need. It is important to leave no one behind, particularly the furthest behind. The African Group commends and fully supports the African Union Road Map on Shared Responsibility and Global Solidarity for AIDS, Tuberculosis and Malaria Response in Africa. In that regard, the African Group recalls the pledge made at the special summit of the African Union on HIV and AIDS held in Abuja in July 2013 — the Abuja Actions toward the Elimination of HIV and AIDS, Tuberculosis and Malaria in Africa by 2030  — and renews its commitment to allocate 15 per cent of individual national African Union State budgets to the health sector. Those actions demonstrate clear and strong African political will to strengthen ownership, accountability and partnerships and to accelerate progress to achieve clear deliverables through financing, access to medicines, treatments and diagnostics, and enhanced governance, in order to help countries build long-term and sustainable solutions. The African Group is concerned that the AIDS pandemic is currently responsible for more than 13,000 deaths every week, undermining efforts to achieve universal health coverage, particularly global health targets and the Sustainable Development Goals. The AIDS pandemic is also colliding with the coronavirus disease (COVID-19) pandemic as the world fails to address the underlying barriers to equitable access to health-care services and remains dangerously underprepared and under-resourced to confront both emerging and existing pandemics. That goes against the main goal of the 2021 Political Declaration on HIV and AIDS, according to which States Members of the United Nations committed to take urgent transformative actions to, among other things, end the social, economic and racial inequalities as well as the restrictive and discriminatory laws, policies and practices, stigma and all forms of discrimination and manifestations, and to achieve commitments that will reduce annual new HIV infections and annual AIDS- related deaths to set targets by 2025. The African Group applauds the achievement of efforts to provide HIV testing in antenatal settings and to advance viral suppression by providing antiretroviral therapy before pregnant women living with HIV deliver their babies, which resulted in greatly improved health outcomes for mothers living with HIV and the reduction by more than half — 54 per cent — of HIV infection among children between 2010 and 2020. Again, HIV testing and treatment coverage among pregnant and breast-feeding women living with HIV is higher than the global average. An estimated 85 per cent globally of women living with HIV were receiving antiretroviral therapy in 2020 to prevent vertical transmission and stay healthy. However, the Group is alarmed that treatment gaps continue to be large in many countries in West and Central Africa, which is home to more than half of the pregnant women with HIV who do not receive antiretroviral therapy and must deal with substandard public health systems, the ongoing imposition of user fees for basic health care services and persistent stigma and discrimination. In addition, the African Group is concerned that sub-Saharan Africa remains the worst-affected region. HIV cases are again increasing in North Africa. The AIDS response continues to fail children and young people in Africa. According to the Secretary-General’s report, six countries in sub-Saharan Africa accounted for nearly two thirds of children acquiring HIV aged 5 to 14 years. Those children are unaware of their HIV- positive status until their immune systems weaken and they become ill. The single-biggest paediatric treatment challenge is finding and linking to care the children who are not diagnosed at birth or during breastfeeding. Unfortunately, AIDS continues to be the leading cause of death for adolescent girls and women aged between 15 and 49 years. The African Group underscores that universal access to life-saving HIV and AIDS treatment, testing, care, support and cure remain paramount in global response strategies and constitute a fundamental human right. Advances in HIV treatment contribute to a longer lifespan. The Group agrees with the finding of the Secretary-General’s report that equity, quality and affordability are among the building blocks of universal health coverage. Key health system functions, especially at the primary care level, should be strengthened to support the effective delivery of HIV health-care services, including access to safe, affordable, efficacious and high-quality medicines, diagnostics and other health commodities, technologies and innovations. In that vein, the African Group believes that innovation is required to produce better, optimized and long-lasting formulations of antiretroviral medicines, vaccines and cures, including effective and affordable treatment for common infections such as tuberculosis, sexually transmitted infections and hepatitis. We are of the view that ending the AIDS epidemic will require the availability of innovative and effective tools without delay. Countries need capacity-building to be able to access available health technologies. In the same vein, global trade and other policies should support health goals and respond to health emergencies, with a particular focus on developing countries. In that regard, the Group is of the view that more efforts should be geared towards achieving a lasting solution to HIV before 2030, including by strengthening HIV vaccine innovation efforts. The African Group applauds the fact that the global uptake of pre-exposure prophylaxis, a valuable additional HIV prevention option for people who are at high risk of acquiring HIV, continued to expand slowly in recent years, despite the challenges created by the COVID-19 pandemic. Unfortunately, much of the scaling-up of pre-exposure prophylaxis is still highly concentrated in a small number of countries. The total number of people using that prevention option in 2020 was just 8 per cent of the 2025 target of 10 million people at substantial risk of infection. The Group reiterates that it is important that pre-exposure prophylaxis prevention be available and affordable to all countries, including those in Africa. Exceptional action is required at all levels to curb the devastating effects of the epidemic. The African Group believes that emphasis should be placed on prevention, advocacy and education on healthy lifestyles. Treatment and innovation of new medicines, including vaccines, should be at the core of our efforts. The African Group reaffirms the need for technology transfer, capacity-building, market access and support to make full use of existing flexibilities within the Agreement on Trade-Related Aspects of Intellectual Property Rights, including by simplifying and strengthening health regulatory procedures. The Group recognizes that poverty and unemployment exacerbate HIV and AIDS. The African Group therefore calls for increased resources to be devoted to HIV and AIDS health-care responses across sectors, including the implementation of the Addis Ababa Action Agenda and the fulfilment of all respective official development assistance commitments, including the commitment of many developed countries to support national strategies, financing plans and multilateral efforts aimed at combating HIV and AIDS and strengthening health systems — especially of the most affected countries — in that regard. The African Group is concerned that stigma and discrimination against people living with HIV and AIDS continue to prevail, which undermines an effective AIDS response. People living with HIV continue to face challenges in all regions of the world, including discriminatory laws, policies and practices that violate human rights and maintain structural conditions that leave patients without access to HIV health-care services. In some instances, people with disabilities are at higher risk of HIV infection because they are vulnerable to violence, sexual abuse and stigma, and discrimination. While there are increasing numbers of people living with HIV to older ages, many HIV health-care services are not equipped to address the needs of the ageing population. Furthermore, displaced persons affected by humanitarian emergencies face heightened exposure to HIV vulnerability risks and limited access to quality health care and nutritious foods. On the other hand, migrants, refugees and asylum seekers living with HIV may face discrimination from States that restrict their entry, enforce mandatory HIV testing or forcibly return them. In some countries, people living with HIV are criminalized and denied health-care services and family-planning measures. In some instances, they are forced or coerced into sterilization or abortion, including facing sexual and gender-based violence, while in others they are refused employment. Those in prison and/or in closed settings are denied HIV treatment. Such discriminatory laws and practices undermine efforts to bring HIV treatment to all who need it. The African Group recognizes that all human rights are universal, indivisible, interdependent and interrelated, and that the international community must treat human rights globally in a fair and equal manner. As such, the Group strongly urges that people living with HIV and AIDS be treated fairly and equally and be protected from stigma, discriminatory practices and related intolerance. The African Group extends its appreciation to States that have enacted laws and lifted travel restrictions on people living with HIV and AIDS. The Group is also grateful to States that offer employment opportunities and HIV treatment to migrants regardless of their migration status, as well as refugees and asylum-seekers. As part of combating new HIV infections, the Group believes that more emphasis should be placed on efforts, including counselling and other means, that encourage people to refrain from using opioids. In Africa, drug use and abuse remain a critical legal matter. Finally, the African Group reaffirms its commitment to fight HIV and AIDS. We believe that zero new infections, zero discrimination and zero AIDS deaths are possible and achievable even before the set deadline. The true outcome of that vision rests on its implementation.

It gives me great pleasure to be a part of this discussion on the remorselessly practical action that our shared political commitment has empowered. Last year in June, Australia, together with our good friends from Namibia, co-facilitated the Political Declaration on HIV and AIDS adopted at the high-level meeting of the General Assembly on HIV/ AIDS (see A/75/PV.74). We acknowledge the Joint United Nations Programme on HIV/AIDS (UNAIDS) for its great work in leading the global effort to support the implementation of the Global AIDS Strategy 2021-2026 and the 2021 Political Declaration. I would also like to thank the Australian Federation of AIDS Organizations, which supported our work and demonstrated that we achieve better results when communities and civil society are at the heart. Since 2002, the world has made impressive gains against HIV. Let me quickly give a few statistics. Globally, between 2002 and 2020, there was a 65 per cent drop in AIDS-related deaths. In my region, the Indo-Pacific region, between 2010 and 2020 there was a 56 per cent drop in AIDS-related deaths. Through the Global Fund to Fight AIDS, Tuberculosis and Malaria partnership, in 2020 some 2.4 million people were provided with antiretroviral therapy, including 34,000 people in the Pacific. Those remarkable achievements are the result of long-term collaborative efforts between people with HIV and their communities, civil society, health professionals and global and regional leaders, including UNAIDS, the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Despite those wins, much more remains to be done. While Target 3.3 of the Sustainable Development Goals captures our ambition to end the AIDS epidemic by 2030, our 95-95-95 goals remain off track. In the Asia-Pacific region, only 75 per cent of people are aware of their HIV status, and of those only 80 per cent are on treatment. The coronavirus disease pandemic has also set back the HIV response, leading to major disruptions to HIV services. There has been an 11 per cent drop in people receiving HIV treatment globally, while the number of people being tested has dropped by 22 per cent. Those statistics represent real people being left behind. We need to upscale efforts in order to make sure that we advance HIV-prevention actions, community- led responses and equitable access to medicines, vaccines and health technologies. We need to do that working with and for communities, key populations and marginalized groups. There are indeed challenges to ending the AIDS epidemic, but it is important that we pause for a moment and commend those who deliver HIV services, who still managed to provide 21.9 million people with antiretroviral therapy in 2020. We should also welcome key innovations such as the Global Fund’s Breaking Down Barriers programme, which has driven a sevenfold increase in results across 20 countries by reducing barriers to health services for key populations. We have the tools to get back on track, and the Political Declaration on HIV and AIDS provides a clear mandate on the way forward to ending the epidemic. However, it will take renewed political and financing commitments by us all. We commend President Biden’s commitment to host the upcoming Global Fund replenishment, to which Australia has provided more than A$920 million since its creation. Australia looks forward to attending the replenishment later this year and to working with all partners to achieve our shared vision to end the HIV epidemic. In conclusion, we need to remember that all we do and say in the General Assembly has meaning only to the extent to which it improves the quality of life of individuals and saves lives.

