UNAIDS Asia-Pacific 
The world has spent more than 40 years learning what works in the AIDS response. For the Pacific, with its long tradition of collective action in tackling shared challenges, those hard-won lessons could help prevent today’s growing HIV epidemics from becoming a much larger crisis.
The recent surge of international attention to Fiji’s HIV epidemic has carried uncomfortable echoes of an earlier era of AIDS.
A rapid rise in new infections. A national crisis declaration. Stories of people struggling to access services or staying away because of pervasive stigma. Health systems racing to catch up with an epidemic moving faster than the response. Once again, HIV has made international headlines with an urgency many had hoped belonged to the past.
But there is one fundamental difference. This is 2026.
Today, we have effective treatment, powerful new prevention tools and decades of experience that did not exist at the start of the AIDS epidemic. The Pacific cannot afford to lose time or repeat past mistakes.
The need to act is urgent: Fiji has seen one of the fastest-growing HIV epidemics globally, with new infections rising approximately twelvefold between 2010 and 2025. But Fiji is not the only warning sign. Papua New Guinea remains the largest HIV epidemic in the region, with an estimated 110,000 people living with HIV. HIV diagnoses have also risen recently in Palau, Solomon Islands and Vanuatu. Across the Pacific, new infections increased by an estimated 65% between 2010 and 2025, while they declined across Asia and the Pacific overall.
In countries with small populations, even relatively few new infections can signal a major shift in the epidemic. Waiting until the numbers become alarming means losing valuable time to prevent further transmission.
First, HIV is everyone’s concern.
In 1989, American artist and activist Keith Haring painted a mural: Todos juntos podemos parar el sida—Together We Can Stop AIDS. More than a slogan, it captured the spirit of a movement that brought together people who had rarely worked side by side: doctors and politicians, activists and scientists, faith leaders and teachers, police and community advocates, celebrities and people living with HIV.
That mobilisation required heads of state to speak publicly about AIDS, parliaments to change laws that fuelled stigma or blocked access to services, and societies to confront deep-seated prejudice. The early AIDS response showed how fear and misinformation can contribute to discrimination—a lesson worth bearing in mind when measures such as mandatory testing or restrictive border controls are considered. It also demanded action across sectors: from health and education to law enforcement and justice, alongside broader efforts to advance human rights, gender equality and development.
Fiji’s declaration of a national HIV crisis is an important political step. It recognises that the health sector cannot tackle the epidemic alone.
Across the Pacific, addressing discriminatory laws, stigma and other barriers to prevention and treatment requires the kind of political leadership and collective action that shaped the global AIDS response.
Second, let communities lead.
The AIDS response was transformed by the communities most affected by HIV. They challenged stigma, fought for access to treatment and helped shape services around people’s needs.
Even today, despite advances in treatment and prevention, stigma and discrimination still keep many people away from HIV services. Fear of judgement or unwanted disclosure can determine whether someone seeks testing or treatment at all.
Community organisations and peer outreach workers help bridge that gap by building trust and reaching people who might otherwise remain outside the health system. This is especially important in the Pacific, where small island communities and remote settings can make privacy harder to protect and confidentiality all the more important.
As Pacific countries move towards greater national ownership and sustainable financing, community-led services need to become an integral part of national HIV plans and budgets, rather than remain dependent on short-term donor-funded projects. With external funding under pressure, this transition must not come at the cost of prevention, or of the independence and trust that make these services effective.
Third, close the gap between progress and access.
Medical science has transformed what is possible. Antiretroviral treatment now enables people living with HIV to lead long, healthy lives.
When people take effective antiretroviral treatment and achieve and maintain an undetectable viral load, they do not transmit HIV sexually—the principle known as U=U, or Undetectable = Untransmittable.
Yet treatment coverage remains alarmingly low in parts of the Pacific. In Fiji, only about a quarter of the total estimated people living with HIV accessed treatment, and in Papua New Guinea, only about half.
