The Covid-19 pandemic and the fight against HIV/AIDS: global solidarity needed!
The Covid-19 pandemic has shifted the attention of decision-makers away from their previous commitments, such as the fight against HIV. For our last GenerAction essay, we dive into the three 95 percent goal and the objective to end this epidemic by 2030.
A “scandal” and a “stain on our collective conscience”. These were the words used by Tedros Adhanom Ghebreyesus, the Director General of the World Health Organisation, in reference to the recently released data of the United Nations Joint Programme on HIV/AIDS, depicting the stark reality that in 2021 only half of children living with HIV were receiving treatment.
While the world’s eyes have been frantically moving in the past year from one crisis to another, our progress against HIV has faltered significantly. If we are still aiming to reach the UN Sustainable Development Goal to end the epidemic by 2030, we must take urgent action now.
The fight against HIV is a challenge I started working on as I was 19 years old when I first joined the Lebanese Red Cross in Lebanon. As a youth volunteer in Byblos and Jounieh, I became a trainer in a peer-to-peer prevention program that developed essential life skills in youth and created a safe platform to learn about and discuss matters like healthy relationships, substance abuse, and sexually transmitted infections like HIV.
Today, as a Youth Ambassador with the ONE Campaign in Brussels, my fellow volunteers and I are tackling the problem from another angle: international solidarity.
During our GenerAction campaign, we engaged with policymakers across Europe asking them to take urgent and bold action to ensure that decades of progress don’t slip from our hands, and with them millions of preventable infections and deaths. How? By investing in an already vetted mechanism, the Global Fund.
Since its inception 20 years ago, this international partnership has saved 44 million lives through its HIV, tuberculosis and malaria programs. It provides 25 percent of all international financing for HIV programs and in countries where it has a presence, has reduced AIDS-related deaths by 65 percent and new infections by 54 percent.
However, the impact of the Covid-19 pandemic on the HIV epidemic has not been small, and we are yet to fully understand its consequences. Compared with 2019 pre-pandemic levels, HIV tests taken in 2020 fell by 22 percent on average (and as much as 50 percent in some places, while the number of people reached by prevention programs and services fell by 11 percent.
The 95-95-95 goal
A key part of the UNAIDS global strategy to end the epidemic by 2030 is to reach the 95-95-95 target.
Such a goal aims to have 95 percent of all people infected with HIV aware of their positive status; of those people, have 95 percent of them on sustainable antiretroviral therapy (ART); and of those on treatment, have 95 percent with suppressed viral loads. This means that the virus would be present in such low amounts in the patient’s body, that their immune system functions well, and they cannot transmit the virus.
Where do we stand today? 85-88-92.
Similarly, the global strategy also aims to reduce by 90 percent all new infections and deaths by HIV in 2030 compared to 2010 levels. Today, we have managed to achieve barely a 37 percent and 47 percent reduction in new infections and deaths respectively.
Behind these numbers and statistics are 38 million individuals living with HIV, 67 percent of whom live in Sub-Saharan Africa. Indeed, just like the Covid-19 pandemic, diseases like HIV also tell a story of deep-seated inequalities.
Twenty-five percent of new HIV infections in Sub-Saharan Africa are in adolescent girls and young women, despite them being only 10 percent of the population. The Covid-19 pandemic threatens to further widen this gap as UNESCO estimates that 11 million girls around the world may not go back to school next year. Outside school, girls are at a much higher risk of abuse, violence, and teenage pregnancies, which are in turn big risk factors for HIV.
These concerns have recently been expressed by high-profile women leaders in a letter addressed to European Commission President Ursula Von Der Leyen.
We need to support local communities
On the other hand, the Covid-pandemic has also highlighted the resilience of many communities in their fight against HIV. Eswatini is a clear example of this. Although it’s a country of only 1 million people, 27 percent of its people live with HIV.
Yet, they’re also the only country, along with Switzerland, to have reached the 95-95-95 goal a whole decade before the 2030 deadline. This great progress was threatened to be lost by Covid-19-induced poverty and lockdowns, as people struggled to access their medications and essential sexual and reproductive services.
Girls and women were particularly at risk as reports of gender-based violence and teenage pregnancies increased. With the help of grants from the Global Fund, local organisations led by women successfully developed and adapted their HIV prevention programs to reach vulnerable groups remotely, using social media recruitment campaigns and conference call technology to deliver their sessions.
So many stories exist about local organisations and community-led initiatives that are creatively using available resources and technologies to maintain their progress against HIV. There is no lack of effort at the individual and local level, but it must be matched at the global level.
These local initiatives are often funded by organisations like the Global Fund, which brings us to a critical opportunity we must not miss. In a few weeks, the United States will be hosting the Global Fund’s seventh replenishment. Of the 18 billion dollars (18,01 billion euros) requested, the European Union’s fair share requires an investment of 715 million euros, a 30 percent increase from the last call, reflecting the extra cost needed to compensate for the setback that Covid-19 has caused in the fight against the three epidemics.
With no shortage of competing global crises on the agendas of politicians, there is a palpable risk that important players in the fight against HIV/AIDS, like the Global Fund, are left underfunded, threatening to undo decades of progress in our fight against the disease (we have already seen this happening at the G7 with the failure to scale-up the response to the food security crisis). We must not allow that to happen. That’s why we’re speaking up…will you speak up too?