On June 22 and 23, 2026, UN Member States gathered at the High-Level Meeting of the General Assembly in New York to consider and ultimately adopt a new Political Declaration on HIV/AIDS. The agreement establishes the global priorities, targets, and actions that will guide the HIV response over the next five years and accelerate progress towards ending AIDS as a public health threat by 2030.
This declaration is preceded by others with similar content; however, according to data from 2024, the HIV response faced a deficit of 3.2 billion dollars. Therefore, the declaration establishes that there is a risk that this funding gap will widen further due to recent and sharp cuts in HIV-related development assistance. The reality is that HIV remains a public health emergency, and infections increased between 2010 and 2025 in three regions, namely the Middle East and North Africa (by 77%), Latin America (13%), and Eastern Europe and Central Asia (15%), as documented by the UN declaration itself.
Supports and oppositions
Despite the severity of the global situation (which no one has questioned), although the declaration was approved by a large majority, the negative votes, abstentions, and the criticism from several countries regarding the brief negotiation period are concerning. This affected the work of the delegations of Botswana and Georgia, who were in charge of the necessary lobbying efforts for this type of document that aims to gather broad global consensus.
The US, Russia, Israel, Burkina Faso, Burundi, North Korea, Niger, and Senegal voted against the declaration, while there were 14 abstentions, including nine from Middle Eastern countries and Paraguay in South America.
The US delegation expressed its rejection of the declaration due to its alleged deviation from the 95-95-95 targets (that 95% of people with HIV know their serostatus; that 95% of people with HIV receive antiretroviral therapy (ART); and that 95% of people on ART have suppressed viral loads), by including issues that lack consensus or are unrelated to the fight against AIDS. Specifically, Ambassador Tammy Bruce stated that her country was very concerned about the inclusion in the declaration of aspects related to trade, and articles on technology transfer to countries lagging behind in this area that could allow them to produce their own inputs for HIV treatment. On this point, the ambassador questioned the potential impact on intellectual property protection as well as the abandonment of “mutually agreed terms” for its approach. This also led to disapproval from the European Union (EU), Switzerland, and Canada, although they ultimately voted in favor of the initiative.
Precisely, it is relevant to highlight that very close to the end of the debates, the African Union, through the delegation of Malawi, removed from the draft declaration the expression “mutually agreed terms” linked to technology transfer. The reason is that African countries considered that this term undermined the central objective of ensuring access to medicines, vaccines, and medical products, as well as promoting research and development through new initiatives and based on national sovereignty, especially in contexts of health emergencies.
For its part, the Russian Federation opposed the declaration for other reasons, particularly because it argued that the text enables interference in internal affairs, as well as the use of a gender approach not based on international consensus.
Beyond the arguments expressed and the fact that, ultimately, the declaration had a very high number of supporters, if two countries with seats and veto power on the UN Security Council voted against it, the perspective for implementing the main commitments included in the text faces very high obstacles.
Main contents
The 2026 Political Declaration includes the 16 targets for 2030 contained in the Global AIDS Strategy 2026-2031, as well as additional new targets agreed upon by Member States. Among others, it includes:
- It aims to achieve two new goals: on the one hand, that at least 40 million people living with HIV have antiretroviral treatment and that 20 million people have antiretroviral-based prevention by 2030.
- Reaffirmation of the 95-95-95 targets for HIV testing, treatment, and viral suppression by 2030.
- Ensure sustainable funding of $21.9 billion annually by 2030 while minimizing out-of-pocket health expenditures.
- Guarantee the protection of human rights, including gender equality, and end HIV-related stigma, discrimination, and violence.
- Reaffirmation of the commitment to reduce new HIV infections and AIDS-related deaths by 90% by 2030, after which countries will be able to move from mitigating an epidemic to managing a chronic disease, a different and more manageable mission.
- Measurable target to ensure that 90% of all people in need have access to effective prevention options, including condoms and harm reduction.
- Greater explicit emphasis is placed on key populations in all areas of the HIV response, recognizing that it is impossible to end AIDS without reaching and empowering these communities.
- Structural need to reach women and girls with comprehensive education and to fully uphold all human rights of women and girls, including their sexual and reproductive health and reproductive rights (P59).
- Reduction of vertical transmission of HIV and ending pediatric AIDS, and ensuring comprehensive care for women and children living with HIV.
- Strengthen community-led responses by committing to greater social contracting and community monitoring, backed by increased funding.