Effective treatment during pregnancy and breastfeeding can protect women’s health and prevent HIV transmission to their babies. In Papua New Guinea, however, only about one in four pregnant women living with HIV receive antiretroviral treatment, and an estimated 2,700 infants acquired HIV in 2024—a stark reminder of the distance that can remain between what medicine makes possible and what reaches families in time. That is why HIV testing and treatment need to be readily accessible through routine antenatal, maternal and child health services, including in remote communities
Prevention has entered a new era too. Alongside proven approaches such as condoms, harm reduction and oral PrEP, twice-yearly injectable lenacapavir offers an important new option, particularly for people who find taking a daily pill difficult.
Prevention is increasingly about choice: matching proven options to people’s needs and lives. In Fiji, where HIV infections linked to injecting drug use are increasing, recent legal changes have made it possible to introduce a needle and syringe programme—showing how prevention can adapt as the epidemic changes.
But none of these advances can prevent infections or save lives if people cannot access them. New prevention and treatment options need to reach Pacific countries sooner, at prices they can afford.
Access is about more than medicines. Many Pacific nations already face shortages of health workers, limited resources and the high costs of delivering care across remote islands. Climate change adds to these pressures, as extreme weather threatens health facilities and disrupts essential services.
As countries expand their HIV responses, prevention, testing and treatment can be integrated into primary health care and other essential services rather than built as costly parallel systems. This can make care easier to access, use scarce resources more effectively and strengthen health systems for the future, while preserving the specialised and community-led services that people trust.
Services also need to reach people who are often missed, including people in prisons, and ensure continuity of prevention, treatment and care when they return to the community.
For smaller Pacific countries, greater national ownership cannot mean going it alone. Sustained international financing will still be needed alongside growing domestic investment. Regional cooperation can help those resources go further—through pooled procurement, stronger supply chains and shared expertise. Not every country needs to build every service or specialist capability from scratch.
Pacific institutions such as the Pacific Community (SPC), working alongside the UN Joint Programme on HIV/AIDS (UNAIDS)—including UNDP, UNFPA, UNODC and WHO—can help countries put these shared solutions into practice, bringing governments, communities and development partners together around national priorities.
An opportunity the Pacific cannot afford to miss.
Only four years remain until 2030, the target year set by UN Member States for ending AIDS as a public health threat. The UN Political Declaration on HIV/AIDS, adopted in June 2026, renewed commitments to prevention and treatment, human rights, community leadership and sustainable financing.
The Pacific has the knowledge, the tools and a strong history of collective action. What happens next will shape the region’s HIV epidemics for years to come.
Fiji’s experience is a warning for the entire region. But it can also become a turning point.
Authors:
Eamonn Murphy, UNAIDS Regional Director for Asia and the Pacific and Eastern Europe and Central Asia
Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific
Pio Smith, UNFPA Regional Director for Asia and the Pacific
Beate Trankmann, UNDP Deputy Regional Director for Asia and the Pacific and Director, Bangkok Regional Hub
Delphine Schantz, UNODC Regional Representative for Southeast Asia and the Pacific
One quarter of people still lacking HIV treatment globally live in the region, while rising epidemics and financial pressure on prevention programmes threaten further progress
RIO DE JANEIRO/BANGKOK, 27 July 2026—One quarter of all people globally who were still not receiving HIV treatment in 2025 lived in Asia and the Pacific, while an estimated 280,000 people acquired HIV in the region, according to new UNAIDS data released today.
The findings are contained in United to end AIDS, a special UNAIDS report launched at the opening of the 26th International AIDS Conference in Rio de Janeiro, Brazil. The report warns that reductions in international financing and cuts to HIV prevention and community-led services could lead to a resurgence of the epidemic.
Globally, new HIV infections and AIDS-related deaths are at their lowest levels in more than 30 years. However, 1.2 million people acquired HIV and 570,000 people died of AIDS-related illnesses in 2025. New HIV infections rose in three regions and 21 countries.
Asia and the Pacific has made significant progress, but the regional picture remains deeply uneven. Between 2010 and 2025, new HIV infections declined by 21%. Even so, an estimated 280,000 people acquired HIV in the region in 2025, and epidemics continued to grow in several countries, including Fiji, Pakistan and the Philippines.
