Dear friends, 

Greetings on this World AIDS Day, and my solidarity with all around the world as we confront the impact of colliding pandemics.

This year, the world agreed on a bold plan that, if leaders fulfil it, will end AIDS by 2030. That’s so exciting.

But today we, as the Joint United Nations Programme on HIV/AIDS, issue a stark warning. AIDS remains a pandemic, the red light is flashing and only by moving fast to end the inequalities that drive the pandemic can we overcome it.

Where leaders are acting boldly and together, bringing together cutting-edge science, delivering services that meet all people’s needs, protecting human rights and sustaining adequate financing, AIDS-related deaths and new HIV infections are becoming rare.

But this is only the case in some places and for some people.

Without the inequality-fighting approach we need to end AIDS, the world would also struggle to end the COVID-19 pandemic and would remain unprepared for the pandemics of the future. That would be profoundly dangerous for us all.

Progress in AIDS, which was already off track, is now under even greater strain as the COVID-19 crisis continues to rage, disrupting HIV prevention and treatment services, schooling, violence prevention programmes and more.

On our current trajectory, we aren’t bending the curve fast enough and risk an AIDS pandemic lasting decades. We have to move faster on a set of concrete actions agreed by United Nations Member States to address the inequalities that are driving HIV.

Through fighting the AIDS pandemic, we have learned a lot about what we need more of for AIDS and for all pandemics.

We urgently need sufficient community-led and community-based infrastructure as part of a strong public health system, underpinned by robust civil society accountability.

We need policies to ensure fair and affordable access to science.

Every new technology should reach each and everyone who needs it without delay.

We need to protect our health workers and expand their numbers to meet our urgent needs.

We must protect human rights and build trust in health systems.

It is these that will ensure we close the inequality gaps and end AIDS. But they are too often applied unevenly, are underfunded and are underappreciated.

I salute the front-line communities that have pioneered the approaches shown to be most effective, that have driven the momentum for change and that are pushing leaders to be bold. I urge you: keep pushing.

World leaders must work together urgently to tackle these challenges head-on. I urge you: be courageous in matching words with deeds.

There is not a choice to be made between ending the AIDS pandemic that is raging 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.

If we take on the inequalities that hold back progress, we can deliver on the promise to end AIDS by 2030. It is in our hands.

Every minute that passes, we are losing a precious life to AIDS. We don’t have time.

End inequalities. End AIDS. End pandemics.

Thank you.

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.

By Winnie Byanyima, UNAIDS Executive Director

The AIDS epidemic in western and central Africa is an ongoing emergency. The early gains made against HIV in this region have not been translated into the sustained progress that has been made in other parts of sub-Saharan Africa.

Last year, there were 150 000 AIDS-related deaths in the region, and 200 000 people became newly infected with HIV. Every week more than 1000 adolescent girls and young women aged 15–24 years become infected with HIV in the region; 1.2 million people in western and central Africa are still waiting to initiate life-saving HIV treatment. Only 35% of children living with HIV in western and central Africa are on treatment.  

Now the COVID-19 crisis has obstructed services and exacerbated the inequalities that drive the AIDS epidemic. If we don’t act now, not only will many more lives be lost, but containing the AIDS pandemic will be more difficult and expensive in the coming years.

Ending AIDS is achievable: there is a tested set of approaches that are proven to work, including in challenging settings.

From Cabo Verde’s leadership on the elimination of vertical transmission of HIV, to Cameroon’s decision last year to eliminate user fees for all HIV services at public health facilities and accredited community sites, examples that light the way are already there. By aligning policy with the evidence of what has succeeded, we can end AIDS as we promised. 

Countries and communities are already leveraging the experience and expertise of the AIDS response to reduce the impact of COVID-19 across this region. From Côte d’Ivoire, to Guinea, to Senegal, public health authorities, international organizations, civil society actors and communities of people living with and affected by HIV have worked together to ensure that people living with HIV continue to receive their medication, to deliver care and prevention services in safe and innovative ways, to deliver food to people who have lost their incomes in lockdown, to convey messages about the importance of hygiene and social distancing in order to stay well and to dispel myths that feed stigma and discrimination and weaken public health messaging.

