Broderick Mervyn and his colleagues huddled around a computer, curiosity giving way to pride, as they tuned in to the Pacific region’s first-ever virtual concert.

“I’m from Rotuma Island, a lesser known island of Fiji, and when I saw a Rotuman group perform, there was a sense of pride, admiration and patriotism of not only our country but our culture,” said Mr Mervyn, Coordinator and Founder of Ignite4Change, an organization that advocates for political participation by vulnerable groups.

Mr Mervyn’s sentiments were shared by fellow Pacific islanders and diaspora. At a time of isolation, when many are missing their family due to closed borders or feeling alone, listening to songs of hope performed by dozens of notable musicians and emerging, homegrown artists brought reassurance. The concert, Pacific Unite: Saving Lives Together, was organized by the United Nations in collaboration with community partners intent on bringing communities together in the time of COVID-19 in order to foster solidarity, pay tribute to essential workers and encourage everyone to play their part in preventing the spread of the epidemic.

The concert featured supportive messages from leaders and influencers, including Prince Charles, Fijian Prime Minister Frank Bainimarama and New Zealand’s Prime Minister, Jacinda Ardern, and showcased the region’s vibrant cultures.

“It was educational just as it was entertaining—we got to see and hear from other Pacific islands,” said Foto Ledua, a station manager of Buzz FM in Vanuatu. “As a whole, it is such a great promotion for the Pacific and showed how diverse our cultures are, how rich our music is and how incredibly talented our people are.”

Ms Ledua spoke about the changes brought by COVID-19, including the economic crisis from decreased tourism and the losses that artists face without live concerts to perform at. She said that, “At a time like this, when people can’t travel out of their countries, or even their cities, having a concert brought into your living room is really uplifting.” The concert was broadcasted on television and radio in 13 Pacific countries, Australia and New Zealand and has reached nearly 75 000 views on the United Nations YouTube and Facebook platforms.

Ms Ledua observed that among those watching the event with her, the concert sparked conversations about the impact of COVID-19, as well as climate change, economic recession and other issues facing the people of the Pacific. Reflecting on the response to COVID-19, she said, “In our diversity, we are the same—we may be from different islands, different countries, but we all face the same problems here in the Pacific. We've been through difficult periods in our history, and we survived. We can get through this if we all work together.”

The Speaker of Parliament of Fiji and UNAIDS Regional Goodwill Ambassador for Asia and the Pacific, Ratu Epeli Nailatikau, expressed a similar view on the need to come together to combat the spread of COVID-19. “There are those with no safety net to fall back on … until we beat COVID-19, and hopefully nurse our economies back to normal, we need to act together to slow the spread of the virus and look after each other,” he said.

As the first virtual concert in the region, Pacific Unite brought the people of the Pacific together, reaffirming their shared culture and resilience, and also highlighted the critical role that UNAIDS can play in coordinating the COVID-19 response. Across countries, UNAIDS country directors have led or supported efforts in ensuring that United Nations staff and their dependents have access to the latest COVID-19 information, treatment, care and support. UNAIDS staff have the specialized experience of responding to health crises and building the capacity of communities to prevent the spread of epidemics. The Pacific is no different, where Renata Ram, the UNAIDS Country Director for Fiji and the Pacific and Chair of the United Nations Communications Group for the Pacific, led the charge to mobilize United Nations agencies and community partners and to guide the planning and execution of the concert.

“I accepted the United Nations Resident Coordinator’s proposal to organize the concert, recognizing that it must be for the Pacific, by the Pacific. The soul of the concert were the stories told by communities on how they are coping in a COVID-19 world. These stories and the concert itself speak to the driving force of UNAIDS—the power of communities,” said Ms Ram.

An isolated region, the Pacific is not always afforded the opportunity to be heard on the global stage. Ms Ram spoke about the impact of the virtual concert, stating, “We have unlocked a new communication tool through which voices from the Pacific can be heard. Too often our voices are drowned out due to our small numbers, too often we have been left behind.”

The Pacific Unite virtual concert reveals new possibilities for connection and action and exemplifies how the United Nations can mobilize with artists, community partners and governments to innovatively face the challenges at present and in the future.

Ishenim Nuru, which means “Ray of faith” in Kyrgyz, is a community organization that has been operating in the Chui region of Kyrgyzstan for many years. It started as a group of people living with HIV, their relatives and volunteers and then established itself as a nongovernmental organization that continues to work to fulfil its mission of improving the quality of life of people living with HIV.

Today, Ishenim Nuru provides the only shelter in the area for people in key populations. “With the COVID-19 epidemic, the situation has worsened for many people, but it has become extremely difficult for people released from prison who are living with HIV, people with tuberculosis and representatives of key populations—many of whom were left without a roof over their head and without help. Therefore, we decided to open a shelter,” said Elmira Asanovna Dzhorbaeva, the head of Ishenim Nuru.

The shelter is a place where people can come and receive basic services, where they can sleep, eat and wash clothes, explained Ms Asanovna. “In our shelter, people living with HIV and their family members can get, in addition to basic services, referral to medical institutions. We work closely with city and regional AIDS centres, send clients for viral load tests, provide adherence counselling, engage lawyers, restore documents, provide psychological assistance, and even help with employment,” she added.

Currently, the shelter can accommodate only 10 people at a time, but according to Yuri Malyshev, the shelter’s social worker, when the situation becomes bad sometimes up to 30 people live in the shelter. “We put in additional beds, try to find a way out. People with different destinies live here, some have no documents, some cannot apply for a pension, some have recently been released from prison, and everyone should have a chance. Our main condition is for a person to have a desire to change and adherence to antiretroviral therapy.”

To date, the shelter’s activities are supported by a United Nations Development Programme project, with financial support from UNAIDS. According to Ms Asanovna, the organization is actively discussing the sustainability of the shelter in the face of reduced donor funding amid COVID-19. “We are looking for sponsors, writing projects, we are planning to build our own greenhouse, build a carpentry shop and our own bakery, so that clients have work. Of course, we dream that one day the shelter will have its own property, since we are renting a small house. I really hope that all our dreams will come true.”

Meerim Sarybaeva, UNAIDS Country Manager for Kyrgyzstan, said, “People who need critical  support should get it. In the absence of shelters run by the state, this deficiency is being filled by nongovernmental organizations that are mobilizing resources and providing the needed assistance to people during the coronavirus pandemic.”

“I cannot provide my family with sufficient food as my earnings have gone down. I feel depressed seeing my family going through economic pain and hunger,” says Kamal Hossain (not his real name), a person who uses drugs who lives in Dhaka, Bangladesh.

The COVID-19 pandemic is affecting the lives and livelihoods of people everywhere. The impact is especially being felt by people who are socioeconomically disadvantaged or marginalized. In Bangladesh, for people who use drugs and who are already struggling with disenfranchisement from the wider community, the hardships they face in making a living and accessing social protection schemes have been exacerbated.

Some of Mr Hossain’s peers worked before the pandemic, but they lost their jobs during the lockdown. Recreation facilities and drop-in-centres where previously they received health and psychosocial support were either closed or only partially operational, and clinical services were disrupted.

To support people who use drugs during the lockdown, UNAIDS made a donation to the Network of People Who Use Drugs (NPUD). With the donation, NPUD provided meals and clothing during the Eid ul-Fitr festival to people who inject drugs and who are living on the street. Food was distributed by members of the local community. For some, this was the only support they had received during the COVID-19 pandemic.

“I received only one meal during the lockdown. I did not receive any government support as I do not have a national identity card. I also received a mask and soap from a civil society organization,” said Rafiq Uddin (not his real name), who is homeless and uses drugs in Dhaka.

Community-based organizations are struggling to support the livelihoods of people from the populations most at risk, including people who use drugs.

“Since NPUD is an organization of people who use drugs, we cannot stay away from this crisis. In this time of difficulty, some leaders of NPUD have come forward to help and UNAIDS’ support has made the first step to make a difference,” said Shahed Ibne Obaed, the President of NPUD.

After receiving the donation from UNAIDS, NPUD reached out to other partners, including CARE Bangladesh, Save the Children (Bangladesh), local humanitarian agencies and volunteer organizations, to provide more comprehensive food support.

“I received some cash from a volunteer organization in my locality. Some of my relatives and well-wishers helped me with food. I also tried to do some income-generating work to support my family, but it was not available on a regular basis,” said Mr Hossain, who is a member of Ashakta Punarbashan Sangstha (APOSH), a community-based organization in Dhaka.

NPUD mobilized enough resources from various sources to continue to support people who inject drugs and people living with HIV in the older parts of Dhaka and beyond. Around 1600 people who use drugs have benefited from the initiative. Coordination between NPUD and other community-based organizations helped to identify beneficiaries. Outreach workers from drop-in centres, APOSH, Prochesta, Old Dhaka Plus, Alor Pothe and others helped to distribute food and clothes. Members of community-based organizations offered their homes as places to prepare and pack food.

NPUD procured personal protective equipment for outreach workers and masks and soap for beneficiaries and set up an online group to share updates and pictures and give information about their activities. The whole initiative was fully voluntary. 

“A major concern is the shortage of human and financial resources to support all vulnerable people who use drugs. Wider donor involvement is necessary to generate more funds to support them, especially those who are living on the street, and to ensure sustainability of this initiative,” said Saima Khan, UNAIDS Country Manager in Bangladesh.

On the opening day of the Virtual Fast-Track Cities 2020 conference on urban HIV and COVID-19 responses, UNAIDS has released a new report on how to strengthen responses to health emergencies

GENEVA, 9 September 2020—A new report from UNAIDS shows how countries grappling with COVID-19 are using the experience and infrastructure from the AIDS response to ensure a more robust response to both pandemics. COVID-19 and HIV: 1 moment, 2 epidemics, 3 opportunities—how to seize the moment to learn, leverage and build a new way forward for everyone’s health and rights shows that by identifying the dynamic changes needed, systems can be found that are effective, inclusive, equitable and sufficiently resourced.

“Given the epic dimensions of the emergency, the world needs unity and solidarity,” said United Nations Secretary-General António Guterres. “Our decades-long fight against HIV offers essential lessons. By heeding those lessons and working together, we can ensure that national health responses deliver on the promise of the 2030 Agenda for Sustainable Development and the health and well-being of all.”

The three opportunities highlighted in the report are: (1) that key lessons learned from the HIV response should inform COVID-19 responses; (2) how the HIV infrastructure is already driving COVID-19 responses and has the potential to catalyse accelerated progress; and (3) how the COVID-19 and HIV responses offer a historic opportunity to build a bridge to adaptable, results-driven systems for health that work for people.

“This is a unique opportunity to reimagine systems for health,” said Winnie Byanyima, Executive Director of UNAIDS. “All eyes are on health, health systems and health care, with countries wanting to be better equipped to deal not only with COVID-19 but also to create healthier, more resilient societies. We can seize this opportunity by learning from HIV and from COVID-19 to make important changes to develop rights-based, equitable, people-centred systems for health.”   

The report highlights how the HIV response can help to jump-start an accelerated response to COVID-19 in ways that can help to ensure that such efforts do not come at the expense of the HIV response or other essential health priorities. At the same time that the world undertakes focused efforts to slow the spread of COVID-19, it must also redouble efforts to limit any interruption and promote rapid recovery of HIV-related services, including ensuring uninterrupted supplies of essential commodities and technologies for HIV and other global health priorities.

“COVID-19 has caused significant loss of life in many communities, but notably in those where inequities make people more vulnerable to ill health. Leveraging of the HIV infrastructure and workforce has helped to mitigate what might have been a far worse situation,” said José M. Zuniga, President/Chief Executive Officer of the International Association of Providers of AIDS Care and co-organizer of the Virtual Fast-Track Cities 2020 event with UNAIDS. “However, with current HIV spending substantially off-track, the world urgently needs to increase investments in the responses to both HIV and COVID-19 and not siphon off one to respond to the other.”

The extensive, dynamic and agile infrastructure that has been built up around the HIV response is being leveraged in many ways to assist the response to COVID-19 and includes innovative, community-led service delivery. For example, 280 000 new health-care workers trained by the United States President’s Emergency Plan for AIDS Relief are currently assisting as first responders to COVID-19 in many low- and middle-income countries. In addition, 17 HIV treatment reference centres in Morocco are now functioning as the first line for COVID-19 treatment services. The HIV nongovernmental organization Housing Works in New York City opened two shelters specifically for homeless people who have tested positive for COVID-19.

