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© NGO Delegation at 50th PCB Meeting

51st
UNAIDS PCB Meeting

The 51st PCB meeting took place from 13 to 16 December in Chiang Mai and was the first in 14 years to happen outside of Geneva. It was hosted by the Government of Thailand in their capacity as the current chair of the PCB. Ahead of the formal meeting, the Thai Government invited the PCB members to participate in a number of field visits to HIV programmes and facilities in and around Chiang Mai.

The meeting itself was in a hybrid format and stretched out over 4 half days. It could only be attended in person by members of the PCB and their delegations. Observer Member States and NGO Observers could only participate virtually through a secured platform. Therefore direct contact between the Delegation and NGO Observers during and after meetings was difficult.

The 51st PCB meeting focused primarily on the need to close major identified gaps in HIV programming, the UNAIDS funding crisis and the need for a fully funded UBRAF if we are to actively advance the cause of ending the AIDS epidemic.

Seven key agenda items were posited and the NGO delegation made interventions for each one in a bid to ensure that the voice for key and marginalised communities was aptly represented.

The chair called on the Member States to arrive at consensus on the way forward and to give their commitments to increased (or continued) funding as needed and to improve the situations of those affected by HIV.

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NGO Report

51 NGO Report UNAIDS NGO Delegation

NGO Report of the 51st PCB Meeting | 22 November 2022

Undetectable = Untransmittable = Universal Access (U=U=U): A foundational, community-led global HIV health equity strategy

The 2022 NGO report focuses on the untapped potential of U=U as a community-led, HIV health equity strategy to improve the health and quality of life of people living with HIV and contribute to the global treatment targets by advancing universal access to antiretroviral therapy, diagnostics and sustained care, while reducing HIV transmission.

PCB Summary Bulletin

51PCB Rainbow Mask

51st PCB Meeting | 11 January 2023

NGO Delegation’s Summary Bulletin

The NGO Delegation’s Summary Bulletin for the 51st UNAIDS PCB Meeting reflects the engagement of the NGO Delegation on all agenda items amongst which: Report by the NGO Representative; Final Report on community-led AIDS responses based on the recommendations of the Multistakeholder Task Team to the UNAIDS 51st PCB and the Thematic Segment.

Agenda items

1.3

Agenda Item 1.3 | 51st PCB Meeting

Report by the Executive Director

NGO Delegate representing Latin America and The Caribbean

Intervention delivered by Jumoke Patrick

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51PCB Jumoke

Thank you Chair

I speak on behalf of the NGO delegation

There is a popular saying that says “who feels it knows it”.

Board members, the who IS us -myself sitting here in front of you, the communities- we on this delegation represent such as PLHIV, sex workers, gay men and other men who have sex with men, transgender persons, women and girls, people who use drugs. Sadly, many don’t see us with these identities and “classification” as people, persons, or as individuals worthy of a dignified life, and equal opportunities, and that continues to be one of the fundamental issues preventing the Joint Programme from achieving the end of AIDS by 2030.

Given UNAIDS’ strategic mandate to equalize the global HIV response, we commend them through the leadership of Winnie for their work and continued efforts in closing the gaps and finding opportunities to save lives. But friends’ leadership is not only for UNAIDS’ but for all of us in this room. The UNAIDS we need cannot do its job if we allow poverty, racism, and inequalities to continue to feed and breed disparities that derail the Global HIV response.

Eight years shy of the 2030 goal of ending AIDS and to be quite honest we won’t achieve this. In Sub-Saharan Africa, adolescent girls and young women are dying. Millions of children are living with HIV and are not on treatment. Gay men and other men who have sex with men are still contracting HIV at a rapid rate. People who inject drugs, sex workers and transgender women have 35 times, 30 times and 14 times the risk of contracting HIV. Colleagues, a People-centred approach and recognizing community leadership are important and if we continue to not recognize PEOPLE in their diversity such as transgender, gay and bisexual men, sex workers, and people who use drugs then what’s the point of this Board? Why are we truly here when we don’t even know and care that this delegation of people lives in your very same countries?

