One year after adopting a new Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, United Nation’s Member States have highlighted the need to work together to speed up progress on implementation.

In advance of the meeting, the UN Secretary General released a report entitled Tackling inequalities to end the AIDS pandemic on the implementation of the political declaration on HIV/AIDS. The report sets out how inequalities and insufficient investment “leave the world dangerously underprepared to confront the pandemics of today and tomorrow”

The AIDS pandemic is responsible for more than 13,000 deaths every week.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) data show that HIV infections and AIDS-related deaths are not currently declining fast enough to end the pandemic by 2030 as pledged.

The Secretary General’s report highlights solutions including (a) HIV prevention and societal enablers; (b) community-led responses; (c) equitable access to medicines, vaccines and health technologies; (d) sustainable financing for the AIDS response and wider pandemic prevention, preparedness and response; (e) people-centered data systems and (f) strengthening global partnerships.

The UN Secretary General’s statement to the General Assembly, delivered by Chef de Cabinet Courtenay Rattray, outlined three immediate steps to reverse current trends and get back on track. “First, we need to tackle intersecting inequalities, discrimination and the marginalization of entire communities, which are often exacerbated by punitive laws, policies and practices”. He called for policy reforms to reduce the HIV risks of marginalised communities including sex workers, people who inject drugs, prisoners, transgender people and gay men. He noted how stigma is obstructing public health: “Stigmatization hurts everyone. Social solidarity protects everyone”.

The second step is ensuring the sharing of health technologies, including long-acting antiretrovirals, to make them available to people in all countries of the world.

The third step is to increase the resources made available to tackle AIDS. “Investments in AIDS are investments in global health security. They save lives – and money.”

In his opening remarks, the President of the General Assembly, Mr. Abdulla Shahid, noted that “equal access to healthcare is an essential human right to guarantee public health, for all. No one is safe until we are all safe. Striving to achieve the 2025 AIDS targets is an opportunity to work together to increase investments towards public health systems and pandemic responses, and to draw on the hard-learnt lessons from the HIV/AIDS crisis for our recovery from COVID-19, and vice versa.”

Over 35 Member States and Observers made statements during the AIDS review, which included contributions on behalf of the Africa Group, the Caribbean Community and the Central American Integration System and the European Union.

Statements emphasised the urgency of stepping up collective action to get on track to meet the 2025 targets, and the importance of an inequalities lens to ensure a successful HIV response.

The President of the General Assembly, the Secretary General, the Africa group, the EU and several Member States stressed the importance of fully financing the HIV response and strengthening investment in Global Health.

The Africa Group, along with many others, spoke about addressing stigma and discriminatory laws which keep people from accessing health care and social services.

The debate made clear that the end of AIDS is possible, but only if countries worked together and were courageous in addressing inequalities. “The most important message today,” noted the Secretary General’s conclusion, “is that if we work together to tackle the inequalities that perpetuate HIV/AIDS, we can still end it as a public health threat by 2030.”

All said in under one minute. This is huge and unequivocal.
The Chef de Cabinet delivers to the UN General Assembly the urgent insistence from the UN Secretary-General that the technologies for new long-acting HIV medicines must be shared globally now. There is no time to lose. pic.twitter.com/t1DWlPsdB3

— Ben Phillips (@benphillips76) June 10, 2022

GENEVA, 24 May 2022— At the seventy-fifth World Health Assembly, taking place in Geneva, Switzerland, UNAIDS has urged leaders to tackle the global inequalities that drive pandemics such as HIV and COVID-19. UNAIDS highlighted that respect for everyone’s human rights is essential for achieving health for all.

In her address to the World Health Assembly today, the UNAIDS Executive Director, Winnie Byanyima, urged leaders to urgently prioritize the investments needed to stop the AIDS pandemic as well as better prepare the world for future pandemics and ensure health security for everyone.

“The world remains dangerously unprepared to stop today’s pandemics or prevent those of the future because we lack effective plans to ensure access to health technologies and finance trusted community-led organizations for pandemic response,” said Ms Byanyima. “We can beat pandemics and we can protect the health of all if we are bold in tackling inequalities, if we place human rights at the centre of our response.”

Ms Byanyima’s speech touched on three main areas of pandemic preparedness: access, financing and communities.

Communities: to defeat pandemics and protect the health of all people, we need sufficiently financed community-led organizations providing services, doing outreach and providing trusted information as an integral part of the public health response. Communities, who know the situation on the ground best and have the essential relationships of trust, need to be given the resources and the space to lead.

Access: to end AIDS, beat COVID-19 and stop the pandemics of the future, global access to life-saving, pandemic-ending health technologies is critical. We need to replace intellectual property rules that restrict access to life-saving medicines for people in the Global South with those that require technology sharing. This would open up access to COVID-19 vaccines and treatments and to new emerging long-acting medicines for HIV prevention and treatment, as well as for medicines for other pandemics.

Financing: our collective health security, and the effectiveness of global pandemic responses, requires that we adequately finance them. This includes fully funding the Global Fund to Fight AIDS, Tuberculosis and Malaria. This means too that low- and middle-income countries need to be able to increase health investments through progressive domestic resource mobilization and international solidarity, not be shackled by debt or marginalized in the allocation of the International Monetary Fund’s Special Drawing Rights.

During the World Health Assembly, UNAIDS applauded the progress made in developing a new pandemic preparedness and response instrument and submitted that it should include the following essential substantive elements:

• Placing human rights at the core of pandemic responses.
• Putting communities at the centre, including participation in pandemic preparedness and response architecture at the national, regional and global levels.
• Ensuring access to health technologies and medical countermeasures as public health goods to allow equitable access by all those in need.
• Building people-focused data systems capable of highlighting inequalities.
• Supporting the health workforce, including community health workers on the pandemic front lines.

UNAIDS also warmly congratulated Tedros Adhanom Ghebreyesus on his reconfirmation as Director-General of the World Health Organization during the World Health Assembly. “Congratulations my brother Tedros! We look forward to continuing our work together to ensure health for all,” said Ms Byanyima.

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.

The first Arab Forum for Equality, held in Amman on 30-31 May 2022, is organized by the ESCWA and the Pathfinders for Peaceful, Just and Inclusive Societies, and hosted by the Center on International Cooperation at the New York University. This is the inaugural meeting of the Forum, and the theme this year is “Towards inclusive youth employment in the Arab region”.

Following is UNAIDS Executive Director Winnie Byanyima’s address:

Greetings to all participants at this first and vital Arab Forum for Equality. 

Thank you my dear sister, Rola Dashti, Executive Secretary of the United Nations Economic and Social Commission for Western Asia for inviting me.

I’ll share three lessons that we’ve learnt about inequality.

The first lesson is a worrying one: that inequality which was already extreme is being exacerbated even further.

In 2022, nearly half of humanity, 3.3 billion people are projected to be living below the poverty line of 5.50 USD a day. (Source: Oxfam)

New Oxfam estimates show that over a quarter of a billion more people could be pushed into extreme poverty in 2022.

A new billionaire has been created every 26 hours since the pandemic began.  The world’s ten richest men have seen their fortunes double. (Oxfam)

A year and a half since the first doses of a COVID vaccine were delivered, 78% of people in the US are fully vaccinated, 69 % in Europe but still under 50% (46.26%) of people in the Arab region. (Our World in Data).

We also see huge inequalities within the Arab region. United Arab Emirates has reached 97% Covid vaccination. But it is a health emergency that Algeria is only at 15 % and Yemen at just 2.2%. (Our World in Data)

Since the onset of COVID19, wealth inequality has considerable increased in the Arab region, with the richest 10% of the population now controlling more than 80% of total regional wealth. (ESCWA)

Social protection expenditures among developed countries in the Arab States are just 4.2 per cent of GDP, lagging far behind the world average of 20 per cent. (ILO)

On average health expenditure across the Arab World is just 5% of GDP, nearly half that of the European Union (9.92%). (World Bank)

The second lesson is even more worrying: that we won’t be on track to overcome health or economic crises until inequalities come down.

These kinds of extreme, intersecting, inequalities increase the risks our societies face from pandemics such as AIDS and COVID-19. And we’ve seen with COVID just how quickly a health crisis is turned by inequalities into becoming a social, a political, an economic crisis.

The third lesson is a hopeful one, but that hope depends on action: inequalities are a political choice. Courageous leaders can tackle inequalities

We can close tax loopholes and tax holidays for companies.

We can go beyond the 15% tax rate agreement for all corporate taxation around the world, up to 25%.

We can ensure taxes are paid where economic activity happens.

We can increase investment in health, education and social protection.

We can reform laws and policies so that they help us reduce harm and risk, not worsen it.

We can change the global trade rules which kept life-saving vaccines locked up in the North

Inequality is a crisis but it is not fate, tackling it is within our hands.

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.

Members of the All-Party Parliamentary Group (APPG) on HIV and AIDS from the United Kingdom, along with the Director of Stop AIDS, visited UNAIDS Headquarters in Geneva, Switzerland, to strengthen collaboration.

Since the mid-1980s, APPG has brought United Kingdom parliamentarians together from across the political divide to fight for the rights of people living with HIV.

“I think all politicians are driven by wanting to make a difference,” said David Mundell, Member of Parliament, who is Co-Chair of APPG. “This is an established all-party group that has been effective, with a voice in parliament and that also acts globally.”

Mr Mundell said that APPG is focused on maintaining momentum on HIV in the face of several challenges. Not only did some people in the United Kingdom mistakenly imagine that HIV was already sorted, he said, he also alluded to the challenges in keeping attention on HIV given the war in Ukraine and the ongoing COVID-19 pandemic.

“We have to be advocates for change in terms of keeping HIV high on the agenda and resources available,” he said. For example, he believes that funds for Ukraine should be additional and not come from the international development envelope and will argue that case to the United Kingdom’s Foreign Secretary.

In his words, it’s all about putting the best case forward. “There is a competition for attention, therefore we need to put issues into context,” Mr Mundell said. He mentioned UNAIDS and its Cosponsors’ Education Plus initiative as a great way to empower young women while also tackling HIV. “Demonstrating the interconnectedness of such issues will allow us to sustain our arguments.” Every week, more than 4200 young women become infected with HIV in sub-Saharan Africa but keeping girls in secondary school reduces that risk by up to 50%.   

Reflecting on the United Kingdom’s decision to cut its level of official development assistance from 0.7% to 0.5% of gross domestic product and reduce funding for the AIDS response, Mr Mundell explained that there have been many ongoing changes in the United Kingdom, but he is confident in making the case that investment in the AIDS response is good value. “It is quite clear that United Kingdom funding will be more outcome-based, with a need to show direct results based on investment. APPG intends to maintain United Kingdom leadership in the AIDS response, working with community groups on the ground with the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as UNAIDS.”

UNAIDS and APPG reiterated their strong commitment to having a fully replenished Global Fund. Twenty years after the founding of the Global Fund, the target for the seventh replenishment is to raise US$ 18 billion to save 20 million lives. According to estimates, this represents 14% of the total of US$ 130.2 billion needed for the period 2024–2026.

Inter-Parliamentary Union Secretary-General Martin Chungong and UNAIDS Executive Director Winnie Byanyima hosted a joint round table for APPG to discuss the crucial role of legislators worldwide in taking the bold actions needed to end AIDS.

