Events

Feature Story

The importance of young people’s sexual and reproductive health and rights to the global HIV response

21 June 2021

More than a quarter of the world’s population is between the ages of 10 and 24 years—and in some parts of the global South the proportion is two thirds or higher. This is a generation caught between biology and society—between curiosity, questions and concerns about their emerging sexual and reproductive selves and the controls, constraints and conditions imposed by laws, policies and community practices.

On the sidelines of the United Nations High-Level Meeting on AIDS, a group of young activists, government representatives and experts came together in a virtual event on 10 June to discuss the Facts of Life: Youth, Sexuality and HIV.

The meeting, co-hosted by UNAIDS and the International Planned Parenthood Federation (IPPF), brought home the urgency of action. Nearly half of all new HIV infections worldwide occur among young people aged 15 to 24 years, with young women being twice as likely to become infected. Globally, AIDS-related illnesses are the second leading cause of death among young people (aged 10–24 years) and the most common cause of mortality of young people in Africa.

The new Global AIDS Strategy 2021–2026 highlights the urgent need to empower young people to build today’s and lead tomorrow’s HIV response—for themselves and their communities. Nipun Srivastava, a young HIV activist from India, pointed to the challenges ahead. “We have an ambitious target to end AIDS by 2030, but it is not achievable with these regressive policies on sex and sexuality. We lost a lot of people in the 1980s and 1990s because we didn’t talk about sex. We need to stop talking about cows’ and goats’ and bees’ reproduction and speak about sex.”

Efforts to help young people reach their potential in public life need to be mirrored in their private, intimate lives. Alvaro Bermejo, the Director-General of IPPF, emphasized the connection between the physical and emotional well-being of adolescents (including those living with HIV)—and their societies—and access to accurate, age-appropriate sexual and reproductive information and services, allowing them to avoid unwanted pregnancy and unsafe abortion, sexually transmitted infections, including HIV, and all forms of sexual violence and coercion.

And yet, young people’s sexual and reproductive health and rights remain highly controversial. “Case-in-point is the High-Level Meeting on AIDS itself,” said Shereen El Feki, the Director of the UNAIDS Regional Support Team for the Middle East and North Africa. “Some of the most contentious negotiations, and pushback from Member States, on the United Nations Political Declaration on AIDS was on sexual and reproductive health and rights and comprehensive sexuality education.” 

The participants heard that the same governments praised for initiatives on young people’s employment or civic engagement often founder when trying to bring the same spirit of youth empowerment to access to youth-friendly sexual and reproductive health and rights services or sexuality education. Amery Browne, the Minister of Foreign and CARICOM Affairs for Trinidad and Tobago, spoke about the delicate act that governments face in balancing conservative forces and youth voices, and urged those working for greater openness to continue their struggle.

Among them is Nadia Abdalla, the Chief Administrative Secretary at the Ministry of ICT, Innovation and Youth in Kenya. A young person herself, she spoke about her country’s efforts to help young people to organize and mobilize for their intimate rights, including their ability to prevent, or live with, HIV. Half-a-world away, sexual and reproductive health and rights activist Ponny White described her work with Advocates for Youth, a nongovernmental organization in the United States of America that lobbies state governments for legal reform to enable young people to access their full sexual and reproductive rights. “A lot of young people are experiencing sexual encounters they don’t understand because someone else is introducing it to them,” she warned, “We want to equip young people with tools and education so they can be autonomous and living a fulfilling life.”

The Internet is one such tool of empowerment. Abir Sarras, the co-founder of Love Matters Arabic, a pioneering social media platform reaching millions of young people across the Middle East and North Africa, pointed to the importance of sex-positive messaging—emphasizing the pleasures, rather than just the problems, associated with sex—as a key means of communicating with young people. But not all young people yet have access to such online resources—Stefania Gianinni, the Director-General for Education at the United Nations Educational, Scientific and Cultural Organization, described the successes and setbacks faced in implementing the United Nations guidance on comprehensive sexuality education in school curricula. “There is no knowledge pill we can give young people,” she said. “But education, hand in hand with access to youth-friendly services, is the most powerful tool for ending AIDS as a public health threat and giving rights to the new generations.”

Feature Story

City leaders unite to regain momentum in the urban HIV response

11 June 2021

Mayors from four cities, together with a representative of civil society and the core partners of the Fast-Track cities initiative—UNAIDS, the International Association of Providers of AIDS Care (IAPAC), the United Nations Human Settlements Programme (UN-Habitat) and the city of Paris—participated in a virtual side event on urban settings on 10 June, held during the United Nations High-Level Meeting on AIDS.

The participants reflected on the progress made in urban HIV responses and disruptions related to COVID-19, the importance of sustained political leadership and commitment during public health crises and the critical role of communities in strengthening HIV and other health services.

“A Fast-Track city is a city embracing human rights and advocating for more equality and freedom. The freedom to be true to yourself, to live where you want, to live free of prejudice, and with equal chance to stay healthy,” said the Mayor of Paris, Anne Hidalgo, in her opening address.

In her message, Maimunah Mohd Sharif, the Executive Director of UN‐Habitat, highlighted that, “Reducing inequalities is central to both UN-Habitat’s mission broadly and to ending urban HIV epidemics given the unacceptable disparities we see with respect to HIV among sexual and ethnic minorities, including the LGBTQ+ populations, migrants and refugees, and other marginalized populations, such as those in slums and informal settlements.”

Sibongile Tshabalala, the national Chairperson of the Treatment Action Campaign in South Africa, emphasized the importance of community leadership if we want to end AIDS, and called for communities to be at the centre of the HIV response within the context of ending social marginalization and health inequalities.

Attending mayors from Baton Rouge, Johannesburg, Kyiv and Quezon City presented their experiences in exercising public health leadership in HIV responses at the city level and in mitigating the impact of the COVID-19 pandemic. Many cities have made significant progress in accelerating their urban HIV responses since the beginning of the Fast-Track cities initiative on World AIDS Day 2014. In Kyiv, for example, according to national data the percentage of people who know their HIV status and are on antiretroviral therapy rose from less than 50% in 2015 to 83% in 2019, with 95% of those being virally suppressed. In Paris, according to national data the number of new HIV infections dropped by 16% between 2015 and 2018. And in Johannesburg, a targeted testing approach during the COVID-19 pandemic led to an increase in the percentage of people living with HIV knowing their status, from 86% in March 2020 to 91% in 2021, according to national data.

Maria Josefina Belmonte, the Mayor of Quezon City, called on mayors to use the “Power and resources at their disposal towards the common good, including eradicating HIV and addressing issues that others are afraid to address because they are controversial or they may not be acceptable or not be politically sound.” She added that, “It is every person’s right to live freely, humanely and justly in the world they were born in and it is our duty as mayors elected by the people to make that happen for them.”

The moderator of the event, IAPAC President/Chief Executive Officer José M. Zuniga, recognized the progress made by Fast-Track cities, even within the context of the COVID-19 pandemic. “City public health leadership is translating into countless lives saved and enhanced, including as Fast-Track cities grapple with an emerging COVID-19 pandemic and simultaneously work to maintain a continuity of HIV and other essential health services for all of their citizens,” he said.

In many cities, the 90–90–90 targets for 2020 were not achieved, partly because of COVID-19-related disruptions, but also due to persistent inequalities and social exclusion. A prioritization of social enablers is therefore required to regain momentum against HIV across the Fast-Track cities network.

In her closing statement, Winnie Byanyima, the UNAIDS Executive Director, called on cities and municipalities around the world to recommit to accelerated urban HIV responses, to exercise public health leadership to achieve the 2025 targets, to end inequalities and social exclusion and to end AIDS as a public health threat by 2030.

High-Level Meeting on AIDS (8-10 June 2021)

Remarks by Winnie Byanyima

Feature Story

Putting people and communities at the centre of the HIV response

10 June 2021

Communities living with and affected by HIV, including communities of key populations, are the backbone of the HIV response. They have campaigned for their rights, expanded the evidence base for effective action against HIV, supported the design and implementation of programmes and enhanced the reach and quality of health services. They ensured that the greater involvement of people living with HIV principle became an organizing norm for HIV programmes and that rights-based approaches were widely adopted.

A panel, Putting People and Communities at the Centre of the Response to AIDS, held on the sidelines of the United Nations High-Level Meeting on AIDS on 9 June, saw a high-level discussion on the opportunities and challenges for moving towards the global AIDS targets and realizing the political commitments and policy adaptations needed to support community-led responses as the world moves towards ending AIDS by 2030, and does so in the context of COVID-19.


The panel discussed supporting key population-led, women-led and other community-led responses, new priorities emerging from the community-led response to COVID-19 and fair payment for the community workforce, in particular for women living with HIV and women from key and vulnerable populations.

The panellists heard that more than three decades of experience has clearly shown that communities are at the centre of efforts to end AIDS as a public health threat, but their significant contribution is too often set aside or made more difficult by politicians or public health officials who have little or no knowledge of the lives and experiences of the people they are charged to serve.

They also heard that the response to the COVID-19 pandemic has further underscored the importance of communities in navigating difficult and rapidly changing environments and in reaching affected communities with essential services, such as COVID-19 testing and vaccination and HIV prevention, testing and treatment and other health and social services.

