A/RES/75/284 GA
Political Declaration on HIV and AIDS : Ending Inequalities and Getting on Track to End AIDS by 2030 : resolution / adopted by the General Assembly
75
Session
165
Yes
4
No
0
Abstentions
| Draft symbol | A/75/L.95 |
|---|---|
| Adopted symbol | A/RES/75/284 |
| Category | HEALTH |
| P5 Positions |
|
| UN Document | A/RES/75/284 ↗ |
Vote Recorded Vote — A/75/PV.74
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Afghanistan
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Albania
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Algeria
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Andorra
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Angola
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Argentina
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Armenia
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Australia
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Austria
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Azerbaijan
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Bahamas
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Bahrain
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Bangladesh
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Barbados
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Belgium
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Benin
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Bhutan
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Plurinational State of Bolivia
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Bosnia and Herzegovina
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Botswana
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Brazil
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Brunei Darussalam
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Bulgaria
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Burkina Faso
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Cabo Verde
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Cambodia
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Cameroon
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Canada
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Chad
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Chile
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China
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Colombia
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Costa Rica
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Côte d'Ivoire
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Croatia
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Cuba ⚠
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Cyprus
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Czechia
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Democratic Republic of the Congo
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Denmark
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Djibouti
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Dominica
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Dominican Republic
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Ecuador
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Egypt
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El Salvador
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Equatorial Guinea
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Estonia
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Eswatini
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Ethiopia
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Fiji
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Finland
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France
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Gabon
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Georgia
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Germany
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Ghana
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Greece
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Grenada
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Guatemala
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Guinea
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Guinea-Bissau
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Guyana
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Haiti
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Honduras
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Hungary
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Iceland
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India
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Indonesia
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Iraq
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Ireland
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Israel
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Italy
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Jamaica
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Japan
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Kazakhstan
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Kenya
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Kuwait
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Kyrgyzstan
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Lao People's Democratic Republic
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Latvia
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Lebanon
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Lesotho
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Liberia
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Libya
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Liechtenstein
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Lithuania
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Luxembourg
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Madagascar
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Malawi
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Malaysia
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Maldives
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Mali
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Malta
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Marshall Islands
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Mauritania
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Mauritius
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Mexico
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Micronesia (Federated States of)
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Monaco
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Mongolia
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Montenegro
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Morocco
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Mozambique
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Namibia
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Nepal
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Netherlands
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New Zealand
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Niger
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Nigeria
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North Macedonia
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Norway
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Oman
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Pakistan
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Panama
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Papua New Guinea
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Paraguay
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Peru
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Philippines
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Poland
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Portugal
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Qatar
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Republic of Korea
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Moldova
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Romania
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Rwanda
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Saint Kitts and Nevis
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Saint Lucia
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Saint Vincent and the Grenadines
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San Marino
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Saudi Arabia
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Senegal
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Serbia
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Seychelles
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Sierra Leone
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Singapore
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Slovakia
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Slovenia
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South Africa
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South Sudan
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Spain
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Sri Lanka
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Sudan
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Suriname
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Sweden
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Switzerland
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Thailand
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Timor-Leste
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Togo
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Trinidad and Tobago
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Tunisia
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Türkiye
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Uganda
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Ukraine
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United Arab Emirates
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United Kingdom of Great Britain and Northern Ireland
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United Republic of Tanzania
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United States of America
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Uruguay
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Uzbekistan
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Bolivarian Republic of Venezuela ⚠
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Viet Nam
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Yemen
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Zambia
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Zimbabwe
Speeches following this vote (20)
The President
Before giving the floor to those representatives who wish to speak in explanation of vote after the vote, may I remind delegations that explanations of vote are limited to 10 minutes and should be made by representatives from their seats.
Let me begin by joining others in expressing our deep appreciation to the co-facilitators, the Permanent Representatives of Namibia and Australia, for their intense dedication and efforts in leading us in this process.
Brazil is and always has been committed to the fight against HIV and AIDS and we are very proud of our track record. In that context, we maintain active national and international…
I grew up in the 1980s and 1990s and, as a young person and as a young gay person, I remember quite clearly the fear, denial and stigma that the Deputy Secretary-General described to us as she recounted the history of the HIV/AIDS epidemic. When I look back across the past 30 to 40 years, I am absolutely astounded by the advances of science and of our ability to help those with HIV and AIDS to li…
I have the honour to deliver this statement on behalf of the following Member States: Argentina, Australia, Botswana, Canada, Iceland, Liechtenstein, Mexico, Namibia, Norway, New Zealand, the Republic of Korea, South Africa, Switzerland, Thailand, Uruguay and my own delegation, the United Kingdom.
The year 2021 marks four decades since the first report of an AIDS diagnosis and the beginning of t…
I am pleased to deliver this statement on behalf of the States members of the Gulf Cooperation Council — the United Arab Emirates, the Kingdom of Saudi Arabia, the Sultanate of Oman, the State of Qatar, the State of Kuwait and my own country the Kingdom of Bahrain — to explain our position on the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030,…
China attaches great importance to this high-level meeting on HIV/AIDS and the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End
AIDS by 2030 (resolution 75/284, annex) and, as always, participated constructively in the consultations leading to its adoption. China believes that the international community should send a positive message of unity and coherence …
Our delegation is naturally disappointed by the fact that the text of resolution 75/284, which has just been adopted, although it contains many constructive elements, also contains many destructive elements.
The constructive elements, which we support, include the new international 95-95-95 targets of the Joint United Nations Programme on HIV/AIDS (UNAIDS) to combat HIV/AIDS, the provisions on t…
On behalf of the Government of Japan, we welcome the adoption of the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030 (resolution 75/284, annex). We are grateful to the co-facilitators — Namibia and Australia — for their leadership and dedicated work.
First, while we appreciate the 2021 Political Declaration on HIV and AIDS, we would like to r…
The Islamic Republic of Iran is of the view that the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, which was just adopted by the General Assembly in resolution 75/284, encompasses some problematic and concerning notions and terminology. In that regard, as those concepts and language, which are contained in the Political Declaration, contradic…
Hungary would like to express its appreciation to the co-facilitators for their tireless work and commitment in the elaboration of the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, which was just adopted in resolution 75/284.
Hungary is firmly committed to ending inequalities and eliminating HIV/AIDS globally by 2030. Ending this scourge req…
The Constitution of the Republic of Guatemala affirms that the enjoyment of health without discrimination of any kind is a fundamental human right. Accordingly, as a State that values multilateralism, we recognize the importance of the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, (resolution 75/284), adopted by the General Assembly today. Gu…
Iraq welcomes the adoption by the General Assembly of the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030 (resolution 75/284), and would like to thank His Excellency Mr. Mitchell Fifield, the Permanent Representative of Australia, and His Excellency Mr. Neville Gertze, Permanent Representative of Namibia, for co-facilitating this process.
Iraq …
The Republic of Belarus firmly maintains its full commitment to preventing new cases of HIV infection and the treatment of those who are HIV-positive within its national programmes to combat HIV and AIDS in accordance with its international obligations. We share the widespread concern over our distance in achieving the goals established in the Political Declaration on HIV and AIDS (resolution 70/…
At the outset, my country’s delegation would like to thank the Permanent Representatives of Australia and Namibia for their tireless efforts as co-facilitators and for their serious efforts to ensure the success of the negotiations and to produce a Political Declaration that puts the world on the right path to put an end by 2030 to AIDS, which threatens public health.
My delegation joined the co…
Egypt would like at the outset to thank the Permanent Representatives of Namibia and Australia for their efforts to facilitate the negotiating process that led to the adoption of the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030 (resolution 75/284, annex).
