Why Bold Action Against Inequalities Is Needed To End HIV/AIDS

By Lynnet Okumu / Published December 3, 2021 | 10:05 am

KEY POINTS

An estimated 37.7 million people were living with HIV at the end of 2020, over two-thirds of whom (25.4 million) are in the WHO African Region.

HIV/AIDS, has become one of the world’s most serious health and development challenges, having claimed 36.3 million so far since the first cases were reported in 1981.

Over the past two decades, major global efforts have been mounted to address the epidemic and at some point, significant progress had been made.

However, the increase in the rate of HIV infection globally is becoming a worrying trend, especially with the wake of Covid-19 that has thrown it under the bucket.

According to the World Health Organization (WHO), an estimated 37.7 million people was living with HIV at the end of 2020, over two-thirds of whom (25.4 million) are in the WHO African Region.

Furthermore WHO states that some 680 000 [480 000–1.0 million] people died from HIV-related causes and 1.5 million [1.0–2.0 million] people acquired HIV in the same year.

The World Aids Day 2021 that was marked on 1^st December, took a new perspective; End inequalities. End AIDS. End pandemics.

According to the UNAIDS report launched in July 2021, people living with HIV are more vulnerable to COVID-19, but widening inequalities are preventing them from accessing COVID-19 vaccines and HIV services.

The report dubbed ‘Confronting inequalities’, shows that in 2020 the 1.5 million new HIV infections were predominantly among key populations and their sexual partners. People who inject drugs, transgender women, sex workers, and gay men and other men who have sex with men, and the sexual partners of these key populations, accounted for 65% of HIV infections globally.

Key populations accounted for 93% of new HIV infections outside of sub-Saharan Africa, and 35% within sub-Saharan Africa. However, they remain marginalized and largely out of reach of HIV services in most countries.

Confronting inequalities also shows that women and girls in sub-Saharan Africa continue to be at a higher risk of HIV infection, with gender inequality and gender-based violence at the center of that risk robbing them of their fundamental human rights, including the right to education, health, and economic opportunities.

This increases their risk of HIV infection and blocks access to services. In sub-Saharan Africa, adolescent girls and young women account for 25% of all new HIV infections despite representing just 10% of the population.

Other key barriers to health and HIV services and display inequality are Poverty and lack of schooling. Family planning services for women and voluntary medical male circumcision for men and boys are much less likely to be accessed by people living in poverty. In 2020, the number of voluntary medical male circumcisions dropped by more than 30% in 15 priority countries in eastern and southern Africa.

Based on these findings, inequalities are not naturally occurring. They are the result of policy and programmatic actions that divide rather than include and must be confronted boldly to put the emphasis back on respect for basic, fundamental human rights.

According to UNAIDS Executive Director Winnie Byanyima. if leaders fail to tackle inequalities, the world could face 7.7 million AIDS-related deaths in the next 10 years.

UNAIDS further warns that if the transformative measures needed to end AIDS are not taken, the world might stay trapped in the COVID-19 crisis and remain dangerously unprepared for the other pandemics to come.

In Kenya, the HIV new infection trend is taking a heavy toll on the population, especially among the youth.

According to World Health Organization, 1.2 million people are living with HIV/AIDS in Kenya, and at least 180, 000 people die from AIDS annually. Young people from the greater percentage of the new HIV infections because they act as the carriers.

The government through its Ministry of Health has been making relentless efforts to ensure a sufficient supply of HIV commodities such as Anti-Retro-Viral drugs (ARVs).

By partnering with local manufactures, the Ministry of Health has prioritized optimization of ARV regimens to ensure people living with HIV receive the best medicine available most efficiently and cost-effectively.

Many countries including Kenya have reported that the challenges experienced in HIV prevention, care, and treatment services in the recent past are partly attributable to the emergence of the COVID-19 pandemic and the ever-increasing burden of non-communicable diseases.

UNAIDS and global health experts have, however, emphasized that leaders can, by acting boldly and together to tackle the inequalities in which pandemics thrive, end AIDS, overcome the COVID-19 crisis, and be protected from the pandemic threats of the future.

Countries with laws and policies aligned to evidence, strong community engagement and participation, and inclusive health systems have had improved outcomes, whereas the regions with the largest resource gaps and punitive laws have the worst.

“We have an effective strategy that leaders adopted this year, but it needs to be implemented in full. Ending inequalities to end AIDS is a political choice that requires bold policy reforms and requires money. We have reached a fork in the road. The choice for leaders to make is between bold action and half-measures.” Ms. Byanyima added.

To ensure we close the inequality gaps and end AIDS, we must: