The onset of the COVID pandemic has made the 46th PCB Meeting the inaugural fully virtual PCB meeting.
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46th PCB Meeting | 15 July 2020
NGO Delegation’s Summary Bulletin
The NGO Delegation’s Summary Bulletin for the 46th UNAIDS PCB Meeting reflects the engagement of the NGO Delegation on all agenda items amongst which: Progress report on establishment of the Task Team on Community-led responses, and Report of the working group on the Joint Inspection Unit management and administration review of the United Nations Joint Programme on HIV/AIDS (UNAIDS)
Agenda items
All Agenda items >1.3
Agenda Item 1.3 | 46th PCB Meeting
Report of the Executive Director
NGO Delegate representing Asia and The Pacific
Intervention delivered by Jules Kim
The NGO delegation thanks ED Winnie Byanyima for her report and the work of UNAIDS under her leadership. We want to applaud Winnie for emphasizing the underlying drivers and inequalities that continue to drive up new infections and unnecessary AIDS-related deaths. In particular we thank Winnie for raising up the importance of addressing intellectual property issues in ensuring equitable access to medicines for all.
We all acknowledge that this has indeed been an unfortunate time of crisis that has deeply affected many. But it is also a time that we must not forget the unfinished business of the ongoing public health crisis of HIV and AIDS. Unfortunately, what we have witnessed is an increase in human rights violations, escalating stigma and discrimination and targeting of key populations including sex workers, people who use drugs, people living with HIV, LGBTIQ people and we have seen an ever widening chasm in the health inequalities for the very communities most affected by HIV and AIDS. We are witnessing a situation where we are not just being left behind, but our communities are being decimated.
In many regions, we have seen the impact of the COVID-19 pandemic on access to critical life saving services, ART and testing. We have seen how already scarce resources, including human resources in the response to HIV and AIDS, have been reprogrammed to COVID-19 without adequate community consultation or warning. Our colleague from Latin America has shared in her statement the story of the deaths of many people living with HIV in her country, Bolivia, while awaiting access to prevention, treatment and care, especially in securing the supply chain of HIV medications and prevention commodities which is not secure for many of us. These long-fought and necessary means of survival were severely impacted in a matter of months of the COVID-19 outbreak in many regions across the world.
Without continued vigilance, resourcing, effort, and focus, the rates of new HIV infections and AIDS related deaths can escalate. This is a critical juncture that reminds us that we cannot lose ground and momentum. It remains vital to ensure that communities are at the centre, to promote rights-based approaches, and to address the structural and regulatory determinants of health to ensure responses to HIV are strengthened and not lost in responses to COVID-19. We remain vigilant and hopeful that Winnie will lead the UNAIDS we need to meet ambitious HIV targets in this challenging environment.
We wish to take this opportunity to urge member states to continue their support for UNAIDS and for MS and the Joint Programme to work with us to ensure that the response to COVID-19 is not to the detriment of the HIV response, we must not leave HIV behind.
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Agenda Item 1.4 | 46th PCB Meeting
Report of the Chair of the Committee of Cosponsoring Organisations
NGO Delegate representing Africa
Intervention delivered by Lucy Wanjiku Njenga
Thank you Chair.
In dealing with the dual epidemics of HIV and COVID-19, it is encouraging to see Cosponsors standing with communities and UNAIDS in countries, to address the challenges and inequalities exacerbated by the situation. In my country, Kenya, I have seen the UNAIDS country office take on the challenge and work to address the needs of people living with HIV to ensure that continuity of services is not disrupted to unmanageable levels. Provision of hygiene packs and foodstuff for the most vulnerable households of people living with HIV is catered for to go through these difficult times. In some countries, UN Women launched the Shadow Pandemic Campaign to raise awareness on Violence against women and girls during COVID-19 and urge countries to ensure safety measures.
However, even with these interventions, the threat of losing the gains made is a thorn in the flesh. People living with HIV around the world have been affected when the lockdowns and movement restrictions were initiated without prior warning. Dispensing of medication has decreased. Some, especially mothers who have the burden of getting food for their children, stopped taking their medication as the scarcity of food affects their adherence. We need to do more and work with community-based organisations in getting foodstuff and medication to people living with HIV where they are. Still some members of our constituency find it impossible to have the information on the use of country envelopes; we must aim for total transparency and accountability.
