Inequalities hamper efforts to end AIDS
UNEQUAL access to rights, services, science and resources is holding back the end of AIDS and jeopardising the health security of everyone, according to the new UNAIDS report titled “Dangerous Inequalities”.
New HIV infections in epidemics that are concentrated among key populations are not declining globally. We cannot end AIDS among key populations unless we effectively address the societal factors that increase their vulnerability and block their ability to access services.
Discrimination, stigmatisation and criminalisation of key populations are costing lives and preventing the world from achieving agreed AIDS targets.
In Malaysia, perceived socio-cultural preferences and associated stigma discourage men from seeking HIV and sexual health-related services. While 65% of women in Malaysia living with HIV were accessing treatment in 2021, only 52% of men living with HIV were on treatment.
Men and boys accounted for 90% of all new infections in Malaysia in 2021. Since 2010, new HIV infections have increased by 18% here despite new infections among children declining by 94%.
New investments to address Hivrelated inequalities are urgently needed. At a time when international solidarity and a surge of funding is most needed, too many high-income countries are cutting back aid for global health.
In 2021, funding available for HIV programmes in low- and middle-income countries was Us$8bil short. Increasing donor support is vital to getting the AIDS response back on track.
The new UNAIDS report says donor funding also helps to catalyse domestic funding: Increases in external HIV funding for countries from the United States President’s Emergency Plan for AIDS Relief (Pepfar) and the Global Fund during 2018-2021 were correlated with significant increases in domestic funding from national governments.
Malaysia’s leadership in domestic financing on HIV response is laudable. In the past decade, the country’s HIV response has been predominantly funded by domestic sources, including funding for civil society organisations.
Low- and middle-income countries should no longer be kept waiting for access to health technologies. Innovations in health are global public health goods.
Millions of lives are at stake.
Globally, there were 650,000 Aidsrelated deaths in 2021 and 1.5 million new HIV infections. This is one million above the 2020 target of 500,000.
In Malaysia in 2021, there were 1,600 Aids-related deaths, and 15 people became infected with HIV daily.
But this is not a counsel of despair. It is a call to action. Inequalities in health are not inevitable. Countries have the power to overturn laws that criminalise and marginalise entire communities, equalise availability and access to services and ensure differentiated options for HIV prevention based on an individual’s needs.
All over the world, people are mobilising to challenge the injustices that keep people away from lifesaving HIV treatment, care and prevention services.
Determined partnership and action between government, development partners, civil society organisations and communities can mobilise sustainable achievements in national HIV responses.
Malaysia has experienced such an accomplishment by being one of the first countries to address and eliminate mother-to-child transmission, thus ensuring that 96% of children with HIV have access to treatment, of whom 62% are virally suppressed.
The evidence is clear: Protecting the health, safety and human rights of marginalised people expands access to HIV services, accelerates progress in the response to HIV by increasing the number of people on treatment and widens access to prevention tools, thus reducing new infections.
Together, it is possible to end AIDS by 2030 but only if governments act now to equalise access to HIV services, equalise access to rights and equalise access to resources for everyone.
Tackling inequalities will not only help the marginalised. It will help everyone.