During their discussions, all panellists stressed that communities can deliver when there is an enabling legal environment, operating space for civil society organizations and funding and capacity-building.

Quotes

“The government needs to implement the policies and remove the legal barriers that can enable implementation of the required initiatives. There need to be financing mechanisms and technical support for community-led services, as this is crucial to ensure the quality and sustainability of services, and trusting multisectoral partnerships among stakeholders need to be forged so that there is a united front towards achieving the same goal by putting people at the centre of implementation.”

Taweesap Siraprapasiri Senior Adviser to the Disease Control Department, Ministry of Public Health, Thailand

“Whilst communities are best placed to reach their members, governments have the capacity and resources to support and accelerate progress by ensuring a safe space for civil society through law and policy reform to decriminalize key populations, reduce discrimination and prevent hate crimes, to enable everyone to live peacefully and to enjoy their human rights.”

Anneka Knutsson Acting Director, Technical Division, United Nations Population Fund

“Lessons learned from community-led and centred service delivery have strongly shown us that communities have the experience, ability and knowledge on how to best serve their own communities. Communities have a lot to teach us.”

Vuyiseka Dubula Director of the Africa Centre for HIV/AIDS Management, Stellenbosch University, South Africa

“We cannot end AIDS without investing in harm reduction, community-led responses and the rights of people who use drugs.”

Baby Virgarose Nurmaya Affiliate Representative, International Harm Reduction Association

High-Level Meeting on AIDS (8-10 June 2021)

Feature Story

Addressing the impact of the COVID-19 pandemic on the AIDS response

10 June 2021

A panel that met on the sidelines of the United Nations High-Level Meeting on AIDS, Addressing the Impact of the COVID-19 Pandemic on the AIDS Response and Building Back Better for Pandemic Preparedness, examined how the responses to HIV and COVID-19 can contribute to building multisectoral preparedness and response systems through providing concrete examples of innovations and policy and structural changes introduced in the context of COVID-19.

The panellists, comprising leaders, experts and representatives of community organizations and networks of affected people, addressed how to improve pandemic preparedness and response, and health-care systems more broadly, in the pursuit of the Sustainable Development Goals.

The speakers shared ideas and recommendations to help mobilize political leadership, solidarity and support for ending AIDS by 2030 and for stronger pandemic preparedness for the future. They went on to look at how innovation and technology can address the bottlenecks to achieving Sustainable Development Goal 3 (good health and well-being) through digital health infrastructure and agile, differentiated delivery models. The panellists also addressed the importance of community-led responses in delivering health for all, and reflected on the importance of across- and within-country solidarity in ensuring equitable access to health and socioeconomic support.

Quotes

“HIV setbacks because of COVID-19 would not have happened with more effective protective policies and laws. National sovereignty should not be used against populations in need, but laws should be applied to protect communities.”

Gracia Violeta Ross Bolivian Network of People Living with HIV/AIDS

“Adaptable institutions like the United States President’s Emergency Plan for AIDS Relief can provide important foundations to protect against future shocks. Countries around the world have been investing in their health systems—looking to future pandemics, we need to focus on prevention as well as preparedness to respond.”

Gayle Smith Coordinator, Global COVID-19 Response and Health Security, Department of State, United States of America

“We need to explore new institutional arrangements to encourage effective multilateralism. All countries need to respond more effectively to best practices, and, for example, learn from the impact of community engagement and leadership in HIV responses.”

Helen Clark Co-Chair of the Independent Panel on Pandemic Preparedness and Response

“Men who have sex with men, sex workers, transgender people, people who inject drugs and prisoners are particularly vulnerable to HIV and frequently lack adequate access to HIV services. In the context of COVID-19, we must make an extra effort to ensure they access all of the HIV services they need.”

Zsuzsanna Jakab Deputy Director-General, World Health Organization

“Pandemic preparedness must be a priority for the African continent. Africa has the largest HIV burden in the world and the pandemic in Africa has disrupted essential services and these disruptions could indirectly kill more than COVID-19 itself.”

John Nkengasong Director, Africa Centres for Disease Control and Prevention

High-Level Meeting on AIDS (8-10 June 2021)

Feature Story

Gender equality and justice critical for ending AIDS

10 June 2021

On 10 June, representatives of the United Nations, Member States, young women’s movements and civil society laid out strategic pathways for advancing gender justice and women’s rights and agency at a thematic panel, Advancing Gender Equality and Empowering Women and Girls in the AIDS Response, held during the United Nations High-Level Meeting on AIDS.

Despite significant progress in the HIV response, the epidemic continues to take a heavy toll on women and girls. This was an opportunity to reflect on the realities of women and girls in all their diversity in the context of the HIV response and to share forward-looking recommendations on gender equality.

