01 December 2025
It is an immense honour to be joined today by Professor Anthony Fauci, Professor Wafaa El-Sadr, and this extraordinary community of clinicians, researchers, and advocates who have dedicated their lives to combating one of the most formidable pathogens of our time.
HIV has captivated me since my earliest days as a young physician and paediatrician. I trained and cared for patients in an era when no effective treatments existed—a time when a diagnosis often meant watching patients, including children, succumb to opportunistic infections and die.
I vividly remember the neonates born to mothers living with HIV—tiny, fragile infants whose vulnerability demanded intensive medication regimens. Many required gastrostomy tubes to receive the medicines needed to protect them from the relentless infections this virus invited. I also recall young adults, severely wasted, their bodies hollowed out by disease.
Then came 1994—my second year as a paediatric resident—when AZT emerged as one of the first critical tools to prevent maternal-to-child transmission of HIV. For the first time, we could break the chain of transmission from mother to newborn.
Through the 1990s and early 2000s, I witnessed remarkable progress. Combination antiretroviral therapy transformed HIV from a death sentence into a manageable chronic condition. Lives that would have been lost were saved.
Today, we find ourselves in a profoundly different phase of this epidemic. HIV can be prevented and treated. While we still lack a vaccine, we have tools our predecessors could only dream of: pre-exposure prophylaxis, Undetectable equals Untransmittable (U=U), and broad access to antiretrovirals in many parts of the world.
But here, I must turn to the challenges that remain—particularly in my region.
The Eastern Mediterranean has the fastest growing HIV epidemic in the world. Around 610,000 people are living with HIV, and new infections have almost doubled in less than a decade—from 37,000 in 2016 to approximately 72,000 in 2024. Eighty per cent of the burden is concentrated in five countries.
But perhaps the most alarming statistics are these: fewer than four in ten people know their HIV status, and less than a third are receiving treatment. We are dramatically off track from achieving the triple 95 targets. While other regions move towards them, we are moving away.
In our context, it is not only about access to medicines or health systems. It is also about how we speak about HIV. Stigma runs deep. It keeps people from testing, from treatment, and from speaking openly about their status.
We continue to seek the most effective ways to integrate public health imperatives with cultural sensitivity. We remain committed to meeting people where they are, upholding their dignity, and building bridges rather than barriers.
It is obvious we don’t have all the answers. But I believe our path forward requires us to commit to at least the following:
To lead with compassion and treat every person affected by HIV with dignity and respect, regardless of how they acquired the virus.
To frame HIV as what it truly is: a public health issue, not a moral judgment.
To continue investing in research—for better treatments, and for that elusive vaccine that could transform prevention worldwide.
To build coalitions with religious leaders, community elders, and cultural influencers who can help us translate public health messages in ways that resonate locally.
And finally, to tell stories of hope. The journey from those babies with G-tubes in the 1990s to today’s near-normal life expectancy for people on treatment is nothing short of miraculous.
But our work is not finished. We must recommit ourselves to reaching the unreached, to dismantling stigma wherever it exists, and to ensuring that the tools we have developed benefit every community.
