The United Nations’ General Assembly has overwhelmingly approved a declaration calling for urgent action to end AIDS by 2030, noting “with alarm” that the COVID-19 pandemic has exacerbated inequalities and pushed access to AIDS medicines, treatments and diagnosis further off track.
The declaration made late on Tuesday contains targets for countries to reach 95 percent of those in risk groups with HIV prevention options and to provide 95 percent of those who know they have HIV with treatment.
It was adopted with 165 votes in favour and four against, following objections to the text by four countries: Russia, Belarus, Nicaragua and Syria.
“Amidst the fallout from the COVID crisis, we could even see a resurgent pandemic,” Winnie Byanyima, executive director of UNAIDS, said at the high-level meeting in New York.
“But a never-ending HIV pandemic is not our fate,” she continued. “Even in spite of all the setbacks, we can end AIDS as a public health threat by 2030 as we promised, if the world comes together.”
Russia failed in a bid to remove language it said pushed countries to decriminalise prostitution and drug use.
Russia told the General Assembly that under the “cover” of combating discrimination several paragraphs “attempt to directly interfere in national legislation by repealing so-called restrictive and discriminatory laws”.
“As we see from the Global AIDS strategy 2021 to 2026, UNAIDS considers these to include laws that in any way persecute prostitution and drug use,” said deputy Russian UN Ambassador Dmitry Chumakov.
Australian UN Ambassador Mitch Fifield – who led negotiations on the declaration with Namibia – pushed back against Russia, saying that “reforming laws and policies to ensure that they are grounded in evidence and human rights is essential for an effective HIV response.”
The high-level meeting comes days after the 40th anniversary of the first report that brought AIDS to the attention of the public.
The declaration commits the assembly’s 193 member nations to implement the 18-page document, including reducing annual new HIV infections to less than 370,000 and annual AIDS-related deaths to less than 250,000 by 2025.
It also calls for progress towards eliminating all forms of HIV-related stigma and discrimination and for urgent work towards an HIV vaccine and a cure for AIDS.
Without a huge increase in resources and coverage for those vulnerable and infected, “we will not end the AIDS epidemic by 2030,” the assembly warned.
Setbacks in AIDS fight
It said the coronavirus pandemic has created setbacks in combating AIDS, “widening fault lines within a deeply unequal world and exposing the dangers of under-investment in public health, health systems and other essential public services for all and pandemic preparedness”.
While the international investment response to the pandemic is inadequate, it is nonetheless unprecedented, the assembly said. The response to the coronavirus by many nations has demonstrated “the potential and urgency for greater investment” in responding to pandemics, underscoring “the imperative of increasing investments for public health systems, including responses to HIV and other diseases moving forward”, it said.
Shannon Hader, UNAIDS deputy executive director, believes it is key in the fight against HIV to enable more equitable access to medicaments and services.
“One reason that there are disparities in the HIV response can be that services aren’t being provided in ways that are useful and accessible for the people who need it the most,” Hader told Al Jazeera.
“But other reasons can really be because the legal framework, the violence, the gender inequality are such that there are societal barriers for people who are most affected, also accessing services and being empowered to take the measures to prevent HIV,” she added.
Call to accelerate innovations
Calling AIDS “one of the deadliest pandemics of modern times”, Byanyima said 77.5 million people have been infected with HIV since the first case was reported in 1981 and nearly 35 million have died from AIDS.
She said COVID-19 showed that science moves “at the speed of political will” and urged the acceleration of spending on innovations for AIDS treatment, prevention, care and vaccines “as global public goods”.
“HIV rates are not following the trajectory that we together promised,” she said.
On the plus side, the assembly’s declaration said that since 2001 there has been a 54 percent reduction in AIDS-related deaths and a 37 percent reduction in HIV infections globally, but it warned that “overall progress has slowed dangerously since 2016.”
The assembly expressed “deep concern” that in 2019 there were 1.7 million new infections compared with the 2020 global target of fewer than 500,000 infections and that new HIV infections have increased in at least 33 countries since 2016.