The UN General Assembly overwhelmingly approved a declaration Tuesday calling for urgent action to end AIDS by 2030, noting “with alarm” that the COVID-19 pandemic has exacerbated inequalities and pushed access to AIDS medicines, treatments and diagnosis further off track.

The declaration commits the assembly's 193 member nations to implement the 18-page document, including reducing annual new HIV infections to under 370,000 and annual AIDS-related deaths to under 250,000 by 2025. It also calls for progress toward eliminating all forms of HIV-related stigma and discrimination and for urgent work toward an HIV vaccine and a cure for AIDS.

Without a huge increase in resources and coverage for those vulnerable and infected, “we will not end the AIDS epidemic by 2030,” the assembly warned.

It said the coronavirus pandemic has created setbacks in combating AIDS, “widening fault lines within a deeply unequal world and exposing the dangers of under-investment in public health, health systems and other essential public services for all and pandemic preparedness.” While the international investment response to the pandemic is inadequate, it is nonetheless unprecedented, the assembly said.

The response to the coronavirus by many nations has demonstrated “the potential and urgency for greater investment” in responding to pandemics, underscoring “the imperative of increasing investments for public health systems, including responses to HIV and other diseases moving forward,” it said.

The assembly adopted the resolution at the opening session of a three-day high-level meeting on AIDS by a vote of 165-4, with Russia, Belarus, Syria and Nicaragua voting “no.” Before the vote, the assembly overwhelmingly rejected three amendments proposed by Russia.

They would have eliminated references to human rights violations that perpetuate the global AIDS epidemic and a “rights-based” collaborative approach by UNAIDS, the U.N. agency leading the global effort to end the AIDS pandemic. They would also have dropped references to reforming discriminatory laws, including on the age of consent, on interventions to treat HIV among intravenous drug users including “opioid substitution therapy,” and on “expanding harm reduction programs.” UNAIDS Executive Director Winnie Byanyima welcomed the declaration's adoption and told the assembly it “will be the basis of our work to end this pandemic that has ravaged communities for 40 years.” Calling AIDS “one of the deadliest pandemics of modern times,” she said 77.5 million people have been infected with HIV since the first case was reported in, 1981 and nearly 35 million have died from AIDS.

“HIV rates are not following the trajectory that we together promised,” she said. “Indeed, amidst the fallout from the COVID crisis, we could even see a resurgent pandemic.” Byanyima said COVID-19 showed that science moves “at the speed of political will” and urged speeded up spending on innovations for AIDS treatment, prevention, care and vaccines “as global public goods.” On the plus side, the assembly's declaration said that since 2001 there has been a 54% reduction in AIDS-related deaths and a 37% reduction in HIV infections globally, but it warned that “overall progress has slowed dangerously since 2016.” The assembly expressed “deep concern” that in 2019 there were 1.7 million new infections compared to the 2020 global target of fewer than 500,000 infections and that new HIV infections have increased in at least 33 countries since 2016.

Africa, especially sub-Saharan Africa, has demonstrated the most progress in tackling the AIDS epidemic but it also remains the worst-affected region, the assembly said. It called for “urgent and exceptional action” to curb the infection's devastating effects, especially on women, adolescent girls, and children.

Assembly members welcomed progress in reducing HIV infection,s and AIDS-related deaths in Asia and the Pacific, the Caribbean, Western and Central Europe, and North America. But they noted that despite progress, “the Caribbean continues to have the highest prevalence outside sub-Saharan Africa," while the number of new HIV infections is increasing in Eastern Europe, Central Asia, Latin America, the Middle East, and North Africa.

Byanyima stressed the importance of ending inequalities in the availability of drugs, and ensuring that medicines that can prevent deaths of people living with HIV are manufactured by multiple producers at affordable prices, “especially in the global south, where the disease is concentrated.” “This moment calls for us to work together across sectors, across countries,” she said. “Populism''s false promises are proving no match to biology: As COVID reminds us, we're not just interconnected, we're inseparable.” “We cannot end AIDS in one country or one continent. We can only end AIDS everywhere,” Byanyima said.