28 Apr 2020

Why Bill Gates is wrong to draw down HIV to support COVID

Image credit: Mandel Ngan

‘The Bill & Melinda Gates Foundation is taking away funding from HIV and malaria to respond to COVID-19‘. That is the take-away message for many from the interview that Bill Gates gave to the Financial Times on Sunday. If this is true, there are at least three reasons why Bill Gates is wrong.

Firstly, HIV is still here and remains a priority. Even though it is without question that COVID-19 is a daunting global health and economic threat, it does not mean that other health emergencies can be put on the back burner. Every day 6000 people acquire HIV and there are more than 37 million people living with HIV worldwide whose lives depend on accessing daily HIV-treatment. Every single one of them deserves our unconditional support and solidarity, especially in times of crisis. We also know what happens if that support is lacking. A dystopian example is a country like Russia. Here the number of new HIV-infections has been rising for years due to government neglect, with an increase of 29% in HIV-infections in 2019 alone. A rise like this in HIV-infections in other regions would have a devastating effect and put us back years in ending AIDS.

Secondly, any pandemic affects the most marginalized in society first and hardest. These communities suffer whether they are hit by COVID-19 or HIV. Therefore they should be at the center of our approach in addressing inequalities. Here the lessons of the AIDS response can help to create an effective COVID-response. This means that governments and donors should put the most affected communities at the center of their approach and respect their human rights. Not only because it is the right thing to do, but also because it leads to the most effective response that creates sustainable impact. We should not waste precious time in discussing which pandemic deserve our attention most, we should jointly support the needs of the communities that are hardest hit by all pandemics.

Thirdly, it does not make sense to steal from Peter to pay Paul. We cannot address inequalities by creating other inequalities. One of the most valuable lessons learned from the AIDS response is that we need to work together in global health and address cross-sectoral underlying issues. Why provide someone with HIV treatment, to have them die from a malaria infection? Why prevent someone getting HIV, to have them die of criminalization? This lesson has led to the formation of the Global Fund to fight AIDS, TB and Malaria in 2002. The effect has been impressive with more than 32 million lives saved since its inception. The last thing we need is to move back to a situation where funding for fighting one disease is taken away from another disease. This would not only be unethical, it is also a really ineffective way of investing in global health.

These times ask for true leadership in global health. Since the start of the early 1980s, we have lost more than 36 million people to AIDS. We know what is at stake. The immense progress that has been made over the last 40 years has to be upheld. What we need is a joint approach that helps us respond to current and future pandemics, building on the lessons and infrastructure from the AIDS response. We call on Mr. Gates to be clear in his message and to use his position as a global leader to bring people together and formulate an approach that is based on solidarity and an overall increase in funding for global health. Together we stand Mr. Gates.

Rico Gustav (Executive Director GNP+) and Mark Vermeulen (Executive Director Aidsfonds)

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