Thank you Madame Chair and thank you to the Secretariat for this report.
The findings of the report presented by the Secretariat raise serious concerns regarding the capacity of middle-income countries in sustaining their successful treatment programmes.
As we have been learning from several discussions within the Global Fund and elsewhere, the World Bank classification of middle-income countries overshadows the huge economic and social inequalities in those contexts, as well as fiscal burdens on countries such as debt repayments. As CSOs have long alerted, the geopolitical context is undermining our successes on HIV.
For example, in countries like mine, Brazil, but also in many other middle-income countries, political and financial instability are leaving many people behind, especially those who are more vulnerable in the context of the HIV epidemic. Let me alert all of you that the newly elected Brazilian president publicly affirmed his view on HIV / AIDS when he was a parliamentarian, and I quote, “no government money should be used to treat those who contracted diseases in sexual acts”, and also classified the LGBTI population as a risk group. So, right now, I do not know what to expect from my own country, which has always made me proud for its response to HIV.
Therefore, yes, it is a fact that regarding the sustainability of the treatment programmes, the lack of political will is ignoring the needs of people living with HIV and most at risk. But, still more concerning is to face the fact that even when there is political will, the lack of policy options to manage intellectual property rights using a public health lens, has a huge impact on the capability of those countries to access more affordable health technologies, including assured quality generic products, to prevent and treat HIV infection, as discussed in the report we have before us.
The examples of dolutegravir and PrEP are eloquent in showing that in many contexts, high prices and lack of access to less expensive generic formulations are impeding people to have access to the WHO recommended treatment options.
Also, there is a tremendous need to increase the availability of pediatric formulations of HIV treatment regimens, as children are being left behind for not being considered “an attractive market” for both originator and generic companies.
The adoption of the 2030 Agenda and the SDGs was an important opportunity to commit to targets aiming at reducing inequalities in different areas of development, including health. The SDG 3 reaffirmed the commitment of the global community in ensuring healthier lives for all, not only for specific segments of the population, usually in the high-income countries.
In many occasions in the past, UNAIDS has convened people around these objectives, and its 2016-2021 strategy reflects very well this new global commitment. However, it is imperative that those commitments are translated into concrete actions to support countries in overcoming barriers to access to medicines and other health technologies.
In this era where forms of national populism are sweeping the globe as an epidemic, and where attacks on multilateralism are escalating, it is more urgent than ever to foster policy coherence across the Joint Programme, and to ensure stronger coordination to bring the needs of the HIV community into different fora, and deal with access to medicines.
The PCB NGO delegation stresses that it is imperative to restore the capacity of the UNAIDS Secretariat to provide the Joint Programme with consistent technical support & accountability on access to medicines issues, by fulfilling its coordinating and advocacy roles.
The decision points arising from this discussion must enable UNAIDS to find the best ways forward to really keep the access to quality and affordable treatment, diagnostics and other health technologies for all at the centre of the AIDS response.
Delivered by Alessandra Nilo, Latin America and Caribbean
Tags: 43rd PCB Meeting