Egypt voted in favour of adopting the Political Declaration owing to the importance tha…
Allow me at the outset to express the Sudan’s deep appreciation and gratitude to Mr. Mitchell Fifield, Permanent Representative of Australia, and Mr. Neville Gertze, Permanent Representative of Namibia, the co-facilitors of the Political Declaration (resolution 75/284, annex), as well as the entire membership for its constructive engagement.
The Sudan voted in favour of the Political Declaration…
Malaysia commends the United Nations for organizing the High-level Meeting of the General Assembly on HIV/AIDS and recognizes the importance of global collaboration to achieve the target of ending AIDS as a public health threat by 2030. In line with the 2030 Agenda for Sustainable Development, Malaysia embraces the principles of health for all and ensuring that no one is left behind in providing …
Being aware of the time and the busy agenda ahead of us, I will be very brief. I would like to add Israel’s voice in thanking the Permanent Representatives of Australia and Namibia and their teams for their leadership in crafting the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030 (resolution 75/284, annex), which we just adopted. Like other spe…
We would like to share the fact that since 2017 Nicaragua has quadrupled the budget for acquiring antiretroviral treatments and developing programmes to address HIV and AIDS. The Government of Reconciliation and National Unity, with its health policy and the general budget planning of the Republic, makes us a country that tackles the issue of HIV and AIDS in such a way that the main focus is the …
We would like to commend the co-facilitators, the Permanent Representatives of Australia and Namibia, for their wonderful efforts in achieving the comprehensive resolution 75/284. While we support the Political Declaration on HIV and AIDS in its broader aspects, we want to place on record our reservation on some of the terms — for example, multiple and intersecting discrimination and comprehensiv…
Full text of resolution
United Nations
A/RES/75/284
General Assembly
Distr.: General
9 June 2021
21-07531 (E) 140621
*2107531*
Seventy-fifth session
Agenda item 10
Implementation of the Declaration of Commitment on
HIV/AIDS and the political declarations on HIV/AIDS
Resolution adopted by the General Assembly
on 8 June 2021
[without reference to a Main Committee (A/75/L.95)]
75/284. Political Declaration on HIV and AIDS: Ending Inequalities and
Getting on Track to End AIDS by 2030
The General Assembly
Adopts the political declaration entitled “Political Declaration on HIV and
AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030” annexed to
the present resolution.
74th plenary meeting
8 June 2021
Annex
Political Declaration on HIV and AIDS: Ending Inequalities and
Getting on Track to End AIDS by 2030
1.
In order to get the world on track to end AIDS as a public health threat by
2030 and accelerate progress towards achieving the Sustainable Development Goals,
in particular Goal 3 on good health and well-being, we, Heads of State and
Government and representatives of States and Governments assembled at the United
Nations from 8 to 10 June 2021:
(a)
Regret that over 75 million people have become infected with HIV and
over 32 million people have died from AIDS-related illnesses since the start of the
global AIDS epidemic;
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(b)
Express deep concern and regret that the international community did not
meet the 2020 targets set out in the 2016 political declaration on HIV and AIDS, 1
despite the fact that we have the knowledge and tools to prevent every new HIV
infection and each AIDS-related death;
(c)
Commit to urgent and transformative action to end the social, economic,
racial and gender inequalities, restrictive and discriminatory laws, policies and
practices, stigma and multiple and intersecting forms of discrimination, including
based on HIV status, and human rights violations that perpetuate the global AIDS
epidemic;
(d)
Strongly commit to provide greater leadership and to work together
through international cooperation, reinvigorated multilateralism and meaningful
community engagement to urgently accelerate our national, regional and global
collective actions towards comprehensive prevention, treatment, care and support,
increase investments in research, development, science and innovations to build a
healthier world for all, and leverage the decade of action and delivery for sustainable
development and ensure that no one is left behind, with an endeavour to reach the
furthest behind first;
(e)
Commit to build back better in a more equitable and inclusive manner from
the coronavirus disease (COVID-19) pandemic and its impact on the global AIDS
epidemic and build resilience against future pandemics and other global health and
development challenges, and continue to leverage the investments and experience of
the HIV response to further enhance public health and strengthen health systems;
(f)
Commit to urgent action over the next five years through a coordinated
global HIV response based on global solidarity and shared responsibility to fully
implement the commitments contained in the present declaration, and urgently work
towards an HIV vaccine and a cure, recognizing that achieving the commitments will
reduce annual new HIV infections to under 370,000 and annual AIDS-related deaths
to under 250,000 by 2025 and generate progress towards the elimination of all forms
of HIV-related stigma and discrimination.
The end of AIDS is within reach, but urgent action is needed
To this end we:
Reaffirming international resolve
2.
Reaffirm the 2030 Agenda for Sustainable Development, 2 including
Sustainable Development Goal target 3.3 to end the epidemic of AIDS by 2030, the
Addis Ababa Action Agenda of the Third International Conference on Financing for
Development, 3 as well as the Beijing Declaration and Platform for Action, 4 the
Programme of Action of the International Conference on Population and
Development 5 and the outcomes of their review conferences, the Alma-Ata and
Astana declarations on primary health care and other relevant instruments,
agreements, United Nations outcomes and programmes of action;
__________________
1 Resolution 70/266, annex.
2 Resolution 70/1.
3 Resolution 69/313, annex.
4 Report of the Fourth World Conference on Women, Beijing, 4–15 September 1995 (United
Nations publication, Sales No. E.96.IV.13), chap. I, resolution 1, annexes I and II.
5 Report of the International Conference on Population and Development, Cairo, 5–13 September
1994 (United Nations publication, Sales No. E.95.XIII.18), chap. I, resolution 1, annex.
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3.
Reaffirm the 2001 Declaration of Commitment on HIV/AIDS 6 and the
2006,7 20118 and 2016 political declarations on HIV and AIDS;
4.
Reaffirm further the political declaration of the high-level meeting of the
General Assembly on antimicrobial resistance,9 the political declaration of the high-
level meeting of the Assembly on the fight against tuberculosis, 10 the political
declaration of the third high-level meeting of the Assembly on the prevention and
control of non-communicable diseases11 and the political declaration of the high-level
plenary meeting on universal health coverage;12
5.
Recall all relevant resolutions and decisions of the General Assembly,
including the Human Rights Council, the Security Council and the Economic and
Social Council, including the Commission on the Status of Women, and of the World
Health Assembly;
6.
Take note of the report of the Secretary-General entitled “Addressing
inequalities and getting back on track to end AIDS by 2030” 13 and the Global AIDS
Strategy 2021–2026, “End Inequalities, End AIDS”, of the Joint United Nations
Programme on HIV/AIDS;
7.
Reaffirm the Universal Declaration of Human Rights 14 and commit to
respect, promote, protect and fulfil all human rights, which are universal, indivisible,
interdependent and interrelated, including in the context of the HIV response, and
urge that all human rights and fundamental freedoms, including the right to
development, be integrated into all HIV and AIDS policies and programmes;
8.
Reaffirm the right of every human being, without distinction of any kind,
to the enjoyment of the highest attainable standard of physical and mental health, and
affirm that the availability, accessibility, acceptability, affordability and quality of
HIV combination prevention, testing, treatment, care and support, health and social
services, including sexual and reproductive health-care services, information and
education, delivered free from stigma and discrimination, are essential elements to
achieve the full realization of this right;
9.
