Millions of AIDS-related Deaths in Years to Come if Global Inequalities Remain Unaddressed, UNAIDS Warns Ahead of World AIDS Day
UNAIDS Executive Director Winnie Byanyima

Ahead of World AIDS Day, 1 December, UNAIDS has warned that the world could face 7.7 million AIDS-related deaths over the next 10 years if leaders fail to tackle inequalities exacerbated by COVID-19. 

If transformative measures needed to end HIV/AIDS are not taken, the world will also remain dangerously unprepared for pandemics to come, said the agency.

The warning comes with a new UNAIDS reportUnequal, unprepared, under threat: why bold action against inequalities is needed to end AIDS, stop COVID-19 and prepare for future pandemics, launched today. 

“This is a pandemic that we are not in control of,” said UNAIDS Executive Director Winnie Byanyima, during a Monday press launch of the report.

“We cannot be forced to choose between ending the AIDS pandemic today and preparing for the pandemics of tomorrow. The only successful approach will achieve both. As of now, we are not on track to achieve either.”

In order to be on track to ending the AIDS pandemic and prevent future ones, the report calls for increased investments and shifts in laws and policies to end inequalities that drive pandemics forward. 

AIDS progress undermined by 1.5 million new HIV infections in 2020

While some countries, such as Rwanda, have made remarkable progress against AIDS, demonstrating that these ending AIDS is feasible, new HIV infections are not falling fast enough globally to stop the pandemic. The year 2020 saw 1.5 million new HIV infections globally, with increasing rates of infection in some countries. 

Infections notably follow lines of inequality, with six out of every seven new HIV infections among adolescents in sub-Saharan Africa occurring among adolescent girls.

Men who have sex with men, sex workers and people who use drugs also face a 25 – 35 times greater risk of acquiring HIV worldwide. 

‘Startling Opportunism’ of COVID-19 impacted HIV prevention services

Paul Farmer of AIDS-nonprofit Partners in Health

COVID-19 continues to undercut the AIDS response in many places with “startling opportunism”, said Paul Farmer of AIDS-nonprofit Partners in Health at the press briefing:

“Pathogens ranging from HIV to the virus behind COVID-19 invade the cracks and fissures in our society with startling opportunism.” 

During the first year of the pandemic, 2020, the pace of HIV testing declined almost uniformly – fewer people living with HIV pursued treatmen, in 40 out of 50 countries reporting to UNAIDS.

HIV prevention services were also impacted, with 65% of 130 countries surveyed experiencing disruptions in harm reduction services for people who use drugs in 2020.

Rwanda and Haiti – integrating COVID measures into HIV programs

There have been some gains in the fight against AIDS, despite disruptions experienced by COVID-19, with Farmer citing Rwanda and Haiti as examples of countries with HIV platforms that not only had effective HIV prevention strategies, but also sought to integrate HIV prevention and treatment into COVID response measures, and vice versa.

“Rwanda is the symbol of hope that we should look for.”

Rwanda was one of seven countries in eastern and southern Africa where 2,500 HIV treatment sites, serving 1.8 million people living with HIV, dispensed greater amounts of drugs to cover longer periods of treatments, and established social distancing and other preventative measures at clinic.

In six of seven of these countries, these measures actually reduced the percentage of patients who experienced treatment interruptions.

Haiti’s HIV program, while highly regarded, and at the forefront of efforts to integrate prevention care online, has been placed under siege by natural disasters, civil violence, and chronic political crisis worsened by the assassination of Haitain president Jovenel Moïse in July.

But despite drawbacks, Farmer noted that what “Haiti is doing is marking World AIDS Day – to keep the fight going.”

“Our teams, in rural Haiti and across the world, have routinely shown that with comprehensive care delivery, robust forms of accompaniment and social support and a larger dose of social justice, disparities in HIV outcomes can be rapidly narrowed, and health systems swiftly strengthened. We shouldn’t settle for anything less.”

Despite setbacks during the pandemic, a report released earlier in the year by UNAIDS also suggested that over the course of the past decade, dozens of countries have, in fact met or exceeded the ambitious targets set by the UN General Assembly towards a goal of ending AIDS by 2030, with evidence showing that targets were not just aspirational, but achievable.

Human-rights based approach center of global AIDS strategy, outlines UNAIDS report

Helen Clark, Co-Chair of the Independent Panel for Pandemic Preparedness and Response

The new report from UNAIDS outlines the critical elements of a Global AIDS strategy that must be urgently implemented in order to halt the AIDS pandemic, and strengthen global pandemic prevention, preparedness, and response. 

The measures needed to tackle inequalities include: community-led and people-centered infrastructure; equitable access to medicines, vaccines and health technologies; human rights that build trust; elevating essential workers and providing them with the necessary resources and tools; and people-centered data systems that highlight inequalities. 

In remarks at the report launch, Helen Clark, former co-chair of the Independent Panel for Pandemic Preparedness and Response, reiterated the need for a human-rights based approach to HIV/AIDS prevention and treatment. She said that she hopes  governments heed the message of the report, by “following through with deed, not words.” 

“We can only win the fight against AIDS and other pandemics if we put health and human rights at the center and if we are bold enough to end inequalities that drive pandemics,” said Clark. 

Image Credits: UNAIDS/Twitter, UNAIDS/Twitter, UNAIDS/Twitter.

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