Press Release

GENEVA, 8 October 2020—Drawing on 40 years of experience from the AIDS response, UNAIDS is issuing new guidance on how to reduce stigma and discrimination in the context of COVID-19. The guidance is based on the latest evidence on what works to reduce HIV-related stigma and discrimination and applies it to COVID-19.

Since the start of the COVID-19 pandemic, numerous forms of stigma and discrimination have been reported, including xenophobia directed at people thought to be responsible for bringing COVID-19 into countries, attacks on health-care workers and verbal and physical abuse towards people who have recovered from COVID-19. Attacks on populations facing pre-existing stigma and discrimination, including people living with HIV, people from gender and sexual minorities, sex workers and migrants, have also been reported.

“In the wake of the fear and uncertainty that emerge during a pandemic, stigma and discrimination quickly follows,” said Winnie Byanyima, Executive Director of UNAIDS. “Stigma and discrimination is counterproductive. It exposes people to violence, harassment and isolation, stops people from accessing health services and prevents public health measures from effectively controlling pandemics.”

Addressing stigma and discrimination in the COVID-19 response provides countries with rights-based guidance through education, support, referrals and other interventions. It offers solutions across six specific areas: community, workplace, education, health care, justice and emergency/humanitarian settings.

As with the HIV epidemic, stigma and discrimination can significantly undermine responses to COVID-19. People who have internalized stigma or anticipate stigmatizing attitudes are more likely to avoid health-care services and are less likely to get tested or admit to symptoms, ultimately sending the pandemic underground. 

“We know what works and what doesn’t, we know how to change beliefs and behaviour. For the last 30 years we have been successfully leading the HIV response, building valuable experience, knowledge and wisdom along the way,” said Alexandra Volgina, Programme Coordinator, Global Network of People Living with HIV. “We want to share these to change people’s lives for the better, and to make our distinctive contribution to overcoming the COVID-19 pandemic.”

Some countries have used existing criminal laws or new, COVID-19-specific laws, to criminalize alleged exposure or transmission of COVID-19, putting more people in overcrowded prisons, detention centres and other closed settings where COVID-19 is easily transmitted.

“There is no greater manifestation of stigma than when it is enshrined in law. The use of the criminal law or other unjustified and disproportionate repressive measures in relation to COVID-19 is having a devastating impact on the most vulnerable in society, including many people living with HIV, exacerbating inequalities and perpetuating stigma,” said Edwin J. Bernard, Executive Director of the HIV Justice Network. “Measures that are respectful of human rights and empowering of communities will be infinitely more effective than punishment and imprisonment. We hope that these evidence-based recommendations on reducing COVID-related stigma and discrimination will make a difference to those who need it most.”

Reports in the early days of COVID-19 include discrimination related to gender and gender-based violence, targeting of key populations, including sex workers, and arrests and beatings of lesbian, gay, bisexual, transgender and intersex people. In April 2020, following a number of reports of violence and stigma and discrimination arising from the implementation of COVID-19 measures, UNAIDS began to identify the actions needed to respond, and in August UNAIDS issued a report, Rights in a pandemic, that highlights many of the human rights abuses that took place early in the response to COVID-19.

The new guidance, Addressing stigma and discrimination in the COVID-19 response: applying the evidence of what works from HIV-related stigma and discrimination in six settings to the COVID-19 response, is part of efforts by UNAIDS and the Global Partnership to Eliminate All Forms of HIV-Related Stigma and Discrimination to accelerate progress on the goal of zero discrimination, in line with the political commitments that United Nations Member States made in the 2016 Political Declaration on Ending AIDS and in Sustainable Development Goal 3, ending AIDS as a public health threat by 2030.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

WASHINGTON, D.C./GENEVA, 29 September 2020—Despite decades of scientific advance in the HIV response, progress remains uneven, with some countries rapidly reducing AIDS-related deaths and new HIV infections and others seeing increasing epidemics. Laws and policies are driving a significant part of that divergence. 

Launched today, the HIV Policy Lab is a unique initiative to gather and monitor HIV-related laws and policies around the world. 

“Laws and policies are life or death issues when it comes to HIV. They can ensure access to the best that science has to offer and help people to realize their rights and live well, or they can be barriers to people’s well-being. Like anything that matters, we need to measure the policy environment and work to transform it as a key part of the AIDS response,” said Winnie Byanyima, UNAIDS Executive Director.

The HIV Policy Lab is a data visualization and comparison tool that tracks national policy across 33 different indicators in 194 countries around the world, giving a measure of the policy environment. The goal is to improve transparency, the ability to understand and use the information easily and the ability to compare countries, supporting governments to learn from their neighbours, civil society to increase accountability and researchers to study the impact of laws and policies on the HIV pandemic. 

According to Matthew Kavanagh, Director of the Global Health Policy & Politics Initiative at Georgetown University’s O’Neill Institute, “Policy is how governments take science to scale. If we want to improve how policy is used to improve health outcomes, it is essential to monitor and evaluate the policies that comprise it.”

“Reducing stigma and making care easier to access are fundamental for improving the lives of people living with HIV—and those are all consequences of policy choices. Tracking these choices is a key tool for improving them, and ensuring justice and equity for people living with HIV,” said Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The HIV Policy Lab draws information from the National Commitments and Policy Instrument, legal documents, government reports and independent analyses to create data sets that can be compared across countries and across issues. The goal of the HIV Policy Lab is to help identify and address the gaps between evidence and policy and to build accountability for a more inclusive, effective, rights-based and science-based HIV policy response.

The HIV Policy Lab is a collaboration between Georgetown University and the O’Neill Institute for National and Global Health Law, UNAIDS, the Global Network of People Living with HIV and Talus Analytics.

About the Georgetown University O’Neill Institute for National and Global Health Law

The O’Neill Institute, housed at Georgetown University, was established to create innovative solutions to the most pressing national and international health concerns, with the essential vision that the law has been, and will remain, a fundamental tool for solving critical health problems. The Georgetown University Department of International Health is home to scholarship in public health, economics, political science, and medicine. Georgetown’s Global Health Initiative serves as a university-wide platform for developing concrete solutions to the health challenges facing families and communities throughout the world. Read more at oneillinstitute.org and connect with us on Twitter and Facebook.

About UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

About GNP+

GNP+ is the global network for and by people living with HIV. GNP+ works to improve the quality of life of all people living with HIV. GNP+ advocates for, and supports fair and equal access to treatment, care and support services for people living with HIV around the world. Learn more at gnpplus.net and connect with GNP+ on Facebook, Twitter and Instagram. 

GENEVA, 29 September 2020—Survivors of COVID-19 from 37 countries are among almost 1,000 people who have signed an open letter to pharmaceutical industry leaders calling for a ‘people's vaccine’ and treatments that are available to all – free from patents. The letter comes on the eve of a high-level side event about the pandemic at the UN General Assembly in New York tomorrow (30 September).

The signatories include 242 COVID-19 survivors from South Africa to Finland and New Zealand to Brazil. They also include 190 people in 46 countries who have lost relatives to the virus, and 572 signatories with underlying health conditions that mean they are more likely to develop severe forms of COVID-19 and have a greater risk of dying from it.

The letter says: “Some of us have lost loved ones to this killer disease. Some of us have come close to death ourselves. Some of us are continuing to live in fear that contracting this disease would be fatal for us. We see no justification why your profit or monopolies should mean anyone else should go through this.”

It describes pharmaceutical corporations as “carrying on with business as usual - defending monopolies while refusing to share research and know-how” and calls on industry leaders to “ensure COVID-19 vaccines and treatments reach everyone who needs them by preventing monopolies, ramping up production and sharing knowledge.”

Pharmaceutical monopolies will restrict the production of effective vaccines and treatments to a small number of manufacturers, preventing the mass production that is needed to meet global demand. The letter demands that corporations immediately license vaccine technology and intellectual property rights to the WHO COVID-19 Technology Access Pool (C-TAP).

One of the signatories, Dilafruz Gafurova, 43, from Tajikistan, said: “Me and my husband got sick with this disease. We could only rely on ourselves as hospitals were full … It was really difficult to get the right medicines. I am a mother of four children … I was afraid to leave them alone in this world if something bad could happen with me … The reason I am signing this letter is to help others to get [a] vaccine. Not all the people around the world can get this vaccine, as they simply cannot afford it. They hardly [have enough to meet] their daily needs.”

The letter was organised by the People's Vaccine Alliance, a global coalition of organisations and activists united under a common aim of campaigning for a people’s vaccine for COVID-19 that is based on shared knowledge and is freely available to everyone everywhere.

Tomorrow at the UN General Assembly, Bill Gates and UK Prime Minister Boris Johnson will be among other high-profile figures discussing vaccine access. So far rich nations have failed to exert pressure on pharmaceutical corporations to share technology to maximise the supply of successful vaccines and treatments worldwide.

Heidi Chow from Global Justice Now, a member of the People’s Vaccine Alliance said: “Pharmaceutical companies need to pay attention to the demands of people from around the world who have experienced the fear and devastation of COVID-19. The industry cannot block its ears to these voices but should respond immediately by ending their monopolies and commit to sharing manufacturing know-how. These actions are crucial to expand vaccine supplies so that all countries can affordably access effective vaccines.”

Winnie Byanyima, Executive Director of UNAIDS, said: "With AIDS we saw that when treatments were found the wealthier people in wealthier countries got back to health, while millions of people in developing countries were left to die. We must not repeat the same mistake when a vaccine for COVID-19 is found. The right to health is a human right—it should not depend on the money in your pocket or the colour of your skin to be vaccinated against this deadly virus. A vaccine should be a global public good and free of charge for all."

A COVID-19 VACCINE FOR ALL

The Alliance is also calling on governments to make public funding for research and development of COVID-19 diagnostics, vaccines and treatments conditional on pharmaceutical companies sharing their knowledge and technology free from patents. When an effective vaccine is available, the Alliance demands that doses are fairly distributed with priority given to health workers and other at-risk groups in all countries.

Notes to editors:

Read the full text of the letter

The high-level side events, titled Accelerating the end of the COVID-19 pandemic: taking new solutions to scale and making them equitably accessible, to save lives, protect health systems and restart the global economy, will take place on 30 September at the 75^th session of the UN General Assembly in New York. Among the participants are the UN Secretary General, WHO Director General, leaders of a range of countries including the UK and South Africa and UNAIDS Executive Director Winnie Byanyima.

The open letter has been signed by 941 people. They include 242 COVID-19 survivors from the following 37 countries: Australia, Azerbaijan, Bangladesh, Belgium, Brazil, Burundi, Canada, Denmark, Finland, France, Germany, India, Ireland, Italy, Japan, Kenya, Lebanon, Morocco, Netherlands, New Zealand, Nicaragua, Pakistan, Philippines, Poland, Portugal, Republic of North Macedonia, Russia, Senegal, Slovenia, South Africa, Spain

Sweden, Tajikistan, Uganda, UK, USA and Zambia. Some people fell into more than one category and a list of the signatories is available on request. The letter has been sent to the pharmaceutical companies behind the 11 vaccine candidates that are currently in Phase 3 trials.

