The NGO Delegation's Communique for the 45th UNAIDS PCB Meeting

The NGO Delegation's Communique for the 44th UNAIDS PCB Meeting is already out. The Communique contains the following sections: Report of the Executive Director; Report by the NGO representative; Annual progress report on HIV prevention 2020; Report on progress on actions to reduce stigma and discrimination in all its forms; Report of the Joint Inspection Unit on the management and administration review of UNAIDS; Lessons learned on the nomination process of UNAIDS Executive Director; Evaluation Plan; Election of officers; Thematic Segment - Reducing the impact of AIDS on children and youth

You may download a PDF version of the Communique (with photos from the PCB Meeting) here.

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CHAPEAU

Alexander Pastoors, Europe Delegate

The 45th meeting of the Programme Coordinating Board (PCB) took place in calmer waters than the previous meetings of the board. The venue was, as usual, the Executive Boardroom of the World Health Organization (WHO) in Geneva, Switzerland and the meeting was held from December 10 -12, 2019. It was the first meeting of the newly appointed third UNAIDS Executive Director in the history of the Joint Programme, and the first woman to hold that position, Ms. Winnie Byanyima from Uganda. The meeting was chaired by Ms. Li Cui from China.

Winnie’s report to the board was generally well-received, including by the NGO Delegation. Yet, as the current UNAIDS Strategy nears its expiration date in 2021, her report initiated a debate among members of the board about a possible next UNAIDS Strategy and the process involved. This discussion was closely linked with the agenda item that reflected on the report of the Joint Inspection Unit (JIU).

Just as in previous years, the first two days of the PCB discussed the report by the NGO Delegation and several other more policy and programme-driven items such as prevention, barriers to funding of community-led responses, and the Global Partnership for action to eliminate all forms of HIV-related stigma and discrimination. The third day of the meeting focused on the Thematic segment to inform the members of the PCB about possible actions to reduce the impact of AIDS on children and youth.


AGENDA 1.3: REPORT OF THE EXECUTIVE DIRECTOR

Jonathan Gunthorp, Africa Delegate

Winnie Byanyima, in her first report to the PCB as Executive Director, made a focused, strong, and rights-based Executive Director’s report with her vision for UNAIDS, and what needs to be done to achieve that vision.

The Delegation welcomed her appointment and responded with the following points:

What we must do to succeed:

  • Recognize that the current strategies and tools for the response are currently insufficient and must be changed, quickly
  • Reorient our health systems to cope with the coming decades of treatment
  • Put people living with HIV, sex workers, LGBTI people, people who use drugs, women, and young people at the centre of our ‘people-centred’ approaches
  • Stare our multiple failures in prevention in the face, invest for success, and turn these around with speed
  • Use the 2030 Agenda as an opportunity to address the political, social, economic, and commercial determinants of health, and the structural barriers that continue to lead to inequalities, violence, stigma, and discrimination.

Who we must be and how we must organise:

  • Take up the new ED’s feminist approach, implement it internally, as well as externally
  • Recruit for a younger Secretariat to serve young people in the response
  • Keep and promote UNAIDS staff who live out a vision of a rights-based response

AGENDA 1.4: REPORT BY THE NGO REPRESENTATIVE

Jules Kim, Asia and the Pacific Delegate

This year, the report from the NGO Delegation was titled, “If It Is To Be Truly Universal: Why Universal Health Coverage Will Not Succeed Without People Living with HIV and Other Key Populations, Women and Young People.” Despite there having been a thematic session on UHC in June and a High Level Meeting on UHC resulting in a Political Declaration, the NGO Delegation felt it was crucial to highlight what people living with HIV, key populations, women, and young people could bring to UHC. The successes of the community-led HIV response in reaching the most marginalised was an important lesson for UHC if it is to be truly effective for all.

The Report was presented by the Asia Pacific NGO Delegate and was grouped into six key contributions that people living with HIV, key populations, women and young people and their organisations and networks, could make to UHC. Examples of the vital contributions were taken from numerous interviews, case studies, literature reviews, and focus group discussions conducted by the Delegation to highlight within the report, providing conclusive evidence as to why UHC cannot succeed without us, communities at its centre.

