Matshidiso Moeti, Regional Director of the WHO Regional Office for Africa

US President Joe Biden’s announcement today of some 500 million Pfizer doses to the African Union and 92 low- and middle-income countries elsewhere in the world could help begin to “turn the tide’’ on the continent’s pandemic battle, said WHO African Regional Director, Matshidiso Moeti. 

“The tide is starting to turn. We are now seeing wealthy nations beginning to turn promises into action,” Moeti said, speaking at a WHO press briefing on Thursday. “This comes as we see other countries such as France also making tangible deliveries via COVAX, Moeti said, adding,

“Vaccines have been proven to prevent cases and deaths, so countries that can, must urgently share COVID-19 vaccines. It’s do or die on dose sharing for Africa.” 

The White House announcement coincided with Biden’s arrival in the United Kingdom to attend this weekend’s G7 Summit. “This is the largest-ever purchase and donation of vaccines by a single country and a commitment by the American people to help protect people around the world from COVID-19,” said the White House statement. 

The help could come in the nick of time, as African health officials warned that countries are running out of vaccine doses to combat the COVID-19 pandemic – and the number of new COVID-19 cases remains on the rise for the third week running. 

Without more help soon, “nearly 90% of African countries are set to miss new global targets of vaccinating 10% of people against COVID19 by September, Moeti warned.

 

Less than 1% of Africans Vaccinated So Far 

Less than 1% of Africans have yet been vaccinated, and four countries are yet to commence vaccination at all, said John Nkengasong, Africa’s Center for Disease Control director, in a separate press briefing. 

So far, “35.9 million COVID-19 vaccine doses have been administered, which corresponds to 65% of the total supply available in Africa. Only 0.6% of the population has been fully vaccinated on the continent.” 

John Nkengasong, Director of the Africa CDC

Against that landscape, Biden’s announcement was being welcomed by global health leaders as a potential game changer that could also prod other high-income countries to make more generous vaccine donations. 

“Excellent news,” tweeted José Manuel Barroso, chairman of the board of Gavi, The Vaccine Alliance, which is the key co-sponsor with WHO and UNICEF of COVAX, the global vaccine facility, which has been the main clearinghouse for vaccines donated or sold at cost for use in low and middle income countries. 

The deal will see deliveries of the new US donations begin in August, with 200 million doses to be shipped in 2021, and a further 300 million doses by June 2022, said Gavi in a separate statement. 

According to the plan, the vaccine doses will be made available through the COVAX facility to member states of the African Union, as well as a few dozen other countries around the world that are eligible for donor-funded vaccines through Gavi’s procurement mechanisms. 

The 500 million dose donation is in addition to the plan to share 80 million doses of existing vaccines in US stocks, as part of a broader global vaccine sharing strategy detailed just last week by the Biden Administration.    

Missing COVID Vaccination Goals – Third Virus Wave Looms 

vaccine
COVID-19 Vaccination in Africa

Moeti, WHO African Regional Director noted that the delay in vaccine supply to Africa has led to nine out ten countries on the continent to miss their COVID-19 vaccination goal for September.

As of now, 47 out of Africa’s 54 countries will miss the September target of vaccinating 10% of their population, Moeti revealed. The goal could still be met, however, if the continent rapidly receives 225 million more doses, she added. 

According to WHO’s tally, Africa accounts for under 1% of the over 2.1 billion doses administered globally.  Only about 2% of the continent’s nearly 1.3 billion people have received one dose and only 9.4 million Africans are fully vaccinated.

 

That, as the continent faces a third wave of COVID-19 cases, with new case numbers rising for the third week running. 

While Africa’s cumulative case count hasn’t been lower than almost any other continent, officials there are nervously eyeing events in India, followed by Latin America, which have seen massive  new COVID waves recently. In India, those occurred in cities and regions that historically had not suffered from very high case rates – while in Latin America, they are recurring in countries already battered by previous waves of the virus. .   

“As we close in on 5 million cases and a third wave in Africa looms, many of our most vulnerable people remain dangerously exposed to COVID-19,” Moeti said.

Big Vaccine Inequalities within Africa Too  

Even within Africa, there is inequality in access, a brief assessment by Health Policy Watch Reveals.  A closer look at doses administered so far shows just five countries accounting for about 64% of all doses administered on the continent.

Those include Morocco, having administered 15.8 million doses, followed by Egypt (3.1 million), Nigeria (2.1 million),  Ethiopia (1.9 million), and South Africa, (1.4 million doses out of 2.4 million that it has available).  

On the other hand, Tanzania, the Saharawi Republic, Eritrea, and Burundi are yet to receive or administer any COVID-19 vaccines.

Along with the new US vaccine offers, some other fresh donations are finally beginning to trickle into some African countries, Nkkengasong said. 

“On 1 June 2021, Togo received 100,620 doses of the PfizerBioNTech vaccine from the COVAX facility making it the third country to receive such from the initiative. On 4 June 2021, Chad started vaccinating health personnel and the elderly with 400,000 doses of Sinopharm received on 3 June 2021,” he noted. 

Tackling Vaccine Wastage

Along with the plea for more donations, the health officials also acknowledged that African countries need to take more assertive action to avoid vaccine wastage and spoilage – challenges that will become even more significant as temperature sensitive Pfizer vaccines begin to be distributed. 

In April 2021, Health Policy Watch reported on the concerns that many African countries were inadequately prepared to quickly administer the doses before their expiry. 

Following that, Malawi’s incineration of nearly 20,000 expired doses called even more attention to the issue – even as WHO and African CDC officials said that the vaccines could still have been used beyond their expiration date. Other countries, such as the Democratic Republic of Congo, have pre-emptively returned unused doses to the African CDC, saying they could not use them in time. 

At today’s briefing, Moeti revealed that 14 African countries have used nearly all (80 — 100%) of the doses they received in the spring through the COVAX Facility, primarily temperature resilient AstraZeneca vaccines supplied by the Serum Institute of India. 

On the down side, however, 20 countries have used less than 50% of the doses received, while 12 countries have more than 10% of their AstraZeneca doses at risk of expiration by the end of August.

“We need to ensure that the vaccines that we have are not wasted because every dose is precious,” said Dr Moeti. “Countries that are lagging behind in their rollout need to step up vaccination efforts.”

She noted that countries like Côte d’Ivoire and Niger are seeing more success by adjusting their vaccine rollout strategies. 

“Where possible, WHO recommends spreading vaccinations beyond large cities into rural areas, prioritizing vaccines that are close to expiring, tackling logistical and financial hurdles and working to boost public demand for vaccines,” Moeti suggested.

