All of Us: Equity is the Key to HIV Epidemic Control

The United States government’s theme for Worlds AIDS Day 2021—Ending the HIV Epidemic: Equitable Access, Everyone’s Voice—highlights a critical moment in our domestic and global HIV/AIDS response. Colleagues from across the government will share their reflections, progress, and updates on our journey to ending the HIV/AIDS epidemic in the U.S. and globally.

This year’s World AIDS Day theme is particularly poignant as we currently confront the dual challenges of HIV/AIDS and COVID-19.  The lessons learned from the HIV/AIDS epidemic have provided a solid foundation for the COVID-19 response. I recall when global activists marched, protested, and advocated for greater focus on equitable access to life-saving HIV therapies. During my own experiences as a community outreach worker in Western Africa, and as an advocate in Washington D.C., I witnessed firsthand the impact of everyone’s voice to affect change. 

Currently, as the Assistant Secretary for Global Affairs at the Department of Health and Human Services (HHS), I have the privilege of working alongside dedicated public servants to promote more equitable access to services and ensure that the communities’ voices are heard through HHS’s respective responses to HIV/AIDS and COVID-19. These efforts are made possible by leveraging the lessons learned and best practices from existing HIV/AIDS programs such as the Ryan White HIV/AIDS Program and U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

We have made enormous progress towards achieving HIV/AIDS epidemic control in many countries around the world. This success has been possible through a whole-of-society, whole-of-government, and whole-of-globe approach – academic institutions, civil society, governments, non-governmental organizations, the private sector, and regional and global multilateral institutions have all made valuable contributions. The United States Government has played a vital role. Since the launch of PEPFAR in 2003, the program has saved more than 20 million lives around the world through support for life-saving antiretroviral therapy and other proven interventions. The United States has invested more than $100 billion to combat global HIV/AIDS through PEPFAR and U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria. 

However, our work is not yet complete. Despite our progress towards achieving epidemic control, there are persistent gaps in access to HIV/AIDS prevention and treatment services to communities that have historically been disproportionately impacted and yet underserved, such as adolescent girls and young women, children, and key populations, such as men who have sex with men, sex workers, transgender people, people who inject drugs, and people who are incarcerated.  In sub-Saharan Africa, which continues to bear the greatest HIV/AIDS burden, six in seven new HIV/AIDS infections among adolescents aged 15 to 19 were among girls. Young women in sub-Saharan Africa aged 15 to 24 were twice as likely to be living with HIV/AIDS than men.  Globally, in 2020, key populations and their sexual partners accounted for 65 percent of new infections.

As we have learned throughout this journey, HIV/AIDS affects everyone – and we are all in this together.  Reducing HIV/AIDS-related disparities and health inequities at home and throughout the world is a public health and moral imperative. HHS is committed to promoting health and human rights for all people, which includes addressing stigma, discrimination and harmful policies that serve as barriers to accessing vital services. 

The ongoing COVID-19 pandemic has reminded us that we are an interconnected, interdependent global community. Amplifying global health equity is essential to unlocking opportunity for us all. As we enter this next phase of the global HIV/AIDS response, we must hold fast to our shared vision, purpose, and determination to end HIV/AIDS.