Opinion Express View on UNAIDS report: AIDS and inequality

At a UN General Assembly Meet seven years ago, countries agreed to a bold target of eliminating AIDS by 2030. Since then, research on the disease has made remarkable headway and AIDS mortality has come down appreciably. But the medical knowledge does not seem to be equally distributed. An UNAIDS annual update released last week highlights that poverty and gender inequality remain barriers to achieving the 2030 target. HIV patients from poor and marginalised communities are not only left behind but they continue to be stigmatised. The skew against the most vulnerable is particularly high in parts of West Asia and large parts of Africa. The report highlights that though lower and middle-income countries have substantially increased their overall health budgets, their AIDs related expenditure is largely reliant on external funds — and these are not enough.

There is no cure for AIDs, but there have been stray reports of people getting cured of HIV — the viral infection that leads to AIDS. Advances in medical sciences have made it possible for HIV patients to live long and healthy lives with very little chance of transmitting the virus. Globally, about 70 per cent of people with HIV had suppressed viral loads in 2022. But the picture gets complicated because “hyper-masculinity” prevents many heterosexual men from getting tested for HIV or seeking treatment for it. At the same time research has also shown that in several areas, women patients are less likely to receive optimal HIV treatment. The UNAIDS data also highlights the need to bring down the gender disparity in access to medical care — 76 per cent of men patients have the more contained form of the disease compared to 67 per cent of women with HIV. The viral suppression rate amongst children is an abysmal 46 per cent. There are still major gaps in basic HIV prevention programmes and supportive programmes for adolescent girls and young women in most of the countries with high HIV burdens, the report points out. Studies by the Global HIV prevention coalition, for instance, show that in sub-Saharan Africa, a little more than 40 per cent of the districts with high HIV incidence are covered with dedicated prevention programmes.

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The report highlights that anti-AIDS programmes have succeeded the most when they have used an adroit mixture of science and gender-equality communication, public health extension and community involvement. Civil society organisations, for example, have played an important role in bringing down India’s HIV infection rate. But the country has also seen patient protests, including last year, over drug shortages. Like several other nations, India has work to do in enabling the poor and marginalised patients.