“We parliamentarians from the United Kingdom cannot tell people in other countries how to run their country, that is not what we want to do,” said Mr Mundell, noting that instead the group worked to share experiences and build partnerships. He cited how criminalization has been linked to higher numbers of HIV infections, which can often lead to much more difficult, long-term consequences. “By highlighting certain practices and steps we want to show that certain changes can have a positive effect without undermining cultural values,” he said.

Mr Mundell noted that during the Commonwealth discussions in mid-March, he urged all nations to have full and frank discussions on progress in advancing the rights of lesbian, gay, bisexual, transgender and intersex people and progress in ending AIDS, saying that a huge amount had been achieved but that there was still a lot to do.

Suki Beavers, UNAIDS Director, Gender Equality, Human Rights and Community Engagement, commended APPG’s inclusive approach. She also stressed that the role of parliamentarians is key.

“Parliamentarians can open up the space to discussions and make diverse voices heard in the national policy process, especially the voices of people who are often excluded from decision-making on the issues that affect them most,” she said. Ms Beavers also said that strengthening peer-to-peer relations (parliamentarian to parliamentarian) can also drive progressive law reform.

Mr Chungong shared how parliamentarians from across the world are stepping up their work with UNAIDS to address the inequalities that hold back progress on ending AIDS.

In Ms Beavers’ closing remarks, she reiterated to the group the fact that the HIV response was at a critical point. “We need to move to a more targeted and systemic approach as laid out in the new Global AIDS Strategy 2021–2026, including fully funded and supported community-led responses,” she said.

“It is really clear that we need major leverage to influence and to create more and more diverse partnerships so that we can achieve the goal of ending AIDS as a public health threat by 2030.” 

By Michel Kazatchkine — This article appeared first on The Telegraph

It is no surprise that the World Health Organization (WHO) is calling for oxygen and critical medical supplies to safely reach those who need them in Ukraine and moving to establish safe transit for shipments through Poland. But nor is the call new. We`ve been here before.

Russian annexation of Crimea and the conflict in the Donetsk and Luhansk oblasts of Eastern Ukraine in 2014 threatened the supply of HIV and tuberculosis medicines. Fragile trans-internal border efforts and financing by the Global Fund to Fight Aids, Tuberculosis and Malaria allowed the continued supply of the medicines in the separatist territories despite the conflict during the last eight years. 

One has to assume that should Russia occupy new Ukraine territories, the challenges to guarantee people living with tuberculosis and HIV access to those drugs will be just as great, high risk, if not already lost.

The separatist authorities in the Donbass and the Russian administration in Crimea also abruptly stopped opioid agonist therapy (OAT) for people who inject drugs, which resulted in much suffering and deaths from overdose and suicide.

NGOs working with affected communities in Donbass were basically closed down. Decades of fighting HIV and tuberculosis have taught us just how critical civil society, community leadership and human rights are to ending those diseases.

The Russian Federation refuses to countenance OAT as a harm reduction measure to reduce the risk of HIV transmission through shared needles.

Ukraine on the other hand, is a notable champion of harm reduction, including OAT and needle exchange programs. This matters greatly in eastern Europe and central Asia which continues to be home to the fastest growing HIV epidemic in the world.

Some 1.6 million people are living with HIV in the region (with Russia accounting for 70 per cent) and around 146,000 are newly infected each year. Drug use accounts for around 50 per cent of new infections but unprotected sex is set to become the main driver in the coming years.

Ukraine, however, has been one on of the most successful countries in the region in terms of guaranteeing access to antiretroviral drugs – 146,500 people in the past year.

These gains were at risk before the war with Covid-19 restrictions seeing a drop in people testing by a quarter in 2020. The coming weeks and months of war will cause this effort to collapse entirely. 

Eastern Europe also remains the global epicentre of multi-drug resistant tuberculosis globally. Despite progress in the last ten years, TB prevalence, mortality levels and particularly, incidence of multi-drug resistant tuberculosis remain high in Ukraine which has the second highest number of cases in the region. 

