46th UNAIDS Programme Coordinating Board
I would like to begin my statement with a personal story. A story that may be too familiar for some, but for others, it remains unheard. I started using drugs when I was very young, at the age of 12. And soon later, I found myself on the street trying to get to my next shot. It didn’t take me long to get lost, the street is a very dark place with very little grip to hold on to. At the age of 14, I found myself injecting heroin, and often too, I had to pick up needles that had been used by others. At that time, heroin was easier to find than needles.
At the age of 16, I was seeing different psychiatrists and doctors to help me get off of drugs. At the same time, I was also asked to get tested, but I didn’t do it. I was, at that time, accompanied by my parents, otherwise I would not have been able to access the services. At the age of 17, I was diagnosed with Hepatitis C, and the doctor encouraged my parents to run an HIV test. I didn’t do it. Only after my 18th birthday, I managed to see a doctor and to finally get tested, without having to ask for my parents’ approval. And since then, I have lived with HIV. I am 35 now.
This is a story from 20 years ago, but the reality is still very much the same today. Young people around the world are denied access to an HIV test, ARV treatment and SRHR services because of age-consent laws that are in place. I was fortunate enough to return to get tested when I reached the age of 18, but many others today do not return because they were denied at the first place.
UBRAF reports that 88% of the 33 Fast Track Countries have adopted supportive SRH policies for adolescent and young people. But we also know that age of consent laws are still in place for young people below 18 years old to access SRH services; 52% in Asia Pacific, 53% in East and South Africa, 92% in Eastern Europe and Central Asia, 59% in Latin America, 90% in the Caribbean, 58% in Middle East and North Africa, 61% in West and Central Africa and 57% in Western Europe and North America.
If we are serious in reaching the last mile, this must change.
The last four months have shown us the reality of our public health system preparedness and response. Although the Joint Programme focuses on integrating HIV in national emergency preparedness and response, none of us were prepared. HIV services were crippled around the world. Drug supply chains were disrupted, and many have been affected by this. The global communities have responded very quickly, including donors who have been very vocal and flexible, and we are very grateful for this. However, there are countries that had been left behind even before the COVID-19 pandemic, and now these countries are even left further behind. I applaud UNAIDS’ response by pushing countries to provide 3 to 6 months of ARV supplies to people living with HIV, but this is something that we cannot relate to in my home country, Indonesia. Even before the pandemic, we have had a major ARV stock-out. This month, I was given a one-week supply, and then two-week and another one-week supply of my Tenofovir, Lamivudine and Efavirenz. A three-time-visit to the clinic for a month of ARV supply. This also happened earlier in January, as well as in November last year. Our stock is only enough until July and none of us knows what is going to happen after that. We are living in fear, and the fear is real. The fear of going to the clinic to find out how much ARV we are getting next time.
The recent WHO study found that 12 of 18 countries are showing clear evidence on pre-treatment drug resistance beyond the 10% threshold level. This concerning fact must be addressed by looking deeper into the problems. Having policies and strategies in place alone, will not get the job done. UBRAF reports 95% of the 88 countries have policies and strategies for ART retention and adherence in place. Yet, the fact is very concerning. With the current state in our country, I fear more and more people will have treatment disruption and never return to services.
These are examples of how UBRAF indicators do not tell us the full story on the reality of what we experience on a day-to-day basis. As UNAIDS is currently at a very important stage, let’s rethink what can really make a difference. We need to get the right numbers and data. And behind those numbers and data, there are names and people. We need to bring the stories to the table.
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