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Jakarta Post

Seizing the moment: Tackling entrenched inequalities to end epidemics

Seizing the moment: Tackling entrenched inequalities to end epidemics Illustration of antiretroviral (ARV) drug commonly consumed by HIV patients. (Shutterstock/joel bubble ben)
Winnie Byanyima
Geneva   ●   Wed, July 8, 2020 2020-07-08 13:26 311 6657ac82168da9fa101c8a40664c4e7d 3 Opinion HIV-AIDS,HIV-in-Indonesia,UNAIDS,epidemics,AIDS Free

Like the HIV epidemic before it, COVID-19 is exploiting the extreme inequalities between countries and within them to take root among disadvantaged and vulnerable communities. I am proud that decades of experience in responding to HIV are being used in the fight against the coronavirus and that activists all over the world are working hard to make sure that the disruption to HIV services is minimized.

But I am also deeply concerned.

Even before the onset of COVID-19, the world was failing in its commitment to end the HIV epidemic by 2030. The UNAIDS new Global Report, Seizing The Moment: tackling entrenched inequalities to tackle epidemics, shows that there were 690,000 AIDS-related deaths in 2019 and 1.7 million new infections—far from the global targets of fewer than 500,000 deaths and 500,000 new infections a year that were set for 2020.

The collective failure to implement and sufficiently invest in comprehensive, rights-based HIV responses has come at a dreadful price. There were 3.5 million more HIV infections and 820,000 more AIDS-related deaths from 2015 to 2020 than the world had aimed to achieve.

This is unacceptable when we have medicines to keep people living with HIV alive and well and an array of prevention tools to stop new infections. We are being held back by entrenched inequalities that put vulnerable and marginalized groups of people at higher risk of becoming infected with HIV and dying of AIDS-related illnesses.

More people are on treatment than ever before. Globally around 25.4 million of the 38 million people living with HIV are accessing life-saving antiretroviral therapy, but 12.6 million people are not. Indonesia only has 33 percent of people diagnosed with HIV on life-saving treatment.

As ever, it is the most vulnerable who pay the price. Every day, marginalized groups such as gay men, sex workers, transgender people, people who use drugs, prisoners and migrants are prevented from receiving proper health care and are criminalized and marginalized. Denied their right to health, these groups and their sexual partners comprised 62 percent of all new adult infections in 2019.

Meanwhile, women and girls are too often denied their sexual and reproductive health and rights, while gender-based violence and gender inequalities continue to drive the epidemic forward among young women and girls.

It is estimated that globally 243 million women and girls aged 15-49 years have been subjected to sexual and/or physical violence perpetrated by an intimate partner in the past 12 months. months. In Indonesia, the National Commission on Violence Against Women reported more than 400,000 reported cases of violence against women in 2019. Meanwhile, we know that women who experience such violence are 1.5 times more likely to acquire HIV than women who have not experienced violence. 

All this must change, and we have to act on multiple fronts. In Indonesia for instance, various civil society groups, development partners and academics are strongly advocating for the Bill on the Elimination of Sexual Violence which aims to expand the definition of sexual violence with a focus on protection and victim restitution.

Just like HIV, COVID-19 holds up a mirror to the stark inequalities and injustices that run through our societies. The COVID-19 pandemic will also be exacerbated unless we address the human rights impact on vulnerable people and their lack of access to health services, education, protection from violence and social, economic and psychological support.

Successful pandemic responses are grounded in human rights, implement evidence-based programming, and should be fully funded to achieve their targets.

HIV has been slipping down the international agenda for some years. Now, I am calling on leaders to convene a new United Nations High-Level Meeting on Ending AIDS next year to address with urgency the outstanding issues that are holding us back from ending AIDS as a public health threat by 2030.

We cannot drop the ball on HIV. The futures of millions of people are at stake.

The UNAIDS 2020 global report is a call to action. It highlights the terrible scale of the HIV epidemic and how it runs along the fault lines of inequalities.

We can and must close the gaps.


Executive director of UNAIDS

Disclaimer: The opinions expressed in this article are those of the author and do not reflect the official stance of The Jakarta Post.