Key populations and their sexual partners accounted for the large majority of new HIV infections in the region. Yet gay men and other men who have sex with men, transgender people, sex workers, people who inject drugs, and people in prisons and other closed settings continue to face some of the greatest barriers to accessing appropriate HIV prevention, testing and treatment services.
Testing and treatment gaps also remain substantial. Of the nearly 9 million people living with HIV globally who were not receiving treatment in 2025, around one quarter lived in Asia and the Pacific. Greater efforts are needed to expand differentiated, voluntary and confidential HIV testing and ensure that everyone diagnosed with HIV can access treatment and achieve viral suppression.
The global HIV response experienced dramatic financial upheaval in 2025. Overseas development assistance fell by 23% – the sharpest decline on record – with global health and HIV programmes hit particularly hard.
International financing for HIV declined by more than US$1.5 billion, from US$8.8 billion in 2024 to US$7.3 billion in 2025 – an 18% reduction and the lowest level in nearly two decades.
This financing shock has serious implications for Asia and the Pacific. In many countries, prevention programmes and community-led organizations remain heavily dependent on international support, leaving essential services particularly vulnerable to sudden funding reductions.
Globally, a 2026 study across 47 countries found steep reductions in community-led services, including cuts of 50% to community-led support for HIV prevention medicines and care, 85% to services for gay men and other men who have sex with men, 82% to services for sex workers and 72% to services for survivors of gender-based violence.
These cuts risk deepening existing inequalities across Asia and the Pacific, particularly for key populations, young people and people living in remote, fragile or humanitarian settings. They could also undermine the community organizations that connect people with health systems and often reach people who cannot safely or easily access conventional services.
At the same time, countries across the region are demonstrating what can be achieved when political commitment, sustainable investment and community leadership come together.
Twelve countries in Asia and the Pacific have reported increases in their domestic public budgets for HIV since 2025. Cambodia was among 11 countries globally to achieve the 95–95–95 treatment targets in 2025, while Thailand’s sustained investment in its national HIV response demonstrates what determined political leadership and strong domestic commitment can deliver.
Across the region, countries are also expanding HIV self-testing, community-led monitoring, differentiated service delivery and access to oral and long-acting HIV prevention medicines. These advances show that the region already has much of the knowledge and experience needed to accelerate progress. However, innovation must be affordable, accessible and equitable and brought to scale.
UNAIDS is calling for urgent action to:
- protect HIV prevention, treatment and community-led services from further cuts;
- increase sustainable domestic financing while maintaining international solidarity;
- rapidly expand equitable access to oral and long-acting HIV prevention medicines, HIV self-testing and other innovations;
- remove stigma, discrimination and punitive laws that prevent people from accessing services; and
- integrate HIV services with primary health care and other health programmes without weakening specialized and community-led services.
Despite growing challenges, 149 United Nations Member States adopted a new Political Declaration on HIV and AIDS in June 2026, providing a renewed path towards ending AIDS as a public health threat by 2030.
Its commitments include ensuring that 40 million people are receiving life-saving HIV treatment and that 20 million people have access to antiretroviral-based HIV prevention. The declaration also includes targets to reduce stigma and discrimination, gender inequality and violence, and punitive legal and policy environments that limit access to HIV services.
If fully implemented, the commitments could avert an additional 3.2 million new HIV infections and 1.3 million AIDS-related deaths by 2030.
“The region has shown that remarkable progress is possible,” said Mr Murphy. “Protecting those gains will require sustained investment in prevention and community-led services, equitable access to innovation and continued international solidarity as countries build more sustainable HIV responses.”
Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific Region
Eamonn Murphy, UNAIDS Regional Director for Asia-Pacific and Eastern Europe and Central Asia
Manila, 19 June 2026 – “UNITED TO END AIDS”, a new UNAIDS report released ahead of the 2026 UN General Assembly High-Level Meeting on HIV/AIDS, sends a clear warning: progress against AIDS is real but fragile.
The devastating funding disruptions of 2025 have exposed how vulnerable HIV responses remain.
