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PCB Summary Bulletin

40th PCB Meeting | 21 July 2017

NGO Delegation’s PCB Summary Bulletin

#TheUNAIDSWeNeed is embracing the new realities of the global HIV architecture, is adjusting to new ideas and is facing the challenges of change.  This was evident at the 40th UNAIDS Programme Coordinating Board (PCB) meeting held in Geneva, Switzerland, June 27-June 29, 2017, under the chairpersonship of Hon. Kwaku Agyeman-Manu, Minister of Health for Ghana.  

Agenda items

1.3

Agenda Item 1.3 | 40th PCB Meeting

Report of the Executive Director

NGO Delegate representing Africa

Intervention delivered by Musah Lumumba El-Nasoor


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Thank you Chair.

Recognizing the urgent need to face the “challenge of change” together at this tempting moment, the NGO Delegation supports the EXD’s report and recognises his extra-ordinary leadership in the response.

Characterized by partnership, innovation and activism, as communities, we are the living face to the AIDS journey.

The global solidarity has served to register these gains, 18.2 million people on treatment, 60% reduction in new infections among children, increased recognition of the role of communities in the HIV response.

A new plan of action, a revised operating model and #TheUNAIDSweneed, is that which will not let down people. A strong, visionary, well–resourced Joint Program that won’t only exist to survive, but will serve to work with communities, including those left behind.

The new operating model should, then, be stronger in highlighting the role of civil society, communities and key populations in the HIV response. It should also ensure that there is a clear engagement strategy across the joint program for communities including people living with HIV, young women and girls, gay men and men who have sex with men, people who use drugs, sex workers and transgender people. This strategy must avail of the necessary tools and resources for communities to engage with relevant stakeholders especially at country level. Madam First Lady, we applaud you for your demonstrable contribution to the HIV response, and the strong message on zero discrimination. Zero discrimination is not negotiable. You are a leader who gets results for communities. We also appreciate interventions crystallizing the role of communities and the need to have communities at the center, that have been made by Portugal, Germany, Sweden, and United Kingdom and the delegations they represent.

As a game changer, we contend that the active maintenance of civil society as an independent and key actor in the AIDS response should be an explicit goal of any financing system in the proposed plan of action.

We are outraged that:

• 18 Million more people are waiting for treatment

• In the past hour 125 people died of AIDS related causes

• 240 people were newly infected with HIV

• We are failing young women and adolescent girls

• Men are not accessing testing and services

• Men are not accessing testing and services, key populations are still marginalized and driven to margins of society

• There is growing inequality/gap and vulnerability in South Sudan, Venezuela, West and Central Africa amongst migrants from the Mediterranean region as well as indigenous people and the underlying factors driving these inequalities.

#TheUNAIDSWeNeed leaves no one behind.

NGO Delegate representing Asia and The Pacific

Intervention delivered by Sonal Mehta


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Thank you Chairperson for the opportunity.

It is more than clear to everyone that the HIV response will neither runs on the charisma and brilliance of any one individual, nor on the commitment of only a few organisations or countries. For an epidemic as complex as this, the response has to be multi-sectoral, multi-layered and based on multi-partnership. But the most important aspect in a complex partnership is to be able to emphasize the unique measurable position of each of the actors. One of the most critical calls we as an NGO Delegation would like to make is that UNAIDS provides us with appropriate language and messaging on the unique contribution of the Joint Programme in the global architecture of the AIDS response, to ensure coherence in the communication from the Secretariat, Co-sponsors, Member States and at the community level. We, the strong allies on the ground, need these tools when we talk to our communities.

UNAIDS has provided targets for the HIV programme that the world chases after. These targets provide momentum to donors and member states, but it is most critical in the current situation to ensure that the Joint Programme is able to articulate its unique positions, the convening power and the political clout it holds that lubricates the investments made by other actors. It is imperative for the Joint Programme to clearly articulate its own contribution to the same effort, not only in terms of numbers, but in terms of quality.

Globally, the HIV response is known for its capacity to empower people, listen to the most affected communities and putting them in the driver’s seat. In the present situation, there is great concern that the focus of the key actors in the Joint Programme partnership, is more on their reduced capacity as organizations, rather than on how these changes affect the communities we serve. As guardians of the global response, we request the UNAIDS Secretariat most importantly, objectively and dispassionately evaluate the reasons for the current financial crisis and learn lessons from it for the future.

