30th meeting of the UNAIDS Programme Coordinating Board (PCB), Geneva, Switzerland, June 5-7, 2012
The 30th board meeting agenda included a wide variety of issues – from financial updates to a closer look at strategic investment. Discussions over decision points arising from this meeting were again dominated by the difficulty of some governments speaking about key populations, sexual and reproductive health rights, intellectual property and trade related agreements and criminalization issues. This was especially evident in the agenda items that dealt with civil society (NGO report) and legal issues (follow up to the last board meeting’s thematic session on HIV and the law). At one point in the meeting, the refusal of a minority of countries to support the right to justice of key populations caused the NGO Delegation and civil society Observers to stand in solidarity as the incoming Africa Delegate took the floor. He reminded the board that key populations exist in all regions of the world and that they remain essential partners in an effective and ethical HIV response.
This year’s NGO report focused on the financial impacts on civil society working in HIV and was of wide interest to all board members. The NGO Delegation was able to make some positive gains in the decisions arising from this paper, including that mechanisms for civil society support and accountability be enhanced within the new Global Fund architecture, and a focus on increasing civil society capacity to improve advocacy work on intellectual property and trade barriers.
UNAIDS continues to undergo an internal transition that will hopefully have the affect of increasing staff capacity, notably in the areas of human rights and gender, at the country level. It will be imperative that civil society activists pay close attention to how these changes are implemented at regional and local levels in order to assure UNAIDS progress and accountability.
THANK YOU to the civil society Observers and organizations who supported the NGO Delegation!
The NGO Observers who attended and intervened in this board meeting were vital part of reminding the board of all the persons who are implicated in their work. All your interventions can be found on our website. The participation of Observers in the board meetings strengthens the work and accountability of the NGO Delegates. We would also like to thank all the civil society partners who contributed to the preparatory briefing calls run by the NGO Delegates and supported the development of the thematic session.
The ED Report highlighted the areas where the ED sees progress, challenges and opportunities in the response to the epidemic. He highlighted progress in new political commitments in Africa, Middle East and North Africa (MENA), Latin America and the Caribbean, Eastern Europe and the G8, and in working toward the goals and targets of the High Level Meeting on HIV/AIDS. The major challenges identified were: dependence on external resources, potential for market failure in the development and supply of HIV medication, and how to ensure consistent progress on HIV and human rights; the areas considered for opportunity were: strategic investment, innovation, commitment of partners and potential for political and cultural organizations to advance the Political Declaration and goals of the High Level Meeting (HLM).
The NGO Delegation called for massive scale up of treatment access now to reach the 2015 goal of putting 15 million people on treatment. The Delegation fully supported the UNAIDS strategy on promoting local production in countries with emerging economies and least developed countries, but also focused on extending local production to second and third lines. The Delegation supported the Executive Director’s public calls to postpone the intellectual property (IP) transition period for the least developed countries beyond 2016 and urged UNAIDS to assist the countries to make full use of TRIPS flexibilities. The NGO Delegation also called on UNAIDS to help countries improve the enabling environment and guarantee the human rights of all people, emphasizing that to achieve the 2011 HLM Political Declaration commitments and the Millennium Development Goals (MDGs), increased leadership and coordinated actions are still required from different stakeholders at all levels. However, the NGO Delegation was disappointed that the ED Report did not include any reference to the Financial Transaction Tax. Finally, the NGO Delegation welcomed UN Women as the 11th Cosponsor of UNAIDS.
In their report, the Cosponsors raised the importance of the post-2015 agenda, and the NGO Delegation strongly supported this engagement. While acknowledging the Cosponsors’ efforts towards achieving the 2011 HLM commitments, the NGO Delegation emphasized that increased leadership is still required at all levels – including more coordinated actions within the UNAIDS family, as well as between the UNAIDS cosponsors and civil society. The NGO Delegation requested an agenda item for the next PCB Meeting to discuss the challenges in the post-2015 agenda.
The 2012 NGO Report to the Programme Coordinating Board focused on the devastating – and worsening – impact of reductions in funding for HIV on civil society. This includes people living with HIV (PLHIV) and key populations, such as men who have sex with men, transgender people, people who use drugs and sex workers and their partners. The NGO Report draws on wider evidence and reporting from civil society and is built on eight country case studies that illustrate how civil society is being directly and significantly impacted by the global funding crisis.
The NGO Delegation proposed decision points, based on the recommendations issued from the report. After negotiations with members of the PCB, the NGO Delegation was pleased to be able to ask UNAIDS to advocate that existing funding for civil society be continued and that mechanisms for civil society be enhanced within the new Global Fund architecture. The Delegation also asked UNAIDS and Member States to improve civil society capacity to advocate for efficient and effective responses to HIV and to build knowledge focused on HIV funding mobilization and access to treatment advocacy. Finally, the board called on UNAIDS to propose ways forward to address the decrease in funding, especially affecting developing countries.