Many Member States, Cosponsors, and civil society observers spoke strongly in recognition of the critical role of these communities and the need for these to be incorporated into UHC. The Decision Points (DPs) from the NGO Report did go to a drafting room, as consensus could not be reached on the floor. However, agreement was reached fairly swiftly and importantly, the vital aspects of the DPs were agreed upon. These included DPs recalled from previous PCB meetings and recognition of the need to address structural, economic, and social drivers of the AIDS epidemic in advancing broader global health goals. Of special note were new DPs that requested the Joint Programme to continue supporting Member States in creating an enabling environment for people living with HIV and other key populations, women and young people by addressing and overcoming relevant economic, social, structural, and regulatory barriers – including stigma, discrimination and criminalization and a DP that called on the UNAIDS Joint Programme to continue supporting Member States in ensuring all the elements of comprehensive HIV programming, as set out in the UNAIDS Strategy (2016-2021), remain or become available and accessible to people living with HIV and other key populations, women and young people under UHC frameworks and policies.


AGENDA 3: ANNUAL PROGRESS REPORT ON HIV PREVENTION 2020

Aditia Taslim Lim, Asia and the Pacific Delegate

The NGO Delegation was extremely concerned with this agenda item, as it seemed to be a repeat of the discussions at the 40th PCB Thematic Segment on HIV Prevention 2020 in June 2017, and its follow-up discussion at the 41st PCB meeting in December 2017. The data from the report shows significant reduction in HIV prevention since 2010, but if examined closely, the annual trend is still very similar, and in some countries, new infections have increased. Some examples that we can pull out from the data is South Africa which had 39% decrease since 2010, but with only 10-11% decrease every year since 2015. Indonesia was reported to have 29% decrease since 2010, but with only less than 10% decrease every year since 2015. Uganda had a 36% decrease since 2010, but only had a 4% decrease in 2017 and an increase of 6% in 2018.

The Global HIV Prevention Coalition was formed in 2017 to accelerate prevention efforts and to galvanize political commitment among its member countries. Despite all the progress made towards its roadmap implementation, countries are still not doing enough to reduce infections. In some instances, they have even regressed. Member States argue that it requires time for the Coalition to make an impact. However, the NGO Delegation reminded the PCB that communities of key and most affected populations do not have the luxury of time. We need to ensure that the promised 25% investment for prevention is fulfilled, condoms for both male and female must be made available and accessible, harm reduction services must be funded, PrEP must be scaled up, and vertical transmission must be eliminated, now!

This is business as usual wrapped in a different ambition. UNAIDS and Member States need to stop pretending that they are doing something different, when they are caught doing exactly the same thing.


AGENDA 6: REPORT ON PROGRESS ON ACTIONS TO REDUCE STIGMA AND DISCRIMINATION IN ALL ITS FORMS

Alessandra Nilo, Latin America and the Caribbean Delegate

We welcomed the results of the report, “Update on actions to reduce stigma and discrimination in all its forms.” This agenda item was a special moment for us, since the Global Partnership resulted from an idea proposed by the PCB NGO Delegation at the 41st PCB meeting in December 2017.

We thanked the support from all co-conveners -- UNWomen, UNAIDS, GNP+, and UNDP -- but we expressed deep concerns about the challenges before us. Fighting stigma and discrimination is clearly an urgent necessity in all countries, including those with structured AIDS responses in place. As example, we mentioned the recent results of the Stigma Index in Brazil, of which 64% of respondents suffered HIV-related stigma and/or discrimination.

This Partnership is a timely opportunity, but global political declarations or commitments will continue to be inefficient if followed by almost zero budgets, including for responses or approaches that address human-rights issues in the AIDS responses.

It is regretable that our communities are losing faith in public policies, but we expressed hope that this Partnership won't be one of many initiatives that UNAIDS begins without concluding. We demand that it should be given all the human and financial support required in order to support Member States to address structural barriers that keep stigma and discrimination among the most perverse symptoms of AIDS.


