1) Why is  World AIDS Day still so important today, decades after the first cases of HIV/AIDS were identified? 

Debs Daley: World AIDS Day is still incredibly important because HIV/AIDS hasn’t gone away. Even though treatment and prevention have come a long way, millions of people around the world are still affected. The day gives us a chance to:

• Honour the more than 32 million people who have lost their lives to AIDS-related illnesses.

• Raise awareness about the challenges that persist—things like stigma, discrimination, and unequal access to care.

• Encourage communities and governments to keep up the momentum, funding, and commitment needed to prevent new infections and support those living with HIV.

By the end of 2024, an estimated 40.8 million people were living with HIV, about 1.3 million people acquired the virus that year, and roughly 630,000 died from AIDS-related illnesses. These numbers are a reminder of why World AIDS Day still matters.

When we talk about where HIV hits hardest, sub-Saharan Africa still carries the greatest burden. Countries like Eswatini, South Africa, Lesotho, Botswana and Mozambique have some of the highest adult prevalence rates, with Eswatini at the top.

If you look at absolute numbers, South Africa has the largest population of people living with HIV—about 7.8 million. India follows with 2.6 million, then Mozambique, Nigeria and Tanzania.

It’s also important to recognise that the impact isn’t limited to low-income regions. In Western countries, Black communities are disproportionately affected. For example, in the United States, Black/African American people make up nearly half of new HIV infections among heterosexual women and a significant portion among gay and bisexual men, even though they represent a smaller share of the overall population.

A lot of this comes down to structural issues—stigma, discrimination, poverty, and limited access to healthcare and education all contribute to these disparities and make prevention and treatment more difficult.

2) Why are African countries still disproportionately affected by HIV/AIDS compared with other regions? 

DD: There are several underlying issues that continue to fuel the HIV epidemic. Poverty is a major one—when people are struggling financially, it becomes much harder to access prevention tools, get tested or stay on treatment.

Healthcare systems also play a big role. HIV prevention and treatment programs need consistent funding and well-trained staff, and when these resources are lacking, it slows down everything from awareness to diagnosis to effective care.

Gender inequality is another major factor (SDG 5). Young women, especially in certain regions, are about three times more likely than men to contract HIV. Unequal power dynamics and the impact of gender-based violence make it harder for women to protect themselves.

Cultural and social barriers matter too. Stigma around HIV can discourage people from getting tested or seeking treatment, which increases the risk of transmission.

And finally, funding remains a big challenge. Many countries depend heavily on international aid, which means any global funding cuts can seriously undermine progress and put vital HIV programs at risk.

3) What progress has been made toward achieving Target 3.3 in Africa, and what challenges remain? 

Flora Okumagba: Many countries in the African continent have made significant progress toward achieving SDG Target 3.3, by expanding access to HIV testing, treatment, and prevention.  Over the past decade, millions more people are now on lifesaving antiretroviral therapy, and records show that AIDS-related deaths have dropped substantially.  There is also growing uptake of prevention tools like PrEP, stronger community led programmes, and improved mother-to-child transmission rates in several countries. 

However, despite these gains, key challenges remain.  Unequal access to healthcare continues to affect rural communities, young women and girls, and marginalised groups.  Shame, stigma and discrimination still prevent many people from seeking services, and funding gaps put pressure on already stretched health systems in some countries.   In some regions, new infections are not falling fast enough to meet the 2030 target, especially among adolescents and young adults. 

Africa’s progress shows what’s possible with commitment and investment, but meeting SDG 3.3 will require sustained resources, continued political will, and a focus on equity to ensure no country nor community in Africa is left behind. 

4) How does Target 3.3 challenge the world to take stronger action against AIDS? 

FO: Observing World AIDS Day each year creates an important accountability checkpoint for SDG Target 3.3, the global commitment to ending the epidemics of major communicable diseases by 2030.  It reminds governments, organisations, and communities to pause and ask: Are we making the progress we promised? 