People’s Vaccine Alliance is a coalition of organisations and activists united under a common aim of campaigning for a ‘people’s vaccine’ for COVID-19 that is based on shared knowledge and is freely available to everyone everywhere. A global common good. It is coordinated by Oxfam and UNAIDS and its members include Frontline AIDS, Global Justice Now, Nizami Ganjavi International Center, STOPAIDS, Wemos and the Yunus Centre. More than 140 world leaders, former leaders and economists have called on governments to unite behind a people’s vaccine against COVID-19.

Earlier this month, an analysis by Oxfam revealed that a small group of wealthy nations representing just 13 percent of the world’s population have already bought up more than half (51 percent) of the future doses of leading COVID-19 vaccine candidates. 

NEW YORK, 23 September 2020—The World Health Organization (WHO) together with the UN, specialised agencies and partners today called on countries to develop and implement action plans to promote the timely dissemination of science-based information and prevent the spread of false information while respecting freedom of expression. 

WHO, the UN, UNICEF, UNAIDS, the UN Development Programme (UNDP), UNESCO, the International Telecommunication Union (ITU), the UN Global Pulse initiative and the International Federation of the Red Cross and Red Crescent Societies  (IFRC), together with the governments of Indonesia, Thailand and Uruguay held a webinar on the margins of the 75th UN General Assembly to draw attention to the harm being done by the spread of misinformation and disinformation, the latter being deliberate misinformation to advance an agenda.

“As soon as the virus spread across the globe, inaccurate and even dangerous messages proliferated wildly over social media, leaving people confused, misled and ill-advised”, said UN Secretary-General António Guterres. ”Our initiative, called “Verified”, is fighting misinformation with truth. We work with media partners, individuals, influencers and social media platforms to spread content that promotes science, offers solutions and inspires solidarity. This will be especially critical as we work to build public confidence in the safety and efficacy of future COVID-19 vaccines. We need a ‘people’s vaccine’ that is affordable and available to all.”

“Misinformation and disinformation put health and lives at risk, and undermine trust in science, in institutions and in health systems,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “To fight the pandemic we need trust and solidarity and when there is mistrust, there is much less solidarity. False information is hindering the response to the pandemic so we must join forces to fight it and to promote science-based public health advice. The same principles that apply to responding to COVID-19 apply to managing the infodemic. We need to prevent, detect and respond to it, together and in solidarity.” 

“On top of the immediate impact on pandemic responses, disinformation is undermining public trust in democratic processes and institutions and exacerbating social divides”, said UNDP Administrator Achim Steiner. “It’s one of the most concerning governance challenges of our time. UNDP is actively collaborating with Member States, fellow UN agencies, and other partners to find holistic responses which respect human rights.”

“Misinformation is one of the fastest growing challenges facing children today,” said Henrietta Fore, UNICEF Executive Director. “It takes advantage of the cracks in trust in societies and institutions and deepens them further, undermines confidence in science and medicine, and divides communities. In its most pernicious forms, such as when it convinces parents not to vaccinate their children, it can even be fatal. Because misinformation is more a symptom than a sickness, countering it requires more than just providing truth. It also requires trust between leaders, communities and individuals.” 

“We can beat COVID-19 only with facts, science and community solidarity,” said Executive Director, Winnie Byanyima. “Misinformation is perpetuating stigma and discrimination and must not come in the way of ensuring that human rights are protected and people at risk and those marginalized have access to health and social protection services.”

“Since the start of the pandemic, UNESCO has mobilised its international networks of media partners, journalists, fact-checkers, community radio stations, and experts, to give citizens the means to fight against false information and rumours — phenomena that have been exacerbated by the pandemic,” said Audrey Azoulay, the UNESCO Director-General. ”Collective mobilisation to promote quality and reliable information, while strictly ensuring respect for freedom of expression, is essential. A free, independent and pluralistic press is more necessary than ever.”

“Trust is a cornerstone of our digital world,” said Houlin Zhao, Secretary-General of the International Telecommunication Union. “Building on the long-standing WHO-ITU BeHe@lthy BeMobile initiative, ITU has been working with national ministries of telecommunications and health and mobile network operators since the beginning of this crisis to text people who may not have access to the internet, providing them with science- and evidence-based COVID-19 health advice directly on their mobile phones.”

WHO and partners urged countries to engage and listen to their communities as they develop their national action plans, and to empower communities to build trust and resilience against false information. 

“Engaging communities on how they perceive the disease and response is critical to building trust and ending outbreaks,” said Jagan Chapagain, IFRC Secretary General. “If our response does not reflect the communities’ concerns and perceptions, we will not be seen as relevant or trusted by affected populations, and the epidemic response risks failure.  More than ever, local responders are at the forefront of this crisis. We need to recognize the incredible role they play in understanding and acting on local knowledge and community feedback.”

The co-hosts also called on the media, social media platforms, civil society leaders and influencers to strengthen their actions to disseminate accurate information and prevent the spread of misinformation and disinformation. Access to accurate information and the free exchange of ideas online and offline are key to enabling effective and credible public health responses.

"UN Global Pulse was set up a decade ago inside the UN System to pioneer the use of real-time and predictive insights to protect vulnerable communities in times of crisis”, said Robert Kirkpatrick, Director of UN Global Pulse, the United Nations Secretary-General’s initiative on big data and artificial intelligence (AI). “During this pandemic we have seen a tremendous increase in requests for advanced analytics from across the UN System and Member States. We will continue to work with WHO and other partners to help identify and combat mis- and disinformation.” 

