How has COVID-19 derailed the fight against diseases of poverty?

By Imraan Valodia, Dean of the Faculty of Business, Law and Management and Director of the Southern Center for Inequality Studies at the University of the Witwatersrand

The COVID-19 pandemic has worsened global inequalities. The world’s poor have borne the brunt of national lockdowns and will struggle to recover, and the poorest countries have not been able to roll out comprehensive immunization campaigns due to extremely uneven vaccine distribution.

On top of that, COVID-19 has also derailed progress against diseases that affect people living in poverty. Imraan Valodia sat down for a conversation with Winnie Byanyima, the Executive Director of UNAIDS.

Imran Valodia: What impact has COVID-19 had on the fight against HIV in countries, especially in the South, which bear the greatest burden of disease and have significantly weaker health systems?

Winnie Byanyima: First, we must recognize the successes of the AIDS response. We achieved what many said was impossible. Of the 38 million people living with HIV, 27.5 million have access to life-saving antiretroviral therapy. We have more than halved the rate of new HIV infections and prevented 16.6 million deaths.

But let’s be clear: fighting a pandemic without a cure or a vaccine is difficult.

Hundreds of thousands of people are still dying of AIDS and 1.5 million people were newly infected last year. AIDS remains a crisis and COVID-19 is making it worse.

Even before COVID-19, we were on track to meet global AIDS targets, and the COVID-19 pandemic has set us back even further. COVID-19-related restrictions have hurt the most vulnerable, including marginalized and stigmatized communities, and disrupted access to HIV-related services.

Since the COVID-19 hit, the Global Fund to Fight AIDS, Tuberculosis and Malaria estimates that the number of mothers receiving services to prevent mother-to-child transmission has fallen by 4.5%, the number of people reached by HIV prevention programs fell 11%, HIV testing fell 22%, and medical male circumcision to prevent HIV fell 27%.

In settings of very high prevalence in Africa, it is estimated that the effects of COVID-19 could contribute to a 10% increase in HIV deaths over five years.

Amid unprecedented global disruptions, we must act urgently to prevent a resurgence of the global AIDS pandemic and to quickly recover our progress towards eradicating AIDS. To get back on track with HIV completely, we absolutely need to get COVID-19 under control.

COVID-19, like HIV, has exacerbated inequalities in society and disproportionately affected women while widening the long-standing gender pay gap. How do we start to fight this pandemic of economics and gender inequality?

COVID-19 and HIV feed on inequalities: women whose rights are not respected; women who lack economic security or access to basic health or education services. They are the ones paying the heaviest price for our inaction in the face of inequality. They pay the price for insecurity, poverty, disease and too often death.

Five out of six African adolescents newly infected with HIV are girls. The reason is power. Research shows that completing secondary school halves a girl’s risk of contracting HIV, and even more if this is supplemented with a set of rights and services. Yet as countries grapple with current budget challenges, girls’ education and empowerment are among the sectors suffering the biggest budget cuts.

Governments also have a responsibility to shift the burden of care away from the invisible unpaid work of women. Affirmative action is essential to address the legacy of discrimination against women.

Economic interventions are needed to reverse the glaring imbalance of wealth. But ending the era of inequality requires strengthening social and cultural emancipatory forces to reverse the blatant imbalance of power in all of its interconnected forms.

You say that extreme inequality is not inevitable, it is a political choice. Explain what you mean by this. What roles can individuals, communities and nations play to end it?

There is a pandemic of inequality – between men and women, between South and North, between dominant and marginalized communities, between elite and majority – which holds back our enormous potential.

Inequalities are perpetuated by laws, by informal rules (social norms), by national social and economic policies and resource allocation, and by global policies and finances. And the key to determining all of these outcomes is the inequalities of voice and power.

In the face of colliding crises, it has become clear that we need bold new approaches to survive and thrive. Action is needed at all levels, not to build a perfect world, but to make one resilient.

The responses are articulated by activists and organizers, in particular young people from the most marginalized communities. They show how to build societies capable of overcoming any crisis and unleashing the potential of all. They did it because the people most affected are the ones who understand it best.

As a leader of the UN, I have experienced the power of lobbying communities, women’s groups and grassroots movements that push us forward. Sometimes this push is uncomfortable for us; but my message to you is: Keep pushing!

What lessons can we learn for managing future pandemics from the science, government and communities triangle that was in place to fight HIV?

We have learned a lot about how to fight pandemics. This year marks 40 years of fighting AIDS and our successes and failures have taught us that we cannot beat a pandemic without working together to end inequalities, promote people-centered approaches, engage communities and respect human rights.

It is one of the most difficult times in the history of HIV and global health. We need greater urgency in our response to pandemics, global solidarity behind data-driven global plans to end AIDS and COVID-19, and partnerships to prepare to respond to the next threatens.

We must build on the collective experience, intelligence and set of values ​​of the AIDS response. If we apply the hard-learned lessons of AIDS from the start, we will increase our chances of winning.


This article was originally published by The Conversation. Read the original article here.


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