The event came on the heels of a new global pledge by world leaders to reduce the annual number of new HIV infections and AIDS-related deaths, eliminate new HIV infections among children, end paediatric AIDS and eliminate all forms of HIV-related discrimination by 2025. Governments missed the targets made in 2016 to reduce the number of adolescent girls and young women aged 15–24 years becoming newly infected with HIV to 100 000 per year by 2020.

Phumzile Mlambo-Ngcuka, the Executive Director of UN Women, noted the enormous work yet to be done, especially with the challenging convergence of gender-based violence, COVID-19 and HIV, with increased levels of violence against women and girls during lockdowns, spiking by up to 500% in some countries.

Nadine Gasman, President of the National Institute for Women, Mexico, shared best practices from Mexico, where municipal authorities and civil society have worked together to improve access to comprehensive quality HIV services for left-behind populations, such as transgender people, and integrated HIV and sexual and reproductive health services for women living with HIV as well as for gay men and other men who have sex with men and people who inject drugs.

The panel noted that many women, girls and gender-diverse communities at higher risk of and living with HIV are being left behind in HIV testing, treatment and care services. Women and girls continue to face intersecting forms of discrimination, stigma, violence and criminalization.

Particular concern was raised about adolescent girls and young women in sub-Saharan Africa, who remain at intolerably high risk of HIV. In 2020, six in seven new cases of HIV among adolescents between the ages of 15 and 19 years in the region were among girls. The participants stressed the importance of leveraging education, particularly girls’ completion of quality secondary education, as a powerful entry point for accelerating HIV prevention, gender equality, an inclusive environment free of stereotypes, economic empowerment and preventing gender-based violence.

Education Plus, a bold new initiative co-led by the heads of UNAIDS, UN Women, the United Nations Population Fund, the United Nations Educational, Scientific and Cultural Organization and the United Nations Children’s Fund that is calling for high-level political action for the empowerment of young women and girls in sub-Saharan Africa to urgently reduce HIV was hailed as a timely and much needed response. Many emphasized the need to put gender justice at the heart of the HIV response and the sustained meaningful engagement and inclusion of adolescent girls and young women in decision-making at all levels.

The calls to action stressed the importance of scaling up investments in gender-transformative interventions and support for young people’s movements and leadership in the HIV response, legal and policy reforms in parental consent requirements that undermine the right to health of adolescents, the protection of the sexual and reproductive health and rights of all women and adolescent girls and urgently scaling up comprehensive HIV prevention programmes as well as engaging men and boys in transforming harmful gender norms and promoting positive masculinities.

Quotes

“We are closer to ending AIDS than ever before, but HIV is not over, with unacceptably high new HIV infections among adolescent girls and young women in sub-Saharan Africa. Through Generation Equality we will take urgent action on key issues, including women’s bodily autonomy and gender-based violence, working in solidarity through an intergenerational coalition of governments, civil society, feminist and youth organizations, the private sector, philanthropy and international organizations. By working together to address gender inequalities we can drive systemic and lasting change.”

Phumzile Mlambo-Ngcuka Executive Director, UN Women

“Now is the time for all of us in the global community to come to grips with the intersecting exclusions and inequalities that perpetuate this crisis. We need radical and rapid transformation of harmful gender norms and practices. But to make that happen, we must give those most affected by HIV a louder voice in our conversations, so they can contribute to the solutions.”

Karina Gould Minister of International Development, Canada

“Criminalization and punitive laws and policies based on sexual activity, sexual orientation and gender identity, drug use and HIV status further expose adolescent girls and young women from key populations to extreme levels of violence, stigma and discrimination. Such laws and policies only drive them further from accessing the HIV prevention and treatment services they need, with little if any recourse to gender and social justice for violations of their rights.”

Irene Ogeta a young women’s rights activist from Kenya

“We need to enhance our collaborative initiatives between the communities and the schools and realize that the school is a microcosm of what society looks like. The school and the classroom are a reflection and mirror of our communities, and communities mirror what is happening in the classrooms. I implore all of us to make that investment now in adolescent girls, young women and boys as well.”

Steven Bernardus Harageib Technical Director and Head of Programmes, Namibia First Lady’s Office

‘’Any discussion about women’s agency and full participation in decision-making to strengthen HIV prevention and the AIDS response must be anchored in fulfilling a core element of women’s empowerment that cuts across their education, health and economic security: that is, the full respect and protection of their sexual and reproductive health and rights.”

Nadine Gasman President of the National Institute for Women, Mexico

High-Level Meeting on AIDS (8-10 June 2021)

Press Release

United Nations High-Level Meeting on AIDS draws to a close with a strong political declaration and bold new targets to be met by 2025

NEW YORK/GENEVA, 14 June 2021—After weeks of robust discussions, the 2021 United Nations General Assembly High-Level Meeting on AIDS is drawing to a close with the adoption of a new, ambitious and achievable Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030. The declaration is based on evidence, grounded in human rights and will serve as an important road map to advance the global HIV response over the next five years.

