GENEVA, 12 December 2020—The world is only 10 years away from the deadline for the universal health coverage target of the Sustainable Development Goals. Only 10 years away from when everyone should have access to quality essential health services and access to safe, effective, quality and affordable essential medicines and vaccines. But that target seems as far away as ever. In 2017, less than half of the world’s people were covered by essential health services, and if current trends continue it is estimated that only 60% of the global population will enjoy universal health coverage by 2030.

On Universal Health Coverage Day, UNAIDS is calling for the world to meet its obligation— universal health coverage, based on human rights and with people at the centre.

“Health for all: protect everyone” is the theme for this year’s Universal Health Coverage Day, making it clear that health is a fundamental human right.

“It’s a disgrace that inequalities are still impacting the ability of people to access health care,” said Winnie Byanyima, UNAIDS Executive Director. “Health is a human right, but it is so often denied, especially to the most vulnerable, the marginalized and the criminalized.”

Someone’s socioeconomic status, gender, age, sexual orientation, citizenship or race can affect their ability to access health services. Like the HIV response, equality lies at the heart of universal health coverage and progressing towards universal health coverage means progressing towards equity, social inclusion and cohesion. A rights-based and people-centred approach to universal health coverage can help to ensure equitable health for all.

COVID-19 has shown that public health systems have been neglected in many countries around the world. In order to promote health and well-being, countries need to invest in the core functions of health systems, including public health, as common goods for health.

“Money should never determine someone’s access to health,” added Ms Byanyima. “No one should be pushed into poverty by paying for health services. User fees must be abolished and health for all paid for from public funds.” 

Even before the COVID-19 pandemic hit, the global AIDS response was off track, in part because of a long-term underinvestment in health systems. Universal health coverage and the end of AIDS cannot be achieved and sustained without resilient and functioning health systems that can respond to the needs of everyone, without stigma and discrimination.

The HIV response has shown that communities make the difference. During the COVID-19 pandemic, community-led organizations, including communities of people living with HIV, around the world have mobilized to protect the vulnerable, working with governments to keep essential services going.

Communities have campaigned for multimonth dispensing of HIV treatment, organized home deliveries of medicines and provided financial assistance, food and shelter to at-risk groups. Communities are part of systems for health and are fundamental to attaining universal health coverage. They must be better recognized and supported for their leadership, their innovation and their immense contribution towards health for all.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 10 December 2020—UNAIDS announces the launch of its Solidarity Fund, which will support social entrepreneurs and micro-business owned by key populations facing special hardship during the COVID-19 pandemic.

“Key populations are among those disproportionally impacted by COVID-19,” said Winnie Byanyima, UNAIDS Executive Director. “COVID-19 has highlighted and exacerbated the profound and widening economic and social inequalities. We must act to support and protect the people who are most impacted by the pandemic.”

Experience from the COVID-19 and HIV pandemics, and from other diseases, such as Ebola, has shown that key populations are more likely to be impacted by food insecurity, face barriers to health care and access to medicines, and suffer losses of livelihood, unemployment, homelessness and domestic violence.

Launched today, Human Rights Day, the new Solidarity Fund will support social entrepreneurs and small-scale businesses owned by people living with HIV, women or members of key populations, including sex workers, transgender people, people who use drugs and gay men and other men who have sex with men, the people who so often have their human rights violated.

“The fund will help bridge the gap between aspirations and opportunities of people from my community. It places trust and gives us a chance to show our innovation and entrepreneurship with no limitations,” said Maite Schneider, the cofounder and Chief Executive Officer of TransEmpregos.

To be piloted initially in five countries—Brazil, Ghana, India, Madagascar and Uganda—with a US$ 250 000 budget from UNAIDS, the initiative will scale up to additional countries over the coming months, with a goal of raising an additional US$ 3 million to US$ 5 million in 2021–2022.

UNAIDS will closely work with community networks, national innovation ecosystems, the private sector and other partners to create tailored support, especially capacity development on social entrepreneurship and mentoring to enhance the sustainability of social ventures and impact for the wider community, with special attention given to young key populations.

