Delivered by Valeriia Rachynska, Europe NGO Delegate
The 30 years of the epidemic showed that meaningful involvement of PLHIV including women, girls and adolescents and key populations - such as sex workers, people who use drugs, men who have sex with men, people in closed settings, people of trans experience - at all stages of planning, implementation and evaluating programs increases the effectiveness of the national and global responses to HIV and other health challenges.
But let us remember that key populations in many countries are still criminalized and the lack of human rights-based and structural barriers continue to keep people away from health services. 68 countries still criminalize men who have sex with men. In many countries, abortion is considered a crime. Sex workers are subject to criminalisation and legal oppression in almost every country in the world. In these cases, the slogan “leave no one behind” will remain a rhetoric.
We can develop adequate service packages for all key populations, but we need to ensure that key populations are not left behind due the threats of imprisonment, stigma, and discrimination. Decriminalization of key groups, removal of punitive laws, access to sexual reproductive health and rights, including safe abortion, addressing structural barriers to health access, harmonization of national legislation according to the recommendations of WHO and respect for human rights must be the basis of UHC.
The other point is financing. Countries are facing barriers to transition to national funding and “middle-income” definitions hide inequalities within the countries. The UHC system assumes it can reach everyone. Think about people who use drugs and indigenous people. Countries do not keep good data on these groups, and healthcare systems often exclude them.
We urge governments to put the most vulnerable and marginalized communities in the first place. And social protection for all must be also considered in this conversation. It is with equal access for these groups that the new system must differ from the existing one. This requires changes in the policy and financing system, when socially vulnerable communities will not be faced with a choice: to pay for medical services or for food and shelter. But the question remains: how will advocacy, community mobilization, capacity development, human-rights related projects be funded?
Ensuring universal health coverage as a global goal is a good goal. But to achieve it requires the development of sustainable international exchange and cooperation, international and national initiatives that, together, will help to foster joint investments and improve collaboration. And in all of that, community-led organizations and community-led responses must be at the center of any new approach. Thank you.
Photo from UNAIDS Communications and Global Advocacy
Tags: 44th PCB Meeting