Throughout history, people have faced pandemics: the bubonic plague, smallpox, influenza, HIV and now COVID-19. Pandemics affect people of every creed, color and class. But they do not affect everyone equally. These health crises expose the ugly fault lines within our societies. Inequality, marginalization, poverty and other human rights barriers to healthcare dictate who gets infected and who dies and have a devastating impact on vulnerable communities.
When people are blocked from accessing prevention, treatment and medical services because of stigma, discrimination or criminalization based on gender, race, class, health status, drug use or sex work, they become more susceptible to disease. Combine this with lack of leadership and lack of accurate information and a legal framework where abuse and discrimination go unpunished, and you are condemning marginalized communities to become easy victims of a virus.
We learned this the hard way in the fight against AIDS, when many people were left behind. Despite enormous progress, key and vulnerable populations are still infected with HIV at much higher rates than the general population because of a failure to protect human rights and gender equality. In sub-Saharan Africa, five in six new infections among adolescents aged 15-19 years are among girls. According to UNAIDS, a staggering 62% of new HIV infections globally were among key populations – sex workers, people who inject drugs, prisoners, transgender people, and gay men and other men who have sex with men. This is not an accident: key populations are disproportionately infected because they do not have equal access to health services.
COVID-19 lockdowns and restrictions are making this worse – bimonthly Global Fund surveys of more than 100 countries show that up to 75% of lifesaving HIV, TB and malaria services had been seriously disrupted. Health services that have taken years to build are suffering major setbacks, leaving people already vulnerable to other diseases now at greater risk of COVID-19. Human Rights Watch warns that inability to access HIV testing during lockdowns has put LGBT people at particular risk of suffering serious illness or death from COVID-19.
COVID-19 has also exacerbated human rights violations related to health, including stigma, discrimination, gender-based violence and police brutality. In some countries, vulnerable groups have been turned into scapegoats for the new pandemic. Sixty-one percent of respondents of a major survey reported increases in stigma, as well as misinformation, as serious challenges to an effective TB response due to COVID-19.
Bringing together key players in government and civil society to develop a rights-based response [ download in English | Français ] to COVID-19 is absolutely critical. You don’t win against epidemics by trampling on human rights, but by strengthening them. The Global Fund is helping countries to strengthen rights by funding concrete programs to enable people to claim their human rights in the midst of pandemics. South Africa, for example, set up hotlines to provide legal support and organized online human rights training for vulnerable populations and police. In Botswana, civil society groups developed activities to tackle stigma related to HIV, TB and COVID-19. The Indonesia AIDS Commission is conducting a national survey on the impact of COVID-19 on vulnerable populations, looking into issues such as criminalization, gender-based violence, and service accessibility. In Ghana, a police unit specializing in gender-based violence has been trained in creating avenues for inclusion of women in their work.
These extraordinary examples of adaptation and resilience provide us with hope that the fight against COVID-19 can be both an equitable and effective one. But we must do more.
Fair, balanced and science-based news coverage is critical in informing the public. The media must be empowered to report freely and factually, providing bias-free and accurate information when reporting about critical health issues and the challenges to accessing health services. The free-flow of lifesaving information needs to be protected. To this end, the Thomson Reuters Foundation and the Global Fund have joined forces to train journalists on human rights and health issues, and support awareness-raising on human rights-related barriers to health. This is critical in the context of COVID-19, where accurate information can make a difference between life and death.
We should use this pivotal moment in history as a springboard for advancing human rights. The global response to HIV changed the path of global health, inspiring unprecedented global solidarity in demanding that governments recognize health-related rights and ensure equitable access for all. The global response to COVID-19 can have a similarly transformational impact.
In the fight against COVID-19, we must learn from previous pandemics and ensure we leave no one behind. The ACT-Accelerator, a groundbreaking coalition of global partners, is working to ensure equitable access to tests, treatments, vaccines and critical health supplies. We must commit to protecting everyone, everywhere, from the deadliest infectious diseases. We must strengthen the community systems and responses that are so critical to ending all epidemics. And we must address human rights violations where they occur, knowing from experience that protecting the most vulnerable protects everyone.
Peter Sands is the executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria and Antonio Zappulla is the chief executive of the Thomson Reuters Foundation.