Note to Editors

WHO defines an infodemic as an overabundance of information, both online and offline. It includes accurate information as well as mis- and disinformation. 

In May 2020, WHO Member States passed Resolution WHA73.1 on the COVID-19 response at the World Health Assembly. The Resolution recognises that managing the infodemic is a critical part of controlling the COVID-19 pandemic: it calls on Member States to provide reliable COVID-19 content, take measures to counter mis- and disinformation and leverage digital technologies across the response. The Resolution also called on international organisations to address mis- and disinformation in the digital sphere, work to prevent harmful cyber activities undermining the health response and support the provision of science-based data to the public. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS stakeholders met virtually to engage in the development of the next strategy for the global AIDS response

GENEVA, 18 September 2020—With only 10 years left to deliver the Sustainable Development Goals, including the target of ending the AIDS epidemic as a public health threat by 2030, UNAIDS is developing its next global AIDS strategy. The next strategy, which is scheduled to be adopted by the UNAIDS Programme Coordinating Board by March 2021, will be a road map for all countries and partners in the global AIDS response to get back on track to reach the goal of ending AIDS.

The first phase of the development of the new strategy took place from May to August 2020, during which UNAIDS held broad consultations and conducted a review of the current UNAIDS 2016–2021 Strategy and its implementation. More than 10 000 stakeholders were consulted through a global online survey, interviews with key informants, focus group discussions and workshops. The UNAIDS evidence review raises critical questions about what is working and how to sustain or scale up what is working, where we are falling behind and how to overcome the gaps and obstacles for the next global AIDS strategy in order to remain ambitious, visionary and evidence-informed.

On 16 September 2020, UNAIDS held a multistakeholder consultation on the next global AIDS strategy online, with more than 170 representatives of Member States, civil society, nongovernmental organizations, the private sector and academia taking part, along with representatives of all 11 UNAIDS Cosponsors.

“We cannot assume that solidarity in the global AIDS response will be maintained,” said Winnie Byanyima, Executive Director of UNAIDS. “We do not plan to reopen discussions on the issues that could take us back. We want to focus on how to make progress across the areas and issues for which we are already off-track  and we need to advance to reinvigorate progress, enhance urgency in the HIV response and strengthen global solidarity.” 

The evidence review and the strategy consultations that UNAIDS has conducted to date indicate that the priorities in the current UNAIDS strategy remain relevant, but progress and results need to be accelerated across all countries, contexts and populations. Some issues that were discussed during the consultation included: political leadership and financing; partnerships and accountability; COVID-19; key populations; adolescent girls and young women; community-led responses; eliminating stigma, discrimination and punitive laws; regional specificity; HIV and universal health coverage; multisectorality; and inequalities.

The multistakeholder consultation explored these 11 issues in more detail, generating inputs on how to amplify game-changers, how to move from commitment to action and how to measure and monitor action to drive accountability.

Government representatives emphasized the importance of having the voice of countries, at the government and community levels, at the forefront in the development of the new strategy. Civil society representatives highlighted the need to further strengthen youth empowerment and leadership, an area noted as a major shortcoming in the current strategy, in order to seize the potential of communication, education and capacity-building for the next generation. Representatives of international organizations reinforced the critical importance of the next UNAIDS strategy to maintain and enhance community engagement, including in closer coordination with the new strategy being developed by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The UNAIDS strategy development process now transitions into the next phase, with updates to be considered during briefings and meeting of the UNAIDS Programme Coordinating Board. A detailed annotated outline of the next UNAIDS strategy, which will integrate new global HIV targets for 2025 and resource needs estimates, will be presented to the 47th meeting of the Programme Coordinating Board in December 2020. The next UNAIDS global AIDS strategy will provide a critical link to inform the preparations for the next United Nations General Assembly high-level meeting on AIDS.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

On the opening day of the Virtual Fast-Track Cities 2020 conference on urban HIV and COVID-19 responses, UNAIDS has released a new report on how to strengthen responses to health emergencies

GENEVA, 9 September 2020—A new report from UNAIDS shows how countries grappling with COVID-19 are using the experience and infrastructure from the AIDS response to ensure a more robust response to both pandemics. COVID-19 and HIV: 1 moment, 2 epidemics, 3 opportunities—how to seize the moment to learn, leverage and build a new way forward for everyone’s health and rights shows that by identifying the dynamic changes needed, systems can be found that are effective, inclusive, equitable and sufficiently resourced.

“Given the epic dimensions of the emergency, the world needs unity and solidarity,” said United Nations Secretary-General António Guterres. “Our decades-long fight against HIV offers essential lessons. By heeding those lessons and working together, we can ensure that national health responses deliver on the promise of the 2030 Agenda for Sustainable Development and the health and well-being of all.”

The three opportunities highlighted in the report are: (1) that key lessons learned from the HIV response should inform COVID-19 responses; (2) how the HIV infrastructure is already driving COVID-19 responses and has the potential to catalyse accelerated progress; and (3) how the COVID-19 and HIV responses offer a historic opportunity to build a bridge to adaptable, results-driven systems for health that work for people.

“This is a unique opportunity to reimagine systems for health,” said Winnie Byanyima, Executive Director of UNAIDS. “All eyes are on health, health systems and health care, with countries wanting to be better equipped to deal not only with COVID-19 but also to create healthier, more resilient societies. We can seize this opportunity by learning from HIV and from COVID-19 to make important changes to develop rights-based, equitable, people-centred systems for health.”   

