Archive for category: HIV/AIDS

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The Proactive Fight Against HIV/AIDS in the Solomon Islands

HIV/AIDS in the Solomon IslandsThe Solomon Islands, a vibrant archipelago of nearly 1,000 islands in the South Pacific, continues to demonstrate remarkable resilience in public health management. While the nation faces geographic and economic hurdles — ranking 156 out of 193 on the Human Development Index — the rate of HIV/AIDS in the Solomon Islands remains one of the most stable in the region.

For decades, the archipelago has maintained a low HIV prevalence rate. Data shows that since 1994, only 0.1% of the population aged 15-49 lives with HIV/AIDS in the Solomon Islands. Between 1994 and 2016, health officials recorded only 30 cases, a testament to the nation’s early intervention and cultural protective factors. 

While the historical numbers remain low, recent years have seen a slight uptick in reported cases of HIV/AIDS in the Solomon Islands. Rather than viewing this as a setback, health experts interpret increased numbers as a sign of enhanced diagnostic capabilities. 

The Ministry of Health and Medical Services (MHMS) has significantly expanded testing sites and medical supply procurement. By making testing more accessible, the government identifies cases earlier, enabling immediate treatment. This shift from low numbers through limited testing to active surveillance marks a positive evolution in the country’s medical strategy.

Overcoming Barriers to Treatment

With nearly 1,000 islands in total, treatment for HIV/AIDS in the Solomon Islands has not come without its unique set of obstacles:

  • Geographic Isolation: Realizing a central clinic for antiretroviral therapy (ART) can be physically and financially taxing for rural residents.
  • Stigma and Discrimination: Social and religious norms, combined with a lack of confidentiality in small island communities, create a fear of social rejection that discourages individuals from seeking HIV testing and life-saving treatment.
  • Regulatory Scrutiny: For non-nationals, entry and residency restrictions based on HIV status can create significant legal hurdles for accessing long-term care.

Strategic Measures To Improve Access

To address these difficulties, the Ministry of Health and Medical Services (MHMS) and its partners have introduced the following improvements:

  • Decentralized Testing and Treatment: The program equips area health centers with rapid diagnostic test kits and ensures that even in remote provinces, health workers can identify new cases within minutes and immediately connect patients to antiretroviral therapy (ART).
  • Commodity Security: Health Minister Dr. Paul Bosawai recently emphasized that the ministry is streamlining the supply chain to ensure that HIV commodities and diagnostic kits remain in stock and are readily available in all provinces.
  • Mother-to-Child Prevention: By integrating HIV testing into routine antenatal care, the MHMS has successfully maintained a near-zero rate of mother-to-child transmission in recent years. These proactive efforts mean that 100% of those diagnosed now have access to free, government-sponsored treatment, transforming a potential surge into a manageable and treated health condition.

Beyond clinical settings, the nation prioritizes education as a primary tool for preventing HIV/AIDS in the Solomon Islands. Community-led initiatives utilize radio broadcasts and local leaders to share information about sexual health and disease prevention. 

By involving traditional leaders and local health workers, the government ensures that health messaging respects cultural nuances while providing vital medical facts. These programs empower citizens to take charge of their own health and encourage voluntary testing, further contributing to the slight rise in known cases, which allows for a more accurate public health response.

Looking Toward a Healthy Future

The Solomon Islands is not merely reacting to HIV; it is building a prevention strategy. The government’s commitment to the Fast-Track targets set by UNAIDS shows a clear path forward. By prioritizing education and investing in rural health care infrastructure, the nation ensures that the recent surge in data translates into a long-term surge in survival and well-being. 

With continued international support and a dedicated local workforce, the Solomon Islands stands as a model for how a developing nation can manage infectious diseases through unity and proactive care.

– Rebecca Cameron

Rebecca is based in Edinburgh, Scotland and focuses on Technology and Global Health for The Borgen Project.

Photo: Flickr

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HIV/AIDS in Dominica

HIV/AIDS in DominicaDominica is a small island country in the Eastern Caribbean with a population of around 70,000. Historically, the Caribbean has been one of the regions that HIV/AIDS has affected the most in the world, with an overall incidence rate surpassed only by Africa.

Considered an epidemic in the Latin American-Caribbean region since the beginning of the 1980s, HIV has had a widespread and lasting impact across many countries. Many Caribbean countries witness a prevalence rate of more than 1%, markedly above the international average of 0.7%.

Despite the fact that the greater region is still witnessing a ‘generalized epidemic’ of HIV, Dominica has made remarkable progress in tackling the disease and today accounts for some of the lowest rates of transmission and new infections in its locality, thanks to targeted testing efforts, expanded training and local education programs. Here is more information about HIV/AIDS in Dominica.

Improvement of Prevalence Rates

Dominica has succeeded in improving all of its incidence rate metrics in the fight against HIV and AIDS. In terms of new infections in the past year, Dominica saw a decisive downturn from a rate of 0.47 per 1,000 people in 1990 to 0.23 by 2024, demonstrating a fall by over half of new cases. This places it significantly below the regional average for the Caribbean, which is at approximately 0.58 per 1,000 people in 2024. Similarly, deaths stemming from HIV infections decreased by almost half from 14.46 per 100,000 people in 2000 to 7.64 by 2021.

In 2021, Dominica announced that it had eliminated mother-to-child transmission of HIV and the World Health Organization (WHO) duly awarded the country the official certification. The organization described this landmark achievement as indicative of the strength of government and civil society efforts and Dominica became the eighth country in the region to be awarded this certification.

Work on the Ground To Address HIV/AIDS in Dominica

Dominica’s success in tackling HIV has been accredited to tireless work on the ground and successful partnership between government bodies and civil society partners. 

