Dar Es Salam -Tanzania
Global efforts to combat HIV/AIDS are largely hampered by increasing inequalities especially in South Saharan Africa, according to the new UNAIDS report 2022.
The report dubbed ‘Dangerous Inequalities’ was launched in Dar Es Salaam, Tanzania on Tuesday. It reveals how inequalities are obstructing global commitments and progress in ending HIV/AIDS epidemic by 2030.
Winnie Byanyima, the Executive Director of UNAIDS and the Under Secretary General for the United Nations, confirmed that the world is not on track in ending HIV/ AIDS epidemic by the set target due to the widening inequality gap.
“But by equalizing, which is possible, we can end AIDS. How? We must equalize (for women and girls) to reduce their risk of HIV infection,” she explains.
According to Byanyima, the women and girls in Sub-Saharan Africa are three times (x3) more likely to be infected with HIV than men and boys of the same with inequality as a key driving factor.
“If we can enable girls to stay in school until they complete secondary education, this will reduce their vulnerability to HIV infection by up to 50%. And if we include in the comprehensive sexuality education i.e learn how to protect themselves, then this risk is reduced even further,” she adds.
Through Education Plus (EP), an initiative supported by the UNAIDS, at least twelve (12) African countries have come together to promote free and quality secondary education for all girls and boys in sub-Saharan Africa by 2025.
.The initiative further promotes universal access to comprehensive sex education, fulfilment of sexual and reproductive health and rights, freedom from gender-based and sexual violence; school-to-work transitions, and economic security and empowerment.
Beyond this, Byanyima continues, there need to combine services for Sexual and Reproductive health, together with services for preventing and responding to Sex and gender-based violence, and services for preventing and responding to HIV.
“We must design these three sets of services in such a way that they are tailored to meet the needs of girls and women in all their diversity groups,” she noted, adding that the strategy was tested and it worked in Malawi in Machinga district since the HIV/AIDS prevalence among girls and women fell by over 30 per cent in two years.
Byanyima urged all governments in the Sub-Saharan region to scale up these programs and reach every girl because they are such vital interventions that girls need in the HIV campaign.
Four decades into the HIV response, UNAIDS maintains, inequalities still persist for the most basic services such as testing, treatment, and condoms, and more so, for the new technologies.
Ending AIDS in children
The report further points out the treatment gap for children that can be closed if more pregnant and breastfeeding women and their infants are supported to confirm the child’s HIV status at birth and at the end of breastfeeding.
It advocates for intensified, mother-centred strategic efforts needed to prevent vertical transmission. Still, the recent optimization of child treatment has led to increases in viral load suppression among children who are receiving antiretroviral therapy.
With concern about the inequality against Children Living with HIV, Byanyima says the gap is widening amid all improved science and services that are needed to prevent further infections.
With the availability of advanced science today such as the Prevention of Mother To Child transmission, babies should be born without the virus. “And those with HIV should not live without treatment because there’s necessary service in place,” she maintains.
Equalize Campaign
The “Equalize” slogan is a call to action that stimulates all stakeholders to work for the proven practical actions that are needed to address inequalities and assist the efforts to end AIDS.
According to the UNAIDS, the slogan aims at increasing the availability, quality and suitability of services, for HIV treatment, testing and prevention, so that everyone is well-served.
It further looks at reform 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 and is welcomed.
Another aim is to ensure the sharing of technology to enable equal access to the best HIV science, between communities and between the Global South and North.
And lastly to ensure the communities will be able to make use of and adopt the “Equalize” message to highlight the particular inequalities they face and to press for the actions needed to address them.
Stigma and Discrimination
Stigma, in simpler terms, is a sentence passed by society on people for who they are and therefore the report suggests the need to end stigma against People Living with HIV since stigma in kills. It appeals to the cultural, traditional, political, religious and leaders.
According to Byanyima, there is a need to fight major barriers including criminalization, discrimination and stigma which limit people’s access to effective HIV services, especially in Uganda and Tanzania among other Sub-Saharan African countries.
She insists that some marginalized groups such as people who use drugs, sex workers, prisoners and others are usually sidelined when it comes to HIV/AIDS services.
“Discrimination against marginalized people is hurting and breaking the HIV response globally. Such as men engaging in same-sex are 28 times more likely to be infected than other men,” she noted.
The people using drugs, she continues, have 35 times the risk of infection, and commercial sex workers are 30 times the risk, while transgender women are 14 times the risk.
Byanyima says with emphasis “We will not end AIDS unless we end it for everyone. When we decriminalise, people will come forward and get the services because decriminalising saves lives.
