She is an African, feminist and human rights activist who has just been appointed to arguably one of the most important jobs in coordinating and leading the international AIDS response, possibly at the most significant moment in the epidemic’s lifespan.

Winifred “Winnie” Byanyima was on Wednesday 14 August formally announced as the new executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). Byanyima will vacate her position as head of Oxfam International. She replaces Gunilla Carlsson, who had been the interim leader of UNAIDS since Michel Sidibé stepped down earlier in 2019.

I am honoured to be joining UNAIDS as the executive director at such a critical time in the response to HIV,” said Byanyima in a UNAIDS statement released overnight.

“The end of AIDS as a public health threat by 2030 is a goal that is within the world’s reach, but I do not underestimate the scale of the challenge ahead. Working with all its partners, UNAIDS must continue to speak up for the people left behind and champion human rights as the only way to end the epidemic.”

Byanyima, who has no high-level experience in HIV, had been the executive director of Oxfam International since 2013. Prior to that, she served for seven years as the director of gender and development at the United Nations Development Programme.

“Byanyima began her career as a champion of marginalised communities and women 30 years ago as a member of parliament in the National Assembly of Uganda. In 2004, she became the director of women and development at the African Union Commission, working on the Protocol on the Rights of Women in Africa, an international human rights instrument that became an important tool for reducing the disproportionate effect of HIV on the lives of women in Africa,” said UNAIDS.

Byanyima holds an advanced degree in mechanical engineering (in energy conservation and the environment) and an undergraduate degree in aeronautical engineering.

However, Byanyima takes the reins at UNAIDS when it is at its most precarious. Sidibé, who is now the minister of health and social affairs in Mali, left the position under a cloud for his shockingly poor management of serious sexual harassment cases at UNAIDS. Sidibé also weakened UNAIDS to the point where there had been talk of collapsing this crucial organisation into the World Health Organisation.

Advocacy organisation AIDS-Free World was one of the first to congratulate Byanyima, but cautioned that she is joining UNAIDS at a decisive moment. “She has a major internal governance issue to confront in her first months on the job,” said the organisation.

AIDS-Free World founding directors Paula Donovan and Stephen Lewis for decades worked within the United Nations system and have held back no punches on Sidibe’s leadership as well as various weaknesses in the UN system.

In December 2018, an independent expert panel (IEP) excoriated the leadership of Sidibé, who presided over an organisational structure that “failed to prevent or properly respond to allegations of harassment including sexual harassment, bullying and abuse of power”.

But, as AIDS-Free World points out, the fault was not Sidibé’s alone. The IEP found “convincing evidence” that “the leadership team at UNAIDS is responsible and accountable for the organisational culture in which such behaviours have been allowed to flourish”.

“Ms Byanyima must ensure that Sidibé-era members of the leadership team are no longer able to influence the institutional culture of UNAIDS,” the AIDS-Free World statement continued.

Closer to home, the Treatment Action Campaign (TAC) joined the welcoming chorus.

“We welcome Winnie into the position as a highly experienced black woman from sub-Saharan Africa, an area that is the worst-hit region in the world. We welcome her passion and intense motivation to see the end to AIDS deaths and new HIV infections in the near future. We commit to working with her in whatever way we can to fulfil this mandate as well as to end the toxic masculinity that pervades our society. Aluta continua!” said Sibongile Tshabalala, TAC national chairperson.

Advocacy organisation Health GAP’s managing director, Jamila Headley, said AIDS was inarguably a global crisis and that Byanyima was stepping up to the plate during a do-or-die period.

“She must lead the response by the United Nations family of organisations – and the world – in delivering a bold strategy to close a yawning gap in political will and funding for the HIV response; combat harmful laws and practices that criminalise and marginalise the communities most affected by HIV, in particular gay men, trans women, sex workers, and people who use drugs; work with people living with HIV to accelerate the uptake of effective HIV treatment and prevention technologies and evidence-based service-delivery models worldwide; and address the alarmingly high rates of new infections among women in sub-Saharan Africa, among other daunting challenges.

“She must also lead real cultural and institutional transformation and work to prevent sexual harassment and abuse of power within UNAIDS itself,” said Headley.

recent report released by UNAIDS shows that, despite major progress and scientific advances, much of the hardest work in ending the AIDS crisis remains ahead. In 2018, at least 770,000 people died of AIDS-related causes, and about 1.7 million people became newly infected with HIV worldwide. More than half of all new infections were among men who have sex with men, sex workers, transgender people, and people who use drugs – communities that often face high levels of violence, criminalisation, stigma, and discrimination.

Headley added that in the coming years, against this backdrop, Byanyima must inspire the world and lead the charge towards achieving universal access to HIV prevention and treatment, and ending the AIDS epidemic by 2030.

The Global Network of People living with HIV (GNP+) said it was looking forward to working with Byanyima “as we work collectively to ensure the rights of all people living with HIV and key populations”.

“Winnie Byanyima faces an incredibly difficult task in leading UNAIDS at a time when the HIV response is in a crisis. She must place the needs of the poorest and most marginalised members of society at the start and centre, and put the last mile first. Today’s epidemic is driven by marginalisation, stigma, and discrimination, resulting in poor healthcare, insufficient access to treatment, and substantial power imbalances.

“Full decriminalisation of key populations is non-negotiable to ensure that we have the means to protect ourselves and improve the quality of our lives as more than half of new HIV infections are among key populations. We are ready to work with her to take bold action and find solutions,” said Rico Gustav, executive director of the GNP+.

AIDS-Free World pointed out that further, and central to Byanyima’s success, will be the prompt implementation of a key recommendation of the IEP. The panel called for the establishment of an “independent body external to UNAIDS” that would receive complaints of sexual harassment, bullying, and abuse of power; conduct “safe, confidential” fact-finding investigations with access to “relevant documents and witnesses”; and be empowered to “impose appropriate sanction”.

“External, independent systems and oversight, we have long argued, are essential to mending the UN’s broken processes,” the statement said.

The new executive director will also face significant external challenges.

In its Global AIDS Update released on July 16, UNAIDS conceded that the fight against the pandemic was far from over. Worryingly, the number of new HIV infections has increased in Latin America, the Middle East, North Africa, Central Asia, and Eastern Europe, where the rate has spiked to frighteningly high levels.

The number of new infections recorded among adolescent girls and young women has remained virtually unchanged at 6,200 each week.

Of perhaps greatest importance, the new executive director will be tasked with reversing a disastrous decrease in funding, likely exacerbated by UNAIDS’ decision to embrace a marketing campaign that trumpeted the impending “end of AIDS”, inspiring complacency among donors. Between 2017 and 2018, the global resources available for the AIDS response declined by a stunning $1-billion.

“Ms Byanyima can start by urging the Global Fund to Fight AIDS, Tuberculosis, and Malaria, which is holding a replenishment conference in October, to increase its overall target significantly beyond the painfully inadequate $14-billion to which it is now committed.

The challenges are many. The work of UNAIDS remains urgent and necessary,” said AIDS-Free World.

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