The National HIV and AIDS Response Programme (NHARP), headquartered in the nation’s capital Roseau, is a government initiative that the Health Ministry overseeds. The program has made significant inroads in minimizing stigma and has helped to dramatically reduce cases through its provision of education, training and support. Its efforts led to regional recognition in 2017, when Dominica received the Most Improved Award at the Caribbean HIV Testing Day ceremony.

Pan Caribbean Partnership Against HIV/AIDS (PANCAP) is another regional organization which supports Dominica in tackling HIV/AIDS. The umbrella organization of governments, local members of civil society, agencies and donors not only funds Regional Testing Day but also advocates for policy coordination in relation to HIV, has established a regional HIV directory search function and manages an accessible log of HIV data for its constituent countries. Such efforts have proven instrumental in the fight against HIV.

Looking Ahead

In conclusion, despite an ongoing struggle against HIV in the Caribbean, Dominica has successfully reduced rates of HIV/AIDS through successful testing and education programs and a directed campaign to support pregnant mothers, which has led to the eradication of mother-to-child transmission. Consequently, Dominica has become one of the most visible examples of successful communicable disease reduction in the region and trajectories suggest the country is moving in a promising direction towards continually reducing HIV rates.

– Phoebe Lang-Clapp

Phoebe is based in Montréal, Québec, Canada and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Politics and Healthcare Colliding: HIV/AIDS in Serbia

HIV/AIDs in SerbiaPrejudiced attitudes toward homosexuality in Serbia are preventing early diagnosis and treatment of HIV/AIDS, which has resulted in suffering and even death, as reported in 2013. Progressive groups and residents have spoken out over the years, claiming that hostile attitudes toward homosexuality in socially conservative Serbia have fostered this culture of fear. In extreme cases, individuals endanger themselves. The World Bank states that HIV/AIDS in Serbia affects 0.1% of the population, but despite this, the number of untreated cases or late-stage diagnoses remains a concern.

HIV Demographics

The main demographic of HIV sufferers is men who have sex with men (MSM), making up 80% of cases. As already vulnerable members of Serbian society, according to the foreign press and citizens alike, additional barriers to health care have a significant impact. These barriers include social stigma and a lack of self-testing, outreach or information about discreet HIV diagnosis. Additionally, since the early 2000s, the number of HIV/AIDS diagnoses in Serbia per year has increased (diagnoses, not necessarily incidence). HIV/AIDS in Serbia is becoming more of a pressing issue despite modern interventions available to address it. The preventability of mortality and late-stage diagnosis remains a major concern.

In 2013, the painful and preventable death of an HIV sufferer, “Marko,” was reported. This story presents the extremes individuals may face when confronting negative social pressures. With 49.2% of new diagnoses detected late in 2021, it suggests that people may delay seeking care due to social stigma and potential repercussions.

Serbian Politics

Serbia’s prime minister (PM), Ana Brnabic, is the only openly gay leader in the Balkans and the leader of the Serbian Progressive Party. Progressive critics have reprimanded the prime minister’s leadership style, arguing that she has not adequately addressed hostility within society toward LGBTQ+ individuals.

This is not new to Brnabic, who has previously faced criticism during her leadership regarding homophobia in Serbia. Numerous LGBTQ+ spokespeople have suggested that denying the prevalence of homophobia minimizes the experiences of an already marginalized sector of Serbian society. In 2018, she was reportedly “uninvited” from Belgrade’s Pride parade.

Shift Toward Equality

As time progresses, Serbia has seen improvements toward equality. Despite decriminalizing homosexuality in 1994, the country has welcomed an openly gay leader and has numerous groups campaigning for the LGBTQ+ community. De Se Zna! (a queer activist group in Serbia) has been providing psychological and legal support as an association since 2016, advocating for queer individuals to feel safer in Serbia and increasing the sense of support and community among marginalized groups.

Out groups have long applied pressure on the government to take a more active stance. The Friedrich Naumann Foundation (FNF) has been a notable group pushing for progressive legislative proposals and the establishment of a centralized database compiling homophobic hate crime offenses. These efforts highlight the lack of comprehensive information on crimes committed against queer people in Serbia. The Serbian government continues to face pressure to promote a more equitable society and improve accountability.

Looking Ahead

While stigma and late diagnoses remain challenges, continued advocacy, expanded outreach and improved access to discreet testing services can help reduce preventable HIV-related deaths in Serbia. Furthermore, ongoing efforts by community organizations and policy reform initiatives offer pathways toward improved health outcomes and greater social inclusion.

– Maya Hollick

Maya is based in the United Kingdom and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Fighting HIV/AIDS in Nigeria: Healthy Economic Future for Women

HIV in NigeriaNigeria has the second-largest HIV epidemic globally, with approximately 2 million people living with HIV (PLHIV) as of 2023. Studies show women and adolescent girls in sub-Saharan Africa are more than twice as likely to contract HIV as men and are more likely to face social stigma for taking HIV medication. Factors contributing to the disparity include poverty, limited access to education and gender-based violence, which increase vulnerability among women and girls.

Organizations, including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the Achieving Health Nigeria Initiative and the Institute of Human Virology, Nigeria, work with trusted local leaders to combat stigma and expand access to HIV testing and treatment. By promoting updated perspectives within communities, these efforts educate adolescents and broader populations about gender equality and sexual health. Advocates say the programs provide women with critical mental and physical support, thereby improving employment opportunities and long-term stability.

NGO’s Improving HIV/AIDS Cases and Female Economy

The disease has had a devastating effect on the nation as a whole, particularly on women. The United Nations (U.N.) in Nigeria reports that gender inequalities and the low socioeconomic status of women and girls continue to increase their vulnerability to HIV infection and other forms of abuse. President George W. Bush launched PEPFAR in 2003 to address this crisis.

