By Onesmus Kansiime
Could the pandemics be playing an equal and united role in a ‘fight against’ unequal divided human race? Are the pandemics and epidemics beating humans, the summits of creation and upright conscious, on what would have been the human mastery of union and equality? Are humans, who in my short life so far have seen leading ethnic cleansing, racial divides and hoarding vaccines, ready for an equal and united world against HIV/AIDS?
Would I be right to be comfortable when the tents around my castle are burning? Of course not; I would be worse than the biblical rich fool. Even if I burned last, I would be burnt by a similar fire. Would it be wrong to think that the rich and poor have more and less lives respectively than the other? Very wrong indeed. No upright logic would justify the shorter lives of either, but rather why all should live healthily and access the minimum health standards accessed by the most privileged. Nothing will unite us more than the fact that we are equally human and are equally faced with common threats.
The world stands at crossroads of colliding pandemics whose little, but growing triumph over human life has been wrought by a systemic pandemic of inequalities; yet, the pandemics, in revealing what is possible when communities and countries unite and when they do not, should leave us less unequal in response. The individual nations such as Uganda, with a 6.2% prevalence rate among adults 15-64 years (7.6% among females and 4.7% among males), have deeper margins that exacerbate inequalities in the fight to end HIV/AIDS such as rural vs urban communities, young vs old. According to a 2009 study by David Lubogo et al in Kumi District Eastern Uganda, respondents in the age group 25-34 years were 3.4 times more likely to access HIV care services than those in the age group 18-24 years; Males and urban respondents were significantly associated with higher access to HIV care services compared to female and rural counterparts.
The world remains divided and unequal in the face of pandemics and epidemics whose commonness to all beings should have united them as an equal force. The history of decades of HIV/AIDS, identical to other pandemics and plagues, is one tainted with surprise, unpreparedness and inequalities that we have less cared to solve than we should. The expanding list of pandemics to include COVID-19 have used these long created and increasingly expanding equality gaps to blossom and reign havoc on the human lives especially those of the vulnerable in poor, partisan and racist communities. To take bold actions against inequalities is the only way we can unselfishly prepare and guard against future pandemics; and not to do so is for us to agree to the triumph of health threats over human pride.
Even though the world is significantly progressing in fighting HIV/AIDS, we are not meeting set global targets such as closing HIV service access by 2025 and to end AIDS by 2030. The inequalities and rigidities block equity in care, treatment, access to health technologies and information. According to UNAIDS 2021, the world will face 7.7 billion AIDS deaths over the next decade due to inequalities. In the face of COVID-19, the governments need to take greater efforts in combatting the effects of the new pandemic on the decades of progress made in reducing inequalities in fighting HIV/AIDS.
To end inequalities to end AIDS, we must engage the grassroots through community led networks, decentralizing an equal health care system which will take services to the vulnerable and affected, poor and rich, emerging and wealthy economies, black and white communities, all continents, women and men, and adolescents and youth. This will ensure equitable access to medicines that are characterized as a public good. The lack of access by all to a public good is also a question of human rights. The observance of human rights must be a material that constructs the pivot for the fight against HIV/AIDS. To keep trust in the public health system by making it equal, governments such as Uganda must be keen to respond to all forms of human rights violations.
“It is my aspiration that health finally can be seen not as a blessing to be wished for, but as a human right to be fought for,” Kofi Annan.
Organisations and ministries of health must mainstream the use of data to make decisions that respond to inequalities unbiasedly as the data guides. It is pointless, useless and not enough of an importance to use data only and only for reporting if that reporting cannot inspire actions. To report a burning house and do nothing about it does not cause clouds to fall upon the flames. Political leaderships must engage all to take up the responsibility to prevent and treat HIV/AIDS and empower all with knowledge and information.
We pray that the voices to global leaders do not continue to fall on ears of non-listeners. Global leaders must unite with all citizens to confront the inequalities and avail HIV/AIDS prevention, care and treatment services to all that are not receiving them, dump disparity, triumph over the violation of human rights and defeat the disruptions of COVID-19 challenging the progress made in achieving equality in the fight against HIV/AIDS, and achieve zero new infections and zero AIDS related deaths. We cannot end AIDS by just ending AIDS, but by fostering better governance, creating more inclusive policies and equality driven funding to end AIDS.
“Let it be said, decades from now when each of us is nothing more than photographs and memories, that we left the world a healthier, safer and fairer place than we found it,” WHO Director-General Dr Tedros Adhanom Ghebreyesus.
The writer is a health equity advocate