Reaffirm the commitment to sexual and reproductive health and
reproductive rights, in accordance with the Programme of Action of the International
Conference on Population and Development, the Beijing Declaration and Platform
for Action and the outcome documents of their review conferences, and reaffirm the
right of every human being to the highest attainable standard of physical and mental
health, including sexual and reproductive health;
10. Reaffirm the sovereign rights of Member States, as enshrined in the
Charter of the United Nations, and the need for all countries to implement the
commitments and pledges in the present declaration consistent with national laws,
national development priorities and international human rights;
11.
Emphasize the important role of cultural, family, ethical and religious
factors, including the key role played by religious leaders in the prevention of the
global AIDS epidemic and in treatment, care and support;
__________________
6 Resolution S-26/2, annex.
7 Resolution 60/262, annex.
8 Resolution 65/277, annex.
9 Resolution 71/3.
10 Resolution 73/3.
11 Resolution 73/2.
12 Resolution 74/2.
13 A/75/836.
14 Resolution 217 A (III).
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12. Recognize that ending AIDS requires ending all inequalities and driving
multisectoral action across a range of Sustainable Development Goals and targets,
and that the HIV response is making a vital contribution to the achievement of the
2030 Agenda for Sustainable Development;
13. Also recognize that poverty and poor health are inextricably linked and
that poverty can increase the risk of progression from HIV to AIDS owing to a lack
of access to comprehensive treatment-related services and adequate nutrition and care
services and to the inability to meet costs related to treatment services, including
transportation;
14. Note that 2021 marks 40 years since the first cases of AIDS were reported,
25 years since the Joint United Nations Programme on HIV/AIDS commenced its
work as a unique multi-stakeholder and multisectoral programme to lead the efforts
of the United Nations system against the global AIDS epidemic and 20 years since
the landmark 2001 Declaration of Commitment on HIV/AIDS and the decision to
establish the Global Fund to Fight AIDS, Tuberculosis and Malaria;
Progress and gaps
15. Express deep concern that the global AIDS epidemic continues to affect
every region of the world, remaining a global emergency and a paramount health,
development, human rights and social challenge;
16. Recognize that, while AIDS is a global epidemic, with 38 million people
globally living with HIV, national and regional epidemics have different
characteristics and drivers and that, based on different epidemiological contexts,
differentiated responses and interventions are required for addressing them;
17. Welcome and encourage regional efforts to set ambitious targets and
design and implement strategies on HIV and AIDS;
18. Reiterate with profound concern that, while Africa, in particular sub-Saharan
Africa, is the region that has demonstrated the most substantial progress, it remains
the worst-affected region and that urgent and exceptional action is required at all
levels to curb the devastating effects of the epidemic, particularly on women,
adolescent girls and children;
19. Express deep concern that in 2019 HIV and AIDS affected every region of
the world, welcome recent reductions in HIV infections and AIDS-related deaths
achieved in Asia and the Pacific, the Caribbean, Western and Central Europe and
North America, and note with concern that despite progress, the Caribbean continues
to have the highest prevalence outside sub-Saharan Africa, while the number of new
HIV infections is increasing in Eastern Europe and Central Asia, Latin America and
the Middle East and North Africa, and note that 90 per cent of people newly infected
with HIV live in just 41 countries;
20. Welcome the progress achieved since the 2001 Declaration, including a
54 per cent reduction in AIDS-related deaths and a 37 per cent reduction in HIV
infections globally, including a 68 per cent reduction in vertical transmission of HIV,
while noting with concern that overall progress has dangerously slowed since 2016;
21. Express deep concern that insufficient progress has been made in reducing
HIV infections, with 1.7 million new infections in 2019 compared to the 2020 global
target of fewer than 500,000 infections, and that new HIV infections have increased
in at least 33 countries since 2016;
22. Note with concern that inequalities across multiple forms and dimensions,
whilst different in different national contexts, can include those based on HIV status,
gender, race, ethnicity, disability, age, income level, education, occupation,
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geographic disparities, migratory status and incarceration and these often overlap to
compound each other, and have contributed to the failure to reach the 2020 global
HIV targets;
23. Note with alarm that the COVID-19 pandemic has exacerbated existing
inequalities, created additional setbacks and pushed the AIDS response, especially
access to medicines, treatments and diagnostics, further off track, widening fault lines
within a deeply unequal world and exposing the dangers of under-investment in public
health, health systems and other essential public services for all and pandemic
preparedness;
24. Welcome recent efforts by countries to put in place societal enablers,
including enabling laws, policies, public education campaigns and anti-stigma
training for health-care workers and law enforcement that dispel the stigma and
discrimination that still surrounds HIV, empower women and girls to take charge of
their sexual and reproductive health and reproductive rights, in accordance with the
Programme of Action of the International Conference on Population and
Development, the Beijing Declaration and Platform for Action and the outcome
documents of their review conferences, and end the marginalization of people living
with and at higher risk of HIV infection;
25. Note that each country should define the specific populations that are
central to their epidemic and response, based on the local epidemiological context
and note with concern that global epidemiological evidence demonstrates that key
populations are more likely to be exposed to HIV or to transmit it, and that these
include people living with HIV, men who have sex with men who are at 26 times
higher risk of HIV acquisition, people who inject drugs who are at 29 times higher
risk of HIV acquisition, female sex workers who are at 30 times higher risk of HIV
acquisition, transgender people who are at 13 times higher risk of HIV acquisition,
and people in prisons and other closed settings who have six times higher HIV
prevalence than the general population, and further note with concern that these
populations and their sexual partners account for 62 per cent of new HIV infections
globally and for 98 per cent in Asia and the Pacific, 60 per cent in the Caribbean, 99
per cent in Eastern Europe and Central Asia, 28 per cent in Eastern and Southern
Africa, 77 per cent in Latin America, 97 per cent in the Middle East and North Africa,
69 per cent in Western and Central Africa and 96 per cent in Western and Central
Europe and North America;
26. Note that, depending on the epidemiological and social context of a
particular country, other populations may be at elevated risk of HIV, including women
and adolescent girls and their male partners, young people, children, persons with
disabilities, ethnic and racial minorities, indigenous peoples, local communities,
people living in poverty, migrants, refugees, internally displaced persons, men and
women in uniform and people in humanitarian emergencies and conflict and
post-conflict situations;
27. Express concern that, in sub-Saharan Africa, five out of six new infections
among adolescents aged 15–19 years are among girls, that adolescent girls and young
women (15–24 years) account for 24 per cent of HIV infections despite representing
10 per cent of the population, and that AIDS is the leading cause of death for
adolescent girls and women aged between 15 and 49 years;
28. Express deep concern about stigma, discrimination, violence and
restrictive and discriminatory laws and practices that target people living with, at risk