Image Credits: Paul Adepoju.

mental health
Dr Michelle Funk of the Department of Mental Health and Substance Use, who led the development of the WHO guidance

Providing community-based mental health care that is respectful of human rights and recovery-focused has proven successful and cost-effective, according to a new report released by the World Health Organization. 

WHO’s new “Guidance on community mental health service: promoting person-centered and rights-based approaches”, released today, includes examples from countries including Brazil, India, Kenya, Myanmar, New Zealand, Norway, and the United Kingdom of community-based mental health services that have demonstrated good practices that are non-coercive, incorporate the community, and respect people’s legal capacity, or their right to make decisions about their treatment and life. 

“[These services] look more holistically at supporting people in their overall lives. [There are also] services that don’t tell people what to do but work in partnership with people, to find the best way forward for that person in their life,” Dr. Michelle Funk of the Department of Mental Health and Substance Use, who led the development of the guidance, told Health Policy Watch.  

The report reviews what is required in areas that include mental health law, policy and strategy, service delivery, financing, workforce development, and civil society in compliance with the Convention on the Rights of Persons (CRPD), adopted as the international human rights standards in 2006. 

Few Countries Meet CRPD Requirements; Majority of Mental Health Budget Towards Psychiatric Hospitals

Though an increasing number of countries have sought to reform their laws, policies, and services to mental health care, few countries have established the frameworks necessary to meet the requirements of the CRPD. 

“We see many of the services that are being provided are not helping people in the way that they want to be helped,” said Funk. 

Reports from around the world highlight severe human rights abuses and coercive practices that are still far too common for countries of all income levels. These include forced admission and forced treatment; manual, physical, and chemical restraint; unsanitary living conditions; physical and verbal abuse. 

The lack of compliance with the CRDP is “very challenging for many countries,” she added, attributing this to several reasons. 

There is still a stigma associated with mental health that leads people with psychosocial disabilities and mental health conditions to be perceived as incapable of making decisions for themselves. There is also the lack of overall investment in mental health services, with a focus instead towards institutionalization and specialized care. 

“Countries continue to invest in what they’ve been investing in.” 

According to WHO’s latest estimates, governments spend less than 2% of their budgets on mental health, with the majority of reported expenditure on mental health allocated to psychiatric hospitals. 

Good Mental Health Services Already Exist, Should Be Scaled-Up

Users and Survivors of Psychiatry in Kenya (USP-Kenya) – promotes and advocates for the rights of persons with psychosocial disabilities through peer support

Shifting the whole paradigm to community-based mental health service that respects human rights may be difficult, but there have been successful services that remain on the periphery and can demonstrate to policymakers and service providers that it is possible to achieve.

These services include crisis support, mental health services provided within general hospitals, outreach services, supported living approaches, and support provided by peer groups. 

“The services are available and functioning well in low-, middle-, and high-income countries are producing really good results. And they’re doing it at either a comparable cost or even less than the traditional mainstream services,” said Funk. 

While it is important to focus on services provided in a low-income context, she added, middle-income and high-income countries also have services that can be adapted and scaled-up by low- and middle-income countries. 

Funk emphasized the importance of learning from the principles of these services to create country-specific mental health services, whether it is a low-, middle-, or high-income country.  

Larger Investment in Mental Health Needed

During the COVID-19 pandemic there has been increased recognition of the importance of mental health

In addition to adapting and scaling up existing person-centered mental health services, there also must be a larger investment in mental health. 

Over the course of the COVID-19 pandemic, there has been increased recognition of the importance of mental health and how it is closely linked to what is happening around us and the psychosocial determinants of health.

Concluded Funk: “We cannot afford to just perpetuate the services we have already. If we’re going to have increased investment, we must change the way we invest that money in mental health – towards community mental services that respect and promote human rights.” 

Image Credits: USPKenya/Twitter, AMSA/Flickr.

Reeta Roy, President and CEO of the Mastercard Foundation

The Mastercard Foundation will spend US$ 1.3 billion over the next three years to help vaccinate 50 million Africans against COVID-19 and accelerate the continent’s economic recovery from the pandemic, one of the world’s biggest foundations has announced.

Tuesday’s announcement by the Foundation and the Africa Centres for Disease Control and Prevention(Africa CDC) comes less than a week after the World Health Organization’s Africa region called for an increase in vaccine dose sharing as it witnessed a resurgence of COVID-19 cases in southern and eastern African countries – some of which are also entering the chilly winter season now. 

It also comes amid growing global concerns over Covid-19 vaccine inequality – with WHO’s African Regional Office announcing on 3 June that only 0.54% of Africa’s 1.2 billion people have been fully vaccinated. The African Development Bank has warned that the COVID-19 pandemic could drive 39 million people into extreme poverty in 2021, and said that widespread vaccination is critical to the economic recovery of African countries.

Reeta Roy, President and CEO of the MasterCard Foundation said the Foundation’s new Saving Lives and Livelihoods initiative will also lay the groundwork for establishing more vaccine manufacturing capacity in Africa by focusing on human capacity development, and strengthening the Africa CDC.

Roy told journalists during a media briefing that the aim of the initiative is to ensure that “all lives are valued and Africa’s economic recovery is accelerated”. “Ensuring equitable access and delivery of vaccines across Africa is urgent,” she said.

Describing the new partnership as a “bold step towards establishing a New Public Health Order for Africa”, Africa CDC Director John Nkengasong said: “Ensuring inclusivity in vaccine access, and building Africa’s capacity to manufacture its own vaccines, is not just good for the continent, it’s the only sustainable path out of the pandemic and into a health-secure future.”

Africa’s Race To Economic Recovery and Vaccination Agenda

A $1.3-billion donation from the Mastercard Foundation will help vaccinate 50 million Africans over the next three years.

With billions of doses of COVID-19 vaccines administered globally, the reopening of several economies now hinge on expanded vaccine coverage to begin the journey towards economic recovery.

This is also expected to happen in Africa which however has been plagued by the dual impacts of vaccine inequality and vaccine hesitancy that could further prevent the continent from regaining the economic losses attributable to COVID-19.

For the first time in 25 years, Africa, in 2020, faced an economic recession and the African Development Bank warned that COVID-19 could reverse hard-won gains in poverty reduction over the past two decades and drive 39 million people into extreme poverty in 2021. It described widespread vaccination as critical to the economic recovery of African countries.

The Mastercard Foundation said the initiative was aligned with the African Union’s vaccination goal. While less than 2% of Africans have received at least one dose of the COVID vaccine, the AU aims to vaccinate 6 out of 10 Africans by 2022, this means reaching about 750 million Africans — roughly the continent’s entire adult population.

