The U.N. Program on HIV and AIDS warns that stigma and discrimination against marginalized populations are driving both the AIDS crisis and COVID-19 and must be tackled and eliminated to end what officials call the dual, colliding pandemics.
In a report released in advance of World AIDS Day on December 1, the U.N. agency called on governments to put the most vulnerable at the center of their pandemic responses.
HIV/AIDS emerged nearly 40 years ago. While progress in the treatment of the disease has been made, AIDS remains a public health menace. Last year, UNAIDS reported 1.7 million people were infected with HIV and 690,000 died.
Health officials said the global response to ending AIDS as a public health threat by 2030 was off track even before the COVID-19 pandemic hit. The rapid spread of coronavirus, they said, is creating additional setbacks.
Part of UNAIDS’ new strategy for tackling AIDS is to direct money to the people most at risk. Yet, Sigrid Kaag, minister for foreign trade and development cooperation in the Netherlands, said that is not happening.
She noted a study commissioned by the Netherlands found only 2 percent of AIDS funding worldwide targets those who are most at risk.
“Sixty-two percent of new HIV infections are among gay men, sex workers, drug users and transgender people," Kaag said. "How can we end the HIV pandemic, or any pandemic for that matter, if we ignore those most at risk? Stigma and criminalization impede access to medical services, and this is exactly how pandemics continue to spread.”
Eastern and southern Africa is the region most heavily affected by HIV. The region is home to nearly 21 million out of the 38 million people living with HIV worldwide. The study said 12 million were not receiving treatment for their illness.
Yet even under these circumstances, countries such as Eswatini and Botswana in sub-Saharan Africa and Cambodia and Thailand in Asia have made remarkable progress in tackling the deadly disease by implementing people-centered policies.
UNAIDS Executive Director Winnie Byanyima said governments must focus on helping the most vulnerable, marginalized people. She said they must target preventive measures and reproductive and other health services toward them and not just implement policies that are politically palatable.
“We are going to have to be more focused, focusing on the hot spots, not choosing what we want to address because that is what we are comfortable with," Byanyima said. Efforts must be "evidence based, targeting closely where the risk is, not where we do not want to see.”
Byanyima said governments also must focus on reducing the inequalities that are the drivers of HIV and COVID-19. She said more investment must be made in strengthening health systems and providing treatment and care to all in need. She said respecting the human rights of people most at risk is crucial in beating back the twin pandemics.