Though some progress has been in reducing HIV incidence, sadly the rates remain above targets in some areas.  Meeting the target requires scaling up prevention interventions, testing, treatment services and improved data collection. 

By highlighting new data, sharing real-world experiences, and tracking progress against prevention and treatment goals, World AIDS Day keeps transparency at the forefront. It ensures that gaps in access, funding, and equity aren’t ignored, and it pushes leaders to address the barriers that still prevent many people from receiving the care they need. 

6) How does gender (in)equality (SDG 5) influence HIV infection rates, particularly among women and girls? 

Abiola Lawal: Gender inequality  is a major driver of HIV infection rates among women and girls in Africa, creating structural, social, and economic conditions that increase vulnerability. Women account for 63% of people living with HIV in Africa and 60% of new infections among adults, while adolescent girls and young women (aged 15–24) are more than twice as likely to acquire HIV as young men and boys, with over 4,600 new infections occurring weekly in this group. These inequalities stem from unequal power dynamics, gender-based violence, and harmful cultural norms that limit women’s ability to negotiate safe sex or access health services. In high-prevalence areas, intimate partner violence increases women’s risk of HIV by 50%, and child marriage—affecting roughly 1 in 3 girls before age 18—further compounds risk by reducing autonomy and access to education.  

Economic disempowerment and lack of schooling also play critical roles; studies show that each additional year of secondary education after year nine reduces girls’ HIV risk by 12%, yet nearly one-third of the poorest adolescent girls have never attended school. Gender inequality also intersects with poverty, pushing many young women into transactional relationships with older men, where condom negotiation is rare. These factors collectively make HIV not only a health issue but a gender challenge, underscoring the need for gender-responsive interventions—such as keeping girls in school, expanding female-controlled prevention options, and addressing violence—to achieve both SDG 5 and SDG 3 targets.  

7)  How does HIV/AIDS highlight global inequalities and relate to  SDG 10 (Reduced Inequalities)? How does addressing HIV/AIDS help reduce these inequalities? 

FO: HIV/AIDS has always shone a light on global inequalities because the people most affected are often those who face social, economic, or structural barriers for example: poverty, marginalisation, gender inequality, and limited access to healthcare.  These challenges mean that some communities carry a far heavier burden of HIV than others, which directly links the epidemic to SDG 10: reducing inequalities within and among countries. 

Addressing HIV/AIDS is, in many ways, an act of reducing inequality.  When we improve access to testing, treatment, and prevention for everyone, regardless of income, identity, or location, we make progress in breaking down the systemic barriers that have kept certain groups at higher risk.  Investing in equitable healthcare, tackling stigma, and enabling people to live healthy, empowered lives all contribute to fairer outcomes across society.  In this way, the fight against HIV doesn’t just improve health, it drives social justice.  Every step we take to close the gaps in HIV services is also a step toward the wider goal of reducing inequalities globally. 

8) How has stigma around HIV/AIDS affected progress in African nations? 

AL: There is still heavy stigma around HIV/AIDS across Africa. Sufferers can be rejected by their communities.  Stigma surrounding HIV/AIDS has significantly slowed progress in African nations by creating barriers to testing, treatment, and prevention. Fear of judgment and social exclusion discourages people from seeking HIV testing, with studies showing that over 50% of people in 38 African countries hold discriminatory attitudes toward people living with HIV, and 74% perceive stigma, which reduces testing uptake. In some regions, up to 26% of women living with HIV remain undiagnosed, largely due to fear of discovery in their communities that they have the disease. 

