Florence Riako Anam, GNP+ Co-edBegin speech:
I am deeply honored to stand before you today as a person living with HIV, as a leader from the Global Network of People Living with HIV (GNP+), and as someone who believes, with every fiber of my being, that the leadership of people living with HIV is not just needed, it is now.
This year, through the #PLHIVLeadersNow initiative at GNP+, together with my Co-Executive Director Sbongile Nkosi, I have walked alongside hundreds of my peers globally and across regions while staying grounded to the realities of my own beloved Africa, and we have declared one truth loudly:
This is the era of PLHIV leadership, and today I bring you that voice.
We meet at a historic and deeply challenging moment.
The UNAIDS 2025 World AIDS Day report released yesterday lays bare the stark reality: progress towards ending AIDS as a public health threat by 2030 has stalled, with new infections rising in regions like ours due to disruptions.
Global funding for the HIV response fell by 5% last year alone, leaving 10 million people without life-saving treatment and threatening to reverse hard-won gains.
Yet, amid this urgency, the report calls for transformation through renewed political will, PLHIV and community leadership, and bold domestic investments echoing that “communities are the backbone of the AIDS response” and must drive accountability and innovation to get back on track.
I stand unapologetically on this truth: People living with HIV are not just part of the HIV response. We are its very foundation.
This year, Sbo and I have made it our mission to shout this from every platform. Why? Because the bold new chapter we are writing particularly of integrating HIV services into primary health care on the road to Universal Health Coverage will only succeed if two forces lead together:
1. Government, with its political will, policies, and domestic resources to drive quality, sustainable care; and
2. PLHIV (When we fully know who we are)—the people who will walk into these transformed systems, feel every friction, face every barrier, celebrate every victory, and bring back real-time, unflinching lived-experience data that turns our collective good intentions into services that actually work.
Without government ownership, there is no system.
Without PLHIV at the forefront shaping that system with our daily realities, there is no success.
Biomedically, the HIV Response has never been in a better time! HIV science has delivered something our predecessors could only dream of:
A person living with HIV who is on effective treatment and virally suppressed cannot sexually transmit the virus. Undetectable equals Untransmittable. (U=U).
This is not an opinion. This is settled science, endorsed by WHO, UNAIDS, CDC, and over 1,000 organizations worldwide. And yet, U=U is more than science, it put PLHIV movement at the heart of achieving HIV Epidemic control.
For too long, we who live with HIV have carried the twin burdens of illness and stigma.
U=U lifts both.
It tells the young woman newly diagnosed in Kampala that she can still dream of love, marriage, and children, without fear of passing the virus to her partner or her baby.
It tells the man in Gulu who stopped treatment because of shame that returning to care will keep him healthy and productive at work while protecting his wife and restore his dignity.
It tells entire communities that HIV is no longer a death sentence or a moral sentence, it is a manageable health condition when we have access to treatment.
U=U gives us the greatest narrative shift in the history of this epidemic. And if we seize this moment, we can do three transformative things at once:
1. Drive massive increases in HIV testing, because people will no longer fear a positive result the way they once did. There is magnitude of evidence on this.
2. Motivate rapid treatment uptake and lifelong adherence, because people will understand that treatment is not just about their own survival, but for health and quality of life.
3. Achieve population-level viral suppression, which gives every person living with HIV the gift of long, healthy lives, and drives new infections toward zero.
This is how we finally end AIDS as a public health threat, not in 50 years, not in 20, but in this decade. But we must dare to lead.
We know that science alone will not get us there. Global funds are shrinking. The old promise of endless external support is fading.
That is why today’s theme, Domestic Resource Mobilization for the HIV Response, is not just important, it is urgent.
And that is why the community of people living with HIV and civil society must be at the very center of how countries pay for, design, and deliver their HIV responses.
We are not beneficiaries. We are investors. We invest our bodies, our time, our stories, our leadership. It is only realistic that we must enjoy a return on that investment through services that work, budgets that reflect our priorities, and accountability when promises are broken.
So how do we, as PLHIV and civil society, drive domestic resource mobilization?
Let me offer a clear, practical pathway, born from regional experience and our daily realities.
First, we lead from within, through four powerful roles that only we can play:
1. Advocacy inside collaborative health governance: PLHIV are service recipients/ patients if you will. Our advocacy must be that which collaborates with our governments, fellow community groups, CSO’s, and partners to share how to ensure all PLHIV are on treatment,are adherent and achieve viral suppression and, our communities access HIV prevention. We have progressed from consultation to co-decision making, from Country Coordinating Mechanisms, to national AIDS councils, to parliamentary health committees.
2. Self-care and treatment literacy: When we understand our own health, when we proudly say “I am undetectable,” we become the most persuasive advocates for testing and treatment in our families and villages.
3. Health literacy and demand creation :We translate complex science into village languages. We turn U=U into songs, dramas, WhatsApp messages, and radio call-ins so that every Ugandan knows that treatment equals prevention.
4. Real-time data and lived evidence: Through community-led monitoring, we document stock-outs, stigma in clinics, long queues, adolescent-unfriendly services, and we bring that evidence straight to the Ministry of Health, to Parliament, and to the media. Our evidence is undeniable because it is lived.
And then, together with key populations, women’s groups, youth movements, and broader civil society, we scale three high-impact strategies:
1. Community task-shifting and differentiated service delivery :Community health workers, expert clients, and peer navigators are often the difference between a person staying in care or being lost forever. These models save money and save lives. Countries that fund them properly see higher retention and lower costs per patient. That is the economic argument for domestic budgets to pay community actors decent salaries, not allowances.
2. Smart advocacy for progressive, sustainable financing :We push for AIDS trusts funded by airline levies, alcohol and tobacco taxes, mobile money transaction taxes, whatever works in our context, because the money is here. Uganda has shown leadership with the AIDS Trust Fund; now we must fill it and protect it.
3. Community-led monitoring as the accountability glue: When communities track every shilling and every pill, corruption fears drop and donor confidence rises, which in turn unlocks more domestic political will to fund the response. Transparency is the best friend of domestic resource mobilization.
Colleagues, what I have learned this unprecented and challenging year is that the new HIV response model is an opportunity.
The old model said: “Wait for donors.” The new model says: “We are the owners.”
We, people living with HIV, are ready to own this response. We are ready to lead it. We are ready to fund it with our governments, our taxes, our innovations, and our unbreakable spirit.
So my call to the Uganda AIDS Commission, to government, to parliament, and to every partner in this room is simple:
- Invest in PLHIV leadership now.
- Resource community systems now.
- Trust us with decision-making power and budgets now.
Because when you invest in us, you are not giving charity. You are making the smartest public health investment any country can make.
Thank you.