The program has provided billions of dollars in funding for HIV treatment and prevention in more than 50 countries. PEPFAR is a bipartisan initiative involving multiple U.S. agencies that works to strengthen global health security and control the epidemic through direct support and partnerships. Since its inception, the U.S. government has invested more than $100 billion in the global HIV/AIDS response, saving more than 25 million lives.

NGO’s Involved

Achieving Health Nigeria Initiative (AHNi) is one of several NGOs involved in PEPFAR’s work. Founded in 2009, the organization implements public health interventions focused on education and youth development. It also works on disease prevention and epidemic control.

In addition, it runs humanitarian programs addressing health, protection and the prevention of sexual and gender-based violence. AHNi also led the National Aligned HIV/AIDS Initiative (NAHI) in collaboration with the Nigerian government and PEPFAR. The initiative aims to help Nigeria achieve epidemic control and meet the UNAIDS 95-95-95 targets by 2030, the organization reports.

Another NGO supported by PEPFAR is the Institute of Human Virology, Nigeria. Its ASPIRE project focuses on HIV testing services, laboratory diagnosis and patient tracking. It also includes prevention of mother-to-child transmission, antiretroviral treatment, including for pregnant women and support services for orphans and survivors of gender-based violence. The project also operates a well-being hub for PLHIV and AIDS and members of the surrounding community.

The Positive Economic Effect on Nigerian Women

Training from projects such as these has expanded employment opportunities for women. Stella Obianuju, a member of the Association of Women Living with HIV/AIDS in Nigeria, participated in a leadership training program and described a significant change in her life. She said she moved from a state of stigma and abuse to being “well informed and empowered,” with the knowledge to report violence and discrimination and seek justice.

By raising awareness and expanding access to prevention measures, such programs aim to reduce new HIV infections as well as HIV-related illness and death. Reduced morbidity, stigma and mortality can also create conditions for economic growth and poverty reduction, including expanded access to family planning services. The expansion of HIV treatment centers has also created jobs in logistics, health care and data management as systems shift from paper records to digital platforms.

This transformation has improved quality and accountability by allowing real-time assessment of clinical outcomes. In Nigeria alone, PEPFAR has invested more than $6 billion in the national HIV/AIDS response, according to the U.S. Embassy in Nigeria. Overall, PEPFAR funding supports the hiring of thousands of health workers, including doctors, nurses, pharmacists, laboratory technicians and counsellors, particularly in rural and underserved areas.

The program also provides grants to Nigerian NGOs, community-based organizations and faith-based groups, creating administrative, management and field-level jobs.

Final Remarks on HIV/AIDS in Nigeria

Recent U.S. funding freezes in 2025 have threatened the continuity of HIV services and increased the risk of treatment interruptions. This prompted the Nigerian government to seek domestic alternatives. In response, it approved about $3.6 billion in 2025 to fund 150,000 HIV treatment packs.

According to the Gates Foundation, “These advances have been driven by sharp science and collaboration between the private sector, governments, research institutes, advocates and PLHIV everywhere. But what makes long-acting PrEP so exciting isn’t just the science. It’s what these prevention methods could offer: Options.”

These options offer greater choice for women, families and adolescents, increasing autonomy and long-term health security.

– Gemma Nailer

Gemma is based in Manchester, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Sustained Funding & Combating HIV/AIDS in Comoros

HIV/AIDS in ComorosLimited health care infrastructure, economic vulnerability and heavy reliance on external humanitarian aid make the fight against HIV/AIDS in Comoros fragile. While HIV prevalence remains low, progress depends largely on donor-funded programs. Inconsistent and short-term funding threatens to reverse gains in prevention, treatment access and health system resilience. Sustained funding for HIV/AIDS in Comoros is essential to ensure long-term prevention, uninterrupted treatment and national health stability.

HIV/AIDS in Comoros: A Fragile Success

HIV prevalence in Comoros remains below 1%, one of the lowest rates in sub-Saharan Africa. This success is largely due to early prevention strategies, cultural factors and donor-supported health programs. However, limited domestic health financing means that HIV/AIDS services depend heavily on external support for antiretroviral treatment (ART), testing services and public awareness campaigns. Any reduction in funding risks service disruption, increased transmission and setbacks to national health goals. Donor-supported programs have included nationwide HIV awareness campaigns, voluntary counseling and testing services and integration of HIV services into primary health care, all of which have contributed to maintaining low prevalence levels. Here is why sustained funding matters.

Continuity of Treatment

HIV is a lifelong condition with no cure and requires continuous treatment with antiretroviral drugs to suppress the virus and protect the immune system. According to the World Health Organization (WHO), uninterrupted ART significantly reduces HIV-related deaths and prevents drug resistance. Funding interruptions can lead to medication shortages, treatment gaps and declining health outcomes. Sustained funding for HIV/AIDS in Comoros ensures consistent patient monitoring, reliable medication supply and effective long-term care.

In Comoros, antiretroviral treatments are largely financed internationally, particularly grants from the Global Fund. According to UNAIDS, this external supply creates challenges such as supply chain delays, limited laboratory capacity and difficulties to provide a consistent patient follow-up across the islands. Sustained funding for HIV/AIDS in Comoros ensures consistent patient monitoring, reliable medication supply and effective long-term care.

Prevention and Education

Prevention and education programs are critical to maintaining low HIV prevalence in Comoros. One major example is the national prevention of mother-to-child transmission (PMTCT) program, supported by international partners such as UNICEF and WHO, which provides testing, treatment and counseling to pregnant women living with HIV; as a result, HIV prevalence among pregnant women stands at an exceptionally low level and infants born to HIV-positive mothers have consistently tested HIV-negative under this initiative.

