James Hargreaves

The plenary addressed how the HIV response intersects with global health and society. The syndemics framework helps us understand how HIV and global health interact. We must retain our energy on HIV, we must integrate with health systems, challenge stigma in our health system and respect youth.

ART scale up sees PLHIV live longer, but TB, Hepatitis, diabetes and cancer deaths are stable / rising including among PLHIV. Pollution, tobacco are key causes of death, including among PLHIV. Cascade frameworks are often worse for NCDs than for HIV. “Ending AIDS” rhetoric has bred complacency. Millions of people will need ART for decades. Domestic financing must increase, but donors must stay the course. Expansion of HIV prevention and funding share should increase. Data guided prevention is key but we must strive for a vaccine. We must promote global health solidarity. Black MSM experience poverty, lack of insurance, housing instability, criminalisation, stigma of HIV and same sex behaviours and racism as major barriers to the treatment cascade. We must investigate what happens in the clinic in understanding what is needed to support the treatment cascade. Young people must be treated with respect and dignity.

An important plenary session today asked us to think differently about the HIV response today. The conference has been dominated by discussions of progress with the treatment cascade, but there is also a growing recognition of how this requires us to think about the health system more broadly. The AIDS response must support global health and build on its innovations and community engagement. The plenary ended with a powerful address from David Malebranche, and a passionate call to action from Yana Panfilova.