AGENDA 7: REPORT OF THE JOINT INSPECTION UNIT ON THE MANAGEMENT AND ADMINISTRATION REVIEW OF UNAIDS

Alexander Pastoors, Europe Delegate

The Joint Inspection Unit (JIU) is the only independent external oversight body of the United Nations system mandated to conduct evaluations, inspections and investigations system-wide. In its reportthe JIU reviewed the management and administration of the Joint Programme, specifically the UNAIDS secretariat and its relation with the Cosponsors, as well as the role of the PCB regarding oversight and accountability. The inspection and evaluation started in 2018 and were temporarily halted during the time that the Independent Expert Panel (IEP) did its investigation regarding prevention of and response to harassment, including sexual harassment, bullying and abuse of power at UNAIDS Secretariat.

The extensive evaluation and inspection by the JIU culminated in a number of formal and informal recommendations to the UNAIDS secretariat, the PCB and to the Cosponsors. The progress on the eight formal recommendations will be monitored by the JIU, but the twenty-five informal recommendations will not be monitored. It came as no surprise that the discussions among the Member States with regards to the JIU report were largely focused on the recommendation to strengthen oversight and accountability by the PCB of the Secretariat and specifically, human resource management, much like the discussions at the 43rd and 44th PCB meetings. As this is the fourth JIU report in a row pointing out the structural lack of oversight by the PCB, this necessitated being addressed by the PCB and could no longer be brushed aside. The issue at stake here is to find a balance between keeping the structure of the Joint Programme agile and flexible while strengthening oversight by the PCB, in order to ensure that donor countries keep faith in the organisation.

That was also the position the NGO Delegation brought forward in the negotiations that took place in the drafting room. The PCB resolved to create a time-limited working group that will develop recommendations (options) to the PCB on how to establish better oversight. The NGO Delegation will be represented in this working group, which will report back at the 47th PCB meeting in December 2020. Meanwhile, a stand-alone agenda item for Secretariat to inform the PCB on internal and external audits, ethics, and other topics on accountability, will be included in future meetings.


AGENDA 8: LESSONS LEARNED ON THE NOMINATION PROCESS OF UNAIDS EXECUTIVE DIRECTOR

Alessandra Nilo, Latin America and the Caribbean Delegate

In 2019, the NGO Delegation engaged in the process of finding a new Executive Director for UNAIDS through its membership in the Search Committee. The report that was presented in this Agenda item was a synthesis of the work done and lessons learned by the Search Committee, which included two of our NGO delegates, Alessandra Nilo (LAC) and Jonathan Gunthorp (Africa), whom we thank for their dedication.

One of the existing rules of the ED selection is that the PCB does not have a say in the final recommendation or decision. The candidates who are shortlisted by the Search Committee are considered at some extent by the PCB, but it is the Cosponsors who will give the final recommendation to the UN Secretary General, who then appoints the Executive Director. At the 45th PCB meeting, the possibility of changing this rule was raised. However, the idea had little support from other Member States and after some consideration, the process remained the same. The NGO Delegation is thankful to the entire Search Committee and its chair, the Republic of Belarus, for seeing this selection process through.


AGENDA 9: EVALUATION PLAN

Andrew Spieldenner, North America Delegate

The Evaluation Unit at UNAIDS emerged out of the need to assess how well the Joint Programme is working where, and to assess what other kinds of data are needed. UNAIDS has had inconsistent evaluation activities over its lifetime, and this was the first reportsince the Evaluation Unit was approved at the 44th PCB meeting in June 2019. Evaluation is a staple of many public health and HIV programs, but large international or intergovernmental organizations are often not under the same pressure to produce data to funders as our NGOs.

Some Member States questioned the Evaluation Unit in terms of their budget and how they do their work. While oversight is expected and required, it seems short-sighted to constantly question the processes until findings are presented. The NGO Delegation interventions on this item looked at the importance of effective evaluation for key populations, as well as support for evaluating the impact of the Joint Programme on Gender-Based Violence.

Preliminary findings showed some strengths and some gaps in the Joint Programme. The strengths include UNAIDS impact regionally in terms of policies and guiding HIV responses, as well as the importance of direct funding. Some gaps include coordination across Cosponsors and the impact of policies in-country. This kind of data can help UNAIDS reflect on how it does its work, correct where the work can be improved, and enhance and sustain the work that is going well.