Existing initiatives include community-based awareness campaigns supported by UNAIDS and the Global Fund, HIV testing and counseling services and outreach programs targeting young people and women. International assistance has supplied critical testing equipment and strengthened health worker training, helping expand access to HIV information and services. These programs promote safe practices, reduce stigma and encourage early testing. Long-term funding allows these initiatives to operate consistently and expand into underserved communities, particularly in rural areas.

Strengthening Health Systems

Efforts are underway to broaden health system improvements in Comoros. Investments have supported clinic infrastructure, trained health care workers and strengthened disease surveillance systems. However, challenges remain, including shortages of medical staff, limited laboratory capacity and unequal access to care between urban and rural regions. These weaknesses increase vulnerability to HIV transmission and hinder treatment access.

In Comoros, HIV/AIDS-related investments have contributed to improved primary health facilities and health worker training, but the country continues to face shortages of medical personnel and limited diagnostic infrastructure, particularly outside urban areas. According to the World Bank, stronger health systems improve economic resilience and reduce poverty in developing countries.

Solution in Action: The Global Fund

Established in 2002, the Global Fund has played a key role in supporting HIV/AIDS programs in Comoros. The Global Fund is one of the main external financiers of HIV/AIDS programs in Comoros, supporting HIV treatment and prevention efforts in collaboration with national health authorities. By financing antiretroviral therapy, HIV testing and health system strengthening, the organization has expanded access to essential services.

According to the Global Fund, its investments support the delivery of HIV services across the country, demonstrating how sustained international funding strengthens national health capacity. In 2023, countries supported by the Global Fund reported that approximately 25 million people were on antiretroviral therapy, and 53.8 million HIV tests were conducted through its investments, reaching millions with prevention services. While these figures reflect global outcomes, they illustrate the scale of support provided to countries like Comoros.

Poverty and HIV/AIDS in Comoros

Poverty remains a significant challenge in Comoros, where a large portion of the population lives below the national poverty line. Using the international poverty line of $3.65 per day, about 39.5% of Comorians lived in poverty in 2023, reflecting persistent economic hardship that constrains access to essential services like health care, education and transportation. In Comoros, long distances to health facilities, high out-of-pocket costs for care and shortages of trained health workers make it difficult for poor households to obtain HIV testing and treatment services, contributing to health inequalities. People living in poverty are also more vulnerable to poor health outcomes due to malnutrition and limited medical access. Addressing HIV/AIDS through sustained funding helps reduce these inequalities and supports broader poverty reduction efforts.

The Role of International Support

International support remains vital to sustaining HIV/AIDS programs. Comoros participates in regional HIV response efforts coordinated by UNAIDS and partners, such as Indian Ocean Island forum meetings aimed at strengthening prevention and treatment planning, demonstrating the active role of international support in shaping the country’s HIV strategy. Donor countries and multilateral institutions help bridge funding gaps while the government gradually strengthens domestic health financing. Sustained funding aligns with global commitments to end AIDS as a public health threat by 2030 and ensures that small island developing states like Comoros are not left behind.

Conclusion

The fight against HIV/AIDS in Comoros is about securing long-term public health and economic stability. Sustained funding ensures uninterrupted treatment, effective prevention strategies and stronger health systems. Programs supported by the Global Fund and other international partners show that long-term investment expands access to ART, increases testing in rural communities and reduces health disparities. With predictable and sustained funding, Comoros can continue to maintain low HIV prevalence, improve health outcomes and support sustainable development.

– Numahaiseta Sillah Tunkara

Numahaiseta is based in Duisburg, Germany and focuses on Technology and Politics for The Borgen Project.

Photo: Flickr

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The HIV Epidemic in Zambia: Project HOPE

HIV Epidemic in ZambiaAccording to the Centers for Disease Control and Prevention (CDC), in 2023, 9.8% of Zambia’s population ages 15 to 49 was living with HIV, with about 15,000 related deaths recorded that same year. Based on the distribution of HIV across the population, the United Nations Children’s Fund (UNICEF) classifies Zambia as having a generalized HIV epidemic. HIV epidemics are considered “generalized” when transmission occurs largely through sexual activity in the general population, meaning programs that focus only on specific vulnerable groups are unlikely to significantly reduce overall transmission or achieve eradication.

In Zambia, several nongovernmental organizations (NGOs) have worked to reduce the impact of the HIV epidemic. These include the Elizabeth Glaser Pediatric AIDS Foundation and FHI 360. One of these organizations was Project HOPE, a global health and humanitarian organization operating across five continents with a mission to improve access to care and health outcomes worldwide. Project HOPE has operated in Zambia since 2019, focusing on reducing the effects of the HIV epidemic, particularly among children and adolescents.

Project HOPE’s Efforts in Zambia

Because Zambia is experiencing a generalized epidemic, HIV transmission occurs primarily through unprotected sexual activity. However, there is a significant disparity between young men and women ages 15 to 24. In 2020, HIV prevalence among young women was 5.7%, compared with 1.8% among young men. This disparity may be linked to factors such as high rates of early pregnancy, earlier sexual debut, coercion linked to unequal power dynamics and age-disparate sexual relationships, all of which are prevalent among adolescent girls and young women in Zambia.

Project HOPE identified these dynamics as a major concern and focused its work on addressing the underlying socioeconomic factors that influence HIV transmission among adolescents and young adults.

On the ground, Project HOPE supported HIV treatment efforts by helping ensure access to pre-exposure prophylaxis (PrEP), counseling adolescents and young people on positive sexual health practices and supporting HIV health informatics programs. The organization also partnered with the Centre for Infectious Disease Research in Zambia to support the Empowered Children and Adolescents Project through community interventions and case management.

