World AIDS Day 2020 will be like no other.

COVID-19 is threatening the progress that the world has made in health and development over the past 20 years, including the gains we have made against HIV.

Like all epidemics, it is widening the inequalities that already existed.

Gender inequality, racial inequality, social and economic inequalities. We are becoming a more unequal world.

I am proud that over the past year the HIV movement has mobilized to defend our progress, to protect people living with HIV and other vulnerable groups and to push the coronavirus back.

Whether campaigning for multimonth dispensing of HIV treatment, organizing home deliveries of medicines or providing financial assistance, food and shelter to at-risk groups, HIV activists and affected communities have again shown they are the mainstay of the HIV response. I salute you!

It is the strength within communities, inspired by a shared responsibility to each other, that has contributed in great part to our victories over HIV.

Today, we need that strength more than ever to beat the colliding epidemics of HIV and COVID-19.

Friends, in responding to COVID-19, the world cannot make the same mistakes it made in the fight against HIV, when millions in developing countries died waiting for treatment.

Even today, more than 12 million people are still waiting to get on HIV treatment and 1.7 million people became infected with HIV in 2019 because they could not access essential services.

That is why UNAIDS has been a leading advocate for a People’s Vaccine against the coronavirus.

Global problems need global solidarity.

As the first COVID-19 vaccine candidates have proven effective and safe, there is hope that more will follow, but there are serious threats to ensuring equitable access. We are calling on companies to openly share their technology and know-how and to wave their intellectual property rights so that the world can produce the successful vaccines at the huge scale and speed required to protect everyone and so that we can get the global economy back on track.

Our goal of ending the AIDS epidemic was already off track before COVID-19. We must put people first to get the AIDS response back on track. We must end the social injustices that put people at risk of contracting HIV. And we must fight for the right to health. There is no excuse for governments to not invest fully for universal access to health. Barriers such as up-front user fees that lock people out of health must come down.

Women and girls must have their human rights fully respected, and the criminalization and marginalization of gay men, transgender people, sex workers and people who use drugs must stop.

As we approach the end of 2020, the world is in a dangerous place and the months ahead will not be easy.

Only global solidarity and shared responsibility will help us beat the coronavirus, end the AIDS epidemic and guarantee the right to health for all.

Thank you.

Winnie Byanyima

Executive Director of UNAIDS

Under-Secretary-General of the United Nations

World AIDS Day 2020 playlist

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The experience of the UNAIDS Country Director for El Salvador, Celina Miranda, a trained medical doctor, has been very useful during the COVID-19 outbreak. When the United Nations Resident Coordinator nominated her to be the COVID-19 response team leader within the United Nations in the country, she was honoured.

“I accepted the challenge, since the experience of working at UNAIDS on HIV has given me the skills needed to handle these types of situations,” she said.

To date, she has handled six confirmed COVID-19 cases of United Nations personnel from different agencies. “Some went to hospital, while others self-quarantined, and all are already emerging from the acute stage,” Ms Miranda said.

A main task for COVID-19 coordinators is to determine whether local hospitals could admit and treat United Nations personnel and their dependents. El Salvador was not ready for the pandemic, she said, which added to the pressure.

Ms Miranda, along with four other UNAIDS country directors, has been nominated by the United Nations Country Teams as COVID-19 coordinators in their respective countries.

Vladanka Andreeva in Cambodia, Yafflo Ouattara in Chad, Job Sagbohan in Burkina Faso and Medhin Tsehaiu in Kenya have all felt honoured to take on such a responsibility.

Ms Andreeva explained how in early March the United Nations in Cambodia set up a United Nations Internal COVID-19 Preparedness and Response Team, and she was asked to lead the efforts in ensuring that more than 2500 United Nations staff and their dependents have access to the latest COVID-19 information, treatment, care and support. She developed a contingency plan for the United Nations family and supported the establishment of a medical evacuations process and mental health support services for staff.

Mr Sagbohan, a trained medical epidemiologist who has worked for the World Health Organization during Ebola and yellow fever outbreaks, said he spent a lot of time reassuring employees in order to overcome stress and fear. “Staff were scared, so during the lockdown period I got up to 300 calls a week despite the regular virtual town hall briefings for staff across Burkina Faso.”

He explained that despite UNAIDS’ size and lack of resources compared to other agencies, knowing about infectious diseases has helped greatly. He quickly requested focal points from different organizations and set up a United Nations taskforce against COVID-19. “I have been able to tap into a solid group of motivated people to help me and it has made all the difference.”

