Inequalities fuel new HIV/ AIDS infections

The world is not doing so well in the response to HIV/ AIDS, says Senior Coordinator, Human Rights at the Global Fund to Fight Aids, TB, and Malaria, Ralf Jürgens.

Painting a picture of what is happening on the global front, he said that a recent report released by UNAIDS titled, ‘ in Danger’ talks about the progress that has been made by countries and the fact that many people are on treatment and able to live healthy lifestyles, while they are on Antiretroviral treatment. But he said that they are not able to see the same advances in prevention, and that too many people still contract HIV.

Adolescent girls and young women are disproportionally contracting HIV in many African countries. Other groups that contract HIV are from key populations such as Men who have sex with Men, Sex workers, people who use drugs, internally displaced people and prisoners, he said.

Jürgens was speaking during a recent media engagement that was organised by the Thomas Reuters Foundation to update the media about the strides made by the Breaking Down Barriers programme, an initiative of the Global Fund. The briefing was held on the sidelines of the 24th International AIDS Conference which was held in Montreal, Canada ( July 29thAugust 2nd).

He said that due to the Covid- 19 pandemic, there have been setbacks that include many people not being able to access HIV treatment or get tested.

“And now we are in an economic situation where there are many issues at the centre of attention and there is not much attention to HIV as there used to be and we are at a danger of not meeting our targets, which is a serious setback,” he explained.

In the midst of all this, the Global Fund report shows a significant progress in Breaking Down Human Rights- Related Barriers to HIV and TB services.

The new report was released at the International AIDS Conference. It summarises the results and impact of investing in programmes, and policies to address various issues such as GBV.

According to the Executive Director of the Global Fund, Peter Sands, one of the most powerful lessons from the history of the fight against HIV is that success in confronting such a formidable disease cannot be achieved through biomedical interventions alone.

“We must also confront the injustices that make some people especially vulnerable to the disease and unable to access the health services they need. The same is true for TB, malaria, and other diseases, including COVID- 19,” he said.

The Global Fund’s Breaking Down Barriers Initiative, was launched in 2017 to provide intensive financial and technical support to 20 countries including Botswana, Cameroon, DRC, Ghana, South Africa, Kenya, Jamaica, Uganda, Ukraine, Nepal, Senegal, Sierra Leone to address stigma and discrimination, criminalisation and other human rights- related obstacles that continue to threaten progress against HIV, TB and Malaria.

According to the Midterm assessments conducted between 2019 and 2021, all countries involved in the Breaking Down Barriers initiative saw progress in removing human rights related barriers to HIV services, a mean increase of 0.9 points from baseline on the 0.5 scale.

However, the report revealed that even the top five scoring countries, Ukraine 3.7, Jamaica 3.5, Botswana 3.3, Senegal 3.1 and Kenya 3.1 are falling short of the scores that would represent a comprehensive response at a national level - above 4.0. Meanwhile, Sierra Leone (+ 1.7), Jamaica (+ 1.6), Cameroon (+ 1.3) and Mozambique (+ 1.3) showed the greatest increase in scores.

All countries surveyed also showed progress on TB programming. The TB scores at midterm ranged from Ghana ( 2.8) to Sierra Leone ( 0.2), with an average increase from baseline of 0.6.

According to the report, for many countries, addressing human rights barriers to TB services entailed the development of new interventions, and the progress reported in the midterm assessment reflects a rapid expansion. The greatest increase was seen in Ukraine (+ 1.1) and Côte d’Ivoire (+ 1.5).

However, the assessments also show that COVID- 19 slowed the progress of the Breaking Down Barriers initiative in many countries. But they also chronicle the ways in which human rights- related work on HIV contributed to rights- based approaches to COVID- 19, the report says.

In a few countries, the report said support was provided to community- based paralegals to address human rights violations that occurred during lockdowns. The report also highlights that many innovative measures were undertaken to ensure that key populations would continue to receive services despite lockdowns or quarantines.

In several countries, community awareness- raising focused on prevention of gender- based violence during lockdown periods. In the meantime, another round of evaluations, planned for late 2022 and the first six months of 2023, will capture up to five years of activity and provide further insights into the results and impact achieved in the countries involved in the Breaking Down Barriers initiative.

The good news is that global Fund human rights funding is unprecedented. In the 20 countries of the Breaking Down Barriers initiative, Global Fund has investments in programnes to reduce human rights- related barriers are said to have increased more than 10- fold – from slightly over US$ 10 million to now over US$ 130 million.

“The Breaking Down Barriers experience demonstrates that where there is sufficient funding and technical support, multiple stakeholders can be energised to combine and strengthen their efforts, and as a result, can make real progress in removing long- standing barriers,” Sands said.

“This is critical to defeating HIV, TB and malaria, building truly inclusive systems for health that leave no one behind, and enabling everyone, everywhere to realizing their right to health and well- being,” he noted.

The Global Fund provides 30 percent of all international financing for HIV programs - 12 percent of all available resources and has invested US$ 22.7 billion in programs to prevent, diagnose and treat HIV and AIDS and US$ 3.8 billion in TB/ HIV programs as of June 2021.

In countries where the Global Fund invests, total AIDS- related deaths have dropped by 65 per cent over the last 20 years. The US will host the Global Fund’s Seventh Replenishment Pledging Conference in New York City on 19- 21 September 2022.

With a Replenishment of at least US$ 18 billion, the Global Fund together with partners, could reduce new HIV infections by 68 percent, from 1.1 million to 348,000; AIDSrelated deaths by 59 percent, from 579,000 to 239,000; incidence and mortality rates by 71 percent and 63 percent respectively; HIV incidence among adolescent girls and young women in most affected countries by 72 percent; and provide antiretroviral therapy to 28 million people in 2026 to reach 91 percent treatment coverage in 2026.