What the Doha Declaration Says (and Doesn't Say) About People Living With HIV

Overview

The Doha political declaration places the HIV response under the wider category of “pandemics and other health emergencies,” marking a notable change from earlier, HIV-specific global commitments. This shift risks diluting the visibility of people living with HIV and the distinct needs of HIV programmes within a broad emergency framework.

Framing HIV as an emergency

The declaration treats HIV alongside other pandemics, positioning it primarily as a public health security and emergency management issue. While this framing can mobilize resources and attention during crises, it can also encourage short-term, reactive responses rather than long-term, rights-based strategies tailored to HIV.

What the declaration says

The text affirms commitments to universal access to prevention, treatment, care and support, and acknowledges the contribution of measures that improve access to affordable medicines. It references the importance of using existing international flexibilities on intellectual property to facilitate access to antiretroviral therapy and other health technologies.

Intellectual property and medicines

The declaration is grounded in the legacy of the original Doha Declaration on TRIPS and Public Health, which confirmed that trade rules can and should be interpreted to protect public health. This includes compulsory licensing and other mechanisms that have enabled low- and middle-income countries to expand access to generic antiretroviral medicines.

What the declaration doesn’t say

The text is relatively quiet on the leadership and meaningful participation of people living with HIV in shaping policy and programmes. It also does not fully spell out obligations to protect communities from discrimination, criminalization and other human rights violations that continue to fuel the epidemic.

Human rights and communities

Earlier HIV-specific commitments strongly linked effective responses with the protection of human rights, including non-discriminatory access to services and the participation of affected communities. In contrast, the Doha political declaration embeds rights language more generally, without clearly naming key populations or specifying concrete protections for people living with HIV.

Programmatic implications

By subsuming HIV under a broad health emergency agenda, the declaration may encourage integrated approaches but also risks weakening focused HIV funding, monitoring and accountability. Civil society organizations warn that without explicit references to HIV and affected communities, gains in treatment access and community-led services could stagnate or reverse.

People living with HIV

The declaration acknowledges the burden of pandemics but offers limited explicit recognition of the lived experience, leadership and expertise of people living with HIV. This silence contrasts with decades of advocacy that placed people living with HIV at the centre of decision-making and accountability for the global response.

Quotes

“Although we have seen significant progress in the first decade since the Doha Declaration was adopted, much more needs to be done in the second decade if we are to achieve universal access to HIV prevention, treatment, care and support.”

The Doha Declaration on TRIPS and Public Health reaffirmed that the agreement “can and should be interpreted and implemented in a manner supportive of WTO Members’ right to protect public health and, in particular, to promote access to medicines for all.”

Author summary

The article argues that by folding HIV into a broad emergencies agenda, the Doha declaration preserves language on access to medicines but sidelines rights, leadership and visibility of people living with HIV, putting hard-won gains at risk.

Global Network of People living with HIV — 2025-11-28