Eliminate HIV by 2030? Portugal says yes. The data says no.

Portugal will not achieve UNAIDS' 2030 targets as long as it maintains a model of HIV prevention, screening, and treatment that is blocked by inadequate rules and institutional inertia. It is urgent to implement a true “green path” focused on science and human rights.

Pre-exposure prophylaxis (PrEP) continues to involve months of waiting, and in 2025, there will be no vacancies. Non-governmental organizations (NGOs) and CSPs, which are essential for expanding access, did not receive funding in 2025. The costs of the National Health System (SNS) must be optimized: hospital consultations are 43% more expensive than consultations contracted with NGOs, and the SNS pays more than double for PrEP co-payments than it does when the dispensing is free at the hospital pharmacy.

With nearly 25 years of community work and support from AHF and Coalition Plus, GAT is now a national reference and offers a concrete alternative for the country: a real green light to eliminate HIV by 2030.

First, it is necessary to unlock access to PrEP by expanding and simplifying access, ensuring specific and stable public funding for ULS and NGOs.

Second, screening is also completely insufficient: data from 2024 reveal that only 68,000 rapid tests were performed in Portugal, 62% of these by GAT—which benefits from an economical test financing model.

In treating and living with HIV, the challenge continues. Most people have adequate treatment, but it is necessary to ensure that 95% of people with HIV undergoing treatment do not transmit the virus, reinforcing the accessibility, updating, and effectiveness of treatments and meeting UNAIDS targets. For those living with HIV, aging is associated with a higher risk of comorbidities and therefore requires an integrated response: medical, social, and community care.

Eliminating HIV stigma must be a strategic priority. According to the Stigma Index 2.0, four in ten people living with HIV have experienced some form of social discrimination. Stigma compromises the entire prevention chain, and we must ensure that people living with HIV can access treatment, live with dignity, and age with quality.

As for institutions and the national framework, we finally celebrate the appointment of the new director for PNISTVIH, Bárbara Flor de Lima. This change is positive, but it must be accompanied by a robust and updated national strategy, as well as a strengthened team at PNISTVIH. Portugal, a pioneer in several areas of public health, must ensure a green light for access to HIV and STI prevention.

Portugal urgently needs a genuine National Strategy for HIV and other STIs that is up to date, coherent, and based on human rights and scientific evidence. This strategy must be multisectoral, transdisciplinary, and cover issues related to HIV, such as substance use and risk reduction, migration, and gender. Health, social action, and education must be coordinated, with guaranteed coordination between institutions. Without an adequate and coordinated national strategy, time and resources will be wasted, and above all, lives will be lost.

To this end, it is imperative that agreements be established with pharmaceutical companies that guarantee the protection of public health without imposing excessive costs on taxpayers. The provision of medicines and preventive interventions must take into account economies of scale, the impact on health, and the financial sustainability of the National Health Service.

If Portugal adopts this “green path,” it could achieve or come significantly closer to the UNAIDS goal of eliminating HIV and AIDS as a major public health problem by 2030. The strategy is demanding and requires commitment and political leadership. In civil society, we are ready to be partners in this collective challenge.

This opinion piece was originally published on December 1, 2025, in the newspaper Público, by Luís Mendão, General-Director of GAT.

Translated with DeepL.com (free version)