“New HIV infections are rising in an alarming number of countries, regions and cities around the world. There were 1.5 million new HIV infections in 2021 — 1 million higher than the 2020 target of 500,000,” said UNAids. 

“To support countries in driving down new infections, UNAids and partners have brought together HIV-prevention experts and implementers from the 28 countries with the highest rates of new infections to establish why they are failing to decline at scale, to discuss solutions and to help countries set ambitious prevention targets.”  

Eva Kiwango, UNAids’ country director for South Africa, said an emergency meeting convened by UNAids this month had looked at roll-out plans for the targets set in the global Aids strategy of prevention, and the 2021 political declaration that was approved by member states. 

“We did see an impact in the HIV response during Covid-19, along with the socioeconomic indicators, because dealing with Aids is not just about testing and treatment. People were worried about going to facilities and health workers were under immense strain. 

“During lockdown, a lot of girls were out of school. According to Stats SA, 17 million learners were out of school during closures and only about 11% of schools were offering remote learning. So, you can only imagine the implications for children, especially in rural areas … high levels of unprotected sex and teenage pregnancy. Young girls and boys were also dealing with sexual violence, as gender-based violence spiked as well.” 

Visit Daily Maverick’s home page for more news, analysis and investigations

Kiwango said HIV treatment and prevention need integrated services, and if people weren’t accessing protection, contraceptives, nutrition and services that help with communicable diseases, this affects how the virus is managed. 

She said there had been flatlining in testing and treatment before the Covid-19 pandemic and attributed this to people starting and stopping treatment for various reasons, including stigma and discrimination. 

“But we are still trying to analyse that data and pinpoint why there was a flatline,” said Kiwango.  

“We are not on track to meet the 2025 target, but South Africa has had a significant decrease in cases despite the global challenges. We are sitting at around 220,000 new cases, so they are not falling fast enough. They are still way too high amongst adolescent girls and young women. This group makes up 11% of the population in South Africa and yet it makes up 30% of new infections.  

“One of our bigger challenges is vertical transmission from parents — I say parents and not mothers because some women test negative and test positive later on in pregnancy and during breastfeeding … [causing a] high [number of] cases of children being infected.” 

Kiwango called for global unity to lower prices for prevention and treatment tools.  

“Adolescent boys and young men have been left behind previously. We are cognisant of that and have made them integral to UNAids plans going forward,” Kiwango said.  

“If we do not confront HIV, then other pandemics will be hard to curb. HIV is not yet over.” DM/MC