Thailand wishes to thank the President of the General Assembly for convening this meeting and to thank the Secretary-General for his report (A/76/783). Last year, the General Assembly adopted the Political Declaration on HIV and AIDS against the backdrop of the coronavirus disease (COVID-19) pandemic, which has disrupted health services and set back gains in the HIV response. In the ongoing recovery from the COVID-19 pandemic, HIV remains a serious public health challenge. In that regard, Thailand would like to reflect on a few points. First, ending inequalities, especially by eliminating HIV-related stigma and discrimination, is key to ending AIDS, as called for in recommendation 1 of the Secretary-General’s report. Due to fear of discrimination, many are reluctant to seek HIV prevention, testing and treatment. We must work towards the vision of zero discrimination, including by observing Zero Discrimination Day on 1 March of every year and leveraging the potential of the concept that undetectable is untransmissible or U = U. That is why Thailand joined the Global Partnership for Action to Eliminate All Forms of HIV-Related Stigma and Discrimination as a pioneer country. Secondly, we see positive signs in the report that the COVID-19 response has led to innovative approaches to HIV service delivery, including community-led services. For Thailand, community-led and key- population-led health services have been instrumental in expanding the coverage of HIV services to fill the services gaps of traditional health facilities and promote the right to health, including sexual and reproductive health and rights, while also addressing stigma and discrimination. The Ministry of Public Health provides training and certification to communities, key populations and civil society partners, who then carry out services that are key-population-friendly, along the reach-recruit-test-treat-retain cascade. We therefore support the implementation of recommendation 2 of the report and stand ready to share our experiences. Thirdly, we believe that universal health coverage remains a key tool for enabling access to, and the affordability of, essential health services, including HIV-related services. The integration of HIV services such as pre-exposure prophylaxis into the coverage scheme will help people access comprehensive HIV prevention and treatment early, which in turn will help reduce new infections. Thailand also calls upon Member States to act on recommendation 3 of the report to make full use of the Agreement on Trade-Related Aspects of Intellectual Property Rights and other mechanisms in order to ensure that the latest medicines and health technologies for HIV response are made available and affordable for all low- and middle-income countries. As Chair of the Programme Coordinating Board of the Joint United Nations Programme on HIV/AIDS this year, Thailand will continue to advance the priorities set out in the 2021 Political Declaration and the Global AIDS Strategy. We also hope to receive support from Board members for our proposal to host the fifty-first meeting of the Programme Coordinating Board in Thailand in December. Thailand stands ready to work with all Member States and stakeholders to end inequalities and get back on track to end AIDS by 2030.

Let me thank the President for creating this platform to discuss the progress made and to review the challenges ahead with regard to the 2021 Political Declaration on HIV and AIDS. I believe this will give us the impetus to reassess the progress made and determine the road map towards the ambitious goal of ending AIDS by 2030. Ever since the first known case of HIV/AIDS was reported, we have found ourselves in a race to eliminate this threat to public health. In addition to the biological complexity of the virus, its severity and danger stem from its social repercussions and reception  — as it unequally affected marginalized communities from the early stages — and the social stigma surrounding its transmission. While reiterating our commitment to the 2021 Political Declaration on HIV and AIDS and the preceding declarations — adopted in 2001, 2006, 2011 and 2016  — Sri Lanka is of the view that there is a need for much work to be done to achieve the progress envisioned in the 2021 Political Declaration. We believe that eradicating HIV/AIDS requires not only scientific answers but also a substantial amount of practical work and holistic policy approaches involving a cross-section of society, including State leaders, civic leaders, youth leaders and the persons who are themselves affected by the disease. Action on AIDS has been truly transformational for public health. AIDS has also introduced a new paradigm for the involvement of affected individuals and communities and changed the dynamics among caregivers, the pharmaceutical industry, the public health establishment, international organizations and affected communities. Arguably the most extreme public health issue of our time, AIDS has underscored the imperatives to think and act beyond the confines of the classic public health arena, adopt comprehensive approaches and engage leadership at all levels, even in presenting our response to the pandemic. Building on the early history of political action around other health issues, the experience of the AIDS response  — both the good political action and the challenges of bad politics and denial  — has important lessons for the public health community. Early engagement by political leadership at all levels is, without a doubt, essential to effectively address significant public health issues. Alone, it cannot ensure an effective response, but in combination with community mobilization, a public health apparatus, continuing economic development and innovations in science, it can help bring about advances in even the most challenging health issues. It is a well-known fact that a public health threat has no consideration for gender, race or ethnicity. As such, it is of paramount importance to mobilize global efforts to implement the commitments contained in the Political Declaration, and thereby to reduce the number of AIDS-related deaths to under 250,000 by 2025, generating progress towards the elimination of all forms of stigma and discrimination. The National Sexually Transmitted Disease/AIDS Control Programme of Sri Lanka is carrying out a commendable task in the context of coordinating the national response to HIV and AIDS, in collaboration with national and international stakeholders. Due to its coordinated efforts, Sri Lanka was able to achieve a 57 per cent reduction in new cases and a 56 per cent reduction in AIDS-related deaths, as compared to the 2010 baseline. Sri Lanka also eliminated the vertical transmission of HIV and congenital syphilis beginning in 2020, while there have been zero cases of mother-to- child transmission of HIV since 2017. At present, the number of new cases reported annually is below 200, and the adult prevalence rate for persons aged 15 to 49 years is less than 0.1 per cent. The theme of the 2021 Political Declaration, “Ending Inequalities and Getting on Track to End AIDS by 2030”, is itself challenging, as the whole world is currently building back better from the impact of the coronavirus disease pandemic. The priorities of countries have changed, and so has the allocation of their resources. Therefore, inequalities are prone to occur, and it is incumbent upon all nations to maintain their course and stay on track to a successful realization of the 2030 Agenda for Sustainable Development. We must appreciate that times have changed. Political will is one of the things most vulnerable to change in the AIDS response. Resolutions such as the Declaration of Commitment on HIV/AIDS were adopted when the right elements came together. The document is still there, and the pledges still stand, but the political environment continues to evolve. A constant process of revitalization and coalition-building will be required to build and sustain an exceptional response for many decades to come.

I wish to thank the President for convening this meeting, as well as the Secretary-General for his report (A/76/783) on tackling inequalities to end the AIDS pandemic. I wish to highlight that the report shows that underinvestment in the HIV response of low- and middle-income countries was a major reason that the global targets for 2022 were missed. The report also noted that, although the General Assembly had called for annual investments in the AIDS response of low- and middle-income countries to reach $29 billion by 2025, only $21.5 billion was available in 2021. In that regard, my delegation wishes to reiterate the call for sustainable financing for the AIDS response, as well as other pandemic prevention, since the coronavirus disease pandemic and the response to contain it have disrupted health service delivery. Last year, at the high-level meeting on HIV/ AIDS (see A/75/PV.74), the Philippines reaffirmed its commitment to the 2021 Political Declaration on HIV and AIDS and a global AIDS strategy, based on the following three priorities. The first is the extension of access to HIV prevention, testing and treatment services to homes and communities. The second is the continuous increase of access to HIV prevention through the integration of safe and quality treatment in care services within health-care provider networks. The third is the strengthening of multisectoral support and the enhanced participation of civil society, communities and persons living with disabilities for more inclusive policy development and programme implementation. The rising prevalence of HIV and AIDS cases in the country called for intensified measures. We have enacted the HIV and AIDS Policy Act to ensure non-discriminatory access to HIV and AIDS-related services by eliminating the climate of stigma and discrimination that surrounds the country’s HIV and AIDS situation, especially against people living with HIV and those directly and indirectly affected by it. Health services for HIV and AIDS are accessible, including for adolescents aged 15 to 18 years old, who can now undergo HIV testing without the consent of a parent or guardian. The Universal Health Care Act was also enacted to ensure that all Filipinos are guaranteed equitable access to quality and affordable health- care goods and services, including much-needed HIV services, without causing financial hardship. The Philippines will continue to work and contribute to our shared commitment to end the AIDS epidemic and pursue the best possible outcomes for persons living with HIV and vulnerable populations.

