We must act now to reduce the likely impact of COVID-19 in Africa

With overstretched medical staff struggling to treat their patients and intensive care facilities overwhelmed in rich countries. Imagine then the effect on health systems in Africa when the virus takes a hold there. This crisis is already exposing glaring inequalities between the rich and the poor in the developed world, and it is about to reflect even greater inequalities between the North and the South. We need to act!

This health crisis, like others, will hit the poorest and the most vulnerable the hardest, especially in Africa. What does social distancing mean in Africa’s congested townships, its packed markets and buses. How will people wash their hands several times a day to protect themselves from the virus without having access to water and basic sanitation? And what does that mean for women and girls who bear the daily burden of hauling water from rivers and wells for their households? How will countries test and isolate people to contain COVID-19? How will a mother choose between going to work to put food on the table or staying at home with a cough or a fever? How do we tell informal workers, taxi drivers and all those who operate in the platform economy and live hand-to-mouth not to go to work? We must prepare an African response and time is running out.

The lack of investment in Africa’s social infrastructure, including in its health systems, mounting debt and massive corporate tax dodging has left the continent ill-prepared to face this coming emergency. Without publicly provided health care, people are left exposed to disease. User fees for accessing health services deny ordinary people their right to health. This is the time to abolish them. Rich countries are rightly pumping billions of dollars into their own economies and social security systems to keep people and businesses afloat, but will there be massive coordinated international financial support for the developing countries to fight Covid-19? We are in this together or no one is safe. Nothing but a global response will defeat this aggressive virus.

I am also extremely concerned for what COVID-19 might mean for people living with HIV. Two out of three people living with HIV globally reside in sub-Saharan Africa. Millions are still unaware of their status and not on treatment. We know that older people and people with pre-existing heart and lung conditions, including those living with HIV, are at higher risk. It is therefore essential that people living with HIV follow the same guidance for avoiding the virus as the general population. In addition, it has never been more important to test people for HIV and get them on to antiretrovirals.

For people living with HIV who are already on treatment, governments must move to the recommended guidelines of the World Health Organization for multimonth dispensing of medication. This will help alleviate the burden on health facilities should COVID-19 arrive and allow people to maintain their treatment regimens uninterrupted without having to risk increased exposure to COVID-19 to retrieve their medicines. And we must make sure that vulnerable groups of people living with or affected by HIV are not forgotten in the rush to deal with the corona virus crisis.

During this serious and difficult situation, UNAIDS is working closely with networks of people living with HIV throughout the world to ensure that their concerns are heard and that they can bring solutions to the table. We will continue to do so throughout this crisis.

The response to COVID-19 in Africa and throughout the world must be grounded in human rights. There have already been incidents all over the world where individuals or communities are being blamed for the virus. This must stop. It’s wrong and counter-productive for the wider public good. Let us learn the lessons of the AIDS response and know that stigma and discrimination will hold us back in getting to grips with this pandemic.

In responding to the HIV epidemic, community-led services have been core to our most important advances in preventing new infections and getting people on treatment. In the response to COVID-19, communities will no doubt step into the breach and public health authorities must engage with them now and build trust for the upcoming battle. We will not win without communities. It is communities who will design and implement their own context specific prevention measures, in markets, in buses, at funerals. As we have seen in the AIDS response, it will most often be women who will lead the charge in terms of caring for the sick and making sure that their children and communities are as safe as possible. We must ensure that resources flow to them so that they can carry on their important work and that they are fairly compensated and their families financially secure.

I wish we were in a different place. That everyone had the right to health and that we were in a stronger position to face this new challenge. That debate will continue and my voice will stay strong. For now, we must do the best we can for our communities. 

Let us help and support each other during this time – we are all in this together and we will beat this virus through solidarity, compassion and kindness.

Winnie Byanyima, UNAIDS Executive Director