For Yafflo Ouattara, the COVID-19 coordinator role suits UNAIDS country directors perfectly. “We are used to getting buy-in from our Cosponsors, so joint teamwork is part of our DNA,” he said. His main task in Chad has been expanding intensive care units and setting up a strong referral system for the management of severe cases. Nearly 7000 United Nations employees and dependents are spread out across the country, some in places where there is no overnight care.

Like others, he also helped out with the national COVID-19 contingency plan to ensure that people living with HIV have access to treatment and care.

He said that the pandemic highlighted gaping holes in the country’s health system. “Not only were key investments in intensive care never made, some of the basics, like gloves, masks, soap, have been missing all along.”

Living in a COVID-19 world means a lot of readjustments. “We have an opportunity to step in and make our voices heard to overhaul systems,” Mr Ouattara said.

Medhin Tsehaiu agrees. She has been proud to see UNAIDS be part of the greater discussion.

“We are present and we are very actively and willingly doing our share,” she said. But she believes that COVID-19 has forever changed how people work.

All the virtual meetings and no travel has meant that people were much more available, so there was non-stop communication, but it was very time-consuming, she explained. “The crisis brought us together, whether we like it or not, and that has required a lot of collaboration,” Ms Tsehaiu said.

Aside from her long list of tasks as a COVID-19 coordinator, she and a few others started the United Nations Kenya solidarity fund. After much back and forth, they opened a bank account where staff can choose to contribute money during a three-month period that will be dispatched to people in need.

“It’s a way for employees to show empathy and support to the Kenyan people during these difficult times,” she said.

Speaking of solidarity, Ms Andreeva said that the pandemic really tested United Nations reform at the country level, not just in terms of responding to the pandemic but also regarding duty-of-care issues. According to a survey in May, 90% of the staff in Cambodia said that the United Nations leadership at the country level is making the right decisions managing the crisis.

During a virtual town hall meeting of 300 United Nations staff members in El Salvador recently, there was also positive feedback. Ms Miranda said she doesn’t ask for accolades or additional thanks. “I just enjoy helping people and seeing them recover, living their lives fully.”

When the son of Kymbat Toktonalieva (not her real name) was finally diagnosed with HIV after numerous visits to the hospital over many months, it was only the beginning of the fight.

Her husband left her, leaving her to look after their child on her own. She fought for her son and his rights, for justice. She went to court, attended rallies, wrote letters, worked with other like-minded people and helped other women in the same situation.

For the past six years, Ms Toktonalieva has channelled that campaigning zeal into working as a peer consultant in a multidisciplinary team in a family medical centre in Osh, Kyrgyzstan, helping people living with HIV to get services, providing support and motivating them to adhere to their HIV treatment. There are 10 multidisciplinary HIV teams in the country, which were formed by UNAIDS in 2013; they all include a specialist in infectious diseases or a family doctor, a nurse and peer consultants.

The peer consultants come from the same environments and backgrounds as the people who they work with and have faced similar problems. They may be people who are living with HIV or people who have been affected by HIV. They have decided to act, helping themselves and others, often serving as a bridge between the medical workers and people living with HIV.

“Working as a peer consultant has given me an opportunity to help people to overcome their problems, many of which I have come across myself in the past,” said Ms Toktonalieva.

The peer consultants work with the medical staff, directing, prompting, helping, talking and listening. They are trained to be non-judgemental and help people who have recently been diagnosed as HIV-positive to accept their status and to learn to live with the virus.

The role of the peer consultants is being expanded by the COVID-19 pandemic. From the very beginning of the pandemic they were in contact with people living with HIV, delivering medicine to people’s homes so they could stay on treatment during the lockdown, distributing food packages and providing psychological support.

Another peer consultant, Kalmurza Asamidinov, who works in Kyzyl-Kiya, said, “My work brings good, but I can’t say that everything works out perfectly. We work with different people. Some need to be persuaded to adhere to their HIV treatment because they don’t believe in the treatment, while others are tired of taking antiretroviral therapy—we have to find a different approach for everyone. People are increasingly in need of simple human communication. Many clients miss mutual help and the support groups, which we cannot provide during the COVID-19 lockdown.”

The peer consultants working in the 10 multidisciplinary teams each have a different story to tell. Mannap Absamov, one of the peers in the multidisciplinary team in Osh, said, “Initially it was difficult. We were not able to understand the medical staff, and they could not understand us. But slowly we found points of contact. The main thing is that almost simultaneously, both on our side and the doctors’ side, there became a clear understanding that we all have one goal. It is important that their patient and our client go to the medical facility and start getting treatment.”