#THEUNAIDSWENEED is capable of learning from the past and venturing forth into the non-conventional future for the betterment of the communities we serve.

NGO Delegate representing Latin America and The Caribbean

Intervention delivered by Alessandra Nilo


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Thank you, Michel, for your report. It is important to keep in mind the context we are facing, while, continuing to push for a Joint Program that is innovative and designed to lead the world in achieving universal access to HIV prevention, treatment, care and support.

The NGO Delegation has a unique responsibility with this board, which is to bring the perspectives – and expertise – of people living with, vulnerable to, marginalized and affected by HIV. And, to us, the only way to do so is to have an honest dialogue about the challenges we see.

We value UNAIDS and its unique multisectoral approach that has led the way for member states to set inspiring targets and policies. For many years, at all levels, UNAIDS has shown that it is key to meaningfully engage civil society, to promote human-rights and gender equality-based response and to address the needs of key populations. We have been able to count on timely strategic information to shape policies and programmes, and to provide better technical support to countries and communities, including to access Global Fund grants. Therefore, the global AIDS architecture, for its own sake, can’t give up on UNAIDS. We can’t give up on UNAIDS.

Although this has been reflected in the Global Review Panel process, we remain extremely concerned with the current capacity of the Joint Programme to deliver more and better – whatever the model designed –, with less funds and resources.

In the context of multiple crises, with growing conservative forces and regression of human rights, we need UNAIDS to be stronger than ever in standing with and supporting communities. Because we learned that governments won’t expand access to public health services, including to life-saving medicines, without civil society pressure. We know why we are trapped by so many crises, we know what to do to respond them and we know the players that take geopolitical moves against multilateralism and accountable democracy.

Each Board meeting, we sit in the same room, having conversations about ending AIDS: But, we need a reality check. And the reality is that communities are being left behind, country programs are closing or operating at minimum capacity and, at the global level, although the multisectoral approach called for by the SDGs is an opportunity for the Joint Programme to show its leadership, what we see, in fact, is that UNAIDS has not yet visibly taken this role.

Therefore, we are concerned. We need more effective coordination among co-sponsors and the Secretariat, with stronger accountability at all levels. For instance, this Board has been effective in adopting new ideas and tools and while that is important, it is time to strengthen UNAIDS capacity to follow up and monitor those initiatives, recognizing what works and fixing what is not working –the “ending AIDS approach” is an example of what I am saying here.

And, yes, progress has been achieved– after all, many of us continue to work tirelessly to respond to this epidemic – but AIDS is far from over. People are still dying in all continents; people still lack access to medicines and combined prevention; stigma and discrimination, violence, and human-rights violations, including gender inequalities, continue to fuel this epidemic. There is still a long way ahead and that’s why we won’t give up on UNAIDS. But #THEUNAIDSWENEED is a strong joint partnership, capable of self-criticism, learning and change, and incapable of being complacent with itself.

As the NGO Delegation, we will continue to work closely with communities, with the Secretariat, Co-Sponsors and members states, to engage in frank, constructive dialogues which will lead us to real, lasting change to improve the lives and uphold the rights of all those affected by HIV. Together, as a Board, let us ensure that the call to leave no one behind is coupled with concrete actions, coordination and accountability in all that we do. Thank you.

1.4

Agenda Item 1.4 | 40th PCB Meeting

Report of the Chair of the Committee of Cosponsoring Organizations (CCO)

NGO Delegate representing Asia and The Pacific

Intervention delivered by Sonal Mehta


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Thank you Chairperson, for clear, direct, and sensitive report.

Few people realise the complexity and magnitude of the Joint Programme and the impressive results it provides. While most of us, including country governments, communities, and civil society experience the Joint Programme as a blind person experiences elephant, and therefore based on the Co-Sponsors we experience we describe the entire programme as that part of the body of elephant. But only when one reads the complicated UBRAF and CCO report one realizes it is not easy to work in a complex, accountability framework.

