Earlier this month the HIV Policy Lab released a report that details how different countries' HIV policies compare to the international standard — highlighting which countries have adopted essential HIV-related laws and policies recommended by UNAIDS and the World Health Organization, and which have not.
The HIV Policy Lab looked at four categories of policies in its comparison: Clinical/Treatment, Testing and Prevention, Structural Policies, and Health Systems.
The results of the report revealed that no country has yet adopted all of the recommended policies, and while a few are making headway in some policy changes, most are falling behind on testing and prevention policies.
South Africa is the only country in the world to have adopted at least 80% of the recommended international standards in all four policy categories tracked by the HIV Policy Lab. While not yet at 100% of all policy adoption, this is an encouraging effort as South Africa is tackling the biggest HIV epidemic in the world.
Some of the policy changes that countries need to make include: ensuring HIV prevention medicines are available to everyone who is at substantial risk; providing six months’ supply of treatment medicines to patients at one time; and decriminalizing same-sex relationships.
The report explains that although there has been impressive progress in the advancement of science in the study of HIV, minimizing the spread of the virus will continue to be difficult so long as there is no policy implemented as a result of this scientific advancement.
An example of such scientific advancement is the recent breakthrough in HIV prevention, where South African scientists announced that a new injection has proven to be more effective in preventing HIV infections in women than the Truvada pill that is currently available on the market.
However the report explains that these scientific advancements need to work in tandem with laws and policies in order for HIV to be eradicated.
Executive Director of UNAIDS, Winnie Byanyima — announced this week as a finalist for the Global Citizen Prize for World Leader — and Director of the Global Health Policy & Politics Initiative at Georgetown University’s O’Neill Institute, Matthew Kavanagh, reiterated this point in an article published on World AIDS Day earlier this month.
“Science is not the barrier,” the article, published in The Guardian, states. “We have a greater understanding of HIV epidemiology than ever before.”
“However, science means little when laws and policies drive inequality and stop the benefits being reaped,” they continued.
The pair went on to explain that laws that criminalize same-sex relationships, personal drug use, and sex work can be a barrier in a country’s HIV policy progress. They highlight that there is evidence that shows that criminalizing these things can cause stigma and political animosity that could result in driving people away from essential HIV treatment services.
The HIV Policy Lab report also details that, although there may be advancement in laws and policies in some countries, they may be contradicted by other laws and policies which have not advanced, and this could serve to be an obstacle in these HIV policies being effective.
“Even when a country has adopted many or most of the recommended Clinical/Treatment policies, the absence of good testing, prevention, service delivery, structural enablers, and health systems policies imposes barriers to people accessing the care that they need,” the report states.
As a result of the information laid out in the report, UNAIDS plans to put a larger focus on policy change around the world.
“In 2016, the world set a goal of ending AIDS by 2030 — we are off track,” say Byanyima and Kavanagh. “So the new UNAIDS World AIDS Day report includes new targets. These include a goal that, by 2025, more than 90% of countries will have decriminalized sex work, possession of small amounts of drugs, and same-sex sexual behaviour.”