AGENDA 11: ELECTION OF OFFICERS

Aditia Taslim Lim, Asia and the Pacific Delegate

At this PCB meeting, several changes to the composition of the Board were announced. This include the composition of the 22 Member States, the chair of the Committee of Cosponsoring Organizations (CCO), the NGO Delegation, and the PCB Bureau.

Member States Composition Changes:

Outgoing

Incoming

Algeria

Tunisia

Madagascar

Kenya

Indonesia

Thailand

Mexico

El Savador

Finland

Denmark

Australia

Canada

Belgium

Luxembourg

Sweden

Switzerland

Full composition of Member States

The 2020 Chair of CCO: United Nations Development Programmes (UNDP)

NGO Delegation: Latin America and the Carribean: Bolivian Network of People Living with HIV/AIDS, represented by Gracia Violeta Ross Quiroga and the Jamaican Network of Seropositives represented by Jumoke Patrick; Europe: Eurasian Key Populations Health Network represented by Caren Badalyan.

PCB Bureau (2020): United States of America (Chair), Namibia (Vice Chair), India (Rapporteur), UNDP (CCO Chair) and NGO Delegation (Andrew Spieldenner, main representative; Jonathan Gunthorp, alternate representative).


AGENDA 12: THEMATIC SEGMENT – REDUCING THE IMPACT OF AIDS ON CHILDREN AND YOUTH

Lucy Wanjiku Njenga, Africa Delegate

The 45th PCB Thematic Segment on Reducing the Impact of AIDS on Children and Youth was deemed successful, as it brought together different voices from various fields that needed to be heard. The most notable and applauded sessions were the Keynote speech and the presentations and speeches of all the young people in the three panel sessions. They brought out the lived experiences and realities that needed to be heard by Member States, the Cosponsors and UNAIDS, as the review of prevention, treatment, and care given to children and youth takes shape in the 2020 and 2030 targets. We know the world is failing on the ambitious HIV targets for them.

From the discussions that happened in the room, the next steps that needed to take place were clear. To list a few:

  • Ensuring and sustaining the meaningful involvement of adolescent and youth in HIV Programming from design, implementation to monitoring and evaluation
  • The need to scale up children-friendly antiretroviral medication and Point of Care – Early Infant Diagnosis.
  • Sustaining what has worked, like the DREAMS programme for prevention of new infections for girls and young women and engaging the whole circle of social influencers in their lives, as well as EGPAF, with mentor mothers.


REFLECTIONS FROM INCOMING DELEGATES

This was my first PCB meeting as the incoming Europe NGO Delegate, representing the Eurasian Key Populations Health Network. I am happy to be a part of a team of delegates from five regions, with outcomes-focused and equity-guided principles committed to improve pathways and policies that support UNAIDS and countries in the HIV/AIDS response.

It was very important and helpful for me to participate in the pre-PCB orientation meeting focused on addressing and understanding diversity between current, outgoing and incoming delegates and improving processes critical to delegates’ success, including retention and transition to a new role in the PCB NGO Delegation. I found my involvement process very effective since it began with a strong collaboration between Delegates and a supportive UNAIDS Secretariat. My fellow Delegates openly reflected on what they have learned and shared insights with new Delegates, passing on to us the knowledge they have acquired being PCB delegates. We should keep the tradition of organizing orientation meetings for future newcomers.

It was also very important to recognize our diversity within the group and map-out key roles and missions for each individual Delegate and for the full Delegation. My commitment is to bring the gender approach to the HIV/AIDS context and gender mainstreaming of UNAIDS work, as well as to use evidence-based data, research, and evaluation methods to improve policies, programs, and practices to enhance community participation and involvement in UNAIDS work at the national, regional and international levels.

- Caren Badalyan, Eurasian Key Populations Health Network, incoming Europe Delegate


Being present in the UNAIDS PCB after many years, I think the UNAIDS PCB looks much more organized and fit for its purpose. The NGO Delegation deserves my acknowledgement. When I was in the Delegation before (2007-2009), the Communication and Consultation Facility (CCF), the technical support provider for the NGO Delegation, did not yet exist. My colleagues and I presented and advocated for the CCF and I am very glad it got approval. I see the results of investing in communities and civil society.

