Agenda Item 4 – Follow-up to the Thematic Segment from the 34th PCB Meeting: Addressing social and economic drivers of HIV through social protection
Delivered by Charles King, North America NGO Delegate
The NGO Delegation is pleased with the report on the thematic segment of the 34th meeting of the PCB, and we strongly support the decisions points offered. But we also think it is important to put these decision points into the context of an evolving epidemic.
Let’s start with the acknowledgement that we are fighting a biologically intelligent virus that has strategically imbedded itself in certain groups who we often refer to as key populations that may vary by country context. As we all know, it is nothing about the characteristics of these groups that has given cause for their selection by the virus. It is not skin colour, culture, gender, sexual orientation, gender identity or age that make people become infected with HIV.
There are, rather, contextual factors that make certain populations, often defined by social exclusion, less likely to be able to protect themselves and make it more likely that exposure will occur. Not surprisingly, it is these same contextual factors that inhibit access to care, retention in care, and adherence to treatment, all of which are essential not only for personal well-being, but also for ending the epidemic.
These contextual factors can be categorized very simply as poor health care, poverty, inequality, and geography. All too often, these contextual factors are multiply-overlapping, heightening risk, such that no matter the amount of condom distribution and no amount of anti-retroviral drugs will end the epidemic. Therefore, we must address these contextual factors, otherwise known as social drivers, if we are to defeat this virus.
We recognize that the global AIDS budget will never grow to such a magnitude to be able to address these drivers. That is not a bad thing if it compels us to place the AIDS response appropriately in the context of global health and social and economic development. Multiple sectors need to come together around strategic interventions that address these social drivers with the expectation that the co-benefits will magnify the impact. If we seek to end the epidemic, we must make it our common purpose to eradicate these social drivers, which means the eradication of extreme poverty and inequality and the promotion of human rights, including the right to health, dignity and social protection.
One final point: An effective strategy to address these issues must necessarily address the affected people in research, design and implementation and evaluation. We must make People Living with HIV and other key populations full partners if we are to succeed in this endeavour.