Both during COVID-19 and after, one thing is certain—peer consultants will continue to play a vital role in bringing HIV services to people living with HIV in Kyrgyzstan. 

When the Government of Cameroon ordered everyone to stay at home as part of the COVID-19 response, Marie-Jeanne Oumarou (not her real name) rushed to buy groceries and to gather her three children and move them the countryside.

With her children in safe hands, she hoped she could still work.

“I didn’t realize how hard it would be during confinement,” she said. “It doesn’t make sense for us sex workers.”

Ms Oumarou has learned the ins and outs of the couloirs—the avenues of small hotels where sex workers work—in Cameroon’s capital city, Yaoundé, over the past 10 years. Abandoned with her young children, she became a sex worker in 2010. She has grown to know the various older women, former sex workers themselves, who she pays to access safe places to work. COVID-19 changed her life overnight, though. 

“Hotels closed, clients were rare, the police constantly around, I cannot survive,” she said.

Denise Ngatchou, Executive Director of Horizons Femmes, a nongovernmental organization that helps vulnerable women, said she was shocked to see how sex workers suddenly became a target.

“Police arrested and held women, disclosing zero information,” she said. “We felt powerless because the government had the upper hand with all the COVID-19 measures.”

Rosalie Pasma, a manager at one of the Horizons Femmes drop-in health centres, shrugged her shoulders in agreement during a Skype interview.

“Everything became much more complicated during COVID-19,” she said. “From women missing health check-ups because of transport issues to our legal expert not being able to access the police stations to defend arrested female sex workers, we felt the confinement in more ways than one.”

Ms Ngatchou piped in, saying that there was no reason to give up. Horizons Femmes vowed to stay open. A skeletal staff with condensed hours still provided HIV testing and other services by respecting preventive measures. 

“People told us to stop all our on-the-ground awareness visits, but we held on as long as we could, giving coronavirus tips to women so they knew of the potential dangers,” she said.

They also kept handing out masks and started a crowdfunding project to purchase more protective gear. What really bothers Ms Ngatchou is how so many things happened before their eyes and they could do so little.

“Easing laws against sex work and ending arbitrary arrests of sex workers would really make an impact,” she said.

In the end, she believes that chastising sex workers only worsens the situation.

“Don’t you think that if sex workers hide they are more likely to work and infect themselves or become infected than if there was an infrastructure to help them?” she asked.

Reflecting on what she said, she added that this applies to COVID-19 as well as HIV.

In early April, UNAIDS and the Global Network of Sex Work Projects sounded the alarm on the particular hardships and concerns facing sex workers globally. They called for countries to ensure the respect, protection and fulfilment of sex workers’ human rights.

“Authorities have got to understand that we are not promoting sex work, we are promoting good health,” Ms Ngatchou said. “That’s the priority.”

GENEVA, 15 May 2020— Ahead of the International Day against Homophobia, Transphobia and Biphobia (IDAHOT), on 17 May, UNAIDS is calling on governments to immediately stop arbitrary and discriminatory arrests of lesbian, gay, bisexual, transgender and intersex (LGBTI) people based on their sexual orientation or gender identity and to enact laws to protect their human rights.

Since the start of the COVID-19 pandemic, there have been news reports of murders of transgender people in Puerto Rico, arrests of LGBTI people in Egypt, the United Republic of Tanzania and Uganda and increasing violence and abuse in Cameroon and the Republic of Korea.

“Arbitrary and discriminatory arrests and harassment of LGBTI people must stop,” said Winnie Byanyima, UNAIDS Executive Director. “The COVID-19 crisis has exposed and exacerbated the inequality, violence and abuse that LGBTI people face every day. We need to break the silence against these draconian laws, which only serve to further marginalize people,” she added.

As of December 2019, more than 70 countries criminalize same-sex sexual behaviour. Under the Universal Declaration of Human Rights and the 2030 Agenda for Sustainable Development, governments have a moral and legal obligation to remove those laws and to enact laws that protect people from discrimination.

A few weeks ago, UNAIDS and MPact released a 12-point plan to uphold the human rights of LGBTI people and ensure their inclusion in COVID-19 response strategies.