The NGO Delegation appreciates the readiness of the Cosponsors to work on the Joint Review Panel recommendations, and agreement for joint resource mobilization. We also appreciate the Global Fund – UNAIDS evaluation since efforts will bring clarity on complementarity. But we would like to emphasise the unique strengths of each Cosponsors is clear and utilized. Some of our community experiences bear evidence of lack of coordination and duplication among various Cosponsors, while complete neglect of some critical issues.

My experience in India shows at least three Cosponsors working on verticle – UNICEF, UNAIDS, and UNFPA bombs no one with young people living with HIV on sexual reproductive health.

One concern we would like to highlight is in the area of managing the communication around the budget cuts and its impact on the work on ground. It is important to prepare countries and communities, therefore we encourage a constant dialogue with civil society [and other country stakeholders] with complete transparency and openness. We think there is room for improvement there and it is important that a new crisis of loss of trust and faith should not start, just as we are learning to control a financial crisis.

While reviewing the report of the CCO, one observation was that out of the 11 Co-Sponsors 10 case studies come from Africa, which may or may not mean anything. But it is very necessary that the joint response is focused where the need is, but it is critical that no one is left behind in our responses.

Mr. Chairman, #THEUNAIDSWENEED ensures communities engagement not only as recipients but as designers and architects of the HIV response.

4

Agenda Item 4 | 40th PCB Meeting

Unified Budget Reporting and Accountability Framework (UBRAF)

NGO Delegate representing Africa

Intervention delivered by Kene Esom


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The NGO Delegation notes the UBRAF Performance Monitoring Report 2016. We particularly wish to commend the efforts of the Joint Programme to work towards the achievement of the set targets to end AIDS, despite the current challenges in the global AIDS response, key among these being the question of lack of funding to the response and its consequence on fully resourcing the UBRAF.

The strength of the Joint Programme lies in the capacity of the Secretariat to carry out the key functions of leadership, coordination, partnership, strategic information and accountability and the co-sponsors’ to deliver on the targets of ending AIDS as an epidemic by 2030. We are concerned by the impact that the funding cuts and the inevitable prioritization exercise by the co-sponsors, will have on key interventions to key populations, both in fast-track and non-fast countries, if there is not a clearly articulated and coordinated approach to this prioritization effort. To quote the report ‘Stabilization of the Joint Programme in Light of the Budget Shortfall’ presented under Agenda 5 of the 39th PCB, “the capacity … to deliver on several of its core functions – particularly generating strategic information, empowering and supporting civil society and providing dedicated support to key and other marginalized populations – will be severely weakened.”

For communities, this translates practically to service providers who will have to close their doors; national AIDS strategic plans and Global Fund concept notes that will no longer be effectively supported to ensure inclusion of human-rights and evidence-based interventions for those that need it the most; on-going legal and policy reforms that will be dropped mid-stream and the attendant regression for efforts to create enabling environment necessary to end AIDS; a high number of young girls and adolescent women who will be infected, drop out of treatment and/or be added to the statistics of AIDS-related deaths; and the communities key populations who will be forced back into the shadows. Chair, I could go on and on.

As a Delegation, we join the appeal to donor countries to increase their commitments funding the UBRAF. We also need to be more innovative in resource mobilization, in the utilization of available resources. The fulfilment of global and regional commitments to resource health is imperative in general and HIV targets in particular. For example, The African Union under the Abuja Declarationhas committed to allocating at least 15% of their national budget to health. 15% of the budget expenditures of the top 6 Fast-Track African countries by 2016 budget expenditure was $27.43Bn. Imagine the impact that $27bn investment in the health systems of these 6 countries would have on their national health, and AIDS targets.

The #UNAIDSWENEED supports Member States to implement innovative financing mechanisms, as well as to fulfill their commitment to domestic financing of the AIDS response.

NGO Delegate representing Asia and The Pacific

Intervention delivered by Sonal Mehta


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Thank you Chair.

The NGO Delegation appreciates the detailed reporting on core and non-core spending and regional expenditure details. We would further appreciate if there was a simpler and direct infographic on achievements till date and the impact of the budget cuts on the lives of people living with HIV and other key populations, which would make it simpler for our communities and organisations to understand.