This spirit of cooperation and partnership is vital for stronger pandemic responses.

This week, hosted by the President of Senegal, Macky Sall, UNAIDS and the Civil Society Institute for HIV and Health in West and Central Africa are organizing a summit in Dakar on how to close the gaps in the region’s HIV response and strengthen pandemic preparedness.

Here are three of the bold actions we need to take.

First, embrace and enable communities to be at the centre of planning and delivery.

Communities know the situation on the ground—they must be given the resources and the space to lead. Countries need to ensure an enabling environment for communities to be involved in providing services as an integral part of the public health response, be involved as co-planners, be able to highlight experiences and concerns and be able to play their essential role ensuring accountability. 

Countries need to lift those legal, policy and programmatic barriers that hold this back, and to scale up financial support to unleash the incomparable contribution of communities.

Second, increase investment.

Countries need to increase the scale of provision in prevention, testing and treatment and eliminate all financial barriers to ensure universal access to services.

The Abuja commitment to invest 15% of government budgets in public health needs to be met. Joint commitments made by health and finance ministers at the Africa Leadership Meeting to increase domestic revenues dedicated to health must be fulfilled.

International donors too have to step up with support at the time of the worst crisis in decades. Enabling the required fiscal space will require debt cancellation to support governments in scaling up investments in health and in tackling the social drivers of HIV and pandemic risk.

International action to prevent harmful tax competition and illicit financial flows is likewise key. It is difficult to advance towards fair and progressive taxation, and grow revenues, when large corporations and high-net-worth individuals are systemically enabled internationally to evade the taxes the ordinary citizen must pay, and which are essential for health, education, social protection and economic investment.

Third, address the inequalities that drive the epidemic.

COVID-19 has once again shown the world how epidemics thrive on inequalities, both between countries and within them. The new UNAIDS strategy adopted earlier this year puts the fight to end inequalities at the centre of the mission to end AIDS.

Inequalities drive HIV. Vulnerable groups of people represent 44% of new HIV infections in western and central Africa. Their partners represent a further 27%. 

The ECOWAS Strategy for HIV, TB, Hepatitis B & C and Sexual and Reproductive Health and Rights among Key Populations puts it so well:

“the protection of human rights for all members of each key population is crucial to success. Laws that discriminate or create barriers should be reformed, to ensure that key populations are free from stigma, discrimination and violence and their vulnerability to HIV is reduced.” 

Gender inequality likewise drives HIV: of the new HIV infections among young people in western and central Africa, almost three quarters are among adolescent girls and young women. The issue is power. 

Research shows that ensuring that girls complete secondary education reduces their risk of acquiring HIV by up to half, and that combining this with a package of services and rights for girls’ empowerment reduces their risk further still. 

The Education Plus initiative, co-convened by UNICEF, UNESCO, UNFPA, UN Women and UNAIDS, with governments, civil society and international partners, is helping to accelerate the actions and investments needed to ensure that every African girl is in school, safe and strong. 

What we need to do to end AIDS is also what we need to do to enable Africa to rise.

Governments, international organizations, scientists, researchers, community-led organizations and civil society actors cannot be successful alone, but together they can create an unbeatable partnership and an unstoppable force to end AIDS as a public health threat by 2030.

Despite the great progress made since the early days of the HIV epidemic, the HIV response for children is still lagging behind the response for adults.

Children living with HIV are particularly susceptible to tuberculosis (TB), one of the leading causes of AIDS-related deaths. In 2020, according to government statistics, 9400 people died of AIDS-related illnesses in Côte d’Ivoire, including 800 children under the age of 14 years. There were 21 000 people under the age of 15 years living with HIV in the country—only 49% had access to antiretroviral therapy. How to correct such an inequality was the question at the heart of a national consultation on paediatric HIV and TB that was held from 8 to 10 June in Abidjan, Côte d'Ivoire.

The consultation, Acting Together for a Generation without AIDS and Tuberculosis, was aimed at improving the prevention and management of HIV and TB among children and adolescents in Côte d’Ivoire.

