Global crises threaten progress curbing HIV/AIDS, UN warns

Compounding crises in recent years have slowed the global fight against HIV, threatening the health of millions and potentially derailing international goals aimed at eradicating the virus.

In a report released this week, the Joint United Nations Programme on HIV and AIDS (UNAIDS) announced that the number of new HIV infections worldwide between 2020 and 2021 fell by just 3.6%—the smallest decline since 2016. Specifically, the agency found that roughly 1.5 million people were newly infected with HIV last year. The figure represents over 1 million more than health authorities had targeted for 2021.

“These data show the global AIDS response in severe danger,” Winnie Byanyima, the executive director of UNAIDS, said in a statement. “If we are not making rapid progress, then we are losing ground, as the pandemic thrives amidst COVID-19, mass displacement, and other crises.”

Experts have long warned that the COVID-19 pandemic significantly threatens other areas of public health. As the World Economic Forum stated in its Global Risks Report 2022, “The COVID-19 crisis has also had extensive collateral health impacts, partly because other diseases were deprioritized.”

In particular, COVID-19 has shifted public health resources away from HIV care and prevention. Governments have also cut domestic funding to HIV programmes due to the economic fallout from the pandemic. In fact, in 2021, global resources dedicated to HIV care were 6% less than in 2010, according to UNAIDS.

The agency also notes that crises such as the war in Ukraine and the global food price spike pose significant risks to the availability and affordability of HIV treatment medication. This includes antiretroviral therapy—known as ART—which requires a daily dose. ART, when administered regularly, can significantly reduce an individual's ability to transmit the virus. When care is distributed, however, resistance to the medication can develop.

Access to ART was significantly disrupted in Ukraine following the Russian invasion in February. By May, UNAIDS estimated that 30,000 Ukrainians living with HIV had fled into neighboring countries and were in immediate need of ART.

The UNAIDS report warned that new infections have disproportionately affected certain groups. This includes most notably young women and adolescent girls, who accounted for nearly half of all new infections worldwide in 2021. The report noted that other groups like gay men, sex workers and people who inject drugs also face increasing risk.

Regionally, the Middle East, North Africa, Latin America, and Eastern Europe and central Asia continue to experience an increase in infection rate. Meanwhile, in certain areas of Asia and the Pacific, infection rates have increased where they had previously been decreasing.

UNAIDS determined that if the current rate of transmission continues, up to 1.2 million people could be newly infected in 2025. The figure would be a major set back from the previously stated goal of just 370,000 new infections in 2025.

“Do we care about empowering and protecting our girls? Do we want to stop AIDS deaths among children? Do we put saving lives ahead of criminalization?” Byanyima added in her statement. “If we do, then we must get the AIDS response back on track.”