Strengthening Africa’s Public Health Institutions

In remarks at the launch, Paul Kagame, President of Rwanda, said the initiative will strengthen the continent’s public health institutions and help save lives.

“It is practical and immediate. Lives are going to be saved through the vaccines  that will be purchased. There is also a commitment to work directly with our public health institutions and make them strong, creative parallel systems have not been effective,” Kagame said.

The partnership, said Kagame, also puts Africa’s long-term vision to produce medicines and vaccines on the continent into consideration. “But we have to do our part with a sense of urgency and excellence,”  said Kagame, urging key players in Africa to do things differently and not “a business-as-usual” mindset.

Nkengasong said the new initiative will work in synergy with others to advance and expand vaccine access in Africa –  including the WHO co-sponsored COVAX vaccine facility and the African Union’s own COVID-19 African Vaccine Acquisition Task Team (AVATT), which has offered a continent-wide procurement and financial mechanisms for African countries purchasing their own vaccines. However, many countries have been reluctant to borrow funds to buy needed vaccine doses. 

Kagame again called on the global community to expand access to vaccines across Africa, noting that doses of vaccines available to Africa are only a small portion of the global supply. Nkengasong said the continent still needs to meet the financial costs to purchase, deliver, and administer vaccines remain significant. 

But he was confident in the continent’s ability to meet the vaccine goal which he said will be achieved with active involvement of governments, global funders, the private sector, and other key players including citizens’ acceptance of the vaccines when they become available. 

The move received wide applause from other leading African health influencers with former Liberian President Ellen Johnson Sirleaf calling it a ‘game changer’.

 

Voting on the UN High-Level Declaration on AIDS

Russia stunned the United Nations High Level Meeting on AIDS on Tuesday when it proposed a series of last-minute oral amendments to the meeting’s final political declaration – removing references to “rights”; the decriminalisation of sex work; and harm reduction in the context of the battle against HIV/AIDS.

The text of the final declaration had been negotiated over the past two months under the leadership of Australia’s Mich Fifield and Namibia’s Neville Gertze, and Gertze told the meeting that 73 changes had already been made to accommodate Russia’s concerns.

The declaration text was finally adopted, not by consensus but by a vote, after the vast majority of delegates rejected further last-minute amendments proposed by Russia at the meeting. The declaration was approved by 162 countries voting in favour and four against, with Belarus, Nicaragua and Syria siding with Russia.

However, after the vote, a number of countries that supported the declaration also made it clear that their support was qualified.  Countries including Bahrain, Egypt and Libya disassociated themselves in particular from references to “key populations” – those groups considered particularly vulnerable to HIV, including sex workers, men who have sex with men and injecting drug users.

They described such groups as being against their culture, while Russia described them as an affront to “family values”.

Meanwhile, a number of African countries including South Africa, Rwanda and Cameroon expressed disappointment that the declaration, which is meant to guide the next stages of the global campaign against HIV, had not been adopted by consensus at the High Level meeting.

Declaration ‘Does Not Measure Up’

However, the US was the most direct in its condemnation of Russia’s “new and hostile amendments” – as well as the compromises that had been made to get to the current declaration.

“The political declaration before us, put simply, does not measure up,” said the US delegate.

What started as a “strong, ambitious declaration” that was evidence- and science-based, has become a text that “lacks the ambition needed to meet the stated goals of this High-Level Meeting: ending inequalities and ending AIDS”, she said.

The main issue the US had with the declaration was how “national sovereignty” had been given prominence, enabling countries an escape from implementing various clauses because of “national context”.

“Comprehensive sexuality education, and the recognition of sexual orientation and gender identity are central to an effective HIV/ AIDS response,” stressed the US delegate.

“HIV prevention and treatment programmes that do not recognise the diversity of populations and their unique needs will not successfully stop HIV infection or ensure that all persons living with HIV AIDS have access to treatment.”

Delegates from the US, Canada and Portugal (on behalf of the European Union) also condemned Russia’s approach which scuppered weeks of sensitive negotiations.

Research findings, such as a study published just this week also underline the importance of sensitivity to sexual orientation and gender identity in the battle against HIV/AIDS. The study, led by Matthew Kavanagh, of the Global Health Policy and Politics Initiative at Georgetown University, found that countries that criminalise same-sex relationships, illicit drug use, and sex work have worse outcomes against HIV.

Kavanagh’s research found that “in countries with criminalised legal environments, a smaller portion of people living with HIV knew their HIV status and had suppressed virus compared to countries with less criminalising laws”.

Russia Opposed to Harm Reduction, ‘Key Populations’ and ‘Rights’

Russia opposed a number of clauses including harm reduction measures.

The clauses that particularly offended Russia included those related to “key populations”, harm reduction; and reference to a “rights-based” approach in combatting HIV/AIDS.

In particular, Russia had wanted to drop a clause that committed the global community to “urgent and transformative action to end the social, economic, racial and gender inequalities, restrictive and discriminatory laws, policies and practices, stigma and multiple and intersecting forms of discrimination, including based on HIV status, and human rights violations that perpetuate the global AIDS epidemic”.

In addition, Clause 28, was also viewed as unacceptable by Moscow. This expresses “deep concern about stigma, discrimination, violence, and restrictive and discriminatory laws and practices that target people living with, at risk of and affected by HIV”.

Clause 37 on countries’ lack of progress on “expanding harm reduction programmes” was also earmarked for deletion. 

Overall, Russia accused UNAIDS of abandoning it’s science-based approach in favour of a “rights-based approach” and asked that all such references to “rights-based” be removed. 

In addition, Russia sought to delete language committing countries to “eliminating HIV-related stigma and discrimination, and to respecting, protecting and fulfilling the human rights of people living with, at risk of and affected by HIV” and “reviewing and reforming restrictive legal and policy framework” that create barriers or reinforce stigma and discrimination was also unacceptable (Clause 65 A and B).

These clauses are in line with the Joint UN Programme on AIDS (UNAIDS) 2025 “10-10-10 targets”: Less than 10% of countries with punitive legal and policy environments; less than 10% of people living with HIV and key populations experiencing stigma and discrimination, and less than 10% of women, girls, people living with HIV and key populations experience gender inequality and violence.

AIDS is Not Over, Says UNAIDS Head

UNAIDS Executive Director Winnie Byanyima

UNAIDS Executive Director Winnie Byanyima, told the opening plenary: “AIDS is not over. It is one of the deadliest pandemics of modern times. Since the start of the pandemic, 77 and a half million people have been infected with HIV globally and we have lost nearly 35 million people to AIDS. An AIDS death every minute is an emergency.”