Through these efforts, Project HOPE provided antiretroviral therapy to 388,836 adults and children living with HIV and delivered gender-based violence education to 2,565 individuals. On Sept. 8, 2025, Project HOPE announced that it had ended operations in Zambia as of June 2025. The organization cited reductions in U.S. foreign assistance funding following a realignment of foreign aid policy as the primary reason for the decision.

The America First Global Health Strategy

The America First Global Health Strategy was introduced by the U.S. Department of State in September 2025. The strategy responded to concerns about inefficiencies in global health foreign assistance programs. According to the Department of State, only about 40% of global health aid reached frontline workers and commodities, while 60% supported technical assistance, program management and other overhead costs.

Officials attributed this imbalance to earlier policies that emphasized direct investment through NGOs, which they said created parallel supply chains and procurement systems alongside local governments.

As a result, the policy shift led to significant reductions in U.S. Agency for International Development funding for NGOs, with a greater emphasis on delivering aid through local governments. The stated goal is to strengthen public health systems and build long-term self-sufficiency in responding to crises such as the HIV epidemic.

The Role of NGOs in Zambia

As the America First Global Health Strategy takes shape, organizations such as Project HOPE have struggled to sustain operations in countries like Zambia. However, Steven Neri, Project HOPE’s senior regional director for Africa, emphasized the continued importance of NGOs when speaking with The Borgen Project.

“Project HOPE was able to bring our expertise from across Africa and around the world to support the HIV prevention, care and treatment program in Zambia,” Neri said. “Our ability to bring lessons from outside Zambia and work with Zambians to translate those lessons into effective HIV programs is something that I am proud of.”

Neri also highlighted the role of the President’s Emergency Plan for AIDS Relief (PEPFAR), which has invested more than $110 billion in HIV programs globally, in advancing innovation and expertise in HIV management.

The Future of HIV Management in Zambia

Although Project HOPE has concluded its operations in Zambia, HIV epidemic management continues through coordination between the U.S. and Zambian governments. On Nov. 18, 2025, the Department of State announced that the first doses of lenacapavir had been delivered to Zambia.

Lenacapavir is a twice-yearly injectable PrEP medication that offers a long-acting alternative to daily oral pills, particularly for individuals who face challenges with adherence or access to health care. On Nov. 4, 2025, after 12 working days of review, both tablet and injectable forms of lenacapavir received approval for HIV prevention from the Zambia Medicines Regulatory Authority.

As U.S. funding shifts away from NGOs and places greater responsibility on local governments, Project HOPE has emphasized the importance of retaining proven best practices during this transition. Neri expressed cautious optimism about the future of HIV management in Zambia while stressing the need for continued support for on-the-ground delivery.

“Making lenacapavir available in Zambia is consistent with the original focus of PEPFAR,” Neri said. “Without medicines, it is impossible to have a successful HIV program, and without program funding, it is hard to imagine how access to medicines will improve. The two go hand in hand.”

– Nikhil Kumar

Nikhil is based in Lexington, MA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Addressing HIV/AIDS in Malta

HIV/AIDS in MaltaMalta is a developed island located in the Mediterranean Sea, between Sicily and North Africa. With a relatively small population, 532,956 in 2023, according to the World Health Organization (WHO), the population still suffers from HIV/AIDS diagnoses. Despite these challenges, promising progress from NGO HIV Malta and the country’s effective health care facilities and expertise continue to steady the rate of positive infections. Here is information about HIV/AIDS in Malta.

What Are HIV and AIDS?

HIV, also known as human immunodeficiency virus, is a virus that results in illness from a weakened immune system. The virus attacks healthy cells in the body, ultimately exposing the body to other infections. People most commonly spread it through unprotected sex, contact with the body fluids of someone with HIV or even when sharing injection equipment.

Eventually, if people leave it untreated, it can lead to AIDS, which stands for Acquired Immunodeficiency Syndrome. AIDS is described as the last stage of HIV, where the body’s cells and immune system are severely damaged. It can eventually lead to death if people leave it untreated during the initial HIV stage.

The Times of Malta recorded Malta’s first case of AIDS in 1984. In 1986, an estimated 25 individuals had a positive HIV test, which triggered a national health response. The Health Education Unit published leaflets named Fatti dwar 1-AIDS, to warn people of the untreatable infection. Moving into the 2000s, positive HIV tests mounted to 210 in 2003. According to The Times of Malta, “HIV was then named a notifiable infection on January 27, 2004.”

According to the HIV Justice Network, Malta passed a disease transmission law in 2005, which made it a crime for someone with an HIV infection to recklessly or intentionally pass it on to another. The sentencing powers include life imprisonment, and monthly sentences or fines.

Poverty in Malta – HIV/AIDS Prevalence Amongst Migrant Groups 

While Malta’s economy continues to excel as a developed nation, poverty still affects the less fortunate, in this case, migrants fleeing their home to settle elsewhere. According to Trading Economics, Malta’s risk of poverty in 2024 reached 16.8%. Over the years, Malta has seen a fluctuating poverty rate, with both high and low peaks. Its highest recording reached 17.1% in 2019. The factors influencing poverty in Malta include variations in living conditions, unemployment rates and income inequality.

Across Malta, HIV/AIDS prevalence in migrants is more common than in nationals. To date, the country has welcomed 2,000 asylum seekers and 11,000 refugees, according to the World Health Organization (WHO). HIV testing is free for all individuals in Malta; however, if migrants receive a positive test, the treatment policy differs. Ultimately, those who do not have legal employment must pay for their treatment, resulting in higher untreated cases amongst migrants, due to high medical costs ranging between €600 to €1,500 monthly according to HIV Malta.

