Richard Amenyah | The relevance of celebrating World AIDS Day

Since 1988, the world has celebrated World AIDS Day in remembrance of those who died of AIDS-related illnesses and those living positively and bravely with HIV. World AIDS Day remains as relevant today as it has always been, reminding people and governments that HIV has not gone away. There is still a critical need for increased funding for the AIDS response, to increase awareness of the impact of HIV on people’s lives, to end stigma and discrimination and to improve the quality of life of people living with HIV.

After 40 years of the HIV pandemic, there is still no cure or efficacious vaccine. However, there are antiretroviral drugs for treating HIV as a chronic manageable illness. Having HIV is no longer a death sentence like it used to be. But critical questions remain: Why are people still contracting HIV? Why are people still dying of AIDS today? Why are children still born with HIV?

The answers to these questions point to rampant inequalities. That is why we continue to celebrate World AIDS Day until we end AIDS as a public health threat. Inequalities and their varied intersectionalities drive the AIDS pandemic. They manifest in a variety of ways in different settings and circumstances. Inequalities include legal and policy barriers, and cultural, social and economic factors that exacerbate the HIV epidemic in communities. Inequalities widen when governments clamp down on marginalised communities instead of repealing outdated laws, and inhibiting control instead of promoting and enabling inclusive, community-centred delivery.

Inequalities in access to quality HIV services and financing for public health programmes negatively impact on the resilience of community HIV responses as well as the capacity to close HIV-related inequalities which increases HIV vulnerability and further diminishes access to HIV services.

We cannot end AIDS without ending inequalities.

Inequalities within and between communities or countries are stalling progress in the HIV response, and HIV is widening those inequalities. Punitive and discriminatory laws and policies, for example, undermine the AIDS response by pushing people away from the services they need and weakens public health efforts to reach those most at risk of new HIV infection or death. Removing these laws will help get the AIDS response back on track. Putting vulnerable women and girls at the centre of the AIDS response, alongside well-resourced efforts to eliminate gender-based violence, helps them to realise their sexual and reproductive health and rights.

Addressing inequalities and closing the gaps helps to increase access to HIV prevention, testing and treatment services and improve their health outcomes.

CALL TO ACTION

In the Caribbean, new HIV infections have reduced by 28 per cent since 2010 while AIDS-related deaths have reduced by over 50 per cent. This progress is significant and very impressive. In the case of Jamaica, new infections have reduced by 12 per cent since 2010 (11 per cent among males and 14 per cent among females) whereas AIDS-related deaths have declined by 16 per cent (but only six per cent among males and 28 per cent among females).

This year’s call to action, for World AIDS Day, is encouraging more men to utilise available HIV services. There is need to reach men where they are and educate them about early health seeking behaviours like women do. There is need for more man-to-man’ talk about their risk to HIV; breaking down barriers to accessing HIV services, including their other general health needs; there is need for healthcare providers to have a tailored package of health services for men, addressing their physical and mental health needs and having a conversation about masculinity as well as stigma and discrimination which compromises the health and health seeking behaviours of men.

By breaking down legal, cultural, social and economic factors which help fuel inequalities, the Caribbean would be able to fast-track the HIV response to end AIDS by 2030, as a public health threat.

UNAIDS calls on governments to:

* Increase availability, quality and suitability of services for HIV treatment, testing and prevention, so that everyone is well served.

* Work towards achieving the 10-10-10 targets through reform of laws, policies and practices to tackle the stigma and exclusion faced by people living with HIV and by key and marginalised populations, so that everyone is shown respect, dignity and self-worth and feels included.

* Acquire and expand on large-scale access to medical technologies and innovation (e.g., long-acting pre-exposure prophylaxis) to enable equal access to the best HIV science.

* Increase partnership and collaboration between state and non-state actors and invest more to strengthen civil society and communities living with or affected by HIV. We cannot end AIDS without sharing our responsibilities and the meaningful engagement of communities at the centre of the response to strategically tap into their local knowledge, local capacities and innovations.

Responding to these is not easy but it’s not impossible to do. Governments must address inequalities to end AIDS as a development issue, a human rights issue, a gender issue, and a health issue. It requires bold and accountable leadership to meet the needs of communities living with or affected by HIV. There is need for courageous marshalling of a whole-of-government and a whole-of-society approach to remove barriers due to inequalities and inequities to improve the health and wellbeing of people and to attain all the related sustainable development goals.

THE RESPONSE

The global HIV response has faltered and been knocked off track due to the COVID-19 pandemic, the war in Ukraine and other global crises resulting in diversion of development resources to other areas of need. These realities are putting millions of lives at risk of HIV due to the widening inequality gaps in accessing basic services like testing, treatment, and condoms. We need to stop and protect the 270 people who get infected with HIV every week in the Caribbean and the 110 people who die weekly of AIDS in the Caribbean.

Wear your red ribbons with great pride, which is the universal symbol of awareness of, support for, and solidarity with people living with HIV. Continue with your advocacy and awareness efforts about HIV; continue with your local resource mobilisation drives and get governments and businesses to act and to finance human rights and anti-stigma and discrimination programmes in communities and at the workplaces.

I conclude in the words of Winnie Byanyima, UNAIDS executive director, “We can end AIDS – if we end the inequalities which perpetuate it. This World AIDS Day we need everyone to get involved in sharing the message that we will all benefit when we tackle inequalities.”

“To keep everyone safe, to protect everyone’s health, we need to equalise.”

Richard Amenyah is a medical doctor from Ghana and is the UNAIDS Multi-Country Director for the Caribbean. Send feedback to columns@gleanerjm.com