Economic costs

RIO DE JANEIRO, BRAZIL, 29 October 2024—Today, at a special event organized for the G20 Joint Finance and Health Ministerial, the Brazilian government and experts from the Global Council on Inequality, AIDS and Pandemics backed calls for efforts to break the “inequality-pandemic cycle” that is fueling continued disease emergencies. Two crucial measures could enable the world to tackle current and future pandemics.

They urged leaders to recognise, for the first time in G20 history, inequality as a driver of pandemics, requiring both measurement and decisive action. They also championed boosting the development, production and supply of life-saving health products in every region of the world.

Evidence gathered by the Global Council on Inequality clearly demonstrates the inequality-pandemics cycle. Inequalities within countries and between them deepen the disruption and loss of life in current and recent pandemics, from AIDS to COVID, mpox and Ebola. Failure to address these inequalities is leaving communities across the world vulnerable and exposed to future outbreaks.  This presents an important opportunity for the G20, which sets the agenda for international financing, to focus attention and action on the social determinants of pandemics.

The dependence of countries across the Global South on medicine production in the Global North has also been shown to undermine pandemic responses. They are consistently last in line to receive life-saving vaccines and medicines, despite bearing much of the world’s disease burden.

Nísia Trindade, Brazil’s Minister of Health, who is also a member of the Global Council on Inequality, AIDS and Pandemics, declared: “By building production capacity in every region, we can learn from past mistakes by ensuring that medicines for neglected and socially determined diseases are made around the world and that capacity is available to respond swiftly to future outbreaks.”

Joseph E. Stiglitz, Nobel Prize Winning Economist, Co-Chair of the Global Council on Inequality, AIDS and Pandemics, explained: “Reforms in both the developed and developing countries and in international agreements and institutions, and investments which help broaden the production of medical products and reduce prices are vital to address market failures and accelerate access to medicines for the people in greatest need.”

Sir Michael Marmot, Professor of Epidemiology and Director of the Institute of Health Equity at University College London, Co-Chair of the Global Council on Inequality, AIDS and Pandemics noted: “The evidence is clear: social determinants increase the intensity of pandemics. The greater the inequality in society, the worse is the pandemic. But we also know we can intervene against these with education, social protection measures, and making societies more fair. Re-investing in the public good and upholding of human rights will make societies less vulnerable to pandemics.”

H.E. Monica Geingos, former First Lady of Namibia and Co-Chair of the Global Council on Inequality, AIDS and Pandemics set out: “To effectively end the AIDS pandemic and prepare for future health crises, we must confront the complex web of inequalities that exacerbate these challenges. Inequality encompasses more than just income disparities; it includes social, political, and health inequities that intersect in significant ways. The geopolitical landscape further complicates these dynamics, as nations characterized by pronounced inequality are disproportionately impacted by the responses to pandemics. This systemic inequality is often reinforced by international frameworks that perpetuate and deepen existing disparities, underscoring the urgent need for comprehensive and equitable approaches to health and governance.”

The two initiatives—addressing inequality as a pandemic driver and the move to boost regional health product production— offer a unique opportunity for G20 leaders to take transformative action towards greater health equity and global health security, speakers agreed.

Winnie Byanyima, UNAIDS Executive Director and Convenor of the Inequality Council, remarked: "President Lula has put equality at the heart of Brazil’s G20 agenda. He is right. Inequalities need to be addressed urgently, and the production of medicines and vaccines expanded across the world, or the next pandemic will hit us even harder. G20 leaders here in Rio have the opportunity to transform the way the world responds to outbreaks and pandemics by tackling the inequalities which drive them. We are counting on G20 leaders to seize this moment to save lives and protect the health of everyone.”

Joe Phaahla, Deputy Minister of Health, South Africa, confirmed: “As we assume the G20 presidency in 2025, South Africa will continue to champion the agenda of universal health coverage through equity, solidarity and innovation.”

Tributes were paid to the Ministry of Health in Brazil for its leadership in advancing these critical issues at the G20, including proposing a new Global Coalition for Regional Production, Innovation and Equitable Access and including social determinants of pandemics in the work of the G20 Joint Health and Finance Ministers task force.

