This World AIDS Day I am encouraged to find that our efforts to fight this complex disease are making a difference. According to the latest UNAIDS report the number of people who have become newly infected with HIV is coming down.
It’s a ray of good news and something we should recognise as we mark World AIDS Day this year. We have the clear evidence that increased investment in the HIV response is working.
As we remember those we have lost to this disease, those who fought so hard to get us where we are, I think it’s worth reflecting on what we have achieved.
The global incidence of HIV infection has fallen by 19 per cent between 1999 and 2009. Encouragingly the decline has exceeded 25 per cent in 22 countries in sub-Saharan Africa, the worst hit continent and access to HIV treatment has increased so that 5.2 million people are now receiving it. HIV prevention and treatment are working.
But our progress rests on a knife edge. While we can clearly see that the financial investment has made a difference, this progress is threatened by difficult economic times.
This is testing us. Will we waver in our response to the epidemic or continue to invest and move forwards?
I believe it is simple, there is no choice. We cannot afford to see the money already invested in the HIV response wasted and lives lost. We have a duty to all those who have gone before with the hope that things would change, to make sure no more people become infected with HIV through ignorance, stigma or discrimination or die from AIDS-related illnesses.
This World AIDS Day, the Alliance is drawing attention to the critical need to improve the legislative environment for people living with or affected by HIV. As we know HIV doesn’t exist in a vacuum. It thrives and is exacerbated by individual circumstances and social conditions. As the new aids2031 report reveals, the value of improving structural approaches is critical in the long-term perspective of tackling HIV and AIDS.
Punitive laws and enforcement practices make it hard for people who may feel judged or punished to access HIV services. Many Alliance partners sadly see stigma and discrimination all too often.
Women are particularly vulnerable. The latest figures show that slightly more than half of all people living with HIV are women and girls. Women find themselves unfairly blamed for bringing HIV into the home but because they have more contact with the health system through pregnancy and childbirth they are more likely to know their HIV status than their male partners. They are therefore more likely to face prosecution, homelessness and violence.
Every month reports have been coming out of Africa in particular where men who have sex with men (MSM) are being persecuted because of their sexual orientation. With HIV rates steadily increasing among MSM across parts of Africa we need to work together to make sure that there is an environment where men feel able to get the HIV support and services they need, not to be criminalised because of their sexual orientation.
Just last month, governments removed sexual orientation from the UN resolution condemning extrajudicial, summary or arbitrary executions. The resolution urges states to protect the right to life of all people, including by calling on states to investigate killings based on discriminatory grounds. For the past 10 years, the resolution has included sexual orientation in the list of discriminatory grounds on which killings are often based. The killings haven’t stopped but the protection clearly has.
This is one reason why we are working with the Commonwealth Foundation to look at how enabling legal environments can provide an effective HIV response. It’s particularly important given that over 60 per cent of people living with HIV live in Commonwealth countries.
So as we pause to reflect on World AIDS Day we need to make a decision whether we continue to rise to the challenge of HIV and AIDS or permit the gains we’ve made to be lost. For me the choice is clear. The Alliance will continue to strive to find reasons to hope.
Alvaro Bermejo, Executive Director