The report highlights that although different in many respects, COVID-19 and HIV share important characteristics and that by incorporating key lessons learned from HIV, the response to COVID-19 can avoid many errors. One essential element is the buy-in and leadership of communities. Community activism has sped up the delivery of life-saving HIV medicines, community surveillance has alerted officials to dangerous medicine stock-outs and communities have delivered essential door-to-door HIV testing and treatment services and are leading efforts to strike down punitive laws that drive populations such as gay men and other men who have sex with men, sex workers and people who use drugs away from critical health services.

The report also shows the importance of firmly grounding health responses in human rights and the need for gender-transformative responses. Other actions include strengthening strategic information systems capable of delivering timely, accurate data on the pandemic to identify new outbreaks and global coordination, sustained political will and a multisectoral response.

“The emergence of COVID-19 has exposed the underlying weaknesses in health systems, which have proved to be under-resourced, unprepared and unsustainable,” said Ms Byanyima. “UNAIDS is urging that systems for health be reimagined to ensure that they are inclusive, just and equitable.”

Systems for health in the future must be prepared to address any new major health crisis by being agile, results-driven, inclusive and people-centred. COVID-19 and the response to HIV should be used as an opportunity to reimagine systems for health that work for people, maximize efficiency and effectiveness, attract sufficient resources and engage communities as essential partners for health.  

The Virtual Fast-Track Cities 2020 conference is taking place on 9 and 10 September, bringing together around 1500 representatives of more than 300 cities and municipalities around the world to discuss urban responses to COVID-19 and HIV. Anthony Fauci, Director of the United States National Institute of Allergy and Infectious Diseases, will give the keynote speech and UNAIDS will be presenting on the importance of the continuity of HIV services during COVID-19 and discussing mitigation strategies to protect gains made in the response to HIV. 

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.

For many Guyanese families, COVID-19 has meant far more than mask-use and movement restrictions.

“The disruptive effect on economic activity means that for some there simply is not enough food,” said Michel de Groulard, UNAIDS Country Director, a.i., for Guyana and Suriname.

But for people living with HIV in Guyana, there’s been no need for a hastily improvised nutrition support solution. For almost 14 years the National AIDS Programme secretariat has invested in the development of a food bank specifically for people living with HIV, including those coinfected with tuberculosis.

The programme started with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and continues to receive Global Fund contributions. From the start there were consistent, major donations from the National Milling Company of Guyana. Since 2017, the Government of Guyana and the Food for the Poor charitable organization have been the primary donors. Importantly, throughout the years the food bank has attracted significant inputs from the private sector. In 2019, there were more than 20 corporate contributors.

Referrals come from the clinical teams attending to people living with HIV. Food support is granted for an initial six-month period, after which the situation is reassessed. In the interim there is a collaborative effort with the Ministry of Social Protection and the Recruitment and Manpower Agency around job placement and other types of social support.

Rhonda Moore worked as an HIV doctor for six years and in three regions before assuming leadership of the National AIDS Programme. She’s seen the difference nutrition assistance makes for people and families on the brink. When people are worried about whether they will eat, they don’t take their treatment properly.

“Food insecurity creates a vicious cycle,” she said. “For people living with HIV it is important to have a healthy, balanced diet along with treatment to control the disease. But when someone doesn’t have food it affects them both mentally and physically. Adherence becomes an issue and the mental health impact also undermines the immune system.”

In the context of COVID-19, the food bank has expanded its reach to HIV-negative members of key populations. The National AIDS Programme is collaborating with community organizations to pair dissemination with the provision of information on COVID-19 and HIV as well as HIV prevention and testing services.

So far, more than 2700 food and personal hygiene packages have been distributed. Rather than have people journey to the food bank, the supplies are now being distributed through the treatment sites in their districts. An open invitation was issued to diagnosed people who hadn’t started or continued antiretroviral therapy to go to their nearest treatment centres for HIV medicines and food—two essentials for surviving COVID-19.

In 2019, Guyana became the first Caribbean country to introduce national nutrition and HIV guidelines. The strategy supports health-care providers, policymakers, social workers and other HIV response stakeholders in responding to the nutrition care and support needs of people living with HIV in diverse conditions. In an epidemic response often dominated by concerns around treatment, Guyana has been proactive about addressing the food insecurity challenge some people living with HIV face either consistently or—as is the case with COVID-19—in exceptional circumstances.

