As the executive director of the Eurasian Harm Reduction Association, Ganna Dovbakh joined the numerous public health officials and advocacy group heads who were shocked by the recommendation put forward to “terminate the agency in four years”.
Increasing Infections in Eastern Europe and Central Asia
In the eastern European and central Asian (EECA) countries where her organization operates, data confirms that the infection rates are climbing. Over the past decade, there has been a significant jump in new infections, and a 32% rise in fatalities from AIDS, particularly hitting vulnerable and stigmatized groups such as sex workers, gay and bisexual men, and people who inject drugs.
“With the end of UNAids, there is a significant danger that the nation could neglect the concerns of those with HIV and at-risk groups,” she says.
Essential Work of the program
UNAids, says Dovbakh, has always acted as the region’s diplomat, capable of speaking with national leaders where open dialogue is constrained, fight for the protections of at-risk individuals, and coordinate the sourcing of essential HIV medications from international funders. In one Central Asian nation, for example, where the national HIV response is moving away from being backed by global aid to being financed locally, she calls it vital to keeping HIV on the agenda.
Global Concern Over Sudden End
Such possible consequences mean the idea of closing the program four years earlier than expected has sparked broad anxiety across the UNAids board, notably as it happens at a time when international support for poor nations is disappearing, throwing the global HIV response into chaos.
At the international meeting in the German capital recently, UNAids executive director Winnie Byanyima informed attendees of medical officials: “That rapid decline [in funding] is costing lives, let’s be clear about that.”
Institutional Surprise
Angeli Achrekar, second-in-command of the operations section of the agency, described the UN80 proposal – an initiative to restructure UN operations on its eightieth anniversary – as “a big shock”. This happens as the program is in the midst of substantial reorganization to reduce expenses, halving the agency’s 600 staff to a smaller team. She said that the program has been crucial this year in supporting states and community groups across the global south deal with the quick cessation of foreign aid, striving to guarantee that treatments remained available, and observing the statistics of those suffering.
“Ending UNAids quickly is a final blow for the AIDS fight,” the official warns. “With financial decreases from the the United States and global supporters, the epidemic could escalate once more.”
Statistics and Analysis
Experts note the agency's capacity to gather accurate demographic information as being especially valuable in analyzing the shifting patterns of the HIV crisis, and an asset not easily substituted. Via the agency, it’s evident that the Africa remains HIV’s centre with 67% of the 40.8 million people living with HIV. On a finer level, the organisation’s data has helped demonstrate that while the chance of infection has fallen by 60% in the region since its height in the mid-90s, case incidence remain persistently high among teenage girls and young females.
“Numerous officials and researchers across Africa use the program's information to understand where more efforts need to be put in place,” says Kenneth Ngure, president-elect of the International Aids Society and an academic at the Jomo Kenyatta University of Agriculture and Technology in Nairobi. “UNAids holds the mirror to the situation for all to observe and respond.”
Consequences of Closure
Without UNAids’ data and the comparisons generated between countries and regions, the physician-scientist, a medical expert at the the health organization in South Africa, is fearful that it will become tougher to promote certain health objectives, such as programs to prevent perinatal HIV. She also fears that getting rid of the agency will lead to governments increasingly grouping HIV alongside other competing priorities, which will have a harmful consequence on the power to curb new cases.
“In the region, for example, we lack a specialized HIV prevention team like different regions,” she says. “And because of that, HIV prevention is not as good in the area. You can’t focus on HIV in particular if it’s just included in a broader category.”
Area-Specific Issues
In the region, experts worry that shutting the agency would make it almost impossible to continue tracking HIV in marginalized communities such as gay men and IV drug users. She points out that this is very nuanced effort which has been achievable over the last twenty years only through the agency’s trust-building and outreach networks. Lacking these, she suspects that some EECA countries will become similar to Russia, where there is a concentrated HIV epidemic among stigmatized populations, yet government officials say HIV is solely a youth problem that can be addressed through health camps.
“The disease situation will become hidden,” the expert cautions. “Certain nations could entirely eliminate their AIDS programs within a short time, we will lack information, and then in five years’ time, we will start to see broader outbreaks [among the general public] with HIV cases being detected in kids, females and hospitals.”
Medical Breakthroughs
Per the expert, chief officer of the Aids Vaccine Advocacy Coalition, the scheduling of the closure comes with a cruel irony. In the recent period, numerous scientific advances have been made, including the advancement of injectable treatments such as the new drug that are effective at stopping transmission with very high success rates.
“We have these fantastic possibilities, and we should be focusing more on that than what groups will remain in the near future,” says Warren.
The expert explains that while lenacapavir in particular has been an exciting development, its rollout will be hindered by the missing statistics from the program indicating high-priority areas, and
