Message of the WHO Regional Director for Africa, Dr Matshidiso Moeti
As a working-class Senegalese man, Mbaye (not his real name) was proud of his success in 2019. But by 2020, his clothes were floating around his body. He went for an HIV test and discovered he had AIDS. His pregnant wife also tested positive. The family hastened to Dakar, Senegal’s capital, from Thies, in west-central Senegal, and were started on antiretroviral drugs for their health and to prevent the infection of the unborn child. “Thank heavens, my son tested negative at birth,” exclaimed Mbaye. The experience of Mbaye is not every family’s experience across the continent. This prompts us to call for AIDS not to slide down the priority list.
No other day is more appropriate for this call than today, 1 December, when we yearly come together with the global community to mark World AIDS Day. We support people living with HIV and remember those who have lost their lives to AIDS. This year, the theme is “Equalize” urging each of us to address the inequalities driving the epidemic and holding back progress in ending AIDS.
At the United Nations General Assembly high-level meeting on AIDS in 2021, world leaders adopted the Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. The Heads of State and Government committed to end all inequalities faced by people living with - and affected by - HIV in communities and countries, which are barriers to ending AIDS. With 25.6 million people living with HIV, the African Region continues to be most affected.
Nevertheless, progress has been made over the past decade, reducing new infections by 44% and reducing AIDS-related deaths by 55%. This progress was made because WHO and partners: 1) advocated for and supported the expansion of new HIV prevention and treatment technologies; 2) provided guidance on combination HIV prevention, testing and treatment; 3) built capacity in countries to improve data availability and quality; 4) increased access to affordable medicines, diagnostics and health technologies; and 5) supported national HIV treatment catch-up plans in west and central Africa.
Even so, 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. Four decades into the HIV response, inequalities persist for the most basic services like testing and treatment.
For example, HIV prevention programmes reach only 40% 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 criminalisation, discrimination, and stigma. They include sex workers, men who have sex with men, people who inject drugs, people in prisons and detention and transgender people.
With only eight years left to the 2030 goal of ending AIDS as a global health threat, coordinated action is required to stop the effects of the epidemic, with a precise focus to reach those most affected—especially children, adolescent girls, women, and key populations.
This World AIDS Day, I urge governments and partners to close the inequality gaps in the progress toward ending AIDS by focusing on the populations that are being left behind. We need to put people at the center of the response by organising services around people’s needs and promoting integrated patient-centered approaches that are strongly linked with primary health care services. All Member States, supported by partners, should expand, and sustain access to essential HIV prevention and treatment services by all, using innovative service delivery models. We 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.
Finally, I call on the community leaders to reach out and assist their populations with access to HIV services when needed. The leaders and all communities should combat stigma and discrimination by ensuring that everyone feels safe to access HIV services.