Latin America and the Caribbean have made progress in addressing HIV, tuberculosis, and malaria, reducing mortality and expanding access to treatment. However, new HIV acquisitions are not declining at the pace required. Social inequities, discrimination, and limited public investment continue to determine who becomes ill and who can access healthcare.
In this context, and ahead of the IV CELAC–EU Summit, which will bring together leaders from Latin America, the Caribbean, and the European Union in Colombia on 9–10 November, Salud por Derecho has sent a letter to Spain’s Prime Minister, Pedro Sánchez, emphasizing the importance of keeping global health—and particularly the response to HIV, tuberculosis, and malaria—high on the political agenda. The summit represents a unique opportunity to renew political and financial commitments between the two regions and to ensure that the response to these three diseases remains at the heart of cooperation.
HIV: Treatment Expands, Prevention Slows
Three out of four people living with HIV in the region are receiving antiretroviral therapy. AIDS-related deaths fell by 30% between 2010 and 2023, yet significant gaps persist: 12% of people living with HIV remain undiagnosed, and nearly one in three are diagnosed late, when immune deficiency is already advanced. Cuba, Belize, Jamaica, and Saint Vincent and the Grenadines have successfully eliminated mother-to-child transmission of HIV.
New HIV acquisitions are concentrated among key populations—including men who have sex with men, transgender women, sex workers, and migrant people—who continue to face stigma, discrimination, and punitive laws. The use of pre-exposure prophylaxis (PrEP) tripled between 2021 and 2023, and community-led self-testing and diagnostic initiatives are growing. Despite this, Latin America remains far from reaching the goal of 2.3 million people using PrEP by 2025; in 2023, only 204,000 people were estimated to have used it at least once. The exclusion of most countries in the region from voluntary licenses for long-acting injectable PrEP (lenacapavir) constitutes an avoidable barrier to access in a priority region for this prevention strategy. Meanwhile, insufficient investment and discriminatory policies continue to hinder progress toward UNAIDS’ 95-95-95 targets for 2025.
Tuberculosis: The Disease of Inequity
Tuberculosis remains one of the leading causes of death from infectious disease in the region. In 2023, 342,000 new cases and 35,000 deaths were reported—44% more than in 2015. Eighty percent of cases occur in just eight countries, mainly Brazil, Peru, Mexico, and Haiti, and disproportionately affect people deprived of liberty, Indigenous communities, migrant people, and people living with HIV.
Shorter and safer treatments, such as the BPaLM regimen and the 3HP preventive treatment, have improved adherence, while the introduction of molecular testing and AI-assisted digital radiography is accelerating diagnosis. However, without sustained investment and social policies that address the root causes of disease, tuberculosis will remain tied to inequity.
Malaria: Achievements and Ongoing Challenges
Malaria reflects an unequal picture across the region. While Belize, Paraguay, El Salvador, and Argentina have been certified malaria-free, 2023 saw a 5% increase, with 505,000 cases and 116 deaths. The Amazon basin—including areas of Brazil, Venezuela, Colombia, Guyana, and Suriname—continues to account for most infections, driven by deforestation, migration, and climate change, which expand the habitats of the mosquito vector.
The Regional Malaria Elimination Initiative (IREM), funded by the Global Fund, has been vital in reducing malaria in Mesoamerica and Hispaniola. In Nicaragua, transmission dropped by 80% between 2020 and 2024 thanks to rapid testing, prompt response, and community-based health networks.
These advances show that malaria elimination is achievable, but the recent uptick demonstrates the need to maintain funding and preventive measures—even in countries close to elimination. The Pan American Health Organization (PAHO) and the World Health Organization (WHO) continue to call for sustained support.
Support for the Global Fund
Since 2002, the Global Fund to Fight AIDS, Tuberculosis and Malaria has invested over US$3 billion in Latin America and the Caribbean—saving lives, strengthening health systems, and supporting affected communities. Its impact has been profound, yet cuts in international cooperation risk reversing these gains.
The upcoming replenishment conference, on 21 November, will be essential to sustaining the global response. Europe must show leadership, with a European Commission contribution of at least €800 million—up from €715 million previously—and stronger commitments from Member States.
Salud por Derecho welcomes the Spanish Government’s announcement of a €145 million pledge to the Global Fund. Building on this leadership, we hope Spain will consider increasing its total contribution to €200 million, either during the replenishment conference in Johannesburg or in the months ahead. Such a commitment would place Spain alongside countries like Italy and the Netherlands, reaffirming its dedication to an ambitious and coherent international response.
We also call on Prime Minister Pedro Sánchez to use the CELAC–EU Summit to convey a clear message to European Commission President Ursula von der Leyen and European leaders, underlining the importance of acting with solidarity and shared responsibility.
Investing in global health saves lives, strengthens the ties between Europe and Latin America, and enhances preparedness for future pandemics.
