Johannesburg 30 November 2020: Today, the HIV Policy Lab, a collaboration among academics, United Nations and civil society partners from around the world, publish the first ever Global HIV policy report. The world, according to the United Nations, is not going to reach the global HIV targets set for 2020. And looking at laws and policies helps us explain why.

The HIV Policy Lab looked at 33 different policy areas and we see that no country in the world has yet adopted the core HIV policies that are in line with the recommendations of the World Health Organization, UNAIDS and the Commission on HIV in the Law.

South Africa comes the closest to aligning its policies with international standards with 28.5 of the 33 policies adopted. This means the country has embraced many science-based policies on HIV treatment, on pre-exposure prophylaxis, on testing. South Africa does not criminalise gay sexual relationships, and lets nurses initiate patients on anti-retroviral therapies (ART) and many more policies that advance the right to health.

“These are policies that the rest of the world could really learn from,” says Dr Matthew Kavanagh from the Georgetown University’s O’Neill Institute for National and Global Health Law. “Our report shows, for example, that only 34 percent of countries follow South Africa’s lead and have adopted policies that make HIV prevention medicines for pre-exposure prophylaxis available to everyone at substantial risk.”

South Africa still, however, has gaps that are getting in the way of the AIDS response when it comes to policy. For example, South Africa has not yet expanded ART refills for HIV medicines to four to six months as the WHO recommends. South Africa also still criminalises sex work, which undermines the fight against HIV, as UNAIDS has said. And South Africa has not yet amended its patent laws to fully adopt public health flexibilities in international trade law, though the government’s IP policy is an excellent step forward. However, there is still some way to go before South Africa can successfully win the fight to end HIV and part of this gap is due to non-implementation or partial implementation of law and policy.

In Eastern and Southern Africa, some of the countries that have adopted the fewest policies are also those that are making the least progress against HIV. Angola, for example, is really struggling to get people with HIV onto treatment. And it’s also the country that’s adopted fewer recommendations than nearly any other country in the region, far fewer than, for example, eSwatini or Malawi, which are far closer to controlling the HIV epidemic despite having far less resources to work with.

“What we find is that in a pandemic, when policy falls short, people die,” says Dr Kavanagh. “And until we fix the gap between policy and HIV science, we will not end the AIDS pandemic.”

Download the executive summary here.

Download a voice note from Dr Matthew Kavanagh here.

Download the scorecard per country here

For more information or to arrange interviews please contact Nontsikelelo Mpulo on 082 782 7143 or mpulo@section27.org.za