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Inequality is Set to Kill Millions – “We Have to Fight it Together.”

The UN commemorated World Aids Day on 30 November. Credit: UNAIDS

GENEVA, Dec 1 2021 (IPS) - This week I called out to the world to warn them that inequalities are making us all unsafe. I noted starkly our new analysis that we face millions of additional AIDS deaths – 7.7 million in the next decade alone – as well continued devastation from pandemics, unless leaders address the inequalities which drive them. We have to treat this threat as an emergency, as a red alert.

To end AIDS, we need to act with far more urgency to tackle these inequalities. And it’s not just AIDS. All pandemics take root in, and widen, the fissures of society. The world’s failure to address marginalization and unequal power is also driving the COVID crisis and leaving us unprepared for the pandemics of tomorrow. We need all leaders to work boldly and together to tackle the inequalities which endanger us all.

To tackle inequalities requires leaders to take these courageous steps:

    ● Support community-led and people-centred infrastructure
    ● Ensure equitable access to medicines, vaccines and health technologies
    ● Strengthen human rights, to build trust and tackle pandemics
    ● Elevate essential workers and provide them with the resources and tools they need
    ● Ensure people-centred data systems that highlight inequalities.

At the United Nations General Assembly High-Level Meeting on HIV/AIDS in June this year, member states adopted a bold new plan to end the AIDS epidemic, including new targets for 2025.

We are seeing around the world examples of the transformative impact of tackling inequalities – with some people and some countries making progress against AIDS that many had believed impossible. These prove that it can be done, and guide us in what we need to take to scale worldwide to end AIDS.

On my recent visit to Senegal, I saw the power of leadership in driving down new HIV infections. In Dakar I met with the inspirational Mariama Ba Thiam, a peer educator at a harm reduction programme for people who inject drugs.

The programme helps them protect their health and to secure economic independence. Mariama’s approach works because it starts by considering the whole person, connecting the medical with the social. It rejects the failed punitive and stigmatizing approaches taken by so many, and it instead respects the dignity of every person.

It succeeds because it involves frontline communities in service provision and in leadership, and because it recognizes that access to the treatments grounded in the best science is a human right and a public good. We know what success looks like, and it looks like Mariama. Thousands of Mariamas worldwide have shown the way by walking it.

But in too many cases we are not only not moving fast enough to end the inequalities which drive pandemics, and are moving in the wrong direction – tech monopolies instead of tech sharing, donor withdrawal instead of global solidarity, austerity instead of investment, clampdowns on marginalised communities instead of repeals of outdated laws.

Six in seven new HIV infections among adolescents in sub-Saharan Africa are occurring among girls. Gay men and other men who have sex with men, sex workers, and people who use drugs face 25-35 greater risk of acquiring HIV worldwide.

Progress in AIDS, which was already off track, is now under even greater strain as the Covid crisis continues to rage, disrupting HIV prevention and treatment services, schooling, violence-prevention programmes, and more. Harm reduction services for people who use drugs were disrupted in nearly two thirds (65%) of 130 countries surveyed in 2020.

We have reached a fork in the road. The choice for leaders to make on inequalities is between bold action and half-measures. The data is clear: it is being too gradual that is the unaffordable choice.

Leaders need to turn this moment of crisis into a moment of transformation. Ending these inequalities fast is what needs to be reflected in every leader’s policy programme and every country’s budget.

If we take on the inequalities which hold back progress, we can deliver on the promise to end AIDS by 2030. It is in our hands. But if we don’t act to end inequalities, we will all pay the price.

Inequalities kill. Every minute that passes, we are losing a precious life to AIDS, and widening inequality is putting us ever more in danger. We don’t have time.

Winnie Byanyima is Executive Director of UNAIDS and Under-Secretary-General of the United Nations


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  • Red Robbo

    ‘We have reached a fork in the road. The choice for leaders to make on inequalities is between bold action and half-measures. The data is clear: it is being too gradual that is the unaffordable choice.’

    We reached that fork long ago.

    1685: “I never could believe that providence had sent a few men into the world, ready booted and spurred to ride, and millions ready saddled and bridled to be ridden” (Richard Rumbold when on the scaffold).

    1776: ‘…wherever there is great property there is great inequality. For one very rich man there must be at least five hundred poor, and the affluence of the few supposes the indigence of the many’ (Wealth of Nations, Adam Smith).

    1899: ‘Far better it is to dare mighty things, to win glorious triumphs, even though checkered by failure, than to take rank with those poor spirits who neither enjoy much nor suffer much, because they live in the gray twilight that knows not victory nor defeat’ (Theodore Roosevelt). Oscar Wilde described us ‘poor spirits’ more accurately and succiently when he said ‘To live is the rarest thing in the world. Most people exist, that is all’.

    1951: ‘It is time for mankind to ensure itself of material abundance by establishing a free, self-managed world-society of productive labor, thereby freeing its mental powers for perfecting its knowledge of nature and the universe’ (A History of Astronomy, Anton Pannekoek).

    2020: ‘The fight against impoverishment remains a policy of aid, of charity, not a fight to eradicate the structural factors that cause impoverishment; the countries that signed the Treaty of Paris undertook to allocate 100 billion a year from 2020 to the fight against climate disaster. Well, none of the powerful dare to say where the 100 billion is; we know, however, by whom and where the trillion and 800 billion were spent in 2019 on armaments, 25 percent of which would be enough to cover all the above-mentioned financial needs. Finally, we know that military spending will not decrease in 2020.’ (Health for all? Professor Riccardo Petrella).

    A post-capitalist world of peace and plenty has long been possible. Let us make it so.

  • newestbeginning

    Hear hear!

    Have you by chance read The Ragged Trousered Philanthropists? Highly recommend it if you have not.

  • Red Robbo

    “Under the existing system of society but a very few people no matter how well off they may be, can be certain that they or their children will not eventually come to want; and even those who think they are secure themselves, find their happiness diminished by the knowledge of the poverty and misery that surrounds them on every side.”

    A re-reading is long overdue!

  • newestbeginning


    ‘Poverty,’ continued Owen after a short silence, ‘consists in a shortage of the necessaries of life. When those things are so scarce or so dear that people are unable to obtain sufficient of them to satisfy all their needs, those people are in a condition of poverty. If you think that the machinery, which makes it possible to produce all the necessaries of life in abundance, is the cause of the shortage, it seems to me that there must be something the matter with your minds.” ~~ Robert Tressell, The Ragged Trousered Philanthropists

    It is well worth a re-read. Hope you are well, Red. We don’t see enough of you around. Best to you.

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