We strongly want to see a renewed political commitment from Member States where communities are not criminalized, women are not being killed, and stigma and discrimination are no more. We need world leaders who will level the playing field and allow ALL countries to access advanced HIV medicine and novel technologies for all PEOPLE so WE can live longer as communities. Communities want to see the issue of Funding of the UNAIDS not reserved only for fixing by the Secretariat. This space we are in is called the United Nations for a reason; it is called the joint programme for a reason, and it is quite clear that the words united, and joint are not action words for this funding crisis we are in or to tackle the real issues at hand. We the people of the communities infected and affected deserve better engagement from the Joint Programme and bold and brave leadership from Member States towards ending inequalities and ending AIDS.

Thank you.

1.4

Agenda Item 1.4 | 51st PCB Meeting

Report by the NGO Representative

NGO Delegate representing North America

Presentation delivered by Christian Hui

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Thank you Chair and esteemed members of the PCB. We thank civil society experts who served on the advisory for the NGO report and submitted case studies.

As a person with an undetectable viral load, it is with great honour to present this year’s NGO Report on Undetectable = Untransmittable = Universal Access (U=U=U): A Foundational Community-led Global HIV Health Equity Strategy.

Today’s presentation focuses on:

  1. Recognizing U=U as a global HIV health equity strategy and policy tool
  2. Leverage U=U as a SMART complement to the current Global AIDS Strategy
  3. Addressing the global inequalities gaps in U=U to the reaching of the global targets

Recognizing U=U as a global HIV health equity strategy and policy tool is immense:

U=U first gained the support of the global community in 2016, The science and benefits of U=U, as evidenced by large RCT trials HPTN052, large-scale longitudinal observational studies PARTNER 1 and 2, and population-specific studies such as the OPPOSITES ATTRACT Studies, has confirmed people living with HIV on effective treatment cannot pass on HIV sexually to others. This science is integrated into technical guidances, including the 2022 WHO Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations.

At the current juncture, the question we are asking is no longer about if U=U works, but how we can achieve U=U for all people living with HIV.

The community was the first to demand the science of U=U be widely shared, representing groups across 105 countries.

All people living with HIV, decision-makers and public health bodies, and the general population, need to know about the benefits of U=U as it is scientifically proven for implementation by countries

This past World AIDS Day, the world rallied to demand for solutions on how we can “Equalize” the dangerous inequalities hindering our collective progress. Thus it is encouraging to see countries recognizing the benefits of U=U in supporting them to advance the health and well-being for all people living with HIV.

The 2021 Political Declaration on HIV/AIDS recognized U=U as an integral component of the combination HIV prevention strategy and its use as an effective anti-HIV stigma intervention amongst people living with and affected by HIV.

Our report provides recommendations the Joint Programme, Member States, and Civil Society can leverage U=U as a foundational health equity strategy and policy instrument to reach the 95-95-95, 10-10-10, and 30-80-60 targets by 2025, and the SDG goal to eliminate HIV as a global public health threat by 2030.

We request everyone present to go beyond taking a business-as-usual approach by applying U=U as a SMART complement to the current Global AIDS Strategy to end inequalities. We must start with common clinical standards on viral load suppression and policy definition of U = U.

Through amplifying the anti-HIV stigma benefits of U=U, we can dismantle systemic and structural HIV stigma and discrimination, including efforts on criminalization reform.

All people living with HIV, especially young women and girls, transgender people, youth, key and priority populations, clinicians, allied health care providers, and the public can all benefit from learning, and leveraging U=U to dismantle inequities.

By linking U=U with Universal Access, we call on all stakeholders present to reconsider how we can reach universal access to affordable, quality life-saving HIV treatment, viral diagnostic and testing and access to differentiated care.

