The global HIV response cannot succeed without women’s leadership
Gender inequality and racism are preventing us from ending new HIV transmissions and ending AIDS by 2030.
This was what I heard first-hand at the International AIDS Conference in Montreal the other week. I heard it from activists living with HIV, from academics and civil society leaders.
I didn’t hear it so much from politicians or governments – the conference itself was marked by a distinct lack of political leadership, barring a small handful of parliamentarians. This speaks to the wider, and very worrying, issue of de-prioritisation of HIV; the idea that AIDS is “over”, and HIV is more or less dealt with. That couldn’t be further from the truth.
HIV continues to disproportionately affect young women and adolescent girls, with one becoming HIV positive every two minutes in 2021
UNAIDS’ latest global update report, In Danger, paints an alarming picture of the global response as having faltered to the point of endangering millions of lives. Last year there were over 1.5 million new transmissions of HIV, over one million more than the global target. One stark finding is how HIV continues to disproportionately affect young women and adolescent girls, with one becoming HIV positive every two minutes in 2021 often as a result of sexual violence.
Indeed, the gendered HIV impact – particularly amongst African women and girls, occurred amidst disruption of key treatment and prevention service during the height of Covid-19, with millions of girls out of school due to pandemics, and spikes in teenage pregnancies and gender-based violence. In sub-Saharan Africa, adolescent girls and young women are three times as likely to acquire HIV as adolescent boys and young men.
Tackling inequality is central to an effective response. Whilst women are disproportionately affected by HIV, they are strongest advocates and leaders in the response at local, national and international levels.
When women have a seat at the table and exercise their power, they create real change.
I was fortunate and honoured to meet many inspiring leaders in this space, including when I shared a panel with Joyce Ouma and Maurine Murenga, advocates from Kenya openly living with HIV.
It was made clear to me just how great the gap between the political leaders who have made commitments to end AIDS by 2030 and the communities that are warning about the faltering response, and who must be listened to, is.
It is through the leadership of women and their lived experience that others are galvanised to action.
For example, the creation of the Global Fund in 2002 enabled women like Maurine and her child Kenya to begin treatment. Since then, she has had another baby who is HIV-free and the entire family remains healthy, whilst the Global Fund itself has saved over 44 million lives.
Similarly, Unitaid, where Maurine sits as board member representing communities, funds and supports research and development of innovative health tools that are critical to speeding up the response to infectious diseases. In 2021, Unitaid announced a partnership agreement to expand access to blood-based HIV self-tests, making them available for less than $2 each in 135 eligible countries; an essential tool in helping people know their status.
Despite historic funding commitments, it is concerning that the UK may step back from its leadership in supporting Unitaid, exactly when we require investment in innovation to deliver the game-changing developments we need to accelerate a decline in transmissions and deaths.
Women’s leadership is also present at other levels, and in a meeting with Winnie Byanyima, Executive Director of UNAIDS, we discussed the ongoing concerns the effects that HIV and AIDS has on women, girls and children. The recent decision to pause UK government funding awarded to UNAIDS that would go towards the “Education Plus” initiative is wrong, and will result in lives lost and additional HIV transmissions.
We have the means to end AIDS and new HIV transmissions by 2030, we have the initiatives like the Global Fund and Unitaid to implement effective value-for-money programmes and tools, and we have the leaders - like Joyce, Maurine and Winnie - to champion the agenda.
Women are ensuring we address the inequalities and structural barriers like racism that are holding back the HIV response. We must listen to them, and demand political courage from governments to get the global fight back on track.
Florence Eshalomi is the Labour MP for Vauxhall and co-chair of the APPG on HIV and AIDS.
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