Drug resistant tuberculosis represents around 27.9 per cent of new tuberculosis patients and 43.6 per cent of previously treated patients and treatment success of multi-drug resistant tuberculosis is around 50 per cent.

If Covid-19 halved case detection in 2020, it is not hard to imagine it being totally wiped out by the ongoing war.

As health systems collapse and treatment and prevention services are interrupted, mortality from HIV, tuberculosis, multi-drug resistant tuberculosis and Covid-19 will readily increase in Ukraine. Hundreds of thousands of people are internally displaced and cities such as Lviv are running short of medicines and medical supplies.

Scarily, the fallout of the invasion will also go beyond Ukraine: over a million refugees have already fled for their lives. The impact of this will be felt across border towns and areas in central Europe whose response to tuberculosis, HIV and more recently Covid-19, has been fragile. 

Border locations and neighboring countries will have to anticipate and address an avalanche of new health needs. We are at an impasse: international cooperation and solidarity towards the Eastern European region has not been a strong feature of the last two years of the global pandemic response.

The arrival of WHO health supplies and the formation of a safe corridor for refugees are fragments of good news in this unfolding tragedy, but we need so much more.

Health systems and facilities must be protected, be functional, safe and accessible to all who need essential medical services, and health workers must be protected.

Michel Kazatchkine is Course director at the Graduate Institute for International Affairs and Development in Geneva, Switzerland, and the former UN Secretary General and UNAIDS special Envoy on HIV/AIDS in Eastern Europe and central Asia. Previous to that he was the Executive Director of the Global Fund to fight AIDS, TB and malaria.

On 1 March, Marc Angel, a Member of the European Parliament and former champion for the 90–90–90 HIV targets, hosted a virtual Zero Discrimination Day parliamentary event. The event, co-organized by the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination (Global Partnership), brought together high-level speakers who are passionate about ending discrimination in the European Union (EU) and beyond.

The speakers addressed HIV-related rights violations, societal barriers, including laws and policies, and the underlying stigma and discrimination that fuels the AIDS pandemic. Reflecting on their own work and experiences, they discussed how the EU and its member states could advance the work of the Global Partnership in ending discriminatory laws, policies and practices within the EU region and partner countries.

“Stigma and discrimination hurt the fight against HIV/AIDS, as they constitute a major obstacle to seeking testing and accessing or staying on treatment,” said Helena Dalli, the EU Commissioner for Equality. “We can, and must, combat HIV stigma and discrimination, speak up, collect evidence and share facts and knowledge.”

Evidence gathered by community networks and civil society organizations reveals significant levels of stigma and discrimination and other human rights violations that impact people living with and affected by HIV in the EU, which has been exacerbated by the COVID-19 pandemic.

“When it comes to the EU, there are still growing inequalities, which are major barriers in the HIV response,” said Ferenc Bagyinszky, the Executive Coordinator of AIDS Action Europe. “The global AIDS strategy gives an excellent opportunity for the EU and its member states, together with the communities, to work towards ending these inequalities in the EU, especially in relation to the 10–10–10 targets.”

“The EU can make a critical contribution to address HIV-related stigma and discrimination by establishing linkages with its various human rights and gender equality projects,” said Mandeep Dhaliwal, Director of the HIV, Health and Development Group of the United Nations Development Programme.

“By leveraging its expertise, resources and political leadership to support communities and partner countries in ending HIV-related stigma and discrimination wherever it exists, the EU can make a huge contribution to getting the HIV response back on track,” said Matthew Kavanagh, UNAIDS Deputy Executive Director, a.i., Policy, Advocacy and Knowledge.

To date, 29 countries, none of which are EU member states, have joined the Global Partnership.

