We, the global community of clinical researchers, scientists and affected people and communities, come together to meet virtually at the 20^th International Conference on Human Retrovirology: HTLV and related viruses, hosted in Melbourne, and call for meaningful action in response to the ongoing HTLV-1 epidemics worldwide.

HTLV-1 is a blood-borne and sexually transmitted virus distantly related to HIV. HTLV-1 establishes a lifelong infection of cells in the immune system and causes serious diseases, most notably adult T-cell leukaemia/lymphoma and progressive myelopathy, in up to 10% of people with the infection.

We call for adequate resources to empower communities, educators, clinicians, and researchers to establish effective and lasting responses to HTLV-1 both in their own countries and globally.

This statement embolden people affected by HTLV-1 and experts to engage nationally and internationally with decision-makers and demand action towards three specific priorities.

Specific goals:

1. Public health strategies that implement effective and locally acceptable transmission prevention education and strategies, including preventing both sexual transmission and vertical transmissions.
2. Protocols that establish timely and appropriate HTLV-1 specific clinical referral pathways for people affected by HTLV-1 infection, including rapid linkage with clinical trials.
3. Sufficiently funded research programs that strive to develop new therapies and vaccines into clinical trials and onward licenced release for community use.

Needed outcomes:

1. Reduce HTLV-1 transmissions leading to its final elimination.
2. Improve the health outcomes for all people affected by HTLV-1.
3. Make discoveries that will translate into effective biomedical HTLV-1 prevention, treatment, and cure, including HTLV-1 vaccines and pharmacological pre- and post-exposure prophylaxis.

The 21^st International Conference on Human Retrovirology: HTLV and related viruses will be held in 2024. We call for support from health ministers and other policymakers to take meaningful actions by this date so we can confidently announce that together we have made significant progress towards the prevention, treatment, and elimination of HTLV-1.

We call on all organisations and individuals to sign on to this call to action posted on the HTLV2022 conference and IRVA website to affirm a commitment to real action, strengthening the global response to HTLV-1.

This call to action will be revisited at the next IRVA Conference in 2024, to reflect on progress made in response to HTLV-1.

We encourage organisations to do the following:

• Incorporate this statement into your own strategies
• Include this statement on your website, demonstrating your commitment to action
• Promote your commitment to the statement to your members
• Communicate any actions that have progressed the aims of this statement in your local jurisdiction to IRVA, to report back on in time for the 2024 conference