More importantly, we are very concerned about the budget cuts, and it is critical to understand its wider implications on communities and other donor institutions and their capacities and efficiencies in the future. In the changing scenario, most of the financial mechanisms of bilateral or multilateral donors leave countries and sometimes entire regions, when the Joint Programme is most needed to create space for communities and civil societies to organize dialogues with our governments to increase domestic funding or politically prioritise the issue.

We are particularly concerned and would like to know what is the implication of the reduced budget on the earlier commitments of the 2016 Political Declaration in particular 60(d) on expanding community-service delivery to 30% of all service delivery by 2030, and 64(a) on ensuring that at least 6% of all global AIDS resources are allocated for social enablers including advocacy and community mobilization.

A specific point we would like to highlight is more clarity on Figure 2 of the 2018-2019 budget document report on page 17 about the 22 million (and save is true for 58 million) that is supposed to be allocated as country envelopes. We seek clarity on how the priorities of countries will be decided in reference to the set of criteria on page 35, when country level presence of the Joint Programme is severely affected by the proposed budget cuts. We urge the Joint Programme to ensure that communities are involved in this decision-making process, especially in the absence of the Joint Programme on the ground. The process mentioned on page 35 in box needs to be coupled with principles or ground rules. It will be unfortunate if the Joint Programme decides within itself with blessings from governments rather than engaging communities.

We would like to appeal to donor Member States to keep their contributions and increase them if they can, and for other Member States to be new donors, since every penny counts. We are tired of hearing that money is short when we see millions being spent on criminalizing and locking up people who use drugs, sex workers, transgender people and men who have sex with men. Every year, according to latest HRI reportgovernments spend 100 billion dollars on drug control strategies. Stop the criminalization of our people by stopping the investment on punitive actions and invest those resources into cost-effective life-saving prevention and treatment programmes for all.

The AIDS response is not mere disease response, but it is a statement of inclusion, an example of a rights-based movement and a successful model of a multi-sectoral complex partnership.

Finally, we would like to emphasise that we do not forget the communities whose lives are going to be affected by the decisions we make today. #THEUNAIDSWENEED must make decisions based on its mission and not simply to ‘keep the model’.

5

Agenda Item 5 | 40th PCB Meeting

Follow-up to the thematic segment from the 39th Programme Coordinating Board meeting

NGO Delegate representing Europe

Intervention delivered by Ferenc Bagyinszky


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Thank you, Chair.

During the last PCB in December, we had the privilege to dedicate a whole day to the theme of HIV and ageing. I am saying privilege, as although ageing is a normal part of a life cycle, for us, people living with HIV, ageing became a reality not that long ago with the era of combination antiretroviral therapy.

The NGO Delegation appreciates the development of the rich draft decision points and that our suggestions were mostly integrated into the final draft. We can only encourage the Board to approve these decision points.

However, in the era of SDGs, we must raise our concern, that our proposed decision point, aiming at exploring innovative ways of affordable and sustainable research and development structures, has been omitted. It is clear that we need to continue the multilateral discussion on the issues of pricing, affordability and sustainability of treatment and care programmes.

Most importantly, we must not stay silent about the tragedy that not every person living with HIV is granted the chance to age. In 2017, over 30 years into the epidemic and over 20 years after the introduction of combination therapy, globally half of the people living with HIV have no access to antiretroviral treatment. In some regions, such as Eastern Europe or Latin America and the Caribbean, these figures are even more tragic.

People living with HIV still die every hour all over the world, as universal access to treatment is blocked by criminalization, by restrictive policies and guidelines, by stigma and by intellectual property issues, or because their Governments cannot afford or decide not to allocate enough funds for all people in need of treatment. And because humanitarian disaster constantly emerge and we fail to respond, such as the ongoing tragedy of communities of PLHIV in Venezuela who do not have access to medication or food any more.

As the proposed Decision Point 7.2 b says – quote – an ageing population of people living with HIV is a measure of a successful response to HIV – end quote, we must also admit that every life lost to HIV is a failure of the response to HIV.

We call on Member States to remove all legal and structural barriers that block universal access of HIV treatment and care and request the Joint Programme to continue providing its assistance in reaching the treatment targets.

#TheUNAIDSWeNeed ensures that every person living with HIV is granted the opportunity of ageing with HIV.

Thank you.