Background on HIV Malta 

HIV Malta is a non-governmental organization working to help focus on the well-being and necessary quality of life of those with HIV/AIDS in Malta. The NGO addresses HIV in Malta by implementing educational programs, prevention methods, advocacy groups and support services. Its main aims also include:

  • Relevant treatment and policy work should be carried out to improve the quality of life of those with HIV.
  • Educational campaigns that provide factual, knowledge-based information.
  • Making sure those with HIV can live their life with respect for their human rights.
  • Providing accurate information that is scientifically proven for testing and prevention. 
  • Working with stakeholders in the medical sector to perfect treatment. 
  • Working with the community and with other NGOs with strong, compatible objectives.

Key Accomplishments and Collaborations 

We Are Positive is an advocacy group that HIV Malta created in partnership with Checkpoint Malta and activist/artist Emma Grima. It aims to humanize HIV and promote sexual health in communities.

Its first artistic action, held in 2014 at the LOVE Monument in Spinola Bay, St Julian’s, included plastering the monument with 620 self-testing boxes and urging people to interact with them. The general public engaged in conversations, and people received encouragement to tell their HIV journey story. The box contained cards and stickers explaining where people could get tested. They highlighted the success of the campaign across their web page.

Checkpoint Malta also set up monthly peer support in 2024, encouraging those living with HIV to share their experiences in a confidential and safe space. Their ongoing monthly meetups provide an opportunity for people to communicate outside of medical settings.

The Future of HIV/AIDS in Malta 

With HIV Malta leading as a forefront NGO in providing expertise to reduce the spread and risk of HIV transmission across Malta, the country is looking at a promising decline in infections. According to the World Health Organization (WHO), the number of new HIV infections in Malta (per 1,000 uninfected population) has remained at 0.1 per 1,000 since the 1990s up until 2024. HIV/AIDS in Malta is showing promising progress with the availability of testing methods, prevention methods and treatment from expert clinics and hospitals. However, changes to treatment availability across the country, particularly for migrants, will help tackle the decline in positive infections.

– Zara Ashraf

Zara is based in London, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Unsplash

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What Funding Cuts Mean for HIV/AIDS in Developing Countries

HIV/AIDS in developing countriesWorld AIDS Day was commemorated by the U.S. government on the first day of December every year since 1988 to honor those who have lost their lives to the disease, until this year. The White House made the decision this year not to commemorate World AIDS Day for the first time since the tradition was established, with promotion through official communication channels being prohibited for federal employees. This decision aligns with what UNAIDS has described as the most significant setback to the global HIV response in decades.

The organization attributes this decline to the 2025 funding crisis, driven by the White House’s cancellation of foreign aid for HIV/AIDS research and prevention, as well as the depletion of the President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is the U.S. government’s global HIV program established under President George W. Bush. The Guardian reports that PEPFAR is estimated to have prevented 25 million early HIV/AIDS-related deaths.

Nearly a year after the onset of the crisis, HIV/AIDS poses a greater threat to the global population than it has in recent years. The impact on HIV/AIDS in developing countries is especially severe, as they tend to rely most heavily on these resources.

A 75% Halt in Global HIV Funding

According to the UNAIDS’ 2025 World AIDS Day report, the U.S., the world’s largest economy, was the largest donor to the HIV/AIDS response, providing 75% of all international funding. This was until funding was halted earlier in the year, with other members of the international community, particularly European countries, caving to pressure from the White House to divert funding from foreign aid toward national defense spending, as reported by Reuters.

The report revealed that by the end of 2024, before the funding crisis began, the world was closer than ever to achieving SDG 3’s goal of eradicating AIDS worldwide by 2030. Of the 40.8 million people living with HIV, 31.6 million were receiving lifesaving treatment. Between 2010 and 2024, HIV prevention and treatment services contributed to a 40% decline in new infections and a 54% drop in AIDS-related deaths.

These improvements coincided with increases in funding during the same period, rising 28% domestically and 12% internationally. The 2025 UNAIDS Global AIDS Update reported that sub-Saharan Africa achieved a remarkable 56% decline in new HIV infections between 2010 and 2024. The report also highlighted that five countries, most of them in sub-Saharan Africa, are on track to reduce new infections by 90% by 2030 compared to 2010 levels.

HIV/AIDS in Developing Countries

According to the 2025 UNAIDS Global AIDS Update, by the end of 2024, external funding supported nearly 80% of HIV prevention programs in sub-Saharan Africa, 66% in the Caribbean and 60% in the Middle East and North Africa—making these regions particularly vulnerable amid the funding crisis. The report also noted that the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) had identified more than 60 countries at risk of losing assistance or having their grants reduced, including some that had recently been reclassified as upper-middle-income.

The 2025 UNAIDS World AIDS Day report notes that antiretroviral therapy programs are largely financed domestically outside of sub-Saharan Africa. However, they are particularly vulnerable to donor reductions in western and central Africa, where donors provide 90% of treatment-related funding—53% of which comes from the Global Fund. Some examples of how countries in these regions have been affected include:

  • The HIV prevention program in Eswatini lost 20% of its funding between 2024 and 2025, despite a 23% HIV prevalence among people aged 15 to 49.
  • The number of people using PrEP (prevention medication) fell by 64% in Burundi, 38% in Uganda and 21% in Vietnam.

What Needs To Change

Despite the challenges facing the global HIV response, UNAIDS executive Winnie Byanyima believes that AIDS can still be eliminated as a public health threat by 2030 through “urgency, unity and unwavering commitment.” The most impactful and simultaneously most challenging path forward is for the international community to help close the funding gap for HIV prevention. According to the 2025 UNAIDS Global AIDS Update, achieving global targets in low- and middle-income countries would require an annual investment of $21.9 billion.