Among the partners is the venture development and investment platform Social Alpha, which will provide mentoring and entrepreneur support to the chosen beneficiaries. “We look forward to partner with communities and UNAIDS on the Solidarity Fund and leverage our experience in working with social entrepreneurs for solving complex social, economic and environmental challenges,” said Manoj Kumar, the Chief Executive Officer and founder of Social Alpha.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

From the very beginning of the pandemic, UNAIDS has been helping people living with and affected by HIV to withstand the impacts of COVID-19.

In January and February, when COVID-19 forced a lockdown in Wuhan, China, the UNAIDS China Country Office started to receive messages on social media from people living with HIV, expressing their frustration and seeking help.

A survey of people living with HIV in China devised and jointly launched by UNAIDS found in February that the COVID-19 outbreak was having a major impact on the lives of people living with HIV in the country, with nearly a third of people living with HIV reporting that, because of the lockdowns and restrictions on movement in some places in China, they were at risk of running out of their HIV treatment in the coming days.

The lockdowns had also resulted in people living with HIV who had travelled away from their home towns not being able to get back to where they live and access HIV services, including treatment, from their usual health-care providers.

The UNAIDS China Country Office worked with the BaiHuaLin alliance and other community partners to urgently reach the people at risk of running out of their medicines to ensure that they got their medicine refills. By the end of March, special pick-ups and mail deliveries of HIV medicines arranged by UNAIDS had reached more than 6000 people in Wuhan. UNAIDS also donated personal protective equipment to civil society organizations serving people living with HIV, hospitals and others to help in the very early stages of the outbreak.

But the UNAIDS China Country Office didn’t just help people in China. Liu Jie, the Community Mobilization Officer in the UNAIDS Country Office in China, was surprised when she had a call from Poland in March. “A Chinese man introduced himself, saying he is stranded and will run out of HIV medicine in two days,” she said.

With travel restrictions closing down more and more countries, the man could neither return home nor access medicine. Not knowing what to do, he reached out to a Chinese community-based organization and through it contacted UNAIDS in Beijing. A series of phone calls later and the National AIDS Center in Poland followed up—24 hours later, Ms Liu received a photo of the same man who called her, holding up a box of HIV medicine.

The man stuck in Poland wasn’t the only example of UNAIDS helping individuals to get the treatment they needed. By May, UNAIDS had helped hundreds of stranded people to obtain HIV medicine in countries around the world.

A day before Deepak Sing (not his real name) planned to return to India, all international travel ground to a halt, and he was stuck in Luanda, Angola. “I visited more than 10 pharmacies and explored options of delivery of antiretroviral medicines from India to Angola, but without success,” he said. The UNAIDS Country Director for Angola guided Mr Sing towards the national AIDS institute in Angola, which organized a conference call with a medical doctor because one of the medicines that Mr Sing took is not yet in use in the country. The doctor proposed a substitute and in less than 24 hours he picked up his medication.

It was realized early on in the COVID-19 pandemic that one way of ensuring that people on HIV treatment can continue to access their medicines, and to avoid the risk of transmission of the new coronavirus, was to ensure that people living with HIV got multimonth supplies of their treatment.

An early adopter of multimonth dispensing was Thailand, which announced in late March that it would dipense antiretroviral therapy in three- to six-month doses to the beneficiaries of the Social Security Insurance Scheme. After the decision, UNAIDS worked closely with the Ministry of Public Health and partners to advocate for the adaptation of the same policy for all health insurance schemes.

UNAIDS has supported countries worldwide to ensure that people living with HIV access multiple-month supplies of HIV treatment. For example, in Senegal in May, weaknesses in the supply chain, including inadequate assessments of the needs at some clinics for supplies of antiretroviral therapy and irregular supplies centrally, meant that not all people who needed such supplies got them. UNAIDS supported the government in tracking orders of antiretroviral medicines and in strengthening the supply chain.

