On this Zero Discrimination Day join UNAIDS in raising awareness about the inequalities that prevent people from living a full and productive life and demanding that governments fulfil their commitments and obligations to end all forms of discrimination. Inequalities surrounding income, sex, age, health status, occupation, disability, sexual orientation, drug use, gender identity, race, class, ethnicity and religion persist around the world. We cannot achieve sustainable development and make the planet better for all if people are excluded from the chance of a better life.
UNAIDS reports that the Kyrgyzstan Constitutional Court excluded HIV from the list of diseases that prevent people from adopting children or becoming guardians or foster parents. The barrier to parenting for people living with HIV had been in effect for many years. The change—brought about by a joint effort of activists, lawyers and human rights defenders, but primarily by people who personally suffered from discrimination and fought for their rights—is a victory against stigma and discrimination against people living with HIV in Kyrgyzstan.
UNAIDS reports on the challenges faced by sex workers in Bangladesh and Myanmar as a result of the COVID-19 closure of brothels. Street-based sex work increases the risk of violence, condom-less sex and no pay or low pay. Sex workers are also experiencing increasing vulnerability to gender-based violence. Without a source of income, conflicts about finances arise resulting in abuse at the hands of spouses, partners and brothel owners. Other challenges include homelessness, stigma and discrimination from other forms of employment and restricted health services and screenings.
The COVID-19 pandemic and women living with HIV
Every year, on 1 December, the world commemorates World AIDS Day. People around the world unite to show support for people living with and affected by HIV and to remember those who lost their lives to AIDS. In 2020, the world’s attention has focused on health and how pandemics affect lives and livelihoods. COVID-19 is showing once again how health is interlinked with other critical issues, such as reducing inequality, human rights, gender equality, social protection and economic growth. With this in mind, this year the theme of World AIDS Day is “Global solidarity, shared responsibility”.
HIV service providers in Jamaica have been challenged this year with responding both to new challenges caused by COVID-19 and long-standing service delivery stumbling blocks. CHARES had been used to writing three-month prescriptions for stable clients, but since COVID-19, state-run pharmacies have been dispensing only a one-month supply. The Comprehensive Health Centre serves a number of people living with HIV alongside those infected with other sexually transmitted infections. Here, too, multimonth dispensing has not been possible during COVID-19.
While recent data collection has shown that the COVID-19 pandemic has had a significant impact on HIV testing services, the impact on HIV treatment is less than originally feared. In a study conducted by UNAIDS, World Health Organization and United Nations Children's Fund, only five out of 22 countries reported monthly declines in the number of people on treatment after April—these include Zimbabwe in June, Peru and Guyana in July, the Dominican Republic in April, and Sierra Leone in May through to July. The remaining 18 countries did not show a decline and some countries showed a steady increase (e.g. Kenya, Ukraine, Togo and Tajikistan).
Survivors of COVID-19 from 37 countries are among almost 1,000 people who have signed an open letter to pharmaceutical industry leaders calling for a ‘people's vaccine’ and treatments that are available to all – free from patents. The letter came on the eve of a high-level side event about the pandemic at the UN General Assembly in New York. The letter says: “Some of us have lost loved ones to this killer disease. Some of us have come close to death ourselves. Some of us are continuing to live in fear that contracting this disease would be fatal for us. We see no justification why your profit or monopolies should mean anyone else should go through this.”
Significant breaches of human rights and other life-threatening and discriminatory disruptions have made part of the COVID-19 responses worldwide. The UN Secretary General has requested all UN entities to support the efforts of the WHO in their own respective areas of expertise. So, to better inform the response going forwards, UNAIDS commissioned a report on how COVID-19 public health orders and restrictions on movement have impacted the response to HIV and human rights.
The COVID-19 Law Lab initiative gathers and shares legal documents from over 190 countries to help states establish and implement legal frameworks to manage the pandemic. The goal is to ensure that laws protect individuals and communities and that they adhere to international human rights standards. Well-designed laws help build strong health systems; evaluate and approve safe and effective drugs and vaccines; and create healthier and safer public spaces and workplaces. The new Lab is a joint project of UNDP, WHO, UNAIDS and partners.
Seventy-three countries warned that they are at risk of stock-outs of antiretroviral (ARV) medicines as a result of the COVID-19 pandemic. Twenty-four countries reported having either a critically low stock of ARVs or disruptions in the supply of these life-saving medicines. This new WHO survey follows an exercise convened by WHO and UNAIDS which forecasted that a six-month disruption in access to ARVs could lead to a doubling in AIDS-related deaths in sub-Saharan Africa alone.
Getting calls at all hours of the day is not unusual for Liu Jie, the Community Mobilization Officer in the UNAIDS Country Office in China. Because of the COVID-19 outbreak in China, the whole office has been active in helping people living with HIV to continue to access treatment, especially in Hubei Province, where the pandemic was first reported. Recently, Ms Liu was surprised when she had a call from Poland. UNAIDS country offices and the Community Mobilization Team in Geneva, Switzerland came to the rescue.
Discrimination and gender inequality remain a huge barrier for women and girls with a serious impact on the AIDS response. This is an important year for women and girls, starting with the Beijing +25 Conference and the Commission on the Status of Women in March, through the UN General Assembly High-level session in September. The theme of Zero Discrimination Day on 1 March 2020 is “Zero discrimination against women and girls.” The day is not limited to HIV, or health-related themes, but aims to highlight all issues related to discrimination.
UNAIDS is calling on governments to ensure that the right to health is realized by all by prioritizing public investments in health. At least half of the world’s population cannot access essential health services. “The right to health is eluding the poor and people trying to lift themselves out of poverty are being crushed by the unacceptably high costs of health care. The richest 1% benefit from cutting-edge science while the poor struggle to get even basic health care,” said Winnie Byanyima, Executive Director of UNAIDS. Nearly 100 million people are pushed into extreme poverty (living on US$ 1.90 or less a day) because they have to pay for health care, and more than 930 million people spend at least 10% of their household budgets on health care. Publicly financed health care is the greatest equalizer in society. Health should not be a privilege for the rich—the right to health belongs to everyone.