We cannot divert funding from the HIV and AIDS response
“Responding to COVID-19 must not be a zero-sum game. Somehow, we have to integrate our response with the existing landscape of global health. …all of us who work in global health must ensure that we don’t turn away from a wider perspective on health. For, if we do, the pandemic will have inflicted two mortal wounds on the world.” Richard Horton, The Lancet
In light of a recent analysis conducted by the World Health Organization and UNAIDS, FCAA is calling on private philanthropy to safeguard the resources required to fight HIV and AIDS during the ongoing COVID-19 pandemic.
COVID-19-related interruptions to health services and supplies in sub-Saharan Africa will have a devastating impact on the response to HIV and AIDS, according to the findings of a modeling group convened by the World Health Organization and UNAIDS. The modeling shows more than a decade of progress is at risk, unless we make enormous efforts to mitigate and overcome interruptions. In fact, the current crisis may pose the biggest single threat to progress since the earliest days of government inaction and complacency. As it was back then, it is incumbent upon private philanthropy to not only maintain, but to redouble its efforts.
The modeling group suggests the impact will be felt in both the short and long term. A six-month disruption could lead to as many as 500,000 additional deaths from AIDS-related illnesses, including tuberculosis, in the next year and an annual average excess death rate of 40% for the next five years. The findings show that:
In sub-Saharan Africa, an estimated 25.7 million people were living with HIV and 16.4 million (64%) were taking antiretroviral therapy in 2018. Those people now risk having their treatment interrupted because HIV services are closed or are unable to supply antiretroviral therapy because of disruptions to the supply chain or because services simply become overwhelmed due to competing needs to support the COVID-19 response.
The COVID-19 pandemic has also created an environment which exacerbates human rights violations and gender-based violence. It presents complex challenges in terms of reaching key populations, such as people who inject drugs and sex workers, who are already stigmatized and hesitant or unable to seek treatment. Per UNAIDS:
Since the start of the COVID-19 pandemic, there have been news reports of murders of transgender people in Puerto Rico, arrests of LGBTI people in Egypt, the United Republic of Tanzania and Uganda and increasing violence and abuse in Cameroon and the Republic of Korea.
Without concerted efforts to mitigate the impacts of the disruption, it is almost certain that the HIV and AIDS targets identified for 2030 will remain out of reach. As so many informed stakeholders have noted since the onset of the pandemic, the current environment is all too reminiscent of the early days of the global AIDS crisis. We should take that as inspiration to fight as hard as we did at that time – protecting gains made to date and ensuring continued progress.
It is a time when we must maintain and increase funding for these efforts. We must not only mobilize resources for the tools and programs we know work, but we must also hold governments and global institutions accountable, ensuring policies to address COVID-19 do not violate human rights or further stigmatize and marginalize key populations. As UNAIDS’ Executive Director, Winnie Byanyima, aptly states, “The COVID-19 pandemic must not be an excuse to divert investment from HIV…The right to health means that no one disease should be fought at the expense of the others.”
Our community is well positioned to remind the world of that.