A modelling group convened by the World Health Organization and UNAIDS estimated in May that if efforts were not made to mitigate and overcome interruptions in health services and supplies during the COVID-19 pandemic, a six-month disruption of antiretroviral therapy could lead to more than 500 000 extra deaths from AIDS-related illnesses and that gains made in preventing mother-to-child transmission of HIV could be reversed, with new HIV infections among children up by as much as 162%.

The physical distancing and hygiene recommendations to counter the new coronavirus are particularly difficult for some communities to follow. In April, the UNAIDS Regional Support Team for Eastern and Southern Africa and Reckitt Benckiser joined forces to distribute more than 195 000 hygiene packs to people living with HIV in the eastern and southern African region. Each pack consisted of a three-month supply of Dettol soap and Jik surface cleaner and was distributed in 19 countries through UNAIDS country offices and networks of people living with HIV as part of efforts to reduce exposure to the impact of COVID-19 among people living with HIV.

Kyrgyzstan saw a state of emergency imposed on some regions in March, which resulted in a loss of earnings for many people. The UNAIDS Country Office in Kyrgyzstan, with the support of a Russian technical assistance programme, organized the delivery of food packages for the families of people living with HIV, along with colouring books, marker pens and watercolour sets for the children of people living with HIV, to help them get through the lockdown. “We hope that this small help will go some way to enabling people living with HIV to remain on treatment,” said the UNAIDS Country Manager for Kyrgyzstan at the time.

The UNAIDS Country Office for Angola leveraged its partnerships to reach thousands of people in Luanda with food baskets. UNAIDS and partners provided support to women who inject drugs in camps and settlements in Dar es Salaam, United Republic of Tanzania, while a partnership that included UNAIDS provided cash transfer to vulnerable households in Abidjan, Côte d’Ivoire, for nutrition and food security and basic health kits.

Members of key populations and people living with HIV have been particularly impacted by the response to COVID-19. UNAIDS has supported the rights of gay men and other men who have sex with men, transgender people, sex workers, people who inject drugs and prisoners throughout the pandemic.

The Global Network of Sex Work Projects and UNAIDS in April called on countries to take immediate, critical action to protect the health and rights of sex workers during the COVID-19 pandemic. UNAIDS embarked on a project with the Caribbean Sex Work Coalition to help national networks address sex workers’ knowledge, HIV prevention and social support needs during COVID-19. “Sex workers need to be included in national social protection schemes and many of them need emergency financial support,” said the Director of the UNAIDS Caribbean Sub-Regional Office.

UNAIDS Jamaica provided financial support to ensure that Transwave, a transgender rights organization, had personal protective equipment and to supplement care package supplies and ensured that transgender issues are included in the coordinated HIV civil society response to COVID-19 in the country. “COVID-19 has laid bare just how vulnerable people are when they do not have equitable access to opportunities, justice and health care,” said UNAIDS Jamaica’s Community Mobilization Adviser. “That’s why it’s so important and inspiring that Transwave has continued its core work through all this.”

Since the start of the COVID-19 pandemic, UNAIDS has repeated the call that governments must protect human rights and prevent and address gender-based violence. In June, UNAIDS published a report highlighting six critical actions to put gender equality at the centre of COVID-19 responses, showing how governments can confront the gendered and discriminatory impacts of COVID-19.

“Just as HIV has held up a mirror to inequalities and injustices, the COVID-19 pandemic has put a spotlight on the discrimination that women and girls battle against every day of their lives,” said Winnie Byanyima, the Executive Director of UNAIDS, on the launch of the report.

In August, UNAIDS urged governments to protect the most vulnerable, particularly key populations at higher risk of HIV, in a report intended to help governments to take positive steps to respond to human rights concerns in the evolving context of COVID-19.

In the next month, UNAIDS issued a report that shows how countries grappling with COVID-19 are using the experience and infrastructure from the AIDS response to ensure a more robust response to both pandemics.

