by Emily Bass

By the time the schools in New York City had been closed and a shelter-in-place order was imminent—or not, depending on the hour—COVID-19 had not yet hit sub-Saharan Africa in earnest. The steady drip of articles warning that it was a matter of time were like media coverage of the 1990s AIDS epidemic run on warp speed. The epidemic gained attention first in America and Europe; Africa was, for longer than it should have been, a “powder keg” of undifferentiated countries.

Within hours, Africa caught up. South African President Cyril Ramaphosa declared a “state of disaster” in a clear, firm 90-minute address days before a spike in cases, including several cases of community transmission. Ramaphosa’s state of disaster speech earned him high marks in comparison to U.S. President Donald Trump and UK Prime Minister Boris Johnson; it also rattled people living with HIV, including activists like South African AIDS activist Yvette Raphael, one of the leaders of Advocacy for Prevention of HIV and AIDS (APHA).

“One of the things that really has us worried is this whole direction of social isolation and distancing,” she remarked. “It works from an elite point of view. If I do get the virus and I stay [in] an informal settlement with 12 other people, how do I self-isolate?”

In Uganda, President Yoweri Museveni issued many of the same edicts, larding them with anti-Western sentiments and declaring that everything except for petroleum would be imported for the time being. The directions reminded Lillian Mworeko, the Uganda-based leader of the International Community of Women Living with HIV, about the early days of the HIV epidemic, when the only prevention was a condom, and women were supposed to practice safer sex to save their lives.

“I see countries taking action that are not taking into consideration the reality of vulnerable groups, of women, of children,” she said. “When you isolate, what is it that you put in place to help this woman who is going to be on the front line to be sure that they will be able to respond to the call, that their needs and priorities will remain taken care of?”

For Mworeko, Raphael, and many other people living with HIV (PLHIV) worldwide, UNAIDS head Winnie Byanyima is the leader they have been waiting for to bring a bold, feminist analysis to the AIDS response and to health in general. TheBodyPro worked with Mworeko and Raphael to come up with questions for Byanyima, who did this interview—her first full-length conversation since COVID-19 started—from her Geneva apartment during a chaotic week that saw the office shifting to “tele-working” and the news shifting every day.

Emily Bass: What should HIV program preparedness look like in sub-Saharan Africa and AIDS-endemic countries that are also now dealing with COVID-19, and what is UNAIDS thinking about in terms of providing guidance?

Winnie Byanyima: Coronavirus is very serious, it’s totally unprecedented. We have not seen anything like this in our lifetime, and it’s hitting countries really hard, from the richest to the poorest, and it’s going to hit countries with the highest burden of HIV quite soon. Read more via Body Pro