The head of UNAids, Winnie Byanyima, has strongly criticised pharmaceutical giants for prioritising profits over saving lives, and warned that “racist” inequalities are undermining progress towards ending Aids, especially in Africa.
“The World Trade Organization rules allow lifesaving medications to be traded in the same way we could trade luxury goods. They allow pharmaceutical companies to set the price wherever they want, hoard their technologies and reap billions at the cost of lives,” she said.
The injectable drug cabotegravir, for instance – administered every two months and considered the most effective form of prevention – is only available in high-income countries like the UK and the US, and even there remains largely unaffordable. Last year, Zimbabwe became the first African country to approve the drug for use, but with the country in economic crisis the drug remains effectively unavailable.
Such policies expose racial inequalities and discrimination in health, she said. “To me, that’s racism, even though people don’t want to call it out: valuing the profit of a few people, who happen to be white, over the lives of black and brown people around the world.”
“For Africa, the lesson was: you must have the capacity to produce yourself.”
Sub-Saharan Africa accounts for more than half of all new infections, with women and marginalised groups facing higher new infection rates.
Aids-related illnesses were the leading cause of mortality among African women, and adolescent girls and young women were three times more likely than men to get HIV.
Marginalised groups on the continent, including sex workers, gay men and transgender people, accounted for a large proportion of new infections in 2021.
Thirty-two African countries have laws criminalising same-sex relations, and this often stops LGBTQ+ people accessing sexual and reproductive health services. Gay men in countries with the most severe anti-LGBTQ+ laws were more than three times less likely to know their HIV status than their counterparts in countries with the least restrictive laws,
Kenya spends up to five times more on debt servicing than it does on health.