South Africa aligns itself with the statement delivered by the representative of Namibia on behalf of the Group of African States. As we commemorate the anniversary of the adoption of the 2021 Political Declaration on HIV and AIDS, South Africa remains committed to the attainment of universal health coverage. Our instrument for universal health coverage, the national health insurance bill, is currently under consideration by our Parliament. The coronavirus disease (COVID-19) pandemic has shown the urgency of implementing universal health coverage globally. The COVID-19 pandemic has affected the provision of other health services, including those for the treatment of HIV and AIDS in many countries. As the report of the Secretary-General (A/76/783) shows, the COVID-19 pandemic put a strain on health systems in general. Its socioeconomic impact reduced the fiscal space of countries, and in some countries led to elevated levels of indebtedness. In turn, that meant a reversal of years of progress in the provision of services to populations with HIV and AIDS as well as tuberculosis. The COVID-19 pandemic also aggravated inequalities and had negative impacts on gender equality and women’s empowerment. The scourge of gender-based violence rose in most countries. Food insecurity also saw people living with HIV facing increased malnutrition. It should be a matter of concern for all of us that HIV infections and AIDS-related deaths worldwide are not declining fast enough to end the HIV/AIDS pandemic by 2030. We also learned from the Secretary- General’s report that funding continues to be a common resource gap. Societal barriers such as discriminatory laws, gender inequalities and lack of respect for human rights also slow progress. Those challenges notwithstanding, we also know which interventions work. HIV testing and treatment are effective. Evidence-based HIV prevention reduces incidence and cases. Comprehensive sexuality education promotes health and well-being and contributes to the broader growth of young people. A key lesson of the COVID-19 pandemic has been the efficacy of integrating HIV services with the treatment of other diseases. All the strategies I mentioned have been integral to South Africa’s response to HIV and AIDS. We are currently implementing a national strategic plan for the period 2017 to 2022, which is our road map for eliminating the HIV pandemic in our country. Our strategic plan is based on our national development plan and is informed by the core principles of our Constitution, including respect for human rights, human dignity, non-racialism, non-sexism and the rule of law. Given the high number of people living with HIV in our country, we currently have the largest antiretroviral treatment programme in the world. We have witnessed the proven benefits of antiretroviral treatment in longer life spans in affected populations and reduced HIV- related morbidity rates. We are still concerned at the continued spread of HIV infections among our young people, especially girls. We therefore continue to advance a multisectoral response to AIDS that is grounded in human rights principles and equal access. That includes the scaling up of economic empowerment of young women and girls and ensuring that they have access to sexual and reproductive health services, as well as comprehensive sexuality education that is free of stigma and discrimination. Our policy is currently to provide treatment for everyone who tests positive in order to achieve viral suppression and reduce transmission. South Africa was the first country on the African continent to approve the use of pre-exposure prophylaxis, which has been key to our prevention programme. On the 90-90-90 cascades, by June 2021 South Africa had a score of 93-76-89. That means that, while we are doing well with the first 90, we still have to improve our strategies to ensure that we initiate patient treatment and keep patients on treatment until they are virally suppressed. We are currently implementing innovative strategies to ensure that we reach the 95-95- 95 targets by 2025. Stakeholder and community engagement have been key to South Africa’s HIV and AIDS programme. We recognized early on that the affected populations, civil society and community-based organizations needed to be central pillars of our response system. Community organizations, for example, can help break some of the barriers caused by traditional laws and cultural stigmas. South Africa continues to make significant investments to fight HIV and AIDS using our own domestic resources. We also appreciate the continued investment in our country by the Global Fund to Fight AIDS, Tuberculosis and Malaria. Since 2003, the Global Fund has made available $1.3 billion to South Africa and has increased its allocation for the period 2022 to 2025 to $546 million, up from $369 million for the period 2019 to 2022. South Africa will honour its own financial commitment to the Global Fund during the current replenishment period. We continue to call for flexibilities in the Agreement on Trade-Related Aspects of Intellectual Property Rights in order to enable the local production of medical commodities and encourage technology-sharing mechanisms to meet public health objectives. The experience of the COVID-19 pandemic has shown us the importance of equitable access to health technologies and medicines. We therefore concur with the Secretary-General’s report that health technologies for HIV prevention, testing and treatment, including a future HIV vaccine, should be rapidly made available and affordable for all low- and middle-income countries.

I thank the President for convening this very important meeting, which creates a platform for reviewing progress and sharing perspectives on the implementation of the Declaration of Commitment on HIV and AIDS and the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. My delegation takes note of the report of the Secretary-General (A/76/783) and hails the progress made in addressing HIV/AIDS, especially in the most affected regions, including sub-Saharan Africa and the Caribbean. However, it is concerning that HIV infections and AIDS-related deaths are not declining fast enough to end the pandemic by 2030. With eight years to go, the fact that more than 13,000 people still die weekly because of HIV/AIDS makes it imperative for all of us to take urgent actions against the challenges that are slowing progress towards global targets. In that regard, allow me to share efforts by the Government of Liberia to implement the Declaration of Commitment on HIV/AIDS and the Political Declaration on HIV and AIDS. Liberia’s approach to addressing the HIV/AIDS pandemic is characterized by persistent efforts in strengthening collaboration with local and international partners, research and assessments to determine the trend of the pandemic and in exploring ways to mobilize resources domestically. Strategically, emphasis has been placed on interventions for key population groups. Under the stewardship of the National AIDS Commission, Liberia continues to make steady progress in its commitments in terms of reducing new HIV infections and AIDS-related deaths, reducing mother-to-child transmission and increasing access to antiretroviral treatment. A Spectrum 2020 assessment estimates that 35,000 persons are living with HIV in Liberia. Annual new infections are at 1,400, while annual AIDS-related deaths stand at 1,300; 85 per cent of pregnant women who need antiretroviral treatment are on treatment. The availability of prevention of mother-to-child transmission centres across the country offering counselling and testing to pregnant women has greatly contributed to that result. Primary HIV prevention remains a central component of Liberia’s AIDS response strategy. Liberia has scaled up HIV combination prevention for both the general and key populations, with pre-exposure prophylaxis now rolled out nationwide. We have updated HIV testing guidelines to include index testing and self-testing. We have also updated treatment protocols to include multi-month dispensing and differentiated drug dispensing. Building on those successes, Liberia joined the Global Partnership for Action to Eliminate All Forms of HIV-related Stigma and Discrimination in 2021 and developed and launched its Zero Discrimination Action Plan with the aim of accelerating the implementation of commitments made to end HIV-related stigma and discrimination. The plan focuses on six priority areas: health, households and communities, legal aid and justice, education, the workplace, and humanitarian settings. To that end, and with the support of partners, including the Joint United Nations Programme on HIV/ AIDS, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the United Nations Development Programme, the United States Agency for International Development and the United States President’s Emergency Plan for AIDS Relief, Liberia is implementing the following: an assessment of the legal environment to determine discriminatory laws and holding consultative meetings with strategic stakeholders, such as legislators, Cabinet ministers, religious and traditional leaders, developing the necessary policies to ensure that persons living with HIV and key and vulnerable populations have access to justice and can challenge rights violations, ensuring zero denial of health services based on perceived or positive HIV status, reducing the incidence of sexual and gender-based violence and holding consultative meetings with opinion leaders on the issue of stigma and discrimination against persons living with HIV. While we have made progress, challenges remain. Our response efforts are impeded by inadequate funding, a weak supply chain management system and a struggle to retain people living with HIV on care. Other challenges include poverty, resulting in inadequate nutrition, and not having prompt access to medical facilities due to long distances to travel. Despite those challenges, the Government of Liberia remains resolute and committed to the global effort to rid the world of this scourge by 2030. We encourage the consistent galvanization of financial resources to bolster efforts to achieve our global objective.

The fight against AIDS is an objective that we all share. The international community has the resources, the technology and the knowledge necessary to obtain better results against this and many other diseases. However, the lack of political will prevents that. Millions of dollars are devoted to irrational military spending, while millions of people lack access to quality health care and medication. The coronavirus disease pandemic has had an impact on the health systems and economies of all countries and has worsened inequality in terms of access to health in many of those countries. The response to the pandemic should not lead us to overlook efforts to fight HIV/AIDS. In that context, which has been particularly complex for developing countries, we need greater cooperation and international solidarity to ensure global success in combating HIV/AIDS. We need to move forward on implementing the Declaration of Commitment on HIV/AIDS and the political declarations on HIV/AIDS adopted by the General Assembly. We reiterate Cuba’s commitment to United Nations efforts in the fight against this disease, under the leadership of the Joint United Nations Programme on HIV/AIDS. We will also continue to guarantee the enjoyment of the right to health of our people and contribute to global and regional responses in order to put an end to the HIV/AIDS epidemic. One part of our modest contribution to the achievement of that goal is the effective national response to the disease, which begins with the primary care public health system. Cuba takes a public health approach to tackling the HIV/ AIDS response, which is part of our people-centred primary care system and also includes intersectoral participation with a focus on key populations, while addressing the specific needs of every group. AIDS-related deaths are gradually declining in our country, and its incidence is showing a stabilizing trend. One of the positive indicators is that people under the age of 15 are practically not affected by the epidemic. In 2015, Cuba became the first country to eliminate the transmission of HIV and syphilis from mother to child, something for which we received the support of the World Health Organization, and which was revalidated in the years 2017 and 2019. Our programme for antiretroviral treatment, prevention and diagnosis contributed to that. About 2 million serology tests are conducted every year, including more than 300,000 tests for pregnant women, with coverage of screening services and antiretroviral treatment in excess of 99 per cent. We have also achieved a high coverage of treatment, and we make efforts to reduce the circulating viral load and to increase therapeutic adherence, coming close to the level of 90-90-90. Those results have not been easy to attain. In order to achieve them, Cuba has had to overcome its condition as a small developing State, as well as the adverse impact of the criminal economic, commercial and financial blockade imposed by the United States of America for more than six decades, which was intensified opportunistically and inhumanely during the time of the pandemic. In the first seven months of 2021, the blockade by the United States resulted in losses of $2.57 billion for Cuba, which represents more than $375 million per month, or $12 million per day. In the health sector, the one most affected by the blockade, the losses during that period exceeded $113 million. How much more access to health could Cuba have provided for its people, including in the area of HIV/AIDS, were it not for the loss of those resources? The blockade also makes it difficult to carry out projects financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria, which is managed by the United Nations Development Programme and provides medication, antiretrovirals and laboratory equipment that benefit people of all ages who live with HIV/AIDS. For example, and as acknowledged in the relevant report of the Secretary-General (A/76/405), in 2020 it was not possible to approve a purchase order with the provider Mylan Laboratories because the bank would not accept payment for antiretroviral drugs with Cuba as the beneficiary country. That meant that another provider had to be used and the procurement of those drugs, which are essential for HIV services in the country, was delayed. However, nothing will stop us building a society that is increasingly just and inclusive, including for people who live with HIV/AIDS. We will continue to make extraordinary efforts to guarantee a better quality of life for those people and to gradually diminish infections. The real solution to HIV/AIDS and many other diseases will depend on joint action, international cooperation and solidarity. Cuba will continue to defend multilateralism as the only way to resolve the major challenges we face as the international community, including HIV/AIDS.