NGO Delegate representing Africa

Intervention delivered by Musah Lumumba El-Nasoor


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Estimated to be over 5 million, adolescents and young people represent a growing share of people living with HIV worldwide, who are faced with low treatment rates, increasing AIDS related deaths and poorly disaggregated data.

Children born with HIV are also growing up into adolescents who have to deal with their HIV status as they grow and develop. If the current trends continue, hundred of thousands will become HIV positive in the coming years, widening not only the pool of YPLHIV, but also the number of PLHIV globally, impacting on existing health and other socio-economic interventions.

The medical, psychosocial and economic aspects of a growing and aging population of people living with HIV cannot be over emphasized. As adolescents have to deal with taking medicines in school environments, cognitive deficiencies, and management of HIV infection for the rest of their lives, the older people living with HIV are dealing with livelihood, employment and ageing associated co-morbidities.

What worries us however is that, science seems to be insufficiently understanding the cause for accelerated ageing, yet, as communities of PLHIV, we are the living examples of this dichotomy.

In a rights-based approach, we can clearly see that PLHIV are not just treatment models, as in a homogenous group, which only require Septrin and ARVs, but we are individuals with different health needs beyond our HIV status. If it is messy to allow young girls living with HIV to discuss their sexual health and reproductive rights, shall we as well forget about cervical cancer, children being born with HIV, and forced sterilization? Shall we not pay attention to ano-rectal cancers, as well as, diabetes, mental health, etc.?

Therefore, we need differentiated interventions for all PLHIV especially for those with cross vulnerabilities. Lastly, I pay tribute to my senior colleagues here, who have over time, shaped the way the world looks at us. The first people to bring attention to human rights abuses, the people who paved the way for future generations and set the standards of inclusion, equality and zero discrimination.- It takes courage. I also salute those who have lost the battle in the long run, when science had no tools to manage HIV complications. When everyone seems to be good at just talking, with no actions.

#THEUNAIDSWENEED ensures that interventions are delivered in a continuum for everyone in a life cycle approach – leaving no one behind.

6

Agenda Item 6 | 40th PCB Meeting

Update on strategic human resources management issues

NGO Delegate representing Asia and The Pacific

Intervention delivered by Jeffry Acaba


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Thank you, Chair.

I would like to begin by reminding everyone that June is Pride month, and on behalf of the NGO Delegation, welcome the update on the strategic human resources management, specifically in rolling out the UN for All training on diversity and inclusion among its staff. We thank the Secretariat in its efforts to make the workplace safe and enabling for its staff to work in dignity by respecting each other regardless whether they belong to one color or to different colors of the rainbow.

We note the developments in the staff realignment with regards to the Gender Action Plan, and communities in my region are beginning to feel its impact, with women moving and representing UNAIDS Secretariat at the country level and in some of the key UNAIDS posts, which must continue to set an example for the UN system towards gender equality.

With regards to the realignment process, community networks in my region are worried that some of the UNAIDS Secretariat positions that are considered critical to the HIV response may not be present anymore, and we request UNAIDS Secretariat to take into consideration the concerns and priorities of communities to understand the need and urgency of keeping critical posts such as those that deal with human rights and law reform.

The other point that I would like to raise is that with the changes in its ways of working, the challenge of UNAIDS right now is to ensure that there is continuous and quick support to non-Fast Track countries, especially those in transition to middle-income status. The UNAIDS office in my country, the Philippines, where people who use drugs are being gunned down on a daily basis; the only country in the region that has an exponential increase of new HIV infections of up to 400% since 2010; and is not a Fast-track country, has had no UNAIDS Country Director for the last six months, at a time when we need UNAIDS to undertake its political and convening role with the government.

The UNAIDS we need is a UNAIDS that puts and maintains the right people with the right capacities in the right places right now.

Thank you.

NGO Delegate representing North America

Intervention delivered by Marsha Martin


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Thank you Chair.

We heard yesterday about a very important campaign against discrimination in Panama presented by First Lady Lorena Castillo: Zero discrimination is not negotiable across the continuum of the global, national and local HIV response. Most of the time in this room this phrase is used in the context of the lives and experiences of people living with HIV, to those vulnerable to HIV acquisition, and to diverse communities living on the edge, generally left out and left behind. Today I want to apply this phrase to the human resource challenges in the HIV architecture.