In her opening speech, Dominique Ouattara, the First Lady of Côte d’Ivoire, called for “The development of an ambitious road map that will enable Côte d'Ivoire to achieve its commitments.” She invited all the participants to engage in a dialogue on the challenges and priority actions needed, and to discuss the roles, responsibilities and contributions of each partner.

The consultation is part of the Confessional Initiative, a UNAIDS and United States President’s Emergency Plan for AIDS Relief initiative that is organizing national consultations and training in Cameroon, Côte d’Ivoire, Kenya, Nigeria and the United Republic of Tanzania.

“The consultation presented the national situation regarding diagnosis, treatment and prevention of HIV and tuberculosis among children, identified the key challenges, outlined the solutions, priority actions and resources needed to improve the national roll-out of optimal paediatric HIV and tuberculosis treatment and diagnosis and identified good practices for replication through civil society and faith-based organizations,” said Patrick Brenny, the Director for the UNAIDS Regional Support Team for Western and Central Africa.

The targets in the 2016 United Nations Political Declaration on Ending AIDS and in Start Free, Stay Free, AIDS Free for paediatric AIDS have not been met. Globally, during 2020 an estimated 160 000 children acquired HIV, far from the global 2020 target of 20 000. Modelling has also shown that the COVID-19 pandemic could have a major impact on new HIV infections among children in sub-Saharan Africa.

Ms Ouattara appealed to the 350 participants to work towards reducing inequalities and asked all stakeholders to join forces to achieve certification of the elimination of mother-to-child transmission of HIV. “Today, in 2021, no child should die of AIDS or tuberculosis in our country," she added.

Excellencies, distinguished delegates, colleagues, friends.

Thank you, General Assembly President Bozkir, Deputy Secretary-General Amina Mohammed, co-facilitators Ambassador Gertze of Namibia and Ambassador Fifield of Australia, and all Member States; together you’ve drafted, negotiated, and delivered this Political Declaration. It will be the basis of our work to end this pandemic that has ravaged communities for 40 years.

AIDS is not over. It is one of the deadliest pandemics of modern times. Since the start of the epidemic 77.5 million people have been infected with HIV. We have lost nearly 35 million people to AIDS. An AIDS death every minute is an emergency! HIV rates are not following the trajectory that we together promised. Indeed, amidst the fall-out from the Covid crisis, we could even see a resurgent pandemic.

But a never-ending HIV pandemic is not our fate. In spite of all the set-backs, we can end AIDS as a public health threat, as we promised, by 2030, if we come together.

Business as usual, however, would fail. The programmes that have secured substantial progress will not enable us to finish the journey because the road is blocked. The evidence and analysis is clear. Inequalities in power, status, rights and voice are driving the HIV pandemic. Inequalities kill. As the Global AIDS strategy sets out: to end AIDS, we have to end the inequalities which perpetuate it.

There’s another huge benefit to this approach. The same laws, policies and strong people-centred health services needed to end AIDS, will also help the world overcome Covid-19, be ready to tackle future pandemics, and support inclusive economic growth and the human rights of all. We will all do better.

Here are three bold shifts we need to take together:

1. We need to end inequalities in access to health technologies, by spurring the best science and getting it to everyone.
   COVID-19 showed science moves at the speed of political will. We need to speed up AIDS science by investing in innovations in treatment, prevention, care, and vaccines, as global public goods.
   And we need to deploy science in ways that shrink instead of grow inequalities.
   For example, let’s get the new long-acting anti-retroviral medicines that will make it easier to treat and prevent HIV to women in all their diversity and key populations in the global South first, not years after people in rich countries have access.
   Let us ensure that all medicines which can prevent deaths of people living with HIV are manufactured by multiple producers affordably especially in the global South, where the disease is concentrated
   We need funding, but we also need to reform failing rules on intellectual property, and support globally distributed production, so access to life-saving science is no longer dependent on the passport you hold.
2. We need to end the inequalities in access to essential services, by delivering on guaranteed health and education for everyone. For many communities, new HIV infections have become rare; and living long, fulfilling lives with HIV is the norm. But within and between countries, a widening gap separates those who have prevention, treatment and care services and their rights respected and those who are excluded.
   Today we are setting bold, ambitious goals to reach 95% of those in need with HIV treatment and prevention: to get there we need to re-imagine HIV services, making them easy to access and designed around people’s lives.
   We need to ensure all girls complete secondary education and are empowered with the full set of services and rights.
   We need to end user fees for essential services and provide these services through public systems funded by taxation. We need to integrate community-provided services. We need to combat tax avoidance, which impedes domestic resourcing for health and education.
   Most developing countries are facing severe fiscal crisis, with a revenue loss above 20% in 2020 and health budgets under threat, with Africa under especial pressure.
   This is a time to increase revenues, and that requires an end to tax dodging and tax competition that empty public coffers.
   We also need debt restructuring to overcome the COVID19 shock and the establishment of a fair debt crisis resolution mechanism. We need to step up, not step back on the commitment to aid as 0.7% of gross national income by all developed countries and ensure that more of the IMF’s USD 650 billion Special Drawing Rights issuance flows to low and middle-income countries.
3. We need to end the inequalities in the realisation of rights, particularly for people living with HIV, and those vulnerable to or affected by HIV.
   I applaud Member States’ commitment to reform laws and protect rights. The evidence shows that when laws are strengthened to support gender equality and the rights of key populations and confront stigmatisation, countries have much greater success in treatment and prevention programmes, benefiting everyone. They’ve rolled back HIV.
   We need to keep moving forward in our common journey, away from harmful, punitive, outdated often colonial laws and from all forms of discrimination.

This moment calls for us to work together across sectors, across countries. Populism’s false promises are proving no match to biology: as Covid reminds us, we’re not just interconnected, we’re inseparable.

We cannot end AIDS in one country or one continent, we can only end AIDS everywhere.

I pay tribute to the civil society groups from across the world whose fight against inequalities has been the spur to action. You, communities, women’s groups and grassroots movements, have constantly pushed us; at times that pushing has been uncomfortable; but my message to you is: keep pushing us all. Keep the fight on! Pressure from the power of people is key to ending inequalities and ending AIDS.

Martin Luther King said the moral arc of the universe is long, but it bends towards justice. He didn’t mean this process is automatic. As he noted, “social progress never rolls in on wheels of inevitability; it comes through the tireless efforts of people”. The trajectory of new HIV infections and AIDS deaths will not, through business-as-usual, bend down, but we can pull it down.

We cannot be neutral on inequalities. To get back on track to ending AIDS, we must be deliberate in confronting them. The only alternative is a vicious cycle of injustice, illness, and emergency. The most unrealistic thing we could do now is to imagine we can overcome our crises through minor adjustments or tinkering.

Whether we are remembered as promise-breakers or promise-keepers, as failures or victors, as the people who ended AIDS, or only as the people who could have ended AIDS, is up to us.

Epidemics magnify our worst traits—inequalities, injustices, and fear; but also, our best traits—ingenuity, resilience, and courage.

I’m confident we will win, together. Thank you.

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.

By Winnie Byanyima, UNAIDS Executive Director; and Tomas Tobé MEP, Chair of the European Parliament’s Development Committee

Forty years since the first cases of AIDS were diagnosed, the fight against HIV goes on. Although the world has developed the scientific knowledge and medical expertise to keep people living with HIV alive and healthy and prevent new HIV infections, we are not on track to end the AIDS epidemic as a public health threat by 2030.

In 2019, almost 700,000 people died from AIDS-related illnesses. A staggering 1.7 million people were newly infected by HIV - more than three times the target set in 2016, which would have put us on course to end the AIDS epidemic.

The medicines, information, and prevention tools are simply not reaching the people who need them most. We need a new approach that reduces the inequalities that drive the AIDS epidemic and puts people at the centre, prioritising human rights, respect, and dignity.

Social injustices and inequalities fuel epidemics. For example, the AIDS epidemic is having a devastating impact on an entire generation of young women and girls in sub-Saharan Africa. Around 4500 adolescent girls and young women aged 15-24 acquire HIV every week in this region, and they are twice as likely to be living with HIV as their male peers.