In October, UNAIDS issued guidance on reducing stigma and discrimination during COVID-19 responses. Drawing on 40 years of experience from the AIDS response, the guidance was based on the latest evidence on what works to reduce HIV-related stigma and discrimination and applies it to COVID-19. As with the HIV epidemic, stigma and discrimination can significantly undermine responses to COVID-19. People who have internalized stigma or anticipate stigmatizing attitudes are more likely to avoid health-care services and are less likely to get tested or admit to symptoms, ultimately sending the pandemic underground.

Looking to the future, UNAIDS joined the call for a COVID-19 People’s Vaccine—a vaccine that is affordable and available to all.

It is a sunny weekday morning in the small town of Morija, Lesotho. On the expansive lawn of the Morija Museum and Archives, under the shade of tall trees, a group of children and teenagers sit on evenly spaced plastic chairs.

They have all had their temperatures checked, have washed their hands at purpose-built tippy-taps and are wearing brightly coloured seshoeshoe fabric face masks.

The learners would usually be in school at this time, but schools throughout the country remain closed due to COVID-19. In response to this crisis, local community-based organizations have had to implement new and innovative programming.

This particular programme is called Skills & Soup, implemented by the Hub, a Morija-based nongovernmental organization. On a bi-weekly basis, groups of learners visit to receive a nutritious meal and participate in a range of activities and educational programming, including dance and taekwondo, maths and science lessons and COVID-19 awareness sessions.

Today, the Hub is hosting a pair of guest facilitators from the Maseru-based nongovernmental organization Kick4Life, which specializes in delivering HIV and life skills education through sports-based curricula.

Puky Ramokoatsi, an experienced educator and gender equality activist, is leading the session with confidence and ease. She begins with an energizer, getting the learners to stand up to chant and dance along with her, all the while remaining at a two-metre distance from one another. She keeps her mask on throughout the session, the volume and authority of her voice unhindered.

During the session, Ms Ramokoatsi and her co-facilitator, Mbulelo Mochochoko, play a series of sound clips from a portable speaker. The clips, taken from new animations developed by Kick4Life, feature catchy music and short conversations between two characters who discuss a range of health-related topics, including HIV, nutrition, mental health and ways to protect oneself against COVID-19.

“Who can remind me which fluids can transmit HIV?” asks Ms Ramokoatsi after one of the clips has played. The children stand up and stretch their hands out eagerly, competing to be the first to give the correct answer.

The session is a far cry from Kick4Life’s signature programming, which typically includes close-contact games and activities, with children huddled in groups for discussions or holding hands while standing in a circle.

As with community-based organizations across the region, Kick4Life has adapted its approach to HIV and health education to mitigate the risk of COVID-19 transmission and in response to national lockdowns and government-mandated restrictions.

“We were forced to close our offices in March, when Lesotho went into lockdown, so we had to quickly adjust,” Ms Ramokoatsi explains. “We partnered with the British High Commission in Lesotho to adapt our curriculum into six short animations which could be easily distributed through our online platforms and to include new messaging about COVID-19. We also aired the sound clips from these animations on national radio stations. These are some of the ways that we continued to engage with young people even during the lockdown.”

While COVID-19 cases remain relatively low in Lesotho, at just over 2000 cumulative cases as of November 2020, testing capacity is also low. Only 25 500 tests have been conducted since March 2020. By comparison, a neighbouring country, South Africa, has conducted more tests than this in one day.

In 2019, there were 340 000 people living with HIV in Lesotho, 120 000 of whom are not on HIV treatment.

In addition, a third and silent epidemic plagues Lesotho—that of sexual and gender-based violence. It is estimated that one in three women in Lesotho have experience sexual or physical violence in their life—the same as the global average.

Ms Ramokoatsi has been involved with Kick4Life since 2010, when she began to participate in the organization’s programmes because of her love for football. At the time, she knew very little about HIV, and her interest in the issue was piqued by the fact that her aunt had recently died of AIDS-related illnesses.