The NGO Delegation welcomes this report on Strategic Human Resource Management. We encourage UNAIDS to continue strengthening the capacity of the staff to support and carry out the mission and vision of achieving universal access to HIV prevention, treatment, care and support and uniting the world against AIDS. To successfully implement the mission and vision, a strong, capable, committed and cared for workforce across the UNAIDS family is essential. As stated in the report, the future of the global HIV response will require an agile and dynamic workforce, careful deployment of staff resources according to evolving needs, priorities and realities. UNAIDS needs to sustain a high-performing and engaged workforce that is free from discrimination, that is invested in for its diversity; that is supported to continuously move toward greater gender equity. People working in the community-led response to HIV have been in the forefront and remain key for full implementation of the global response; however, sufficient attention has not been given to their maintenance, sustainability, re-tooling, trauma healing, and care.

We request UNAIDS to encourage national and regional governments to take note of community networks and civil society organizations that are doing the work, implementing the HIV agenda, and integrate their work, with adequate budgets, clearly and sustainably in their HIV response. We are pleased to see and read the recognition that “while change and challenges have confounded our human resources” we must be prepared to modify, modernize and maximize our human resources. We agree and call on everyone in the room to make accessible the tools to support human resource development in ALL of our workspaces in our global HIV architecture if we are to see the end of this epidemic.

What does that look like: It is a collective civil society sector that has a secure line of financing. It is a workplace that moves from greater involvement of people living with HIV to meaningful involvement of people living with HIV at all levels of responsibility. It means a workplace that supports growth and development of staff and encourages full participation in the mission and vision of responding to and ending AIDS. It means a workplace that clearly demonstrates that people living with HIV and those from communities most affected including our gay, lesbian, bisexual, and transgender brothers and sisters, communities of color, formerly incarcerated persons, migrant and immigrant communities, our family and friends who are sex workers or who use drugs are valued and shows this through honest engagement, employment, leadership, respect, and support. However, that is not what we experience currently in the field.

Success in achieving the 20-20 targets and the 20-30 goals hinges on sustaining a strong HIV architecture with infrastructure built on expertise, solid financing, capacity, relationships and networks available all along the continuum.

The UNAIDS WE NEED recognizes the true value of a well cared for workplace at all levels of the response, inside the UNAIDS family, its relatives around the globe and their off spring.

We are a big family. Our shared goals and vision require that our family is well fed, clothed, safe, secure, is stably housed and learns to nurture and take verty good care of its members.

9

Agenda Item 9 | 40th PCB Meeting

Thematic Segment

NGO Delegate representing Europe

Intervention delivered by Vitali Tkachuk


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All these days we talk a lot about the obligations of the countries. And, first of all, about the obligations to ensure the right to health for all its citizens. When we talk about health for all citizens of our countries, we first start talking about medicines. The main points of Fast Track are focused on drugs – the second and third 90. We want to draw attention to the fact that health is not only treatment and drugs. We understand that health is prevention. Moreover, if we talk about 90-90-90 – then prevention gives us the opportunity to realize the first 90 – testing.

For the countries of my region that are in the transitional period, it is fundamental importance not to lose the prevention component when switching to domestic funding.

In Ukraine, we manage to make big steps towards that, right now in the new round of the Global Fund. We, civil society and the community, decided to completely revise the country application. Together with civil society, communities, and government we were working hard to plan the process of transition of prevention to domestic financing. Every player has a responsibility to work together on this transition.

But the experience of colleagues from neighboring countries of our region tells us that in reality nothing is as smooth as at the planning stage. The devil is in the detail. All countries of our region inherited the budgetary process of the Soviet period. It means that states allocate funding for activities, that were to be done during the year – at the end of the year. It means that NGOs cannot make this work because they do not have their own resources. And state institutions can not make this work – because they can not work effectively with key groups.

Specifications for social orders that are done by state structures are often created without consulting with NGOs, and we get such examples:

Kazakhstan – state money can not be used for people with chronic diseases, we understand what this means for our groups.

Belarus – technical barriers, but thanks to the efforts of civil society and the constructive and dedicative position of the state, work to overcome them is under way right now.

