Is HIV Making a Comeback? Uncovering the Stark Realities and Emerging Threats – Health Policy Watch

Great news on the HIV front: science is advancing rapidly! We don’t have a vaccine yet, but a new injectable drug can offer protection against HIV for up to six months. This single dose could change the game in the fight against a pandemic that still claims a life every minute.

But there’s a catch. The rise of populism and regressive government policies is threatening the progress we’ve made in HIV prevention and care. In the United States, the President’s Emergency Plan for AIDS Relief (PEPFAR) faces potential cuts. This program has saved about 26 million lives over the last two decades and was established to combat the devastation caused by AIDS in lower and middle-income countries.

Moreover, the National Institutes of Health (NIH) is currently under scrutiny, with some questioning the validity of years of HIV research. This comes as Robert F. Kennedy Jr., known for his vaccine skepticism, is touted as a candidate for the next U.S. health secretary. His views pose a significant risk to evidence-based public health initiatives.

In regions hardest hit by HIV, human rights restrictions continue to be a major obstacle. For instance, Uganda recently upheld some of the world’s toughest anti-LGBTQ+ laws. Countries that criminalize same-sex relationships, particularly in sub-Saharan Africa, tend to have higher HIV rates. In Russia, strict drug laws and anti-LGBTQ+ measures have fueled one of the world’s fastest-growing HIV epidemics.

The disregard for science and human rights not only threatens our progress against HIV but also heightens the risk of future pandemics. Recent outbreaks of Mpox and H5N1 bird flu serve as reminders that we must act swiftly before we face another crisis. Here’s what we can do instead:

Protect Human Rights

Upholding human rights isn’t just a moral issue; it’s essential for public health. Discriminatory laws harm the very people who need help the most. Urgent reforms are necessary to protect marginalized groups, including LGBTQ+ individuals, sex workers, and people who inject drugs. Civil society organizations play a crucial role in fighting HIV and must receive support, not hostility.

Support Civil Society

Engaged civil society is vital for effective public health strategies. Organizations that assist vulnerable populations provide lifesaving services. Unfortunately, over 50 countries restrict foreign funding for these initiatives, which undermines their effectiveness. The global HIV community is feeling the impact of these restrictions, and it’s crucial to protect their ability to operate freely.

Keep Public Health Free from Politics

Even with lessons learned from the COVID-19 pandemic, efforts to create a new pandemic treaty met resistance. This agreement aimed to ensure equitable access to health resources and better global coordination. The inability to finalize this treaty shows how politics can overshadow public health needs.

Moreover, the potential reintroduction of the Global Gag Rule would further threaten the HIV response by limiting essential health information and services. This policy, which withholds U.S. funding from organizations that provide abortion-related services, paradoxically leads to higher reliance on abortion and can increase HIV transmission rates.

Foster Global Cooperation

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has seen its funding decrease significantly, now sitting at less than half of what was available in 2015. Institutions like PEPFAR and the Global Fund to Fight AIDS, Tuberculosis, and Malaria have saved millions of lives and should be supported, not defunded.

Future progress against HIV relies on a united front of science, effective policy, and vibrant civil society. This movement has roots in civil rights, LGBTQ+ rights, and women’s rights, demonstrating that inclusive approaches lead to lasting change. We must build on this legacy and resist anti-human rights movements while advocating for science-based policies, or we risk going backward rather than moving forward.

Beatriz Grinsztejn is President of the International AIDS Society.

Birgit Poniatowski is Executive Director of the International AIDS Society.

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