“HIV treatment will fail if people don’t have food—healthy food. The fact that Guyana has been able to respond immediately to alleviate food security challenges and thus protect the well-being of people living with HIV right from the outset of the humanitarian crisis demonstrates the value of making psychosocial support investments integral to our regular treatment programme,” Mr de Groulard said. “It makes countries and communities more resilient, more agile and better prepared to respond to crises.”

GENEVA, 26 August 2020—UNAIDS is calling on countries to adopt urgent measures to reinforce social protection programmes to shield the most vulnerable people from the health impact and socio-economic fall-out of the COVID-19 pandemic.

People living with HIV and tuberculosis (TB) are being significantly impacted by COVID-19. Modelling has estimated the potential catastrophic impacts of the COVID-19 pandemic with increases of up to 10%, 20% and 36% projected deaths for HIV, TB and malaria patients, respectively, over the next five years.

Among the most vulnerable are women and girls, gay men and other men who have sex with men, sex workers, people who use drugs and transgender people. Many of them are excluded from existing social protection programmes.

“Countries must ensure that everyone is able to receive essential services including health care and they must invest adequately in social protection programmes to keep people safe and to shield them from the consequences of losing their livelihoods,” said Winnie Byanyima, Executive Director of UNAIDS.

The socio-economic fall-out of the COVID-19 pandemic will have the greatest impact on some of the most disadvantaged people in societies around the world. For example, COVID-19 threatens to double the number of people facing acute food insecurity to more than 265 million by the end of the year. Most of these people will be in countries already badly afflicted by conflict, economic or climate crises. Refugees are among the groups facing the greatest dangers.

Hundreds of millions of people around the world are also in line to lose their jobs in the formal and informal sectors of the economy. Around 150 million full time jobs were lost in the first quarter of the year and millions more people are set to lose their livelihoods in the months ahead.

“Today, only 29% of the world’s population has access to adequate social protection coverage,” said Guy Ryder, Director General of the International Labour Organization.” Governments must act to ensure the sustainability of livelihoods, businesses and jobs and the protection of workers’ health, rights and incomes during and after COVID-19.”

Women are particularly vulnerable to the economic crisis being disproportionately employed in the informal sectors of the economy and therefore most likely to lose their incomes. They are also often employed on the frontline of the response to COVID-19, making up 70% of the workforce in the health and social care sectors, as well as carrying out the bulk of unpaid domestic duties in the home, childcare and other caring functions.

An increase in gender-based violence during lockdown also makes it imperative for governments to invest in social protection programmes designed specifically for the protection of women and girls.

A generation of young people are also at risk from the socio-economic crash caused by the pandemic. The vulnerability of children and young people is being further amplified by school closures which have affected more than 90% of the world’s student population, interrupting their education and their access to crucial social services, such as school meals.

“Children and young people are suffering disproportionately from the socio-economic impact of the COVID-19 crisis,” said Henrietta H. Fore, Executive Director of UNICEF. “Before the outbreak, two out of three children had no or inadequate social protection fund. Countries need to live up to their commitment for social protection for everyone who needs it.”

The call for action for governments to invest adequately in social protection programmes is endorsed by UNAIDS, the United Nations Children’s Fund (UNICEF) and the International Labour Organization (ILO) and supported by the World Food Programme (WFP), the Office of the  United Nations High Commissioner for Refugees (UNHCR), the United Nations Entity for Gender Equality and the Empowerment of Women (UN Women), the United Nations Office on Drugs and Crime (UNODC), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the World Bank.

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.

Report reveals interruptions of HIV services, violence, harassment, abuse, arrests, deaths and a failure to respect human rights in their early responses to the pandemic—UNAIDS urges governments to protect the most vulnerable, particularly key populations at higher risk of HIV

GENEVA, 27 August 2020—During the early response to COVID-19 UNAIDS received numerous reports of interruptions to HIV services and disturbing human violations against vulnerable and marginalized populations. The experience of the response to HIV has proved that violations of human rights during a pandemic undermine trust, harm individuals, and set back public health responses.

The United Nations Secretary General has requested all United Nations entities to support the efforts of the World Health Organization in their own respective areas of expertise. So, to better inform the response going forwards, UNAIDS commissioned a report on how COVID-19 public health orders and restrictions on movement have impacted the response to HIV and human rights. The findings are reflective of trends across the world and uncovered significant breaches of human rights, life-threatening disruptions to health and social services, violence, abuse and discriminatory targeting of marginalized, poor and key populations.