- Enable civic space for civil society and reaffirm the 10-10-10 targets, which call for the elimination of HIV-related stigma and discrimination, punitive legal barriers, and violence against women and key populations.
- Guarantee global accessibility, availability, and affordability of quality-assured essential HIV medicines, diagnostics, vaccines, and other health technologies, through tailored technical assistance and technology transfer while supporting the rapid scale-up of innovations, including long-acting formulations.
- Strengthen disaggregated data systems and accountability at the national level, including through investment in community monitoring.
The declaration and Indigenous Peoples
Despite repeated proposals made by Indigenous organizations worldwide, the declaration approved in 2026 maintains an astonishing lack of specific consideration for ethnic groups, especially Indigenous Peoples. This omission is not an accidental error; it is structural discrimination, as Indigenous organizations assert.
It is striking, for example, that in Article 6, where the relevance and consideration of human rights are reaffirmed, the UN Declaration on the Rights of Indigenous Peoples is not included in the list of international instruments mentioned there.
Indigenous Peoples are barely mentioned in Article 47 of the declaration among a “wide range of stakeholders” with whom States must expand their commitments, a text that, in reality, adds nothing due to its vagueness and generality.
As the Latin American and Caribbean Coalition of Indigenous Peoples in the comprehensive response to HIV and AIDS has repeatedly expressed, without the active, leading, and decisive participation of Indigenous Peoples, it will be impossible to achieve the 95-95-95 targets, nor the global target of ending AIDS by 2030. “If they leave us out, the figures will not be real, the disease will continue to advance silently in our territories, and the promise of equality and health for all will become empty of content.”
Unfortunately, before and now, Indigenous Peoples have not been taken into account. As the Coalition’s declaration itself states, they were never consulted; rather, programs were designed from the outside, without knowing their worldview, their territories, or even less their knowledge. They especially emphasize the latter, because their ancestral knowledge, their traditional doctors, their spiritual guides, and their community health guardians have been ignored.
But the Coalition does not limit itself to claiming against this unjustifiable omission; moreover, it has presented a wide range of proposals to be considered by the United Nations Organization. Among other aspects, the Coalition proposes the following concrete actions:
- States must recognize Indigenous Peoples as main actors and strategic partners in the response to HIV and AIDS, under the principle of self-determination, with epistemic inclusion, and fair and equitable recognition as communities.
- Fully integrate traditional health practitioners (shamans, healers, grandmothers, midwives) alongside official medical personnel, creating comprehensive, complementary, and differentiated health systems. Recognize the response of the Indigenous Peoples’ health system as a priority key population in the response to AIDS in Latin America and the Caribbean.
- National programs for the prevention and control of STIs and HIV/AIDS, international cooperation agencies, UN agencies (UNAIDS, UNFPA, UNHCR, IOM, among others), NGOs, and States must turn their gaze towards Indigenous and native peoples as subjects of rights in the present and future: economic, social, and participatory.
- No policy, program, or research may be carried out without prior, free, informed, and good-faith consultation, and without the consent of peoples and communities.
- Strengthen work on human rights as contemplated in ILO Convention 169 and the UN Declaration on the Rights of Indigenous Peoples.
- Support the creation of community protocols against HIV and AIDS carried out by Indigenous peoples, recognizing and respecting their own norms.
- Combat gender-based and sexual violence, recognizing the vulnerability of Indigenous women to HIV, especially expressed in sexual violence, and during pregnancy and childbirth concerning the vertical transmission of HIV.
- Design preventive and educational programs that protect their lives, to build a new generation of Indigenous people free from HIV and AIDS.
- Implement adequate prevention and care programs for Indigenous children, migrant women, and victims of armed conflict.
- Explicitly recognize and respect “Indigenous Ancestral Sexual Diversity,” in addition to already recognized diversities such as LGBTIQ+, guaranteeing their health and life free from discrimination.
- Promote actions for zero racism and discrimination and the principle of “Leaving No One Behind” due to HIV and AIDS.
- Facilitate permanent spaces for dialogue and exchange where medical knowledge and ancestral knowledge meet, respect each other, and mutually enrich each other, integrating traditional and contemporary perspectives on health for the well-being of humanity.
The Coalition states that, 25 years after the 2001 UN General Assembly Special Session on HIV/AIDS, we continue to see how human groups are left out of public health policies for 2030. Racial discrimination and inequality remain in force. Without Indigenous peoples, it will not be possible to achieve this by 2030 in terms of public health. Today we call on international agencies, cooperation, and civil society to look at Indigenous peoples as subjects of rights.