During the last two years of Covid and other global crises, progress against the HIV pandemic has faltered, resources have shrunk and millions of lives are at risk as a result. This year, UNAIDS is challenging us to tackle the inequalities and inequities in HIV prevention and treatment. Inequity exists between countries and within countries. In Madagascar, only 15% of those infected with HIV know their status while in the U.S.A., 87% of those infected know their status. Both countries are striving to reach at risk populations.