“I didn’t understand enough about HIV when my aunt was sick,” recalls Ms Ramokoatsi. “I judged her negatively and didn’t support her. When I learnt more about HIV, I realized how wrong I had been. I made it my purpose after that to support people living with HIV, to give others the support that I hadn’t given my aunt.”

Having experienced sexual abuse herself, Ms Ramokoatsi is acutely aware of the healing power of sports and education and reflects on the difficult transition from face-to-face learning and close-contact activities to virtual and socially distanced programming.

“Before COVID-19 we were in the process of helping several young women who had experienced sexual violence and were slowly opening up to us after taking part in our programmes,” Ms Ramokoatsi explains. “When we were forced to close, we lost touch with some of them. We’ve had to find ways to continue with our programmes and to keep reaching out to our participants, but it hasn’t been easy.”

Ms Ramokoatsi emphasizes the importance of organizations working together in their responses to COVID-19 awareness and health education. “Today, for example, we’re delivering this session thanks to our partnerships,” she says. “I hope more organizations can work like this to share resources and information.”

“I always say that the best part of the game is the opportunity to play. That attitude applies to everything: instead of sitting on the sidelines, get involved. Learn about the situation or the issues around you, whether it’s HIV or gender-based violence or COVID-19. Learn how you can adapt, how you can take care of yourself, and then find a way to help others,” she says.

Irina Kutsenko, a deputy of the Odesa City Council in Ukraine responsible for social issues, is an active advocate of community rights who campaigned for medical and social services for HIV to be brought closer to the most disadvantaged. She is the first and so far the only government official nominated by civil society for the #inYourPower award. The award, which is given by civil society to leaders, government officials and eastern European and central Asian politicians, is given to people who have contributed to improving the financial sustainability and effectiveness of HIV programmes for key populations and to removing legal barriers to HIV services and protecting human rights.

However, the route to the award was not straightforward. “As a deputy, I closed the opioid substitution therapy site in my district. I collected signatures from people against the gay movement in our city,” she said. But after completing a course run by the International Academy of Harm Reduction, she began to research the topic in more detail. “I started reading about the issue on the Internet, listening to interviews of people, listening to life stories, until I understood that I was wrong!”

Ms Kutsenko started to cooperate with community organizations to make Odesa a safer city for key populations.

“When representatives of community organizations came to me with a harm reduction project in the city, I already understood what they were talking about. At that moment, I realized that nongovernmental organizations today know more than officials. At the beginning, I was only listening,” she said.

The first task for Ms Kutsenko and the community organizations was to find a common language and common platform. “We needed everyone: doctors, the authorities and public organizations to unite and work towards one common goal,” she said. “It didn't work out when everyone was separate.”

But, as Gennadiy Trukhanov, the Mayor of Odesa, said, it was not easy for the city. The city authorities, in addition to responding to local everyday problems also need to address global challenges, in particular helping health-care workers to fight the COVID-19 pandemic. “Mayors are assessed by the state of the city: roads, public spaces, etc. We can have clean cities, but with the spread of infectious diseases around the world, the time may come when there will be no one to walk along these roads,” he said.

Over the past few years, Odesa has been implementing steps within the framework of the Paris Declaration to end the AIDS epidemic in cities and was the first city in Ukraine to commit to the Zero TB Cities initiative. The city has initiated outpatient treatment of tuberculosis, instead of in hospital, and has begun widescale testing programmes for HIV, increasing the detection rate of HIV and ensuring that people who test positive access treatment.

“Of course, there are still many problems, but, step by step, we are changing the situation in the city,” said Ms Kutsenko.

Ms Kutsenko’s story can be viewed on YouTube.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

A new community-led public information campaign, It is in Your Power to, aimed at encouraging people living with HIV to start antiretroviral therapy has been launched in the four largest areas of the Russian Federation.

The campaign’s website has 12 “capsules” with inspiring stories told by people living with HIV. By “opening” the capsule, visitors can find out about people’s lives, find facts on antiretroviral therapy, ask questions and get help from peer counsellors on HIV-related issues.

All the stories deliver a message that being diagnosed with HIV does not define a person and that if people living with HIV start treatment they can live a long and productive life.