This report is designed to help governments take positive steps to respond to human rights concerns in the evolving context of COVID-19. “It is a myth that there can be a trade-off between human rights and public health,” said Winnie Byanyima, Executive Director of UNAIDS. “Human rights are not only intrinsic, but they are also the very means by which governments can successfully beat a pandemic.” 

Rights in a pandemic – Lockdowns, rights and lessons from HIV in the early response to COVID-19 is a snapshot in time, focusing on the very early days of the pandemic, from February till mid-May 2020, drawing attention to the experiences of some of the most marginalized and vulnerable communities. Violations have included instances of police using rubber bullets, tear gas, and whips to enforce physical distancing, people being arrested and detained for not wearing masks and being issued fines—people who could not pay fines remained in jail longer than those who could pay.

Doctors were arrested and detained for travelling to and from health facilities. Reports were also received of pregnant women dying after strict restrictions on movement prevented them from reaching health-care services—some died while walking to hospital. One report detailed a motorcycle taxi-driver being beaten to death by police after taking a woman in labour to hospital during curfew hours.

Rights in a pandemic outlines 10 immediate areas for action for governments towards building effective, rights-based COVID-19 responses. These include taking proactive measures to ensure that people, particularly people in vulnerable groups, can access HIV treatment and prevention services, designating and supporting essential workers, including community-led organizations, and implementing measures to prevent and address gender-based violence.

"This report is coming at a critical time,” said Felicita Hikuam, Director of the AIDS and Rights Alliance for Southern Africa. “Sadly, it seems that we have not learned the lesson HIV has tried to teach us: epidemics expose and exacerbate existing inequities and impact most negatively on those who are already marginalised.”

A major concern has been safety during lockdowns, particularly for people most affected by HIV including women and girls, children and key populations including sex workers, lesbian, gay, bisexual, transgender and intersex people. In many countries, reported incidents of gender-based violence increased by 40–70%, with even greater spikes in certain cities and regions. Transgender people were harassed and arrested for leaving their home on the “wrong day” under gendered lockdown policies. Sex workers lost incomes and were largely not eligible for financial support. As UNAIDS has repeatedly stated, violence against key populations and women and girls increases vulnerability to HIV.

“The report gives visibility within the framework of this pandemic to those of us who are pushed to the margins,” said Elena Reynaga Executive Secretary of the Network of Women Sex workers of Latina America and the Caribbean. “From a human rights perspective, we need governments to listen and implement these recommendations, which represent an important step towards ending AIDS by 2030 by leaving no one behind."

In May, UNAIDS warned of the risk that access to HIV services may be disrupted during the COVID-19 pandemic. Early modelling showed that a severe disruption in HIV treatment could result in an additional 500 000 AIDS-related deaths in sub-Saharan Africa. This new report shows that HIV prevention and treatment services were disrupted in 10 of the 16 countries reviewed. Some countries reported reductions in medicine collections of up to 20% in some areas. There were multiple reports of people living with HIV not having enough antiretroviral medicine for a lockdown of more than 60 days as well as reports of people having abandoned their HIV treatment due to a lack of food.

In addition to learning lessons from the HIV response, the HIV pandemic must not be forgotten during this crisis. “Communities of people living with and affected by HIV, have again found themselves at the crossroad of injustice and targeted discrimination in the wake of the COVID-19 pandemic,” said Rico Gustav, Executive Director of GNP+. “As a global network of people living with HIV, we call for a rights-based law enforcement that respects and recognises the need of marginalised communities to move freely to access HIV and other medication, as well as the roll out of multi-month dispensing of antiretroviral medicines for HIV.”

There are however many positive examples. In 15 of the 16 countries reviewed, governments released people from prisons to reduce overcrowding and stem COVID-19 transmission. Where governments partnered with civil society and the private sector, responses to COVID-19 were more positive and inclusive. In some countries free transport was provided for emergency medical care during curfews and in others, police handed out masks rather than fines. Some countries provided temporary homeless shelters and supplies of food to people living in camps for displaced people. Others declared that water supplies could not be suspended for non-payment of bills and placed a moratorium on evictions or invested heavily in food support.

