Perilous days in the fight against hiv and aids – Guyana must take the lead

December 1st was World AIDS Day. I have been actively engaged in World AIDS Day from the inception. Each year, I found something to give me hope. I must confess that for World AIDS Day 2025, I feel less optimistic than I ever did on World AIDS Day.
In 1988, on the first ever World AIDS Day, the knowledge that AZT was an effective drug to control AIDS, even if it was never a cure, and even though the vast majority of people in the developing world at the time could not dream of affording the medicine, brought optimism that we might be able to combat HIV and win the war. Each year since 1988 brought us closer to a real chance of successfully combating HIV and AIDS. Yet here in 2025, optimism is hard to embrace.
For World AIDS Day 2025, the President of the US decided he has no interest, and for the first time since 1988, the US did not actively participate in World AIDS Day. In fact, few global leaders seemed to bother with World AIDS Day 2025. Whether we want to admit it or not, from the perspective of global leaders, the inconvenient truth is that there has been a general disinterest in World AIDS Day 2025. This disinterest is reflected in the poor response to the replenishment of funds for the global fund.
This year’s replenishment for the Global Fund was held at the same time as the G20 Meeting in South Africa. The Global Fund did not realise its target for replenishment. The Global Fund had hoped that its 8th replenishment in 2025 would raise a minimum of US$18 billion. But by its replenishment meeting in South Africa in November, the GF had only reached $4 billion. The target in South Africa, therefore, was $14 billion. It raised just $11 billion. Every significant donor, from the US to the UK, Germany and other EU countries, pledged less than they did in the past.
Given that the GF is still the largest donor in the fight against HIV, TB and malaria, the dwindling funding available is more than concerning. The Fund provides 73 per cent of all international financing for TB, 60 per cent for malaria and 24 per cent for HIV. But even more worrying is that more effective tools have become available to fight against HIV and AIDS. With dwindling financial support, these tools will become a mountain too far and too high.
New HIV prevention and treatment medicines, improved malaria control measures and innovations in TB treatment and vaccination present a tantalising opportunity to end AIDS, TB and malaria by 2030. But this opportunity is being squandered because of funding difficulties. Just as we seemed to be reaching the finishing line, important donors stepped aside.
At the same time, several countries reported disturbing news on the AIDS front. Guyana reported an upsurge of HIV-positive cases. The Minister of Health reported 450 new cases of HIV in 2025 so far. For a country where each year we saw reducing incidence rates for HIV, this is not good news as we near the 2030 End of AIDS timeline. The Minister urged testing for all pregnant women. For decades now, every pregnant woman has been tested for HIV. Health facilities routinely tested women, not because they asked, but because it was part of the routine care of pregnant women. For sure, these women could opt out. But they did not have to opt in. Guyana must ensure that such successful measures as routine testing become the norm again.
Since the inaugural World AIDS Day in 1988, the world has been able each year to show an expanding response to HIV and AIDS. By 2010, the world was able to gain confidence in its fight against HIV and AIDS and began to speak of the end of AIDS. In fact, we had become so confident that by 2010 we began to speak of the end of AIDS by 2030. But globally we seem to have taken our eyes off the prize.
Guyana is too close to ending AIDS for it to not ensure we cross the line. We are on our last grants from the Global Fund. But Guyana has the resources to fight HIV and AIDS. We must pursue all avenues to end AIDS. Prevention is the key. Between 2001 and 2012, Guyana became a global champion for education and awareness; everywhere one went in Guyana, there was messaging about HIV and AIDS. The “Reach One, Teach One, Save One” campaign entered every home, every workplace, every church, every mandir, and every masjid. Teachers became involved, and pastors, pandits and imams became champions. Every parliamentarian, every Minister, and the President were champions in the fight against HIV and AIDS. We must return to the fight.
For those who were HIV positive, the best treatment available became accessible in Guyana. Today, there are powerful new medicines that are both powerful prevention tools and powerful treatments to control AIDS. These are expensive medicines. But it is cheaper for Guyana to make these expensive medicines available. In the developed north, countries in North America and Europe, the promise of ending AIDS by 2030 is still within grasp. But this trajectory is slipping away from most developing countries.
Guyana must not be one of these developing countries. We have the leadership, the knowledge, the experience and the resources to stop HIV and AIDS. Guyana has taken global leadership in some of the world’s most difficult challenges. The HIV and AIDS challenge is one we can overcome, and we can lead the world. Let us seize the opportunity and end HIV and AIDS by 2030 in Guyana.