We seek commitment from all to work towards the ending of systemic and structural HIV stigma and discrimination and persecution of people living with HIV which continue to violate the human rights and dignity of people living with HIV.

As we move towards embracing U=U as a global HIV health equity strategy and policy tool, we must also apply community-led innovations we have gained through the global HIV and COVID-19 pandemics.

Incorporating U=U as a foundational community-led global HIV health equity strategy adds immense value to tackling global inequalities. The proposed decision points we have tabled will support Member States and the UNAIDS Joint Programme in fulfilling the global targets.

We thank members of the PCB for supporting our proposed decision points for the NGO Report.

NGO Delegate representing Europe

Intervention delivered by Aleksei Lakhov

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Thank you, Chair.

I speak on behalf of the NGO Delegation.

We heard suggestions to make our report more evidence-based and more clear as to what U equals U really is. Though there is ample data on the benefits of U=U, we do agree that more research would be beneficial as it pertains to the direct relationship of U=U with tackling HIV-related stigma and discrimination. But calling for more research for the sake of it is not enough.

Numerous studies have already been done on the effectiveness of harm reduction programs and dangers of criminalizing sex work, to name a few. However, 153 countries still criminalize some aspect of sex work. 134 countries criminalize HIV exposure, nondisclosure and/or transmission. 115 countries criminalize the use or possession of limited amounts of drugs for personal use. 68 countries criminalize same-sex sexual activity, among others. This shameful list includes countries that are Members of the UNAIDS PCB. Meanwhile, the plight of people in humanitarian settings and Indigenous Peoples has practically not been highlighted at all.

What else should we do in order to be heard, seen and listened to? Wait a minute, we have an idea! What if we start naming ourselves differently? For example: people who DO NOT use drugs? Or non-sex workers? Or SAD men and other men who DO NOT have sex men with men? Or people in OPEN settings?

Sounds weird and meaningless, doesn’t it? No less weird than our need to prove what has already been proven – over and over and over again.

Yesterday, the world celebrated Universal Health Coverage Day. It’s the third U in the name of our report to ensure that Universal access is achievable for all. But we are not even halfway through to achieving this universality. The time to hold ourselves accountable for this failure is NOW.

Thank you.

2

Agenda Item 2 | 51st PCB Meeting

Follow-up to the thematic segment from the 50th PCB meeting

NGO Delegate representing Africa

Intervention delivered by Iwatutu Joyce Adewole

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Thank you for your presentation.

I am speaking on behalf of NGO Africa, where I come from.

I want to remind us of the inequalities we face today, which are structural, systemic, economic and racial.

Education is the most important tool to close the inequality gap, between south and north, genders, adults and youth. Through situational context/analysis and tracking generated around educational participation and learning, we see a high rate of out-of-school girls..

Centering education and empowerment schemes around women and girls will provide adequate and needful life skills and display their fundamental human right (right to education) for full integration into society, enabling core values and principles as well as generating economic pathways and expanding their choices. While the Education Plus Initiative is doing this, we need transformative and sustainable change from this program that seeks to challenge world leaders and decision-makers to model leadership and fulfill their essential duties of ensuring that every child, with emphasis on girls, has access to comprehensive and inclusive education and health information and services.

Additionally, there should also be an increase in education financing and ensured government adherence to commitment around education.

To destigmatize people living with HIV, we need inclusive laws and policies hence putting an end to years of discrimination and exclusion. A paramount thing to do is meaningfully engage young people living with HIV as leaders especially those affected directly by the pandemic. This will ripple into a sense of community, and a feeling of belongingness.

NGO Delegate representing Asia and The Pacific

Intervention delivered by Midnight Poonkasetwatana

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Thank you Chair and thank you Suki and Caroline for the presentation.

As an NGO Delegation from Thailand, I would like to also say Sawasdee krub – a very warm welcome to Chiang Mai and to Thailand. And thank the leadership of Thailand for hosting the 51st PCB Meeting, and for arranging the field visits that shows strong involvement and meaningful engagement with key populations-led interventions.