In conclusion, all this work can and should be accelerated. We the NGO delegation believe that UNAIDS can and should coordinate this work and not only in the Fast Track countries.

UNAIDS can help focus government attention on the fact that:

First: Without prevention – the right to health will not be realized and the level of diagnosis for HIV – the first 90 – will not be reached.

Second: Without NGOs, there will be no prevention in key populations and it is necessary to quickly remove the barriers blocking the work and funding of NGOs and communities.

This is how we see #TheUNAIDSWeNeed, especially in this transition period.

Thank you!

NGO Delegate representing North America

Intervention delivered by Trevor Stratton


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The United Nations Permanent Forum on Indigenous Issues recently recommended that the Joint United Nations Programme on HIV/AIDS, in collaboration with the United Nations Population Fund (UNFPA) and the Inter-Agency Support Group on Indigenous Peoples’ Issues, sponsor an expert group meeting on HIV/AIDS by 2019, which would include the full and effective participation of indigenous peoples living with and affected by HIV/AIDS, to analyse the sociocultural and economic determinants of health for HIV/AIDS prevention, care and treatment in indigenous communities, with the Forum’s collaboration, in order to ensure the realization of target 3.3 of the Sustainable Development Goals.

The Permanent Forum also recommended that States collaborate with indigenous peoples to ensure adequate resources to design and fully implement HIV/AIDS and hepatitis B and C programs that address the social, economic and cultural determinants of health for HIV prevention, care and treatment in indigenous populations, in particular indigenous women and youth.

My question is: how legitimate is UNAIDS for Indigenous Peoples? How can UNAIDS work with member states and Indigenous Peoples to scale up primary prevention?

NGO Delegate representing Asia and The Pacific

Intervention delivered by Sonal Mehta


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The PCB NGO Delegation appreciates that often there is more flexibility in implementing programmes supported by Foundations. And therefore Foundations grants are probably the best support for work around structural barriers in HIV prevention – the intervention that can lead to most sustainable outcomes.

What is the commitment from the Gates Foundation to not merely invest in coalition but also on the ground in interventions, especially to middle-income countries that need such interventions since that is where highest number of concentrated epidemic countries belong and that is from where most bureaucratic donors are transitioning from. And especially to interventions that change policies, norms, and laws, not just service delivery.

And to UNAIDS: how can we ensure this investment in the refined model of resource mobilization that in allocating these resources will include communities?

NGO Delegate representing North America

Intervention delivered by Marsha Martin


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Thank you Mr Chair,

We, the NGO delegation, welcome the establishment of the Global Coalition for HIV Prevention and invite UNAIDS to draft the Coalition’s agenda in partnership with communities and Civil Society Organizations. There is urgent need to work collectively on a global level to prioritize and target HIV prevention efforts both on structural levels with a location focus. There is also an urgent mandate to address a number of social and structural determinants, community and economic challenges, such as disproportionate exposure to violence, lack of access to health care, unyielding discrimination, stigma, racism, homophobia, transphobia and poverty, to name a few.

I want to share an important challenge today: Recently while speaking with a group of young men in the US about HIV prevention, I was saddened by their despair as expressed in statements like: HIV is,

“part of the party”

“just a matter of time” before I become infected

“making me afraid to go out” and meet people

“easier to get it over with.”

Colleagues and friends, we have missed the boat in prevention if those at risk believe HIV infection is an inevitability. We have proven and effective tools to prevent HIV infection. The question is, do we have the will. HIV infection should never be thought of as an inevitability. We, the NGO Delegation, invite the new Global Coalition to draft an agenda that is inclusive of the needs of all those at risk and to consider today’s landscape, and the complex and complicated challenges it presents.

We are learning we cannot treat ourselves out of this epidemic, prevention is key.

NGO Delegate representing Africa

Intervention delivered by Kene Esom


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Let me start by appreciating the Panelists for their very insightful interventions.

According to the Prevention Gap Report 2016, new infections in adults 15+ has stayed static since 2010 at an average 1.9m annually. There is no gainsaying the fact that we have dropped the ball. These figures are an indictment on us all and this is totally unacceptable.

