At the World Health Summit 2026, the findings of The Lancet Commission on 21st Century Global Threats to Health were presented. The commission’s experts analyzed 17 catastrophic threats that could have the greatest impact on human health by the end of the 21st century. These include pandemics, antimicrobial resistance, climate change, rising inequality, poverty, cuts in international health aid, conflicts, and other challenges. For Ukraine and the HIV community, the findings of this report are particularly important. They demonstrate that success in combating the HIV epidemic depends not only on access to treatment but also on global political and economic decisions.

HIV cannot be overcome without investment in health

One of the threats identified by the Commission is a potential collapse of international health aid (Development Assistance for Health, DAH). Researchers warn that cuts to international funding could have serious consequences for countries that rely on donor support to combat HIV, tuberculosis, and other infectious diseases. This is particularly relevant for Ukraine. For many years, international partners—including the Global Fund, PEPFAR, and other donors—have helped expand access to testing, prevention, and antiretroviral therapy. It is thanks to this support that thousands of lives have been saved and progress has been made toward bringing the HIV epidemic under control.

Today, as many countries shift their focus to domestic challenges and security issues, the risk of reduced international investment in global health is growing. The Commission’s conclusion is clear: cutting back on such investments will have long-term consequences for the health of millions of people.

Poverty remains a driving force behind epidemics

One of the report’s key findings is that the number of people living in extreme poverty is no longer declining at the same rate as in previous decades. This problem is particularly acute in the world’s poorest regions. For the HIV sector, this finding has direct implications. Poverty remains one of the most significant social factors influencing the risk of infection, timely access to medical care, and adherence to treatment.

Ukraine today is also grappling with the consequences of war, forced displacement, economic instability, and the loss of income sources for many families. Under these conditions, supporting people living with HIV requires a comprehensive approach that includes not only medical services but also social protection, access to housing, employment, and psychological support.

Pandemics Remain a Serious Threat

The Commission has identified pandemics as among the greatest risks to human health in the 21st century. COVID-19 has demonstrated how quickly an infectious disease can disrupt the functioning of health care systems and access to services and life-saving treatment. For people living with HIV, treatment continuity is critically important. Ukraine’s experience in recent years has shown that even during war and crises, it is possible to ensure access to antiretroviral therapy through collaboration among government agencies, civil society organizations, and international partners.

Antimicrobial resistance threatens progress in the fight against HIV and TB

The Commission pays particular attention to antimicrobial resistance (AMR). According to expert estimates, it could result in the loss of billions of healthy life-years by the end of the century. For Ukraine, this issue is doubly significant. On the one hand, it is directly linked to the spread of drug-resistant tuberculosis. On the other hand, people living with HIV may be more vulnerable to infectious diseases and their complications.

That is why the development of modern diagnostics, access to new medications, investment in science, and the strengthening of infection control programs remain strategically important priorities for the entire public health system.

Inequality and education directly affect health

The report also demonstrates that income inequality and low levels of education continue to have a significant impact on the health of the population. In the context of HIV, this means the need to continue working to combat stigma and discrimination, expand access to information on prevention, testing, and treatment, and involve communities in decisions that affect their lives.

It is civil society organizations in many countries around the world, including Ukraine, that have proven their effectiveness in working with the most vulnerable population groups. This experience is a vital resource for overcoming future challenges.

A Lesson for Ukraine

The Lancet Commission’s main conclusion is that the future is not predetermined. Most of the threats humanity may face by 2100 can be significantly mitigated through timely investments, international cooperation, and people-centered policies. For Ukraine, this means maintaining the priority of programs addressing HIV, tuberculosis, and public health even amid the war. Support from international partners, a resilient health care system, the fight against inequality, and community engagement remain key conditions for achieving the goal shared by both the government and civil society: a life free of new HIV cases, free of discrimination, and free of preventable deaths.

Read the full report: https://www.thelancet.com/commissions-do/global-threats-to-health