A number of countries have made good progress to eliminate new cases by 2030 – a goal set at the last UN High Level Meeting in 2016 – but the COVID-19 pandemic had undermined progress, she added.

“The evidence shows that when laws are strengthened to support gender equality, the rights of key populations and confront stigmatisation, countries have made greater progress in treatment and prevention programmes benefiting everyone,” added Byanyima. “We need to keep moving forward in our common journey away from harmful punitive, outdated, often colonial laws and from all forms of discrimination.”

Yana Panfilova, a 23-year-old woman who was born with HIV and is a member of GNP+ Global Network of People Living with HIV, also addressed the plenary.

“The AIDS response is still leaving millions behind: LGBTQ people, sex workers, people who use drugs, migrants and prisoners, teenagers, young people, women and children who also deserve an ordinary life with the same rights and dignity enjoyed the most people in this room,” said Panfilova.

“If we’re going to make a real change, these four things must become a reality. First one, comprehensive sexuality education in all schools in all countries. Second, psychological support, and peer support for every adolescent living with HIV and young key populations.

Third, the community needs HIV services to become the reality, not the exception. And the last one, finally, get an HIV vaccine.”

President of Uganda Yoweri Museveni addressing the nation

Uganda has imposed more stringent measures to control COVID-19 transmission after it recorded over 1000 new cases per day on 2 June – its highest tally ever, mostly among people aged between 20 and 39 years.

On Sunday, President Yoweri Museveni instituted a 42-day lockdown during which time all schools and institutions of higher learning will be closed. Teachers will also have to be fully vaccinated before they are accepted back to the classrooms.

Since March, Uganda’s education institutions have been a major source of COVID-19 infections with a total of 948 reported cases in 43 schools from 22 districts. 

Over 60% of cases have come from Kampala, Gulu, Masaka and Oyam districts. 

“We believe this number is much higher, only that most schools are not reporting. They are hiding because they don’t want to be closed and most of them want to get money,” said Museveni. 

The increased COVID-19 infections in schools has been attributed to poor compliance with behavioural guidelines such as mask-wearing, inadequate sanitation facilities and overcrowding.

Communal gatherings of over 20 people, including at places of worship, conferences and cultural gatherings, have also been suspended for the next 42 days.

However, the Cabinet, legislature, and the judiciary are allowed, as are small gatherings under 20 people and agriculture activities, factories, construction, shopping malls, food markets and supermarkets. But all have to close by 7pm.

Test Positivity Reaches 18%

Last Friday, the Ministry of Health’s testing results indicated 1,259 new cases out of 7,289 samples tested and nine deaths. 

Uganda’s cumulative confirmed cases are 52,935 and deaths are up to 383. Active cases on admission at health facilities are 634 and the test positivity rate has increased to 18.1%.  

“A test positivity above 10% is a cause for concern especially in a country where testing is reasonably being done,” said the World Health Organisation regional director for Africa, Dr Matshidiso Moeti. 

Museveni said this situation is beginning to stress the health facilities, with pressure of available  beds and oxygen in hospitals.

“The intensity of the illness and severity among the COVID-19 patients is higher than what we experienced in the previous phase,” said Museveni about the second wave. He encouraged people to work from home with only 30% of the staff who work in offices allowed with physical presence.  

Inter-district movement has also been suspended except for tourist vehicles and cargo trucks that have to carry only two people.

Museveni said all travelers have to undergo mandatory COVID-19 testing because some who would come into the country with purported negative PCR test results were tested positive.

To date, Uganda has confirmed a total of 126 cases from travelers coming in through Entebbe International airport out of 4,327 travelers entering the country since the pandemic started. 

 

Health Director General Henry Mwebesa

Meanwhile, the country has used 748,676 AstraZeneca vaccines out of 964,000 available, with 712,681 people having their first dose and 35,995 people having received both doses.

The country received 864,000 doses from COVAX in March and 100,000 as a donation from the Indian government.

Museveni said the government is committed to vaccinating all the 21.9 million eligible Ugandans, starting with the priority groups of 4.8 million people. 

The country is also trying to avoid wastage of COVID-19 vaccines by reassigning vaccines from low to high absorption areas. Malawi destroyed vaccines last week due to expiration.

Districts that have a below 50 percent uptake of COVID-19 vaccines in Uganda will have them withdrawn and redeployed elsewhere unless they act immediately, the Ministry of health has announced. The vaccines are due to expire by 10 July.

Vaccines to be Redeployed

Health Director General Henry Mwebesa says the withdrawn vaccines will be redeployed to the  Kampala Metropolitan Area where the infection rate and uptake are high.

“Take note that there will be penalties for those that waste vaccines or allow vaccines in their possession to expire yet these are very expensive life saving vaccines,” warned Mwebasa.

When the vaccines were delivered, the districts were given three months to vaccinate vulnerable groups including health workers, teachers, security personnel and anyone between 18 and 50 years with comorbidities.

According to some district leaders, some places have been unable to roll out vaccinations properly as they are under-staffed or newly created with inefficient management systems.

“Most of these districts have valid reasons for the low absorption. Ultimately, they have no capacity to translate policy into action,” said Alfred Driwale, the manager of the Uganda National Expanded Programme on Immunization (UNEPI) at the Ministry of Health.

Meanwhile, Museveni warned the public to either comply or face a total lockdown and fines: “Failure to observe the stated directives within a week, I will direct a total lockdown. Those who do not care for the health of Ugandans will pay financially.”

 

 

A smoke-free poster at a bus stop in Yunnan

Eight campaigns and initiatives aimed at encouraging people to quit smoking were launched this week by Vital Strategies and partners to mark World No Tobacco Day on 31 May 2021. 

Tobacco use is the single greatest source of preventable death and disease worldwide – responsible for eight million deaths each year and the theme of this year’s World No Tobacco Day was “commit to quit.” 

José Luis Castro, President and CEO of Vital Strategies

“Now is the time for bold, comprehensive action on tobacco. COVID-19’s tragic toll has fuelled vulnerabilities from decades of under-investment and inattention to prevention and preparedness, including more than a billion people more susceptible to illness because of current tobacco use,” said Jose Luis Castro, President and CEO of Vital Strategies, in a statement. 

Vital Strategies’ World No Tobacco Day campaigns support policies to discourage and reduce smoking, and to keep the industry out of tobacco control legislation, reaching millions around the world. 

India – “When You Quit” Campaign

Vital Strategies and WHO India launched the campaign, “When You Quit” on national radio stations and on digital television platforms, and disseminated a communications toolkit with social media resources to communicate the harms of tobacco use. 

