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Heath officials check the lists of people to be tested for Covid-19, as well as HIV and tuberculosis, in downtown Johannesburg, South Africa, on April 30. Photo: AP
OpinionLetters

Letters | Covid-19 or Aids: world must fight inequalities to fight epidemics

  • With Aids-related deaths and new infections exceeding the targets set for 2019, more must be done to tackle the entrenched inequalities that put certain groups at higher risk of infection
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Even before the onset of Covid-19, the world was failing in its commitment to end the HIV epidemic by 2030. The UNAids new global report, “Seizing the moment: tackling entrenched inequalities to tackle epidemics”, shows that there were 690,000 Aids-related deaths in 2019 and 1.7 million new infections – far from the global targets of fewer than 500,000 deaths and 500,000 new infections a year set for 2020.

This is unacceptable when we have medicines to keep people living with HIV alive and well, and an array of prevention tools to stop new infections. We are being held back by entrenched inequalities that put vulnerable and marginalised groups at higher risk of becoming infected with HIV and dying of Aids-related illnesses.

Every day, marginalised groups such as gay men, sex workers, transgender people, people who use drugs, prisoners and migrants are prevented from receiving proper health care and are criminalised and marginalised. Denied their right to health, these groups and their sexual partners comprised 62 per cent of all new adult infections in 2019.

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China needs more access to drugs that stop new HIV infections, Aids education advocate

China needs more access to drugs that stop new HIV infections, Aids education advocate

Meanwhile, women and girls are too often denied their sexual and reproductive health and rights. In 2019, young women and adolescent girls accounted for one in four new infections in sub-Saharan Africa, despite making up about 10 per cent of the total population.

Gender-based violence and gender inequalities continue to drive the epidemic forward among young women and girls. Female sex workers have a 30-times greater risk of acquiring HIV than the general population.  

All this must change, and a multisectoral approach that respects the rights and dignity of women and of all marginalised groups is urgently needed, to reduce HIV infections and guarantee their right to health and other essential services.

Just like HIV, Covid-19 holds up a mirror to the stark inequalities and injustices that run through our societies. And we need a global commitment that diagnostics, medicines and an eventual vaccine against the coronavirus are available free at the point of use to everyone everywhere. When a vaccine becomes available it must be a “people’s vaccine”.

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Successful pandemic responses are grounded in human rights, implement evidence-based programming and should be fully funded to achieve their targets.

Unfortunately, HIV has been slipping down the international agenda for some years and the funding gap for HIV responses is widening. Funding in low- and middle-income countries decreased by 7 per cent between 2017 and 2019 after adjusting for inflation.

Now, I am calling on leaders to convene a new UN High-Level Meeting on Ending Aids next year, to address with urgency the outstanding issues that are holding us back from ending Aids as a public health threat by 2030.

We can and must close the gaps.

Winnie Byanyima, executive director, UNAids

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