“I would like to thank all Member States,” said Winnie Byanyima, Executive Director of UNAIDS. “Over the past two months they have drafted, negotiated and delivered a bold political declaration that will guide global efforts to end a pandemic that has ravaged countries and communities for 40 years.”

Important advances have been achieved in the 2021 political declaration, including new targets to ensure that 95% of people at risk of HIV use combination HIV prevention services, a greater emphasis on community-led provision of services—including a target to ensure that 80% of prevention services for key populations are provided by communities—and a commitment to end inequalities, going far beyond Sustainable Development Goal 10, reduce inequalities.

The High-Level Meeting on AIDS was convened by the President of the General Assembly, with the co-facilitators—the ambassadors of Australia and Namibia—leading negotiations on the political declaration; 193 Member States were represented and the speakers included 14 presidents, five vice-presidents and four prime ministers, with many high-level dignitaries also participating in the thematic panels and 30 supporting events. The events covered issues from how to increase treatment coverage for children to how to scale up harm reduction and empower young people and adolescents.

The five thematic panels were:

  • Addressing Inequalities to End AIDS: 10 Years to 2030.
  • Putting People and Communities at the Centre of the Response to AIDS.
  • Resources and Funding for an Effective AIDS Response.
  • Advancing Gender Equality and Empowering Women and Girls in the AIDS Response.
  • Addressing the Impact of the COVID-19 Pandemic on the AIDS Response and Building Back Better for Pandemic Preparedness.

The High-Level Meeting on AIDS featured the participation of people living with HIV, senior United Nations officials, representatives of international organizations, the private sector, civil society and academia and other stakeholders, who discussed practical ways of translating the new political declaration into action and results.

Eminent person and long-time AIDS activist Sir Elton John, founder of the Elton John AIDS Foundation, made a strong call to action by video message, saying, “With your leadership, we can defeat AIDS and COVID-19 and be better prepared for other pandemics that will follow. You can and will make the difference. And you have an army of supporters standing behind you, including the 38 million people living with HIV around the world. Together, we can bring an end to fear and inequality—and, by the end of this decade, end the AIDS pandemic, once and for all! The world is watching and we don’t have a moment to waste.”

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.

Contact

UNAIDS
Sophie Barton-Knott
tel. tel. +41 79 514 68 96
bartonknotts@unaids.org

High-Level Meeting on AIDS (8-10 June 2021)

"Compassion, courage and equality," says Sir Elton John

"Let us learn the lessons of the past and not repeat them," says Sir Elton John

Feature Story

Global HIV Prevention Coalition reinforces the need for leadership and decisive action

14 June 2021

Forty years into the HIV epidemic, despite there being a range of HIV prevention interventions, none of the recommended HIV prevention packages have come close to being delivered to half of the people who need them.

But there have been successes in reducing new HIV infections among the most vulnerable populations where rights-based multisectoral action has been taken, where data-driven solutions have been promoted and resourced and where the voices and contributions of the most affected communities have been leveraged.

On the sidelines of the United Nations High-Level Meeting on AIDS, a side event, No Prevention, No End: The Importance of Leadership for HIV Prevention, saw the participants—political, technical and community leaders and donors—address the gaps in HIV prevention, discuss the most effective ways to invest in and develop HIV prevention programmes and share experiences of successful country-level action.

Nguyễn Thanh Long, the Minister of Health of Viet Nam, shared an example. A threefold decrease in HIV prevalence among people who inject drugs in Viet Nam was principally a result, he said, of considering drug addiction as a medical condition requiring treatment and not as a crime. Introducing this perception into legal policy documents, including the Government Decree and the Law on HIV/AIDS Control, enabled the initiation and scale-up of comprehensive harm reduction programmes for people who inject drugs.

Adolescent girls and young women account for one in four new HIV infections in sub-Saharan Africa, yet dedicated HIV prevention programmes are present in only a third of high HIV burden districts.  According to Pascalle Grotenhuis, the Dutch Ambassador for Women’s Rights and Gender Equality, who also drew on her experience as the Ambassador of the Netherlands to Mozambique, the time is ripe for pragmatism and common sense in strengthening sexual and reproductive health services for young people, with sexual health at the core, offering dual protection against sexually transmitted infections, including HIV, and unwanted pregnancy. Above all, sexuality education for young people must be recognized as a life-saving intervention, she said. 

Quotes

“Forty years into the epidemic, we can’t lean on the excuse that prevention is complicated, it is not. We all have to raise our voices and speak truth.”