The NGO Delegation welcome the report of harnessing the power of education to end HIV related stigma and discrimination, empower young people and provide a comprehensive HIV response through education.

We welcome many examples of how CSE have made a positive impact on young people’s empowerment, that CSE was one of best HIV prevention tools, especially when integrated with sexual and reproductive health and rights and psychosocial support.

We stress:

  • The incorporation of granular data disaggregated by age and gender.
  • Develop and scale up implementation of policies and programmes to end HIV- related stigma, discrimination, sexual and gender-based violence in education settings.
  • Increased investment in innovative, sustainable and equitable financing for the education sector and for school and out-of-school programmes is needed to promote an integrated, multisectoral and coordinated HIV response in the education settings.

We note that the power of education and the importance of CSE is also mentioned in the 51st Thematic Segment on HIV and men, in all their diversity: How can we get our responses back on-track?

The report stresses HIV awareness, advocacy and responses by and for young people, including transgender people, and gay men and other men who have sex with men, and education includes peer education programme and social marketing campaigns.

We really need member states to support countries with policy guidance and technical assistance as set out in the Global AIDS Strategy as well as in evidence-based programmes to end HIV-related stigma and discrimination through education and empowering young people.

Kob khun krub. Thank you very much.

4

Agenda Item 4 | 51st PCB Meeting

Final Report on Community-led Aids responses based on the recommendations of the multistakeholder Task Team

NGO Delegate representing Africa

Intervention delivered by Mubanga Chimumbwa

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Thank you, Chair,

Thank you, task force team, for this report which highlights key issues and progress in addressing Community led AIDS Response.

I am speaking on behalf of the NGO Delegation. As a person living with HIV, I rarely see well designed data collection in countries that support community interventions because there is lack of investment in technology for easy reporting and communities require capacity building and funding to evaluate their own work.

There is a lack of mechanisms to assess community-led HIV responses data around the world despite the series of commitments made by Member States.

In 2016 Political Declaration was made on Ending AIDS by 2030 with a pledge of 30% of all service delivery to go towards community-led interventions through investment in human resources for all forms of health in the HIV response e.g equipment tools and medicines.

Member States also committed 6% of HIV resources being allocated for social enabling activities, including human rights laws and policy reforms, to end stigma and discrimination in all it’s closed sittings through community advocacy community monitoring, public communication to support outreach programmes such as rapid HIV tests and diagnosis.

It is very unfortunate that most of the commitments are not being fulfilled despite being pronounced.

Therefore, we are calling on member states, or as we in non diplomatic language call them, “Countries”, to invest more in community led AIDS response through developing data driven tools that will inform and evaluate the interventions by communities. We also call upon Member States “Countries” to support communities in developing standardized tools that will respond to community led AIDs response as per recommendations in order to align with national policies and communities, including cost effectiveness, of community-led HIV responses to national responses.

Lastly, the benchmark is to see a well funded community led AIDs response that drives the agenda of community voices at country level.

5

Agenda Item 5 | 51st PCB Meeting

Update on the Global Partnership to eliminate all forms of HIV-related stigma and discrimination

NGO Delegate representing Africa

Intervention delivered by Mubanga Chimumbwa

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51PCB Mubanga2

Dear Chair

I am speaking on behalf of the NGO delegation as a co-convener of the Global Partnership

People living with HIV and key population still face stigma and discrimination at all levels – in our homes, communities, workplaces, within health services, and at policy level – and these experiences are often internalised, creating mental health challenges, and social isolation.

And this is compounded by marginalisation, ableism, criminalisation and exclusion on the basis of intersecting factors including gender, age, sexual orientation,gender identity, race, sex work, and drug use among others. Stigma, discrimination and violence continue to act as barriers to HIV prevention, treatment, retention in care and quality of life especially among sex workers, people who use drugs, LGBT+ people, and adolescent girls and young women.

