Inequalities threaten Africa's gains in fighting HIV/AIDS

Despite progress being made in Africa's fight against HIV/AIDS over the past decade with the continent reducing new infections by 44 percent and reducing AIDS-related deaths by 55 percent, inequalities still persist for the most basic services like testing and treatment thereby slowing down the fight against the epidemic.

In a report titled 'Dangerous Inequalities' released by the UNAIDS ahead of the World AIDS Day, which falls on Thursday, experts argue that gender inequalities, inequalities faced by key populations and inequalities between children and adults pose a threat to the gains made in the fight against HIV/AIDS so far.

In her message on World AIDS Day, Matshidiso Moeti, WHO regional director for Africa, said that discrimination, stigmatization and criminalization of key populations are costing lives and preventing the world from achieving agreed AIDS targets.

"Despite measures being put in place to fight the epidemic, the progress is slow and inequalities persist in HIV prevention, testing and treatment services. Data from WHO on the global HIV response reveals that since the start of COVID-19 and other global crises, progress against the HIV pandemic has wavered, resources have decreased and millions of lives are at risk," Moeti said.

"For example, HIV prevention programs reach only 40 percent of adolescent girls and young women. Only one in three key populations, who are particularly vulnerable to HIV, have regular access to HIV prevention services and they still face significant structural barriers, including criminalization, discrimination and stigma," she added.

Winnie Byanyima, executive director of UNAIDS also said that currently, the world is not on track to end AIDS by 2030 and the reason is inequality. While issuing her statement on this year's World AIDS Day which is themed 'Equalize', she said that discrimination against marginalized people is hurting the HIV response.

"We will not end AIDS unless we can end it for everyone. An inequality that breaks my heart is that against children living with HIV. With the science that we have today, no baby should be born with HIV and no child who has HIV should be without treatment. But today, while three quarters of adults living with HIV are on treatment, only half of children are. This is intolerable," Byanyima said.

Another major obstacle obstructing Africa's fight against HIV/AIDS identified in the UNAIDS Dangerous Inequalities report is gender inequality.

"Gender inequalities are a key driver of the AIDS epidemic. Adolescent girls and young women in sub-Saharan Africa are three times more likely to acquire HIV than their male counterparts. Unequal power dynamics between men and women and harmful gender norms increase the HIV vulnerability of women and girls in all their diversity, deprive them of their voice and the ability to make decisions regarding their own lives thereby hampering their ability to mitigate the impact of AIDS," the report said.

To end the impact of inequality in Africa's fight against the disease, Moeti called on African governments to expand and sustain access to essential HIV prevention and treatment services by all, using innovative service delivery models. She said that Africa must ensure that everyone everywhere has equal access to HIV prevention, testing, treatment and care.

"I urge the ministries of health to build resilient and adaptable health systems that can detect inequalities and provide appropriate approaches to address those inequalities. This requires financial investment, integrated laboratory systems, a well-trained and adequate health workforce, equitable access to medicines and robust data systems," Moeti said.