In developing the upcoming UNAIDS Strategy, I echo the Cosponsors on the importance of not leaving anyone behind. Key Populations have felt the full force of the epidemics and we must do right and better. Shocking news of a huge increase in teenage pregnancies in my country begs the question of the new infections that could accompany them, which makes a bad situation way worse. People keeping away from health facilities is another added salt to the injury as testing will not happen. We will have to address the root causes and not just keep putting balm to a recurring wound.
Let us all buckle up as the situation will only get worse before it gets better. A strong UNAIDS will require all of us to work together, keep to our commitments and shield fiercely all the gains made in HIV work, development, and gender equality.
Thank you.
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Agenda Item 3 | 46th PCB Meeting
UNAIDS Strategy beyond 2021
NGO Delegate representing Africa
Intervention delivered by Jonathan Gunthorp
Thank you chair, I speak on behalf of the entire NGO Delegation.
Many people in our communities are alive today because of the leadership of UNAIDS, and
yet we have not ended AIDS. Not as a public health threat, not as the leading killer of adolescents in southern Africa, not as a silent stalker of key populations worldwide.
Nor are we on track to end AIDS. Twenty-four months ago, the Lancet Commission report, – made up of some of the best minds in the global response – reminded us of this; warned of possible rebounds; advised to make common cause with broader global health; and found that existing tools and strategies are insufficient. I repeat, found that existing .. “strategies are insufficient”.
We face a strategic turning point in the Joint Programme, at a time of both the Coronavirus pandemic and the approaching economic recession.
The recession will push scores of millions back into poverty and, in the absence of UHC, eat away at their ability to pay for health, and at their countries ability to fund their HIV responses.
And the pandemic, while flaying the wealthy along with the poor, has exposed global inequities, between countries & within countries. It has reminded us who can and who cannot afford health.
While countries in the north have been heavily hit by the pandemic, it is in Latin America that bodies lie in the streets, that children with AIDS once again haunt TV screens as supplies and supply chains collapse, and it is in Asia that people break COVID-19 isolation and wait in vain for disrupted supplies of medicines.
And these scenes of increasing pain are only those we all see on TV.
It is, above all, the uncounted, as Professor Sarah Davis of the Global Health Centre, calls those whose data do not make it to our TV screens or our reports, that concern us in civil society.
- It is people who use drugs in countries where they face psychiatric wards if counted
- gay men or Trans women in countries where torture or beheading or murder in the street face them if they are counted
- It is sex workers who face weekends of rape in police stations if they are counted
- It is adolescent girls who face expulsions from school and home and sometimes community if they are counted, and who face backstreet abortions because they cannot be counted
- And it is people living with HIV all over the world who face dismissals from employment, rejection by family, stigma, & discrimination if they are counted.
Our bold & imaginary strategy must, above all, ensure that if we are not able to count all of our people, that they still count in the response.
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Agenda Item 4 | 46th PCB Meeting
UBRAF
NGO Delegate representing Asia and The Pacific
Intervention delivered by Aditia Taslim Lim
Thank you Chair. I would like to begin my statement with a personal story. I started using drugs when I was 12. At 14, I started injecting heroin, often picking up used needles. Back then, heroin was easier to find than needles.
At 16, my parents would accompany me to psychiatrists and doctors. If not, I would not have been able to access the services. I was asked to get tested, but I refused. A year later, I was diagnosed with hepatitis-C, and was told to do an HIV test. Again, I refused. Only after I turned 18, I got tested, without my parents’ approval. Since then, I have lived with HIV. I am 35 now.
This story is from 20 years ago, but the reality remains the same today. Young people continue to be denied access to services because of age of consent laws. And many, never return to services.
UBRAF reports 88% of the 33 Fast Track Countries have adopted supportive SRH policies for adolescent and young people. However, age of consent laws to access SRH services are still in place; 52% in Asia Pacific, 53% in East and South Africa, 92% in Eastern Europe and Central Asia, 59% in Latin America, 90% in the Caribbean, 58% in Middle East and North Africa, 61% in West and Central Africa and 57% in Western Europe and North America.
If we are serious in reaching the last mile, this must change.
