At a recent global meet, a session cut through the usual conference optimism with a stark warning: the global AIDS response is being hit by a coordinated anti-rights and anti-gender backlash at the precise moment when funding is collapsing.

Gender justice, bodily autonomy and the leadership of key populations are not optional add-ons. They are the foundation on which any credible path to ending AIDS rests. With only 54 months left to the 2030 targets, that foundation is cracking.

Fragile progress meets organised resistance

The numbers do look impressive on paper. Since 2010 the world has cut new HIV infections by more than 40% and AIDS-related deaths by 57%. Last year 32 million people were on treatment - a scale once unimaginable. Yet in 2025 alone 1.2 million people were diagnosed with HIV and someone still dies of an HIV-related cause every minute. The hardest remaining work depends entirely on reaching those most at risk. None of those who got diagnosed with HIV should have got infected in the first place given the science, evidence and combination prevention tools we have. Likewise, no one should have died of AIDS.

But we cannot end AIDS unless we recognise the simultaneous assault. Deep cuts in HIV programmes' financing worldwide coincide with an organised, well-funded political campaign that seeks to rollback the very rights that make an effective response possible. These are not separate crises. They compound each other. Money is being withdrawn just as political attacks make community-led services harder to deliver and people harder to reach.

Numan Afifi of the APCOM Foundation in Thailand put it plainly: "This is not an abstract mood. It is a strategy." The tactics are concrete. First come 'family values' bills (like the draft charter on family, sovereignty and values) and anti-propaganda laws that re-criminalise same-sex relations, sex work and gender expression. Protections that were advancing are being pushed back, said Afifi, who was among the speakers of SHE & Rights session at the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro, Brazil, organised by Global Center for Health Diplomacy and Inclusion (CeHDI), CNS and partners.

Numan Afifi added that the regressive Geneva Consensus Declaration and the proposed draft African Charter on Family, Sovereignty and Values are being used to water down global health and human rights norms, redefining 'family' and 'gender' in ways that erase the people the HIV response must serve.

Defunding and disinformation starve community organisations while framing LGBTQ+ people and the idea of gender itself as dangerous 'foreign ideology.'

The goal is consistent across regions: to dismantle the rights environment that allows key populations to access testing, treatment and prevention without fear.

Why rights are non-negotiable for ending AIDS

Criminalisation and stigma do not make key populations disappear. They push them away from services. Globally the risk of acquiring HIV is 80 times higher among gay men and other men who have sex with men, 17 times higher among transgender people, 34 times higher among people who inject drugs, and 17 times higher among sex workers. UNAIDS is clear: this risk is driven by marginalisation, discrimination and criminalisation — not by identity, said Numan Afifi.

He reflected that a young gay man who fears arrest will not walk into a clinic. A transgender woman turned away once may never return. Every law that treats communities as criminal becomes a barrier to the tests, medicines and prevention tools that end the epidemic. When budgets are cut, they are cut first from the community-led services that reach these groups, widening the gap further. In the Asia-Pacific region, PrEP — one of the most powerful prevention tools — still reaches only about 2.5 percent of people who need it, even as Fiji, the Philippines and Papua New Guinea report sharp alarming increases in HIV infections.

"When we defend the rights of the most marginalised, we defend the health of everyone,” Afifi said. “Rights are not a luxury of the response. They are the foundation.” APCOM’s demands are concrete: decriminalise same-sex relations, sex work and drug use; protect the rights of transgender and gender-diverse people; fund community-led organisations with sustained, predictable financing that reaches grassroots level; and reject instruments such as the regressive Geneva Consensus Declaration and the regressive draft African Charter.

Youth and communities forced to start from scratch

The human cost is felt most sharply by the next generation. Fairoze Diedricks of Y+ Global (Global Network of Young People living with HIV) described the emotional weight of watching hard-won gains unravel. "So much of this anti-rights movement is undoing work that has been done over so many generations… The young people that I work with now have to kind of start almost from scratch and to rebirth on things and progress that we thought we have already made."

Young people consistently say they need spaces where they can be themselves. Those spaces are shrinking. Respectful dialogue, support to challenge misinformation, and the confidence to advocate in hostile environments are all under pressure. Diedricks rejected the caricature that 'family values' exclude queer people. Lesbian mothers, she noted, are often among the most protective, values-driven parents. Queer young people carry faith, community and moral frameworks; they are not “lesbian” or “gay” for a living. They simply need the same access to healthcare, rights and belonging.

Despite the pressure, young people continue to organise, educate peers and support one another. The role of allies, Diedricks stressed, is not to speak for them but to ensure they have real space, resources and influence in decision-making - not merely token consultation.

Domestic pushbacks and the COVID turning point

Sangeet Kayastha of YPEER Asia Pacific Center, who has worked on HIV, gender rights and sexual and reproductive health and rights since 2006, reminded the session that the rollback did not begin with recent US funding cuts. "When COVID happened, many countries found a way how they can push back the rights they have already given and they also cut the services that were already available."

Pre-COVID progress - decriminalisation of same-sex relations in several countries, growing recognition of same-sex marriage, expanding domestic funding - has stalled or reversed. Domestic funding cuts for communities have been severe. The impact reaches beyond formal organisations to individuals, young people seeking information, and advocacy efforts. Violence against LGBTQI communities has spiked. One country’s regressive turn influences others in the region.

In Bhutan, Dechen of Disability 2030 noted hard-won gains: same-sex activity was decriminalised in 2021, health centres across districts began providing check-ups, self-testing kits and PrEP (Pre-Exposure Prophylaxis) for HIV prevention. Those programmes are now at high risk as international funding dries up. Continuity depends on whether the government integrates them into national plans and allocates domestic resources. Youth advocates continue working to keep politicians informed and to dismantle remaining human rights and gender barriers.

Gender equality remains the strongest prevention strategy

As the host of SHE & Rights, I would like to remind our readers that a 2026 study across 47 countries has found steep reductions in community-led services - including 82 percent cuts to services for sex workers and 72 percent to services for survivors of gender-based violence. It is shameful that the draft African Charter on family, sovereignty and values urges governments to withdraw from progressive agreements including the legally binding Maputo Protocol of 2003, which has been central to advancing gender equality and reproductive rights across Africa.

Gender equality is one of the strongest HIV prevention strategies. We cannot end AIDS without gender equality, bodily autonomy and the leadership of women in all their diversity.

Writing on the wall is crystal clear: Progress against HIV has always depended on rights. When those rights are attacked, the epidemic gains ground. Defending community-led responses, rejecting regressive international instruments and delivering on rights-based international instruments, restoring funding that reaches the people most affected, and centring young people and key populations in decision-making are not side issues. They are the only practical path left to ending AIDS. Rights are not a distraction from the response. They are the response.