Stigma also means sufferers do not stick to antiretroviral treatment; for example, in Nigeria, 37.2% of HIV reported experiencing stigma, and those individuals had five times poorer rates of treatment (24.7%) compared to 5.1% among those without stigma. Internalised stigma is widespread, affecting 35.7% of HIV across Africa, leading to social isolation and mental health challenges. Prevention efforts suffer as stigma discourages open conversations about safe sex and tools like PrEP, while systemic discrimination persists—13% of HIV sufferers report stigma when seeking HIV-related care, and 12% were denied non-HIV health services in the past year. These measurable impacts show that stigma is not just a social issue but a structural barrier that perpetuates transmission and delays progress toward ending AIDS. Tackling stigma through education, community-led initiatives, and policy reform is essential to achieving the 2030 SDG goal of ending AIDS as a public health threat. 

9) What impact has HIV/AIDS had on economic and social development in Africa? 

AL: HIV/AIDS has had a profound impact on Africa’s economic and social development, reversing decades of progress in health, education, and poverty reduction. Economically, national growth rates have fallen by 2–4% annually in many African countries, primarily due to the loss of skilled labour and declining productivity among adults aged 18–49; normally the most economically active group. In East Africa, HIV prevalence has lowered labour force participation by up to 10%, while households with HIV-positive members spend twice as much on healthcare, diverting resources from education and investment and pushing families deeper into poverty.  

Socially, HIV/AIDS has devastated communities by reducing life expectancy by up to 20 years and orphaning over 9 million children in sub-Saharan Africa, forcing many to leave school and perpetuating cycles of poverty and illiteracy. Education systems have suffered as teachers and students succumb to illness, while stigma and gender inequality exacerbate vulnerability among adolescent girls, who account for over 80% of new infections in some regions. Governments face mounting financial pressure from increased healthcare costs and social welfare needs, slowing investment in other areas that need development.  

10) How do community-led responses strengthen the fight against HIV/AIDS? 

DD: Community-led initiatives are powerful because they’re driven by people who truly understand the realities of those they’re supporting. These often take the form of peer outreach and local support networks. For example, in South Africa, Mentor Mothers—women living with HIV who are trained to support pregnant women and new mothers—provide guidance and care right in people’s homes. In Uganda, TASO uses volunteers to deliver HIV testing, counselling and ART. And in Mozambique, volunteer-led support groups offer home-based care that combines education with emotional support, helping people stay on treatment and feel less isolated.

These community-led responses work so well because they meet people where they are and build real trust:

• Cultural relevance: The programmes are shaped by people who share the same language, traditions and lived experiences as the community, which makes the support feel genuine and relatable.

• Reducing stigma: Peer educators often talk openly about their own experiences with HIV, helping to break down fear, shame and misinformation.

• Better accessibility: Services like home visits and mobile clinics remove barriers such as transport costs or the anxiety of going to an HIV clinic.

• Holistic support: Many of these initiatives go beyond HIV care, linking in mental health support, gender-based violence prevention and even economic empowerment. This helps tackle the root causes of vulnerability.

• Advocacy and accountability: Community groups also push for policy changes and fight for proper funding, making sure frontline efforts are recognised and supported by national health systems.

Overall, these initiatives work because they come from within the community itself—building trust, improving access and creating long-term change.

10) What can the world learn from Africa’s resilience and leadership in combating HIV/AIDS?

Felicity Agyemang: There has been major progress in the HIV response in eastern and southern Africa, the region most affected by the HIV pandemic. The annual number of people acquiring HIV fell by 59% from 1.1 million to 450 000 between 2010 and 2023. The number of AIDS-related deaths decreased by 57%, from 600 000 to 260 000 between 2010 and 2023. Seven countries (Botswana, Eswatini, Kenya, Malawi, Rwanda, Zambia and Zimbabwe) have already reached the UNAIDS 95–95–95 testing and treatment targets for the general population (Ref. 1)

• Eastern and southern Africa: 59% decrease in new HIV infections since 2010 

• Western and central Africa 46% decrease in new HIV infections since 2010 (Ref. 1)

Understanding the reasons behind these successes, can and should be used to inform Global policies and other local solutions. 

