This report shows how community-led interventions are central to achieving the end of AIDS and to sustaining the gains into the future. People living with or affected by HIV have driven progress in the HIV response—reaching people who have not been reached; connecting people with the services they need; pioneering innovations; holding providers governments international organizations and donors to account; and spearheading inspirational movements for health dignity and human rights for all. They are the trusted voices. Communities understand what is most needed what works and what needs to change. Communities have not waited to be handed their leadership roles — they have taken the roles on themselves and held fast in their insistence on doing so. They have applied their skills and determination to help tackle other pandemics and health crises too including COVID-19 Ebola and mpox. Letting communities lead builds healthier and stronger societies. This report shines a light on the underreported story of the everyday heroes of the HIV response. But it is much more than a celebration of the achievements of communities. It is an urgent call to action for governments and international partners to enable and support communities in their leadership roles.

Every year on the occasion of World AIDS Day 1 December the Joint UN Programme on HIV/AIDS (UNAIDS) releases a report on pressing issues facing the global response to the AIDS pandemic. As the AIDS and COVID-19 pandemics collide the 2021 World AIDS Day report warns that the colossal new challenges created by COVID-19 threaten the gains made against AIDS thus far. Entrenched inequalities stand in the way of further progress against AIDS and leave the world vulnerable to COVID-19 and future pandemics. The damage done by COVID-19 to HIV programmes varies across countries. There have been substantial setbacks particularly during the first six months of the crisis. People living with HIV are also at elevated risk of COVID-19-related morbidity and mortality. In many places the upheaval caused by COVID-19 has summoned the inventiveness and resilience that have become hallmarks of the HIV response. HIV programmes that are well-resourced willing to adapt and anchored in strong community involvement have tended to cope the best. The Global AIDS Strategy 2021–2026 and the UN General Assembly’s 2021 Political Declaration on Ending AIDS call on countries to address inequalities and close gaps. With no time to spare those agreed actions are not being made at the required speed and scale. What is at stake is bigger than AIDS. During negotiations on a global framework for pandemic prevention preparedness and response the hard-won successes and bitter failures from the response to AIDS have experiences to share. Those lessons must be quickly learned and applied to end AIDS within the next decade to swiftly defeat COVID-19 and to proactively confront the pandemics of tomorrow.

This report argues that power in fact rests in the hands of the people as can be seen in countless local national and international movements to redistribute power and bring greater attention to neglected issues. Mass movements to redistribute power often have humble beginnings born out of desperate need or simmering injustice—sparks of frustration that ignite infernos of change. In the early days of the HIV response grossly insufficient leadership and medical care ignited a global civil society movement. It was the loud and persistent voice of people living with HIV and key populations at high risk of infection that accelerated the pace of research on antiretroviral medicines and drove down their prices and it is that same determination that continues to expand the provision of affordable life-saving treatment to millions of people around the world living with HIV.