In the last 40 years, we’ve said and heard the words stigma and discrimination so many times that they no longer mean anything. But they do. They mean the difference between an effective HIV response and one that falls short of the mark; the difference between love and fear; the difference between life and death.

We need political commitment of donor countries to invest in what we have called for and in what they have committed and started – that is defending human rights and pushing for enabling policies and laws, which enable all to make healthy choices and live full lives.

The Global Partnership is the engine we need to leverage resources, political will, evidence, actors and opportunities that will help us bring about a stigma revolution – translate global and national rhetoric around stigma and discrimination into hard, uncompromising actions, led by and with communities of people living with HIV and key populations.

NGO Delegate representing North America

Intervention delivered by Cecilia Chung

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Dear Chair

The NGO delegation is heartened that through the Global Partnership and in-country offices, progress has been made to counter stigma and discrimination against people living with HIV and key populations. We applaud the Global Partnership’s commitment in working with member countries to strengthen the capacity in community-led interventions in HIV response.

Yet as a transgender woman living with HIV who migrated from Asia to North America and a survivor of violence, I am keenly aware of the humanitarian crises that continue to hinder the efforts by civil society and communities on the ground.

If we skim the recent headlines, we will find the following:

  1. The UN estimated 45,000 women and girls killed by a family member in 2021.
  2. The denial of access to PrEP, contraceptives, SRHR, and comprehensive sex education In the name of Religious Freedom and traditional values.
  3. The UN’s own expert noted the rights of LGBTIQ+ are being ‘deliberately undermined’ in my own backyard. It is 2022 and there are still countries actively persecuting women and girls in all their diversity and key populations, and passing new laws to punish them.
  4. Globally, one in eight people today are migrants, a group which is often overlooked and continues to face discrimination due to xenophobia and racism.

HIV-related stigma and discriminations do not exist in a vacuum, they intersect with many other issues such as gender inequality, racial inequity, homophobia, transphobia, food insecurity and climate crisis. Addressing systemic and structural stigma and discrimination requires all of us to passionately respond with evidence-base programs and through radical law reform so that key populations, including sex workers and people who inject drugs, are not criminalised, The HIV pandemic will not end until everyone can access HIV prevention and treatments safely.

The NGO delegation believes that we must protect all the gains we achieved and increase the investment to design and scale up and implement effective services – and these can happen through a global strategic partnership. After all, how can we put a financial value on human lives and dignities.

6

Agenda Item 6 | 51st PCB Meeting

Report of the PCB Bureau on UNAIDS’ funding situation based on the recommendations of the Informal Multistakeholder Task Team

NGO Delegate representing Europe

Intervention delivered by Aleksei Lakhov

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Thank you, Chair.

I speak on behalf of the NGO Delegation.

We would like to thank members of the Informal Multi Stakeholder Task Team for their work and contributions.

“Core and non-core funds”, “UBRAF” and “resource mobilization” may seem like technical jargon but a fully funded Joint Programme is a prerequisite for the very survival of our communities – such as PLHIV, sex workers, gay men and other men who have sex with men, transgender persons, women and girls, people who use drugs, people in closed settings, as well as other priority populations. That is why PCB Member States will find envelopes on their tables, with the cheques inside for half a million or 1,000,000 US Dollars. We kindly urge you to sign them and make transfers to UNAIDS before the end of 2022, in line with the Task Team recommendations for Member States to step up and show up!

And it’s just one of dozens ongoing humanitarian crises globally. 1,000,000 US Dollars is also less than 5 percent of the DAILY spend on the court that effectively ended the sexual health and reproductive right to an abortion for millions of women. According to the International AIDS Society statement, “the right to abortion is a critical link to HIV services.”

