AFRAVIH: Fighting HIV is no longer an issue of science, but an issue of equality | Planet of the future

Every step we take today in the fight against HIV will be difficult: we must do more to move forward. Experts on the virus are meeting this week in Yaoundé, Cameroon, for AFRAVIH, the largest French-language international conference on HIV/AIDS. In the early years of fighting this virus, our progress was often rapid and enormous because everywhere you looked there was great need. These were devastating times: the disease killed three million people in 2000, more than 2.4 million of them in Africa. In the southern tip of the continent where I come from, disease threatened to destroy the social fabric.

As the world came together and formed partnerships like the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR, it challenged the injustice that only rich people could receive HIV treatment. This was to prevent the possibility of a lost generation of people in many low- and middle-income countries, and those who were stigmatized and discriminated against because they were seen as different.

We have come a long way, from fewer than 50,000 people receiving HIV treatment in Africa in 2000 to more than 20 million today.

I can proudly say that we have come a long way since then. From fewer than 50,000 people receiving HIV treatment in Africa in 2000 to more than 20 million today, innovations in HIV prevention have proliferated, leading to a dramatic decline in HIV infections. However, in 2022, more than 1.3 million people were infected with the virus worldwide.

These infections currently occur primarily among men who have sex with men, people who inject drugs, trans women and sex workers. Moreover, their voices are increasingly silenced and they are under constant threat of violence and abuse as discriminatory anti-LGBTI legislation emerges around the world. Among these groups, young people aged 15 to 24 years bear a disproportionate burden of HIV and are even more vulnerable because they face greater barriers to accessing health services.

The fight against HIV is no longer a matter of science, but an issue of equality. To accelerate progress again, we must restore the strong spirit of equality that inspired us two decades ago. This means focusing on the communities most affected by HIV. In Africa, focusing on adolescents of both genders is an urgent need.

In Africa, focusing on adolescents of both genders is an urgent need.

Although HIV incidence among adolescent girls and young women has declined significantly over the past decade, 4,000 girls and young women continue to become infected with HIV every week worldwide, primarily in sub-Saharan Africa. This is unacceptable. This group continues to suffer the most unjust conditions of all: structural injustice predisposes them to disease.

If we want to prevent HIV infection among this population, we must bring together diverse partners to invest in long-term efforts to keep girls in school. Education transforms girls into women with greater equality of opportunity and protects them from diseases such as HIV. Educated girls have lower rates of teenage pregnancy, sexual violence, early marriage, and ultimately lower rates of HIV infection. We must also accelerate investments in programs that support comprehensive sexual and reproductive health and rights, especially for adolescent girls and young women.

And we must ensure that young women and girls are at the center of projects that require their participation. These are some of the goals that the Global Fund partnership seeks to achieve through projects such as Voix EssentiELLES and the HER Voice Fund, which seek to meaningfully engage young women and girls in key health programs and decision-making forums in their communities.

Educated girls have lower rates of teenage pregnancy, sexual violence, early marriage, and ultimately lower rates of HIV infection.

To end HIV infection among young women and girls, we must also reduce HIV infection among their sexual partners. This means investing in efforts to change the cultural and social norms that predispose men and boys to HIV and that shape their relationships with girls and women in their communities. It also means that men at high risk of contracting HIV are tested and supported to start and stay on treatment. Protecting heterosexual men and boys from HIV can also help protect women and girls.

It’s about renewing our focus on ensuring justice. We know how to do it. We did this at the turn of the millennium, striving for equity in HIV treatment. There are three months left until the 25th International AIDS Conference in Munich. Let’s move forward now and end this unfinished fight by reducing HIV infections among the hardest hit groups. To achieve this goal, we can renew our strength by building on the goals and enduring spirit of those golden years of progress in the fight against HIV.

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