The COVID-19 pandemic has shown a new reality. The Joint Programme focuses on integrating HIV in national emergency preparedness and response, but none of us were prepared. I applaud UNAIDS for pushing countries to provide 3 to 6 months supply of ARV, but this is not the case in Indonesia. This month, I was given one-week, two-week and another one-week supply of my ARV. This also happened earlier in January and November last year. We are living in fear of going to the clinic, not knowing how much ARV we will get.
A recent WHO study found 12 of 18 countries showing evidence on pre-treatment drug resistance beyond the 10% threshold. UBRAF reports 95% of 88 countries have policies and strategies for ART retention and adherence. But having policies and strategies in place is not enough. With the current state in my country, for instance, I fear more people will have treatment disruption and never return to services.
UBRAF indicators alone, do not tell us the full story. As UNAIDS is embarking on the next strategy, let’s rethink what we are measuring. We need to get the right numbers and data. And behind those numbers and data, there are names and people. We need to bring the stories to the table. We need to ensure transparency and G/MIPA should remain in the core of the process.
Thank you.
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Agenda Item 7 | 46th PCB Meeting
Update on the Implementation of the Management Action Plan
NGO Delegate representing Europe
Intervention delivered by Alexander Pastoors
Thank you Chair, Madame Executive Director,
I am delivering this statement on behalf of the entire NGO Delegation.
The NGO Delegation welcomes the progress being made with the implementation of the Management Action Plan for a healthy, equitable and enabling workplace for all UNAIDS staff. We note with appreciation that in many areas, significant progress has been made since the last meeting of the PCB.
The NGO Delegation however notes that there are a number of issues in which progress seems to stagnate. We reiterate therefore the recommendation in the reports on oversight and audit to push forward the implementation of the MAP especially on the areas where there is less progress, to address, among others, the staff priority issues and concerns identified in staff surveys, with the end view of achieving the vision of a healthy, equitable and enabling workplace for all UNAIDS staff.
We note with particular concern that the staff survey shows three cases of perceived discrimination based on a worker’s actual or assumed HIV status. There is no room for such workplace discrimination anywhere, but especially in the UN’s Joint Programme on HIV.
Furthermore, we request the Secretariat to speed up the recruitment process of the position of the director of the independent ethics office. According to the MAP, the recruitment process is foreseen to be finalised in the second quarter of 2021. Given the importance of the office within the MAP the recruitment shouldn’t be postponed until next year.
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Agenda Item 8 | 46th PCB Meeting
Update on strategic human resources management issues
NGO Delegate representing Europe
Intervention delivered by Dr. Karen Badalyan
I am delivering this statement on behalf of the NGO Delegation.
The PCB NGO Delegation appreciates the Secretariat’s input to move forward with its ambitious agenda across the four pillars of the 2016– 2021 Human Resources Management (HRM) Strategy. We also recognize the immense ongoing efforts of the HRM department to uphold dignity, accountability, and wellbeing in the UNAIDS workplace, and to provide an environment in which staff members feel safe and happy to work, and are supported and empowered to perform to the best of their abilities.
It is important also to acknowledge that women’s empowerment has been mainstreamed with the overall proportion of female staff members in UNAIDS standing at 55% for the past 5 years, and 68% of the internship positions offered to women.
Despite these achievements, we must raise your attention to the gender equality issues within HRM. Gender parity at all levels is an important goal in the UNAIDS 2018–2023 Gender Action Plan. We are extremely disappointed with being informed that the Staff members’ biological sex has been automatically taken as an indicator to identify people’s gender self-identification, as well as the binary approach to the gender with a diversification of Staff members only to men and women. These are so out of date, so retrogressive, so cis-normative. We must, as a global health programme, recognise gender identities and gender expressions in all their diversities and must collect data appropriately. We call upon the Secretariat to include gender diversity in its full spectrum in all future human resource management reports. What we ensure and demand internally, we must work for externally.
I strongly believe that who hasn’t actually walked a mile in transgender, non-binary, intersex, gender queer, gender non-conforming, bigender people’s shoes, hasn’t full understanding of their needs and problems inside out.
We must do better. We must recognise the wonderful diversity in our communities and our constituencies and we must structure our response to work with this diversity, and to protect, and serve all of our constituencies.
Thank you!