Natalia Kanem Executive Director, United Nations Population Fund

“The most remarkable options developed by science will not end the epidemic. Our leadership, our policies and programmes that are grounded in the communities we seek to serve provide choices to people.”

Mitchell Warren Executive Director of AVAC, incoming Co-Chair of the Global HIV Prevention Coalition

“The law shows the standard which the public are expected to observe. Above all, the law says that discrimination against LGBTQ communities is wrong. It recognizes that prejudice kills whereas equality saves lives and makes everyone safer. That is the case for decriminalization.”

Lord Fowler former Lord Speaker, House of Lords, United Kingdom of Great Britain and Northern Ireland, UNAIDS ambassador

“HIV prevention and sexual and reproductive health services are critical to the lives of every young woman and girl. These services should be free, they should be fully integrated, should be delivered at scale and tailored to meet the holistic needs of young women. New commodities and prevention technologies should be rolled out and made available to every young woman. Having these tools will mean nothing if they don’t get into the hands of young women.”

Joyce Ouma Y+ Global Network, Kenya

“We are together in this quest for zero new HIV infections and our leadership that can turn this epidemic. Our commitment for HIV prevention must be translated into funding at an adequate scale for impact, and we must invest in national stewardship and coordination support so that HIV prevention programmes do not fragment into the piecemeal projects that we sometimes see in countries.”

Sheila Tlou Co-Chair of the Global HIV Prevention Coalition

High-Level Meeting on AIDS (8-10 June 2021)

Feature Story

What responses to HIV and COVID-19 in Asia and the Pacific led by civil society can teach us

11 June 2021

COVID-19 continues to threaten the gains made in the HIV response and has brought inequalities to the forefront, but civil society and community-based organizations in Asia and the Pacific have been quick to respond to the pandemic. From the start, networks of people living with HIV and key populations responded to the global health crisis by coming up with innovative courses of action.

A side event organized on the margins of the United Nations High-Level Meeting on AIDS showcased best practices of community-led responses to COVID-19 and HIV prevention in Asia and the Pacific.

It was noted that, since the onset of the COVID-19 pandemic, key population networks have rapidly mobilized volunteers and partners to assist people affected by COVID-19, ensured the continuity of HIV services and found new ways to adapt to the new normal with online-based interventions.

For example, the Asia Pacific Network of Sex Workers responded to the pandemic by modifying its existing programmes to meet the urgent needs of the sex worker community, such as by reallocating funds to subsidize transport costs for sex workers living with HIV to ensure their access to HIV treatment services.

Other regional networks, such as the Asia Pacific Transgender Network, the Asia Pacific Network of People Living with HIV and Youth LEAD, established emergency relief funds to provide emergency food supplies, housing and rent, transport, protective gear, including personal protective equipment, masks, sanitizer and sanitary products for the most affected communities.

In several countries, community-led organizations of people who use drugs delivered door-to-door provisions of antiretroviral therapy and harm reduction services, including opioid substitution therapy and sterile needles and syringes. These experiences have been compiled by the Asia Pacific Network of People who Use Drugs in a best practice report to advocate for the full and equal participation of people who use drugs within the HIV response.

The panellists also heard about the Australian Federation of AIDS Organisations, which in its national and community-led responses has been supporting community-based HIV testing, working directly with clinics run by the community for the community. Also, APCOM, a regional network for gay men and other men who have sex with men based in Bangkok, Thailand, implemented a condom promotion campaign during the COVID-19 pandemic, known as #PartyPacks, where key populations can order online (for free) packages containing condoms, lubricant and information on harm reduction.

The speakers agreed that service delivery needs to be modernized, domestic investment should be increased and services led by key populations should be integrated into national health systems.  

The panellists highlighted that dealing with the colliding pandemics of HIV and COVID-19 requires working in unison and solidarity.

Quotes

“While the journey has not been smooth, one of Australia’s key learnings is that the voices of the community are essential. Communities of people living with HIV and those populations at high risks and young people—communities who, if we are to really make a difference, must have a central role in sharing the view of those most affected by HIV with national governments.”

Mitchell Fifield Permanent Representative of Australia to the United Nations

“Thailand’s effort on HIV/AIDS is one area where civil society plays a particularly vibrant role in our country. We recognized that the collaboration of different sectors, especially civil society and the network of people living with HIV, is one of the most important factors in Thailand’s success in controlling the spread of HIV and AIDS.”

Vitavas Srivihok Permanent Representative of Thailand to the United Nations

“The valuable experiences of communities reflect their long-standing active participation in the response to the HIV epidemic. This is exhibited in the way they continue to innovate at the forefront of the response to HIV and, most recently, address the intersectionality that emerged out of having to respond to the impact of COVID-19 as well.”