At the outset, I would like to thank the President of the General Assembly for convening this first annual meeting to review the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, which was adopted in June 2021. My delegation takes note of the report of the Secretary-General (A/76/783) and the recommendations therein. Zambia aligns itself with the statement delivered by the representative of Namibia on behalf of the Group of African States. The global community, including Zambia, has been ravaged by the devastating impact of the coronavirus disease (COVID-19) pandemic over the past two years. The response to HIV has not been spared. The COVID-19 health crisis has greatly increased the risks faced by my people living with HIV. For instance, the pandemic has caused shortages and disruptions of the global supply chains for important commodities and supplies that are required for the HIV response. In addition, the health workforce to fight HIV has been depleted, either through COVID-19-related sicknesses and deaths or through the redistribution of some health professionals to fight the pandemic. Health- care delivery for HIV preventive and treatment services has seen a negative effect. Services for HIV have been scaled down in order to focus efforts on the COVID-19 response and reduce COVID-19 transmission. In addition, laboratory HIV services, including viral testing platforms, saw competition from COVID-19- related demands, which resulted in reduced coverage. We have also seen disruptions in HIV drug testing. Despite that, the HIV programme has shown resilience. The Zambian Government, through the Ministry for Health and working with all relevant partners, has developed innovative approaches and interventions that have allowed it to navigate the pandemic so far. The Zambian Government is in the process of developing a new HIV strategic framework for the next five years and is making efforts to ensure the domestication of the new HIV/AIDS global strategy. Furthermore, the eighth national development plan, which is currently under preparation, has integrated HIV as a strategic area, focusing on four areas: protecting gains with respect to the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95- 95 targets, breaking barriers, particularly stigma and discrimination, accelerating prevention, including the elimination of mother-to-child transmission of HIV, and health financing to increase domestic funding. Allow me to take the opportunity to mention that, as of today, 90 per cent of people living with HIV in Zambia know their HIV status, while 98 per cent of those are on antiretroviral therapy and 96 per cent have achieved viral load suppression. In the past 12 months, we initiated antiretroviral therapy for more than 180,535 individuals, bringing the total number of Zambians on antiretroviral therapy to 1.2 million. In the wake of the COVID-19 pandemic, we have developed key innovations to sustain the gains attained in the fight against HIV and AIDS, including by scaling up multi-month dispensation of antiretrovirals from 45 per cent to 80 per cent, which has resulted in the decongestion of antiretroviral therapy facilities, the reduction of COVID-19 infections among people living with HIV and the reduction of patients stopping antiretrovirals from about 15 per cent to 8 per cent. The Government has also incorporated the provision of COVID-19 vaccines to people living with HIV in antiretroviral therapy spaces. We have continued to provide essential health services even as we make adjustments from the traditional means of service provision to newer adopted methods that comply with COVID-19 prevention methods. The Zambian Government has embarked on a health decentralization agenda in order to achieve universal health coverage. It is hoped that, through that commitment, health needs will be addressed at the local level. To that end, the Government has placed a premium on human resources for health, and is therefore significantly scaling up the number of health- care workers. We remain committed to ensuring commodity security for antiretroviral drugs and allied commodities to support the HIV response. The Government has, for the first time, exceeded its pledge for antiretrovirals for the year 2022, from $15 million to $18 million. The Government will increase the budgetary allocation for antiretroviral drugs for the year 2023 as well. There are also various considerations for broadening the resource envelope from domestic resources. We believe that those efforts will slowly move the country towards the sustainability of the HIV prevention, treatment, care and support agenda. In conclusion, despite those efforts, we continue to face challenges, such as the increase in new infections, especially in adolescents, girls and young women. The threat of donor fatigue in sustaining the gains beyond HIV pandemic control is also a real issue and needs to be addressed. The hallmark of our leadership is fiscal discipline and the prudent use of resources. On our part, we will ensure that every dollar that is given reaches its intended beneficiary. However, stronger commitments and collaborations are also needed as Governments continue to make progress towards efforts aimed at increasing domestic financing.

The fight against HIV/AIDS showcases the impact the international community can have if we all join forces. We are encouraged by the shared commitment to the 95-95-95 testing, treatment and viral suppression targets, as well as the most recent data in the report of the Secretary- General (A/76/783) on their implementation. Today 84 per cent of people living with HIV globally know their serostatus, of whom 87 per cent are accessing antiretroviral therapy and 90 per cent have suppressed viral loads. In addition, the availability of pre-exposure prophylaxis for particularly vulnerable populations has been scaled up significantly in recent years. Despite achievements in many parts of the world, the international response to HIV/AIDS is also a reminder of how fragile progress can be if we fall back into complacency or lose sight of our goals. The coronavirus disease pandemic continues to place a heavy strain on public health systems and to disrupt HIV prevention, testing and treatment services across the globe. Our concerted efforts to end one pandemic should not come at the expense of our decades-long commitment to end another. Instead, to effectively address those pandemics and prevent future pandemics, we must strengthen public health systems in line with Sustainable Development Goal (SDG) 3 and promote effective, accountable and inclusive institutions in line with SDG 16. We must also remind ourselves that the fight against HIV/AIDS is not only about our health and well-being but also about human rights and fundamental freedoms. One year ago, the General Assembly responded to this particularly challenging moment for the global fight against HIV/AIDS by adopting a political declaration on ending the inequalities, including those based on race and gender, that limit progress towards an AIDS- free world by 2030. For our efforts to be successful, it is indeed crucial to remove societal barriers to services for those communities in greatest need. Discriminatory laws targeting the LGBTIQ populations in many countries remain an obstacle to effectively addressing the pandemic. The economic and social marginalization of groups at higher risk of HIV infection, such as people who inject drugs, sex workers, prisoners, transgender people and men who have sex with men, often prevent them from fully enjoying their fundamental freedoms and human rights, above all the right to health. Women and girls are still disproportionally vulnerable to the pandemic. Their particular situation must be considered, and their special needs must be met. That also includes their social and economic empowerment, equal access to quality education, including comprehensive sexual education, as well as full, equal and meaningful participation in decision-making processes. We express our support for the recommendations of the Secretary-General and commend his staff for their tireless work to translate the 2021 Political Declaration on HIV and AIDS into reality. The guidance and leadership of the Joint United Nations Programme on HIV/AIDS (UNAIDS) have been pivotal for our collective action, as has the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria and relevant civil society organizations. Since 2007, Liechtenstein has made regular financial contributions to UNAIDS, and we aim to continue our support. By investing in prevention, we have the best chance to create sustainable results in the long-term and to eradicate HIV/AIDS once and for all.

