A three-day regional summit on HIV/AIDS held in Dakar, Senegal, has concluded with a call to action that urges stronger support for community-led responses, policies driven by science and data, increased investment in the HIV response and putting HIV at the centre of pandemic preparedness and response. In his closing remarks, the President of Senegal, Macky Sall, committed to advancing the call to action with the African Union and pledged additional funds to implement it in Senegal and across the region. 

Western and Central Africa is home to 4.7 million people living with HIV—12% of those living with HIV globally—but experiences 22% of all HIV deaths in the world. Countries in the region, on average, have seen slower declines in HIV infections than other countries on the continent and HIV prevalence in women is significantly higher than in men. Access to HIV testing and treatment reached 73% of people living with HIV in 2020, up from 38% in 2015, but short of the 81% goal that was set for 2020. The region has the world’s highest number of HIV-positive pregnant women still waiting for treatment, and just 24% of children living with HIV were virally suppressed.

The Dakar Call to Reinvent the Response to the HIV Pandemic calls for urgent action in four main areas:  

1. Expand community-led infrastructure and organizations to strengthen national systems for health and shift policies to enable sustained funding for community organizations. Too many of the most vulnerable people in Western and Central Africa region do not have access to conventional health systems. Evidence shows community-led organizations and networks are critical to filling the gaps. This includes expanding the provision of HIV treatment and prevention services by community-led organizations in partnership with the public health system, ensuring that organized civil society and affected communities are included as key partners in decision-making bodies, and building accountability structures such as community-led monitoring.

2. Update health policies to align with the latest HIV science and evidence. Countries that have aligned their HIV policies and programmes with the current science have made greater progress against HIV/AIDS. Governments are urged to review their health policies in consideration of the latest scientific data and evidence. This is as a key step to improve the HIV response, and particularly to address the needs of those most vulnerable to HIV.

3. Increase national and international resources for HIV in the region by 33% by 2025 and remove financial barriers to access health services by people living with HIV. UNAIDS studies show that $2.67 billion by 2025, representing a 33% increase, would ensure sufficient funding for a comprehensive response to HIV in the region. Insufficient progress in the response to the HIV pandemic is only increasing the long-term costs that will strain already overburdened health budgets.

4. Put HIV and COVID-19 at the centre of pandemic preparedness and response. Many of the measures needed to accelerate the HIV response will also help prevent future pandemics.  These measures include strengthening and protecting the formal and informal health workforce, collecting quality epidemic data to inform decision-making, implementing rights-based responses, and ensuring equitable access to new medical technologies.

These four actions are achievable in the next three years and would move the region closer to the 2025 global target of 95% of people knowing their HIV status; 95% of people who know their HIV status initiating treatment; 95% of people on treatment being virally suppressed. They would contribute to a dramatic reduction in the number of AIDS-related deaths and new HIV infections in the region.

Western and Central Africa has been at the forefront of some of the most innovative and successful efforts in the global response to HIV. Ending the AIDS epidemic as part of the 2030 Sustainable Development Agenda remains a priority even though the region faces multiple challenges including the response to the COVID-19 pandemic, numerous economic and security crises, and climate change.  

During the summit governments, civil society actors, community-led organizations, scientists, and other partners reviewed new data and progress against HIV in the last 5 years and took note of the new UNAIDS Global AIDS Strategy 2021-2026 and the United Nations General Assembly Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. The summit was co-organized by UNAIDS and the Civil Society Institute of HIV and Health in Western and Central Africa and hosted by the President of Senegal, Macky Sall. It was held with the support of Luxembourg and the Bill and Melinda Gates Foundation.