Inequalities and discrimination are stalling progress in the HIV response worldwide

Inequalities and discrimination are stalling progress in the HIV response worldwide

As World AIDS Day approaches, on 1 December, Aidsfonds is sounding the alarm. The HIV epidemic is growing once again, in more and more countries, even whole regions of the world. In 45 countries, more people are becoming infected with HIV each year. A new Aidsfonds report published today says that the global response to HIV is stalling because of increasing inequalities, and is not on track to end one of the world’s deadliest epidemics – HIV and AIDS.

With the knowledge and treatment available today, the HIV epidemic should be slowing. But in large and densely populated regions of the world, numbers of new HIV infections are rising dramatically. In Eastern Europe and Central Asia, as well as the Middle East and North Africa, the HIV epidemic has grown steadily in the past 10 years. In Asia and in Latin America, where HIV had been reasonably under control, there are now increasing numbers of HIV infections.

As a result of this, the global response to the HIV epidemic is faltering like never before. In 2021, another 1.5 million people were newly infected with HIV. And in the past year, more than 650,000 people died of AIDS-related causes. 10 million people are still not receiving life-saving drugs.

Inequalities and discrimination drive the HIV epidemic. Too many people are excluded from life-saving care and treatment simply because of who they are, where they live and who they love. In more and more countries, there is a lack of political will to invest in accessible healthcare, a fundamental right that is not being upheld. That is ruthless - and disastrous for the global response to AIDS. Despite 40 years of efforts and scientific advances, things are really going backwards again in too many countries.” 

Mark Vermeulen, Aidsfonds Executive Director

Discriminating against key populations

Numbers of HIV infections among key populations have risen significantly in the past year, from 62% to 70% in 2021. Gay men, transgender people, sex workers and drug users plus their sexual partners are all facing stigma and discrimination in more and more countries. This makes it almost impossible for them to access prevention and treatment.

In El Salvador, for example, the number of HIV infections among men who have sex with men has doubled in 1 year, and among transgender women the number is 8 times higher than the year before. In Russia, drug users and their sexual partners are at 35 times higher risk of becoming infected with HIV than other adults.

Excluding young people and women

The worldwide increase in HIV infections is particularly visible among young people between the ages of 15 and 24. Girls and young women in sub-Saharan Africa are hit disproportionately hard by the HIV epidemic. They are 3 times more likely to become infected with HIV than boys and young men of the same age. A lack of education and information, and being unable to insist on condom use, are the main reasons for this. Since the COVID pandemic began, physical violence against women has increased.

Funding shortfall

For the second year running, the countries with most of the people living with HIV have frozen their budgets for the HIV response. The money was needed for the response to COVID and the economic crisis that followed.

Many Western donor countries, with the exception of the US, are not keeping their promises. In the past 10 years, their contribution to the AIDS response in low- and middle-income countries has declined by an alarming 57%. This year, The Global Fund to Fight AIDS, Tuberculosis and Malaria called on international donors, including the Netherlands, to substantially increase their contribution for the coming 3 years - by 30%. Some countries have done just that. The Dutch government did not, only increasing its contribution by 15%.

“The global ambition to end AIDS must not falter. The Dutch government must continue to uphold the right to health for women and minorities, and continue to contribute to global funding of the AIDS response. That is vital, because Western donors are not keeping their promises, and exclusion from HIV care and treatment is increasing everywhere,” according to Mark Vermeulen.

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