of and affected by HIV – including for non-disclosure, exposure and transmission of
HIV – and laws that restrict the movement or access to services for people living with,
at risk of and affected by HIV, including key populations, young people, women and
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girls in diverse situations and conditions, and in this regard, deplore acts of violence
and discrimination in all regions of the world against them;
29. Recognize that sexual and gender-based violence, including intimate
partner violence, the unequal socioeconomic status of women, structural barriers to
women’s economic empowerment and insufficient protection of the sexual and
reproductive health and reproductive rights, in accordance with the Programme of
Action of the International Conference on Population and Development, the Beijing
Declaration and Platform for Action and the outcome documents of their review
conferences, of women and girls compromise their ability to protect themselves from
HIV infection and aggravate the impact of AIDS;
30. Note with grave concern that the holistic needs and human rights of people
living with, at risk of and affected by HIV, and of women and young people, remain
insufficiently addressed because of inadequate integration of health services,
including sexual and reproductive health-care services and HIV services, including
for people who have experienced sexual or gender-based violence, including
post-exposure prophylaxis, legal services and social protection;
31. Note with concern that men generally have poorer outcomes than women
across the HIV testing and treatment cascade;
32. Note with concern that globally HIV continues to disproportionately
impact young people and that young people’s knowledge and awareness of HIV and
AIDS and access to and use of essential HIV-related services remain unacceptably
low, that condom use is on the decline and that young people, who represent 16 per
cent of the global population, account for 28 per cent of new HIV infections, while
stressing the need to create an environment that does not allow the dissemination of
scientifically inaccurate information about HIV, including HIV denialism;
33. Note with alarm that 150,000 children were vertically infected with HIV
in 2019 compared to the 2020 target of 20,000, while 850,000 children living with
HIV were not on treatment, in part because of the lack of early infant diagnosis
coverage and lack of testing options for older children who acquire HIV during
breastfeeding, and thus that 47 per cent of children living with HIV globally – two-
thirds of whom are 5 years old or older – do not have access to life-saving treatment,
especially in developing countries, as a result of similar social and structural barriers
as the adult population faces, as well as age-specific barriers, including low rates of
diagnosis, inadequate case-finding of children outside of vertical transmission
prevention settings, poor linkage of children to treatment and limited number and
inadequate availability of efficacious antiretroviral child-friendly formulations, in
certain countries and regions, stigma and discrimination, and lack of adequate social
protection for children and caregivers;
34. Note that, thanks to the increased access to antiretroviral therapy, a rising
number of people are living longer with HIV, but note with concern that older persons
living with HIV may face particular challenges, such as stigma and discrimination in
health-care settings, treatment access and maintenance, and greater risk of
non-communicable diseases and other comorbidities, including mental health
conditions;
35. Underscore the critical role of science and technology, including
biomedical and clinical science, social and behavioural science and political and
economic science, and evidence-based approaches in shaping the direction of and
accelerating the HIV response;
36. Underscore that combination HIV prevention is a cornerstone of an
effective HIV response and includes the following evidence-based interventions
dependent on national and regional epidemic characteristics: male and female
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condoms and lubricant, treatment as prevention, pre-exposure prophylaxis,
post-exposure prophylaxis, voluntary medical male circumcision, harm reduction, 15
in accordance with national legislation, comprehensive information and education,
including in and out of school, screening and treatment of sexually transmitted
infections, quality secondary education, economic empowerment, sexual and
reproductive health, reducing risk-taking behaviour and encouraging safer sexual
behaviour, including correct and consistent use of condoms, prevention of sexual and
gender-based violence, poverty reduction and food security, and blood safety, and in
this regard note with alarm the limited scale of combination prevention programmes;
37. Note with concern that the majority of countries and regions have not made
significant progress in expanding harm reduction programmes, in accordance with
national legislation, as well as antiretroviral therapy and other relevant interventions
that prevent the transmission of HIV, viral hepatitis and other blood-borne diseases
associated with drug use, particularly those who inject drugs, and call urgent attention
to the insufficient coverage of programmes and substance use treatment programmes
that improve adherence to HIV drug treatment services, the marginalization of and
discrimination against people who use drugs, particularly those who inject drugs,
through the application of restrictive laws, which hamper access to HIV-related
services, and in that regard, ensure access to and use of the full range of such
interventions, including in prevention, treatment and outreach services, prisons and
other closed settings, and promoting in that regard the use, as appropriate, of the
technical guidance issued by the World Health Organization, the United Nations
Office on Drugs and Crime and the Joint United Nations Programme on HIV/AIDS,
and note with concern that gender-based and age-based stigma and discrimination
often act as additional barriers for women and for young people who use drugs,
particularly those who inject drugs, to access and use these services;
38. Commend progress achieved in research, development and proven
efficacy of innovative HIV interventions, including advances in treatment as
prevention, pre-exposure prophylaxis, long-acting antiretrovirals for prevention and
treatment, antiretroviral-based microbicides and other female-initiated options to
reduce the risk of HIV infections, such as vaginal rings, and ongoing initiatives to
define and address the threat of antimicrobial resistance in relation to HIV and
associated diseases, comorbidities and coinfections, especially tuberculosis;
39. Welcome the recent scientific evidence related to the preventative benefits
of antiretroviral drug therapy, demonstrating no evidence of sexual transmission of
HIV within adult couples when the HIV-positive partner is on effective and sustained
treatment, with undetectable viral loads, confirmed by routine testing at intervals as
recommended by the World Health Organization and reflected in its updated 2021
guidelines, which is known as “Undetectable = Untransmittable (U = U)”, also
recognizing the continued need for further research;
40. Commend the progress achieved in several regions of the world as a result of
implementing research which has led to massive and rapid scaling-up of pre-exposure
prophylaxis and the use of post-exposure prophylaxis, in conjunction with treatment
as prevention, resulting in the rapid reductions in the number of new HIV infections;
__________________
15 A comprehensive package for the prevention, treatment and care of HIV among intravenous drug
users should include the following nine interventions: (i) needle and syringe programmes;
(ii) opioid substitution therapy and other drug dependence treatment; (iii) HIV testing and
counselling; (iv) antiretroviral therapy; (v) prevention and treatment of sexually transmitted
infections; (vi) condom programmes for intravenous drug users and their sexual partners;
(vii) targeted information, education and communication for intravenous drug users and their
sexual partners; (viii) vaccination, diagnosis and treatment of viral hepatitis; and (ix) prevention,
diagnosis and treatment of tuberculosis.
