By Martha Isabel Andrés
The Joint United Nations Program on HIV/AIDS (UNAIDS) thinks that this goal might be achieved by 2030 if four key elements are met: following science and evidence, putting human rights at the center, empowering communities and counting on the necessary financing.
This was expressed in an exclusive interview with Prensa Latina by UNAIDS Executive Director Winnie Byanyima, who said that since 2010, significant progress has been recorded at the international level, as demonstrated by the fact that deaths related to the disease were reduced by more than half and there was also a decrease in the number of new contagions.
However, she pointed out that the battle is not over, since currently only about five or six countries have already achieved the goals set for 2025 and others are close to achieving them, but many nations remain outside the ideal path and are even going in the wrong direction.
“Most of the progress has been reported in sub-Saharan Africa, although we see some regions like Eastern Europe and even Latin America, where new contagions are increasing rather than decreasing,” she said.
Despite the many existing challenges, Byanyima underscored that there is a clear path to eliminate AIDS, which includes, first of all, following scientific evidence, knowing who is infected and reaching those people, a task in which UNAIDS plays a key role by compiling data on the subject and presenting it to governments and communities so that they can make decisions through science.
The second thing is to put human rights at the center, because “when people are fleeing laws that penalize, when they are afraid to talk about their HIV status due to the strong stigmas in societies, even if medicines are available, they do not look for them,” said the UNAIDS executive director, who is on a working visit to Cuba from May 6 to 9.
In that regard, she regretted that more than 60 countries enforce regulations that criminalize same-sex relationships or discriminate against on the basis of sexual identity, and that in more than 100 territories some aspects of sex work are criminalized.
“Such a legislation only creates hatred and violence against vulnerable people, which is why, there must be equitable societies that allow everyone to seek the necessary support,” she said.
The UNAIDS head referred, as a third element, to the importance of putting communities at the forefront of confronting the scourge, as it is a sex-related disease, a taboo topic about which people do not want to talk, so the way to get them to address these sensitive issues is to find trust in their own communities, where prevention, detection and treatment can be promoted.
The fourth aspect is financing and resources, which is a great challenge, because those who are vulnerable to HIV are often not valued by governments and not enough is invested in their access to services.
“In addition, we are at a time when solidarity between the rich countries of the North and those of the South has decreased, so programs to outreach the poorest are threatened, in addition to healthcare systems that have been weakened” during the Covid-19 pandemic and they continue to be harmed due to the war in Ukraine, global inflation, and the fiscal and debt crisis in States with larger budgets, so financing is a challenge,” she added.
If these four aspects are met, we could really achieve control of the pandemic by 2030, Byanyima stated.
A DISEASE OF INEQUITY AND INJUSTICE
Eliminating stigmas and discrimination against vulnerable groups and people living with HIV is essential to advance the battle against this pandemic, since the beginning of which 40 million people have died worldwide.
According to the senior official, governments must take ownership of this issue and commit to guaranteeing the right to health of all their citizens. “Where there are privatized, fragmented healthcare systems that provide better services to the rich and others of lower quality or non-existent to the poor, you cannot fight and defeat.”
HIV/AIDS is a disease of inequity and injustice, Byanyima stressed, adding that authorities must commit to providing equitable services, repeal laws that criminalize and, even in cases where there is no discriminatory legislation, promote campaigns against prejudice and exclusion.
Governments must also empower communities, when the value of their leadership is understood, it is possible to confront diseases better, said Byanyima stated, who also highlighted the significance of international solidarity to reduce gaps.
We need rich countries to remain committed and continue to fund, all people have the right to life. However, more nations also need to invest in their own response to HIV/AIDS, such as those that are moving toward a middle-income status, she said.
Byanyima recalled that in the 1990s, rich and developing countries agreed to combat the disease and UNAIDS was created to lead and coordinate global actions. Since then, this program establishes the vision and objectives of the confrontation, collects data to help States plan how to respond, and every five years, the strategy to follow in the following five years is drawn up.
We also raise awareness worldwide and fight for access to better and more affordable medicines for everyone, Byanyima explained, and specifically mentioned that they organized a petition of more than 100 epidemiologists, scientists, economists and lawyers to call the antiretroviral-producing companies to make them available generically at low prices.
We also advocate against laws that discriminate, we urge governments to adopt correct policies, we estimate the amount of funds that countries need, we mobilize resources and support the Global Fund to fight AIDS, she said about the program that she has led since 2019.
EXPERIENCES FOR FUTURE PANDEMICS
According to Byanyima, HIV forced the global healthcare system to work differently, because a multisectoral approach had to be used to address it. “It could not be resolved from health alone, as human rights, legislation, gender equality and women’s rights, the economy, social development, and financing are also involved.”
The fight against HIV also exposes the significance of putting communities at the center, because they are the ones who take the message of prevention and bring it to all citizens, who find every last person who needs to be vaccinated or being under treatment, those who are there to take care of one another, she estimated.
From her point of view, she left behind the teaching of global solidarity, the evidence that a pandemic is global and cannot be ended until the weakest link is reached.
“In the face of HIV, the governments agreed on a strategy and decided to mobilize resources from the North to the South, establishing joint goals,” she highlighted in this regard, and regretted that a similar vision was not adopted in the face of Covid-19, during which the lack of international response delayed the end and harmed poorer nations.
Currently, 38 million people have HIV in the world, but 30 million of them are on treatment, there is no vaccine, there is no cure, but they are living well, also due to global solidarity.
“So that is one of the biggest lessons, the response to HIV shows the success of multilateralism,” Byanyima highlighted.
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