The report highlights how the HIV response can help to jump-start an accelerated response to COVID-19 in ways that can help to ensure that such efforts do not come at the expense of the HIV response or other essential health priorities. At the same time that the world undertakes focused efforts to slow the spread of COVID-19, it must also redouble efforts to limit any interruption and promote rapid recovery of HIV-related services, including ensuring uninterrupted supplies of essential commodities and technologies for HIV and other global health priorities.

“COVID-19 has caused significant loss of life in many communities, but notably in those where inequities make people more vulnerable to ill health. Leveraging of the HIV infrastructure and workforce has helped to mitigate what might have been a far worse situation,” said José M. Zuniga, President/Chief Executive Officer of the International Association of Providers of AIDS Care and co-organizer of the Virtual Fast-Track Cities 2020 event with UNAIDS. “However, with current HIV spending substantially off-track, the world urgently needs to increase investments in the responses to both HIV and COVID-19 and not siphon off one to respond to the other.”

The extensive, dynamic and agile infrastructure that has been built up around the HIV response is being leveraged in many ways to assist the response to COVID-19 and includes innovative, community-led service delivery. For example, 280 000 new health-care workers trained by the United States President’s Emergency Plan for AIDS Relief are currently assisting as first responders to COVID-19 in many low- and middle-income countries. In addition, 17 HIV treatment reference centres in Morocco are now functioning as the first line for COVID-19 treatment services. The HIV nongovernmental organization Housing Works in New York City opened two shelters specifically for homeless people who have tested positive for COVID-19.

The report highlights that although different in many respects, COVID-19 and HIV share important characteristics and that by incorporating key lessons learned from HIV, the response to COVID-19 can avoid many errors. One essential element is the buy-in and leadership of communities. Community activism has sped up the delivery of life-saving HIV medicines, community surveillance has alerted officials to dangerous medicine stock-outs and communities have delivered essential door-to-door HIV testing and treatment services and are leading efforts to strike down punitive laws that drive populations such as gay men and other men who have sex with men, sex workers and people who use drugs away from critical health services.

The report also shows the importance of firmly grounding health responses in human rights and the need for gender-transformative responses. Other actions include strengthening strategic information systems capable of delivering timely, accurate data on the pandemic to identify new outbreaks and global coordination, sustained political will and a multisectoral response.

“The emergence of COVID-19 has exposed the underlying weaknesses in health systems, which have proved to be under-resourced, unprepared and unsustainable,” said Ms Byanyima. “UNAIDS is urging that systems for health be reimagined to ensure that they are inclusive, just and equitable.”

Systems for health in the future must be prepared to address any new major health crisis by being agile, results-driven, inclusive and people-centred. COVID-19 and the response to HIV should be used as an opportunity to reimagine systems for health that work for people, maximize efficiency and effectiveness, attract sufficient resources and engage communities as essential partners for health.  

The Virtual Fast-Track Cities 2020 conference is taking place on 9 and 10 September, bringing together around 1500 representatives of more than 300 cities and municipalities around the world to discuss urban responses to COVID-19 and HIV. Anthony Fauci, Director of the United States National Institute of Allergy and Infectious Diseases, will give the keynote speech and UNAIDS will be presenting on the importance of the continuity of HIV services during COVID-19 and discussing mitigation strategies to protect gains made in the response to HIV. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Report reveals interruptions of HIV services, violence, harassment, abuse, arrests, deaths and a failure to respect human rights in their early responses to the pandemic—UNAIDS urges governments to protect the most vulnerable, particularly key populations at higher risk of HIV

GENEVA, 27 August 2020—During the early response to COVID-19 UNAIDS received numerous reports of interruptions to HIV services and disturbing human violations against vulnerable and marginalized populations. The experience of the response to HIV has proved that violations of human rights during a pandemic undermine trust, harm individuals, and set back public health responses.

The United Nations Secretary General has requested all United Nations entities to support the efforts of the World Health Organization in their own respective areas of expertise. So, to better inform the response going forwards, UNAIDS commissioned a report on how COVID-19 public health orders and restrictions on movement have impacted the response to HIV and human rights. The findings are reflective of trends across the world and uncovered significant breaches of human rights, life-threatening disruptions to health and social services, violence, abuse and discriminatory targeting of marginalized, poor and key populations.

This report is designed to help governments take positive steps to respond to human rights concerns in the evolving context of COVID-19. “It is a myth that there can be a trade-off between human rights and public health,” said Winnie Byanyima, Executive Director of UNAIDS. “Human rights are not only intrinsic, but they are also the very means by which governments can successfully beat a pandemic.” 

Rights in a pandemic – Lockdowns, rights and lessons from HIV in the early response to COVID-19 is a snapshot in time, focusing on the very early days of the pandemic, from February till mid-May 2020, drawing attention to the experiences of some of the most marginalized and vulnerable communities. Violations have included instances of police using rubber bullets, tear gas, and whips to enforce physical distancing, people being arrested and detained for not wearing masks and being issued fines—people who could not pay fines remained in jail longer than those who could pay.

Doctors were arrested and detained for travelling to and from health facilities. Reports were also received of pregnant women dying after strict restrictions on movement prevented them from reaching health-care services—some died while walking to hospital. One report detailed a motorcycle taxi-driver being beaten to death by police after taking a woman in labour to hospital during curfew hours.

