The 1st of December marks World AIDS Day – a day dedicated to raising awareness of the issues surrounding HIV/AIDS. This year, the World Health Organisation (WHO) has joined partners and communities around the globe to reflect on the theme: “Overcoming disruption, transforming the AIDS response.” 

It is estimated that 40.8 million people are currently living with HIV (PLHIV) worldwide. Although HIV is now considered a chronic, treatable infection, progress is under threat due to funding shortfalls. 

A recent UNAIDS report highlighted a sharp decline in funding over the past year, leading to severe disruption in HIV treatment pathways, particularly in fragile settings. With programs affected globally, an additional 3.3 million new HIV infections could potentially emerge over the next five years. The deprioritisation of HIV treatment in community-led regions is becoming a critical issue. 

Prevention programs have been especially strained, with some dismantled entirely. The loss of initiatives for young women has heightened vulnerability, while stigma, discrimination, punitive laws, and the lack of community-based services continue to present major barriers to prevention, testing, and care. 

Most HIV programs rely heavily on external funding. Without urgent action, infection rates are expected to rise, and health systems will face greater strain. 

To address this, countries need to increase investment in HIV treatment programs, develop innovative service delivery models, expand prevention and harm reduction initiatives, strengthen community engagement, and improve surveillance and monitoring of HIV responses. 

Winnie Byanyima, Executive Director of UNAIDS, has implored the public to keep fighting for HIV to remain front and centre, emphasising “the funding crisis has exposed the fragility of the progress we fought so hard to achieve”. 

“We know what works – we have the science, tools, and proven strategies… [W]hat we need now is political courage. Investing in communities, in prevention, in innovation, and in protecting human rights as the path to end AIDS.” 

Nurses and midwives have always been on the frontline of the AIDS response, advocating with affected communities to deliver the change required to tackle the infection.  

“What really struck me was that during the AIDS crisis, nurses and their unions and affected communities fought for and won an approach to infection control and approach to public health in general,” historian Geraldine Fela notes in her book Critical Care: Nurses on the frontline of the AIDS crisis. 

“By having that collaborative bottom-up approach, trust was built and often in very marginal communities,” she continued. 

This advocacy has never wavered, and the professions continue to push for improved care and investment, in line with evidence-based practice.