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41. Welcome that over 26 million people living with HIV are on antiretroviral
therapy – a number that has more than tripled since 2010 – but note that, despite this
progress, 12 million people living with HIV still do not have access to treatment,
especially in Africa, and that these 12 million people are prevented from accessing
treatment owing to inequalities, multiple and intersecting forms of discrimination and
structural barriers;
42. Reaffirm that access to safe, effective, equitable and affordable medicines
and commodities for all, without discrimination, is fundamental to the full realization
of the right of everyone to the enjoyment of the highest attainable standard of physical
and mental health, yet note with grave concern the high number of people without
access to medicine and that the sustainability of providing lifelong safe, effective and
affordable HIV treatment continues to be threatened by factors such as poverty and
underscore that access to medicines would save millions of lives;
43. Note that tuberculosis remains the leading cause of death among people
living with HIV and that less than half of tuberculosis cases among people living with
HIV are diagnosed and treated appropriately, and notes the necessity to increase
financing for research and development of new tools for tuberculosis prevention,
diagnosis and treatment, including for multi-drug resistant tuberculosis, for people
living with HIV, as well as in the context of COVID-19;
44. Note that viral hepatitis coinfection with HIV, including mortality due to
viral hepatitis coinfection, is reported across populations at higher risk of HIV,
especially among people who inject drugs;
45. Note that people living with HIV are at substantially higher risk for many
types of cancer, including those caused by the human papillomavirus, that women
living with HIV are about six times more likely to develop cervical cancer and that
anal cancer rates are substantially higher for men and women living with HIV than
their HIV-negative peers;
46. Recognize that the HIV response has transformed global health responses,
strengthened health systems and contributed to socioeconomic development in many
countries;
47. Recognize the resilience and innovation demonstrated by communities
during the COVID-19 pandemic in reaching affected people with safe, affordable and
effective services, including COVID-19 testing and vaccination, HIV prevention,
testing and treatment and other health and social services;
48. Welcome that HIV-related investments in leadership, expertise, research
and development, community responses, large cadres of community health workers,
enhanced health information and laboratory systems and strengthened procurement
and supply chain management systems now play important roles in the response to
the COVID-19 pandemic, including the development of COVID-19 vaccines;
49. Note that, while international investment in the COVID-19 response has
been unprecedented but nonetheless inadequate, many national responses to COVID-19
have demonstrated the potential and urgency for greater investment in pandemic
responses, underscoring the imperative of increasing investments for public health
systems, including responses to HIV and other diseases moving forward;
50. Welcome the steady increase in domestic HIV investment and note the
importance of public policies, finance and capacity-building to spur even greater
domestic resource mobilization, including through public-private partnerships and
innovative financing mechanisms, and for enhanced revenue administration through
modernized, progressive tax systems, improved tax policy and more efficient tax
collection;
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51. Express concern over the stagnation and decline in international resources
for the HIV response, reaffirm the importance of international public finance as a
complement to domestic resources, reiterate that the fulfilment of all official
development assistance targets remains crucial and recall the respective commitment
of many developed countries to official development assistance, including 0.7 per
cent of gross national income provided as official development assistance, with 0.15
to 0.2 per cent allocated to least developed countries;
52. Recognize that there are still many gaps in financing for HIV and AIDS
and the need to further encourage technology transfer on mutually agreed terms,
improve access to medicines in developing countries and scale up capacity-building
and research and development, including local production of pharmaceutical
products;
53. Underscore the importance of enhanced international cooperation to
support efforts of Member States to achieve health goals, including the target of
ending the AIDS epidemic by 2030, implement universal access to health-care
services and address health challenges;
54. Recognize that each country faces specific challenges to achieving
sustainable development, and we underscore the special challenges facing the most
vulnerable countries, in particular African countries, least developed countries,
landlocked developing countries and small island developing States, as well as the
specific challenges facing middle-income countries;
55. Note with alarm that if we do not share responsibility to increase and
equitably allocate resources and massively scale up coverage, we will not end the
AIDS epidemic by 2030;
Commitments
Ending inequalities and engaging stakeholders to end AIDS
56. Commit to reducing annual new HIV infections to under 370,000 and
annual AIDS-related deaths to under 250,000 by 2025, and eliminating all forms of
HIV-related stigma and discrimination;
57. Pledge to end all inequalities faced by people living with, at risk of and
affected by HIV and by communities, and to end inequalities within and among
countries, which are barriers to ending AIDS;
58. Commit to reinforce global, regional, national and subnational HIV
responses through enhanced engagement with a broad range of stakeholders,
including regional and subregional organizations and initiatives, people living with,
at risk of and affected by HIV, key populations, indigenous peoples, local
communities, women and men, girls and boys, including adolescents, young people
and older persons, in diverse situations and conditions, refugees, migrants, internally
displaced persons, political and community leaders, parliamentarians, judges and
courts, communities, families, faith-based organizations, religious leaders, scientists,
health professionals, donors, the philanthropic community, the workforce, including
migrant workers, the private sector, media and civil society, and community-led
organizations, women’s organizations, feminist groups, persons with disabilities and
their representative organizations, youth-led organizations, national human rights
institutions, where they exist, and human rights defenders, and relevant United
Nations entities and other key international partners such as the Global Fund to Fight
AIDS, Tuberculosis and Malaria;
59. Commit to effective, evidence-based, operational mutual accountability
mechanisms that are transparent and inclusive, with the active involvement of people
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living with, at risk of and affected by HIV and other relevant civil society, academia
and private sector stakeholders, to support the implementation and monitoring of
progress on the commitments contained in the present declaration;
Effective implementation of combination HIV prevention
60. Commit to prioritize HIV prevention and to ensure by 2025 that 95 per
cent of people at risk of HIV infection, within all epidemiologically relevant groups,
age groups and geographic settings, have access to and use appropriate, prioritized,
person-centred and effective combination prevention options by:
(a)
Increasing national leadership, resource allocation and other evidence-
based enabling measures for proven HIV combination prevention, including condom
promotion and distribution, pre-exposure prophylaxis, post-exposure prophylaxis,
voluntary male medical circumcision, harm reduction, in accordance with national
legislation, sexual and reproductive health-care services, including screening and
treatment of sexually transmitted infections, enabling legal and policy environments,
full access to comprehensive information and education, in and out of school;
(b)
Tailoring HIV combination prevention approaches to meet the diverse
needs of key populations, including among sex workers, men who have sex with men,
people who inject drugs, transgender people, people in prisons and other closed
settings and all people living with HIV;
(c)
Ensuring the availability of pre-exposure prophylaxis for people at
substantial risk of HIV and post-exposure prophylaxis for people recently exposed to
HIV by 2025;
(d)
Using national epidemiological data to identify other priority populations
who are at higher risk of exposure to HIV and work with them to design and deliver
comprehensive HIV prevention services; these populations may include women and
adolescent girls and their male partners, young people, children, persons with
disabilities, ethnic and racial minorities, indigenous peoples, local communities,
people living in poverty, migrants, refugees, internally displaced persons, men and
women in uniform and people in humanitarian emergencies and conflict and
post-conflict situations;
(e)
Delivering integrated services that prevent HIV, comorbidities and
coinfections, sexually transmitted infections and unintended pregnancy among
adolescent girls and women in diverse situations and conditions, including urgent
scale-up of these services for all adolescent girls and young women in sub-Saharan
Africa, integrated with efforts to ensure girls’ rights to access quality secondary
education, eliminating all harmful practices such as child, early and forced marriage
and female genital mutilation, protecting, promoting and fulfilling all human rights
for women and girls, including their sexual and reproductive health and reproductive
rights, in accordance with the Programme of Action of the International Conference
on Population and Development, the Beijing Declaration and Platform for Action and
the outcome documents of their review conferences, ensuring that all women can
exercise their right to have control over, and decide freely and responsibly on, matters