The campaign covers four major Russian areas—the Novosibirsk, Sverdlovsk and Chelyabinsk regions and the city of Saint Petersburg—where, according to the Federal AIDS Center of the Russian Federation, 200 000 people are living with HIV, about 20% of all registered HIV cases in the country.

“In the Sverdlovsk region, some people do not start treatment because they do not believe that HIV exists, some can’t accept their diagnosis, some are afraid of the side-effects of antiretroviral therapy and some have doubts about the effectiveness of the drugs. But the biggest obstacle is the fear of discrimination, fear of losing their job, fear of isolation. We believe we can address this by telling true stories of people living with HIV on treatment,” said Vera Kovalenko, Head of the New Life civil society organization. 

The campaign was initiated and developed by several community-led civil society organizations, including Humanitarian Action (Saint Petersburg), the Humanitarian Project (Novosibirsk), Light of Hope (Chelyabinsk) and New Life (Sverdlovsk), with the support of a regional SOS_project funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria and in close cooperation with other partners in the Russian Federation.

Denis Kamaldinov, Head of the Humanitarian Project, invited people to get help. “If you know you are HIV-positive but are not receiving treatment, please contact us for help. We will help with the registration at the AIDS centre. And the treatment is provided free of charge at the expense of the state,” he said.

“Our mission is to fight for every life, to give hope to everyone,” said Alexei Tananin, Head of Light of Hope.

More than a thousand people of faith working in the HIV field recently came together for an online HIV interfaith conference, Resilience & Renewal: Faith in the HIV Response.

“More than ever, it is important that faith communities and leaders are strong voices for people. This means, in a time of COVID-19, recognizing that a call to action on COVID-19 and a call to action on HIV should be complementary and synergistic—they are not in opposition to each other. We will rely on faith partners to be strong and true voices of support for people living with HIV,” said Shannon Hader, UNAIDS Deputy Executive Director, Programme.

During the three-day meeting, the participants identified joint action to address some of the challenges and emerging issues related to the achievement of the 2020 and 2030 HIV targets. All people of faith were invited to sign the online declaration of commitment to the HIV response: Our Promise to Action—Resilience & Renewal: Faith in the HIV Response. 

The conference also saw the launch of the 13 Million Campaign to engage faith leaders, individuals and communities to promote access to health services by the 13 million children, women and men living with HIV who are not yet on antiretroviral therapy.

Winnie Byanyima, the Executive Director of UNAIDS, reminded the participants that the nearly four decades-long HIV response has taught us that global solidarity is essential to overcoming the COVID-19 pandemic. Like HIV, this new pandemic is not just a disease, it has social, economic, ethical and political implications on society and only a multisectoral approach, including the involvement of faith communities, can help the world to overcome it. 

Jessie Milan Jr, the Chief Executive Officer of AIDS United, highlighted the increased vulnerability of marginalized communities to both epidemics. Racial injustices have compounded the suffering. “When our faith in systems and society is shaken, our faith community is needed even more,” he said.

Thabo Makgoba, a South African Archbishop, noted that religious institutions are serving the vulnerable, especially at the national level, and are providing a substantial proportion of services and cooperating actively with government agencies. He proposed that 5% of global funding for HIV be channelled through faith-based initiatives.

Katy Godfrey, from the United States President’s Emergency Plan for AIDS Relief (PEPFAR), shared her experience in providing HIV services to 15.7 million people, in close collaboration with governments and faith communities. She reiterated that services could only be effective if they are underpinned by a learning process that listens to community needs, and works with them, that is responsive to convenient client-centred care and that does not neglect care for the carers.

Good practices by faith groups that ensure the provision of HIV services during COVID-19 were shared. The conference was also an opportunity for faith groups to learn from the science, research and information presented at the 2020 International AIDS Conference. Narratives shared by people engaged in the HIV response spurred discussions and presented opportunities to learn from their experiences and journeys. Songs, prayers and petitions from children challenged the current paucity in the HIV response for children and adolescents.