Countries have moved quickly to protect treatment when external support was suspended, reduced or delayed.
However, specific programmes that have been under-prioritised in national budgets, including HIV prevention, testing, community-led services and efforts to remove barriers to care, have been hit hard. Without decisive action, these gaps risk fuelling new infections and AIDS-related deaths. Indeed, we are already seeing worrying signs.
Asia and the Pacific, with 60% of the world’s population, remains home to the world’s second-largest HIV epidemic. Currently, around 7 million people are living with HIV. Each year, an estimated 280,000 people acquire HIV and 120,000 die from AIDS-related illnesses.
Several countries, including Fiji, the Philippines and Papua New Guinea, are grappling with some of the world’s fastest-rising HIV epidemics.
The High-Level Meeting and new Political Declaration must respond to this reality and truly drive the political choices needed to sustain and transform the HIV response.
The Global AIDS Strategy 2026–2031 provides a clear path: country-led sustainability, people-focused services, and community-led response.
Country-led sustainability
The financing landscape has changed drastically. Global development assistance has fallen sharply, and international support for HIV continues to decline.
Our new reality requires a shift away from donor dependence towards country ownership and domestic financing, backed by continued global solidarity.
It is encouraging that across Asia and the Pacific, governments are taking greater responsibility, particularly for treatment.
China, India, Malaysia, Singapore and Thailand finance more than 90% of their HIV responses from domestic resources. Since 2025, 12 more countries have reported plans to increase domestic HIV funding, including Fiji, which has allocated an additional US$4.5 million to its urgent ongoing national HIV response. Papua New Guinea has allocated an emergency fund of US$13.5 million for HIV, tuberculosis and malaria.
But prevention and community-led services remain heavily dependent on international funding. Around 76% of HIV prevention spending in the region still comes from external sources, leaving outreach and community-led services for key populations exposed as international support declines.
Long-term sustainability requires more than replacing external funds. It means integrating HIV into universal health coverage and primary health care, strengthening national systems and data, addressing societal barriers to services, and accelerating access to innovation.
Targeted donor support remains critical in this transition, with UNAIDS, WHO and partners helping countries protect essential services and build sustainable, country-owned HIV responses.
Sustainability will only matter if services reach people
Lifesaving antiretroviral treatment is reaching 5 million people in Asia and the Pacific, but nearly one third of people living with HIV are still not receiving it. The regional treatment coverage remains at 71%. Late diagnosis continues to drive avoidable illness and deaths.
Prevention is also far behind: coverage of oral pre-exposure prophylaxis, or PrEP, a genuine game changer in preventing infection, is only around 2.5% of what is needed.
The new UNAIDS report calls for integrated, differentiated and people-focused services.
Across the Asia-Pacific region, the priority is to ensure that prevention, testing, treatment, and care reach those facing the greatest barriers, including people living with HIV, key populations, young people, and migrants.
This means applying evidence, removing service barriers and combining biomedical tools with stigma reduction and rights-based delivery.
We have clear examples of how this approach can work. Cambodia’s achievement of the 95–95–95 HIV treatment targets (95% of people living with HIV know their status, 95% of those diagnosed are receiving antiretroviral treatment and 95% of people on treatment have achieved viral suppression), a first for Asia and the Pacific, sends a clear message to the region and the world: progress is possible when services are designed around people.
Strong political commitment, national leadership, long-term partnership and community trust have expanded access to testing and treatment, multi-month dispensing, stronger links with the wider health system, and innovations such as PrEP and HIV self-testing.
At the seventy-sixth WHO Regional Committee for the Western Pacific last year, a joint WHO–UNAIDS session on HIV and substance use engaged 38 countries and areas around this same priority: making services respond to people’s realities.
Innovations accelerate progress, but only if access is equitable.
Long-acting prevention tools, including lenacapavir as a twice-yearly injectable, could transform prevention for people who face stigma, barriers to daily pills, and regular clinic visits.
Asia-Pacific has major manufacturing potential, with four of the six currently licensed generic manufacturers for lenacapavir based in India and Pakistan, which could support faster product introduction.