For me, the best part of the 45th PCB Meeting was the Thematic Segment about the impact of AIDS in children and youth. The decrease of vertical transmission of HIV affected the functionality of the HIV pediatric market. For good reasons, we have less children born with HIV, but a small market looks less attractive for the pharmaceutical industry. The NGO Delegation in the PCB made sure this reality gets the recognition it deserves. Wake up, our children are dying! This is what we said.

I was impressed with the new Executive Director of UNAIDS, Winnie Byanyima, after the rocky period that UNAIDS just went through. I am confident that Winnie will take us through the next phase.

- Gracia Violeta Ross Quiroga, Bolivian Network of People Living with HIV/AIDS, incoming Latin America and the Caribbean Delegate


A Caribbean boy representing one of two Latin America and Caribbean Delegates at the UNAIDS PCB means a lot to him and those he has been representing, including communities affected by HIV in his work with civil society.

Attending my first PCB was an experience that allowed me to understand the UN system as it relates to governance and strategic decision-making regarding HIV/AIDs globally, and how systems of government and procedures are used to ensure that political will is in alignment with what is needed, e.g., human rights and protection of communities around the world.

I particularly took a keen interest in the thematic segment of the PCB meeting which focused on adolescents and young people, as this allowed for direct conversation and interaction with technocrats and community representatives who are on the ground working and advocating globally. This represented for me the core of what the response should look like and how it should continue as we push towards the fast track targets.

- Jumoke Patrick, The Jamaican Network of Seropositives, incoming Latin America and the Caribbean Delegate


THE NGO DELEGATION’S COMMUNIQUE FOR THE 44th UNAIDS PCB MEETING

The NGO Delegation's Communique for the 44th UNAIDS PCB Meeting is already out. The Communique contains the following sections: Report of the Executive Director; Report of the Chair of the Committee of Cosponsoring Organisations; Report of the PCB working group to strengthen monitoring and evaluation role on zero tolerance against harassment, including sexual harassment, bullying and abuse of power at the UNAIDS secretariat; Update on strategic human resources issues; Unified Budget, Results, and Accountability Framework (UBRAF); Nomination of the next Executive Director of UNAIDS; Thematic Segment.

You may download a PDF version of the Communique (with photos from the PCB Meeting) here.

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CHAPEAU

Jules Kim, Asia and the Pacific Delegate

With the shadow of the challenging 43rd Programme Coordinating Board (PCB) meeting in December 2018 fresh in our minds, there were significant concerns about what we could expect at the 44th PCB, which took place on June 25-27, 2019, in Geneva, Switzerland. Chaired by Mr. Xia Gang,Deputy Director-General of the National Health Commission of China,the 44th PCB was held at Starling Hotel and not at our usual venue, the WHO Executive Boardroom. A heatwave across western Europe meant we were anticipating scorchingly hot temperatures for the whole PCB week - an apt backdrop for the heated discussions expected throughout the PCB.

The June PCB has traditionally been the ‘housekeeping’ meeting for the administrative and governance aspects of the Joint Programme. But this was also the PCB where the selection of the new Executive Director would be discussed, as well as the Management Action Plan and Report of the Working Group of the Programme Coordinating Board (PCB) to strengthen the PCB’s monitoring and evaluation role on zero tolerance against harassment, including sexual harassment, bullying and abuse of power at the UNAIDS Secretariat.

The agenda for the first two days was planned to run from 9 am to 9 pm with a third full day for the Thematic Segment on Delivering on SDG3: Strengthening and Integrating Comprehensive HIV Responses into Sustainable Health Systems for Universal Health Coverage.

Surprisingly, each day ended ahead of schedule, a likely result of China’s chairing, which included traffic lights to remind PCB members and observers when to wrap up and end their interventions. A clear set of decision points were agreed upon on the floor of the PCB often ahead of the time allotted in the agenda.

The NGO Delegation held numerous side meetings with civil society, cosponsors and member states to discuss issues of concern, hear and raise important perspectives and manage potential areas of conflict. Importantly, the regional and global civil society calls prior to the PCB and debrief sessions with CS observers throughout provided an important opportunity for us to maintain a community-centered perspective to the key issues being presented.