Representatives of community groups played a major role in the conference.

Nine women with disabilities from Nigeria from the BOLD (Beautiful Outstanding Ladies with Disabilities) Hearts Network participated. Ndifreke Andrew-Essien, the Coordinator of the BOLD Hearts Network, said, “It was wonderful to listen to and see how persons with disabilities living with HIV were building even more resilience and inspiring many. We truly benefitted from the conference. It is our hope that in future our deaf constituents can participate through sign language interpretation.”

“I was particularly impressed by the good practices from Kenya, especially those of linking peers who have achieved viral suppression. The use of celebration as a strategy, rather than punitive, is something which inspired me,” said Aarti Parab, one of six adolescents living with HIV who were facilitated to attend the conference.

A consortium of organizations from several faith traditions and people living with HIV from around the world organized the meeting, which was held from 22 to 24 September, with the support of the UNAIDS/PEPFAR Faith Initiative. 

Community-based organizations in Dar es Salaam, United Republic of Tanzania, with assistance from UNAIDS, are supporting women who use drugs and their families to survive during these difficult times.

“Before the pandemic, life was simple and better. I used to do activities at the beach, such as cleaning fish, helping people load and clean their boats, and they would pay me. I would help my daughter wash her clothes; I would escort her to school and cook food for her. Life was simple,” said Doroth Hassan as she sits in the office of SALVAGE, a sister organization of the Tanzania Network for People who Use Drugs (TaNPUD), in Kigamboni, Dar es Salaam.

Ms Hassan would normally provide for herself and her daughter by doing sex work and other informal jobs, such as the work on the beach. But this has become a challenge since the onset of the COVID-19 pandemic.

“Now life has changed. I live in fear and worry. People who I worked for don’t want to pay, with the excuse that they have no cash because of the coronavirus. Everything changed. Life is tough. Clients disappeared, vanished. And the few who are still coming cheat; they pay less for sex,” said Ms Hassan.

She is not alone in her worry. Most of the women who use drugs in Dar es Salaam survive in the same way as Ms Hassan does, by doing sex work, trading and doing other jobs in the informal sector. They live in camps for people who use drugs or in informal and densely populated settlements.

With support from UNAIDS and other partners, local community-based organizations, including TaNPUD and SALVAGE, have been able to provide some relief to women in the camps and settlements in Dar es Salaam.

“TaNPUD raised awareness and SALVAGE provided buckets, soap and food with other hygiene materials to us and other women in the community. TaNPUD always advocates for our health rights,” said Oliver Kinanda, a person who previously used drugs and is now on opioid substitution therapy.

Ms Kinanda also volunteers at the Medication-Assisted Treatment (MAT) clinic in Temeke, where she lives. Here, she informs people on prevention of tuberculosis (TB) and takes samples from clients for TB screening. With the onset of COVID-19, however, her tasks have shifted.

“As a peer educator I have knowledge of prevention of COVID-19 and provide education and awareness. Together with other people who use drugs I also got help; for example, face masks,” said Ms Kinanda. She has also received information and support from other local community-based organizations, including donations to the community and the clients she works with in the Temeke MAT clinic.

Ms Hassan received the same support.

“TaNPUD is raising a voice on our behalf, and SALVAGE, as the sister organization of TaNPUD, supporting women, has been linking us to care and treatment with other services and providing shelter, food and hygiene support to us,” she said.

The support, distributed with financial and material assistance from UNAIDS, will help to alleviate some of the consequences of the global pandemic, even as the effects of COVID-19 are slowly wearing off in the United Republic of Tanzania.

Happy Assan, the Coordinator of TaNPUD, said this support has so far reached 55 families of women who use drugs in Dar es Salaam.

“The support covered food and hygiene needs. It also provided women with the ability to stay at home instead of going out, for example to do sex work, and to negotiate less risky sex. The support reduced fear and worry about meeting the food needs of families with children,” said Ms Assan.

