The UN General Assembly adopted a new Political Declaration on HIV/AIDS this week reaffirming global commitments to end AIDS as a public health threat by 2030. However, for the first time since political declarations on HIV began in 2001, the declaration was not adopted by consensus. And importantly, the US delegation voted against the declaration. Deputy US Representative to the UN, Tammy Bruce, said in a comment rejecting the declaration that it strayed too far from the targets for ending AIDS “by including divisive topics”. The declaration acknowledges that progress toward the 2030 goal is off track, highlighting widening funding gaps, disruptions to HIV services, and persistent barriers faced by populations at high risk of HIV. Advocates and civil society played an important role in ensuring the declaration included commitments to evidence-based, rights-based HIV responses and renewed calls for sustained investment in prevention, treatment and community-led services.
The divided vote underscores how geopolitical tensions and domestic politics in the US are shaping global health policy at a moment when the HIV response faces its greatest financing crisis. While the declaration provides an important political framework for countries and advocates, it carries no binding obligations and offers few concrete answers to address the growing funding shortfall as nationalism rises and development assistance falls. The US government’s opposition marks an insular, ideologically driven retreat from longstanding consensus for rights-based HIV programming, particularly for key populations who continue to bear a disproportionate burden of HIV. This is consistent with the harmful policies and positions the US Administration has taken against communities vulnerable to HIV including the Promoting Human Flourishing in Foreign Assistance (PHFFA) and the invisibility of vulnerable populations in the most recent PEPFAR data.
In response, global civil society groups led by Health GAP have elevated the People’s Declaration on HIV/AIDS as a counter to the resulting Political Declaration. Over 400 organizations signed onto the People’s Declaration, illustrating a major show of power and call for action by governments to reaffirm commitments, rights, and investments to end HIV for everyone, everywhere.