At the same time, girls and young women face sexual and gender-based violence, unintended pregnancy and may be forced to drop out of school. Yet, completion of a high school education, including comprehensive sexuality education, is one of the surest ways to keep young women and girls free of HIV.

It is also deeply concerning that more than 60 percent of new HIV infections globally occur among key populations (gay men and other men who have sex with men, people who use drugs, sex workers, transgender people, prisoners, and migrants) and their sexual partners. Entire communities and groups of people are being locked out of the right to health, well-being and to dignity because they are marginalised and criminalised.

This can - and must - change.

The UNAIDS Global AIDS Strategy 2021-2026 provides clear and effective guidance on what needs to be done to create fairer societies to get the world back on track to end the AIDS epidemic as a public health threat by 2030.

The strategy aims to put people at the centre, removing social and structural barriers that prevent people from accessing HIV services, empowering communities to lead the way, strengthening and adapting systems so they work for the people who are most acutely affected by inequalities, and fully mobilising the resources needed to end AIDS.

The European Union has the political weight, the financial clout, and the policy tools to significantly contribute to the global fight against HIV/AIDS. The European Parliament has just adopted a Resolution on Accelerating progress and tackling inequalities towards ending AIDS as a public health threat by 2030 in response to the Global AIDS Strategy.

It outlines concrete actions that the EU should take to end AIDS once and for all. These include supporting partner country efforts to build strong and resilient health systems able to deliver HIV-sensitive universal health coverage, to prioritise health as part of EU-Africa relations and to scale-up investments in UNAIDS and the Global Fund to Fight HIV, Tuberculosis and Malaria.

The resolution also seeks to mobilise EU leadership in addressing the human rights and gender inequality drivers of HIV/AIDS and to ensure that the EU supports community-led responses as key components in an effective HIV/AIDS response.

Next month, countries will gather for the United Nations General Assembly High-Level Meeting on HIV/AIDS where they are expected to back a bold new plan to end the AIDS epidemic, including new targets for 2025.

By achieving these targets, the number of people newly infected with HIV will fall to 370,000 by 2025, and the number of people dying from AIDS-related illnesses would be reduced to 250,000. Tackling the intersecting inequalities that fuel the HIV epidemic will be crucial to success.

The COVID-19 pandemic has exposed profound social and economic inequalities, underfunded public health systems, and the fragility of global responses. Certainly, COVID-19 is threatening to undermine hard-won gains made by the HIV/AIDS response, further threatening progress towards ending AIDS by 2030.

At the same time, countries are leveraging the HIV infrastructure and lessons learned from dealing with the HIV epidemic for a more robust response to both pandemics. Indeed, we have a unique opportunity to translate the right to health into rights-based, equitable, people-centred systems.

We must utilise this window to intensify global solidarity, including sustained investments in development, to build more resilient societies that reinforce everyone’s security.

The EU and UNAIDS share core values of humanity and equality to ensure that no one is left behind. Ending the AIDS epidemic by 2030 remains within the world’s reach but it cannot be done without creating stronger societies built on the principles of gender equality, social justice, and the recognition of universal human rights, including sexual and reproductive health and rights.

Failure to do so will put the lives of millions at risk and undermine the common mission of achieving the 2030 Sustainable Development Agenda, including the end of AIDS as a public health threat.

This op-ed was first published on theparliamentmagazine.eu

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.

I applaud the announcement from United States Trade Representative Katherine Tai supporting the waiving of intellectual property protections for COVID-19 vaccines.  

This is the kind of global leadership the world desperately needs as we witness horrific scenes in countries like India, where only nine in 100 people have been vaccinated. To date, more than 1.1 billion doses of vaccine have been administered globally, but more than 80% of those have been administered in high- and upper-middle income countries, while just 0.3% have been administered in low-income countries.

We are in a race to vaccinate the majority of the world’s population to curb death tolls and before more potent variants of COVID-19 emerge, rendering current vaccines ineffective. The faster we can scale up global vaccine supply, the faster we can contain the virus and the less chance we will face a day when variants prove resistant to existing vaccines. As the United Nations Secretary-General, Antonio Guterres has said “no one is safe until everyone is safe”.