Behind every dollar, euro, yuan, rupee, ruble, pula, franc, peso, rial, yen, shilling, krone, baht, dinar, and pound spent on HIV prevention, treatment and care, there is a story of a life saved. A story of Jumoke, and Xavier, and Gaston, and Mubanga, and Joyce, and Martha, and Midnight, and Charan, and Cecilia, and Christian, and Erika. And my own story.

Every minute during the last year, we have been losing a life due to AIDS-related causes. 650,000 stories have ended too soon. It is up to us to not let it happen again.

51PCBchecques 1

7

Agenda Item 7 | 51st PCB Meeting

Evaluation Annual Report and Management Response

NGO Delegate representing Europe

Intervention delivered by Erika Castellanos

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51PCB Erika C

Thank you Chair.

The NGO delegation welcomes the Annual Evaluation Report and celebrates progress made in the crucial role of evaluations. We note the progress made in the evaluation plan despite the multiple challenges, including and most crucially the financial situation of UNAIDS.

The precarious financial situation has prevented the 1% allocation to evaluations and has limited the human resources to 2 staff with no administrative support. We would like to stress that the financial situation goes beyond the evaluation office and what is required is for Member States to stand up for the challenge not only to have a fully financed evaluation office but a fully resourced UNAIDS.

We invite Member States to consider the importance of evaluations and how evaluation can lead to a measure of impact on countries, on health systems and most importantly in human lives.

We welcome the planned consultative process to develop the subsequent evaluation plan and request that civil society and communities living with and affected by HIV play a central role in the consultations.

The NGO Delegation would like to stress the importance of evaluating the impact of the Joint programme and particularly UNAIDS offices at country level and look forward to results of the evaluation. I invite you to listen to communities on the ground on the impact that UNAIDS has had in policy change, access to treatment, in decriminalization efforts, in giving us a voice where our governments criminalize us and society kills us, and in improving the quality of life of people living with HIV.

To conclude, we ask that you Open your ears and listen, open your hearts to the call of communities but most importantly open your wallets to make the difference.

10

Agenda Item 10 | 51st PCB Meeting

HIV and men, in all their diversity, how can we get our responses back on track?

NGO Delegate representing Latin America and The Caribbean

Intervention delivered by Gastón Devisich

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Thank you, Moderator.

Before getting to our wonderful intervention, I would like to thank the wonderful female speakers, who so kindly have mansplained manhood to us.

We have missed the mark and I wonder what would have happened should it have been the other way around having a predominantly men panelist addressing the needs of women being left behind. This only proves that this is not a matter of just gender or misogyny but one of ownership. Allowing people to speak out for themselves is an issue we need to work on.

The NGO Delegation commends the celebration of this very needed Thematic Segment.

This is an opportunity to shed light to those who have no voice, but not because they can’t speak but because they are not listened to. People who our societies often wish not to see, people who are made responsible for their outcomes, who have it coming for stubbornly “choosing a way of life they could easily avoid”. They resist and for that they’re made to pay. They’re to blame for their failures, while the system takes pride in any of their accomplishments.

This is also an opportunity to learn. But in order to incorporate knowledge, space needs to be made for it. We can’t learn when we are convinced we already know it all. The course of the HIV response won’t be corrected by repeating the same mistakes again and again and expecting a different result. Today, we got to hear how men in all their diversities are stepping up to the challenge and setting the example themselves . They are survivors, but not because of overcoming HIV but for navigating poor health-systems that are actively trying to exclude them on a daily basis.

Nonetheless, getting the HIV response back on track depends on much more than having these experiences highlighted, it requires the commitment of all of us in this room to do better and really be there for those who need it. We need to do what it takes to tackle the societal barriers that are distancing these and all people from accessing the quality of life we deserve.

But now, if you want to program for men being left behind, summon us. Invest in us, perform research with us, prioritize us. Involve us meaningfully in your interventions addressing us across their design, development, implementation, monitoring, evaluation and dissemination.

We need you walking side by side with us. Here, throughout the Joint Programme and in every single country.

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.

 Read more >

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