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Courageous political leadership is needed to end AIDS


3 min read

We have come a long way. In the mid 1980s, when I started to work on the campaigns to respond to AIDS, there were no medicines.

We were able to warn the public using television, posters and newspaper advertisements.

But, at that time in the mid 1980s, HIV was an almost certain death sentence. My abiding memory is of conversations with patients in their last weeks and with despairing doctors and nurses who knew there was nothing they could do to halt it.

For millions of people across many countries today, that position has been transformed. Treatment is now available and, with that treatment, people living with HIV can lead long and successful lives and will not transmit HIV.

At a moment when international solidarity is most needed, too many high-income countries are cutting back assistance

All over the world are examples of good practice that can increase the uptake of HIV prevention, testing, and treatment services.

We can end AIDS. And yet, in just the last year alone, 650,000 people died of AIDS-related illnesses and 1.5m people became infected with HIV. Why are people still dying of AIDS? Why are there so many new HIV infections each year?

The Covid-19 crisis and the Ukraine crisis have knocked the response off track - impacting services and increasing risks. The deeper challenge is that the world has not sufficiently addressed the inequalities which drive the pandemic. Tackling those inequalities is at the heart of UNAIDS strategy to end AIDS as a public health threat by 2030.

One of the inequalities standing in the way of ending AIDS is in access to education. Six in seven new HIV infections among adolescents in Sub-Saharan Africa are among girls. Enabling girls to complete secondary education reduces their vulnerability to HIV infection by up to 50 per cent. The Education Plus initiative, co-convened by Unicef, Unesco, UNFPA, UN Women and UNAIDS, with governments, civil society and international partners, is pressing leaders to ensure that every African girl is in school, safe and strong.

Another inequality standing in the way of the end of AIDS is in the realisation of human rights. Sixty-eight countries still criminalise gay men. Laws which punish same sex relations, in addition to contravening the human rights of LGBT people, are barriers to LGBT people seeking and receiving healthcare for fear of being punished or detained. Decriminalisation saves lives.

We need courageous political leadership in international cooperation. At a moment when international solidarity is most needed, too many high-income countries are cutting back assistance. In 2021, international resources available for HIV were 6 per cent lower than in 2010. When you exclude the United States, whose contribution to the global AIDS response has been the most generous, international assistance for the AIDS response from other bilateral donors has plummeted by 57 per cent over the last decade. I do not underestimate the challenges faced by donors, but ending AIDS is far less expensive than not ending AIDS.

We can end AIDS by 2030, but only if political leaders are bold in their actions and investments. It is up to us.


Lord Fowler, conservative peer, former lord speaker and former health secretary.

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