Luxembourg’s Minister for Development and Humanitarian Affairs, Franz Fayot, announced Luxembourg’s support for the Global Partnership, the first EU member state to do so. “We support the work of the Global Partnership and can only applaud its role in assisting countries in achieving the 10–10–10 targets by removing laws that harm and creating laws that empower. The Global Partnership’s strategic approach and inclusive platform to manage the diverse human rights violations faced by people living with HIV and marginalized populations will be key to addressing counterproductive discriminatory practices,” Mr Fayot said.

“The Global Partnership is a unique opportunity for the EU and its member states to end intersecting inequalities and injustices for a pandemic-resilient Europe and the world,” said Mr Angel.

Catharina Rinzema, a Member of the European Parliament, spoke about the importance of talking about HIV openly, to correct misconceptions and help the public to educate themselves. She also alluded to the stigma and discrimination that lesbian, gay, bisexual, transgender and intersex people face in the EU. “We should have a blood donation policy where it doesn’t matter with whom you have sex, but whether the sex was safe,” she said.

Maria Walsh, a Member of the European Parliament, referred to the effects that stigma and discrimination has on the mental health and well-being of people living with HIV and called for an inclusive and comprehensive EU mental health strategy. “In order to break the stigma and empower HIV-positive people, it is essential that we speak openly and honestly about their lived experience,” she said.

Mr Angel concluded by encouraging EU member states to join the Global Partnership and highlighted the need for global and concerted action to meaningfully advance towards ending HIV-related stigma, discrimination, inequalities and AIDS by 2030. 

Global health and financing leaders and experts have come together at a high-level virtual event to tackle one of the most pressing issues facing the world today—health security. The event, “Investing in health is investing in economic recovery: Financing for HIV, stronger public health systems, and pandemic preparedness and response” was held ahead of the sixth Africa - European Union (EU) Summit which is taking place on 17 and 18 February.

While hosting 16% of the global population, and facing 26% of the global disease burden, Africa accounts for only 2% of global health spending. Despite the 2001 Abuja Commitment of governments to allocate 15% of their budget to health, the average is still only 7%.

Speakers discussed how Africa has been left behind in the COVID-19 response, with less than 12% of people in Africa fully vaccinated against COVID-19. Insufficient access to vaccines, medicines and technologies, and weak health systems have impeded the realization of the right to health of all Africans during the pandemic. In addition, fiscal constraints and unsustainable debt burdens, are hindering the path to recovery.

Cosponsored by the Government of France, the event was convened by UNAIDS, the African Union, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, the United Nations Development Programme, and the World Health Organization. Moderated by Dr. Donald Kaberuka, High Representative for Financing, African Union (AU), the session strived to find ways of broadening the revenue base available to African countries to increase health financing and to boost global solidarity.

Participants underlined the overarching need for investment in strengthened public health systems for universal healthcare, including community-led services, and avoiding overburdening the most vulnerable with out-of-pocket expenses to overcome the COVID-19 crisis. Further, tackling the current pandemics of HIV and COVID-19, and other infectious diseases such as malaria and TB, must happen simultaneously to prevent future pandemics and protect global health security.

Leaders stressed how essential HIV, health systems and pandemics preparedness investments are to save human lives and for economic recovery, and how there will be no steep recovery for Africa without health security for all.

Tackling existing pandemics, such as COVID and HIV, needs to happen at the same time as countries strengthen health systems and build up pandemic preparedness. 

Participants praised the increased African leadership and sovereignty and called for a renewed Africa-EU partnership that would support African institutions and rely on its leadership, in collaboration with multilateral institutions. Specifically, they called on the EU to further dedicate financing mechanisms for HIV, health and pandemic preparedness, including sustained and increased overseas development assistance (ODA).

The panel members also recognized the importance of domestic financing for long-term sustainability. However, the current financial constraints are overwhelming for many countries in the region. Decisive action to eradicate tax evasion and tax dodging will be critical: every year between 25 and 50 billion that could be used for the health and education of Africans are lost. Increasing domestic revenues requires brave international and national tax reforms. Possible ways forward discussed for broadening the revenue base included combating tax evasion, improving the conditions under which African countries obtain financing, debt relief and cancellation policies, and Special Drawing Rights reallocation.

