World AIDS Day 2021 – Message of WHO Regional Director for Africa, Dr Matshidiso Moeti

As we come together with the global community on 1 December to mark World AIDS Day, this year’s theme “End inequalities. End AIDS. End pandemic” has particular resonance nearly two years into the COVID-19 pandemic.

We cannot express enough our support for those living with HIV, especially within a context where we know that treatment and care have been negatively impacted across Africa by the demands of COVID-19. As we remember those who have lost their lives to AIDS this year, we also acknowledge the terrible death toll the coronavirus pandemic has taken, and continues to take.

Going forward, we cannot afford to lose focus on the urgent need to end the inequities that drive AIDS and other epidemics around the world. It has been 40 years since the first HIV cases were reported. Yet, in Africa and globally, it remains a major public health concern.

Last year, two out of every three new HIV infections occurred in the African Region, corresponding to almost 2 500 new HIV infections every day. Sadly, AIDS claimed the lives of 460 000 people, or a shocking 1 300 every day, in spite of free access to effective treatment.

Despite the challenges, Africa has made significant progress against HIV in the past decade, reducing new infections by 43% and nearly halving AIDS-related deaths. In the Region, 86% of people living with HIV know their status, and 76% are receiving antiretroviral therapy.

We also salute Botswana, which is on the home stretch to eliminating mother-to-child HIV transmission in what is a truly remarkable public health success. Only 16 countries have been certified for eliminating mother-to-child HIV transmission, none of which had as large an epidemic.

It’s taken more than two decades of hard work by leaders, health workers and communities, illustrating what is possible when the health and welfare of mothers and children are prioritized.

The continent as a whole is, however, unlikely to end AIDS as a public health threat by 2030, after we fell short of the expected 75% reduction in new HIV infections and 81% reduction in AIDS-related deaths by 2020. Despite the very high percentages of people living with HIV who know their status, and treatment rates, new HIV infections and AIDS-related deaths are not decreasing concomitantly.

It remains critical for us to reach those who are fuelling the epidemic, addressing the persistent inequities in the provision of quality care and interventions. For instance, in West and Central Africa last year, key populations and their sexual partners accounted for 72% of new adult HIV infections. Yet punitive laws, policies, hostile social and cultural environments, and stigma and discrimination, including in the health sector, prevent them from accessing services.

In Sub-Saharan Africa, young women are twice as likely to be living with HIV than men. For adolescents aged 15 to19 years, three in every five new infections are among girls who don’t have access to comprehensive sexuality education, who face sexual and gender-based violence, and live with harmful gender norms. They also have less access to school than their male peers.

With COVID-19, people living with HIV appear to be at elevated risk for virus-related illness and death. Nearly 70% live in the WHO African Region, where only 4.5% of people are fully vaccinated against COVID-19.

As efforts to tackle COVID-19 continue gathering force, and the world prepares itself against future pandemics, we risk repeating many of the same mistakes that have kept us from ending AIDS. Addressing inequality is critical to ending both AIDS and COVID-19, and preventing future pandemics – potentially saving millions of lives, and safeguarding our society.

We must ensure that everyone, everywhere, has equal access to HIV prevention, testing, treatment and care, including COVID-19 vaccinations and services.

This World AIDS Day, I urge governments to prioritize investment in health funding for community-led, human rights-based, gender transformative responses. We must boost our essential health workforce, and secure equitable access to life-saving medicines and health technologies.

Global solidarity and shared responsibility are critical components of the kind of rights-based approach we need if we are to end HIV/AIDS and COVID-19.

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