Fast-Track Cities:
How Cities Are Leading
the HIV Response

What Is Fast-Track Cities?

Fast-Track Cities is not a federal program, a grant mechanism, or a top-down mandate. It is a city-level commitment — a mayor's signature on a declaration that says: we take responsibility for the HIV epidemic in our community, and we will act on it.

Fast-Track Cities is a global initiative launched on World AIDS Day, December 1, 2014, in Paris.^[1] Its four core partners are the International Association of Providers of AIDS Care (IAPAC), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat), and the City of Paris. Since its launch, more than 300 cities and municipalities on every continent have signed the Paris Declaration on Fast-Track Cities — a formal commitment to end the AIDS epidemic in their communities by 2030^[2].

Signing the declaration is a political act as much as a public health one. It requires a mayor or elected leader to stand up and say that ending HIV is a priority for their city — not a federal problem, not someone else's responsibility, but something local government is accountable for. The declaration then sets a framework: measurable targets, regular data reporting, and a five-element implementation plan supported by IAPAC.^[3]

The initiative is deliberately city-centered because cities are where the HIV epidemic is most concentrated — and where local political will can move fastest. A city government can act on HIV in ways that states and federal agencies cannot: it controls zoning for clinics, police practices that affect key populations, housing policy, and the day-to-day infrastructure of health services. Fast-Track Cities mobilizes that local authority in service of a specific, measurable goal.

How Fast-Track Cities Works

Signing the declaration is the beginning, not the end. Fast-Track Cities provides a structured implementation framework, data dashboards, peer learning, and technical assistance — so cities have the tools to actually deliver on what they signed.

The Fast-Track Cities implementation framework is organized around five elements, each addressing a different dimension of what a robust city HIV response requires^[4]:

Florida's Four Fast-Track Cities

Florida has four Fast-Track Cities — four communities where the mayor has made a public, formal commitment to end the HIV epidemic. All four are also EHE priority jurisdictions, meaning they receive targeted federal resources alongside their city-level commitments.

What Joining Actually Means

Signing the Paris Declaration gives a city access to the Fast-Track Cities data dashboard, technical assistance from IAPAC, peer learning with cities in the global network, and the ability to compete for grant funding that is available to Fast-Track Cities members. More practically, it gives HIV advocates in that city a formal commitment from the mayor that they can hold up — in budget meetings, in press coverage, in conversations with health department officials — as a baseline expectation for what the city owes its residents living with HIV.

The 95-95-95 Goal — and Why It Matters

Every Fast-Track City commits to achieving the UNAIDS 95-95-95 targets.^[8] Understanding what those numbers mean is understanding the entire logic of the modern HIV response.

The 95-95-95 targets — successor to the earlier 90-90-90 targets^[9] — set three sequential goals for the HIV care continuum:

These three cascading targets matter because each one is a prerequisite for the next. You can't treat someone who doesn't know their status. You can't achieve viral suppression without treatment. And viral suppression is the endpoint that matters clinically — because a person with a suppressed viral load is healthy, cannot transmit HIV sexually, and is not contributing to new infections.^[10] If 95-95-95 is achieved broadly, new infections approach zero.

The targets are sequential and multiplicative. If 95% of PLWH are diagnosed, 95% of those are on treatment, and 95% of those are suppressed — the math means roughly 86% of all people living with HIV have suppressed viral loads. That is the threshold below which epidemics begin to decline sustainably.

Why Cities — Not Just States or Federal Programs

More than half the world's population lives in cities. HIV is an urban epidemic in most countries. And cities have tools that federal and state governments don't — tools that directly affect whether people get tested, stay in care, and live without stigma.

Cities control or heavily influence the conditions that drive HIV outcomes: housing stability, policing practices that affect key populations, the location and accessibility of clinics, the culture of local health departments, and the political willingness to talk openly about HIV without stigma. A mayor who makes HIV a priority changes the operating environment for every clinic, case manager, and public health officer in that city.

The Fast-Track Cities model also creates something that federal programs typically can't: horizontal accountability between peers. When Miami-Dade, Tampa, Jacksonville, and Fort Lauderdale are all in the same network, each reporting their 95-95-95 progress publicly, there is visibility across cities that motivates improvement in a way that a federal grant cycle alone does not.

What You Can Do With This

If you live in Miami-Dade, Broward, Hillsborough, or Duval county, your city has made a public commitment to end the HIV epidemic. That commitment is a lever — use it. Ask your city council member, health department official, or mayor's office what progress looks like against the 95-95-95 targets. Point them to the Fast-Track Cities dashboard. Show up at public health meetings. The declaration is only as powerful as the people who hold the city accountable for it.

If you live in a Florida city that has not yet joined — Orlando, Palm Beach, Pinellas — Fast-Track Cities is open to any city that commits to the framework. Advocates can push elected officials to sign the Paris Declaration. It costs nothing and opens the door to technical assistance, grant funding, and peer learning from 300+ cities worldwide.

References & Sources