Opening remarks at the 2016-2021 UNAIDS Unified Budget Results and Accountability Framework (UBRAF) consultations
Delivered by Laurel Sprague, North America NGO Delegate
As NGO members of the board, much of our public work – for example, our interventions during the PCB – involves linking the theories, practices, and intentions of the HIV response to their consequences for people and communities on the ground. This is the work that many of you see us do at the PCB. This is critical and part of the reason that there are NGO seats on the UNAIDS PCB.
However, we often say that most of our work happens between meetings – and this is true. This is the work of board members: consulting with constituents; gathering information and highlighting emerging issues that might affect the Joint Programme’s work or programmes; reviewing board documents, particularly programme evaluations and financial reports; seeking areas of consensus with other delegations; and attending to the financial stability of the organization.
As Board Members from civil society, we bring the spirit of this behind-the-scenes work to this consultation.
There are four fundamental issues that we wish to raise:
Sustainability, Coordination, Cooperation among multi stakeholders, Evidence
The sustainability of the Joint Programme is essential for civil society. I wonder if you can think for a minute what it meant – and still means – to a young woman, who receives an HIV diagnosis, is terrified, and faces mistreatment, fear, and even disgust at times from her family and community to know that the United Nations values her life so much that there is a program devoted to addressing HIV. The Joint Prograame has many times been the only place that people facing criminalization or abuse, because of who they are, could turn. This is particularly so in current political climates for all of us who are gay men, transgender, lesbians, bisexuals, sex workers, and those who use drugs.
The critical importance of sustainability means the funding conversation – although hard – must be a priority. How do we get from where we are now to where we need to be?
And we need a clear approach to risk management: what will we do if we do not raise the resources we need?
The UBRAF is – as noted in the documents – an instrument to maximize coherence, coordination, and effectiveness
One of the fundamental issues is whether or not the 12 UN organisations are indeed working together as effectively as they could. Coordination amongst the co-sponsors and secretariat must be a primary focus. Noting the simultaneous consultations run by UANIDS and WHO, – as a very first step, the HIV strategies of each organization must be in sync.
Different groups in the room are sometimes quite critical of each other – this is important for accountability – however, we need to do this without every losing track of the fact that we need our collective goals and UNAIDS to succeed.
If we are to provide a model for the post-2015 sustainable development goals, then we must step up our efforts at coordination – guided by a spirit of collaboration and mutual respect – at every level.
Multi stakeholder approach
The Joint Programme’s work has been cited as a model in the post-2015 world. Close collaboration with civil society, including the participation of the NGO Delegation in the PCB, has been fundamental to the Joint Programme’s work and has shaped its success. UNAIDS work must be successful in order to demonstrate how such formal structures of civil society representation can be adopted within other efforts to address the multitude of human rights issues that vulnerable people face.
This means that there must be attention within the UBRAF to the meaningful engagement of communities and to resource mobilization for civil society to be able to get things done. This critical work needs to be part of the work strategy at every level and staff who go out of their way – sometimes quite courageously – to stand up for people living with HIV, LGBT people, sex workers, people who use drugs, young people, and women need to be recognized and affirmed in their evaluations. What is valued, gets measured and what is measured, gets valued.
Measurement is not always difficult but it is often difficult to measure the things that matter most. The number of pills distributed is easy to measure (or should be). This is a challenge for the Joint Programme which often works behind the scenes pressing for rights-based systems to be in place to assure the HIV response is effective.
I was recently in a situation that demonstrates how much harder UNAIDS work is to measure – I was in Southern Louisiana –in the southern US. I learned that, in just one small health insurance company that has 1300 people with HIV enrolled, only 300 people were filling prescriptions for ART. These are people who have access to healthcare – finally, thanks to President Obama’s Affordable Care Act. We all have many examples of needs that go beyond distribution of pills and commodities – this is just one.
It will be essential for this UBRAF to focus on the critical evidence that is needed to show effectiveness, even in areas that may seem difficult to measure – both for sustainability of the programme and for the confidence that we are doing the right work in the right places at the right time with the right people. This means we must struggle with measuring outcomes and all of our measurement must be conducted with the highest levels of integrity.
The updated Strategy assumes that the way we do things will need to change radically: it cannot be business-as-usual. It would be good to be clear how the Joint Programme itself intends to change radically and lead by example in the way it addresses HIV, including how efficiencies in the Joint Programme internally can free up human and financial resources to help meet the additional resources needed to meet the fast-track requirements of the updated Strategy. It is dignity, health, and the lives of people in our communities that are at risk.
We thank the Secretariat, the Co-Sponsors, the Member States, and civil society members in this room for the work you are about to do.