The rapid spread of the novel coronavirus has created additional setbacks for the global AIDS response and there could be an estimated 123,000-293,000 additional new HIV infections and 69,000-148,000 additional AIDS-related deaths between 2020 and 2022 as a result of the COVID-19 pandemic's long-term impact, according to a new report. The Joint United Nations Programme on HIV/AIDS (UNAIDS) said in its new report 'Prevailing against pandemics by putting people at the centre' that as COVID-19 pushes the AIDS response even further off track and the 2020 targets are missed, countries must learn from the lessons of underinvesting in health and to step up global action to end AIDS and other pandemics.
The UNAIDS is calling on countries to make far greater investments in global pandemic responses and adopt a new set of bold, ambitious but achievable HIV targets. If those targets are met, the world will be back on track to ending AIDS as a public health threat by 2030. "The global AIDS response was off track before the COVID-19 pandemic hit, but the rapid spread of the coronavirus has created additional setbacks. Modelling of the pandemic's long-term impact on the HIV response shows that there could be an estimated 123,000 to 293,000 additional new HIV infections and 69,000 to 148,000 additional AIDS-related deaths between 2020 and 2022," the report said.
Executive Director of UNAIDS Winnie Byanyima lamented that the collective failure to invest sufficiently in comprehensive, rights-based, people-centred HIV responses has come at a terrible price. "Implementing just the most politically palatable programmes will not turn the tide against COVID-19 or end AIDS. To get the global response back on track will require putting people first and tackling the inequalities on which epidemics thrive." The report notes that in some low- and middle-income countries, health officials are bracing for a surge in new births due to interruptions to contraceptive access during the pandemic. "In India, for example, it is estimated that COVID-19 interrupted contraceptive access for more than 25 million couples," it said.
The report said insufficient investment and action on HIV and other pandemics left the world exposed to COVID-19. "Had health systems and social safety nets been even stronger, the world would have been better positioned to slow the spread of COVID-19 and withstand its impact," it said, adding that the COVID-19 has shown that investments in health save lives but also provide a foundation for strong economies. Health and HIV programmes must be fully funded, both in times of plenty and in times of economic crisis.
"No country can defeat these pandemics on its own," Byanyima said. "A challenge of this magnitude can only be defeated by forging global solidarity, accepting a shared responsibility and mobilizing a response that leaves no one behind. We can do this by sharing the load and working together." Highlighting bright spots amid the crisis, the report said leadership, infrastructure and lessons of the HIV response are being leveraged to fight COVID-19. The HIV response has helped to ensure the continuity of services in the face of extraordinary challenges and the response by communities against COVID-19 has shown what can be achieved by working together. In addition, the report underscores that the world must learn from the mistakes of the HIV response, when millions in developing countries died waiting for treatment. Even today, more than 12 million people still do not have access to HIV treatment and 1.7 million people became infected with HIV in 2019 because they did not have access to essential HIV services.
"Everyone has a right to health," which is why UNAIDS said it has been a leading advocate for a 'People's Vaccine' against COVID-19. "Promising COVID-19 vaccines are emerging, but we must ensure that they are not the privilege of the rich. Therefore, UNAIDS and partners are calling on pharmaceutical companies to openly share their technology and know-how and to wave their intellectual property rights so that the world can produce successful vaccines at the huge scale and speed required to protect everyone, it said.
The report also noted that the number of countries criminalizing same-sex sexual relations has continued to decline in recent years, with Botswana and India removing previous prohibitions. It said severe criminal penalties for same-sex sexual relations are associated with a 4.7 times higher risk of HIV infection compared with settings that lack such penalties. The impact of decriminalization has been addressed in a study that modelled the effects of the criminalisation of sex work and found a roughly 40% reduction in new infections among sex workers over a 10-year period in Vancouver, Mombasa and Bellary, India, it said.
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