Since we gathered last June for the high-level meeting on HIV and AIDS (see A/75/ PV.74), the compounding crises of conflict, climate and the coronavirus disease (COVID-19) have combined to impact most severely the world’s most marginalized people. As we deliberate on the international actions needed to reduce the spread of HIV/AIDS and support people living with HIV and AIDS, Canada sees three priorities for the international community. First, we must remain laser-focused on living up to our commitments. That starts with Sustainable Development Goal 3 and our collective commitment to end the epidemic of AIDS by 2030. In the face of a large number of competing demands, that promise we made requires that we keep HIV and AIDS at the forefront of our global efforts. Last year’s Political Declaration on HIV and AIDS, which enjoyed overwhelming support in this very Hall, also made a number of commitments to which we must hold ourselves accountable. In it, we pledged that, by 2026, 95 per cent of people in humanitarian settings at risk of HIV will use appropriate, prioritized, people-centred and effective combination prevention options in order to eliminate gender inequalities and gender-based abuse and violence, as well as to increase the capacity of women and adolescent girls to protect themselves from the risk of HIV infection. We must ensure that those commitments are not simply words on a page but that they force increased attention and real policy change in our countries. The second priority is the need to be guided by evidence. We know all too well that people facing multiple and intersecting forms of discrimination are most at risk from HIV. We know all too well that people-centred HIV services grounded in human rights are the most effective way to improve health and life outcomes for people living with and affected by HIV. And we know all too well that gender inequalities continue to drive the disproportionate number of adolescent girls and young women who are being infected with HIV. It is worrisome that an alarming number of girls have not returned to school after COVID-19 lockdowns, which risks threatening decades of progress made towards gender equality. For many girls, school is more than just a key to a better future. It is a lifeline. In fact, evidence confirms that girls — and their communities and countries — reap multiple social and economic benefits from their continued schooling: reduced vulnerability to acquiring HIV and becoming child brides and teenage mothers, while increasing their prospects for securing jobs and higher incomes as adult women. This is about enrolment, but we also must ensure that girls are accessing high-quality education, which includes comprehensive sexuality education and the knowledge necessary to fulfil their sexual and reproductive health and rights, including their right to bodily autonomy, their right to contraception and their right to safe abortion. Another area where we must follow the evidence relates to substance use, which can increase the risk of acquiring HIV. In my country, Canada, we have lost nearly 30,000 people to overdose deaths since 2016, and evidence shows that the COVID-19 pandemic has contributed to an already deadly overdose crisis. In that context, we know that addressing the health and safety harms of substance use must be seen as a pressing and complex health issue  — not a criminal one. The COVID-19 pandemic has greatly exacerbated the everyday reality of people who use substances and those who support them. Moving forward, policies and practices to prevent, treat or reduce harms from substance use must be based on timely and accurate evidence. That is why my Government has taken a number of steps to increase access to health and social services for people who use drugs and reduce the stigma and harms related to substance use. We have also developed national standards for mental health and substance use services in order to provide an evidence-based framework for service delivery. To put it simply, we are treating substance use as a health issue, because the evidence in my country shows that stigma serves as a barrier against accessing important health and social services, including treatment that can help save lives. The evidence on all of that is clear. What is required is the political will to follow the evidence in order to reduce harm and save lives. The third priority is to maintain our momentum. Canada urges every Member State here to make brave political decisions that prioritize the lives of the most vulnerable when designing local, national and international health interventions. We must also seize on international moments to continue to bring attention to the HIV/AIDS epidemic and hold ourselves accountable for fulfilling our promises. In that spirit, Canada is proud that it will host the AIDS 2022 Conference in Montreal from 29 July to 2 August. We hope to see many Member States there as we explore the data and evidence, which show that inequalities are driving the HIV/AIDS epidemic, and as we share solutions for reducing those inequalities and expanding the reach of treatment and services. We also express our thanks to the Government of the United States for hosting the upcoming replenishment of the Global Fund to fight AIDS, Tuberculosis and Malaria, and we encourage all Member States to do their part to ensure a successful replenishment of that important international partner.

Kenya aligns itself with the statement delivered by the representative of Namibia on behalf of the Group of African States. We thank the Secretary-General for his report (A/76/783) on tackling inequalities to end the AIDS pandemic. One year ago, Member States adopted the 2021 Political Declaration on HIV and AIDS. We must keep our commitments on track. Consistent and relentless reviews of progress are key to effectively fighting the scourge. We globally recognize that HIV/AIDS remains one of the world’s significant public health concerns. Moreover, HIV disproportionately impacts the most vulnerable members of our society: the poor, the marginalized, children, women, adolescents and young adults. As highlighted in the Secretary-General’s report, efforts to end the AIDS pandemic by 2030 face programmatic challenges due to the onslaught of the coronavirus disease pandemic, which adversely affected many populations  — especially those living in sub-Saharan Africa, other least developed counties and small island developing States — facing obstacles in accessing necessary preventive and life-saving HIV/ AIDS health-care services. That underscores the need to speed up action towards meeting our goals and the commitments set. Renewing our commitment to end AIDS requires strengthened multilateralism and stronger collaborative efforts to increase awareness, enhance resources and bulk up finances for HIV prevention and treatment, especially among vulnerable young people, such as women and girls. Addressing social enablers, in particular protecting people living with AIDS from stigma and discrimination, is key. Kenya has adopted a people-centred, data-driven and multisectoral approach to the HIV/AIDS pandemic. We have implemented the second phase of the national AIDS strategic framework in order to provide accelerated progress towards a Kenya free of HIV infections, stigma and AIDS-related deaths. Great focus has also been placed on HIV education and awareness, as important components of HIV prevention. We commend community-led efforts to address HIV/AIDS, as highlighted in the Secretary-General’s report. In Kenya, community groups have carried out awareness-raising and delivered antiretroviral medicine and HIV self-testing kits to people’s homes and community distribution points. Kenya also heeds the Secretary-General’s call for sustained financing to close the widening gaps in the AIDS response. We also call for technology transfer and flexibility in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding HIV/ AIDS prevention treatment, testing and cure. Also required are unhindered access to medicine in developing countries and a scaling up of community education efforts, capacity-building and research. As a champion of universal health coverage, Kenya concurs with the Secretary-General’s reports that fulfilling all the commitments in the Declaration will also contribute to broader efforts to reduce inequalities, prepare for future pandemics, achieve universal health coverage, including HIV/AIDS health services and medicines, and achieve the other Sustainable Development Goals (SDGs). We must act now to combat the HIV/AIDS pandemic and invigorate more concerted efforts. We can do so by building on synergies between our global AIDS response and our efforts to achieve universal health coverage as well as the implementation of the other relevant SDGs. In conclusion, I affirm Kenya’s steadfast commitment at the highest level to continue collaboration in the fight against HIV and AIDS and the full and effective implementation of the 2021 Political Declaration on HIV and AIDS.

Let me begin by thanking the Secretary-General for his report (A/76/783), which provides an insightful and informative update on the global fight against HIV/AIDS. While significant progress has been made in the fight against HIV/AIDS, challenges still remain on our path towards eliminating HIV/AIDS as a public health threat by 2030, as set out in the targets of Sustainable Development Goal (SDG) 3. Strong political leadership is most critical for addressing inequalities and gaps in AIDS epidemic response. During the coronavirus disease (COVID-19) pandemic, India took swift and timely action by involving communities, civil society and development partners in order to mitigate the impact of the COVID-19 pandemic on HIV services. In India, the HIV and AIDS Prevention and Control Act of 2017 covers a legal and enabling framework to safeguard the human rights of infected and affected populations. India’s unique HIV prevention model is centred on the concept of social contracting, through which the targeted intervention programme is implemented with support from civil society. The programme aims to bring ab out behaviour change, communication, outreach, service delivery, counselling and testing, and ensuring linkages to HIV care. India is providing free antiretroviral treatment to close to 1.6 million people. Indian drugs are also reaching millions of people living with HIV in Africa. India’s national AIDS control programme has been revived and revamped to focus on hard-to-reach and at- risk populations. We are gradually transitioning people living with HIV to dolutegravir, a safer and efficacious antiretroviral medication regimen. Viral load testing facilities have been scaled up and HIV counselling, testing and community-based screening for early diagnosis have been ramped up to achieve the target of the elimination of mother-to-child transmission of HIV. In 2021, the national AIDS control programme reached almost 8 million high-risk and vulnerable population members with a comprehensive package of targeted peer-led prevention services through revamped interventions. In the same period, more than 43.1 million HIV tests were undertaken among high- risk groups, other vulnerable populations and pregnant women. Communities have always been at the centre of the national AIDS control programme response and considered equal partners, with key contributions that include initiatives such as community-based HIV screening and multi-month dispensation of antiretroviral drugs. We are ensuring uninterrupted delivery of services to the last mile. In India, the latest HIV estimates have revealed that annual new HIV infections declined by 46 per cent between 2010 and 2021, signifying the tremendous impact of prevention efforts. Similarly, AIDS-related deaths have declined by almost 76.5 per cent in the past decade. In that decade, we witnessed the remarkable impact of a very comprehensive and holistic national AIDS response. In 2021, there were about 1.6 million people living with HIV on antiretroviral treatment in the country — the highest number since the launch of antiretroviral treatment under the national AIDS control programme in 2004. People living with HIV receive lifelong access free of charge to the most advanced dolutegravir-based regimen, which significantly improves the quality of life. We have to achieve zero new transmissions of HIV in order to deliver on the promise of ending AIDS in the next 10 years. We need to foresee and identify all challenges and gaps, customize our programmes, share knowledge and emulate best practices. Let me reiterate India’s commitment to strengthening international cooperation in our common fight against HIV. India is ready to intensify cooperation with all partners, including the World Health Organization, in order to achieve the Sustainable Development Goal of ending HIV as a public health threat by 2030.

One year after the adoption of the Political Declaration on HIV and AIDS, which was strongly supported by Argentina and in which States reaffirmed the commitment already conveyed in the 2030 Agenda for Sustainable Development to accelerate the fight against HIV and put an end to the AIDS epidemic by 2030, we have the opportunity to take stock of the successes achieved and the challenges that remain. Argentina believes that, in order to end the HIV epidemic by 2030, we must address inequalities and inequities, put people and communities at the centre of the response, mobilize resources and financing, promote gender equality and the right to bodily autonomy, guarantee sexual and reproductive rights and empower women and girls in all their diversity. In doing so, we must address the impact of the coronavirus disease pandemic and learn from that experience to better prepare for future emergencies. Member States must continue working to guarantee equitable access to HIV prevention, diagnosis, treatment and care. To that end, it is essential to implement an approach based on human rights and gender equality in order to end that disease as a threat to public health, while guaranteeing respect for the dignity of people living with HIV. It is also essential to take into account the needs of all those identified as key populations, that is, those in a situation of vulnerability and with less access. Those populations are especially vulnerable, not only to the virus itself but also to multiple forms of discrimination, stigmatization, violence and exclusion based on their age, disability, economic status, sexual orientation and gender identity, among other things. Working to reduce stigma, discrimination and criminalization is one of the main areas in which Member States must concentrate their efforts. We must put people and populations at the centre of the response. In Argentina, a new draft law on HIV, viral hepatitis, sexually transmitted infections and tuberculosis is under discussion. Civil society organizations of people with HIV and the key populations I mentioned actively participated in the drafting of that law, which represents progress towards achieving comprehensive rights-based answers. My country has also prioritized interventions to reduce new infections and AIDS-related deaths, eliminate new HIV infections among girls and boys and facilitate access to treatment. Work is also being done to expand the combined prevention strategy and eliminate new cases of the vertical transmission of HIV, syphilis and viral hepatitis. Argentina participated constructively last year in the negotiations leading to the adoption of the Political Declaration. It is especially important that it took into account the issues of gender equity and sexual and reproductive health rights. In that regard, we will continue to support the adoption of global strategies against HIV and other sexually transmitted infections for the period 2022 to 2030. We share the belief that Member States need to renew efforts to achieve the Sustainable Development Goals set out in the 2030 Agenda and eradicate the HIV epidemic by that time.