Following the important and extensive thematic on HIV and legal environments at the last PCB, the board received a paper summarizing the proceedings and requesting action from UNAIDS. In the opinion of the NGO Delegation, this report did not capture the richness of the session nor did it engage UNAIDS in going beyond its current work to address this vital topic. Differing viewpoints on human rights and key populations amongst current board members led to nine hours in the drafting room to reach consensus. Unfortunately, when the final decision points were brought back to plenary, Egypt and Iran chose to disassociate themselves. The outcomes commit Member States to work toward enabling legal environments, including: reviewing laws; sensitizing members of the judicial system; increasing anti-stigma and discrimination programs; addressing the specific needs of women and girls (including their sexual and reproductive health as well as legal barriers); and addressing legal barriers to treatment access. Three powerful speeches from civil society observers reminded the board of the reality of the actual experience of key populations on the ground and the impact of punitive legal environments on the HIV response.
The NGO Delegation stressed the need to identify long-term solutions in managing currency exchange fluctuations and to ensure value for money. The performance report showed overall progress on impact reporting rather than just listing activities, but the NGO Delegation asked to see the synergies amongst Cosponsors reflected more clearly in future reporting using the new results matrix.
The NGO Delegation welcomed the mention of the importance of UNAIDS work with key populations; however, the performance report underscored the need to do more to reach people who inject drugs, as well as the need to make more progress in elimination of stigma and discrimination and travel restrictions. The NGO Delegation noted with concern that allocations to work with people who inject drugs, men who have sex with men, transgender people and sex workers remain relatively low. The Delegation expressed disappointment not to see any donor or secretariat reporting on funding directly to civil society, and look forward to seeing that in next year’s Unified Budget, Results and Accountability Framework (UBRAF) reporting.
Finally, the NGO Delegation expressed its wish to re-engage in the further development and refinement of the UBRAF indicators, citing the fundamental principle of UNAIDS to include PLHIV in the policies that affect them. The board approved the Executive Director’s request to cover staff-related liabilities from the fund balance and the establishment of a building renovation fund.
All members of the PCB recognized the need to continue discussions about the Strategic Investment Framework (SIF). Generally, there was a strong consensus to accept its overall principles of supporting evidence-based and right-based interventions and making investments in areas of the HIV response that make the most impact.
The NGO Delegation expressed its appreciation to Ambassador Mboya, who had been leading the consultation, and re-iterated the importance of investing in community mobilization, addressing critical enablers and forming synergies with broader development sectors. The NGO Delegation took note of the tool recently developed by UNAIDS Secretariat – A people-centered investment tool toward ending AIDS - and suggested specific areas that need further refinement and discussions. The NGO Delegation recommended UNAIDS continue to explore ways to address these gaps by setting concrete, time-bound and tangible outcomes for the series of consultations it has already planned to convene in Asia and Latin America. The NGO Delegation also called on UNAIDS and Cosponsors to better coordinate technical support provision within the context of SIF at a country level and specifically suggested that UNAIDS develop a consultative roadmap and a set of guidelines to be used in combination with the tool to help countries planning their investment, while continuing to actively engage civil societies and a broad range of stakeholders in the conversations on the SIF, its applicability and implications.
The board, as it has since the 27th PCB, continued to re-iterate that the technical support strategy has not been strong enough to respond to needs at country and regional level and needs greater attention in the overall strategy of UNAIDS. The board urged UNAIDS to exercise its convening role to facilitate a more strategic, country-driven and better coordinated technical support. The NGO Delegation was successful in gaining board support to explore the establishment of a virtual steering group on technical support which would include civil society. Commitments were also secured from the Secretariat to extend opportunities for civil society in MENA and Sub-Saharan Africa to contribute to a recent civil society consultation on technical support and for general guiding principles to be drawn from this consultation.
This report presented mainly the work of the co-conveners, UNHCR and WFP, in this area of the HIV response and the follow up activities to the passage of UN Security Council Resolution 1983. The NGO Delegation was appreciative of the report but noted that it was difficult to see impact from the reporting on various activities. The Delegation asked for reassurance that there be a stronger link between humanitarian and security aspects as the report had a heavy focus on security and little on human rights. Concern was expressed on independent reports back from women’s groups in Haiti on the increase in gender-based violence and rape of women in the camps and follow up was requested. The Delegation suggested there be a greater emphasis on the humanitarian response working in partnership with PLHIV networks and requested there be a permanent PLHIV involvement in the Interagency Task Teams.
This meeting’s thematic day focused on combination prevention, an approach to prevention that focuses on the comprehensive and multifaceted nature of programs needed in different epidemiological contexts. The day began with three short plenary sessions that investigated the science and evidence of the effectiveness of responses to different interventions and epidemics. Dr. Marie Laga of the Institute for Tropical Medicine in Belgium suggested the need for more evidence outside of just biomedical approaches, particularly in prevention programs for key populations. Meena Seshu, from SANGRAM in India, spoke to the importance of rights-based interventions – using her organization’s work with sex workers as an example – in order to create an environment where programs can be most effective and called for a stop to criminalization. Dr. Alice Welbourn, creator of the Stepping Stones program, highlighted testing and treatment adherence issues and how the wider community can be educated and support an environment that encourages voluntary testing and in which patients are more inclined to keep up with their treatment regimens.
Four breakout sessions were organized for the rest of the day focusing on different aspects of combination prevention approaches: “Reaching Zero New Infections: Young people speak out on HIV prevention”; “Country realities: making tough decisions”; “Mobilising stakeholders: role of civil society organisations and the private sector in HIV prevention”; and “HIV and co-infections with viral Hepatitis B & C”.