Rights in a pandemic outlines 10 immediate areas for action for governments towards building effective, rights-based COVID-19 responses. These include taking proactive measures to ensure that people, particularly people in vulnerable groups, can access HIV treatment and prevention services, designating and supporting essential workers, including community-led organizations, and implementing measures to prevent and address gender-based violence.

"This report is coming at a critical time,” said Felicita Hikuam, Director of the AIDS and Rights Alliance for Southern Africa. “Sadly, it seems that we have not learned the lesson HIV has tried to teach us: epidemics expose and exacerbate existing inequities and impact most negatively on those who are already marginalised.”

A major concern has been safety during lockdowns, particularly for people most affected by HIV including women and girls, children and key populations including sex workers, lesbian, gay, bisexual, transgender and intersex people. In many countries, reported incidents of gender-based violence increased by 40–70%, with even greater spikes in certain cities and regions. Transgender people were harassed and arrested for leaving their home on the “wrong day” under gendered lockdown policies. Sex workers lost incomes and were largely not eligible for financial support. As UNAIDS has repeatedly stated, violence against key populations and women and girls increases vulnerability to HIV.

“The report gives visibility within the framework of this pandemic to those of us who are pushed to the margins,” said Elena Reynaga Executive Secretary of the Network of Women Sex workers of Latina America and the Caribbean. “From a human rights perspective, we need governments to listen and implement these recommendations, which represent an important step towards ending AIDS by 2030 by leaving no one behind."

In May, UNAIDS warned of the risk that access to HIV services may be disrupted during the COVID-19 pandemic. Early modelling showed that a severe disruption in HIV treatment could result in an additional 500 000 AIDS-related deaths in sub-Saharan Africa. This new report shows that HIV prevention and treatment services were disrupted in 10 of the 16 countries reviewed. Some countries reported reductions in medicine collections of up to 20% in some areas. There were multiple reports of people living with HIV not having enough antiretroviral medicine for a lockdown of more than 60 days as well as reports of people having abandoned their HIV treatment due to a lack of food.

In addition to learning lessons from the HIV response, the HIV pandemic must not be forgotten during this crisis. “Communities of people living with and affected by HIV, have again found themselves at the crossroad of injustice and targeted discrimination in the wake of the COVID-19 pandemic,” said Rico Gustav, Executive Director of GNP+. “As a global network of people living with HIV, we call for a rights-based law enforcement that respects and recognises the need of marginalised communities to move freely to access HIV and other medication, as well as the roll out of multi-month dispensing of antiretroviral medicines for HIV.”

There are however many positive examples. In 15 of the 16 countries reviewed, governments released people from prisons to reduce overcrowding and stem COVID-19 transmission. Where governments partnered with civil society and the private sector, responses to COVID-19 were more positive and inclusive. In some countries free transport was provided for emergency medical care during curfews and in others, police handed out masks rather than fines. Some countries provided temporary homeless shelters and supplies of food to people living in camps for displaced people. Others declared that water supplies could not be suspended for non-payment of bills and placed a moratorium on evictions or invested heavily in food support.

“National human rights institutions, such as the one I lead, have a critical role to play in tracking and protecting the human rights of all, both vulnerable and well-to-do, and especially during times of crisis and pandemics such as COVID-19 and HIV,” said Anthony O. Ojukwu, Executive Secretary, National Human Rights Commission of Nigeria. “This report opens to us the opportunity to work with institutions across the world to enforce the checks and balances in place in our own countries to correct excesses such as those of the security personnel during the early days of the lockdown.”

UNAIDS also received reports of countries expanding multi-month dispensing of HIV medicines to 3- or 6-month supplies and of others implementing home deliveries or community-based delivery of medicines.

“UNAIDS acknowledges the positive steps taken. COVID-19 is likely to be with us for a very long time though,” said Ms Byanyima. “We have a commitment to stand up for the most vulnerable even in the tough environment COVID-19 has put us in. We will use this report to convene governments, communities and partners to open a dialogue and to find a way forward to reform bad laws, policies and practices and to protect human rights.”

The report builds on Rights in the time of COVID-19, released by UNAIDS in March 2020, which urged countries to take a human rights approach in responding to COVID-19, in line with best practices from 40 years of responding to HIV.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 26 August 2020—UNAIDS is calling on countries to adopt urgent measures to reinforce social protection programmes to shield the most vulnerable people from the health impact and socio-economic fall-out of the COVID-19 pandemic.

People living with HIV and tuberculosis (TB) are being significantly impacted by COVID-19. Modelling has estimated the potential catastrophic impacts of the COVID-19 pandemic with increases of up to 10%, 20% and 36% projected deaths for HIV, TB and malaria patients, respectively, over the next five years.

Among the most vulnerable are women and girls, gay men and other men who have sex with men, sex workers, people who use drugs and transgender people. Many of them are excluded from existing social protection programmes.

“Countries must ensure that everyone is able to receive essential services including health care and they must invest adequately in social protection programmes to keep people safe and to shield them from the consequences of losing their livelihoods,” said Winnie Byanyima, Executive Director of UNAIDS.

The socio-economic fall-out of the COVID-19 pandemic will have the greatest impact on some of the most disadvantaged people in societies around the world. For example, COVID-19 threatens to double the number of people facing acute food insecurity to more than 265 million by the end of the year. Most of these people will be in countries already badly afflicted by conflict, economic or climate crises. Refugees are among the groups facing the greatest dangers.

Hundreds of millions of people around the world are also in line to lose their jobs in the formal and informal sectors of the economy. Around 150 million full time jobs were lost in the first quarter of the year and millions more people are set to lose their livelihoods in the months ahead.