The Kingdom of Saudi Arabia ensures the provision of health care and protection for all its citizens and residents, including people living with HIV/AIDS. My country has spared no effort to promote the health of both individuals and society through its preventive and therapeutic programmes to combat HIV/AIDS, in particular to combat stigma and discrimination and safeguard the rights of those infected. It also protects young people, women and children from contracting the disease. In 1994, the Kingdom of Saudi Arabia established a national programme to combat HIV/AIDS, which set up a central national unit and 20 other units spread throughout the Kingdom. That programme also provides services to prevent the transmission of HIV, in addition to providing health care, including medical treatment and psychosocial services. The programme is responsible for raising social awareness of HIV, including among mothers and children. It also launches continuous awareness campaigns to achieve the Sustainable Development Goals. The centre works to increase social awareness and provides policies and services such as therapeutic guidelines, counselling services and voluntary screening in fixed and mobile units. One of the most important reforms targeting people living with HIV in the Kingdom of Saudi Arabia was the enactment in 2018 of a regulation to protect people from HIV/AIDS and ensure the rights and duties of those infected. The provisions of that regulation include safeguarding the rights of those infected and their contacts; ensuring the necessary care and rehabilitation of patients; guaranteeing their rights to continue education and work; and obliging health authorities to provide them with health care, counselling and psychological support, while respecting their rights, combating HIV/AIDS, providing information on its means of transmission, prevention and treatment and raising awareness about it. Article 6 of the regulation prohibits forcing pregnant women with HIV/AIDS to have abortions or depriving them of child custody or care. It also emphasizes the need to provide health care to the pregnant woman and foetus. Although the Kingdom of Saudi Arabia has one of the lowest rates of HIV/AIDS infection, its laws and regulations prohibit actions that discriminate against people living with HIV or that deprive them of their rights or degrade or exploit them because of their infection status. Such actions are considered a crime punishable by law in the form of a fine, imprisonment or both. Infected persons can also claim compensation. My country reaffirms its commitment to developing and implementing national plans and legislation to protect the rights of its citizens and residents and to provide them with care. My country also supports regional and international strategies for eliminating HIV/AIDS by 2030, in line with its legislative and national frameworks and its religious and cultural values.

Nicaragua welcomes the holding of this debate to address the achievements and challenges related to the implementation of the commitments made by Member States in the fight against HIV/AIDS and the political declarations on HIV/AIDS. We must intensify joint efforts aimed at increasing investments in order to improve public health systems, strengthen multilateralism and solidarity worldwide and improve the treatment of this disease. We must also take effective actions that are based in science and scientific innovations if we are to reach the goal of ending inequalities and be in a position to end HIV/ AIDS by 2030. With all the challenges that our country has been dealing with as a result of the illegal, unilateral and coercive measures imposed on our peoples, and now aggravated at the global level by the coronavirus disease (COVID-19) pandemic, our Government of Reconciliation and National Unity has always guaranteed free access to health services for the entire Nicaraguan population. Through its national institutions, Nicaragua is working on a policy framework aimed at young people and adolescents, with the objective of decreasing the disease’s rates of infection, raising awareness and promoting responsible health behaviour in our young people and general population. We also have the Nicaraguan AIDS Commission, which is leading our coordinated approach to the HIV response, along with our law on promoting, protecting and defending human rights in the context of HIV and AIDS, which is aimed at preventing and treating HIV/ AIDS, as well as a national strategic response plan on sexually transmitted diseases and HIV. In order to guarantee the rights of people living with HIV, our Ministry of Health has made progress in providing quality care and delivery of free treatment for all, in addition to any needed further testing. We have 105 comprehensive-care clinics nationwide guaranteeing access to the right to dignified health care for the approximately 6,200 Nicaraguans who are receiving antiretroviral treatment. Eighty-four percent of that treatment is financed directly through the Government budget. Nicaragua has an Ombudswoman for Sexual Diversity who monitors, evaluates and assesses compliance with respect for the human rights of these populations and of people living with HIV. Emotional care programmes at psychosocial care centres are also being implemented through our Ministry of Health, with a focus on work in the area of emotional and mental health, in order to provide adequate psychological support, especially for people newly diagnosed with HIV/AIDS. Our Government once again reaffirms its full commitment to continuing efforts aimed at improving the quality of life of Nicaraguans living with HIV/AIDS and guaranteeing the fundamental right to health for our entire population in general. In conclusion, we have a reflection and a request that we want to share. The first cases of individuals diagnosed with HIV/AIDS were recorded in 1981. That was more than 40 years ago, and yet there is still no effective vaccine against HIV/AIDS. Amazingly, a vaccine for COVID-19 was created within one year of the disease’s appearance. It is therefore a legitimate request to ask to see the same effort made to end HIV/ AIDS as soon as possible.

Mexico would like to thank the President for holding this meeting. We have been convened to discuss a global public health challenge that has continued to afflict us for more than 40 years. The human immunodeficiency virus has been advancing in communities every year, a trend that is due not to stronger mutations of the virus but rather to profound inequalities that impede access to health services. One year after the adoption of the Political Declaration on HIV and AIDS, HIV infections are not declining fast enough. Although the worst-affected regions have seen significant declines, Latin America and the Caribbean, my region, has made little progress. This is not a small challenge. In Mexico, 340,000 people are estimated to be living with HIV, of whom seven in 10 are aware of their diagnosis and six in 10 are receiving antiretroviral treatment. Our efforts must focus on closing the inequality gaps that increase the risk of contracting the disease. We should be focusing on the vulnerable populations that suffer from the greatest inequality and multiple and intersecting forms of discrimination, and whose members are stigmatized because of their risk of contracting HIV. Those key population groups, such as men who have sex with men, trans women, vulnerable cis women, sex workers, people who inject drugs, persons deprived of their liberty, indigenous people and migrants, among others, are the ones we must prioritize to effectively respond to both the epidemic and pandemic. Mexico agrees with the conclusion in the report of the Secretary-General (A/76/783) that comprehensive sexuality education, with a gender-transformative approach, is essential to the prevention of HIV and all sexually transmitted infections. The goal is to strengthen responsible citizenship, thereby promoting the health, well-being and critical thinking skills of young people. Such initiatives can help us prevent gender violence, increase the use of contraceptives and reduce the number of irresponsible sexual partners. Comprehensive sexuality education empowers young people and therefore all of society. Empirical data shows that this education is central in getting them to make responsible and healthy decisions. In the same context, Mexico considers prevention essential. We have promoted public policies with combined prevention strategies. For example, we have launched programmes aimed at key populations while also training health personnel, with both approaches focused on community prevention while providing care to people living with the virus. In line with international best practices, we pay special attention to the populations most at risk. In 2021 we developed a new model for achieving the global goal of avoiding cases of vertical transmission that is also applicable to syphilis, based on five essential pillars — timely access to diagnosis and treatment, rapid-response brigades, connection and support, tracking and monitoring and the creation of a monitoring mechanism for the prevention of vertical transmission. The gap in access to care for women, including cisgender and transgender women, is real. Despite the availability of antiretrovirals, limited access to health services is a barrier. In order to promote adherence to HIV treatment, financial support has therefore been provided for transport to care centres, and more than 16,000 women in Mexico have benefited from this programme. We have also created an unprecedented strategy for universal access for children and adolescents living with HIV to antiretroviral treatment. With a view to benefiting minors and young people, we are working to guarantee their access to health services, particularly by delivering antiretroviral drugs to them at home, regardless of whether or not they have social security. All of those actions are in line with the commitments that Member States made a year ago to empowering communities living with HIV, prioritizing a human rights approach, reducing stigma and discrimination and ensuring greater investment in order to strengthen health systems (see A/75/PV.74). Mexico is committed to continuing the fight against HIV/AIDS. Member States can count on our resolute determination to work hand in hand with all United Nations entities dedicated to the promotion of global health. In the case of HIV, we will continue working together with the Joint United Nations Programme on HIV/AIDS to achieve the ambitious goal of ending this epidemic.

