Since HIV/AIDS emerged in the 1980s, public health and care systems have been the frontline in prevention, treatment and care, even as political and social debates vilified people living with – and dying from - the disease. Forty years on, we have changed attitudes and made tremendous progress in treatment. Still, the World Health Organisation reports that last year, an estimated 39 million people were living with HIV, two-thirds of them in Africa. Globally, some countries are reporting a worrisome increase in new infections.

Public health and care systems connect impacted communities, healthcare providers, carers, policymakers, and researchers. These systems provide the infrastructure for developing and implementing comprehensive prevention strategies, widespread testing initiatives, and accessible treatment programs. Our ability to coordinate, educate, and respond effectively is severely compromised without adequate public funding. On World AIDS Day, it is outrageous to see the billions being spent on wars while the imbalance of wealth leaves many countries, particularly in the global south, struggling to cope with HIV/AIDS on top of the recent pandemic and other stresses on our health and care systems.

Prevention can curb the spread of HIV. Community-led public health initiatives, informed by science, are instrumental in raising awareness, promoting safe practices, and ensuring access to preventive measures such as condoms and pre-exposure prophylaxis (PrEP). These efforts extend beyond traditional healthcare settings, reaching communities with targeted outreach programmes, education campaigns, and support networks. The fight against HIV/AIDS is not merely a clinical pursuit, it is a profoundly human struggle that demands compassion, community, and solidarity. Empowering affected communities to take the lead in the fight against AIDS isn't just a slogan but a fundamental paradigm shift that recognizes the unique experience, resilience, and agency of the people most affected by the disease.

The current tide of homophobic legislation across the globe threatens to undermine our solidarity and endangers access to life-saving information and treatment. Homophobia not only fuels discrimination and stigma against LGBT+ people but also hampers efforts to address the unique needs of this community in the context of HIV/AIDS. The intersectionality of homophobia and HIV/AIDS is undeniable, with stigma acting as a formidable barrier to testing, treatment adherence, and support for those living with the virus. Challenging homophobia is not only a matter of fundamental human rights but an imperative in the fight against AIDS. When people fear discrimination, rejection or legal prosecution based on their sexual orientation, gender identity or expression, they are less likely to seek testing, disclose their status, or engage in preventive behaviours.

As we mark World AIDS Day 2023, let us recommit ourselves to the trade union value of solidarity and our demand for proper funding of public health and care. There is no room for complacency. Every day and everywhere, individuals and communities are affected by this virus. We must demand that governments and multilateral institutions strengthen public health and care systems. We can build a future free from the shadows of HIV/AIDS, where health and care are universal rights.

For more information, visit UN AIDS.