The report also highlights a financial incentive for action, noting that “if the world embraces new technologies, efficiencies and approaches, the annual cost of the HIV response could fall by around $7 billion.” Furthermore, the report notes that community-led organizations have been central to the HIV response for more than 40 years, providing information and support, driving advocacy and conducting critical research. Their impact has been significant enough that multiple countries now permit them to deliver treatment services and receive funding from the Global Fund for community-led and civil society initiatives.

Additionally, the World Health Organization supports expanding access to lenacapavir, a six-monthly injection and a recent advancement in prevention medication, offering hope, despite ongoing funding challenges, in the fight against HIV/AIDS in Developing Countries.

– Luca Hanlon

Luca Hanlon is based in Brooklyn, NY, USA. and focuses on Good News, Politics for The Borgen Project.

Photo: Unsplash

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HIV/AIDS in Tunisia

HIV/AIDS in TunisiaHIV/AIDS in Tunisia is still a challenge, but the country is making steady progress through better testing, treatment and community support. New data highlights the need for continued action to protect vulnerable groups and expand access to care.

Recent studies show that HIV/AIDS in Tunisia is shifting with new infections and AIDS-related deaths rising in recent years. In 2024, researchers estimated that 9,750 people were living with HIV in the country with more than 1,000 new cases recorded. Although national prevalence remains low, the epidemic is concentrated among key populations who face higher risks and significant barriers to care.

The Current Situation in Tunisia

Tunisia’s HIV epidemic remains relatively small, but recent data shows a worrying upward trend. In 2024, an estimated 9,750 people were living with HIV, and more than 1,030 new infections were reported. AIDS-related deaths also reached around 485 people, highlighting gaps in early detection and consistent treatment.

The epidemic is concentrated among key populations, including men who have sex with men, sex workers and people who inject drugs—groups that face high stigma and limited legal protection. According to UNDP, only about 20% of people living with HIV in Tunisia know their status and receive treatment, meaning many individuals remain undiagnosed and at risk of developing severe illness. Although overall national prevalence is still low at 0.1%, according to the World Bank, the increase in new infections shows that Tunisia needs stronger prevention, testing and community-based support systems.

Barriers and Challenges

Despite progress in health care, Tunisia still faces several challenges that make it difficult to control the HIV epidemic. One of the biggest issues is stigma and discrimination, especially toward key populations such as men who have sex with men, sex workers and people who inject drugs. UNDP reports that gaps in anti-discrimination laws leave these groups unprotected, making many afraid to seek testing or treatment.

Another major challenge is low testing and awareness. Only around 20% of people living with HIV know their status, which means thousands remain undiagnosed. Without early detection, individuals cannot begin treatment, increasing the risk of AIDS-related complications.

Poverty and Barriers To Accessing HIV Care

For many people living in poverty in Tunisia, getting consistent HIV care is still a major challenge, especially when transportation costs, lack of insurance and financial barriers limit access to clinics.

Treatment services are unevenly distributed across the country — most specialized HIV centers are located in Greater Tunis, Sousse, Monastir and Sfax — leaving the entire western region without coverage, which forces low-income patients to travel long distances they often cannot afford. Limited access contributes to poor treatment adherence, and Tunisia continues to fall behind global HIV goals, with only 32% of people living with HIV receiving antiretroviral therapy despite years of international commitments.

NGOs in Tunisia report increasing drug resistance and worsening health outcomes among patients who struggle to stay in care, underscoring the need for better support for vulnerable and poor communities.

Promising Efforts and Progress

Even with these challenges, Tunisia is taking important steps to strengthen its response to HIV. UNAIDS highlights the country’s leadership role in the region, noting its commitment to rights-based health policies and stronger engagement with young people.

Tunisian youth organizations have partnered with UNAIDS to push for better education, more inclusive services and meaningful participation in decision-making. UNDP is also supporting national efforts to update Tunisia’s HIV Strategic Plan, focusing on human rights, gender equality and better protection for key populations. This includes reviewing laws that limit access to services and working with local groups to improve outreach.

Broader health reforms are helping too. According to WHO and UNICEF, Tunisia is expanding community-based health programs and investing in stronger primary care. These reforms improve access to prevention, testing and counseling, especially for people in underserved areas. Together, these initiatives show that Tunisia is not only aware of the challenges, but actively working toward a more inclusive, accessible and sustainable HIV response.

Conclusion

HIV/AIDS in Tunisia continues to present real challenges, but ongoing reforms and community-led efforts show that progress is possible. With stronger prevention programs, better legal protection and wider access to testing and treatment, Tunisia can reduce new infections and support more people living with HIV. Continued collaboration between the government, NGOs and youth organizations will be essential to building a healthier and more inclusive future.

– Aila Alsakka

Aila is based in Nottingham, UK and focuses on Good News and Technology for The Borgen Project.

Photo: Wikimedia Commons

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Improving the Response to HIV/AIDS in The Gambia

HIV/AIDS in GambiaThe Gambia implemented many initiatives, programs and policies to improve its HIV/AIDS response. The country is focusing its prevention efforts on key populations experiencing higher prevalence rates of HIV and improving the accessibility of treatment services to these populations. The integrated and comprehensive approach empowers girls and young women through secondary education, development of training for health care workers on prevention and treatments and specialized nutritional services for breastfeeding women with HIV/AIDS in the Gambia.

The Background 

The Republic of the Gambia experienced its first detection of HIV/AIDS in 1986. In response, they created a new department within the Ministry of Health called the National AIDS Control Programme (NACP). While the HIV/AIDS prevalence in the general population remains relatively low, at less than 2%, key subpopulations such as men who have sex with men (MSM) and female sex workers (FSW) experience disproportionately high prevalence rates. While the country continuously progresses in its treatment services for HIV/AIDS since 1986, progress stalled during the COVID-19 pandemic. Many resources, skills, personnel and medical equipment essential to HIV/AIDS treatment were repurposed during the pandemic to treat COVID-19 patients. In response to the dual HIV and COVID-19 epidemics, the Gambia improved its HIV/AIDS reduction strategies by investing in better prevention services, especially targeting key subpopulations and increasing the utilization and accessibility of treatment services.