related to their sexuality, including their sexual and reproductive health, free of
coercion, discrimination and violence, in order to increase their ability to protect
themselves from HIV infection, strengthening their economic independence, and
putting in place interventions that challenge gender stereotypes and address negative
social norms;
(f)
Strengthening the role of the education sector as an entry point for HIV
knowledge and awareness, prevention, testing and treatment, and ending stigma and
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discrimination, in addition to its role in addressing the social, economic and structural
factors that perpetuate inequalities and increase HIV risk;
(g)
Committing to accelerating efforts to scale up scientifically accurate, age-
appropriate comprehensive education, relevant to cultural contexts, that provides
adolescent girls and boys and young women and men, in and out of school, consistent
with their evolving capacities, with information on sexual and reproductive health
and HIV prevention, gender equality and women’s empowerment, human rights,
physical, psychological and pubertal development and power in relationships between
women and men, to enable them to build self-esteem and informed decision-making,
communication and risk reduction skills and develop respectful relationships, in full
partnership with young persons, parents, legal guardians, caregivers, educators and
health-care providers, in order to enable them to protect themselves from HIV
infection;
(h)
Considering removing structural barriers and spousal consent requirements
for sexual and reproductive health-care services and HIV prevention, testing and
treatment services;
(i)
Conducting public awareness campaigns and targeted HIV education to
raise public awareness about HIV;
HIV testing, treatment and viral suppression
61. Commit to achieve the 95–95–95 testing, treatment and viral suppression
targets within all demographics and groups and geographic settings, including
children and adolescents living with HIV, ensuring that, by 2025, at least 34 million
people living with HIV have access to medicines, treatment and diagnostics by:
(a)
Establishing differentiated HIV testing strategies that utilize multiple
effective HIV testing technologies and approaches, including point-of-care early
infant diagnosis and HIV self-testing, and rapidly initiate people on treatment shortly
after diagnosis;
(b)
Using differentiated service delivery models for testing and treatment,
including digital, community-led and community-based services that overcome
challenges such as those created by the COVID-19 pandemic by delivering treatment
and related support services to the people in greatest need where they are;
(c)
Achieving equitable and reliable access to safe, affordable, efficacious
high-quality medicines, diagnostics, health commodities and technologies by
accelerating their development and market entry, reducing costs, strengthening local
development, manufacturing and distribution capacity, including through aligning
trade rules and global trade that facilitates public health objectives, as well as
encouraging the development of regional markets;
(d)
Making HIV viral load testing and monitoring regularly available to all
persons receiving HIV treatment at appropriate time intervals, as recommended by
the World Health Organization, including through the use of point-of-care viral load
testing to deliver results by the end of their clinical visits;
(e)
Ensuring that the needs of older persons living with HIV are met through
the provision of available, acceptable, accessible, equitable, affordable and quality
health care, and related services, free from stigma and discrimination, that support
independence and social interaction, health and well-being, including mental health
and well-being, and the maintenance of HIV-related treatment and care and the
prevention and treatment of comorbidities and coinfections;
(f)
Expanding access to the latest technologies for tuberculosis prevention,
screening, diagnosis, treatment and vaccination, ensuring that 90 per cent of people
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living with HIV receive preventive treatment for tuberculosis by 2025, and reducing
tuberculosis-related deaths among people living with HIV by 80 per cent by 2025
(compared to a 2010 baseline);
Vertical transmission of HIV and paediatric AIDS
62. Commit to eliminate vertical transmission of HIV infections and end
paediatric AIDS by 2025 by:
(a)
Identifying and addressing gaps in the continuum of services for
preventing HIV infection among women of reproductive age, especially pregnant and
breastfeeding women, and thus contributing to the reduction of maternal mortality
diagnosing and treating pregnant and breastfeeding women living with HIV, and
preventing mother-to-child transmission of HIV to children, and taking steps towards
achieving World Health Organization certification of elimination of mother-to-child
HIV transmission;
(b)
Ensuring by 2025 that 95 per cent of pregnant women have access to
antenatal testing for HIV, syphilis, hepatitis B and other sexually transmitted
infections, 95 per cent of pregnant and breastfeeding women in high HIV burden
settings have access to re-testing during late pregnancy and in the post-partum period,
and that all pregnant and breastfeeding women living with HIV are receiving life-
long antiretroviral therapy, with 95 per cent achieving and sustaining viral
suppression before delivery and during breastfeeding;
(c)
Ensuring by 2025 that all HIV-negative pregnant and breastfeeding women
in high HIV burden settings or who have male partners at high risk of HIV in all
settings have access to combination prevention, including pre-exposure prophylaxis,
and that 90 per cent of their male partners who are living with HIV are continuously
receiving antiretroviral therapy;
(d)
Testing 95 per cent of HIV-exposed children by two months of age and
after the cessation of breastfeeding, ensuring that all children diagnosed with HIV are
provided treatment regimens and formulas optimized to their needs, and ensuring that
75 per cent of all children living with HIV have suppressed viral loads by 2023 and
86 per cent by 2025, in line with the 95–95–95 targets;
(e)
Identifying
and
treating
undiagnosed
older
children,
including
adolescents, and providing all children and adolescents living with HIV with a
continuum of developmentally appropriate care and social protection proven to
improve health and psychosocial outcomes as they grow and progress through youth
and into adulthood;
(f)
Encouraging adequate training for health-care workers in paediatric HIV
prevention, testing, treatment, care and support;
Gender equality and empowerment of women and girls
63. Commit to put gender equality and the human rights of all women and girls
in diverse situations and conditions at the forefront of efforts to mitigate the risk and
impact of HIV by:
(a)
Ensuring the establishment, financing and implementation of national
gender equality strategies that challenge and address the impact of sexual and gender-
based violence, harmful practices such as child, early and forced marriage and female
genital mutilation, negative social norms and gender stereotypes, and that increase
the voice, autonomy, agency and leadership of women and girls;
(b)
Fulfilling the right to education of all girls and young women,
economically empowering women by providing them with job skills, employment
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opportunities, financial literacy and access to financial services, scaling up social
protection interventions for girls and young women, and engaging men and boys as
agents of change in intensified efforts to transform negative social norms and gender
stereotypes;
(c)
Welcoming and supporting various regional and subregional initiatives
aimed at accelerating actions and investments to prevent HIV, empower adolescent
girls and young women and achieve gender equality, including in sub-Saharan Africa;
(d)
Eliminating all forms of sexual and gender-based violence, including
intimate partner violence, by adopting and enforcing laws, changing harmful gender
stereotypes and negative social norms, perceptions and practices, and providing
tailored services that address multiple and intersecting forms of discrimination and
violence faced by women living with, at risk of and affected by HIV;
(e)
Reducing to no more than 10 per cent the number of women, girls and
people living with, at risk of and affected by HIV who experience gender-based
inequalities and sexual and gender-based violence by 2025;
(f)
Ensuring by 2025 that 95 per cent of women and girls of reproductive age
have their HIV and sexual and reproductive health-care service needs met, including
antenatal and maternal care, information and counselling;
(g)
Reducing the number of new HIV infections among adolescent girls and
young women to below 50,000 by 2025;
Community leadership
64. Commit to the Greater Involvement of People Living with HIV/AIDS
principle and to empower communities of people living with, at risk of and affected
by HIV, including women, adolescents and young people, to play their critical
leadership roles in the HIV response by:
(a)
Ensuring that relevant global, regional, national and subnational networks
and other affected communities are included in HIV response decision-making,
planning, implementing and monitoring and are provided with sufficient technical
and financial support;
(b)
Creating and maintaining a safe, open and enabling environment in which
civil society can fully contribute to the implementation of the present declaration and
the fight against HIV/AIDS;
(c)
Adopting and implementing laws and policies that enable the sustainable
financing of people-centred, integrated, community responses, including peer-led
HIV service delivery, including through social contracting and other public funding
mechanisms;
(d)
Supporting monitoring and research by communities, including the
scientific community, and ensuring that community-generated data are used to tailor
HIV responses to protect the rights and meet the needs of people living with, at risk
of and affected by HIV;
(e)
Increasing the proportion of HIV services delivered by communities,
including by ensuring that, by 2025, community-led organizations deliver, as
appropriate in the context of national programmes:
• 30 per cent of testing and treatment services, with a focus on HIV testing,
linkage to treatment, adherence and retention support, and treatment literacy;
• 80 per cent of HIV prevention services for populations at high risk of HIV
infection, including for women within those populations;
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• 60 per cent of programmes to support the achievement of societal enablers;
(f)
Encouraging the strengthening of peer-led responses and the scaling-up of
efforts to promote the recruitment and retention of competent, skilled and motivated
community health workers as well as to expand community-based health education
and training in order to provide quality services to hard-to-reach populations;
Realizing human rights and eliminating stigma and discrimination
65. Commit to eliminating HIV-related stigma and discrimination and to
respecting, protecting and fulfilling the human rights of people living with, at risk of
and affected by HIV, through concrete resource investment and development of
guidelines and training for health-care providers, by:
(a)
Creating an enabling legal environment by reviewing and reforming, as
needed, restrictive legal and policy frameworks, including discriminatory laws and
practices that create barriers or reinforce stigma and discrimination such as age of
consent laws and laws related to HIV non-disclosure, exposure and transmission,
those that impose HIV-related travel restrictions and mandatory testing and laws that
unfairly target people living with, at risk of and affected by HIV, with the aim of
ensuring that less than 10 per cent of countries have restrictive legal and policy
frameworks that lead to the denial or limitation of access to services by 2025;
(b)
Adopting and enforcing legislation, policies and practices that prevent
violence and other rights violations against people living with, at risk of and affected
by HIV and protect their right to the highest attainable standard of physical and mental
health, right to education and right to an adequate standard of living, including
adequate food, housing, employment and social protection, and that prevent the use
of laws that discriminate against them;
(c)
Expanding investment in societal enablers – including protection of human
rights, reduction of stigma and discrimination and law reform, where appropriate – in
low- and middle-income countries to 3.1 billion United States dollars by 2025;
(d)
Ending impunity for human rights violations against people living with, at
risk of and affected by HIV by meaningfully engaging and securing access to justice
for them through the establishment of legal literacy programmes, increasing their
access to legal support and representation and expanding sensitization training for
judges, law enforcement, health-care workers, social workers and other duty bearers;
(e)
Working towards the vision of zero stigma toward and discrimination
against people living with, at risk of and affected by HIV, by ensuring that less than
10 per cent experience stigma and discrimination by 2025, including by leveraging
the potential of Undetectable = Untransmittable;
(f)
Ensuring political leadership at the highest level to eliminate all forms of
HIV-related stigma and discrimination, including by promoting greater policy
coherence and coordinated action through whole-of-government, whole-of-society
and multisectoral response;
(g)
Ensuring that all services are designed and delivered without stigma and
discrimination, and with full respect for the rights to privacy, confidentiality and
informed consent;
Investments and resources
66. Commit to increasing and fully funding the HIV and AIDS response by
mobilizing finance from all sources, including innovative financing, and enhancing
global solidarity and increasing annual HIV investments in low- and middle-income
countries to 29 billion dollars by 2025 by:
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(a)
Mobilizing additional sustainable domestic resources for HIV responses
through a wide range of strategies and approaches, including public-private
partnerships, debt financing, debt relief, debt restructuring and sound debt
management, progressive taxation, tackling corruption and ending illicit financial
flows, identifying, freezing and recovering stolen assets and returning them to their
countries of origin, and ensuring progressive integration of financing for HIV
responses within domestic financing for health, social protection, emergency
responses and pandemic responses;
(b)
Complementing domestic resources through greater North-South, South-
South and triangular cooperation, taking into consideration that South-South
cooperation is not a substitute for, but rather a complement to, North-South
cooperation, and renewed commitments from bilateral and multilateral donors –
including through the Global Fund to Fight AIDS, Tuberculosis and Malaria and the
United States President’s Emergency Plan for AIDS Relief – to fund remaining
resource needs, especially for HIV responses in countries with limited fiscal ability,
and those whose economies have been severely affected by the COVID-19 pandemic,
with due attention to the financing of services for populations being left behind, peer-
led HIV responses and societal enablers;
(c)
Encouraging and supporting the exchange of information, research,
evidence, best practices and experiences, among countries and regions, to implement
the commitments contained in the present declaration;
(d)
Fully mobilizing the resource needs of the Global Fund to Fight AIDS,
Tuberculosis and Malaria through its replenishment conferences, with continued
priority focus on the Global Fund’s contribution to ending AIDS;
(e)
Recognizing that multi-stakeholder partnerships and initiatives, such as
the Global Alliance for Vaccines and Immunization (Gavi), the Global Fund to Fight
AIDS, Tuberculosis and Malaria, UNITAID and the Medicines Patent Pool have
achieved results in the field of health and encouraging them to better align their work
and improve their contribution to the strengthening of health systems;
(f)
Fulfilling all respective official development assistance commitments,
including the commitment by many developed countries to achieve the target of
0.7 per cent of gross national income as official development assistance and the target
of 0.15 to 0.20 per cent of gross national income as official development assistance
to least developed countries and increasing the percentage of official development
assistance for HIV response;
(g)
Strengthening development cooperation, including by increasing access to
concessional financing for developing countries and addressing the debt sustainability
challenges facing many least developed countries, landlocked developing countries
and small island developing States, as well as a growing number of middle-income
countries;
Universal health coverage and integration
67. Commit to accelerating integration of HIV services into universal health
coverage and strong and resilient health and social protection systems, building back
better in a more equitable and inclusive manner from COVID-19 and humanitarian
situations, and strengthening public health and enhancing future pandemic response
and preparedness by:
(a)
Utilizing the experience, expertise, infrastructure and multisectoral
coordination of the HIV response across diverse sectors such as health, education,
law and justice, economics, finance, trade, information technology and social
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protection, as well as among development, humanitarian and peacebuilding actions
to advance achievement of the Sustainable Development Goals;
(b)
Investing in robust, resilient, equitable and publicly funded systems for
health and social protection systems that provide 90 per cent of people living with, at
risk of and affected by HIV with people-centred and context-specific integrated
services for HIV and other communicable diseases, non-communicable diseases,
sexual and reproductive health care and gender-based violence, mental health,
palliative care, treatment of alcohol dependence and drug use, legal services and other
services they need for their overall health and well-being by 2025;
(c)
Reducing the high rates of HIV coinfection with tuberculosis, hepatitis C
and sexually transmitted infections, including the human papillomavirus and hepatitis B,
as they contribute to HIV transmission and increased morbidity and mortality among
people living with HIV;
(d)
Ensuring that science- and evidence-based differentiated HIV services
comprise part of the package of universal health coverage, including for people living
with, at risk of and affected by HIV;
(e)
Ensuring the systematic engagement of HIV responses in pandemic
response infrastructure and arrangements, leveraging national HIV strategic plans to
guide key elements of pandemic preparedness planning and ensuring that 95 per cent
of people living with, at risk of and affected by HIV are protected against pandemics,
including COVID-19;
(f)
Building on the resilience and innovation demonstrated by community-
based health systems during the COVID-19 pandemic in reaching affected
communities with essential HIV and health-care services;
(g)
Ensuring that by 2025 45 per cent of people living with, at risk of and
affected by HIV and AIDS have access to social protection benefits in accordance
with national legislation;
(h)
Expanding the delivery of primary health care, which is a cornerstone of
efforts to achieve universal health coverage, through people-centred, community-
based services and strengthening referral systems between primary and other levels
of care;
(i)
Investing in community-based emergency response infrastructure and
providing strengthened community ownership, outreach, information and peer
support during health emergencies and pandemics;
(j)
Promoting full access to effective health emergency responses with full
respect for human rights and ensuring that 95 per cent of people living with, at risk
of and affected by HIV are protected against health emergencies, that 90 per cent of
people in humanitarian settings have access to integrated HIV services and that 95
per cent of people in humanitarian settings at risk of HIV use appropriate, prioritized,
people-centred and effective combination prevention options;
68. Commit to ensuring global accessibility, availability and affordability of
safe, effective and quality-assured medicines, including generics, vaccines,