Eamonn Murphy UNAIDS Regional Director for Asia and the Pacific

“Key populations are widely recognized as the pioneers and leaders of the HIV response. Since the emergence of HIV, key populations have led the way in pioneering effective prevention responses, sharing their knowledge and skills with the community as well as providing essential care and support.”

Jules Kim member of the nongovernmental organization delegation to the UNAIDS Programme Coordinating Board

“Community-led organizations are the most effective way to reach sex workers during emergencies as they are capable of providing therapy assessment, identifying priority areas and allocating the resources for various types of relief for sex workers. This is facilitated by an established peer-to-peer model that is led by the trust and knowledge of peer outreach programmes, which is also able to deliver emergency aid to the most in need.”

Kay Thi Win Regional Coordinator, Asia Pacific Network of Sex Workers

High-Level Meeting on AIDS (8-10 June 2021)

Region/country

Feature Story

Addressing inequalities to end AIDS: 10 years to 2030

10 June 2021

HIV is fuelled by inequalities. A panel, Addressing Inequalities to End AIDS: 10 Years to 2030, held on the sidelines of the United Nations High-Level Meeting on AIDS on 9 June, brought together a passionate mix of grass-roots activism and experience, academic wisdom, evidence-informed strategic guidance and experience from United Nations Member States and UNAIDS to discuss this urgent issue.

All the panellists underlined the need for urgent, evidence-informed and transformative action to unlock social enablers and to end the social, economic, racial and gender barriers—which include punitive laws, policies and practices, stigma and discrimination based on HIV status, sexual orientation and gender identity, and other human rights violations—that create and deepen the inequalities that perpetuate the HIV pandemic. They shared strategies and action for ending the HIV epidemic based on lived experience and backed by lessons from four decades of the HIV response.

The panellists underlined lessons from HIV and COVID-19 that have shown the world that unless all countries, communities and individuals access the benefits of science and technology without stigma and discrimination, benefit from fair taxation and equitable distribution of wealth and are respected in all their diversity, epidemics will continue to rage.

The participants heard that six out of seven new adolescent HIV infections in sub-Saharan Africa are among girls—Winne Byanyima, the Executive Director of UNAIDS, noted that this was because of inequalities of power. The participants also heard, though, that strong political commitment to ensure that prevention services were available at the community level, with a special focus on reaching adolescent girls and young women and their partners, saw Eswatini successfully meet its HIV prevention targets.

Jeffrey Sachs, a professor at Columbia University, in the United States of America, reminded the participants that well laid out goals and time-bound and evidence-informed plans must be matched by adequate financing, without which poorer nations and poorer communities even within rich nations will not enjoy good health and well-being.

The powerful testimony of Abhina Aher, a transgender activist from India, spoke of the multiple, intersecting and dynamic inequalities faced by a person who does not conform to the social norms of mainstream Asian society.

All the participants underlined the centrality of enabling laws and policies and of the need for comprehensive sexuality education to empower young people to make informed decisions about relationships and sexuality and navigate a world where gender-based violence, gender inequality, early and unintended pregnancies, and HIV and other sexually transmitted infections still pose serious risks to their health and well-being.

Interventions from representatives of the Bahamas, Germany, Mexico, Spain and the United Kingdom of Great Britain and Northern Ireland underlined the urgency of an HIV response that addresses gender inequalities and protects and enables human rights.

In summary, it was concluded that inequalities both feed and drive the HIV epidemic as well as other diseases, but that inequalities should be fought with the right policies, strategies and legislation in order to end AIDS by 2030 and at the same time strengthen pandemic preparedness. 

Quotes

“Universal health coverage will not be achieved without sexual and reproductive health and rights. We need to ensure interventions that safeguard women’s and girls’ right to their own bodies and lives, which includes access to safe and effective contraceptives and HIV testing without third-party consent.”

Per Ohlsson Fridh Minister of International Development Cooperation, Sweden

“Giving communities accurate information about HIV, encouraging relationships that empower women and men to make healthy decisions and addressing some of the social norms that discriminate against women and girls can finally put an end to HIV-related stigma and discrimination.”

Simon Zwane Principal Secretary, Ministry of Health, Eswatini

“We have the tools and services that can prevent people from being prey to stigma and discrimination. What we need is not new knowledge, what we desperately need is a different politics to guarantee that everyone, everywhere has an equal and appropriate right to health and dignity. I am a transwoman, a woman of colour, blind in one eye, a woman without a womb or vagina, Asian, and also a former sex worker. You peel one layer and there are more layers for discrimination based on my gender, sexuality, sexual orientation, profession—inequalities that can impact my life and my access to HIV services.”

