An opinion piece in The BMJ: To end covid-19, we must end discrimination and inequality.
Inequalities, fueled by stigma and discrimination, have for decades obstructed proven solutions in HIV prevention and treatment. For example, at least 92 countries still criminalize HIV transmission, exposure, or nondisclosure, and at least 68 countries and territories criminalize consensual same-sex sexual relations, exacerbating stigma in such a way that hinders key populations’ access to prevention and care.
Research shows that punitive laws and discriminatory policies fuel HIV transmission among key populations, which includes people living with HIV, gay men and other men who have sex with men, sex workers, transgender people, people who use drugs, and people in prisons and other closed settings.
The covid-19 pandemic and accompanying response measures are also compounding inequities for marginalized groups, particularly in LMICs, disrupting access to HIV and other services and threatening decades of progress. Women and key populations, for example, are reporting an elevated risk of domestic and family violence, increased social isolation, and difficulties accessing HIV and health services.
Typically, marginalized communities in high income nations have not been spared either: a new report from the US Centers for Disease Control and Prevention confirms that gay, lesbian, and bisexual people experience stigma and discrimination in their lives that “can increase vulnerabilities to illness and limit the means to achieving optimal health and wellbeing,” leading to higher covid-19 risks overall.
We need global solidarity to support strong systems for health, for everyone
Ensuring that discriminatory laws, policies, practices, and inequalities do not hinder lifesaving tools from reaching all who need them requires strong systems for health and inclusive governance built on trust. As with HIV, covid-19 responses should be grounded in data, evidence, and human rights, and communities are central to ensure people have continued access to the services they need to survive.
That is why in July 2020 the United Nations Development Programme (UNDP), World Health Organization, UNAIDS, and the O’Neill Institute launched the COVID-19 Law Lab to support evidence and rights based legal frameworks for covid-19 responses. It is also why UNDP and the Global Fund work with community led organizations, such as those in Panama, to ensure marginalized groups have access to HIV services during covid-19.
But there is still much more to be done—we need to walk the talk on global solidarity to prevent millions more deaths. It is critical that countries increase funding and support for international cooperation. We must marshal the full strength and capacity of the multilateral system to deliver equity—now.