Speakers highlighted that a growing share of revenue allocation, as well as better investment and the use of health and pandemics´ resources are urgently needed, leveraging the AIDS infrastructure and lessons learned from the rights-based AIDS response to prevent future pandemics.

The leaders called for robust international financing, through special drawing rights reallocation, debt relief, new concessional sources and additional ODA. They identified The Global Fund replenishment in 2022 as a key moment to ensure overarching support for the fight against AIDS, malaria and TB, to get back on track.  

Watch the event

Participants from 21 countries in central and eastern Europe and central Asia and the Balkans met in December 2021 in Istanbul, Turkey, for the International Health Sustainability Forum: HIV and COVID-19 in Eastern Europe and Central Asia.

The participants discussed the most efficient means to ensure the sustainability of AIDS programmes and the role of community organizations in providing uninterrupted HIV services during the COVID-19 pandemic in the region.

The results of a three-year project implemented by the Alliance for Public Health in a consortium with 100% Life (formerly the All-Ukrainian Network of People Living with HIV), the Central Asian Association of People Living with HIV and the Eurasian Key Populations Coalition, with the participation of a wide range of partners, were also presented and reviewed. The project was funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and was supported by UNAIDS.

Addressing the forum, Peter Sands, the Executive Director of the Global Fund, highlighted the key elements of successful AIDS programmes in the region, among them “systems, not project-based interventions,” the meaningful engagement of communities and their ownership of the HIV response and removing human rights barriers.

“Increasing public funding of HIV services through social contracting mechanisms, which was a rare case a few years ago, has now become an important component of a systemic response to the HIV epidemic in many countries of the region,” said Andriy Klepikov, the Executive Director of the Alliance for Public Health. He noted that over the past three years public funding of HIV services through social contracting mechanisms in the region amounted to more than US$ 30 million. “This is one of the most important achievements of the joint efforts of community organizations and governments in the region.”

However, as the participants noted, to sustain this success an appropriate legal framework, the support of governments and the strengthening of initiatives made by communities are needed.

Several cities across the region have produced impressive results due to the leadership of local governments that have not only taken responsibility for developing and funding municipal AIDS programmes, including services for key populations, but also through the involvement of community organizations in their implementation.

Thus, systematic work by the city government in close cooperation with community organizations saw Odesa, Ukraine, achieve the 90–90–90 targets. “Odesa has managed to change the strategy for HIV testing and treatment. Our experience has already received recognition from the international community. And we are ready to share our best practices and successes,” said Gennadiy Trukhanov, the Mayor of the city.

The experience of the Republic of Moldova was presented by Fadei Nagachevsk, the Vice-Mayor of Chisinau, and Ruslan Poverga, from Initiative Positiva, who demonstrated the importance of close interactions between city governments and community organizations to ensure the accessibility of services for key populations. Mr Poverga also noted that the integration of peer consultants and social workers in public institutions helps to ensure the sustainability of services.

The best practices of municipal responses to the HIV and COVID-19 epidemics of Kyiv, Ukraine, Osh, Kyrgyzstan, Podgorica, Montenegro, Kragujevac, Serbia, Bern, Switzerland, Prague, Czechia, and Istanbul, Turkey, were also presented.

According to Sergiy Dmitriev, an international expert on public health, civil society organizations have also played a leading role in reducing the prices of antiretroviral medicines by monitoring the procurement cycle and budget and attracting generic suppliers. The price of an annual course of first-line antiretroviral therapy has decreased to US$ 131—the average cost of first-line antiretroviral therapy in nine countries in the region was US$ 192 in 2017. Most of the savings on purchases, about US$ 119 million, remained within AIDS programmes.

