Mozambique has played such an inspirational role in the history of our continent, and is such a vibrant and beautiful country, that arriving here has always been a great joy. But on this visit, whilst so happy to be reunited with you, I share also in your pain and frustration at the humanitarian crisis from the conflict in Cabo Delgado.
As UN Under Secretary-General, and as the leader of the UN’s work to beat AIDS, I have come to Mozambique to express my solidarity with you, and to learn how best we can strengthen our support for you. At this painful time for Mozambique, we the United Nations are with you.
As Mozambicans from across government, civil society organisations and communities have all told us, the impact of the humanitarian crisis intersects with the social and economic impact of the climate crisis, of COVID-19, of the ongoing HIV epidemic, and of the acute debt crisis the country was already suffering before the pandemic landed. As they noted too, whilst the effects of these crises are being felt across society, these crises are not being experienced by people equally, but are exacerbating pre-existing inequalities.
Living with HIV
About 2.2 million Mozambicans are living with HIV, the second highest number of people living with HIV in the world after South Africa. Every hour in Mozambique, four adolescent girls or young women acquire HIV. COVID-19 and conflict in Cabo Delgado have knocked back the life-saving and life-changing progress that had been made in Mozambique towards overcoming HIV and AIDS.
Critical services including sexual and reproductive healthcare and HIV treatment have been disrupted, many people living with HIV and vulnerable populations have faced further stigmatization, and the impact on school attendance has heightened the risk of new HIV infections for adolescent girls. I have been told that there has been an 18 per cent increase in Gender Based Violence cases compared to 2019.
And right at this time, public finances are constrained by the exacerbated debt burden that was already hard in Mozambique before COVID-19 and while there has been some welcome debt relief in the Debt Service Suspension Initiative, it has not been enough to provide Mozambique with the fiscal space it needs, especially alongside the dramatic drop in revenue collection in 2020 and 2021.
But there is hope
Firstly, we are seeing how community-led responses are helping in addressing COVID-19 and in the humanitarian response. The decades of proven experience from effective community-led HIV response have helped inform these, and indeed communities affected by HIV have played leading roles.
UNAIDS is supporting community-based organisations to provide HIV prevention services and to trace ART patients who have stopped treatment and link them back to treatment including provision of multi-month supplies. Building on lessons from the 20 per cent decrease in AIDS-related deaths in Mozambique since 2010, harm-reduction pilots and de-stigmatization efforts are showing how pandemics are most effectively addressed.
Secondly, we have seen the rising of a global advocacy campaign, of which Mozambique is a key champion, for the People’s Vaccine for COVID-19, to speed up access to medicines by requiring companies to waive patents and share knowledge and know-how. Increasing production is the only way to ensure vaccines and treatments for all.
The Africa CDC has set out how African production can be scaled up as barriers are removed. The “Elders” group of former global leaders, represented by Graça Machel, have helped to rally the conscience of the world. The majority of the public in the West, and many legislators in the West, are also urging their own governments to share the vaccine recipes to help the world come out of crisis. They know that we can only overcome this together.
Thirdly, we are seeing across Africa a coming together of a broad movement for girls’ education and empowerment. “Education Plus” is a high-level policy initiative, underpinned by a powerful rights-based campaign, for the policies and upscaled investments that will ensure school completion, through free quality secondary education for all girls and boys, and reinforce this with: violence-free environments, access to comprehensive sexuality education, the fulfilment of sexual and reproductive health and rights and access to services, and young women’s economic empowerment through school to work transitions.
Together, these interventions will not only dramatically reduce HIV infections. They will also reduce early pregnancy. Currently 14 per cent of girls in Mozambique have a child before the age of 15, and 57 per cent of girls have a child before the age of 18.
All in Mozambique are determined to do better for our girls. There is incontrovertible evidence that education and empowerment of girls will also spur economic development and growth. And for girls and young women themselves, equality is priceless.
Fourthly, as the world discusses the challenges of the difficult fiscal situation exacerbated by COVID-19, we see a growing recognition that investments in health, education and empowerment are not unaffordable expenditures, but vital investments for recovery and national development. We see too a growing recognition that the shock of debt crises cannot be absorbed only by debtors, and that debt relief action is still too limited.
As the UN Secretary-General has noted, the world needs a process to “end the deadly cycles of debt waves, global debt crises and lost decades.” Our multiple crises do not herald a moment to step back on investing in universal public services but a moment to step up.
Together, we must find and allocate money to ensure we leave no one behind. Not in rhetoric, but in reality. More aid, debt cancellation, ensuring that there is a more ambitious issuance of Special Drawing Rights – the IMF currency – and a large reallocation to Africa, new progressive domestic revenue sources, and tackling illicit financial flows and tax avoidance, are all essential and urgent.
As the UN we are not only by your side right now, but for the years ahead. We are with you as you work to resolve the humanitarian crisis; we are with you, too, as you work to tackle inequality and the impacts of climate change, so that together we can beat COVID-19, HIV/AIDS, and poverty.
By being bold, together, we can overcome the crises we face.
Ms. Byanyima is the Executive Director of UNAIDS