Indonesia – New Smoke-Free Laws 

In Bandung, Indonesia, Mayor H Oded Muhammad Danial unveiled a new smoke-free law that prohibits smoking in seven types of public spaces. Bandung, with its smoke-free law, was part of the many cities that participated in the Partnership for Healthy Cities global network supported by Bloomberg Philanthropies in partnership with WHO and Vital Strategies.   

Philippines – Running to Quit

The Philippines Department of Health and Vital launched a virtual ‘Smoke-Free Challenge’, where participants competed in virtual distance-based activities, such as running, walking, and swimming, promoting health activities. 

China – Promotion of Smoke-Free Policies 

Vital Strategies promoted smoke-free policies in China with two public service announcements, “Cigarettes are Eating Your Baby Alive” and “Smoke-Free Family”, reaching more than one million people through an online event organized with the National Health Commission. 

Vital also worked with the Yunnan Health Education Center and Health Education Association to provide posters on the importance of smoke-free policies for 200,000 posters bulletin boards across the province. Other cities in China also launched social and mass-media campaigns. 

Ukraine – Tobacco Use and Risks From COVID-19

“A Doctor’s Warning” is a new media campaign on tobacco use and COVID-19 launched in Ukraine, in partnership with the Public Health Center of the Ministry of Health and the NGO Life Advocacy Center. The campaign featured a testimonial from a prominent doctor on how smoking increases the risk of COVID-19. 

Vietnam and Bangladesh – Protecting Loved Ones From Secondhand Smoke

In Vietnam, “Quit Smoking to Protect Your Loved Ones,” recounts the story of Le Thi Tinh, who developed lung cancer after regular exposure to secondhand smoke in her home. The campaign is run on national television channels and on the Smoke-Free Vietnam Facebook page through June.  

In Bangladesh, the government aired the public service announcement, “Smoke-Free” homes for six weeks on the state-owned television channel, Bangladesh Television. The messaging focused on the importance of quitting smoking to protect loved ones from secondhand smoke, and was supplemented by posts to the Facebook page, Stop Tobacco Bangladesh. 

Brazil – Ending Electronic Nicotine Delivery Systems 

The Brazilian Medical Association and Cancer Foundation launched a social media campaign focused on the importance of banning ENDS in Brazil and pushing back against industry efforts to overturn it. 

The Facebook live launch event of “Quit Smoking to Protect Your Loved Ones” in Vietnam

Stopping Tobacco Industry Interference in National Policy

Castro urged governments to enact policies that support healthier choices for all, especially through the use of effective tobacco control laws, such as the WHO’s Framework Convention on Tobacco Control (FCTC). 

“For our healthiest future, we must act to shape our society and our environment to support health,” he said, adding that this includes contending with persuasive marketing from the tobacco industry and the influence of the industry on government policies. 

The Global Tobacco Industry Interference Index 2020, released by STOP (Stopping Tobacco Organizations and Products), also showed that the tobacco industry has been using the pandemic to promote itself through donations of necessary goods, in order to gain a foothold in tobacco policies of national governments.  

Pakistan health authorities continue in their struggle to implement the FCTC, though the treaty was signed in 2004. In addition, tobacco control activists fear that the government has given in to industry pressure to close down its only government body addressing tobacco consumption, the Tobacco Control Cell (TCC). 

Meanwhile, the Kenyan government, earlier this year, had issued a directive requiring the tobacco industry to register all nicotine products as tobacco products. 

The Kenya Tobacco Control Alliance (KETCA) had also called on the government to act fast, as tobacco use is a bigger epidemic than COVID-19, and requested the Ministry of Health to tighten tobacco control regulations. 

“Tobacco use continues to kill at least 9,000 Kenyans every year. This is three times the total number of Kenyans killed by Covid-19 in the last one year. By Sunday, May 30, 2021, Covid-19 had killed 3,157 Kenyans,” said Joel Gitali, chairman of the KETCA.

 

 

Image Credits: Vital Strategies, Vital Strategies.

European Commission President Ursula von der Leyen suggests that the EU’s counter-proposal to the TRIPS waiver offers “concrete short and medium term solutions to ensure universal access at affordable prices”.

Humanitarian organisation Médecins Sans Frontières (MSF) has criticised the European Union’s (EU) opposition to the TRIPS waiver, labelling its counter-proposal published on Friday as a “manoeuvre” to replace a concrete legal solution to COVID-19 vaccine manufacturing.

Ahead of next week’s TRIPS council meeting scheduled for 8-9 June, Senior Legal and Policy Advisor at MSF’s Access Campaign, Yuanqiong Hu, said the EU’s counter proposal not only ignored critical corrections needed to overcome the shortcomings of existing rules, but also failed to address access to a sustainable supply of tests and other life saving devices beyond vaccines and therapeutics.

The EU has consistently opposed India and South Africa’s proposal at the World Trade Organization (WTO) to temporarily waive certain intellectual property rules under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement), a measure that would expand access to lifesaving vaccines and other health products. 

Their entrenched position comes despite growing support for the TRIPS waiver – including an indication by the US that it was willing to move to text-based negotiations on the proposal.

On Friday, the EU published its proposal to WTO members for a multilateral trade action plan to expand the production of COVID-19 vaccines and treatments, and ensure universal and fair access. 

The EU remains adamant that, while it is open to discussing options that could help end the pandemic, the TRIPS waiver is not the solution. 

“(The EU) is not convinced that this would provide the best immediate response to reach the objective of the widest and timely distribution of COVID-19 vaccines that the world urgently needs” the body said in a statement.

Key to the new proposal is a need for voluntary licences to facilitate the expansion of production and sharing of expertise. 

“Where voluntary cooperation fails, compulsory licences, whereby a government grants a targeted licence allowing a willing producer to make a vaccine without the consent of a patent holder, are a legitimate tool in the context of a pandemic,” states the proposal.

EU Proposal Fails to Extend Beyond Vaccines

Highlighting the EU’s counter-proposal, European Commission Executive Vice-President and Commissioner for Trade, Valdis Dombrovskis, warned against “complacency” as the world continues to fight the COVID-19 pandemic. One of the main problems currently, is the lack of sufficient manufacturing capacity to rapidly produce the required quantities of COVID-19 vaccines. 

“We need to urgently concentrate on proposals that accelerate the equitable distribution of COVID-19 vaccines worldwide, said Dombrovskis, adding that: “In this respect, a strong multilateral trade response could deliver a huge boost in the fight against COVID-19.”

“The objective must be to ensure that any available and adequate manufacturing capacity anywhere in the world is used for the COVID-19 vaccines production.”