Abhina Aher transgender and HIV activist and technical expert at I-Tech India

“In a pandemic—AIDS, COVID-19 and beyond—viruses feed on inequalities. When we ignore inequalities, virus spread in the shadows and we get outbreaks. So, we have to ask: are young women seeing the same reductions in new infections as others? Do gay and transgender communities have the same viral suppression? Do the poor have access to the same HIV technologies and easy access to care? The United Nations has not, in the past, focused enough on inequalities. We are shifting. From now on, we will measure success by how fast the inequality gaps are narrowing. Leaders don’t really have much of a choice: you can either fight inequalities or fail on ending AIDS.”

Winnie Byanyima Executive Director, UNAIDS

High-Level Meeting on AIDS (8-10 June 2021)

Remarks by Winnie Byanyima

Feature Story

Resources and funding for an effective AIDS response

10 June 2021

The goal of putting the HIV response on a secure financial footing is a work in progress, with uneven results around the globe towards ensuring a sustainable, fully funded, effective, equitable and gender-sensitive HIV response. The 2020 target to mobilize at least US$ 26 billion for the HIV response was not met. Other targets, such as implementing efficiency measures to optimize the use of existing resources and to clear bottlenecks in scaling up services, were also missed.

A panel, Resources and Funding for an Effective AIDS Response, held on the sidelines of the United Nations High-Level Meeting on AIDS, deliberated on how to reach a sustainable, fully funded, equitable and effective HIV response in a challenging environment for health and development resources.

The panellists surveyed the current situation and key actions for the road ahead, addressing several questions: What does a sustainable, fully funded, equitable and effective HIV response look like? How can the necessary funding levels be secured in the challenging resource environment that we face? What steps can and should we take to improve the impact/effectiveness of the available resources? Are there opportunities that need to be better leveraged within the HIV response, the broader health agenda and the broader development agenda? How can we ensure that we invest in the right interventions for the right populations and places to meet the new global targets and achieve the collective goal of Sustainable Development Goal 3? 

Key actions identified by the panellists to guide future efforts include the following:

  • Better targeting interventions to achieve equity and impact based on diverse and locally specific needs and goals.
  • Approaches and measures to secure the necessary funding mixes, including ongoing international support and appropriate and sustainable domestic funding, and improved equity and efficiency in using those resources.
  • Better integration of HIV into other health and development efforts, including universal health coverage, health system strengthening, pandemic preparedness and response and enablers, such as education and social protection, and to better link and leverage those efforts to maximize impact for people living with, at risk of or affected by HIV.
  • The importance of ensuring that critical cross-cutting factors, such as gender-sensitivity, eliminating inequalities, leveraging data and prevention, are appropriately supported and integrated throughout.
  • The need for shared responsibility, which calls for countries that can pay for their own responses to do so fully, and for those without the ability to pay, to be supported by donors as part of global solidarity.

The panel also examined how investments in the HIV response can help to reduce vulnerabilities and societal inequalities and how to catalyse more effective social spending using a rights-based, people-centred model that empowers individuals and communities. 

Finally, the panel situated the discussion in the broader development and fiscal contexts by exploring the economics of HIV, as well as how to tackle inequalities and use people-centred HIV responses to put us on track to reach Sustainable Development Goal 3. It addressed the costs of inaction and complacency, not only for the HIV response but also across the Sustainable Development Goals. Looking at fiscal realities, the panellists provided a broader analysis of the current situation and thoughts on the way forward for protecting and expanding the much-needed fiscal, budgetary and policy space through measures such as tackling public debt distress, tax injustice and illicit financial flows.

Quotes

“In the face of these diversity of challenges, we must remain clear and focused on what must be done to meet the challenge we are here to discuss today. Political leadership, community-led responses and global solidarity must mobilize and effectively use US$ 29 billion dollars annually by 2025 to accelerate progress towards achieving the targets.”

Kenneth Ofori-Atta Minister of Finance, Ghana

“There is a need to increase our investments in effective prevention and prioritize targeted screening, especially for key populations and vulnerable groups.”

Veronique Kilumba Vice-Minister of Health, Democratic Republic of the Congo

“We all know this epidemic is fuelled by inequity, by discrimination, by human rights-related barriers, by gender-related barriers and we must address those barriers with money and political leadership.”

Peter Sands Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria

“We need to make a case for human capital investments in health, including HIV, education and social protection during stimulus and austerity.”

David Wilson Program Director, Health Nutrition and Population, World Bank

“We have tools that work, but we must use them wisely. Investment is smart and effective only if it is genuinely tailored to the diverse lived experiences. Evidence is essential, accompanied by the obligation to act accordingly.”

Adeeba Kamarulzaman President, International AIDS Society

Remarks by Winnie Byanyima

High-Level Meeting on AIDS (8-10 June 2021)

Subscribe to Events