To end AIDS, we must reclaim our relentless pursuit of justice – opinion

April 18, 2024
by adv. Bience Gawanas, Vice President of the Management Board of Global Fund

As HIV advocates gather this week in Yaoundé on AFRAWIHthe biggest French-speaking international conference on HIV/AIDS, and a number of other months before the twenty fifth International AIDS Conference in Munich, the Vice-Chair of the Global Fund Board calls for a renewed give attention to promoting equality within the fight against HIV, especially for groups that proceed to suffer from a disproportionately high rate of HIV infection.

Every step we take today within the fight against HIV will probably be arduous – we must push harder for progress. In the primary years of fighting this virus, our gains were often rapid and massive because in all places we looked, the necessity was great. These were devastating times: in 2000, the disease killed three million people, greater than 2.4 million of them in Africa. On the southern tip of the continent, where I come from, the disease threatened to disintegrate the very fabric of society.

When the world got here together to create partnerships just like the Global Fund and PEPFARit was intended to challenge the injustice that only the rich could receive treatment for HIV. This was intended to stop the potential of losing a generation of individuals in lots of low- and middle-income countries, in addition to those that were stigmatized and discriminated against because they were considered “different”.

I’m proud to say that we have come a good distance since then. From fewer than 50,000 people on treatment for HIV in Africa in 2000 to greater than 20 million today, innovations in HIV prevention have spread, dramatically reducing the variety of HIV infections.

And yet, in 2022, over 1.3 million people were infected with the virus.

These infections currently occur mainly amongst probably the most marginalized people: men who’ve sex with men, individuals who inject drugs, transgender women and sex staff. Moreover, their voices are increasingly silenced they usually face a relentless threat of violence and abuse as discriminatory anti-LGBTI laws increase world wide. Among these groups, young people aged 15–24 years bear a disproportionate burden of HIV and are much more vulnerable as they face greater barriers to accessing health services.

There’s a protracted road left

In the francophone countries of Africa (24 countries – 373.3 million people), the number of individuals infected with HIV is lower than in the remaining of the continent. However, they accounted for 16% of all recent HIV infections in sub-Saharan Africa in 2022.

Thanks to the collaborative efforts of the Global Fund and other partners, the AIDS-related mortality rate in French-speaking African countries decreased by 82% between 2000 and 2022. During the identical period, AIDS-related mortality rates fell by 95% in Burundi, 91% in Rwanda, and 90% in Côte d’Ivoire and Burkina Faso.

The number of recent HIV infections in Francophone Africa has also fallen, from 325,000 in 2000 to 108,000 in 2022. Between 2001 and 2022, HIV incidence rates fell by 92% in Burundi and Rwanda and by 91% in Côte d’Ivoire and Burkina Faso. Thanks to programs supported by the Global Fund, antiretroviral therapy coverage in Francophone Africa has increased significantly from 4% in 2005 to 72% in 2022.

However, we still have a protracted method to go to attain key goals akin to eliminating AIDS in children. As vertical transmission rates proceed to be high in lots of Francophone countries, it’s of great importance to concurrently improve each prevention and pediatric care.

Another key goal is to cut back stigma and discrimination as barriers to HIV prevention, care and treatment. West Africa regional Stigma Index 2.0 reportbased on data from 10,910 individuals with HIV in seven countries within the region, found that amongst key populations, individuals who inject drugs and transgender women have the best difficulties in accessing testing, care and treatment.

The HIV challenge is a problem of equality, not science

The fight against HIV isn’t any longer a challenge of science, but a challenge of equality. For us to speed up progress again, we must regain that strong spirit of justice that animated us 20 years ago. This means specializing in the communities most affected by HIV. In Africa, there may be an urgent have to give attention to adolescent girls and boys.

Although the incidence of HIV amongst adolescent girls and young women has declined significantly over the past decade, worldwide, mainly in sub-Saharan Africa, 4,000 girls and young women proceed to turn into infected with HIV every week. This will not be acceptable. This group continues to suffer from probably the most iniquitous conditions and structural injustices of all that predispose them to disease.

If we’re to stop HIV infection on this population, we must bring together diverse partners to speculate in long-term efforts to maintain girls at school.

Education turns girls into women with equal opportunities and protects them against diseases akin to HIV. Educated girls experience lower rates of minor pregnancy, sexual violence, early marriage and ultimately lower rates of HIV infection.

We also have to speed up investment in programs that support comprehensive sexual and reproductive health and rights, especially for adolescent girls and young women.

We also have to be sure that young women and girls are at the center of projects that seek to interact them. These are a number of the goals that the Global Fund partnership seeks to attain through projects akin to ESSENTIAL VOICES and the HER Voice Fund, which goals to meaningfully engage young women and girls in key health programs and decision-making forums of their communities.

To end HIV infections amongst young women and girls, we must also reduce infections amongst their sexual partners. This means investing in efforts to alter the cultural and social norms that predispose men and boys to HIV infection and that shape their relationships with women and girls of their communities.

It also implies that men at high risk of HIV infection are tested and supported to start out and stay on treatment. Protecting heterosexual men and boys from HIV can even help protect women and girls from HIV.

We have to refocus on promoting equality. We know do it. We did this on the turn of the millennium by pushing for equity in HIV treatment. Let us now move forward and end this unfinished fight by reducing HIV infections amongst probably the most affected communities. To achieve this, we could be empowered by the aim and relentless spirit of the golden years of progress within the fight against HIV.

This article was originally published on Watch health policy.