Missed targets on the road to ending AIDS - who is to blame?
”COVID-19 might blow off track the AIDS response and reaching the UNAIDS treatment targets and the 2030 target of ending AIDS as a public health threat might be at risk.” – is the new slogan we have been hearing from different stakeholders since the beginning of the SARS-CoV-2/COVID-19 pandemic outbreak. While the concerns are valid, COVID-19 policies and measures have raised additional obstacles on the road to reaching the HIV/AIDS targets, it would be false and irresponsible and a perfect example of political blame game to hold only COVID-19 responsible.
On a Fast Track to ending AIDS?
The data from the latest UNAIDS report is clear, neither the UNAIDS treatment targets (90-90-90) nor the vision of getting to zero new infections, zero AIDS-related deaths and zero discrimination by 2030 are feasible to reach based on the data by the end of 2019. According to the report, the world is not doing great on reaching the targets set by the 2016 UN Political Declaration on HIV/AIDS.
The missed epidemiological targets are results of 2 major obstacles, the serious underfunding of the HIV/AIDS response and the slow progress, if not regression, in the realization of the human rights of people living with HIV and other key populations. Although UN Member States have committed to ending AIDS as a public health threat as part of the SDGs, one can ask how fast a seriously underfunded response can progress, while there is reluctance to remove several of the obstacles on its way?
Funding for the HIV/AIDS response has never been sufficient, but in recent years we have seen a steady decline as international donors are facing difficulties to raise their funds, countries struggle with or show no will to replace it with domestic funding, all leaving communities living with and affected by HIV behind.
The slow progress on the realization of the human rights of all people and applying human rights-based methods and approaches to HIV/AIDS policies further drive inequalities, stigma and discrimination against people living with HIV, key populations, young people and women.
Globally, 62% of new adult HIV-infections are among key populations and their sexual partners, and young women and girls in sub-Saharan Africa accounted for 25% of new HIV-infections.
HIV-criminalization, the criminalization and discrimination against people who use drugs, sex workers, gay men and other men who have sex with men, transgender people, people in prison, and gender inequality are all obstacles on the track to ending AIDS and the world have failed to address and remove them.
We cannot accept that the COVID-19 pandemic will be used as an excuse for the ongoing underfunding of the response and denying the human rights of people living with HIV and other most affected key populations.
The effects of SARS-CoV-2/COVID-19 on the HIV/AIDS response
Although it is clear that the world will fail to reach global HIV/AIDS targets and that it would have happened without the appearance of the COVID-19 pandemic, it is also clear that this pandemic poses further undeniable threats and risks on the HIV/AIDS response even in regions that have shown tremendous progress in the last 10 years.
Service interruptions due to lockdown measures, according to estimates by the World Health Organization and UNAIDS, can result in hundreds of thousands of additional new infections and AIDS-related deaths globally. These interruptions, combined with the introduction of public policy health measures that further increase inequalities and hit those hardest that are already marginalized, will further slowdown the progress and as feared, will blow off track the HIV-response.
As Winnie Byanyima, UNAIDS Executive Director ends her foreword to the report: “The UNAIDS 2020 global report is a call to action. It highlights the scale of the HIV epidemic and how it runs along the fault lines of inequalities. We can and must close the gaps.“