Angola aligns itself with the statement made by the representative of Namibia on behalf of the Group of African States. We thank the Secretary-General for his report entitled “Tackling inequalities to end the AIDS pandemic” (A/76/783) and take note of his recommendations. The review of progress in the implementation of the Declaration of Commitment on HIV/AIDS is an important step in the Angolan Government’s efforts to end AIDS as a threat to public health in the country by 2030. About 340,000 Angolan adults and 3,000 children are living with HIV. The southern and eastern areas of the country, mainly the provinces of Cunene, Lunda-Norte and Lunda-Sul, have the highest prevalence of HIV/AIDS. I would like to focus on three fundamental aspects. The first is the national and integrated response to HIV and AIDS. Angola currently has 800 HIV/AIDS treatment units between health posts and centres and municipal and provincial hospitals. The country also carries out youth training programmes and ensures young people’s access to the HIV-related health services they need. The Government has increased the number of laboratories for HIV testing, which has reinforced knowledge about viral load in patients with HIV/AIDS and expanded care at the level of municipalities. We have also adopted a plan based on educating, informing and communicating to the population, all of which are elements needed to combat the epidemic. The province of Luanda, the capital city, is part of the global Fast- Track Cities Initiative against HIV/AIDS and is pioneering this accelerated initiative to end the HIV epidemic, with a view to achieving the 95-95-95 goals by 2030. In that province the coverage rate of pregnant women increased from 34 per cent in 2018 to 68 per cent in 2020, while the rate of transmission from mother to child decreased from 28 per cent to 19 per cent in the same period. The second aspect is the protection of future generations from HIV infection. In order to protect future generations from HIV infection, in addition to establishing prevention measures and policies to eliminate new HIV infections and advocacy and education to persuade people to adopt responsible and risk-free behaviour, Angola has joined the African Union Born Free to Shine programme, an initiative led by our First Lady, Mrs. Ana Dias Lourenço. It aims to prevent the transmission of HIV from mother to child and accompanies women from the fourth month of pregnancy through their babies’ first 24 months of life. During that period, antiretrovirals are given to prevent mothers from passing the virus to babies during birth or while they are breastfeeding. The Angolan health authorities base their approach on ensuring that women know that HIV/AIDS exists and above all that they have access to free treatment so that no one else is infected or dies. From January to September 2021, the Institute for the Fight against AIDS recorded 14,460 positive cases of HIV in pregnant women, and all were duly monitored by a programme designed to curb vertical transmission. Turning to the third aspect, as in many parts of the world, stigma and discrimination against people living with HIV still pose barriers to fighting the disease in Angola. The Angolan Government continues to develop programmes to protect people living with HIV and AIDS from stigma, discrimination and intolerance. We have created a context where scientific advances and community activism with awareness to end stigma and prejudice are visible and in which we can disseminate the right information in response to the epidemic. Angola maintains that efforts should be made to create an HIV vaccine before 2030, and like most sub-Saharan African countries calls for increased resources to be dedicated to HIV and AIDS responses. In conclusion, Angola reaffirms its commitment to continuing to implement the recommendations of the Declaration of Commitment on HIV/AIDS, within a framework that promotes the protection of human rights and the dignity of people living with the virus.

Poland aligns itself with the statement made on behalf of the European Union, and I would like to add a few remarks in my national capacity. Poland is committed to meeting the goals of the Global AIDS Strategy 2021-2026. In the past few decades Poland has made significant progress in HIV/ AIDS prevention and control, and we are on track to end AIDS in our country by 2030. We were among the very first countries in Central and Eastern Europe to offer wide, free-of-charge access to medical care for people living with HIV/AIDS. Our new national programme for preventing HIV infections and combating AIDS for the period from 2022 to 2026 includes prevention strategies such as pre-exposure prophylaxis. Prevention of mother- to-child transmission is one of the key elements in our HIV/AIDS response, and our national activities also focus on people who are at risk of HIV transmission. A strong partnership between Government, local municipalities and community-based and civil-society organizations has recently ensured uninterrupted antiretroviral treatment for all, including HIV-positive people stranded in Poland due to the coronavirus disease pandemic and the ensuing lockdowns. Last but not least, our nationwide system of anonymous and free-of-charge HIV testing and counselling is open to all, including migrants. In recent months, as a result of the Russian aggression, the number of Ukrainian refugees arriving in Poland has radically increased, and those who are at risk of HIV transmission have access to medical treatment in Poland, including specialized antiretroviral treatment and hospitalization, on an equal footing with Polish citizens. We will continue our efforts to end AIDS as a public-health threat by 2030.

Brazil is honoured to participate in this annual plenary debate, which provides Member States with an opportunity to jointly review the implementation of the Declaration of Commitment on HIV/AIDS and the subsequent political declarations, especially the 2021 Political Declaration on HIV and AIDS. My delegation commends the report of the Secretary-General (A/76/783) entitled “Tackling inequalities to end the AIDS pandemic”, which gives a thorough assessment of where we are concerning the HIV pandemic and what we still have to do in order to achieve our main goal of putting an end to the AIDS epidemic by 2030. In that regard, Brazil shares the Secretary-General’s concern that HIV infections and AIDS-related deaths are not declining fast enough for us to reach that common target. We fully endorse the recommendations for strengthened collective action, with a focus on universal and equitable access to prevention and treatment, engagement with civil society, especially key and priority populations, equitable access to medicines and new health technologies, sustainable financing and international cooperation. Brazil remains fully committed to the fight against HIV/AIDS and to the protection and promotion of the rights of people living with, at risk of or affected by HIV/AIDS. The HIV response is a State policy in Brazil. Since the HIV epidemic began, Brazil has succeeded in converting the most innovative tools for HIV prevention, diagnosis and treatment into public policy. Over the past 30 years, we have made consistent progress in preventing and treating HIV thanks chiefly to our united health system, which guarantees universal free access to diagnosis and treatment. Through the system, more than 700,000 people are being assisted with antiretroviral drugs, more than half of which are produced locally. To ensure early detection, we begin the free distribution of HIV self-tests in public health units, in addition to the national distribution of HIV rapid tests, with the aim of reaching out to key and priority populations, especially in the context of coronavirus disease (COVID-19) pandemic-related restrictions. In 2021 we distributed around 13 million rapid tests for HIV and approximately 360,000 self-tests. In 2021 alone, in order to foster prevention, our health authorities handed out 342 million male condoms and 13 million female condoms. In 2018 we incorporated pre-exposure prophylaxis as a public policy for people at high risk of acquiring HIV, and we have expanded its use ever since. Brazil has included people living with HIV as one of the priority groups for COVID-19 vaccination. Considering that Brazil’s epidemic is concentrated in key populations, the participation of civil society has been instrumental in guaranteeing the inclusiveness and effectiveness of our public policies in the area. Brazil has also built a legal framework to protect people living with HIV and made progress in addressing stigma and discrimination. In 2014, a federal law established that any discrimination against people living with HIV and AIDS is a crime, and this year we enacted a federal law guaranteeing confidentiality about the condition of people living with HIV in various contexts, such as health services, schools and the workplace. In terms of international cooperation, between 2020 and 2021 Brazil donated antiretroviral drugs and rapid tests to several countries in Latin America and the Caribbean at their request. The way Brazil has been dealing with HIV/AIDS would not be possible without the cooperation of third parties. We want to recognize the key role that the Joint United Nations Programme on HIV/AIDS (UNAIDS) has been playing in assisting members in the fight against HIV/AIDS. The international community has succeeded in significantly reducing infection and deaths associated with HIV/AIDS, but there is more to be done to end this scourge by 2030. Brazil reiterates its commitment to the implementation of the 2021 Political Declaration on HIV and AIDS. We must continue to work to put in place all effective policies contributing to prevention, diagnosis and treatment, as well as the promotion and protection of the human rights of people living with HIV/AIDS, and the Assembly can count on Brazil to continue to support those efforts.

We join the international community and all stakeholders here today in the General Assembly in honouring and remembering the more than 36 million people, including 700,000 Americans, who have tragically died from AIDS-related illness since the start of the epidemic. We also renew our commitment to standing with the nearly 38 million people living with HIV around the world as we pursue our shared goal of ending the epidemic. To do that, we must ensure equitable access to HIV services for all, particularly the populations most affected by the epidemic — the LGBTQI+ community, people who use drugs, sex workers, racial and ethnic minorities, women and girls. It is astounding to reflect on the lives lost and on how far we still need to travel together, as a global community, in saving and improving the millions of lives touched by AIDS. The United States recognizes that 2021 was a benchmark year for the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its co-sponsor United Nations agencies, with the Global AIDS Strategy 2021-2026 adopted in Geneva in March, the 2021 Political Declaration on HIV and AIDS, adopted at the General Assembly in New York in June and Human Rights Council resolution 47/15, on HIV and AIDS, in July. Those documents lay out, with clarity, what we must continue to do together, which is to focus on the most vulnerable. We support the Strategy because we know the power of good guidance and good strategic direction when endorsed by United Nations normative bodies, and we expect UNAIDS to deliver. The dual HIV and coronavirus disease (COVID-19) pandemics continue to reveal and exacerbate existing inequities and vulnerabilities. What is of equal importance is that this past year has spotlighted the importance of peer-led civil-society efforts in reaching persons living with and at risk for HIV during the COVID-19 crisis. Community involvement and leadership are central to the HIV/AIDS response, and that is why we continue to ring the same bell. COVID-19 has also reminded us to accelerate the implementation of integrated services previously done separately, such as using the opportunity to conduct HIV viral-load testing or screen for at-risk diseases while delivering anti-retroviral therapy to clients. We commend the United Nations family, the Global Fund, partner Governments and communities on the tremendous progress we have made together in achieving control of the epidemic in several countries, driven by smart investments and critical policy changes. Now we need to maintain those gains as we battle this disruptive pandemic. We will also be seeing several milestones in the fight against HIV/AIDS in the United States. The Emergency Plan for AIDS Relief of the United States President celebrates its nineteenth anniversary this year. Since its inception and with bilateral support, the United States Government has invested $100 billion to transform the global AIDS response. On Worlds AIDS Day, 1 December 2021, President Biden announced that the United States will host the seventh replenishment conference of the Global Fund to Fight AIDS, Tuberculosis and Malaria in the autumn of 2022. We look forward to States’ participation and encourage their Governments to contribute to that important initiative.