 Key Statistics:

  • In 2020, more than half (55%) of the estimated 27,000 people living with HIV/AIDS in the Gambia were females aged 15 years and older.
  • In 2020, among people aged 15-24, three out of four new HIV infections were females.
  • In 2018, the HIV prevalence among FSW was more than 10%.
  • In 2018, the HIV prevalence among MSM was more than 35%.

National HIV/AIDS Policy 2022-2027

UNAIDS and the Gambia created a Joint Programme in 2022 to develop the National HIV/AIDS Policy 2022-2027. The policy advances the prevention and treatment of HIV/AIDS and diminishes societal and legal barriers limiting access to treatment services. The Joint Programme prioritizes the revision and implementation of stronger National HIV prevention policies and strategizing preventive measures targeting key populations to improve the response to HIV/AIDS in the Gambia.

Key Results: 

  • The Programme delivered a total of 100,000 HIV testing kits and more than 724,000 condoms for distribution into health care systems in 2022-2023.
  • On World AIDS Day in 2022, more than 110,000 Gambians accessed HIV testing and counseling services due to community outreach initiatives.
  • In 2022-2023, 122 professional health workers across the country shared best practices for improving access and quality of HIV services.

Education Plus Initiative

The Education Plus Initiative (2021-2025) is a preventative effort against HIV/AIDS specifically in girls and young women in sub-Saharan Africa. This joint Initiative includes UNAIDS, UNESCO, UNFPA, UNICEF and UN Women in response to the startling amount of young women and girls infected with HIV and dying from AIDS in sub-Saharan countries. The Gambia joined eight other countries in 2022 by launching the Education Plus Initiative. The initiative integrates expanded access to secondary education for adolescent girls as an entry point for comprehensive health education, HIV prevention strategies and women empowerment. 

Key Results: 

  • Completing secondary education contributes to a significant reduction in HIV among adolescent girls and young women, such as drops in new cases by one-third to one-half in some countries.

Prevention of Mother-to-Child Transmission Programme

The Gambia initiated the Prevention of Mother-to-Child Transmission Programme (PMTCT) in the early 2000s to prevent the transmission of HIV from HIV-positive mothers to their infants during pregnancy, childbirth and breastfeeding. The programme outlined several strategies and objectives to reduce mother-to-child transmission. Strategies to increase the utilization of services and testing included establishing Voluntary Confidential Counseling and Testing (VCCT) sites in health facilities, dissemination of information on the programme to the community and offering VCCT services to all women attending antenatal clinics. Strategies for effective treatment included providing antiretroviral (ARV) therapy to HIV-positive women, Cotrimoxazole to exposed children and counseling for infant feeding to HIV-positive mothers.

Key Results:

  • By 2009, 35% of facilities with antenatal, delivery and postnatal services offered PMCTC services.
  • By 2009, 51% of HIV-positive pregnant women completed a course of ARV prophylaxis.

HIV Training Services for Maternal and Health Facilities

With support from the Joint Programme, the Gambia improves the treatment of mothers and pregnant women with HIV and the prevention of vertical transmission. Training on providing comprehensive HIV services such as counseling, ARV treatment and infant feeding became accessible to health care workers working in maternal and health facilities. Advancements in HIV training for health workers is an important strategy to improve the response to HIV/AIDS in the Gambia.

 Key Results:

  • In 2022-2023, 115 HIV-positive mothers and pregnant women accessed HIV counseling and testing services.
  • In 2022-2023, 116 health care workers from five different regions completed training supported by the Joint Programme on improved early infant HIV diagnosis and delivery practices to prevent mother-to-child transmission.

Nutrition Education and Services for People Living With HIV

The Ministry of Health and the National Nutrition Agency in the Gambia collaborated to provide a three-month period of specialized nutritious food for breastfeeding women with HIV to optimize health status and outcomes. The National AIDS Control Programme (WFP) partnered with the Joint Programme to create a social and behavioral change communication training empowering community members to inform HIV-positive people on nutrition and breastfeeding with HIV. 

Key Results:

  • More than 3,000 pregnant and breastfeeding HIV-positive women in three regions received specialized nutritious food in order to improve health outcomes.
  • In 2022, 103 HIV-positive people attended community groups providing education on nutrition and health.

Poverty and HIV/AIDS 

Living in extreme poverty increases the risk of contracting HIV, and living with HIV/AIDS only exacerbates the burden of poverty. Basse is a region with one of the highest HIV/AIDS prevalence rates within the Gambia. The Basse region also has the highest rate of food insecurity, at 19%, in the country. Gender inequality and poverty make women in Africa especially vulnerable to infection due to lack of access to information, health care, formal education, financial opportunity and increased exposure to sexual violence. Furthermore, financial insecurity and violence against women lead to more FSW in impoverished communities. Indeed, FSW are a key population disproportionately affected by HIV/AIDS in the Gambia. 

Conclusion

The Gambia has taken various innovative measures to improve HIV/AIDS response. The focus on key subpopulations while developing prevention initiatives improved access to services and distribution of resources to those who need it most. Women and girls benefit from the integration of secondary education and HIV/AIDS information and enhanced nutritional services for breastfeeding women with HIV. The country used lessons learned from the halt in progress during the COVID-19 pandemic to reform and improve their reduction and prevention strategies to eliminate the HIV/AIDS epidemic.

– Sarah Merrill

Sarah is based in Matthews, NC,  USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Pixabay