​44th PCB - Intervention by Wangari Tharao - Agenda Item 9 Thematic Segment

Delivered by Wangari Tharao, North America NGO Delegate

There are both challenges and opportunities to integrate the HIV response into UHC. We have fought to ground the HIV response on rights-based approaches, equity, determinants of health, and sexual rights and reproductive health rights and justice. We will not compromise on any of these hard-won gains in the move to UHC.

Yet the systems we are being asked to trust and into which we are being asked to integrate are the very systems that, rather than being accessible to all, do not engage migrants, people who use drugs, sex workers, gay and bisexual men, people of trans experience, people in prison and other closed settings, and young girls. Can we really trust these systems to serve us in UHC?

As a migrant woman living in Canada, I am not a stranger to Universal Health Coverage. It is the system that serves me and other Canadians. But I was not always a Canadian citizen. I was once a woman without status and was not covered. More than 45% of women who access primary healthcare services at my organization in Toronto have no health coverage, yet they are living in the global North, in a country with one of the most comprehensive UHC plans. Having no health coverage and no income to pay for healthcare services is tantamount to a death sentence for a person living with HIV.

There are so many questions for the HIV response. I will mention only a few:
• Does the universality of UHC cover undocumented migrants and in what ways will it do that?
• How will UHC be universal in countries where both people and their health needs are criminalized?
• How will UHC be universal in places where stigma, discriminaition, and even persecution of key populations is the norm?
• What role will key populations play in planning, delivering, and monitoring of UHC?

Putting the last mile first includes answering these questions. As members of the NGO Delegation, we call on member states, Co-Sponsors and UNAIDS to ensure that the progress we have made in the HIV epidemic is not lost in the rush to UHC. UHC must be comprehensive, people-centred, and community-led. If it is not, it will never be universal.

Photo from UNAIDS Communications and Global Advocacy


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