AIDS 2026 Conference: Scientific progress, political retreat and the challenge of delivery
Jaime Garcia-Iglesias, Waverley Care Trustee and Chancellor’s Fellow at the University of Edinburgh, reflects on his key takeaways from the recent AIDS 2026 Conference in Rio de Janeiro.
AIDS 2026 brought together researchers, healthcare professionals, policymakers, activists and communities from around the world. The conference highlighted both how far HIV science has come and how difficult it is becoming to ensure those advances reach everyone who could benefit from them.
The conference highlighted a clear contrast between scientific progress and the wider political and financial environment.
There is a lot to be hopeful about. HIV treatment and prevention are becoming more effective and giving people more choice. Long-acting treatment is becoming a reality, there are more ways to prevent HIV than ever before, and research into vaccines and a cure continues to move forward.
At the same time, the political and financial picture is more difficult. The health services, community organisations and funding needed to make sure people benefit from this progress are under growing pressure.
One phrase, spoken by Alberto Pereira da Silva Junior, Journalist, director, TV presenter and actor, and conference master of ceremonies summed this up particularly well:
Innovation without access becomes privilege.
A changing global HIV response
One of the strongest messages from the conference was that recent changes to global HIV funding are not a temporary disruption.
As Winnie Byanyima, Executive Director of UNAIDS, put it:
We are living through a seismic change in the global order, and we’re not going back. We must build something new for the AIDS response in the world we have today, not the world we wished existed, not the world of yesterday.
Funding matters because it determines whether countries can provide HIV prevention and treatment, employ healthcare workers and support community organisations. These are all essential if scientific advances are going to reach the people who need them.
There was a clear sense at the conference that the HIV response needs to adapt to this new reality rather than wait for previous levels and models of funding to return.
HIV treatment is changing
For decades, taking tablets every day has been central to HIV treatment. This treatment is highly effective and means people living with HIV can live long and healthy lives. But in future, a daily pill may not be the only option.
Long-acting injectable HIV treatment is already available in some places, and studies presented at the conference showed promising results for treatments that could be taken as little as once a week or twice a year.
These developments could give people more choice over how they manage their HIV. Taking tablets every day works well for many people, but it can be more difficult for others, including people who have concerns about privacy or stigma.
Less frequent treatment does not necessarily mean less need for support. Services still need to make sure people can get their treatment on time, manage missed doses and receive appropriate follow-up.
For me, the key message is that long-acting treatment should give people more choice. Services and policymakers need to think now about how these treatments could be made available so that everyone who could benefit has the opportunity to do so.
PrEP works – now we need to make sure people can access it
There was also encouraging news about HIV prevention.
Pre-exposure prophylaxis, or PrEP, is medication that can prevent HIV. We now have strong evidence that different forms of PrEP, including daily tablets and long-acting injections, are highly effective. But having effective medicines is only part of the picture. People also need to be able to access them easily.
At the conference, we heard about different ways of making PrEP easier to access, including through pharmacies, online sexual health services and nurse-led services.
In Scotland, Waverley Care has long called on the Scottish Government to introduce a national online HIV prevention service and make PrEP available in more settings. It was encouraging to hear examples of similar approaches being used around the world.
Vaccines and a cure: promising, but still early
Researchers also shared promising work towards developing an HIV vaccine and finding a cure, including new ways to help the body’s immune system fight HIV. There are good reasons to be hopeful, but this research is still at an early stage. Much of it is not yet ready to be used as part of everyday HIV care.
In the meantime, we already have the tools to prevent HIV transmission and enable people living with HIV to live long and healthy lives. The immediate challenge is making sure everyone can benefit from them.
New technology still needs strong health services
Another theme was the growing use of artificial intelligence (AI) and other digital technology in healthcare.
Researchers shared examples of AI being tested to support HIV self-testing and the diagnosis of other conditions among people living with HIV. These technologies could make healthcare more accessible and help services reach more people, but they also bring risks.
AI tools can miss important information, and there are questions about privacy, bias and whether the data used to develop them properly represents the people they are meant to help.
For me, this reinforced an important point: technology can support healthcare, but it cannot replace skilled healthcare professionals, good services or the trust of the communities using them. New technology will only improve health outcomes if people can access it safely and confidently, and if it is developed with the needs and experiences of those communities in mind.
Turning scientific progress into real change
If there was one message I took from AIDS 2026, it was that having effective tools is not enough – people need to be able to benefit from them.
Scientific progress depends on healthcare workers who can deliver new treatments and prevention options, services that people can easily access, community organisations that build trust and reach people who may otherwise miss out, and governments willing to fund them.
This is particularly important while global HIV funding is under such pressure. At the conference, we heard about healthcare workers losing their jobs and disruption to HIV prevention, testing and community programmes following funding cuts. This risks undoing some of the progress made over recent decades.
In Scotland, we have an ambition to end new HIV transmission by 2030, and we already have the tools needed to make that possible. But reaching that goal – and supporting people living with HIV to live well – means making sure services keep up with changes in treatment and prevention. People need real choice in how they access care and prevention, and healthcare and community organisations need the resources to deliver them.
AIDS 2026 showed how far HIV science has come. The next challenge is making sure that progress reaches everyone.