There was vocalisation of support for collective action to end AIDS as a public health threat by 2030 by all present at the meeting. There was firm support for the importance of maintaining a strong and independent UNAIDS. And there was a clear sense that delays could not be afforded and that we needed to move forward in the ‘housekeeping business’ to enable progress to meet these goals.


AGENDA 1.3: REPORT OF THE EXECUTIVE DIRECTOR

Aditia Taslim, Asia and the Pacific Delegate

UNAIDS is currently at an important chapter in its existence, with the upcoming selection of a new Executive Director, the development of a new five-year strategy, and setting of new targets for 2025 and beyond. As the previous ED, Michel Sidibe, has left the organization, Gunilla Carlsson has taken the role of Executive Director, ad interim. Her role is to not only ensure a smooth transition, but also to facilitate a stronger UNAIDS through its Management Action Plan implementation and to regain the trust and confidence from the communities, partners, and Member States, particularly donor countries.

Gunilla’s report delivered the message that AIDS is not yet over. Despite the achievements globally, progress remains uneven. Many countries are still lagging behind in reaching the 2020 targets. Low treatment coverage, rising new HIV infections, crisis in HIV prevention, stigma and discrimination continue becoming regular themes that are discussed at every meeting. It is clear that we are not doing enough and there is no room for complacency.

She further noted that in the era of shrinking space of civil society, the communities of people living with HIV and key populations continue to be attacked globally and at the country level. UNAIDS must continue to be the model through its Joint Programme, in putting people most affected at the center of the response, and remain relevant in transforming the HIV response, gaining the political support, and supporting community-led responses.


AGENDA 1.4: REPORT OF THE CHAIR OF THE COMMITTEE OF COSPONSORING ORGANIZATIONS

Lucy Wanjiku Njenga, Africa Delegate

The 44thPCB was a meeting that I was happy to be part of. Compared to my initiation meeting in December 2018, I found this to be a more progressive atmosphere as we look forward to changing and achieving the UNAIDS we need. What would be great to see is greater and meaningful involvement of People Living with HIV in the work of the Cosponsors especially in countries to keep the important community organisation work going and to see fruits from the collaborations. Community organisations in the response, especially young women-led, are important partners that cannot be overlooked, yet, many are still struggling to survive. With UNFPA as the Chair of the Committee of Cosponsoring Organizations (CCO) in the PCB for 2019, the ICPD 25 is also a pivotal arena for engagement. Taking place in November 2019 in Nairobi, Kenya, ICPD25 must take the voices of the community, especially young people, into consideration, and ensure that the next commitments made, and concrete actions taken, are with them, for them, and by them, and that accountability measures are in place.

What also struck me was when UNFPA Executive Director Ms. Natalia Kanem asked for a meeting with the NGO Delegation, to get our perspectives as representatives of civil society and communities. As the CCO is in process to recommend a candidate or candidates to the UN Secretary General for the UNAIDS Executive Director from among the five candidates identified, this was a reminder that our voices matter and why UNAIDS as a UN Joint Programme exists.


AGENDA 3: REPORT OF THE PCB WORKING GROUP TO STRENGTHEN MONITORING AND EVALUATION ROLE ON ZERO TOLERANCE AGAINST HARASSMENT, INCLUDING SEXUAL HARASSMENT, BULLYING AND ABUSE OF POWER AT THE UNAIDS SECRETARIAT

Alexander Pastoors, Europe Delegate

After the presentation of the Independent Expert Panel (IEP) report at the 43rd PCB meeting in December 2018, it was clear that both the working environment at the Secretariat in Geneva and the various regional and country offices of UNAIDS, as well as the public image and reputation of UNAIDS, were negatively impacted by the lack of appropriate senior management action to protect its staff from (sexual) harassment, bullying, and abuse of power. A working group was established to advise the PCB on how to strengthen its monitoring and evaluation role on all of the above-mentioned forms of misconduct at the Secretariat.

