During the recent 52nd UNAIDS Programme Coordinating Board meeting in Geneva, UNAIDS Executive Director Winnie Byanyima gave a report that shows that the work against HIV/AIDS has been hijacked to include the promotion of the broad sexual and reproductive health and rights (SRHR) agenda, including access to abortion.

She stated that the world is facing major challenges “across a broad spectrum of human rights issues” including “women’s rights, girls’ rights, sexual and reproductive rights” and said, “UNAIDS remains committed to ensuring women and girls are empowered to stay safe from HIV and securing their sexual and reproduction rights is critical for doing so.”

Ms. Byanyima associated access to sexual and reproductive rights with the ability to not only fight AIDS but pandemics stating, “Human rights challenges affect our ability to connect people to health services to control AIDS and all pandemics…We must halt and reverse these harmful trends. Doing so requires longer-term funding as such efforts do succeed over time and funding is critical to stay ahead of the curve.” 

She gives voice to a strategic plan to use the fight against AIDS to advance access to abortion and the SRHR agenda. WHO’s Call to Action to attain universal health coverage through linked sexual and reproductive health and rights and HIV interventions  states that there “has been a marked shift in the global development agenda to develop, fund and implement multisectoral interventions that jointly advance both sexual and reproductive health and rights (SRHR), and HIV prevention, treatment and care.” It calls for sharing of “the benefits of integrated SRH and HIV services”.

The U.S. is also seeking to integrate sexual and reproductive health, rights and services with HIV as evidenced in Reimagining PEPFAR's Strategic Direction, the U.S. program to fight HIV/AIDS. Up for a 5-year reauthorization by Congress of $30 billion, the President’s Emergency Plan for AIDS Relief (PEPFAR) has been hijacked and includes in Reimagining PEPFAR that whenever possible PEPFAR programs will “integrate HIV programming into strengthened public health systems to manage tuberculosis, high burden non-communicable diseases, sexual reproductive health, rights and services…”

While PEPFAR is blocked by law from directly funding abortion, it is free to fund international organizations that perform or promote abortion.  UNAIDS welcomed Biden’s decision to rescind the pro-life policy that blocked U.S. funds to pro-abortion organizations— Protecting Life in Global Health Assistance Policy, PLGHA, (previously known as the Mexico City Policy)—and called it a show of commitment to supporting women’s “access to sexual and reproductive health and rights information and service”.

Ms. Byanyima stated in UNAIDS welcomes the United States of America’s decision to support women’s health, safety and rights: “Rescinding the PLGHA is a strong demonstration of the new United States Administration’s commitment to supporting women to claim their rights and to access sexual and reproductive health and rights information and services. We look forward to working closely with the new United States Administration to ensure that all women and girls can exercise their human rights and get the sexual and reproductive health information and services they want and need.”

There can be no doubt that access to abortion is part of the sexual and reproductive health and rights agenda.

Funding for UNAIDS remains critical. Winnie Byanyima recognizes the critical funding from the U.S. as the largest donor to global health in the world and expressed her gratitude to those working to “defend PEPFAR and its budget” as it comes under criticism in the U.S.

Congressional Pro-life Caucus Chair Rep. Chris Smith has raised concerns saying, “Those of us who support the noble goals of PEPFAR are sickened at heart by Biden’s 2022 radical ‘reimagining PEPFAR’ strategic plan that ‘integrates’ abortion promotion with HIV/AIDS projects.”

“In plain language, the Biden Administration further directs PEPFAR to work with organizations seeking to get rid of life-affirming laws in other countries,” Smith continued.

“That is unacceptable. Congress must act to protect PEPFAR—which was created to provide care to those who are ill and tangibly assist women and children—from being radically transformed into a program that promotes abortion on demand.”

Byanyima mentions in her report that UNAIDS has “actively contributed” to the PEPFAR COP/ROP 23 process guidance. The guidance includes that PEPFAR should work with partners and organizations “advocating for structural, systemic, and institutional reforms in law and policy regarding sexual, reproductive, and economic rights of women.”

UNAIDS’ vision to overturn laws on abortion can be found in the report In Danger: UNAIDS Global AIDS Update 2022 which states: “Human rights, including sexual and reproductive health and rights (SRHR), must be upheld. Laws and policies that undermine public health and discriminate on the grounds of gender and sexuality should be replaced with ones that promote equality. That includes laws that require the consent of parents or legal guardians for women and adolescents to access HIV and other sexual and reproductive health services.”

The budget UNAIDS seeks and the program is detailed in 2022–2026 UNIFIED BUDGET, RESULTS AND ACCOUNTABILITY FRAMEWORK (UBRAF). It features work with PEPFAR on developing its country and regional operational plans. In the area of gender equality, it seeks to mobilize “political will and efforts to address gender-based violence and deep-rooted inequalities that deny women and girls information, agency and control over their HIV and sexual and reproductive choices”.

Ms. Byanyima is concerned that UNAIDS is short $51 million for its core budget of $210 million as she seeks to fortify the health care system built to ends AIDS so it can “enhance the world’s capacity for global health and pandemic prevention, preparedness and response. And, all we do to end AIDS helps to achieve the SDGs broadly.”

WHO, as one of 11 UN organizations that form UNAIDS, believes that to achieve the Sustainable Development Goals (SDGs) relating to good health and well-being (SDG3) and gender equality (SDG5) there must be movement so “all individuals have access to quality health care, including comprehensive abortion care services – which includes information, management of abortion, and post-abortion care.”

WHO also includes abortion in the document Adolescent Sexual and Reproductive Health and Rights in which it states, “Adolescents across the world face considerable challenges to their sexual and reproductive health and rights. These include…lack of access to health services, especially for contraception and safe abortion.”

Policy makers around the world need to be aware of the attempts to advance access to abortion through the integration of sexual and reproductive health and rights with HIV interventions. All lives, born and unborn, deserve protection and help.