First of all, good news. Remarkable progress has been made in HIV science. There is no vaccine or treatment yet, but New long-acting injectable drug Now able to provide protection against HIV for up to 6 months.
This breakthrough could revolutionize efforts to curb the pandemic, which is still claiming lives every minute. But the rise of populism and regressive governance threatens to undo many hard-won gains in HIV and public health.
In the United States, the highly successful bipartisan President’s Emergency Plan for AIDS Relief (PEPFAR) is under attack and its possible scrapping could deprive millions of people of access to life-saving drugs. There is a possibility that it will be cut off. The program is estimated to have: Saved approximately 26 million lives Over the past 20 years. The plan was designed out of concerns that the AIDS pandemic could devastate generations of people and fuel political instability in low- and middle-income countries.
The National Institutes of Health (NIH) has faced intense scrutiny over its funding of HIV research, with some policymakers questioning the validity of decades of peer-reviewed science.
Robert F. Kennedy Jr., the Trump administration’s pick to be the next U.S. secretary of health, is a longtime vaccine skeptic. False link between vaccines and autism. Kennedy too On record Denies the causal relationship between HIV and AIDS. Treating evidence-based research as an opinion that can be exchanged with other views without scientific validity is a grave danger, especially when it is entrenched at the highest levels of government.
Human rights restrictions continue to challenge the HIV response in the areas most affected by the epidemic. 2024, Uganda supported one of the strictest anti-gay laws in the world. At least half of 67 countries still criminalize homosexuality They live in sub-Saharan Africa, where the number of HIV infections is highest. Anti-gay laws are correlated with rising global HIV infection rates. in Russiapunitive drug laws and restrictive LGBTQ+ policies continue to drive the world’s rapidly growing HIV epidemic.
Undermining science and human rights risks reversing progress and inviting the next pandemic. reappearance of Mpox and H5N1 avian influenza It’s a warning shot. Next could be HIV. But there is a blueprint that can do the opposite and end HIV for good.
protect human rights
Protecting human rights is not just an ideological position. It’s a proven public health strategy. Punitive laws and discriminatory policies harm those most in need and undermine HIV prevention and care.
Urgent legal reform is needed to protect critical populations and repeal laws that criminalize the LGBTQ+ community, immigrant workers, sex workers, people who inject drugs, and people who are incarcerated. Empowering civil society organizations, including people living with HIV, has been and will continue to be a cornerstone of the HIV response.
Protecting shrinking civil society spaces
One of the most powerful lessons from 40 years of fighting HIV is that successful public health efforts require an engaged and empowered civil society. The work of those most affected has shaped the response to HIV, from the design of clinical trials to health policy.
Civil society organizations provide critical services, especially to people whose access to public health systems is hindered by stigma and discrimination. Protecting these organizations, rather than defunding or persecuting them, saves lives. However, more than 50 countries have enacted laws restricting the foreign funding on which many HIV responses depend.
As convener of the world’s largest HIV conference, we at the International AIDS Society are feeling the impact of shrinking civil society space. Countries most affected by HIV are often barred from our conferences due to safety concerns for the most marginalized and persecuted populations.
In other instances, the government interfered with the agenda and debates of our meetings and threatened to undermine the independence of our movement. We demand the protection of civil society spaces so that people can organize and assemble freely. Because public health responses depend on them to work.
Depoliticizing public health
Despite the lessons of the COVID-19 pandemic, efforts by WHO member states to draft a new pandemic convention in 2024 have failed. The treaty aimed to address gaps exposed by COVID-19, including inequitable vaccine distribution and lack of global coordination.
Failure to agree on the text of the treaty He emphasized that geopolitical and economic forces are increasingly shaping global health policy, undermining global health equity. It is important to resist this ongoing negotiationsand a strong treaty text based on public health will be adopted at the World Health Assembly in May of this year.
The potential reinstatement of the Global Gag Rule is another example of how unrelated political agendas are undermining the HIV response. The law, first introduced under the Reagan administration and revived under the first Trump administration, prohibits international organizations from receiving U.S. funding to provide abortion services or related information.
Paradoxically, this policy increases reliance on abortion by restricting access to contraception. Research results published in PNAS revealed Contributed to 360,000 new HIV infections in just four years (2017-2021). Two-thirds of international HIV funding comes from the US, so reintroducing the gag rule would have devastating consequences.
Strengthening international cooperation
According to the Joint United Nations Program on HIV/AIDS (UNAIDS), its funding in 2024 will fall to less than 50% of what was available in 2015, as will other important multilateral health organizations such as the World Health Organization (WHO). is. They are having trouble raising funds.
institutions such as Pepfer and Global Fund to Fight AIDS, Tuberculosis and Malaria Between them approximately 90 million lives were saved. They deserve to be defended, not defunded. Underfunding and inequity undermine global health cooperation
Progress happens when science, policy and civil society come together. The HIV movement builds on transformative social movements such as women’s rights, LGBTQ+ rights, and civil rights, showing that inclusive and collaborative approaches drive sustainable change.
Today, we must build on this legacy and organize to push back against anti-human rights movements and defend science as the foundation of social progress. The other is a place that humanity has visited many times before, offering little but regression and suffering.
Beatrice Grinstein is president of the International AIDS Society.
Birgit Poniatowski is the Executive Director of the International AIDS Society.
Image credits: kelly callinan, Peter Touchwell Foundation.
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