Inequalities obstruct the end of the Aids epidemic after a new UNAIDs report revealed that adults and children are being denied treatment. Over half of these kids are living on lifesaving medicines.   

The report titled ‘Dangerous Inequalities’ reveals that based on current trends, the world will not meet agreed global targets on Aids, and millions of lives are at stake. It also shows that only urgent action can get the world’s Aids response on track.

The report was officially launched in Dar Es Salaam in Tanzania today. According to UNAIDS Executive Director Winnie Byanyima, the world will not be able to defeat Aids while reinforcing patriarchy.

Inequalities faced by women

“We need to address the intersecting inequalities women face. In areas of high HIV burden, women subjected to intimate partner violence (IPV) face up to 50% higher chance of acquiring HIV,” stated Byanyima.

She also stated that the feminist route map is the only way towards ending Aids, and leaders need to support such movements.

“Across 33 countries from 2015 until 2021, only 41% of married women aged 15-24 could make their own decisions on sexual health. The only effective route map to ending Aids, achieving sustainable development goals, and ensuring health, rights, and shared prosperity, is feminism. Women’s rights organisations and movements are already on the front doing this bold work. Leaders need to support them and learn from them,” said Byanyima.

Sub-Saharan Africa is the most affected

The report also shows that gender inequalities and harmful gender norms are holding back the end of the Aids pandemic. And the effects of gender inequalities on women’s HIV risks are especially pronounced in sub-Saharan Africa, where women accounted for 63% of new HIV infections in 2021.

“Gender inequalities are a key driver of the Aids epidemic. Adolescent girls and young women in sub-Saharan Africa are three times more likely to acquire HIV than their male counterparts. A recent study also found that women experiencing IPV in the past year were more than three times more likely to have recently acquired HIV,” read the report.

Children left behind in the fight

According to the report, the world continues to fail children in the Aids response. As of 2021, 800 000 children living with HIV were still not on life-saving treatment.

“We know what needs to be done to eliminate the vertical transmission of HIV and meet the treatment needs of children. But a failure of leadership has prevented us from doing so, and the widening disparity in treatment coverage between children and adults is increasing rather than declining. Many children are also being diagnosed late, with 60% of children aged five to 14 years living with HIV, not currently receiving treatment,” stated the report.

“We know what to do to end inequalities. Ensure that all our girls are in school, safe, and strong. Tackle gender-based violence and support women’s organisations and promote healthy masculinities to take the place of the harmful behaviours which exacerbate risks for everyone,” said Byanyima.

She also stated: “Ensure that services for children living with HIV reach them and meet their needs. Close the treatment gap so that we can end Aids in children. And decriminalise people in same-sex relationships, sex workers, and people who use drugs and invest in community-led services that enable their inclusion. This will help break down barriers to services and care for millions of people.”

In the lead up to #WorldAIDSDay on 1 December, @UNAIDS is calling on all of us to unite to end the inequalities holding back the end of AIDS.

To keep everyone safe, to protect everyone’s health, we need to #Equalize! pic.twitter.com/zJ5h6iTq7D

— United Nations Geneva (@UNGeneva) November 28, 2022

Putting millions of people in danger

The report also highlighted that the inequalities are not merely harmful to individuals, but they are impeding progress against Aids while reducing the returns on HIV investments and putting millions of people in danger. Although HIV infection and Aids are both entirely preventable, the rates of both are not declining quickly enough to put us on course to end Aids by 2030.

“A lack of policy reform and investment within and beyond the health sector is making it difficult, if not impossible, for adolescent girls and young women to access essential HIV services. Preventing HIV among men and ensuring that men living with HIV achieve viral suppression is also critical to reducing the epidemic’s toll on women and girls in several parts of the world,” the report indicated.

International Aids Society President Sharon Lewin stated that, in a world plagued by inequality, putting people first across all aspects of HIV response is a moral imperative and the only viable route to progress.

“Whether in the design of clinical trials, the formulation of policies or any other aspect of our efforts, people living with and affected by HIV must be not just beneficiaries but the actors driving our efforts,” said Lewin in response to the UNAIDS report.

The report further indicated that although more than two decades of sustained investments in the Aids response have achieved historic results, these gains are now jeopardised by insufficient progress to end HIV-related inequalities.

The importance of equalising

“Failure to use available, simple strategies for preventing HIV acquisition among children is not only a tragedy for each child living with HIV, but also for their families and communities. Society bears the long-term costs of lifelong antiretroviral therapy for children who didn’t need to acquire HIV in the first place,” the report said.

In 2021, 650 000 people were lost to Aids and 1.5 million newly acquired HIV. But according to Byanyima, what the world leaders need to do is crystal clear.

“In one word: Equalise. Equalise access to rights, equalise access to services, and the best science and medicine. Equalising will help the marginalised. It will help everyone,” added Byanyima. – Health-e News