“Today, only 29% of the world’s population has access to adequate social protection coverage,” said Guy Ryder, Director General of the International Labour Organization.” Governments must act to ensure the sustainability of livelihoods, businesses and jobs and the protection of workers’ health, rights and incomes during and after COVID-19.”

Women are particularly vulnerable to the economic crisis being disproportionately employed in the informal sectors of the economy and therefore most likely to lose their incomes. They are also often employed on the frontline of the response to COVID-19, making up 70% of the workforce in the health and social care sectors, as well as carrying out the bulk of unpaid domestic duties in the home, childcare and other caring functions.

An increase in gender-based violence during lockdown also makes it imperative for governments to invest in social protection programmes designed specifically for the protection of women and girls.

A generation of young people are also at risk from the socio-economic crash caused by the pandemic. The vulnerability of children and young people is being further amplified by school closures which have affected more than 90% of the world’s student population, interrupting their education and their access to crucial social services, such as school meals.

“Children and young people are suffering disproportionately from the socio-economic impact of the COVID-19 crisis,” said Henrietta H. Fore, Executive Director of UNICEF. “Before the outbreak, two out of three children had no or inadequate social protection fund. Countries need to live up to their commitment for social protection for everyone who needs it.”

The call for action for governments to invest adequately in social protection programmes is endorsed by UNAIDS, the United Nations Children’s Fund (UNICEF) and the International Labour Organization (ILO) and supported by the World Food Programme (WFP), the Office of the  United Nations High Commissioner for Refugees (UNHCR), the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), the United Nations Office on Drugs and Crime (UNODC), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the World Bank.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

NEW YORK/GENEVA, 22 July 2020—Launching today, the COVID-19 Law Lab initiative gathers and shares legal documents from over 190 countries across the world to help states establish and implement strong legal frameworks to manage the pandemic. The goal is to ensure that laws protect the health and wellbeing of individuals and communities and that they adhere to international human rights standards.

The new Lab (at covidlawlab.org) is a joint project of United Nations Development Programme (UNDP), the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the O’Neill Institute for National and Global Health Law at Georgetown University.

Well-designed laws can help build strong health systems; evaluate and approve safe and effective drugs and vaccines; and enforce actions to create healthier and safer public spaces and workplaces. Critically, they are key to effective implementation of the WHO International Health Regulations: surveillance; infection prevention and control; management of travel and trade; and implementation of measures to maintain essential health services.

“Laws and policies that are grounded in science, evidence and human rights can enable people to access health services, protect themselves from COVID-19 and live free from stigma, discrimination and violence,” says Achim Steiner, UNDP Administrator. “The COVID-19 Law Lab is an important tool for sharing good practices on laws and policies.”

The COVID-19 pandemic has seen a vast increase in urgent legislative action to control and reduce the pandemic.

"Strong legal frameworks are critical for national COVID-19 responses," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Laws that impact health often fall outside the health sector. As health is global, legal frameworks should be aligned with international commitments to respond to current and emerging public health risks. A strong foundation of law for health is more important now than ever before.”

However, laws that are poorly designed, implemented, or enforced can harm marginalized populations, entrench stigma and discrimination, and hinder efforts to end the pandemic.

“Harmful laws can exacerbate stigma and discrimination, infringe on people's rights and undermine public health responses," according to Winnie Byanyima, Executive Director of UNAIDS. "To ensure responses to the pandemic are effective, humane and sustainable, governments must use the law as a tool to uphold the human rights and dignity of people affected by COVID-19.”

The COVID-19 Law Lab is a database of laws that countries have implemented in response to the pandemic. It includes state of emergency declarations, quarantine measures, disease surveillance, legal measures relating to mask-wearing, social distancing, and access to medication and vaccines. The database will continue to grow as more countries and themes are added.

It will also feature research on different legal frameworks for COVID-19. These analyses will focus on the human rights impacts of public health laws and help countries identify best practices to guide their immediate responses to COVID-19 and socioeconomic recovery efforts once the pandemic is under control. It builds off the work of the UHC Legal Solutions Network, which was established to help countries achieve universal health coverage through the implementation of rights-based legal frameworks.

"We need to track and evaluate how laws and policies are being used during the Pandemic to understand what works," said Dr. Matthew M. Kavanagh, faculty in Georgetown University's Department of International Health. Katie Gottschalk, Executive Director of the O'Neill Institute for National and Global Health Law at Georgetown University Law Center added, "We must learn lessons from the early stage of pandemic policies to implement the most effective laws going forward – the COVID-19 Law Lab allows us to do just that."

UNDP

The United Nations Development Programme is the leading United Nations organization fighting to end the injustice of poverty, inequality, and climate change. Working with our broad network of experts and partners in 170 countries, we help nations to build integrated, lasting solutions for people and planet. Learn more at undp.org or follow @UNDP.

WHO

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

O’Neill Institute for National and Global Health Law and Georgetown University

The O’Neill Institute, housed at Georgetown University, was established to create innovative solutions to the most pressing national and international health concerns, with the essential vision that the law has been, and will remain, a fundamental tool for solving critical health problems. The Georgetown University Department of International Health is home to scholarship in public health, economics, political science, and medicine. Georgetown’s Global Health Initiative serves as a university-wide platform for developing concrete solutions to the health challenges facing families and communities throughout the world. Read more at oneillinstitute.org and connect with us on Twitter and Facebook.