The working group, which included two representatives from the NGO Delegation, was very positive in its opinion about the revised management action plan (MAP) that the Secretariat made in order to eliminate all of these forms of misconduct. The PCB adopted the report and its recommendations to implement the MAP fully. Subsequently, the PCB decided to establish an independent evaluation office that reports directly to the PCB.

It could not, however, reach consensus on a number of issues that related directly to the oversight role of the PCB on human resources (HR) related issues. Although this agenda item seemed very internally focused for many civil society observers and very distant to the actual work of UNAIDS, at the core of this discussion lay very fundamental discussions among member states on how UNAIDS should function as a Joint Programme.

On the one hand, you have a number of member states who believe that better oversight by the PCB of human resources and the full implementation of the MAP is needed to avoid any of the recent crises from reoccurring. On the other hand, a number of member states believe that a new ED and fresh focus by the PCB will be sufficient. Member states also differed as to whether changing the PCB’s oversight role in human resources requires going back to ECOSOC for a new resolution on UNAIDS.

The NGO Delegation has a strong position that going back to ECOSOC in this current global climate, where not only UNAIDS, but the United Nations as a whole is under threat, will weaken the Joint Programme and potentially lead to the loss of community and civil society space on the PCB. We believe that current governance mechanisms under the ECOSOC resolution are sufficient for the future, and that a middle way is possible where a better focus by PCB members and better HR reporting by the Secretariat can ensure the workplace staff’s need to thrive and deliver.


AGENDA 4: UPDATE ON STRATEGIC HUMAN RESOURCES MANAGEMENT ISSUES

Millie Milton, Latin America and the Caribbean Delegate

A fit-for-all work-force is the ideal workplace that UNAIDS Secretariat is aiming to achieve. Human resource management involves both strategic and comprehensive approaches to managing people, as well as workplace culture and environment.The 25% reduction of staff not only negatively impacted on the smooth operation of the Secretariat, but also on the delivery of its programmes.

The NGO Delegation noted issues in the report such as the time for filling vacancies was too long and that the annual mobility exercise needed to be more specific in the reason or criteria used to promote staff. We also noted that there is no gender balance in staff employment, for instance, there was no mention of a transgender person being employed.

In terms of training, it is important for training needs to be identified and training in leadership to be increased. Face-to-face trainings are more impactful and should be explored more.


AGENDA 7: UNIFIED BUDGET, RESULTS AND ACCOUNTABILITY FRAMEWORK (UBRAF)

Andrew Spieldenner, North America Delegate

The Unified Budget, Results and Accountability Framework (UBRAF) is a cornerstone to the June PCB meeting, as it involves the performance and financial reporting for UNAIDS and the UN Cosponsors. The UBRAF reports were organized around three agenda items: performance, finances and budgeting. In each area, some member states were selected to highlight. The UBRAF was accepted with particular note of coordinating country-level work across UN agencies, encouraging donor governments to make multi-year contributions and to fulfill their 2018-19 commitments, and to look ahead to the next budgeting process.

The NGO Delegation delivered three interventions on UBRAF: 1) insisting that UNAIDS be more transparent with where the money is for civil society; 2) pay closer attention to the disparities between policy acceptance and policy implementation in policy indicators; and, 3) encourage country-level programs to focus on harm reduction and human rights approaches.

Across these interventions, we noted that country envelopes were not developed with meaningful input from key population networks, as well as advocates for women and girls. We cautioned UNAIDS to take into account political landscapes in country envelopes and country transition plans, as those of us who are marginalized and criminalized are most likely to be overlooked. Furthermore, it is also equally important for the communities to reach out to their respective UNAIDS country office and demand the space in decision-making process. A detailed-list of countries receiving country envelope allocation can be found here (p.7-8).


AGENDA 8: NOMINATION OF THE NEXT EXECUTIVE DIRECTOR OF UNAIDS

Jonathan Gunthorp, Africa Delegate

At a critical time in the HIV response, when the future of the Joint Programme is being debated in global health architecture, who leads UNAIDS is crucial to the success of the global AIDS response.

