The Joint United Nations Programme on HIV/AIDS (UNAIDS) has unveiled a new framework designed to strengthen and expand HIV prevention efforts at a moment it describes as a “tipping point” for the global response.

Reports indicate there are growing concerns that reduced prioritization and declining funding for prevention could undermine progress achieved in lowering new HIV infections.

Even while some countries continue to demonstrate that considerable reductions in HIV infections are possible when preventive programs are consistently implemented and adequately supported, the framework arises against the backdrop of ongoing global challenges.

On a global scale, approximately 1.3 million new HIV infections were recorded annually in both 2023 and 2024.

At the same time, several countries achieved notable success. By the end of 2024, Lesotho, Malawi, Nepal, Rwanda and Zimbabwe had each recorded a 75% decline in new HIV infections compared to 2010.

Building on these advances, new targets for 2030 have been developed through collaboration with countries. These targets have been incorporated into the Global AIDS Strategy 2026–2031, which provides an overarching framework to guide national and international HIV responses in the coming years.

The Global HIV Prevention Coalition (GPC), established in 2017 to strengthen political and financial commitment to primary prevention, has drawn on these targets and the broader strategy to develop the HIV Prevention 2030 Global Access Framework.

According to Angeli Achrekar, Deputy Executive Director of UNAIDS, the objective is to ensure universal access to HIV prevention options for those who need them.

“This is achievable if investments in prevention are robust and sustained, if countries ensure effective use of resources, and if programmes are evidence-based and grounded in human rights with communities at the centre.”
Angeli Achrekar

The Access Framework sets out key 2030 targets, including ensuring that 90% of people in need of prevention services can access them, and that 90% of people living with HIV achieve viral suppression. Together, these goals are expected to contribute to a projected 90% reduction in new HIV infections globally.

To meet these targets in a constrained funding environment, the 2030 Prevention Access Framework defines five Ps for prioritization which includes “put the People in greatest need at the centre; Place-focus on the highest-burden locations; the right Platforms-for service delivery; the right Package-of prevention options to offer people choices; Price-cost effectiveness to ensure sustained country implementation.”

Strengthening Country-Led Systems and Expanding Access

Expanding access to HIV prevention increasingly requires a shift toward country-led, domestically financed programmes, with an emphasis on locally driven solutions that ensure long-term impact.

UNAIDS highlights several global benchmarks for prevention efforts, including 40 million people living with HIV on treatment, 20 million people accessing pre-exposure prophylaxis (PrEP), distribution of 20 billion condoms, and allocating at least 20% of domestic HIV financing to prevention initiatives.

Pio Smith, Deputy Executive Director (United Nations Population Fund (UNFPA), noted that the future effectiveness of the HIV response will depend on the ability to deliver combination prevention at scale, grounded in human rights and dignity, and driven by governments, communities and young people, while remaining integrated within broader sexual and reproductive health systems. He also emphasized that “UNFPA is committed to meeting the needs of all population groups, particularly those of adolescent girls and young women. We will continue working with partners to address critical gaps to ensure no one is left behind.”

Innovations in HIV prevention are further expanding available options for populations at risk. New long-acting prevention methods, including lenacapavir administered as a twice-yearly injection, are becoming available.

Access to stigma-free health services, integrated prevention and care platforms, community outreach initiatives, pharmacies, youth-focused digital and telehealth services, and tools supported by generative AI are playing an increasingly important role in improving accessibility to prevention services.

Mitchell Warren, GPC Co-chair, cautioned that the global community must act decisively to capitalize on scientific advances, stating that, “History will judge us harshly if we as a global community fail to meet this scientific moment.”

“The cost of inaction is detrimental. Innovations, including new and emerging long-acting prevention options, especially lenacapavir, have added toto the array of prevention choices. Now, speed, scale and equity are still needed to translate exciting science into public health impact.”
Mitchell Warren

Despite international commitments, investment in primary prevention remains significantly below required levels, particularly across many low- and middle-income countries.

To address this gap, governments are encouraged to allocate at least 20% of domestic HIV funding to prevention programmes and ensure that essential commodities including antiretroviral-based prevention tools, condoms, needles and syringes, and voluntary medical male circumcision are accessible, affordable, and widely available to those who need them.