Community engagement — co-design and co-ownership, along with local scientific research is key. In 1990, a population-based HIV survey in rural South Africa revealed a deeply gendered pattern of transmission, challenging prevailing priorities at the time. This on the ground research from organisations such as Centre for the AIDS Programme of Research in South Africa (CAPRISA) has informed WHO guidelines (Ref. 2).  

Local research for local solutions: The National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK) is a national network that unites people living with, at risk of, or affected by HIV in Kenya. In partnership with the Ministry of Health under the differentiated service delivery initiative, established community antiretroviral therapy groups to ensure continuity of HIV service uptake and avoid overcrowding in health facilities (Ref. 1). 

Integrating healthcare services: Integrating HIV services with other health services, such as maternal and child health, tuberculosis (TB) treatment, and sexual and reproductive health services, has proven beneficial and can reduce the stigma in associated with attending HIV-specific clinics. For example, in South Africa, integrating HIV services with TB clinics has led to improved detection and treatment of co-infections (Ref. 3).

 11) How can recognising World AIDS Day inspire global action toward ending the epidemic by 2030? 

 FO: Recognising World AIDS Day each year serves as a powerful reminder that the fight to end the HIV epidemic is both urgent and achievable. It creates a moment for the world to pause, reflect, and reignite momentum.  This is essential if we’re to reach the 2030 target goal of ending AIDS as a public health threat. 

When we continually shine a spotlight on real stories, scientific progress and ongoing inequalities, World AIDS Day encourages people, communities, and governments to recommit to action.  It mobilises global collaboration, drives funding and policy conversations, whilst keeping HIV in the public consciousness, this is especially important as other global challenges compete for attention. 

Africa’s community-led HIV responses keeps public attention on HIV. When people stay informed and engaged, there is stronger pressure on institutions to deliver on their commitments.  

Most importantly, this day reinforces a shared message: progress happens when we stand together.  Recognising World AIDS Day continues to empower individuals to learn, advocate, challenge stigma and support those affected.  Small actions, coordinated and amplified worldwide, creates the collective force needed to accelerate testing, treatment, prevention, and education, all critical steps in progressing towards ending the epidemic by 2030. 

References:

1) UNAIDS . Global Data on HIV Epidemiology and Response. Geneva: AIDSinfo; (2024). Available online at: https://aidsinfo.unaids.org/ (Accessed October 9, 2024).  

2) Lessons from Africa: health diplomacy in HIV prevention, https://doi.org/10.1016/S0140-6736(25)01976-2 

3) Obeagu EI, Obeagu GU. Moving forward together: collaborative strategies in HIV prevention across Africa - a narrative review. Ann Med Surg (Lond). 2025 Jan 31;87(7):4117-4126. doi: 10.1097/MS9.0000000000002961. PMID: 40852004; PMCID: PMC12369799. https://pmc.ncbi.nlm.nih.gov/articles/PMC12369799/#R32 

Other sources:

https://www.cdc.gov/world-aids-day/index.html  

https://www.unaids.org/en/resources/fact-sheet  

https://worldpopulationreview.com/country-rankings/hiv-rates-by-country  

https://pmc.ncbi.nlm.nih.gov/articles/PMC2836916/ 

https://link.springer.com/article/10.1186/s12889-024-19022-7 

https://www.prb.org/resources/fighting-aids-related-stigma-in-africa/ 

https://onlinelibrary.wiley.com/doi/10.1155/arat/1843342 

https://link.springer.com/article/10.1007/s40609-023-00321-7 

https://news.un.org/en/story/2020/03/1058751 

Interview created, formatted and edited by India Sapsed-Foster, Associate Publisher and a network organiser of Springer Nature's Black Employee Network (SN BEN)

Responses from members of SN BEN: Abiola Lawal (Senior Publisher) Flora Okumagba (Project Manager, Engineering), Debs Daley (Head of Marketing Planning, Services and Solutions) and Felicity Agyemang (BDA Team Leader - Production). Many thanks for such insightful answers.