MSF’s Hu however called out the EU’s resistance to the TRIPS waiver, pointing out that its reference to compulsory licensing is already permitted in the current provisions and practices of the TRIPS Agreement.

“The EU’s counter-proposal to the TRIPS waiver is a manoeuvre to push for voluntary actions of pharmaceutical corporations as a solution to replace a concrete legal solution backed by more than 100 countries,” said Hu.

According to Hu, MSF’s analysis has found that compulsory licenses alone would not be enough to achieve urgent access to lifesaving COVID-19 medical tools, even for the EU itself, during the pandemic.   

Importantly, said Hu, the EU counter-proposal only applies to patent barriers and fails to address intellectual property (IP) barriers that need to be waived when countries and manufacturers seek to scale up the manufacturing and supply of COVID-19 vaccines, medicines and other health technologies. 

“It also fails to mention the need to ensure access to a sustainable supply of tests and other life saving devices beyond vaccines and therapeutics,” said Hu.

“Concrete Short and Medium Solution” to Vaccine Manufacturing

However, EC President Ursula von der Leyen said the EU’s counter-proposal offers “concrete short and medium term solutions to ensure universal access at affordable prices”.

“Beyond the current crisis, it is important to ensure global preparedness for future pandemics: diversifying manufacturing so that it is not centralised only in a handful of countries and strengthening the resilience of the healthcare infrastructure in least developed countries,” said von der Leyen.

The EU’s proposal is based on trade facilitation and disciplines on export restrictions, support for the expansion of production, and clarifying and simplifying the use of compulsory licences during crisis times”.

Elements of the proposal include limiting the use of export restrictions for vaccine-producing countries and keeping supply chains open and uninterrupted; calling on governments to encourage and support vaccine manufacturers and developers to expand production and ensure the affordable supply of vaccines to low- and middle-income countries. 

“Such actions could include licensing agreements, the sharing of expertise, tiered pricing including non-profit sales to low-income countries, contract manufacturing and new investments in manufacturing facilities in developing countries,” states the proposal.

Image Credits: R Santos/HP Watch.

Ultra-processed food is a staple diet for Mexican 10-year-old Ricky and his mother, Alicia.

UK farmers use half the antibiotics they did in 2014; Mexico has reduced stunting by 6% in the last 30 years, and Pakistan is offering conditional cash transfers to poor families to improve their nutrition. 

These examples of how countries are trying to fix broken food systems were offered at Friday’s Healthy Food Systems dialogue, co-hosted by the World Health Organization (WHO), EAT, and the Global Alliance for the Future of Food.

Opening Friday’s dialogue, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that “we need a new food systems narrative that embraces the interconnectedness of humans, animals, and the planet that sustains us”. 

The dialogue marked the start of a week-long series of global conversations in preparation for the United Nations (UN) Food Systems Summit in September and the civil society “pre-summit” next month.

UN Secretary-General Antonio Guterres has called the summit to address how to build healthier, more sustainable and equitable food systems to achieve the Sustainable Development Goals (SDGs) by 2030.

Tedros told the dialogue that the  WHO proposes a new food system based on five major pathways:

“First, unhealthy diets, and food insecurity, with impacts including overweight and obesity, undernutrition, micronutrient deficiencies and diet-related non-communicable diseases,” he said.

“Second, zoonotic pathogens and antimicrobial resistance which impacts farm ranged and wild-caught animals. 

“Third, unsafe and adulterated foods, including those containing hazards such as pathogens, chemicals and toxicants. 

“Fourth, environmental contamination and degradation through pollution of soil, air and water resources and fifth, occupational hazards, including harm to physical and mental health, suffered by workers in the food system,” said Tedros.

New Food System Narrative is Needed

Dr Agnes Kalibata, UN Special Envoy to the Food Systems Summit

Francesco Branca, WHO’s Director Nutrition and Food Safety, said that the Food Summit provides an opportunity “to develop a new food system narrative centred around upholding human, ecological and animal health using a One Health approach”.

“Current narratives do not always recognise these interconnections and could miss the opportunity of a radical food system transformation, building on the pandemic recovery process,” he added.

Dr Agnes Kalibata, UN Special Envoy to the Food Systems Summit, said that although “we thought our food systems have been designed to provide us with food”, instead we were faced with obesity, hunger, malnutrition and biodiversity loss.

She added that food system dialogues had been taking place all over the world and over 2,500 proposals to fix the broken system had already been put forward.

“I hope that we don’t squander the opportunity that the Food System Summit is giving us to pivot our food system into something that works for all of us,” said Kalibata.

“We have a lot of inequity in our systems. So we need our food system to work for us from a health perspective and from a food perspective.”

Mexico Struggles with Stunting and Obesity

Juan Rivera, Director General of Mexico’s National Institute of Public Health

Juan Rivera, Director General of Mexico’s National Institute of Public Health, outlined a major problem facing many developing countries – the seemingly paradoxical problems of stunting and obesity.

“Stunting dropped in the last three decades from 20% to 14%. And I think that what worked was a combination of nutrition-sensitive actions, such as the provision of nutritional supplements and nutrition education, along with the access to health care of children under five targeted to the poorest population, and conditional cash transfers to incentivise the utilisation of those services,” said Rivera.

“On the other hand, during the same period, we experienced a huge increase in overweight and obesity in Mexico,” he added. 

“In adults, we went from 35% to 70% overweight and obesity and in adolescents from 11% to 40%,” which had made Mexico vulnerable to severe illness and death from COVID-19,” said Rivera. Mexico has one of the highest obesity rates in the world.

“In the last seven years, we have implemented measures to limit the availability and accessibility of unhealthy foods and beverages through taxes, limiting availability to children through school regulations, restraining advertising of unhealthy food for children and adolescents and providing simple and clear information to consumers, and trying to reduce food processing through front of packet warning labels to reduce the intake of unhealthy ultra-processed food,” said Rivera.

Johanna Ralston, Chief Executive of the World Obesity Federation, said that “90% of deaths due to COVID are occurring in countries with high rates of obesity which tells us that probably COVID is the second predictor after age of poor outcomes”.

“COVID-19 highlighted the extremes about all that’s broken in our food systems,”  added Ralston, who said that obesity was “particularly exacerbated by consumption of ultra-processed foods and unhealthy beverages”.

G7 Commits to Addressing AMR 

Dame Sally Davies, the UK’s Special Envoy on AMR

Dame Sally Davies, the UK’s Special Envoy on Antimicrobial Resistance (AMR) reported on a glimmer of hope on addressing AMR.

