UNAIDS warns of millions of AIDS-related
deaths and continued devastation from pandemics if leaders don’t address inequalities
GENEVA, 29 November 2021—UNAIDS issued a stark warning today that if leaders fail to tackle inequalities the world could face
7.7 million* AIDS-related deaths over the next 10 years. UNAIDS further warns that if the transformative measures needed to end AIDS are not taken, the world will also stay trapped in the COVID-19 crisis and remain
dangerously unprepared for the pandemics to come.
“This is an urgent call to action,” said UNAIDS Executive Director Winnie Byanyima. “Progress against the AIDS pandemic, which was already off track, is now under even greater
strain as the COVID-19 crisis continues to rage, disrupting HIV prevention and treatment services, schooling, violence-prevention programmes and more. We cannot be forced to choose between ending the AIDS pandemic today and preparing for the pandemics of tomorrow.
The only successful approach will achieve both. As of now, we are not on track to achieve either.”
The warning comes in a new report by UNAIDS launched ahead of World AIDS Day (1 December) entitled Unequal, unprepared, under threat: why bold action against inequalities is needed to end AIDS, stop COVID-19 and prepare for future pandemics.
including some with the highest rates of HIV, have made remarkable progress against AIDS, illustrating what is feasible. However, new HIV infections are not falling fast enough globally to stop the pandemic, with 1.5 million new HIV infections in 2020 and
growing HIV infection rates in some countries. Infections are also following lines of inequality. Six in seven new HIV infections among adolescents in sub-Saharan Africa are occurring among adolescent girls. Gay men and other men who have sex with men, sex
workers and people who use drugs face a 25–35 times greater risk of acquiring HIV worldwide.
COVID-19 is undercutting the AIDS response in many places. The pace of HIV testing declined almost uniformly and fewer people living with HIV initiated
treatment in 2020 in 40 of 50 countries reporting to UNAIDS. HIV prevention services have been impacted—in 2020, harm reduction services for people who use drugs were disrupted in 65% of 130 countries surveyed.
“It is still possible to end
the epidemic by 2030,” affirmed United Nations Secretary-General António Guterres in his World AIDS Day message. “But that will require stepped up action and greater solidarity. To beat AIDS—and build resilience against the pandemics
of tomorrow—we need collective action.”
This new report from UNAIDS examines five critical elements of the plan agreed by Member States at the United Nations General Assembly High-Level Meeting on AIDS that must be urgently implemented to
halt the AIDS pandemic and which are critical but under-funded and under-prioritized for pandemic prevention, preparedness and response. These include:
- Community-led and community-based infrastructure.
- Equitable access to medicines, vaccines
and health technologies.
- Supporting workers on the pandemic front lines.
- Human rights at the centre of pandemic responses.
- People-centred data systems that highlight inequalities.
The call for upscaled investments
and shifts in laws and policies to end the inequalities that drive AIDS and other pandemics is backed by leaders in global health and pandemic response from across the world.
“If we do not take the steps needed to tackle the inequalities
driving HIV today, not only will we fail to end the AIDS pandemic, we will also leave our world dangerously unprepared for future pandemics,” said Helen Clark, Co-Chair of the Independent Panel for Pandemic Preparedness and Response, in a special foreword
to the UNAIDS report. “Pandemics find space to grow in the fractures of divided societies. The amazing scientists, doctors, nurses and communities who work to end pandemics cannot succeed unless world leaders take the steps that will enable them to do
UNAIDS and global health experts emphasize that while business as usual would kill millions and leave the world trapped with colliding pandemics going on for decades, leaders can, by acting boldly and together to tackle the inequalities in
which pandemics thrive, end AIDS, overcome the COVID-19 crisis and be protected from the pandemic threats of the future.
“Pathogens ranging from HIV to the virus behind COVID-19 invade the cracks and fissures in our society with startling opportunism,”
said Paul Farmer of Partners in Health, a nonprofit that for decades has effectively treated AIDS in settings of material poverty. “That the AIDS pandemic is shaped by deep structural inequalities need not resign us to inaction, however. Our teams, in
rural Haiti and across the world, have routinely shown that with comprehensive care delivery, robust forms of accompaniment and social support and a larger dose of social justice, disparities in HIV outcomes can be rapidly narrowed, and health systems swiftly
strengthened. We shouldn’t settle for anything less.”
This year marks 40 years since the first cases of AIDS were reported. Since that time, where investments have met ambition, there has been huge progress, particularly in expanding
access to treatment. By June 2021, 28.2 million people had access to HIV treatment, up from 7.8 million in 2010, although progress has slowed considerably.
Countries with laws and policies aligned to evidence, strong community engagement and participation
and robust and inclusive health systems have had the best outcomes, whereas the regions with the largest resource gaps and countries with punitive laws and that have not taken a rights-based approach to health have fared the worst.
“We know what
works from seeing brilliant AIDS responses in some places,” said Ms Byanyima, “but we need to apply that everywhere for everyone. We have an effective strategy that leaders adopted this year, but it needs to be implemented in full. Ending inequalities
to end AIDS is a political choice that requires bold policy reforms and requires money. We have reached a fork in the road. The choice for leaders to make is between bold action and half-measures.”
* The estimate of 7.7 million AIDS-related
deaths between 2021 and 2030 is what UNAIDS models predict if HIV service coverage is held constant at 2019 levels. If the Global AIDS Strategy 2021–2026: End Inequalities, End AIDS is executed and the 2025 targets are achieved, UNAIDS
estimates that at least 4.6 million of those deaths can be averted over the decade