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The analysis warned that young women are three times more likely to contract HIV – the virus that causes Aids – than their male counterparts in sub-Saharan Africa, as are women who have experienced domestic violence in the last year.

Meanwhile, the discrimination experienced by men who have sex with men has hampered efforts to stamp out the disease in this group. Although HIV prevalence has fallen by an average of around 60 per cent among all adults in sub-Saharan Africa, it has barely dropped among gay and bisexual men in this region.

“These inequalities aren’t merely harmful to individuals: they are impeding progress against Aids, reducing the returns on HIV investments and putting millions of people in danger,” UNAIDS said.

The report also found that the global response has sidelined children. Some 60 per cent of those aged five to 14 years old who have HIV are not currently receiving treatment – equal to around 800,000 children globally – indicating that they were diagnosed late.

Global response ‘wholly inadequate’

The analysis, published ahead of World Aids Day on Thursday, warned that combating the disease is reliant on addressing these inequalities. It suggests strategies including decriminalising homosexuality, enabling girls to stay in school, and expanding access to contraception would help reduce the threat of HIV/Aids.

Yet funding is increasingly constrained. In 2021, there was an $8 billion gap in lower income countries, despite more than 1.5 million new infections worldwide – three times more than global targets. To “end the Aids epidemic as a public health threat by 2030”, the UN had set targets to cut annual infections to 500,000 in 2021 and 370,000 in 2025.

“The global Aids response has been pushed badly off track,” UNAIDS said. “The declines in new HIV infections and Aids-related deaths have notably slowed, and new infections are rising in many parts of the world. Resources for the response have stagnated at levels that are wholly inadequate.”

Referring to the resurgence of malaria and tuberculosis in the 1980s, as resources and attention on the two killers declined, the report added: “We simply cannot allow the same thing to occur in the case of Aids. The staggering long-term costs of failure are just too great.”

Winnie Byanyima, executive director of UNAIDS, added that the road map for world leaders to reverse this trend is “crystal clear”.

“In one word: equalise. Equalise access to rights, equalise access to services, equalise access to the best science and medicine. Equalising will not only help the marginalised, it will help everyone,” she said.

Sharon Lewin, President of the International Aids Society, added: “In a world plagued by inequality, putting people first across all aspects of the HIV response is a moral imperative and the only viable route to progress.” 

Mike Podmore, Director of STOPAIDS said that while the Covid pandemic also set back progress tackling Aids, “this report underscores the fact that inequality kills”.

“Governments have a responsibility to be working to remove inequality barriers in the HIV response – not only to save lives but to ensure a high quality of life for those living with HIV, one free from discrimination,” he said.