Your Excellency,
The NGO Delegation to the Programme Coordinating Board of UNAIDS takes this opportunity to comment on the report currently under preparation for the September 25th Special Event, recognizing that the Millennium Development Goals have made a substantial contribution to improve global, regional and national policies and programmes, including on HIV and AIDS. With this letter, we would like to kindly ask your Excellency’s support in advocating towards having HIV remaining as a high priority within the Post 2015 framework. This positioning is fundamental to realize the work we started 30 years ago, and continue to preserve the lives of people living with HIV and the robust effort to see an end to new HIV infections and AIDS progression in the 30 years ahead.
Before 2001 there were 5.3 million new infections each year. Thanks in part to the catalytic effects of the MDGs the scale-up of prevention of vertical transmission of HIV services has averted hundreds of thousands of new infections. Globally, there is measurable progress on the HIV specific targets of MDG 6, wherein by 2012 new HIV infections were down 20% from 2001, reflecting the success of a combination of biomedical, behavioural and structural prevention strategies. Access to antiretroviral treatment has been extended to around 10 million people, over half of those in low and middle-income countries, who are eligible for treatment. Achieving zero new HIV infections in children increasingly appears possible: between 2009 and 2011, 24% fewer children acquired HIV.
Despite such important progress, however, there is still much work to be done towards achieving the HIV MDG and it is not time to weaken the commitments. HIV still ranks as the fifth highest burden of disease globally and the current pace of progress is insufficient to reach several of the 2011 Political Declaration on AIDS[1] targets to be achieved by 2015. Strong challenges remain on integrating HIV prevention, treatment, care and support with efforts to eliminate gender inequalities and gender-based violence, and to increase people’s capacity to protect themselves from HIV, including through addressing the social drivers that fuel the HIV epidemic. High rates of prevalence of HIV infection have been registered in populations socially and economically excluded, including but not limited to LGBT, sex workers, people who use drugs. In many countries, setbacks in human rights protection of these populations can be detected – resulting in lack of medical treatment access for them. Besides, every minute one young woman acquires HIV and HIV has been identified as a leading cause of morbidity and mortality among women of reproductive age. Women in sub-Saharan Africa account for 58% of the people living with HIV in the region and, globally, young women aged 15-24 have infection rates twice as high as among young men, accounting for 21% of all new HIV infections.
In stark contrast, while the AIDS Community faces these challenges, in the past 3 years a reduction of financial and political commitment to fight HIV has been documented at different levels. This has hampered the capacity of governments, civil society and communities directly affected by HIV to effectively respond to the epidemic.
It is clear that the Post-2015 framework presents a key opportunity to improve global development and should build on and improve the current MDGs. But, at this stage, we would like to respectfully call your attention to the numerous potential risks if the visibility of HIV and AIDS is weakened in the new development framework. HIV and AIDS remains an urgent global threat to health, sustainable development and human rights and a lack of focus will undoubtedly result in a loss in prevention, in promoting expanded reductions in incidence and inability to sustain progress and wellness for people living with HIV.
The PCB NGO delegation members have actively participated in the numerous global, regional and national consultations aiming to contribute to place AIDS in the Post 2015 Development Agenda broadly, not only within the health framework, but as a human rights and development issue. We have been and remain tireless in this pursuit. However, despite the unrelenting efforts, HIV currently has limited visibility in all the key Post 2015 documents, including the eleven thematic outcomes, in the High Level Panel report – and is alarmingly omitted in the recent report from the Open Working Group meeting on Health that was held last May.
We believe that HIV in post 2015 should go beyond a purely biological response and should be multi-sectoral – we find it imperative that the Post 2015 framework address the illustrative linkages of HIV and violence, inequality, gender equity, sexual and reproductive health and rights, sexuality education and other determinants that can limit health and well being.
In this regard the HIV targets and indicators need to be strengthened to drive scaled-up action through the Post-2015 framework with pronounced focus on human rights, stigma reduction and “people-centeredness”. It is fundamental that “HIV and AIDS” speak has a broad appeal beyond the HIV and health sectors that can support HIV targets through the SDG’s.
Although the MDGs have reflected commitment to halt and reverse the spread of HIV, it is by no means certain that these concerns will be carried through into the Post-2015 development agenda. We hope we can count on your understanding and leadership in advocating towards having HIV remaining as a high priority within the Post 2015 framework .
Sincerely,
The NGO Delegation to the Programme Coordinating Board of UNAIDS