“Through a collaborative and multi-sectoral voluntary approach to antibiotic stewardship in livestock production, antibiotic sales for food-producing animals in the UK has halved since 2014. This makes the UK one of the lowest users of antibiotics in agriculture, amongst those countries, with a significant livestock farming industry,” said Davies.

She was also encouraged by the commitment by climate and environment ministers at last week’s G7 meeting to reduce the inappropriate use of antimicrobials and to make the manufacturing of antibiotics more friendly for the environment.

“Our dependence on antimicrobials has become so excessive that our systems are now unsustainable and our treatments are becoming less effective,” warned Davies.

“This silent pandemic is on the rise. And if we don’t get our act together, it could kill 10 million people each year by 2050. 

“You see antimicrobials being used for food-producing animals to promote rapid growth for a faster route to market. That increases the prevalence of antibiotic-resistant bacteria in animals, potentially untreatable infections. This approach is short-term and risks the sustainability of our food systems.”

Well-being of Animals and People is Connected

Philip Lymbery, CEO of Compassion in World Farming, said that one lesson that could be learned from COVID-19 “is the well-being of people, animals and the planet are all interconnected”.

“COVID has been linked to the ill-treatment of wildlife. A source of both past and future pandemics is industrial animal agriculture or factory farming,” said Lymbery. “Keeping thousands of animals caged, crammed and confined is inherently unhealthy, producing the perfect breeding ground for disease,” he added, pointing out that swine flu from factory farms had killed about half a million people worldwide. 

“Industrial agriculture is not only the biggest causes of animal cruelty on the planet. It is also a major driver of deforestation, decline in the world’s wildlife and a consumer of more than two thirds of the world’s antibiotics.”

Hundreds of local, national and international events are being convened to discuss food system transformation, with those involved in food policy urging a global adoption of a “One Health” approach –  upholding human, ecological, and animal health – before the next pandemic.

 

ends

Image Credits: The American Society for the Prevention of Cruelty to Animals, UNICEF.

White House Press Secretary Jen Psaki at briefing Thursday on the US COVID vaccine- sharing plans

United States President Joe Biden on Thusday unveiled a detailed strategy for sharing 80 million surplus US COVID-19 vaccine doses with other countries in need by the end of June.

A detailed allocation plan for the first 25 million of those vaccine doses calls for sharing 75%  through the WHO-cosponsored COVAX global vaccine facility – while some 25% of doses would be shared bilaterally “for immediate needs and to help with surges around the world.”

The latter group of countries, receiving some six million doses, would include Canada, Mexico, the Republic of Korea and COVID-struck India, as well as the Israeli-occupied West Bank and Hamas-controlled Gaza, according to a detailed statement published this afternoon by The White House.

“Twenty-five million doses will be going out as soon as we can logistically get them out the door,” said White House Press Secretary Jen Psaki, in a briefing on the strategy shortly after the announcement.  She called it a “historic, herculean effort, to get these doses to all of the communities and countries that we committed them to” – before their expiry dates.

She said that all doses being shared would be drawn from US FDA approved stocks – meaning either vaccines produced by Moderna, Pfizer or Johnson & Johnson’s one-dose vaccine – although she provided no details on the exact mix.

US Allies & Countries Embroiled In Regional Conflicts Also Get Some Vaccine Doses

A more detailed fact sheet  also noted that some of the six milion doses to be shared directly would go to a shortlist of countries embroiled in, or bordering on regional conflict zones or natural disaster areas, including: ” West Bank and Gaza, Ukraine, Kosovo, Haiti, Georgia, Egypt, Jordan, Iraq, and Yemen, as well as for United Nations frontline workers.”

Although 19 million doses would be shared with COVAX – in line with recent White House pledges to support the global vaccine sharing plan – Biden’s statement also earmarked specifically where it wants COVAX to distribute those doses. The designations follow in line with a trend whereby donor countries have been sharing spare doses with the COVAX facility – while also prioritizing regional neighbours or allies.

In the case of the US COVAX donations, the detailed rundown of priorities include:

  • Approximately 6 million for South and Central America to the following countries: Brazil, Argentina, Colombia, Costa Rica, Peru, Ecuador, Paraguay, Bolivia, Guatemala, El Salvador, Honduras, Panama, Haiti, and other Caribbean Community (CARICOM) countries, as well as the Dominican Republic.
  • Approximately 7 million for Asia to the following countries and entities:  India, Nepal, Bangladesh, Pakistan, Sri Lanka, Afghanistan, Maldives, Malaysia, Philippines, Vietnam, Indonesia, Thailand, Laos, Papua New Guinea, Taiwan, and the Pacific Islands.
  • Approximately 5 million for Africa to be shared with countries that will be selected in coordination with the African Union.

White House Denies Geopolitical Considerations In Vaccine Priorties

Even so,  a White House statement denied that geopolitical considerations had played a role in its prioritization, with the caveat that, “We are sharing these doses not to secure favors or extract concessions. We are sharing these vaccines to save lives and to lead the world in bringing an end to the pandemic…”

Rather, the statements said that the priortization of doses was meant to favour “countries in urgent need” as well as countries with “vaccine readiness plans that prioritize individuals at highest risk of severe disease and those working to help care for them, like health care workers.”

While not a new commitment, the detailed plan follows upon a pledge made by Biden in May to “share 80 million doses of our vaccine supply with the world.”

The Biden announcement also follows on the heels of a major COVAX donor event on Monday, that raised US $2.4 billion more for the facility, as well as new announcements from Belgium, Denmark, Japan, Spain and Sweden to share a total of 54 million vaccines.

In it, the President also reaffirmed US commitments to funding for COVAX  as well as US support for a temporary waiver on intellectual property associated with COVID vaccine manufacture:

“Already the United States has committed $4 billion to support COVAX, and we have launched partnerships to boost global capacity to manufacture more vaccines,” said the statement. “My administration supports efforts to temporarily waive intellectual property rights for COVID-19 vaccines because, over time, we need more companies producing life-saving doses of proven vaccines that are shared equitably….

Other measures being pursued include: “working with U.S. manufacturers to increase vaccine production for the rest of the world, and helping more countries expand their own capacity to produce vaccines including through support for global supply chains.

“This vaccine strategy is a vital component of our overall global strategy to lead the world in the fight to defeat COVID-19, including emergency public health assistance and aid to stop the spread and building global public health capacity and readiness to beat not just this pandemic, but the next one.

“As long as this pandemic is raging anywhere in the world, the American people will still be vulnerable. And the United States is committed to bringing the same urgency to international vaccination efforts that we have demonstrated at home.”