Colombia highlights the importance of this meeting, devoted to reflecting on the advances made and challenges faced in the implementation of our shared commitment to ending the HIV/AIDS pandemic by 2030. I would like to share a few of the main strides that the Government of Colombia has made in complying with the commitments set out in the Political Declaration on HIV and AIDS, which we adopted last year. My country has a legislative and constitutional framework for combating any type of discrimination against people living with the HIV virus or who belong to key population groups, and we are working to eliminate any type of sexual or gender-based violence. We recently updated the clinical practice guidelines where we have treatment schemes, and we have also implemented combined prevention programmes such as self-tests and pre-exposure prophylaxis in our health- care systems. Colombia also regularly carries out prevalence and sexual behaviour studies analysing the situation of the key populations, the results of which guide our formulation of policies, plans and combined prevention programmes. I would like to highlight the significant efforts that Colombia has made, with the help of international cooperation, in order to guarantee the treatment and well-being of migrant populations coming from Venezuela, which include expediting special residency permits that have made it easier for more than 1 million migrants to join the social security system. Last month Colombia gave its firm support to the adoption of the Global Health Sector Strategies on HIV, Viral Hepatitis and Sexually Transmitted Infections for the period 2022-2030 within the framework of the seventy-fifth World Health Assembly. My country will continue to coordinate efforts to broaden the community response in the fight against the HIV epidemic, creating regulatory frameworks for implementing preventive strategies and diagnostic tests through community-based organizations. We believe the response to the ongoing HIV pandemic should fall within the scope of efforts aimed at achieving the objectives of the 2030 Agenda for Sustainable Development, with a focus on universal health- care coverage.

Sierra Leone aligns itself with the statement delivered earlier by the representative of Namibia on behalf of the Group of African States, and we would like to add some comments in our national capacity. It is indeed a great pleasure and honour to join Member States in this exercise reviewing our collective progress in achieving the 2021 Political Declaration on HIV and AIDS. As we all are aware, the world is at a crossroads. We can either still sustain and accelerate progress in ending HIV and AIDS as a public health threat by 2030 or reduce our investments and risk reversing the gains that have been made over three decades. The coronavirus disease (COVID-19) pandemic and the ongoing conflict between Russia and Ukraine have caused major disruptions in the global economy, with dire consequences for many of our countries. Food prices are rising, and energy costs have increased astronomically. Many countries are facing a debt crisis, a shrinking fiscal space and significant cuts in investment in health, education and other social sectors. That has further deepened the existing inequalities within and among nations, and those inequalities have in turn been exacerbated by the COVID-19 pandemic across the globe. They continue to fuel new HIV infections, particularly among adolescent girls, young women and key populations. In Sierra Leone, the epidemic has been feminized, with HIV infections among women twice as high as among men, at 2.2 per cent versus 1.1 per cent. Similarly, adolescent girls and young women aged between 15 and 24 are three times more likely to be infected with HIV, at a rate of 1.5 per cent, than boys and men of the same age, at 0.5 per cent. Our recently completed integrated biological and behavioural survey clearly shows that although HIV is comparatively low in the general adult population, at 1.7 per cent, its prevalence among the key populations is disproportionately higher, due to unequal access to services and to stigma and discrimination. The integrated surveillance survey, conducted in 2021, indicates that HIV prevalence is much higher for female sex workers, men who have sex with men, transgender persons, people who inject drugs and prisoners. Sierra Leone continues to create opportunities to address the HIV-related inequalities that increase the vulnerability of adolescent girls, young women and key populations. We have almost achieved parity between boys and girls at the primary and secondary levels through our Universal Free Quality School Education programme. Scholarship opportunities have been created for girls interested in science, technology, engineering, agriculture and mathematics, while at the same time ensuring that comprehensive sex education is increasingly available to all students at the primary and secondary levels. Protecting our girls from child marriage, teenage pregnancy and sexual and gender- based violence remains a critical priority for the Government of Sierra Leone. In that connection, we are the first country to announce our commitment to and participation in the Education Plus initiative, which aims to protect young girls from HIV and ensure that they can realize their full potential. We are also providing an enabling environment for key populations to thrive and access critical HIV services across the country. Key populations remain a critical part of the design and implementation of our national HIV and AIDS Strategic Plan, and are now getting adequate representation in our Global Fund country coordinating mechanism and in all our national coordinating structures and technical working groups. Creating equal access to HIV services remains the bedrock of our national response to HIV and AIDS. In conclusion, I want to remind everyone here that the fight to end HIV and AIDS as a public health threat is far from over. The time for increased and sustained investment in the global AIDS response is now, especially considering that the countries worst affected by HIV are in economic distress. It is true that we have developed the right technologies, strategies and structures to end AIDS by 2030, but we cannot afford to be complacent. We are not there yet, and we must keep our feet on the accelerator. Intensifying global solidarity, partnerships and investments will be critical if we are to succeed in putting an end to AIDS. COVID-19 is a constant reminder that an outbreak in a small community in the world is a threat to global public health. Ending inequality is the surest way to end HIV as a public health threat by 2030.

As highlighted in the Secretary-General’s report to the General Assembly (A/76/783), the AIDS pandemic is responsible for more than 13,000 deaths every week, a crisis that is undermining our efforts to achieve global health goals. It is also colliding with the coronavirus disease (COVID-19) pandemic, as underlying inequalities limit access to health services and insufficient investment leaves the world dangerously unprepared to confront the pandemics of today and tomorrow. The General Assembly responded to this urgent situation in 2021 by adopting the Political Declaration on HIV and AIDS, which focused on inequalities. One year later, data from the Joint United Nations Programme on HIV/ AIDS (UNAIDS) show that HIV infections and AIDS- related deaths are not declining fast enough to end the pandemic by 2030. A failure to reach the 2025 targets in the Declaration would result in 7.7 million AIDS- related deaths during the current decade. Norway is committed to Sustainable Development Goal 3, and in particular to ending the epidemics of AIDS, tuberculosis and malaria by 2030. To achieve that, we need to ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes. We still need to remember that prevention is better than cure. The world therefore needs more condom programmes for male and female condoms, pre-exposure prophylaxis for key target groups and comprehensive harm-reduction services for people who use drugs. It is also important to work to achieve universal health coverage and access to quality essential health-care services and safe, effective, quality and affordable essential medicines and vaccinations for all. We need strong health systems at both the national and local levels. Norway has prioritized maternal and child health for many years. We are concerned about the fact that paediatric HIV diagnosis and treatment are lagging behind. We need greater efforts if we are to better integrate HIV into maternal and child health care, both to improve programmes preventing the vertical transmission of HIV and to ensure that babies infected are diagnosed and given access to treatment. All over the world, we need an increased focus on key populations, which represent a majority of new HIV infections. We are particularly concerned about the situation for men who have sex with men, the LGBTI population in general and people who use drugs. Those groups are often criminalized and discriminated against and therefore lack access to evidence-based HIV- prevention interventions and HIV treatment. If we are to reach the targets of the Political Declaration and end AIDS by 2030, we need to ensure a strong community response and address those inequalities. Young people, particularly in sub-Saharan Africa, also need access to sexual and reproductive health and rights, including comprehensive sexuality education. In conclusion, Norway, as a member of the UNAIDS Programme Coordinating Board, would like to express its continuing support to UNAIDS. We encourage all members to provide both political and financial support to the programme as well as to other important partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, Unitaid and the Robert Carr Fund, in order to end the AIDS pandemic.

Since we last met to review the Declaration of Commitment on HIV/ AIDS, the United Kingdom has published its HIV Action Plan and has met the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target for a third year in a row. That trajectory puts us on path to reach net-zero new HIV transmissions by 2030, which would make us the first nation in the world to do so. However, domestic strides must be paired with global action and international support. For the United Kingdom, there are three clear priorities. First, we need global comprehensive sexuality education, which is a necessary intervention for preventing HIV among young people and empowering them to recognize and address issues of violence, sexual abuse and their overall sexual health and well- being. There are inequalities within sex education, and we must continue to support UNAIDS to close those gaps and achieve the UNAIDS Global AIDS Strategy target of reaching 90 per cent of all young people with comprehensive sexuality education by 2026. Secondly, we need to see a more focused and integrated global approach to reducing new infections among key populations. That includes sex workers, people who inject drugs, prisoners, transgender people, gay men and other men who have sex with men. Those populations are at heightened risk of HIV and other life-threatening infections due to their marginalized status in society, the discrimination and violence they experience and the laws, policies and practices aimed at punishing them. Thirdly and lastly, we must make up the ground that has been lost due to the impact of the coronavirus disease and understand how it has affected HIV prevention, testing, diagnosis and care, and the health of people living with HIV. As new infections diminish, they become harder to find, and the UNAIDS approach must therefore be continually adapted and tailored to new groups and needs.

We have heard the last speaker in the debate on this item for this meeting. We shall hear the remaining speakers tomorrow afternoon, 10 June. The details of the programme will be announced in The Journal of the United Nations. The General Assembly has thus concluded this stage of its consideration of agenda item 11.