To end AIDS we must focus our efforts on three priorities

These are my keynote remarks to Uganda's Joint AIDS Review delivered on 26 August 2020

This year, 2020, marks 38 years since HIV was found in Uganda in 1982. As a fellow Ugandan, as an activist and a feminist, I want to appreciate your work since the start of the HIV epidemic, the urgency with which you continue to engage, and the solutions you bring as we work together to defeat it.

Communities courageously fought to stop its spread. Uganda was one of the first countries to fight it before there was any treatment, while many governments across the world were burying their head in the sand. We were a model country pursuing a multisectoral approach to the HIV response and with strong political leadership.

Today it is still a high priority in our country. You, political, cultural and religious leaders have worked hard to do better, and your effort paid off. Uganda is one of the 14 countries in the world to have achieved the 90–90–90 target of 73% of viral load suppression among people living with HIV. This progress must be recognized and celebrated.

However, we need to go further and beyond to defeat HIV for good. For example, in Uganda, I understand, 90% of HIV funding is external, with the government providing 10% of the financial resources. That makes our response vulnerable. We must find pathways for finance. We must have a complete package for our health response. As such I urge you to implement the National Health Insurance scheme, as it is an essential step towards universal health coverage.

At the global level, progress on the AIDS response has also been made. But we are still leaving many behind. Of the 38 million people living with HIV, 25.4 million people are now on treatment. This means that 12.6 million people are still waiting. New HIV infections have been reduced by 23% globally since 2010. We have made progress in our region. But HIV infections have increased in some other regions. And tragically everywhere we are failing children. Children are still much less likely than adults to access HIV treatment and to stay on it.

And now of course the COVID-19 pandemic has changed our world and is setting us back. The latest UN SDG Report finds that this pandemic could reverse decades of progress on fighting poverty, achieving healthcare and education. Our progress towards ending AIDS globally as a public health threat by 2030 was already off track before the COVID-19 outbreak. Now this crisis has the potential to blow us even further off course.

COVID-19 has highlighted our interdependence, but it also exacerbated further the inequalities that exist between and within countries. I will talk about gender inequality, as this is crucial in our fight against HIV too. Gender inequality is driven by the high level of violence against women and girls; driven by our own social norms and by gender blind policies. Adolescent girls and young women are five times more vulnerable than boys and men of the same age. Every week, 5100 young women in sub-Saharan Africa are infected with HIV. These are our daughters, our children.

Decades of experience in responding to HIV are today being used in the response to COVID-19. This is something that we should be proud of. We must fight hard that the world does not repeat the same mistakes. This is why UNAIDS is leading a call for a COVID-19 vaccine to be a People’s Vaccine, available to everyone, everywhere free of charge at the point of use.

And it’s not just about not repeating the same mistakes. It is also about re-setting and building a better normal, with universal health care, that values everyone, and leaves no one behind. We must focus our efforts around 3 priorities:

The first is health financing & debt cancellation. Health care is a human right and should never depend on how much money you have in your pocket. Governments should provide publicly funded health care that is truly “for all”. We need to reform the corporate tax system to free the resources needed for investments in public health and economic recovery. Developing countries lose 100 billion dollars every year through tax dodging. But it is also about spending our resources well, for them not to be diverted and using them cost effectively. UNAIDS will commit to support on effective health financing. And we also need debt relief and debt cancellation to give us the breathing space to fight two epidemics.

The second is about putting communities and human rights at the center. We know where communities can fully participate in decision-making and service delivery, and human rights protections are strengthened, HIV outcomes and impacts have improved. Where stigma and discrimination and criminalization have shut out citizens and whole communities, HIV responses struggle to provide services to those who need them most. That is why the AIDS response globally has committed to channel 6% of all HIV investments to community-led action and social enablers and to ensure that at least 30% of all service delivery by 2030 is community-led.

And thirdly connecting education and health. We know quality secondary education can protect adolescent girls and young women in all their diversity everywhere against HIV – it reduces their vulnerability by 50%. It can also advance health, gender equality and development. I am delighted that UNAIDS is working together with UN Women, UNFPA, UNESCO and UNICEF on a new and exciting initiative to roll out secondary education.

 We cannot allow the hard-fought gains made in the HIV response to be reversed. Especially as there is still so far to go to finish the job. I am proud to be a part of you and I hope you will support me in my global role to end AIDS by 2030.