Ending AIDS by 2030 Requires Reaching People in Conflict, Displacement, and Fragile Health Systems.

Plain Language SummaryHIV care works best when people can continue testing, treatment, follow-up, and support without interruption. However, people affected by conflict, displacement, migration, and fragile health systems often face serious barriers to HIV services. When people are forced to move, they may lose access to clinics, medicines, health records, laboratory tests, and trusted health workers. This can interrupt antiretroviral treatment, delay viral load monitoring, and increase the risk that people living with HIV are left behind. This letter argues that the global goal of ending AIDS by 2030 should not be measured only by national averages or overall treatment targets. It should also ask whether refugees, internally displaced persons, migrants, mobile populations, and people living in insecure areas can continue HIV prevention, treatment, and care. The letter proposes that countries and donors should include crisis-affected populations in HIV plans, provide emergency antiretroviral medicine refills, use portable health records, strengthen cross-border referrals, pre-position HIV supplies in high-risk areas, and support community-led services. Ending AIDS should mean that people are not excluded from care because they live through conflict, displacement, or health-system disruption.