HIV Policies In Most African Countries Are Not Fully Aligned With International Standards, Undermining Progress Against AIDS, New Report Shows

WASHINGTON, Nov. 30, 2020 With the global AIDS response off track and COVID-19 derailing progress, a new report shows many countries have not adopted key policies aligned with scientific breakthroughs in HIV. Ahead of World AIDS Day, the 2020 Global HIV Policy Report tracks laws and policies in 194 countries and finds that, across 33 different issues related to HIV treatment, prevention, and the legal environment, no country in Africa has policies fully in line with WHO, UNAIDS, and other international standards.

"Laws and policies drive who has access to the benefits of cutting edge HIV science, how people living with and affected by HIV are treated, how health systems are structured, and how officials engage with communities," says the report. Yet it finds that worldwide countries have, on average, adopted just over half of the policies tracked.

The report from the HIV Policy Lab scores countries by policies adopted and shows that, while many African countries score better than other parts of the world, major gaps remain. South Africa has the world's highest rate of policy alignment, followed in eastern and southern Africa by Malawi, Rwanda, and Eswatini. These countries have made rapid progress against AIDS in recent years. Angola, South Sudan, and Madagascar have among the lowest rates of adoption in the region and are also among the countries most off track in UNAIDS's 10-year review—derailed, in part, by out-of-date polices. Western and Central Africa as a region has lower adoption scores—with no country aligning more than 80% with international standards. Nigeria and Burundi have the most aligned policies, but still lag behind many countries in Eastern and Southern Africa.

Only half of the countries in sub-Saharan Africa use the latest WHO-recommended drugs to treat HIV in children, despite their worldwide availability and affordability. Though taking pre-exposure prophylaxis (PrEP) can prevent people from contracting HIV, only 36% of countries have approved PrEP medications and made them available to all people at substantial risk, as recommended by the WHO. Meanwhile, 56% of countries in sub-Saharan Africa still criminalize same-sex relationships, 98% criminalize sex work, 100% criminalize drug use, and 67% criminalize HIV exposure/transmission—policies shown to harm efforts to stop HIV.

The 2020 Global HIV Policy Report was produced by Georgetown University's O'Neill Institute