But scale-up will require more than new products.
We need to combine technical and normative guidance on health-system readiness with advocacy on equity, affordability, rights, community engagement and accountability in the HIV response.
With this support, countries can turn innovation into people-focused services that reach those who need them most and, in turn, enhance community-led responses.
Community-led governance is crucial
In Asia and the Pacific, communities are essential: they build trust, reach people missed by formal systems, and make prevention and treatment services work in practice.
In Thailand, average PrEP retention is 268 days through key population-led providers, compared with 148 days in public health facilities – clear evidence of the value of peer-led services.
As the new UNAIDS report underlines, community leadership is central to a sustainable HIV response, but funding cuts, punitive laws and shrinking civic space are putting it at risk.
Key populations – including men who have sex with men, sex workers and injecting drug users – remain criminalized in 39 countries across the region, while stigma and discrimination trends continue to push people away from services.
Legal and policy reform must urgently remove these barriers so people can seek care without fear or discrimination.
In this regard, young people are key.
WHO and UNAIDS have partnered with the civil society organisation Youth LEAD to bring together young key populations, governments and partners from 11 countries to co-design HIV and STI prevention roadmaps grounded in community leadership, youth engagement and rights-based services.
As foreign assistance for HIV declines, community-led organisations need funding, protection and a formal role in the HIV response.
Social contracting can help by enabling governments to fund civil society organisations to deliver services and connect community systems with public health systems. Yet this modality remains underused. Among 39 countries in the region with available data, only 35% report laws, regulations or policies that allow domestic funding for community-led service delivery.
Community leadership is not an add-on. It is central to the AIDS response.
UNAIDS brings the political mandate, community partnerships and accountability role needed to help countries protect civic space, advance human rights and make community-led responses a core part of national HIV systems.
The choice before us
The new UNAIDS report explicitly shows what is at stake. The High-Level Meeting and Political Declaration offer the opportunity to act.
Countries in Asia and the Pacific should seize this moment to sustain financing, close gaps, remove barriers, and put communities at the centre.
The next phase of the AIDS response must be country-led, people-focused and community-driven.
The choice is clear: Squander the significant gains made in tackling one of the biggest public health challenges of all time, or safeguard the progress made and go the last mile in ending AIDS for once and for all.
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For media enquiries, please contact:
Snizhana Kolomiiets, UNAIDS Asia-Pacific and Eastern Europe and Central Asia, at kolomiietss@unaids.org or by telephone at +4915111009830.
Roy Wadia, WHO Regional Office for the Western Pacific, at rwadia@who.int or by telephone at +639189157260.
UNAIDS in Asia and the Pacific is deeply saddened by the passing of Her Royal Highness Princess Bajrakitiyabha Narendiradebyavati Krom Luang Rajasarinisiribajra Mahavajrarajadhita of Thailand. On behalf of UNAIDS, I extend my deepest condolences to His Majesty the King, the Royal Family, the Government and the people of the Kingdom of Thailand.
Her Royal Highness will be remembered for her distinguished public service and steadfast commitment to justice, human dignity and the well-being of people.
Her compassion and dedication to people whose needs and rights are too often overlooked will continue to inspire people across Thailand and the wider region.
UNAIDS recalls with gratitude Her Royal Highness’s engagement with the United Nations and her efforts to advance the rights and dignity of women and people in vulnerable situations. Her leadership helped draw attention to the links between violence, inequality and HIV, and to the importance of regional cooperation in protecting health and human rights.
UNAIDS also recognizes the Royal Family’s longstanding support for the HIV response, including the leadership of Her Royal Highness Princess Soamsawali Krom Muen Suddhanarinatha, UNAIDS Goodwill Ambassador for HIV Prevention for Asia and the Pacific.
Her Royal Highness Princess Bajrakitiyabha leaves a lasting legacy of service, empathy and inclusion. The entire UNAIDS family stands in solidarity with the Royal Family and the people of Thailand and joins them in mourning this profound loss.
Eamonn Murphy
UNAIDS Regional Director for Asia-Pacific and Eastern Europe and Central Asia
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