Many of the women who use drugs are living with or at risk of HIV infection and depend on reliable access to treatment and care, including harm reduction services. Despite the support in the community, some services that the women who use drugs depend on have been halted.

“Harm reduction services have been interrupted; they are less. No condom distribution or other commodities, only needle and syringes distribution. At least now SALVAGE is helping with sanitary items. At hospital there is no other support; HIV treatment only,” explained Ms Hassan.

Ms Hassan and Ms Kinanda both recount facing increased stigma during the pandemic—some derived from unintended consequences of the support, since the face masks they received were a certain colour, making the wearer identifiable in the local community as a person who uses drugs. Stigma and discrimination at hospitals is also reportedly high, adding to the difficulties of accessing services. But most difficult is the financial loss because of the pandemic.

As Ms Kinanda puts it, “No clients, no pay. Financially it is hard because my clients say they have no cash because the coronavirus has affected their jobs. I continue providing awareness and education to the community and my family too. I financially suffer, but what can I do other than continue pushing on?”

WASHINGTON, D.C./GENEVA, 29 September 2020—Despite decades of scientific advance in the HIV response, progress remains uneven, with some countries rapidly reducing AIDS-related deaths and new HIV infections and others seeing increasing epidemics. Laws and policies are driving a significant part of that divergence. 

Launched today, the HIV Policy Lab is a unique initiative to gather and monitor HIV-related laws and policies around the world. 

“Laws and policies are life or death issues when it comes to HIV. They can ensure access to the best that science has to offer and help people to realize their rights and live well, or they can be barriers to people’s well-being. Like anything that matters, we need to measure the policy environment and work to transform it as a key part of the AIDS response,” said Winnie Byanyima, UNAIDS Executive Director.

The HIV Policy Lab is a data visualization and comparison tool that tracks national policy across 33 different indicators in 194 countries around the world, giving a measure of the policy environment. The goal is to improve transparency, the ability to understand and use the information easily and the ability to compare countries, supporting governments to learn from their neighbours, civil society to increase accountability and researchers to study the impact of laws and policies on the HIV pandemic. 

According to Matthew Kavanagh, Director of the Global Health Policy & Politics Initiative at Georgetown University’s O’Neill Institute, “Policy is how governments take science to scale. If we want to improve how policy is used to improve health outcomes, it is essential to monitor and evaluate the policies that comprise it.”

“Reducing stigma and making care easier to access are fundamental for improving the lives of people living with HIV—and those are all consequences of policy choices. Tracking these choices is a key tool for improving them, and ensuring justice and equity for people living with HIV,” said Rico Gustav, Executive Director of the Global Network of People Living with HIV.

The HIV Policy Lab draws information from the National Commitments and Policy Instrument, legal documents, government reports and independent analyses to create data sets that can be compared across countries and across issues. The goal of the HIV Policy Lab is to help identify and address the gaps between evidence and policy and to build accountability for a more inclusive, effective, rights-based and science-based HIV policy response.

The HIV Policy Lab is a collaboration between Georgetown University and the O’Neill Institute for National and Global Health Law, UNAIDS, the Global Network of People Living with HIV and Talus Analytics.

About the Georgetown University O’Neill Institute for National and Global Health Law

The O’Neill Institute, housed at Georgetown University, was established to create innovative solutions to the most pressing national and international health concerns, with the essential vision that the law has been, and will remain, a fundamental tool for solving critical health problems. The Georgetown University Department of International Health is home to scholarship in public health, economics, political science, and medicine. Georgetown’s Global Health Initiative serves as a university-wide platform for developing concrete solutions to the health challenges facing families and communities throughout the world. Read more at oneillinstitute.org and connect with us on Twitter and Facebook.

About UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

About GNP+

GNP+ is the global network for and by people living with HIV. GNP+ works to improve the quality of life of all people living with HIV. GNP+ advocates for, and supports fair and equal access to treatment, care and support services for people living with HIV around the world. Learn more at gnpplus.net and connect with GNP+ on Facebook, Twitter and Instagram.