Another critical area where community organizations have been playing an increasingly important role in the region is community-led monitoring of human rights violations. The results of work on the REAct system (a human rights violation monitoring system) were presented: during 2020 and 2021, more than 6000 cases of human rights violations and cases of stigma and discrimination were registered in seven countries.

Among the most frequent offences in the region are violence by law enforcement officials, denial of access to medical services, disclosure of medical data and stigma in health-care settings, as well as physical violence against women by their partners and relatives. Based on an analysis of all cases, civil society organizations, together with lawyers and governmental partners, developed recommendations for countries that will form the basis for further advocacy.

“Community-led organizations have become leaders in providing people-centred, human rights-based HIV services in the majority of countries in eastern Europe and central Asia,” said Alexander Goliusov, Director, a.i., UNAIDS Regional Support Team for Eastern Europe and Central Asia. “Their meaningful engagement in decision-making processes and financial sustainability provided by government funding are the key for an effective response to HIV and COVID-19 and for future pandemics.”

The forum video is available: in Russian and English

https://www.youtube.com/watch?v=gCVqVUKAJmo

https://www.facebook.com/AlliancePublicHealth/videos/4581620981957116

Representatives of ministries of health of the Commonwealth of Independent States (CIS) countries, health-care experts and representatives of UNAIDS and the World Health Organization (WHO) convened to discuss the priorities of CIS countries in addressing new pandemic challenges and other health-care issues in Minsk, Belarus, at the 34th meeting of the Council for Health Cooperation of the CIS. 

A memorandum on deepening cooperation between the Council for Health Cooperation of the CIS and the WHO European Office was signed during the meeting. “We are stronger when we are united. A global problem such as the COVID-19 pandemic cannot be solved by national measures only,” said Hans Kluge, the WHO Regional Director for Europe.

Igor Petrishenko, the Deputy Prime Minister of Belarus, noted the importance of joint operational decision-making, “so that there is consistency in the CIS on eliminating and counteracting the spread of COVID-19, as well as continuing vaccination and implementation of the Travelling without COVID-19 app within the CIS.”

The Minister of Health of the Russian Federation, Mikhail Murashko, noted that countering infectious diseases requires ensuring that health systems are stress-resistant. “They must quickly adapt to new challenges,” he stressed.

Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia, presented the new priorities for the HIV response in the region outlined in the Global AIDS Strategy 2021–2026: End Inequalities, End AIDS and the new United Nations Political Declaration on AIDS, taking into account the COVID-19 pandemic.

He outlined the directions in the new strategy, on which there is consensus among all the CIS countries, among them: achieving the 95–95–95 targets by 2025, ending inequalities in access to HIV services and health technologies, the active engagement of civil society and community organizations and ensuring the financial sustainability of the HIV response.

Mr Goliusov thanked the Russian Federation, which since 2013 has been providing financial assistance in strengthening health systems and counteracting HIV and other infectious diseases in five countries of the region, Armenia, Belarus, Kyrgyzstan, Tajikistan and Uzbekistan, having allocated more than US$ 49.5 million in financial assistance.

The participants decided to prepare and send to the Government of the Russian Federation a letter recognizing the efforts made under the framework of the regional programme of technical assistance in combating infectious diseases, including HIV, hepatitis and sexually transmitted infections, as highly effective, noting that they had directly reduced the HIV burden in the region, and requesting the Government of the Russian Federation to consider the continuation of the programme in 2022–2025.

UNAIDS also supported proposals from representatives of the Russian delegation on research on mental health and HIV and on oncological pathology among people living with HIV on antiretroviral therapy.

The CIS is a regional intergovernmental organization that was formed following the dissolution of the Soviet Union in 1991. It encourages cooperation in economic, political and military affairs and has certain powers relating to the coordination of trade, finance, law-making and security. The Council for Health Cooperation of the CIS consists of ministers of health and chief state sanitary doctors of the CIS member states. The council maintains relations with WHO, UNAIDS, the World Health Assembly and the United Nations Children’s Fund.