The TRIPS waiver would enable the sharing of technologies, data, know-how, patents and other intellectual property rights across the world. The announcement of the US administration sends a powerful signal to the rest of the G7 and to the European Union to also support the World Trade Organization TRIPS Waiver and inspire other countries to take a powerful stand in favour of people before profits. This remarkable position from the US government is a fundamental step towards a People’s Vaccine.

To ensure everyone, everywhere has access to a lifesaving vaccine, we also need to see a pooling of technology through the World Health Organization’s COVID-19 Technology Access Pool, as well as financing to help build a network of vaccine manufacturing in developing countries. These three actions can together build a sustainable system to vaccinate the world, reach the needed herd immunity and open the paths to make the world best prepared for future pandemics. 

As we have learned from 40 years of fighting AIDS, equitable access to medical technologies is critical both for saving lives and for decreasing the impact of infectious diseases on people, communities and nations.

We are grateful to President Biden and his Administration for the generous humanitarian pledges made on COVID-19 and for the announcement.

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.

Forty years since the first AIDS cases were reported and just weeks before the United Nations General Assembly High-Level Meeting on AIDS, the United Nations Secretary-General has released a new report with recommendations and targets to get the world back on track to end AIDS

NEW YORK, 30 April 2021—The United Nations Secretary-General, António Guterres, has warned that despite intensive action and progress made against HIV in some places and population groups, HIV epidemics continue to expand in others and issued a set of 10 key recommendations.* If followed by all countries, this will end the AIDS pandemic as a public health threat by 2030 as part of the Sustainable Development Goals. In a new report, Addressing inequalities and getting back on track to end AIDS by 2030, the United Nations Secretary-General urges the world to address the inequalities that are slowing progress. 

“It is imperative to break out of an increasingly costly and unsustainable cycle of achieving some progress against HIV but ultimately not enough to bring about an end to the pandemic,” said Mr Guterres in the report. “Inequalities are the key reason why the 2020 global targets were missed. By ending inequalities, transformative outcomes can be achieved for people living with HIV, communities and countries.”

The global targets set out in the General Assembly’s 2016 Political Declaration on Ending AIDS were missed by a long way, allowing the AIDS pandemic to grow in many regions and countries. The staggering 1.7 million new HIV infections that occurred in 2019 are more than three times higher than the 2020 target of less than 500 000 new infections. In addition, the 690 000 AIDS-related deaths in 2019 far exceed the 2020 target of reducing deaths to fewer than 500 000 a year.

“Ending AIDS as a public health threat by 2030 is still within reach—many countries are showing that rapid progress against HIV is possible when evidence-informed strategies and human rights-based approaches are adopted,” said UNAIDS Executive Director Winnie Byanyima. “But it requires bold political leadership to challenge and address the social injustices and inequalities that continue to make certain groups of people and entire communities highly vulnerable to HIV infection.”

The report notes that COVID-19 has caused additional setbacks. The United Nations Secretary-General warned that COVID-19 is not an excuse for missing AIDS targets, but rather a stark warning to the countries that they can no longer afford to underinvest in pandemic preparedness and responses.

At the same time, the COVID-19 pandemic has underscored the many spill-over benefits of HIV investments in health and development. Community-led service delivery pioneered by the HIV response is helping to overcome the extraordinary impediments created by COVID-19.

The set of 10 recommendations to get the world back on track include: addressing inequalities and reaching all people living with or at risk of HIV infection to reduce the annual new HIV infections to under 370 000 and annual AIDS-related deaths to under 250 000 by 2025; prioritizing HIV prevention to ensure that 95% of people at risk of HIV infection have access to effective HIV prevention options by 2025; and eliminating new HIV infections among children.

The report underscores that addressing social and structural factors that perpetuate inequalities is key. It highlights, for example, how gender inequality, underpinned by harmful gender norms, restricts women’s use of HIV and sexual and reproductive health services by perpetuating gender-based violence and limiting decision-making power, including the ability of women and girls to refuse unwanted sex, negotiate safer sex and mitigate HIV risk.