In countries where same sex relationships are legalized, she reveals, the infection rate is lower among these groups than it is in countries where it is still illegal. However, cultural/ traditional and faith-based leaders together with Members of Parliament in Uganda are strongly opposed to UNAIDS’ appeal to legalise same-sex in Uganda.
NACOPHA Officials
Bahati Tenga, a researcher from the National Council of People Leaving With HIV –(NACOPHA) in Tanzania, says girls and women are experiencing Gender-based Violence, and sexual violence, coupled with a high level of stigma and discrimination mostly among PLHIV and key vulnerable populations.
Tenga explains that some societies, especially in Africa, still have dangerous norms that widen the gap in HIV response hence putting the countries off track in ending the HIV pandemic.
‘These ‘harmful’ behaviour and actions hold both women and girls as well as men at high risk of contracting HIV while those living with HIV fail to remain on HIV treatment,” he explains.
In almost all societies in the East Africa region and Africa at large, men are still lagging behind in HIV testing and treatment adherence.
Therefore, according to Tenga, there is a need of strengthening community systems on HIV interventions to inclusively address inequalities in access to HIV treatment, GBV and ensure meaningful engagement of men.
Moving on, it has been established that in different societies PLHIV is still facing stigma and discrimination thereby increasing the risk among them. And as a result, some of them especially school children and adolescents resort to discontinuing their ART to avoid being labelled and discriminated against.
“It is our time now to join efforts and addressed these challenges at the national, regional and global levels to end HIV/AIDS before 2030. We need to equalize and address dangerous inequalities, allocate sustainable human and financial resources to support sustainable HIV programs to stay on track on ending the pandemic,” she suggests.
Tenga says girls and women need to be empowered economically to reduce their economic vulnerability in addition to equipping them with correct information on HIV prevention, treatment, and legal and human rights literacy.
“I call upon the commitment of political and government leaders, Civil Society Organisations, and human rights groups in East Africa, Africa and the world at large, to do everything possible to end inequalities in HIIV response,” she requests.
Tanzanian Officials
George Simbachawene, the Tanzania Minister of State in the Prime Minister’s Office, Policy Coordination and Parliamentary Affairs office, believes that ending AIDS is possible by tackling the inequalities that hold back the progress of various campaigns.
According to the minister, East African countries, Africa and the world can end AIDS through advancing collective efforts to equalise access to prevention, testing and treatment and doing so will benefit everyone.
Tanzania’s vision 2025 identifies health as one of the priority sectors contributing to high-quality livelihood in the country.
The country’s National Development Plan 2021-2022 to 2024 to 2025 seeks to raise both the availability and quality of health, education, skills development, and other social services.
“The implementation of the NDP has produced remarkable results in the health sector, notably, Tanzania has made progress towards controlling HIV and PLHIV are currently aware of their status while those on ART have attained their viral suppression,” he says adding that the number of infected people and the number of HIV-related deaths in Tanzania has reduced tremendously.
He further applauded the development partners including UNAIDS and other UN agencies, US Government through The President’s Emergency Plan for AIDS Relief (PEPFAR), Global Fund and all stakeholders for the financial and technical support rendered to Tanzania to achieve great results in the fight against the AIDS scourge.
Martin Odiit, the UNAIDS Country Director, explains they have achieved remarkable gains in the AIDS response in the country. The organisation has supported and monitored such services as testing and treatment in addition to accelerating the reduction of new infections in Tanzania.
“That said, we still have to do more if we are to achieve the targets we have set for 2025 and are up on the road to ending AIDS as a public health threat in Tanzania,” Odiit explains.
Uganda Stigma, Discrimination
Uganda has made significant progress in the reduction of stigma and discrimination against the PLHIV, according to UNAIDS- HIV AND AIDS RESPONSE 2020.
The report further indicates that external stigma and discrimination reduced from 4.5% in 2013 to 1.3% in 2019 while internal stigma reduced from 50% in 2013 to 24% in 2019.
Uganda became among the eight countries in the world that had fully achieved the 90–90–90 targets by the end of 2020. Others were Eswatin, Switzerland, Rwanda, Qatar, Botswana, Slovenia and Malawi. Uganda has put in place the 95-95-95 targets for ending the AIDS epidemic in the country in line with the UN targets.
However, according to the National Policy Guidelines on Ending HIV Stigma and Discrimination, stigma and discrimination undermine HIV prevention efforts by making PLHIV or people at risk afraid to seek HIV information, take up prevention and treatment services, and fail to disclose their HIV status.
END
English 