Recent estimates from UNAIDS suggest 30 per cent to 40 per cent of people starting antiretroviral therapy in low- and middle-income settings have advanced HIV disease. Some countries in the Caribbean, such as Jamaica, have also documented similar observations. These patients usually present with severe suppression of their immune systems which makes them especially susceptible to severe illness and death, even after starting antiretroviral therapy.

The profiles of patients with advanced HIV disease are not fully described but there is a growing concern about their proportions and mortality among people who started and then stopped HIV treatment but are now returning to HIV care with a risk of drug resistance.

The high prevalence of stigma and discrimination as well as violence and abuse that are meted out to people living with HIV (PLHIV) are among a myriad reasons for these late diagnosis and commencement on treatment. Stigma and discrimination prevent people from knowing and disclosing their HIV status, starting treatment early, and adhering to their treatment regimen. This late presentation, as indicated, puts them at a higher risk of death — a risk that could be avoided with early access to antiretroviral therapy. It is important to address stigma and discrimination to safeguard the health and well-being of people living with and most affected by HIV across the Caribbean region.

On March 1, we observed Zero Discrimination Day, an annual event that serves as a reminder of our collective fight against inequalities that disproportionately affect vulnerable and marginalised populations such as women and girls, migrants, sex workers, and PLHIV.

Zero Discrimination Day is championed by UNAIDS and has been observed for a decade since its inception in Beijing in 2014.

This day is a call to action, a solemn reminder that AIDS is not over as people are needlessly dying without treatment. It urges us to confront and dismantle inequality barriers while empowering those most at risk of HIV to access prevention, treatment, care, and support services. This is a fight for their health, their well-being, and their lives so that PLHIV can fully enjoy their human rights, including their right to health.

Discrimination is fuelled by misconception, misinformation, prejudice, and fear. It can lead to negative consequences for its victims. But Zero Discrimination Day is a beacon of hope for all. It is a day to redouble our efforts to ensure people are treated fairly, justly, and with dignity and compassion, regardless of their age, race, religion, sexual orientation, gender identity, health status, or if they have a disability.

Ending discrimination requires collective action. It requires us to be the voice of the voiceless, to stand up and speak out for the human rights of everyone, especially the most vulnerable. Importantly, it requires political leaders to ensure laws and policies as well as government-led initiatives protect and promote human rights and thereby put people first to facilitate access to health services or legal redress for everyone, whether they are vulnerable women from poor households, migrants, sex workers, persons who uses drug, or members of the LGBTQ community.

In a world where populism and conservatism are on the rise, we are beginning to see pushbacks against human rights, gender rights, and the fight for inclusion and diversity. These pushbacks threaten to widen existing inequalities and inequities and derail the HIV response.

But we stand together to push back against the pushback. We stand in global solidarity for equality, for justice, for community-led efforts to safeguard achievements and combat the HIV epidemic for the overall health and well-being of individuals living with the disease. This is critical because protecting people’s rights equals protecting their health.

UNAIDS implores everyone to embrace the fact that no one can enjoy their health and well-being without enjoying their full rights, and hence the need to foster the spirit of UBUNTU in our society — recognising our interconnectedness and reinforcing the notion that our collective actions shape a world free from discrimination, where every individual can thrive leaving no one behind. Let’s all speak up for human rights to protect people’s health.

Dr Richard Amenyah is a medical doctor from Ghana and international public health specialist. He is the director for the UNAIDS multi-country office for the Caribbean. Send comments to the Jamaica Observer or @UNAIDSCaribbean on X (formerly Twitter).