Remarks by Ms. Diene Keita, Executive Director, UNFPA at the UN High-Level Meeting on HIV/AIDS

Thank you, Mitchell, and thank you, Winnie, for setting out the 40+20 HIV Prevention targets and the urgent need to move from targets to delivery at scale.

Your Excellency Pakishe Aaron Motsoaledi, Minister of Health of South Africa

Your Excellency Sleiman Timios Kwidini, Deputy Minister of Health of Zimbabwe

Dr. Claudes Kamenga, Chief of Staff for the Africa CDC

Ms. Lilian Benjamin Mwakyosi, Executive Director, DARE, Tanzania

Excellencies, esteemed colleagues, distinguished guests,

All protocols observed.

Investing in HIV prevention is not just a public health decision. It is a deliberate political choice. It takes courage to remove barriers and protect the rights of those most often left behind.

I am honored to stand with the Ministers and leaders here today, who have shown that true leadership means prioritizing the dignity and autonomy of all populations.

UNFPA is proud to co-convene this discussion. Prevention is the anchor of a human rights-based HIV response and a core part of comprehensive sexual and reproductive health and rights. We have better prevention tools and innovations than ever, but these tools can only be effective if everyone can access them equitably and sustainably.

Four principles guide UNFPA's HIV prevention commitment:

First, it is important for every person to have decision-making authority, to decide about their own protection and live free of stigma. That is why we say that rights and bodily autonomy are indispensable to ending AIDS. No prevention strategy can succeed if people cannot make free and informed decisions about their own health and future, without fear, stigma, or discrimination.

Second, we must confront the inequalities that drive HIV risk. For many adolescent girls and young women, this risk is shaped by poverty, unequal power dynamics, gender-based violence, and a fundamental lack of agency. For key populations, legal and social constraints limit their choices. To end the epidemic, we must address these structural drivers and expand access to comprehensive combination prevention, including comprehensive sexuality education, condoms, and antiretroviral-based prevention technologies.

Long-acting HIV prevention innovations offer real hope. But realizing their immense potential depends on how fast we move from pilot programmes to scaled, routine delivery. This means integrating these long-acting options directly into the family planning, maternal health, and sexual and reproductive health services that women already trust. This is particularly urgent for pregnant and nursing women. When we fail to support mothers during this critical window, the consequences extend to the next generation.

Around 120,000 babies are still born with HIV each year. About 24,000 are infected because their mother acquired HIV while pregnant or breastfeeding. A further 19,000 cases occur when an HIV-positive woman is unable to keep up antiretroviral treatment during these critical periods. All of this can be prevented. These figures remind us that we cannot end AIDS without closing the prevention gap for women and girls. Long-acting pre-exposure prevention can help close that gap, but only if we can ensure equitable access and integrate it effectively within the services women already use.

Third, technological innovation is critical, but not sufficient alone. How we deliver care matters as much as the tools we use. We have so much new medicine, and yet, if you can't access it, or are not allowed to use it, you can't enjoy the benefit of it and protect yourself. This is why integrating HIV prevention into comprehensive sexual and reproductive health services and primary health care is imperative. In an environment where health workers are stretched thin and resources are tight, running siloed delivery systems is unsustainable. It fragments care, drives up costs, and fails the very people who need these services most.

Finally, national ownership is key. Sustainable prevention requires robust health systems, strong partnerships, increased domestic financing, and true national sovereignty. Communities are at the heart of this. Their power to reach people others miss and demand quality care is the ultimate cornerstone of accountability.

Although this is a global issue, today the highest HIV rate is on the African continent. We know that African countries are full partners in this fight. At the Global Fund's Eighth Replenishment, African countries pledged over US$51 million, including a US$36.6 million public-private commitment from South Africa to support HIV prevention. While global and domestic investment must continue to grow, these pledges mark a profound shift towards shared responsibility and long-term national leadership in sustaining the HIV response.

Excellencies, dear colleagues,

We have unprecedented opportunities before us. Science is advancing. The evidence is clear. The tools exist.

The question now is simple: will we match this moment with the political will to deliver them equitably and at scale?

UNFPA stands resolute in our commitment to governments, communities, and partners to drive an HIV response rooted in human rights, gender equality, and national ownership. Together, we can transform HIV prevention from an aspiration into an undeniable reality for everyone, everywhere.

I thank you for your kind attention.