“HIV: we must not choose between innovation and essential needs”
On the occasion of the International AIDS 2026 Conference, Veronica Noseda, Head of Unit at L’Initiative – Expertise France, calls for moving beyond the false dilemmas that currently shape the global HIV response. As international funding declines, she argues that preserving access to essential healthcare while continuing to invest in innovation, communities and human rights is the only way to keep the goal of ending the epidemic within reach.
LOne of the key functions of global conferences is to build consensus around the priorities that should guide the response to an epidemic. Over the years, these gatherings have given rise to concepts that have become fundamental to the fight against HIV: combination prevention, test and treat, and U = U (Undetectable = Untransmittable).
What will be the defining message of AIDS 2026, which will bring together the world’s leading HIV stakeholders in Rio de Janeiro from 26 to 31 July? Will it celebrate the breakthrough represented by long-acting prevention tools such as lenacapavir, administered twice a year to prevent HIV acquisition? Or will the spotlight instead fall on the collapse of international HIV funding and the perceived need to scale back efforts and focus only on the essentials?
Yet the history of the HIV response teaches us one clear lesson: we must never choose between essential needs and innovation. We must fight to ensure that every person living with HIV has access to the treatment that keeps them alive, while never abandoning the ambition to go further. We must preserve the momentum that has enabled generations of researchers to develop ever more effective diagnostics, treatments and prevention tools. And we must also sustain the commitment of communities, whose role is indispensable in ensuring that these innovations truly reach everyone who needs them—including people living far from urban centres, those facing discrimination, and those lacking the means to access quality healthcare. Many, in fact, experience all of these vulnerabilities at once.
Of course, the crisis in international development assistance cannot be ignored. Difficult choices will be unavoidable, and often painful, given the scale of the remaining needs. But these decisions must be guided by a clear compass: ensuring equitable access to high-quality, integrated, people-centred health services. This is precisely the ambition of L’Initiative’s 2026–2028 Strategy, which prioritises strengthening national capacities, supporting communities, promoting human rights and gender equality, while focusing interventions on the countries and populations facing the greatest vulnerabilities.
In Rio—as everywhere else—the real challenge will therefore not be choosing between responding to today’s emergencies and preparing for tomorrow’s breakthroughs, but preserving both. Only by combining innovation, equity and solidarity can ending the HIV epidemic remain a credible goal.