Globally, gay men and other men who have sex with men are 27 times more likely to be living with HIV than the general population. It is estimated that gay men and other men who have sex with men accounted for 18% of new HIV infections worldwide in 2017. Meanwhile, transgender women are 12 times more likely to acquire HIV than all adults of reproductive age. It is estimated that 0.1–1.1% of the global population is transgender and that 16.5% of transgender women are living with HIV.

IDAHOT, a worldwide celebration of sexual and gender diversity, has chosen the theme “Breaking the silence” for 2020 to commemorate the World Health Organization’s decision in 1990 to declassify homosexuality as a mental disorder.

The day represents a major global annual landmark to draw the attention of decision-makers, the media, the public, corporations, opinion leaders and local authorities to the alarming situation faced by people with diverse sexual orientations, gender identities or expressions and sexual characteristics.

“We need solidarity to save lives and we need to help build healthy communities and societies so they can respond to HIV, COVID-19 and the next pandemic,” Ms Byanyima added.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Two new videos released ahead of the International Day against Homophobia, Transphobia and Biphobia, celebrated on 17 May, highlight different aspects of what it means to be part of the lesbian, gay, bisexual, transgender and intersex (LGBTI) community in Brazil.

‘What is the impact of diversity at the workplace? created by the Free & Equal Campaign, in partnership with the UNAIDS, seeks to inspire people by sharing examples of companies committed to tackling discrimination against transgender people in the workplace, in the formal labour market and in the community.

The second video features Brazilian LGBTI people and members of the electronic music scene raising awareness on COVID-19 and its impact on the LGBTI community. In just four days, the video reached more than 100 000 people with a message on the importance of staying at home.

GENEVA, 27 March 2020—UNAIDS welcomes the decision by the International AIDS Society to hold the 23rd International AIDS Conference in July as a virtual gathering and hopes that the key population networks organizing the HIV2020 conference can find an alternative solution to hold their conference.

In the light of the COVID-19 pandemic, AIDS 2020: Virtual, organized by the International AIDS Society, will enable the participants to access and engage with the latest HIV science, advocacy and knowledge, and to do so safely.

The organizers of HIV2020, a conference that was due to be held in Mexico in order to provide a safe alternative for people who cannot or will not enter the United States of America, have cancelled the conference and will look at alternative arrangements after the Government of Mexico suspended large events in the country.

“I thank the organizers for going ahead with the 2020 International AIDS Conference, and in a way that will protect the lives and well-being of the thousands of participants. I call on people to get together at AIDS 2020: Virtual in greater numbers than ever before and recommit to working together to end the AIDS epidemic,” said Winnie Byanyima, UNAIDS Executive Director. “I hope that HIV2020 can still go ahead in some form and UNAIDS supports the decision of the co-organizers to put the health and safety of communities first.”

Large numbers of people had been expected to attend AIDS 2020 in San Francisco and Oakland, United States. Instead, AIDS 2020: Virtual will allow the participants to engage in virtual sessions, satellites, exhibitions, podcasts and interactive community networking from anywhere in the world. It is hoped that HIV2020 will be held in a similar way.

Kevin Osborne, the Executive Director of the International AIDS Society (IAS), said, “The AIDS 2020: Virtual theme is resilience. There is no better word to describe what’s needed at this time. For today, this resilience is being tested by a rapidly evolving global health landscape, to which we must now add the COVID-19 pandemic. In solidarity, now more than ever the HIV community needs to come together in our shared commitment to ensure that evidence and human rights remain cornerstones of our response.”

Rico Gustav, the Executive Director of the Global Network of People Living with HIV (GNP+), said, “As co-organizers of HIV2020, the Global Network of People Living with HIV and other global networks are unanimous in our decision to cancel the conference. The health and safety of our communities comes first. As COVID-19 affects more countries and communities, we are adapting and supporting our members in these extremely difficult times. The HIV2020 co-organizers will continue to defend and enhance the leadership of key populations and people living with HIV for HIV and health responses locally, nationally and globally, including exploring virtual spaces to enable this.”

UNAIDS urges everyone to remember that COVID-19 is a serious disease. All people living with HIV should take all recommended preventive measures to minimize exposure to, and prevent infection by, the virus that causes COVID-19.

As in the general population, older people living with HIV or people living with HIV with heart or lung problems may be at a higher risk of becoming infected with the virus and of suffering more serious symptoms. We will learn more about how HIV and COVID-19 together impact on people living with HIV from countries and communities responding to both epidemics. Lessons in rolling out innovations or adapting service delivery to minimize the impact on people living with HIV will be shared and replicated as they become available.