Notes for editors

Brazil proposes the establishment a Global Coalition for Regional Production, Innovation and Equitable Access Alliance for Regional Production and Innovation. It is bringing together a network of key actors, including countries, academia, private sector, and international organizations, for research and development and production of vaccines, medicines, diagnostics, and strategic supplies to combat diseases with strong social determinants and that mainly affect vulnerable populations. For more information on the G20 Health Working Group, see the G20 website: https://www.g20.org/en/tracks/sherpa-track/health

About the Global Council on Inequality, AIDS and Pandemics

The Council was established by UNAIDS in 2023 and is comprised of experts from academia, government, civil society and international development actors committed to implementing evidence-based solutions to address inequalities fuelling AIDS and other pandemics. It is chaired by Nobel Laureate Professor Joseph Stiglitz, Former First Lady of Namibia Monica Geingos, and Professor Sir Michael Marmot who chaired the Commission on Social Determinants of Health. Learn more at inequalitycouncil.org.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Debt restructuring and reforms to the global tax system are urgently required to finance health systems and other essential services

WASHINGTON/GENEVA, 16 April 2024—As financial leaders meet in Washington for the annual Spring Meetings of the World Bank and the International Monetary Fund, UNAIDS is calling for increased and sustainable investments in the global response to HIV and other health threats.

“At a time of multiple geo-political and economic crises, the need to tackle the financial constraints threatening the global fight against HIV and other health threats has never been greater,” said UNAIDS Executive Director Winnie Byanyima, “At their Spring Meetings in Washington, global financial leaders must find the courage to reject calls for more fiscal restraint and embrace measures that can release the necessary investments to save millions of people and transform the lives of the most vulnerable all over the world, including women and girls.”

As the world struggles to achieve many of the health goals set out in the United Nations Sustainable Development Agenda, investments in the HIV response have returned extraordinary gains for humanity. Since 2010, AIDS-related deaths have declined by 51% worldwide and new HIV infections have fallen by 38%.

But more than 9 million people are still waiting to receive HIV medication that will stop them dying from AIDS and there were still 1.3 million new HIV infections in 2022. Increased investments in the HIV response today are crucial to reach everyone who needs treatment and to prevent new infections that will only increase future treatment costs.      

However, there is a huge shortfall in the global investments required to end AIDS as a global health threat by 2030. A total of US$ 20.8 billion (constant 2019 US$) was available for HIV programmes in low- and middle-income countries in 2022––2.6% less than in 2021 and well short of the US$ 29.3 billion needed by 2025.

In many countries with the most serious HIV pandemics, debt service is consuming increasingly large shares of government revenue and constraining public spending.

In Angola, Kenya, Malawi, Rwanda, Uganda, and Zambia, debt service obligations exceed 50% of government revenues. Last year, in GDP terms, Sierra Leone spent 15 times more on public debt servicing than on health, 7 times more on public debt servicing than on education and 37 times more on debt servicing than on social protection. For Angola, debt servicing was 7 times more than investments on health, 6 times more than on education and 14 times more than on social protection.

UNAIDS maintains that reform to the global financial system including the cancellation of debt, the introduction of fairer and affordable financing mechanisms and global taxation reform is key to releasing transformative funding for health, education and social protection also required to end AIDS as a public health threat by 2030.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Partners call for urgent action to reverse an explosion in inequalities which are endangering us all

18 July 2023—The Centre for International Cooperation at the University of New York, Development Finance International, Oxfam and UNAIDS are calling for urgent action to save Sustainable Development Goal (SDG) 10: Reduced Inequality.

COVID-19 caused the largest rise in income inequality in three decades, as poorer countries lacked financing to support the incomes of the poor or to confront the COVID-19 and AIDS pandemics. During the COVID-19 pandemic and global inflation crisis, inequality of income, wealth and health outcomes rose sharply. Without seriously tackling inequality, we will not end AIDS by 2030 (SDG 3.3), and the SDGs on poverty, gender and education will be strongly compromised.  

In his 2023 SDG Progress Report, the United Nations Secretary-General announced that SDG10 is one of the worst performing SDGs. Action has never been more urgent on this goal.

For SDG10 to be successful in reducing inequality, it is vital that the international community takes concerted action during the current review of the SDGs which will culminate at the United Nations (UN) General Assembly SDG Summit taking place on 18-19 September 2023.

Action includes better monitoring the inequality of income and wealth within and between countries. This requires using indicators which are used by all member states and institutions including the UN or the World Bank, these indicators are called the Gini coefficient and the Palma ratio.

The official start to the call to action will take place during a high-level meeting on 18 July at the UN in New York, with representatives from government and civil society. H.E. the President of Namibia, Hage Gottfried Geingob, and H.E. the President of Sierra Leone Julius Maada Bio, have expressed their support and willingness to co-sponsor this call to action to Save SDG10 and fight inequality.

In addition, more than 230 leading global economists, political leaders and inequality experts, including former UN Secretary General Ban Ki Moon, Nobel prize laureate Joseph Stiglitz, Thomas Piketty, Jayati Ghosh, Helen Clark and Jose-Antonio Ocampo, are sending an open letter to the UN Secretary-General and the World Bank President urging them to include the incomes and wealth of the rich in monitoring inequality by using Gini and Palma, and to ensure trends in inequality are monitored annually in all countries. This will allow the world to see the true picture of growing extreme inequality, and to strengthen its efforts to promote anti-inequality policies.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.