Laura Ferguson is Associate Director of the Program on Global Health & Human Rights, Assistant Professor at the Institute for Global Health at the Keck School of Medicine of the University of Southern California and Associate Editor at Reproductive Health Matters.
World AIDS Day is a time for reflection, remembrance and re-energizing efforts to address HIV. The latter seems particularly critical this year as we find ourselves in a state of political, economic and social upheaval such as has not been seen for decades.
Until recently, we seemed to be in an era of unprecedented global collaboration on health and, in particular, HIV. But, the UK’s decision to ‘Brexit’, the election of Trump in the US and the ascendance of conservative nationalist parties across Europe and much the rest of the world all signal a rejection of this sense of global community and solidarity, a marginalization of minorities and a return to more inward-looking nations where national interests eclipse international concerns at every turn. The implications for HIV responses are deeply troubling.
The post-Brexit depreciation of the pound has already decreased the amount of development assistance received from the UK without the amount being given having yet changed at all. And with the pro-Brexit Secretary of State for International Development, Priti Patel, prioritizing trade over development, HIV’s place on DFID’s agenda is far from secure.
Given Donald Trump’s extraordinary unpredictability and readiness to switch positions on most issues, it is difficult to anticipate the priority that he might give to HIV nationally or globally. But Mike Pence, the Vice-President elect, has opposed the Ryan White Care Act, which sought federal funding for low-income and uninsured people living with HIV and their families in the US, and his homophobic views are well known. It is impossible to imagine that the rights of women, LGBTI populations, migrants and other marginalized groups will feature in US efforts to address HIV; more likely, these rights will come under severe attack. This will exacerbate the epidemic, jeopardize international targets such as ‘90-90-90’, and, most importantly, negatively impact the daily lives of key populations around the world.
Women’s rights are not safe in any way. In addition to de-funding Planned Parenthood as Trump as pledged to do, re-institution of the Mexico City Policy or ‘global gag rule’ is likely. This policy forbids US government funding for any organizations that provide information or services related to abortion, and will negatively impact women’s access to sexual and reproductive health services in many places, with knock-on impacts for HIV.
Hard as it feels right now, we must not succumb to despair or paralysis in this state of uncertainty, anger and discord within our communities. A functional democracy requires active citizen engagement, not just on election day, but every day: the current situation requires that we organize, that we strategize, that we work together to support one another to articulate our priorities, to fight for action where it is most needed and to hold our governments accountable for their commitments to address HIV. With deep societal divisions evident within many countries, global solidarity has become increasingly critical. Let’s use this World AIDS Day to stimulate our efforts and engender commitment to act not just today but every day. HIV responses around the world depend on this now more than ever before.