Image Credits: C-Span.

unaids
UNAIDS Executive Director Winnie Byanyima

Despite the disruptions of the COVID pandemic, dozens of countries have met or exceeded the ambitious targets set by the UN General Assembly towards a goal of ending AIDS by 2030, with evidence indicating that targets were not just aspirational but achievable, according to a new report by UNAIDS.

The report, released today, shows that countries with progressive laws and policies and strong and inclusive health systems have had the best outcomes against HIV. 

In these countries, people living with and affected by HIV are more likely to have access to effective HIV services, which include HIV testing, pre-exposure prophylaxis (medicine to prevent HIV), harm reduction, and multi month supplies of HIV treatment.

“High-performing countries have provided paths for others to follow,” said UNAIDS Executive Director Winnie Byanyima.

“Their adequate funding, genuine community engagement, rights-based and multisectoral approaches and the use of scientific evidence to guide focused strategies have reversed their epidemics and saved lives. These elements are invaluable for pandemic preparedness and responses against HIV, COVID-19, and many other diseases.” 

Globally, the report shows that the number of people on treatment has more than tripled since 2010, with 27.4 million of the 37.6 million people, 75% of those living with HIV were on treatment. This roll-out of quality, affordable treatment is estimated to have averted 16.2 million deaths since 2000. 

COVID-19 Still Sets Back Progress In Some Countries  

Quarraisha Abdool Karim, Associate Scientific Director of CAPRISA

However, despite those bright spots, some countries and regions are off-track, with previous gains in eliminating AIDS being reversed due to COVID-19, conflicts, and humanitarian emergencies.  Particular problem areas that need more focus exist in eastern Europe, central Asia and parts of Sub-Saharan Africa, she said. 

“Our progress towards ending AIDS is further threatened by COVID-19,” said Byanyima during a launch of the report.

“In the last year, the trend is in the wrong direction. Countries with punitive laws that do not take a rights-based approach to health punish, ignore, stigmatize, and leave key populations on the margins and out of reach of HIV services.” 

“Our gains over the last year are something that we might lose because of COVID-19,” said Maximina Jokonya, Y+ Global HER Voice Fund Coordinator. 

To get sub-Saharan Africa back on track to meet the 2030 targets for HIV/AIDS will require expanding high impact treatment and prevent for key populations – adolescent girls and young women, and young men, said Quarraisha Abdool Karim, Associate Scientific Director of the Centre for the AIDS Programme of Research in South Africa (CAPRISA).

“We need to ensure the sustainability of an HIV response [that breaks down] social and structural barriers.”

“We have seen how community services and leadership enable us to reach affected communities with essential services under the most difficult circumstances.”

Young People as Decision-Makers and Experts in HIV/AIDS

A man uses the HIV self-test and waits a few minutes for his results.

In the fight against HIV/AIDS, Jokonya emphasized the need for countries and decision-makers to not forget the voices and rights of young people, a group often left behind in these important discussions.

“Are we making sure their voices are being heard, their priorities are being put in place, and they’re also involved in key decision making processes to make sure they have access to services?” 

Though ideas are sought out from young people, they are often not involved in program design or implementation.

However, Jokonya pointed out that since young people are the ones experiencing HIV/AIDS, they are the experts when it comes to their health. 

“We need policies that speak to young people themselves in their diversity.” 

These policies give an opportunity not only to integrate HIV services into health more broadly, but also to integrate other aspects of health that are also neglected, such as sexual and reproductive health, and mental health.  

“We are saying no to tokenism, we are saying no to manipulation. We want meaningful and ethical engagement with people being able to participate and have a voice.” 

Gender Inequality in HIV/AIDS Policy

Six out of seven new HIV infections in the sub-Saharan African region are from adolescent girls aged 15 – 19 years

Women are continually left behind in HIV/AIDS policy, especially in sub-Saharan Africa, with six out of seven new HIV infections from adolescent girls 15 – 19 years of age and 4500 adolescent girls and young women newly infected every week in the region. 

AIDS is also the leading cause of death in adult women aged 15 to 49 years old. 

According to Karim, the root cause of this lies in gender inequality.

“[Gender inequality] underpins harmful gender norms that restrict women’s access to HIV and sexual reproductive health services. It’s exacerbated by a parallel pandemic of gender-based violence and limited agency and decision making power.”

Globally, only 55% of adult women have the agency and autonomy to say no to sex, decide on the use of contraception, and decide on their own healthcare.

Girls are least likely to complete second education, leading to missed opportunities for the provision of comprehensive sexual health education that can shift toxic gender norms for both young boys and young girls. 

Law and Policy – Determines Access to HIV Treatment 

Community Health Workers attend a training session on HIV accompaniment in Kirehe, Rwanda.

The growing gap between and within countries on HIV/AIDS elimination is driven very significantly by law and policy, said Matthew Kavanagh, Director of Global Health Policy and Politics Initiative at Georgetown University’s O’Neill Institute. 

“Law is a determinant of health. Law structures inequality; policy drives success and failure in the pandemic response.” 

Countries that criminalized gay men and other men who have sex with men, sex workers, and people who inject drugs saw significantly less sucess in the 90-90-90 targets. 

The 90-90-90 targets, agreed by the United Nations General Assembly in 2016, call for the vast majority of people living with HIV to be tested, start treatment and reduce HIV within their bodies to undetectable levels by 2020. 

HIV Policy Lab data shows that only 21 countries in the world have fully adopted national policies aligned with WHO recommendations for treating, preventing, and managing HIV/AIDS. 82 countries have policies that restrict access to PrEP and are not aligned with the WHO. 

Policy alignment remains uneven and contradictory, with only some people eligible in certain countries – for example, gay men, but not young women or sex workers, may have access to PrEP.  

Kavanagh called the differences in law and policy ‘substantial’, that criminalization is associated with factors that drive HIV infections across the whole population. 

He also added that alongside criminal laws and rights laws, laws on access to science are also impact access to treating HIV.

“It’s critical that in the next five years there’s a sharp focus on building law and policy environments that enable us to get back on track to defeat HIV.” 

UNAIDS Urges Action in Upcoming UN General Assembly Meeting on AIDS 

United Nations General Assembly hall in New York City

With the upcoming UN General Assembly holding its fifth high-level session on HIV and AIDS on 8-10 June, Byanyima called on governments to commit to taking a people-centered, rights-based approach to HIV, and to work with policy reform, to engage and support communities and to end inequalities.

“We need to build on this momentum to drive forward political will and commitment to end AIDS. We need commitment for better technologies and treatments for a vaccine, and for a cure to get the world back on track.”

Image Credits: ©PSI-Dogsontherunphotography, UNAIDS, Cecille Joan Avila / Partners In Health, Patrick Gruban.