It also shows how vulnerable, marginalized and criminalized communities, such as gay men and other men who have sex with men, people who use drugs, sex workers, transgender people, prisoners and migrants, also remain at higher risk of HIV infection than the general population because they are not receiving essential information and HIV treatment, prevention and care services.

The United Nations Secretary-General describes how communities of people living with, at risk of and affected by HIV are the backbone of the HIV response. Initiatives led by people living with HIV, women, key populations, young people and other affected communities have identified and addressed key inequalities and service gaps, advocated for the rights of their constituents and expanded the reach, scale and quality of health services.

In the report, Mr Guterres applauds UNAIDS’ recently adopted Global AIDS Strategy 2021–2026: End Inequalities, End AIDS. “The lessons from the countries, cities and communities that successfully fast-tracked their HIV responses over the last five years are at the heart of the UNAIDS Global AIDS Strategy 2021–2026,” said Mr Guterres. “The global AIDS community and UNAIDS have used an inequalities lens to develop the strategy, with new targets that are ambitious, granular and tailored to reach the furthest behind first.”

The report comes 25 years after the creation of UNAIDS and describes how COVID-19 has exposed social inequalities and health system weaknesses. The United Nations Secretary-General says that the world should leverage the experience from responding to the AIDS pandemic to strengthen health systems across the world and improve pandemic preparedness. He also calls for enhanced global solidarity to close the HIV resource gap and increase annual HIV investments in low- and middle-income countries to US$ 29 billion by 2025. 

*The 10 recommendations in the United Nations Secretary-General’s report:

1.      Reduce and end the acute and intersecting inequalities that are obstructing progress to end AIDS.
2.      Prioritize HIV prevention and ensure that 95% of people at risk of HIV infection have access to and use appropriate, prioritized, person-centred and effective combination prevention options by 2025.
3.      Close gaps in HIV testing, treatment and viral suppression that are limiting the impact of HIV responses and achieve by 2025 the 95–95–95 testing and treatment targets within all subpopulations, age groups and geographic settings, including children living with HIV.
4.      Eliminate vertical HIV transmission and end paediatric AIDS.
5.      Put gender equality and the human rights of women and girls in all their diversity at the forefront of efforts to mitigate the risk and impact of HIV.
6.      Implement the GIPA (Greater Involvement of People Living with HIV/AIDS) principle and empower communities of people living with HIV, women, adolescents and young people and key populations to play their critical HIV response roles.
7.      Respect, protect and fulfil the human rights of people living with, at risk of and affected by HIV and ensure by 2025 that less than 10% of people living with HIV and key populations experience stigma and discrimination.
8.      Enhance global solidarity to close the HIV response resource gap and increase annual HIV investments in low- and middle-income countries to US$29 billion by 2025.
9.      Accelerate progress towards universal health coverage and strong primary health care systems, build forward better and fairer from COVID-19 and humanitarian crises, and strengthen global health security and future pandemic preparedness.
10.  Leverage the 25 years of experience, expertise and mandate of the Joint United Nations Programme on HIV/AIDS (UNAIDS) in building multisectoral, multi-stakeholder and rights-based collaborative action to end AIDS and deliver health for all as global public good.

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.

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.

ABUJA/GENEVA, 10 March 2021—The UNAIDS Executive Director, Winnie Byanyima, has met the President of Nigeria, Muhammadu Buhari, to discuss the country’s response to the colliding pandemics of HIV and COVID-19. The meeting was part of Ms Byanyima’s three-day visit to the country, which also included visits to communities on the frontline of the response and events to mark International Women’s Day on 8 March.

During their meeting, Ms Byanyima thanked Mr Buhari for being an early champion of the People’s Vaccine campaign, which is calling for a fair and equitable distribution of vaccines against the coronavirus to ensure that poorer countries are not left behind in the response. Nigeria began to vaccinate frontline health workers last weekend after taking delivery of 4 million doses of vaccine, facilitated through COVAX, the international mechanism set up to bulk buy vaccines and distribute them equitably worldwide. Of 300 million vaccine doses administered worldwide so far, most have been administered in just 10 countries.

