State of inequality: HIV, tuberculosis and malaria

Overview

HIV, tuberculosis (TB) and malaria are diseases of poverty and marginalization, with a heavy toll among populations that are chronically disadvantaged. Although remarkable progress has been made in reducing the overall burden of each disease over the past decade, certain population groups have persistently higher disease mortality and morbidity and lower access to life-saving interventions.

Existing inequities have been widely acknowledged as barriers to achieving global and national goals and targets in HIV, TB and malaria programmes. These inequities have become even more pressing amidst the uncertainty of the COVID-19 pandemic. Yet, the magnitude and extent of health inequalities remain poorly documented and understood. This is the first monitoring report devoted to systematically assessing the global state of inequality in the three diseases, quantifying the latest situation of inequalities within countries and change over time. The report is timely due to the renewed emphasis on equity in prominent global initiatives and plans, including the United Nations 2030 Agenda for Sustainable Development, and global strategies to end AIDS, TB and malaria.

The novelty of this report lies in its comprehensive and systematic approach to presenting the state of inequality across the three diseases. Using the latest available global data for 32 health indicators (addressing the burden of disease; knowledge, attitudes and practices; detection; prevention; testing and treatment; and social protection) and up to 186 countries, the report quantifies within-country inequalities by sex, economic status, education, place of residence and age.