The HIV response has shown that strong and effective public health response that engage affected communities must be based on human rights and address both the biological and social contexts of the diseases. As COVID-19 moves into high-density settings and threatens marginalized people and communities, it is critical that information needs, basic hygiene supplies such as soap and water, sufficient food and social supports that respond to income loss and poverty are prioritized and addressed as part of preparation and response.

“The COVID-19 pandemic is affecting the lives of billions of people around the world,” added Ms Byanyima. “We must not forget, however, that the HIV epidemic has not gone away. Even in these difficult times, our partners are making sure that the AIDS response carries on—unsung heroes are ensuring that HIV treatment and prevention services for people living with and affected by HIV continue to be available.”

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Many countries have laws or policies that prevent adolescents from accessing essential health services without the consent of a parent or guardian. The original intention may have been to protect minors, but these stipulations often have the opposite effect and increase the risk of HIV and other health problems among adolescents.

A large proportion of countries across all regions restrict access to HIV testing and treatment for adolescents. In 2019, for instance, adolescents younger than 18 years needed explicit parental consent in 105 of 142 countries in order to take an HIV test. In 86 of 138 reporting countries, they needed such consent to access HIV treatment and care. These kinds of laws and policies also may complicate or hinder adolescent access to pre-exposure prophylaxis (PrEP), a highly effective prevention tool.

Research in sub-Saharan Africa shows that in countries where the age of consent is 15 years or lower, adolescents are 74% more likely to have been tested for HIV in the past 12 months compared with countries where the age of consent is 16 years or higher—with girls especially benefiting from the easier access.

Country-level details on which countries have consent laws can be viewed on the UNAIDS Laws and Policies Analytics web page.

With the United Nations Commission on Narcotic Drugs meeting this week in Vienna, Austria, diplomatic attention is once again being given to drugs. In 2018, people who inject drugs accounted for 12% of worldwide new HIV infections.

Laws that criminalize key populations or discriminate against people living with HIV undermine efforts to prevent new HIV infections and AIDS-related deaths in dozens of countries across all regions. Decriminalization of drug use and possession for personal use reduces the stigma and discrimination that hampers access to health care, harm reduction and legal services. In countries where drug use is decriminalized and comprehensive harm reduction is available, HIV prevalence and transmission tend to drop sharply among people who use drugs.

Czechia, the Netherlands, Portugal and Switzerland are among a handful of countries that have decriminalized drug use and possession for personal use and that have also invested in harm reduction programmes. Consequently, diagnoses among people who inject drugs in those countries are low.

With drug use or consumption and/or possession of drugs for personal use a criminal offence in at least 67 countries, it’s time for countries to take the bold step towards decriminalization.

“For five years I have been subjected to harassment and threats—rape threats, murder threats, vilification, character assassination, phone calls to my family, to my mom,” said Lebanese television anchor Dima Sadek.

To raise public awareness about sexual harassment and bullying in Lebanon, particularly against female journalists during the recent protests, the Arab Foundation for Freedoms and Equality—UNAIDS’ regional partner on rights and health—has produced a video that sheds light on this human rights abuse committed against many women in the country.

Made in partnership with the HIVOS Women Empowered for Leadership (WE4L) programme, with funding from the Dutch Ministry of Foreign Affairs, the video highlights cases of harassment and assault—reporters whose bodily autonomy has been violated, whose personal telephone numbers have been leaked and who subsequently received rape threats and pornography and who have been verbally and physically attacked while live on television.

“You don’t expect that someone could be this hurtful or that they could say such things. You don’t know them and they don’t know you, but because you differ on politics, they feel they are allowed to talk to you in this way,” said Layal Saad, a reporter.

Since similar attacks, including online bullying and harassment both online and offline, have also been reported by female protesters, the video also seeks to raise awareness about the everyday sexual harassment, bullying and violence that women in general are subjected to, emphasizing the need for policies that allow women to become leaders.

Diana Moukalled, a journalist, explained that legal protection against sexual harassment is needed, since at present there are no laws that criminalize sexual harassment in Lebanon. “Lebanese women are among the most politically marginalized in the world, not just in the region. We see women present on many levels, yet there is a sharp discrepancy between the role of Lebanese women and their representation,” she said.

The video’s title is We Carry On, echoing the sentiment of the many women who watched and reacted to it—a feeling of resilience in the face of adversity and a determination to achieve the social justice demanded by women in Lebanon.