•650,000 people died from virus in 2021

Ahead of World Acquired Immunodeficiency Syndrome (AIDS) Day, the United Nations has estimated that based on current trends, the world may not meet the agreed global targets to eradicate the virus.

In 2021, the UN disclosed that 650, 000 people were lost to AIDS while 1.5 million people newly acquired HIV. It blamed growing inequalities as a major factor obstructing the efforts to end of AIDS.

A statement by the Executive Director of UNAIDS and an Under-Secretary-General of the United Nations, Winnie Byanyima stated: “On current trends the world will not meet agreed global targets on AIDS. But the new UNAIDS report, Dangerous Inequalities, shows that urgent action to tackle inequalities can get the AIDS response on track.

“UNAIDS set out earlier this year that the AIDS response is in danger—with rising new infections and continuing deaths in many parts of the world.”

She said a new report from UNAIDS showed that inequalities were the underlying reason why the set targets may not be achievable.

“It shows how world leaders can tackle those inequalities, and calls on them to be courageous to follow what the evidence reveals.

“Dangerous inequalities unpacks the impact on the AIDS response of gender inequalities, of inequalities faced by key populations, and of inequalities between children and adults. It sets out how worsening financial constraints are making it more difficult to address those inequalities.

“The report shows how gender inequalities and harmful gender norms are holding back the end of the AIDS pandemic. “The world will not be able defeat AIDS while reinforcing patriarchy,” Byanyima added.

While stressing the need to address the intersecting inequalities women were facing, Byanyima regretted that in areas of high HIV burden, women subjected to intimate partner violence face up to a 50 per cent higher chance of acquiring HIV.

She also said across 33 countries, from 2015-2021, only 41 per cent of married women aged 15 to 24 could make their own decisions on sexual health.

The UNAIDS director said the only effective way to ending AIDS, achieving the sustainable development goals and ensuring health, rights and shared prosperity was to adopt a feminist route map.

According to her, women’s rights organisations and movements were already on the frontlines doing this bold work, adding that leaders needed to support them and learn from them.

Byanyima said the effects of gender inequalities on women’s HIV risks were especially pronounced in sub- Saharan Africa, where women accounted for 63 per cent of new HIV infections in 2021.

“Adolescent girls and young women (aged 15 to 24 years) are three times more likely to acquire HIV than adolescent boys and young men of the same age group in sub-Saharan Africa. “The driving factor is power. One study showed that enabling girls to stay in school until they complete secondary education reduces their vulnerability to HIV infection by up to 50 per cent,” she said.

However, Byanyima said when the girl child education was reinforced with a package of empowerment support, their risks are reduced even further.

She said leaders needed to ensure that all girls attend school and are protected from violence which was often normalised including through underage marriages, and have economic pathways that guarantee them a hopeful future.

“By interrupting the power dynamics, policies can reduce girls’ vulnerability to HIV. Harmful masculinities are discouraging men from seeking care. While 80 per cent of women living with HIV were accessing treatment in 2021, only 70 per cent of men were on treatment. Increasing gender- transformative programming in many parts of the world is key to halting the pandemic. Advancing gender equality will benefit everyone.

“The report shows that the AIDS response is being held back by inequalities in access to treatment between adults and children. While over three quarters of adults living with HIV are on antiretroviral therapy, just over half of children living with HIV are on the lifesaving medicine. This has had deadly consequences.

“In 2021, children accounted for only 4 percent of all people living with HIV but 15 per cent of all AIDS-related deaths. Closing the treatment gap for children will save lives.

“Discrimination against, stigmatisation and criminalisation of key populations are costing lives and preventing the world from achieving agreed AIDS targets. “New analysis shows no significant decline in new infections among gay men and other men who have sex with men in both the western and central Africa and eastern and southern Africa regions,” she said.

The report showed that around the world, over 68 countries still criminalise same sex sexual relations. Another analysis highlighted in the report found that gay men and other men who have sex with men who live in African countries with the most repressive laws are more than three times less likely to know their HIV status than their counterparts living in countries with the least repressive laws, where progress as far more rapid. Sex workers who live in countries where sex work is criminalised have seven times greater chance to be living with HIV than in countries where sex work was legal or partially legalised.

It showed that donor funding was helping to catalyse increased domestic funding. According to the report, new investments to address HIV-related inequalities were urgently needed. The report also showed that 2021, funding available for HIV programmes in low- and middle-income countries was $8 billion short.

[ThisDay]