“National human rights institutions, such as the one I lead, have a critical role to play in tracking and protecting the human rights of all, both vulnerable and well-to-do, and especially during times of crisis and pandemics such as COVID-19 and HIV,” said Anthony O. Ojukwu, Executive Secretary, National Human Rights Commission of Nigeria. “This report opens to us the opportunity to work with institutions across the world to enforce the checks and balances in place in our own countries to correct excesses such as those of the security personnel during the early days of the lockdown.”

UNAIDS also received reports of countries expanding multi-month dispensing of HIV medicines to 3- or 6-month supplies and of others implementing home deliveries or community-based delivery of medicines.

“UNAIDS acknowledges the positive steps taken. COVID-19 is likely to be with us for a very long time though,” said Ms Byanyima. “We have a commitment to stand up for the most vulnerable even in the tough environment COVID-19 has put us in. We will use this report to convene governments, communities and partners to open a dialogue and to find a way forward to reform bad laws, policies and practices and to protect human rights.”

The report builds on Rights in the time of COVID-19, released by UNAIDS in March 2020, which urged countries to take a human rights approach in responding to COVID-19, in line with best practices from 40 years of responding to HIV.

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.

“After COVID-19 kicked in, it has been too difficult to get customers,” says Teddy Francis John, a sex worker from Zanzibar. Since the outbreak of COVID-19, she has faced increased difficulties to earn an income to provide for herself and her two children.

“Everything has become tough and I had to start a small business of selling alcohol—local brew,” she says. The business also helps her meet new clients, as they come to her for drinks and are less vigilant about social distancing guidelines.

Ms John used to live and work in Zanzibar town, but to better earn an income and avoid paying rent, she decided to move to a more rural area. Here, she says, she can more easily find new customers for her local brew.

Rehema Peter is facing a similar situation, just on the other side of the ocean on Tanzania Mainland. She lives in the crowded suburb of Temeke in Dar es Salaam and works as a sex worker and volunteers as a peer counsellor for people living with HIV and for people who use drugs.

Her clients were regulars who used to come to her house, or she would visit those she could trust in their homes. But when COVID-19 broke out, they stopped coming.

“Coronavirus made life very hard. Payment at work used to be little and when COVID-19 came it reinforced the situation. On the side of my partners [clients], they stopped visiting and calling me. The very few who used to visit me often, I called them, but they said they have no money because of COVID-19, as some stopped going to their jobs,” says Ms Peter.

At her job as a peer counsellor she was offered fewer shifts, meaning a lower income. Because she is a former drug user, she has received some support through the Tanzania Network for People who Use Drugs (TaNPUD), which has been supported by UNAIDS to distribute food and hygiene items to people who currently use drugs and people in recovery.

“I just try to be calm and find other means [of income]. I’m searching for additional organizations that can help or support me anyhow. I also try to prepare soap and oil from the knowledge that TaNPUD gave me and I sell it,” says Ms Peter.

Continued services

Both Ms Peter and Ms John are living with HIV and are on HIV treatment. Due to the advocacy and assistance of UNAIDS and other partners of the Tanzanian government, disruptions to HIV services have been minimal in the country. This is felt by both women.

“During this time, it has become difficult to get services in government health facilities; unless you go to a private hospital where you must have cash. However, there is no problem at all in getting HIV-related services, including my treatment,” says Ms John.

Ms Peter say she can now get three months multi-month dispensing of antiretroviral treatment—even up to six months—since the healthcare staff do not want congestion in the clinics. This has helped both women in adhering to their treatment.

Increased stigma

Both Ms Peter and Ms John have experienced an in increase in the stigma and social exclusion they also face as sex workers and as women living with HIV during the COVID-19 outbreak.

“As some people know that I am living with HIV, they tease me. They say ‘prepare yourself for death. People like you never heal. You must prepare for your final journey’” recounts Ms Peter. She has faced discrimination in the community, but her family stands by her.

Ms John also faced increased gossip and mocking of her because of her work.

“People in my surrounding communities started mocking me and others. They gossiped as to how I would earn a living as there are not going to be customers because of the COVID-19 outbreak.” Says Francis John

Despite the COVID-19 outbreak being declared over in Tanzania and despite their continued efforts to find other means of livelihood, earning an income is still hard for the two women, due to continued social distancing regulations.

“[It] has been very difficult to provide this service and this harmed us economically. I know COVID-19 has affected the whole world but it has affected sex workers more because of the nature of our services; it involves proximity,” says Ms John.