Essay by President Michael D. Higgins for the UNAIDS World AIDS Day Annual Report
Date: Sun 1st Dec, 2024 | 14:47
May I thank Winnie Byanyima, Executive Director of the Joint United Nations Programme on HIV/AIDS, for the invitation to contribute this essay for inclusion in the UNAIDS annual report. I recall our stimulating conversation when she visited Dublin in March 2022.
The world is at a critical moment that will determine whether world leaders meet their commitment to end AIDS as a public health threat by 2030 in line with the United Nations 2030 Agenda. Whilst the end of AIDS is within our grasp, currently the world is off track, as with so many of the Sustainable Development Goals, our collective blueprint for a flourishing future.
Globally, of the 39.9 million people living with HIV, almost a quarter (9.3 million) are not receiving life-saving treatment. Consequently, a person dies from AIDS-related causes every minute.
It is 42 years since the first cases of HIV were diagnosed, and while it may be troubling to recall the moral and ethical atmosphere of society then, it is necessary to give testimony to those who lived through the HIV and AIDS experience of that time. Those who suffered the most in the 1980s were those exposed, not only to a prejudice born of misunderstanding of HIV and AIDS, but also to other forms of social oppression which were, and are, too often manifested in our society.
Our multiple, concurrent global crises, including the return of extreme hunger and famine in the Horn of Africa, and the promulgation of war in Ukraine and the Middle East, have the consequence of pushing the fight against HIV/AIDS further down the international agenda. It is essential that we keep the battle against HIV/AIDS firmly and prominently on the agenda. The ending of AIDS requires stepping up action to respect, promote and fulfil human rights.
As we reflect on the past four decades, it is clear that the institutional and societal response in many countries was anything but adequate in those early years of HIV/AIDS. Great strides have been made thanks to the efforts of those campaigners and of campaigning organisations, activism often conducted in the face of ignorance and sometimes hostility.
I take this opportunity to acknowledge and pay tribute to those activists, as well as the researchers working at the frontiers of science, for their endeavours in this most important area of public health policy.
However, there remain many parts of the world where HIV/AIDS remains stigmatised, where a sense of shame is attached to having the illness, where access to treatment is poor.
It is an appalling statistic that over 40 million people have died from AIDS-related illnesses since the beginning of the epidemic, and that 630,000 people died of such illnesses in 2023. While this represents a halving of fatalities from 1.4 million in 2010, and a 68 percent decrease from the peak of 2 million in 2004, these 630,000 people have, for the most part, suffered a preventable death, lives cut tragically short. Sub-Saharan Africa, home to two-thirds of all people living with HIV globally, remains the hardest hit region in the world.
Globally, there is much which needs to be done, and approached with urgency. Access to treatment remains the core challenge, as only approximately half of those with HIV have access to anti-retroviral drugs which have enabled those living with the virus to live a normal lifespan. Nothing less than universal health coverage and access to quality healthcare, including universal access to sexual and reproductive healthcare services, are necessary if we are to meet our goal of eliminating the disease by 2030.
Challenging stigma, discrimination and inequality is key to ensuring public health and the delivery of successful HIV/AIDS programmes. The importance of supporting civil society in securing progress in the realisation of human rights, including those relating to the achievement of public health initiatives such as HIV/AIDS programmes, remains as important today as ever.
The upholding of the rights of girls and women is vital in the HIV response given that gender is an inextricable aspect of HIV/AIDS. Young women are disproportionately vulnerable to infection. Older women and young girls are disproportionately affected by the burden of caregiving in the epidemic’s wake. Gender inequality and poor respect for the human rights of women and girls are key factors in the HIV/AIDS epidemic, both from the point of view of effectiveness and from the perspective of social justice.
Ensuring that the fullness of human rights is achieved, that their interconnectedness is understood, and their moral and practical necessity is realised – all of this is crucial if we are to rid the world of the scourge of AIDS.
Support for the rights of marginalised communities underpins Ireland’s international HIV programmes and the approach to global health initiatives. It is a fundamental tenet that is essential to the success of HIV programmes given that HIV/AIDS is a disease that impacts disproportionately the most vulnerable in society.
Now is the time to look forward to all that which must still be achieved around the world to realise the possibility of an AIDS-free generation and to ensure that those living with HIV may be able to live their lives without stigma, fear or discrimination. We are also required to create the consciousness for more inclusive and just societies.
It is urgent that we come together in solidarity to deliver a response which eliminates inequalities based on gender, sexuality and race; one which raises the dignity of all people, and meets the demands of social justice; one which will be truly capable of eliminating HIV/AIDS and ensuring that those who live with HIV can live lives free of stigma, prejudice and discrimination.
The pledge to end AIDS is a political and financial choice. The time to choose the correct path is long overdue.