For the last few months, a process has been underway to select the next UNAIDS Executive Director. Following the precedent of the last ED selection in 2008, a Search Committee was constituted by the PCB made up of five member states, four co-sponsors, and the two NGO Delegation members who sit in the PCB Bureau. A world-wide search was held focusing on all regions and involving both applications, as well as head-hunting. Because of the confidentiality of a high-profile recruitment such as this, the whole Search Committee had to sign non-disclosure agreements. That meant the two NGO delegates had to operate in an unusual way for civil society; without any ability to consult or report back, even within the NGO Delegation. Nevertheless, they took the values and principles of civil society into PCB discussions that ended with the search criteria and the search process, itself.

After a rigorous process involving short-listing, interviews by the Committee, and discussion at the PCB, the Committee recommended five candidates to the Co-sponsors in the last week of June. Co-sponsors will interview all five candidates in July and recommend one or more names to the UN Secretary General who will then appoint a new ED.

As mentioned during the PCB Special Session in March 2019, the NGO Delegation re-emphasized the value of having someone from the global South to lead such an important movement, given that this is where majority of people living with and affected by HIV come from. We look forward to working with a new ED who will strengthen UNAIDS and steer the global response with and for key populations and all those affected by HIV.


AGENDA 9: THEMATIC SEGMENT

Wangari Tharao, North America Delegate

Held on June 27th, 2019, the 44thThematic Segment aimed to examine ways in which the HIV response could leverage the potential benefits of UHC, while avoiding any potential pitfalls and optimizing on the successes and lessons learnt through the HIV and AIDS response. Keynote speeches were delivered by Rico Gustav, Executive Director of GNP+ and Ambassador Cleopa Mailu of Kenya. They provided insights on opportunities and challenges that have to be navigated and possible ways forward to ensure UHC incorporates relevant SDGs and comprehensive approaches to HIV. This was followed by three panels focusing on: HIV focused programmes which have evolved into integrated platforms for comprehensive health services; achievements and challenges in providing comprehensive, inclusive and non-discriminatory services, including HIV services integrated within broader health services including those targeted to key populations; and financing mechanisms and governance issues in the move to UHC.

In the discussion, it became clear that there was an uneven inclusion of HIV key populations and holistic HIV wraparound services. In terms of key populations, the meaningful inclusion of sex workers, people who use drugs, trans communities, gay and bisexual men and other men who have sex with men, and people living with HIV has been a key part and unique to the HIV response, including shaping policies. Beyond HIV treatment, HIV services have included HIV prevention, sexual and reproductive health and rights, harm reduction, mental health and legal advocacy. The NGO Delegation is concerned with UHC moving forward without including both key populations and holistic HIV wraparound services.

Throughout the day, tough questions were raised ranging from: How universal will UHC be? What will be the essential packages, how and who will design them? How will social enablers be integrated? What about sexual and reproductive health and rights? How accessible will these services be for key populations? What mechanisms will be instituted to ensure the right to access for all? What mechanisms will be used to ensure civil society and key populations are part of the UHC governance? Specific proposals and solutions were discussed and interventions from the floor highlighted gaps and other solutions that needed to be considered.

The NGO Delegation, along with civil society speakers and Thematic Civil Society Advisory Group (CSAG) developed the following key messages:

  • Attention is focused on putting "the last mile first" to facilitate inclusion of all key populations, particularly those that are criminalized and supporting translation of “leaving no one behind” into reality.
  • Proposed actions protect the gains already made in the HIV response through support of comprehensive, people-centered and expanded health systems that are inclusive of community-led responses with allocated financial resources to support them.
  • Any actions on UHC utilizes a rights-based approached, is grounded in equity, determinants of health and sexual and reproductive health and rights, particularly in relation to key populations.
  • Affected communities play a vital leadership role in the move to UHC, with opportunities to shape plans, packages and fiscal mechanisms leading to and in the rollout of UHC.

The NGO Delegation plans to continue pushing these messages to influence any discussions prior and during the High Level Meeting (HLM) on UHC to be held in New York in September 2019. Mindful that negotiations on the draft Declaration is in progress, we have also adopted the UHC Statement by Civil Society released in April 2019 as part of the preparatory advocacy activities for the HLM.

A report of the Thematic will be tabled at the December PCB meeting and Decision Points (DPs) will be negotiated and adapted.


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