As the global HIV response faces shrinking funding, increasing pressure on civil society, and growing attacks on human rights and gender equality, UNAIDS' Eamonn Murphy has called for communities to remain at the centre of the fight against HIV - not only in principle but also in policy, financing and governance.
His powerful message captured both the urgency and the
opportunity facing the global HIV response as governments, civil society,
researchers and community leaders prepare for the world's largest AIDS
conference this year (26th International AIDS Conference or AIDS 2026 in Rio de
Janeiro, Brazil).
Eamonn Murphy leads UNAIDS as Regional Director for
Asia Pacific, Eastern Europe and Central Asia.
Delivering the keynote address at AIDS 2026 Affiliated
Independent Event hosted by GNP+, NCPI+, CNS and partners, Murphy congratulated
governments, communities and technical partners on securing the new United
Nations Political Declaration on HIV/AIDS, adopted last month at the UN General
Assembly High-Level Meeting (UNHLM) on HIV/AIDS.
Describing the declaration as "a joint win,"
Murphy stressed that it was achieved during an exceptionally difficult
political period, making the consensus all the more significant. It is
important to note that such Political Declarations have conventionally been
adopted with consensus by all governments globally. But since last year, US-led
forces have upped their attacks against health and gender rights, said Manoj
Pardeshi of National Coalition of People living with HIV in India (NCPI+). Out
of 194 UN member countries, 149 voted in favour, with the US and a few others
voting against it (and the rest abstained or were absent). Pardeshi chaired an
important session at AIDS 2026 Affiliated Independent Event: Naresh Yadav
Memorial Leadership Summit.
Communities at the heart of the HIV response
"It was critical to have voices of communities
and technical partners working alongside governments long before the UN
High-Level Meeting itself," he said, noting that community advocates
helped shape the final text and ensured that new policymakers understood why
ambitious HIV commitments remain indispensable.
Communities earned their place
UNAIDS' Murphy reminded participants that community
leadership was never a gift bestowed by policymakers. Inclusion of communities
was earned through decades of activism, courage, lived experience and
relentless advocacy.
According to Murphy, community leadership is
indispensable if the world hopes to achieve the global HIV targets by 2030.
Community-led health service delivery model is the
lynchpin to reach the unreached
People living with HIV, key populations and community organizations
have repeatedly shown that they reach those whom formal health systems often
fail to reach. They build trust where stigma persists, support treatment
adherence where health systems are overstretched, and defend human rights where
discrimination remains entrenched.
For Murphy, this is why communities are no longer
viewed merely as beneficiaries of HIV programmes. Still, they are recognized as
equal partners in designing, delivering, monitoring and governing the HIV
response.
The internationally endorsed 95-95-95 targets - which
seek to ensure that 95% of people living with HIV know their HIV status, 95% of
those diagnosed with HIV receive antiretroviral therapy, and 95% of those on
treatment achieve viral suppression - cannot be achieved without trusted community
networks, said Murphy.
Scientific breakthroughs alone will not achieve the
global HIV targets. Murphy noted that the globally agreed 95-95-95 targets
depend on much more than medicines. They require people to trust services
enough to seek HIV testing, begin treatment quickly, remain in care and achieve
viral suppression.
HIV testing, rapid linkage to treatment, long-term
adherence, viral load literacy and widespread understanding of
"Undetectable equals Untransmittable" (U=U) all depend heavily on trusted
relationships built by community-led organizations, he said. U=U is critically
important because when the viral load of persons with HIV is undetectable, the
virus is also untransmittable - or, in other words, HIV treatment works as
prevention.
Do not forget 30-80-60 targets for 2030
Murphy also highlighted the 30-80-60 targets, which
explicitly recognize community leadership. By 2030, community-led organizations
are expected to provide 30% of HIV testing and treatment support services, 80%
of HIV prevention services for key populations, and 60% of programmes
addressing legal and social barriers.
These targets are more than aspirations; they are
accountability tools that communities can use to measure government
performance, said Murphy.
"We must not forget 30-80-60 targets, as these
are very critical if we are to end AIDS in the next 54 months (by 2030),"
said Dr Bharat Bhushan Rewari, who has earlier led the lifesaving
antiretroviral therapy programme at the Government of India's National AIDS
Control Organization (NACO). Dr Rewari also formerly led the WHO as South-East
Asia Regional Advisor for HIV, hepatitis and STIs.
Political commitments require financial commitments
While acknowledging that many governments praise
community organizations during international meetings, Murphy warned that
recognition alone will not sustain HIV programmes.
"Community leadership must be financed - not
simply applauded," he said.
He cautioned that several countries are transitioning
towards domestic financing at a time when international HIV assistance is
declining. Unless national budgets explicitly include community-led services,
many of the programmes responsible for reaching key populations could
disappear.
"A service without a budget line is a service at
risk," Murphy observed.
He pointed out that treatment services and diagnostics
are often protected within government health budgets. At the same time,
prevention programmes, rights-based interventions and community outreach
continue to rely disproportionately on external donor support.
Such an imbalance, he warned, threatens decades of
progress.
He argued that governments should institutionalize
community-led responses through dedicated budget allocations, social
contracting mechanisms and fully costed community service packages.
Communities must also participate in setting national
priorities from the beginning - not simply be consulted after financial
decisions have already been made.
Success stories offer hope
Despite the challenges, Murphy highlighted encouraging
examples from Asia.
Cambodia's recent achievement of the 95-95-95 targets
demonstrates what determined national leadership and community partnership can
accomplish.
Thailand's successful integration of community-based
HIV services into the national health system similarly illustrates how
governments can institutionalize trusted community-led approaches while
improving access to care.
These experiences show that sustainable progress
depends on genuine partnerships between governments, health systems and
communities. These success stories also illustrate that investing in
communities is not simply socially just—it is also good public health.
Innovation must strengthen - not replace - communities
Murphy welcomed scientific advances including HIV
self-testing, long-acting HIV prevention technologies, differentiated treatment
models and expanded viral load monitoring.
However, he cautioned that innovation cannot replace
the trust built by community organizations.
Peer support, community mobilisation, demand
generation and community-led monitoring remain essential if technological
advances are to achieve their full public health impact.
When a bacteria (TB) and virus (HIV) can work together
then why cannot we?
Integration, he added, should also improve
collaboration between HIV and tuberculosis services.
"We will not end AIDS while preventable TB deaths
continue," Murphy said.
A decisive moment
As the world moves towards AIDS 2026, Murphy's message
resonates far beyond conference halls: communities should not merely be
recognised for the role they have played - they must be trusted, empowered and
adequately financed to lead the next phase of the globalHIV response.
Only then can the commitments made in international
declarations become lasting improvements in people's lives.
He called on governments to translate the newly
adopted Political Declaration into funded national action plans, while urging
international donors not to retreat precisely when communities are being asked
to deliver more with fewer resources.
"The declaration is in place. The science exists.
Communities have demonstrated their leadership," Murphy said.
"What we need now is political will that matches
our ambition - with adequate resources, protection of human rights and genuine
partnership with communities."
His message was clear: ending AIDS will require far
more than medical innovations. It will demand sustained political commitment,
investment in community leadership and accountability at every level of the
global HIV response.