UHC Legal Solutions Network

The COVID-19 Law lab is a product of the UHC Legal Solutions Network is a collaboration between the World Health Organization (WHO), the United Nations Development Programme (UNDP), the Joint United Nations Programme on HIV and AIDS (UNAIDS), the Inter-Parliamentary Union (IPU), and the O'Neill Institute for National and Global Health Law at Georgetown University. The initiative aims to support countries to achieve universal health coverage by working with policymakers, civil society groups and other stakeholders to craft laws ensure that all people and communities have the right to access the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

GENEVA, 7 July 2020—The latest report on the progress towards the Start Free, Stay Free, AIDS Free targets shows that despite great progress made since the early days of the epidemic, the HIV response for children has fallen behind. Year after year, the bold target of eliminating new HIV infections among children is being missed and children are dying needlessly from AIDS-related illnesses—deaths that could be prevented with simple and cheap treatments if the children were diagnosed and treated in time.

“To see so many tools available, so many new HIV infections among children that have been prevented, so many children living with HIV doing well, but to see others missed and still left behind is a tragedy,” said Winnie Byanyima, Executive Director of UNAIDS. “We cannot accept that tens of thousands of children still become infected with HIV and die from AIDS-related illnesses every year.”

The Start Free, Stay Free, AIDS Free framework has three simple concepts. First, babies have a right to enter the world free from HIV. Second, through HIV prevention, children, adolescents and young women have a right to stay free from the virus. Third, children and adolescents who do acquire HIV have the right to be diagnosed, treated and cared for, so that they can remain AIDS-free.

The world’s countries have agreed to a range of HIV prevention and treatment targets. So that children start out their lives HIV-free, one of those targets was to reduce new child (aged 0–14 years) HIV infections to less than 40 000 by 2018 and 20 000 by 2020. However, newly published estimates show that 150 000 children were newly infected with HIV in 2019—a 52% reduction since 2010, but still four times the 2018 target.

By ensuring that pregnant women living with HIV are diagnosed, started on and retained on antiretroviral medicines during pregnancy, delivery and breastfeeding, the chance that they will pass on the virus is less than 1%. Globally, 85% of pregnant women living with HIV received those medicines in 2019. But despite this high coverage, children are still becoming infected due to unequal access to treatment services (primarily in western and central Africa), women falling out of care and pregnant and breastfeeding women becoming newly infected with HIV.

“As a global community, we have made remarkable progress toward controlling the HIV pandemic, yet we are still missing far too many children, adolescents and young women,” said Angeli Achrekar, Principal Deputy United States Global AIDS Coordinator, United States President’s Emergency Plan for AIDS Relief. “We must all redouble our efforts to urgently reach these critical populations—and PEPFAR remains deeply committed to doing its part.”

The stay-free component set a target of reducing new HIV infections among adolescent girls and young women to less than 100 000 by 2020. Adolescent girls and young women have long been disproportionately affected by HIV—among the Start Free, Stay Free, AIDS Free focus countries, adolescent girls and young women make up 10% of the total population but represent 25% of new HIV infections and are at an almost twofold higher risk of HIV infection compared with their male peers. However, new HIV infections among young women have been falling. In South Africa, where combination prevention programmes for adolescent girls and young women are in place, new HIV infections among this age group have dropped by 35%. And in Eswatini, new HIV infections among young women aged 15–24 years have dropped by 54%.

“For too long, the response to HIV has overlooked children, adolescent girls and young women,” said Henrietta Fore, the Executive Director of the United Nations Children’s Fund. “But there is hope. The recent momentum in reducing new infections among adolescent girls and young women in countries like Eswatini and South Africa show us what is possible when governments and communities, led by girls themselves, join forces. We must not let COVID-19 and its economic headwinds slow us down. We must remain bold and ambitious in our joint efforts to ensure that the next generation of children remain free of HIV and AIDS.”

So that children and adolescents stay AIDS-free, countries called for ambitious but achievable targets for HIV treatment for children—to provide 1.4 million children living with HIV with antiretroviral therapy by 2020. In 2019, however, only 950 000 (53%) of the 1.8 million children living with HIV were receiving HIV treatment—much lower than the 67% of adults on treatment.  It is clear that to save lives, the missing 840 000 children not on treatment —an estimated two thirds of whom are estimated to be between 5 and 14 years—must be diagnosed and treated as a matter of urgency.

“The lack of optimal HIV medicines with suitable paediatric formulations has been a longstanding barrier to improving health outcomes for children living with HIV, contributing towards low treatment coverage,” said Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization. “Access to services for vulnerable groups must be expanded through stronger community engagement, improved service delivery and tackling stigma and discrimination.”

Despite the failures, the positive news is that we do know how the world could have met the Start Free, Stay Free, AIDS Free targets. And with enough commitment, we can still overcome the main obstacles to the targets and reverse the failures.

“The past decade has been marked by innovation and progress in the field of paediatric HIV, but the dramatic miss on targets for children in this latest report is simply unacceptable. We must urgently renew our commitment to fighting for an AIDS-free generation, but today, as a global community, we are failing the most vulnerable among us: children and youth,” said Chip Lyons, President and Chief Executive Officer, Elizabeth Glaser Pediatric AIDS Foundation.

“We can do better. We must do better,” added Ms Byanyima. “We know how to save lives and stop new HIV infections among children. I demand that we spare no effort. Anything less is shameful.” 

UNAIDS and the United States President’s Emergency Plan for AIDS Relief launched the Start Free, Stay Free, AIDS Free framework in 2016 to build on the achievements of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive, which ended in 2015.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.