diagnostics and other health technologies to prevent, diagnose and treat HIV
infection, its coinfections and comorbidities, by urgently removing, where feasible,
all barriers, including those related to regulations, policies and practices that hamper
access to health technologies and objectives, and promoting the utilization of all
available tools to reduce prices of health technologies and costs associated with
lifelong chronic care and to promote fair and equitable allocation of health products
among and within countries to advance efforts to safeguard the full realization of the
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right to the enjoyment of the highest attainable standard of physical and mental health,
through:
(a)
The use, to the full, of existing flexibilities under the Agreement on Trade-
Related Aspects of Intellectual Property Rights specifically geared to promoting
access to and trade in medicines, and, while recognizing the importance of the
intellectual property rights regime in contributing to a more effective AIDS response,
ensuring that intellectual property rights provisions in trade agreements do not
undermine these existing flexibilities, as confirmed in the Doha Declaration on the
TRIPS Agreement and Public Health, and calling for early acceptance of the
amendment to article 31 of the TRIPS Agreement adopted by the General Council of
the World Trade Organization in its decision of 6 December 2005;
(b)
Encouraging the use of mechanisms to promote the market entry of affordable
health products, including generic formulations, and incentivize the development of
innovative products, including HIV medicines and point-of-care diagnostics, in particular
for children, through entities such as the Medicines Patent Pool;
(c)
Promotion of competition in the pharmaceutical market through the
production of affordable and quality-assured generic formulations of innovative
products;
(d)
Strengthening of market dynamics approaches on procurement and supply
chain management, including pooled procurement;
(e)
Increasing access to innovative health technologies by exploring new and
alternative models for financing and coordination of research and development in the
health sector, where rewards for innovation are independent from rights to market
exclusivity, in cases where market incentives have not delivered satisfactory results,
including through grants and financial awards and other methods to delink research and
development costs from the final prices of health products, improved market
transparency, sharing of intellectual property rights, know-how, technologies and data;
(f)
Developing the capacities of low- and middle-income countries to
strengthen health regulation and to locally produce quality-assured health
technologies, including through North-South, South-South and triangular technology
transfer collaborative platforms, taking into consideration that South-South
cooperation is not a substitute for, but rather a complement to, North-South
cooperation, and strengthen international solidarity in this regard;
(g)
Supporting Africa’s efforts to strengthen its self-reliance in responding to
pandemics and in the local research, development, production and distribution of
medicines, diagnostics and other health technologies, including through the
establishment and effective operationalization of the African Medicines Agency;
(h)
Increasing transparency of prices of medicines, vaccines, medical devices,
diagnostics, assistive products, cell- and gene-based therapies and other health
technologies to prevent, diagnose and treat HIV-infection, its coinfections and
comorbidities across the value chain, including through improved regulations and
building constructive engagement and a stronger partnership with relevant
stakeholders, including industries, the private sector and civil society, in accordance
with national and regional legal frameworks and contexts, to address global concern
about the high prices of some health products;
Data, science and innovation
69. Commit to strengthen and enhance the use of data, innovation, research
and development, and science and technology to accelerate the end of AIDS by:
A/RES/75/284
Political Declaration on HIV and AIDS: Ending Inequalities and
Getting on Track to End AIDS by 2030
21-07531
18/19
(a)
Accelerating efforts to collect, use and share granular data that are
disaggregated by income, sex, mode of transmission, age, race, ethnicity, migratory
status disability, marital status, geographic location and other characteristics relevant
in national contexts in a manner that fully respects confidentiality and the human
rights of people living with, at risk of and affected by HIV and other beneficiaries,
and strengthen national capacity to collect, use and analyse such data, including
through technical, financial and capacity-building support to developing countries,
including to least developed countries, landlocked developing countries and small
island developing States to further strengthen the capacity of national statistical
authorities and bureaux;
(b)
Establishing epidemiological, behavioural, programmatic, resource
tracking, community and participatory monitoring and evaluation systems that
generate, collect and use the estimates and granular, disaggregated data needed to
reach, support and empower all populations, with an urgent focus on people living
with HIV and other people that are still being left behind;
(c)
Leveraging the important role played by the private sector and academia
in innovation, research and development, and engaging strategically with the private
sector;
(d)
Enhancing the potential of digital health technologies and innovations to
advance HIV responses, the right to the enjoyment of the highest attainable standard
of physical and mental health as well as service access securely and consistent with
human rights obligations;
(e)
Expanding investments in science and technology, including research and
development, and accelerating progress towards an HIV vaccine and a functional cure
for HIV, with a view to catalysing innovations that work for people most in need,
including people living with, at risk of and affected by HIV, young people,
adolescents, women and girls;
(f)
Strengthening international scientific cooperation to enhance the global
HIV/AIDS response, including through the provision of capacity-building and
technology transfer to developing countries on mutually agreed terms;
(g)
Committing to establishing effective systems to monitor, prevent and
respond to the emergence of drug-resistance strains of HIV in populations and
antimicrobial resistance;
Joint United Nations Programme on HIV/AIDS
70. Commit to support and leverage the 25 years of experience and expertise
of the Joint United Nations Programme on HIV/AIDS and reinforce and expand the
unique multisectoral, multi-stakeholder, development and rights-based collaborative
approach to end AIDS and deliver health for all as global public good by:
(a)
Supporting the efforts of the Joint Programme to contribute to the follow-up
and review of the 2030 Agenda for Sustainable Development, including the high-level
political forum on sustainable development, in order to ensure that the HIV response
and its interlinkages with other Sustainable Development Goals are fully reflected;
(b)
Requesting the Joint Programme to continue to support Member States,
within its mandate, in addressing the social, economic, political and structural drivers
of the AIDS epidemic, including through the promotion of gender equality and the
empowerment of women, and human rights, by strengthening the capacities of
national Governments to develop comprehensive national strategies to end AIDS and
by advocating for greater global political commitment in responding to the epidemic;
Political Declaration on HIV and AIDS: Ending Inequalities and
Getting on Track to End AIDS by 2030
A/RES/75/284
19/19
21-07531
(c)
Fully resourcing the Joint Programme and supporting its efforts to refine
and reinforce its unique operating model so that it can continue to lead global efforts
against AIDS, support efforts for pandemic preparedness and global health, and in
this regard reaffirm, in accordance with Economic and Social Council resolution
2019/33 of 24 July 2019, that the Joint Programme co-sponsor and governance model
provides the United Nations system with a useful example of strategic coherence,
reflecting national contexts and priorities, through its coordination, results-based
focus, inclusive governance, and country-level impact, noting the contribution of the
Joint Programme to the reinvigorated resident coordinator system;
(d)
Annually voluntary reporting to the Joint Programme on progress in the
implementation of the commitments contained in the present declaration, using robust
monitoring systems and international follow-up and review processes that identify
inequality gaps in service coverage and progress in HIV responses, and to inform the
General Assembly, the Economic and Social Council and the high-level political
forum on sustainable development;
Follow-up
71.
Request the Secretary-General, with the support of the Joint United Nations
Programme on HIV/AIDS, to provide to the General Assembly, within its annual
reviews, an annual report on progress achieved in realizing the commitments contained
in the present declaration, and to contribute to the reviews of progress on the 2030
Agenda for Sustainable Development taking place at the high-level political forum on
sustainable development, as well as the high-level meeting on tuberculosis to be held
in 2023, the high-level meeting on universal health coverage to be held in 2023 and the
high-level meeting on non-communicable diseases to be held in 2025, so as to ensure
that follow-up and review processes assess progress in the AIDS response;
72. Request the Secretary-General to strengthen cooperation among relevant
agencies of the United Nations system to accelerate progress towards ending the
spread of HIV and ending AIDS, under the leadership of the Joint United Nations
Programme on HIV/AIDS;
73. Decide to convene a high-level meeting on HIV and AIDS in 2026 to
review progress on the 2025 targets and other commitments made in the present
declaration and to reach an agreement on the modalities for the next high-level
meeting on HIV and AIDS no later than at the eightieth session of the General
Assembly.
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