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Agenda Item 9 | 46th PCB Meeting
Organizational Oversight Reports: Report of the External Auditor
NGO Delegate representing North America
Intervention delivered by Andrew Spieldenner
I am delivering this on behalf of the entire NGO Delegation. Our written intervention has already been submitted. Based on the interventions made in this PCB Meeting thus far, we would like to expand on one issue.
We applaud UNAIDS for its successful external audit as one way of demonstrating accountability to the Program Coordinating Board and other constituents. We want to address External Audit item 52 more explicitly.
In our current moment, there has been an increase in criminalising key populations, as well as a reduction in resources aimed at supporting people living with HIV, gay men and men who have sex with men, transgender people, people who use drugs, sex workers, migrants and adolescent girls and young women to have meaningful involvement in the HIV responses.
The reporting from UBRAF is inconsistent and relies on self-reporting from various sources. As the NGO Delegation, we see and experience challenges on the ground – including shifting policies in treatment distribution, overlapping and sometimes conflicting government and multinational organisations claiming to respond to the needs of people living with HIV and other marginalised groups, and the legal challenges to many key populations globally.
In 2018, my country passed vast and sweeping laws in order, ostensibly, to stop sex trafficking. These laws made all sex workers more vulnerable to criminal prosecution and law enforcement, driving people engaged in sex work farther from healthcare and other HIV services. In the last two weeks, the federal government has removed a law that explicitly outlines protections for people of trans experience in healthcare settings. We are currently in massive social protests to recognize that Black Lives Matter and addressing disparities in the criminal justice system. These are critical challenges in human-rights and people centered HIV responses.
We encourage UNAIDS to look at including measurable outcomes about structures for every reporting country: gender parity in education, laws that criminalize key populations, laws that explicitly protect key populations, and resourcing the Greater Involvement of People with HIV/AIDS and other key populations. The ways that our voices are encouraged – or silenced – must be – at the bare minimum – acknowledged. As the writer James Baldwin said, “Not everything that is faced can be changed, but nothing can be changed until it is faced.”
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Agenda Item 10 | 46th PCB Meeting
Statement by the representative of the UNAIDS Secretariat Staff Association
NGO Delegate representing North America
Intervention delivered by Wangari Tharao
We all understand the importance of a strong and accountable UNAIDS, particularly in the current context of COVID-19. We recall the recent history of turmoil and crisis of credibility the organization has been through and the fundamental role of staff in all rebuilding efforts. The Statement of the Representative of the UNAIDS Staff Association (USSA) is a good measure of the progress made in the implementation of the Management Action Plan (MAP).
Though the USSA statement shows improvement in a number of areas, we focus on 4 issues that require urgent attention:
1) Issues around COVID-19 and any return to work strategies are highlighted as a major concern for staff. Supporting staff wellbeing is paramount during this trying time. We are gratified that the staff request for accommodation to continue working remotely where necessary, will be considered as indicated by Winnie in her ED report. This is a good safety and cost saving measure.
2) Lack of fairness and transparency which may enable favoritism, continue to be an issue, particularly in areas of recruitment, promotion, and job mobility. These issues have been at the core of staff dissatisfaction for several years. The NGO Delegation is concerned that this continues to persist. We call for expedited implementation of the MAP to eliminate the problem.
3) Increasing workload is identified as a growing problem. This has worsened compared to what was reported in 2019. We were very disheartened yesterday when Winnie indicated that one of the strategies for dealing with budget shortfall is leaving vacancies unfilled. Overwork may lead to stress, low morale, decreased motivation, lower productivity and poor health. We call on UNAIDS to fill vacant positions and explore other ways of eliminating the budget deficit.
4) Issues of discrimination, incivility and gender discrimination and abuse of authority continue to persist. To understand better which staff are impacted by these issues specifically, we call on USSA to disaggregate the data further to highlight how race and gender across the gender spectrum may influence survey responses. UNAIDS can use the generated information to build a more robust staff capacity building and support program.
We are heartened to see discussions of race and racism emerge at this PCB meeting in alignment with what is happening globally. With enriched data, the USSA survey can help inform these discussions.
The NGO Delegation calls for strategic, concerted, and expedited efforts to deal with all identified issues to ensure a fair, healthy, and enabling work environment for staff.