Ms Byanyima also applauded the country’s progress against the HIV pandemic and said UNAIDS stood ready to strengthen its partnership with Nigeria to further reduce the impact of the HIV pandemic and end AIDS as a public health threat as part of the 2030 Agenda for Sustainable Development.

“Nigeria has made good progress on expanding the delivery of HIV testing, treatment and care services over recent years, contributing to a steep decline in AIDS-related deaths,” said Ms Byanyima. “I look forward to reinforcing UNAIDS’ partnership with government, communities and all other stakeholders to drive new HIV infections down and kick-start a decade of action to end AIDS as a public health threat for everyone.”

There were 1.8 million people living with HIV in Nigeria in 2019 and 1.3 million people know their HIV status. Around 1.1 million people are now on HIV treatment to keep them alive and well. AIDS-related deaths have fallen by more than a third over the past decade, although HIV infections have declined at a more modest rate.

During her visit, Ms Byanyima also met community activists, who have been instrumental in minimizing the disruption to HIV testing, treatment and care services despite the challenges caused by the COVID-19 pandemic and the measures taken to contain it.

On Monday, Ms Byanyima took part in events to commemorate International Women’s Day hosted by the Federal Minister of Women’s Affairs, Pauline Tallen. Ms Byanyima stressed the importance of women’s leadership and participation at all levels of decision-making to ensure that issues of importance to women, such as ending gender-based violence and expanding access to essential services, including health and education, were addressed.

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.

This year’s Zero Discrimination Day is an especially poignant one.

It was said at first that viruses don’t discriminate. But as we’ve witnessed again, crises, and societies, do.

COVID-19 has magnified the fissures in society. It has seen marginalized communities, who were already on the edge, taking the hardest economic hit, getting stuck at the back of the line for vital services and getting scapegoated for the crisis.

Yet the crisis has also seen the most excluded communities being, once again, the first to step up to help—rooted in their expertise from experience, in their empathy and in their insistence that health for all and a recovery for all is possible.

UNAIDS joins with communities across the world in demanding equality. We say a resolute no to all inequalities—whether because of gender, income, race, disability, sexual orientation, ethnicity and religion. Such inequalities disfigure society and undermine justice and dignity.

We demand an end to discrimination, stigmatization and criminalization.

We challenge all institutions and all people of influence to not only be non-discriminatory, but to be anti-discrimination.

Discrimination kills. It exacerbates emergencies and it perpetuates pandemics.

The world is off track to end AIDS by 2030 not because of a lack of knowledge, capability or means but because of structural inequalities that stand in the way. For example, research shows that punitive laws regarding sexual orientation double the likelihood of acquiring HIV for gay men and other men who have sex with men. Repealing such laws is central to beating the HIV pandemic.

So too, discrimination against migrants and other excluded and stigmatized populations is obstructing their access to COVID-19 testing, treatment and support. This hurts everybody.

We are seeing the discrimination that scars our countries play out also at the international level. As new vaccines against COVID-19 have become available, there has been gross inequity. Just 10 countries have administered more than 75% of all COVID-19 vaccines, while more than 130 countries have not received a single dose. South Africa has called this vaccine apartheid. As the United Nations Secretary-General has said, “Vaccine equity is ultimately about human rights ... Vaccine nationalism denies it.” Around the world, and in every country, we must value every person as equally precious.

Ending inequalities will advance the human rights of all, make societies better prepared to beat COVID-19 and future pandemics and support economic recovery and stability.

We need to ensure everyone’s right to health through publicly provided and financed health care—and provide it respectfully to all, without reservation or judgement.

All of us need to call out discrimination wherever we see it, and to work to set an example.

A healthier, safer, more equal and prosperous world depends on it.

I am inspired by the leadership shown by communities facing discrimination. Their determination, courage and vision is our guiding light. The United Nations stands alongside, as a resolute ally for equality.

End inequalities. Demand zero discrimination.

Winnie Byanyima, Executive Director of UNAIDS

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.