Can George Floyd’s murder be a gamechanger for HIV?

A year ago, we came together to make sense of the numbness and bubbling cauldron of anger and disbelief at George Floyd’s murder. He wasn’t the first Black man to be murdered by the police and countless other officers have walked free or faced no charges. Derek Chauvin, the white police officer charged with Floyd’s murder, was found guilty on all counts and it is widely believed that video footage, seen by millions of people around the world, was the deciding factor in his murder trial. Chauvin was held accountable for his actions and Floyd got justice, and it made us think: could Floyd’s murder and the landmark ruling be a turning point for tackling inequality in the HIV response?

A damning picture of race and HIV

The HIV response is not immune to pervasive racial disparities. Globally, Black people and people of colour are disproportionately affected by HIV with over 75% of new infections in countries and/or regions where the dominant ethnicities are Black or people of colour.

For people from communities who have been marginalised the figures are starker. People from key populations affected by HIV – men who have sex with men, people who use drugs, sex workers and transgender people – made up 67% of new HIV infections. Harsh social and legal environments are driving infection rates for men who have sex men and transgender people.

In America, black gay men are almost twice as likely to get HIV than their white counterparts, with Latin Americans and Hispanic gay men also experiencing higher HIV rates than white men. According to the Centres for Disease and Prevention Control, racism and discrimination are key factors.

The lasting legacy of racially driven laws and policies

Across Africa, Asia, the Caribbean and the Middle East, the long-lasting impact of Britain’s colonial era anti-homosexuality laws is jeopardising efforts to reduce HIV infections.

These laws, often used to excuse state-sanctioned violence, as seen in Cameroon, can leave lesbian, gay, bisexual and transgender people without legal protection from human rights violations inflicted by the police and wider community.

In absence of state or personal accountability, perpetrators can evade prosecution leaving survivors and advocates wary of legal systems that should protect their basic human rights and ensure access to lifesaving health services.

The picture is no less racially charged for people who use drugs. Harsher penalties for drug possession and the drugs used by Black communities, have boosted incarceration rates and contributed to elevated rates of HIV infection among African Americans.

Although African Americans represent just 12% of the US population, they account for nearly half of the country’s new HIV infections. The war on drugs isn’t working and Black and people of colour continue to bear the brunt of ineffective policies that fail to respect human rights.

Race and COVID-19

It is ironic that a global call to end racism has played out against the backdrop of COVID-19, A report from the Elton John AIDS Foundation and Funders Concerned About AIDS highlights the impact of the pandemic in the US and globally on communities who have been marginalised and disproportionally affected by HIV. What was inequal before COVID-19 such as economic vulnerability, racial disparities, human rights protection and access to healthcare, have been exacerbated during the pandemic.

If we turn to the current refugee crisis, there are tens of thousands of displaced people, largely from Africa and the Middle East, seeking asylum in Europe, stuck in transit countries where they are subject to racially driven inequalities that hinder infection prevention and access to vaccines and treatment.

People’s vulnerabilities are exacerbated when displaced internally and across borders, so their risk of HIV or COVID-19 infections becomes much higher. Infection control measures in such countries have had a higher impact on displaced people, where travel restrictions, border closures and migration processes and assistance for asylum seekers have been suspended or slowed down. Existing stigmatising and exclusion practices carries the risk of higher COVID-19 spread when symptoms are hidden for fear of repercussions, or lack of access to basic sanitation and health services.

Asylum seekers living with HIV experience poverty, isolation, vulnerability, stigma and discrimination, which when coupled with a lack of appropriate medical care and support, have the potential of adding another layer on the denial of fundamental human rights and further stigmatising people who are already fleeing circumstances threatening their very existence.

Global protection at risk

The global response to COVID-19 is an opportunity to address these inequalities. Effective vaccines, proven to reduce infection rates and protect the most vulnerable from serious illness or death, have been developed with public money in record speed. Political will and science have combined and come up trumps.

The mantra ‘no one is safe until everyone is safe’ is a mandate for the global community to get vaccines to people who need them most. Both India and China have donated COVID-19 vaccines or sold them at cost price to get supplies to countries across Africa and Asia. But other governments persist in hoarding vaccines, withholding patents and vaccine components, risking a ‘vaccine apartheid’ where citizens in rich and predominantly white nations are fully vaccinated before first doses reach those in many less wealthy, blacker, and browner countries. The similarities to the campaign led by the Action Treatment Coalition in the late 1990s for access to lifesaving drugs for people living with HIV are startling and alarming.

Accountability can’t wait

The tide is slowly changing so that the colour of your skin, who you are or the legacy and ongoing impact of racially charged policies won’t deny you access to lifesaving services.

For us working in international development, we cannot ignore the racial undertones, colonial power dynamics and ‘white saviourism’ maligning our sector. We are experiencing our own reckoning and must hold ourselves accountable, challenge our attitudes, adapt our approaches, and speak out against racism. Doing this and getting accountability into the HIV response are our key priorities and we need the perpetrators of physical and social violence to be held accountable too.

We call on the police, politicians, healthcare professionals and others charged with preserving and nurturing life to reconsider what constitutes a life worth saving or rights protecting.

Derek Chauvin’s conviction for George Floyd’s murder is unprecedented. The prosecution, bolstered by visual evidence, has reminded us that tackling racism, upholding human rights and documenting abuses will hold people to account and bring us one step closer to ending AIDS.