What happened to the robust prevention agenda that buoyed us in the early days of the epidemic when all that drove the robust response was the passion of the communities impacted greatly by the loss of friends and family to AIDS? We achieved so much on the consciousness of our shared humanity, with no financial agenda to speak of. Prevention worked, and still works, and we need to fund it.

The NGO Delegation welcomes the Background Note – HIV Prevention 2020 and particularly the beginnings of the resurgence of a prevention agenda premised on the right to prevention – combination prevention – as a composite of the right to health. The International Covenant on Economic, Social and Cultural Rights provides for the right to the highest attainable standard of health in Article 12. The Committee on Economic, Social and Cultural Rights explaining the obligation of Member States in this regard in General Comment 12 of 2000 said that the right to prevention [Art. 14(2)(2)] ‘…requires the establishment of prevention and education programmes for behavior-related health concerns such as sexually transmitted diseases, in particular HIV/AIDS, and those adversely affecting sexual and reproductive health, and the promotion of social determinants of good health, such as environmental safety, education, economic development and gender equity’

We can no longer afford to treat prevention as the proverbial Cinderella, the step-sister left behind because there is no wealthy benefactor/stepmother to dress her for the royal ball. We must all become the fairy god-parents that fight the cause of the Cinderellas of our communities – young women and adolescent girls, MSM, sex workers, transgender persons, people who used drugs, prisoners and detainees – who are being left behind by a growing apathy towards combination prevention in our global response. I have used a popular children’s story figuratively to remind us that our shared humanity and the universal right to the highest attainable standard of health should be the primary consideration driving the HIV agenda, not economic gains. 1.9 million new infections per year is unacceptable and this figure requires far less resources to impact, if we re-prioritise the right to prevention in the global response.

My question to the panelist is – In your opinion, what would it take to reinvigorate an HIV Prevention agenda that is premised strongly on the Right to Prevention and resourced?

NGO Delegate representing Latin America and The Caribbean

Intervention delivered by Alessandra Nilo


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Thank you, Chair.

Today, as we engage in important discussions on the topic of “Global Partnerships,” I raise my voice to ask the question, “where is our partnership with the Venezuelan people?” The political and economic crisis in Venezuela should not be treated as a topic alien to us. The images of starvation, violence, oppression and death remind us that the situation in Venezuela is also a serious human rights and humanitarian crisis.

After 30 years of significant gains in the fight against HIV, Venezuela finds itself in a public health crisis as it runs low on HIV essentials. Antiretrovirals, vaccines, surgical and basic medical supplies including reagents for diagnostics are at critical levels throughout the entire country. These shortages are directly affecting the 77,000 persons living with HIV who suffer from frequent interruptions of antiretroviral treatment and face the permanent shortage of diagnostics for CD4 and viral load. Local NGOs and community groups are informing us that thousands are currently living without their medications already. The 90-90-90’s are quickly slipping out of the hands of a people that are struggling to address the 0-0-0’s of their basic needs such as food, water, shelter and security.

As Venezuela is currently ineligible for Global Fund support, a call is made to all global partners to become engaged and respond to the crisis by telling the story of Venezuela from a humanitarian perspective and not a political one. This call is for all global partners to find bold ways of reaching those in need by rising above the political barriers and forging effective partnership. We call for a strengthened UNAIDS office in Venezuela to work with civil society and communities.

As great investments are being made to accelerate efforts to end the HIV epidemic, we cannot and should not ignore the plight of those countries that are regressing due to political and economic challenges. We must reflect on the following “How will we claim global success in 2030, if countries such as Venezuela will be struggling with the effects of a resurging epidemic?” Have we done enough and what will be the cost of our inaction today.

#TheUNAIDSWeNeed and deserve is a UNAIDS that does not lose sight of the human factor of HIV, it is a UNAIDS that exemplifies the core values of global partnership and responsibility.

Thank you!

Our NGO Delegation

The Programme Coordinating Board (PCB) was created to serve as the governing body of UNAIDS. The PCB includes a Nongovernmental Organization (NGO) Delegation composed of five members and five alternates that represent five geographic regions: Africa, Asia and the Pacific, Europe, Latin America and the Caribbean, and North America.

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UNAIDS and the UN

UNAIDS was established in 1994 through a resolution of the UN Economic and Social Council (ECOSOC) and made operational in January 1996.

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