Dr. Amira Herdoiza, UNAIDS PCB NGO Delegate for Latin America & the Caribbean, joined during the 28th UNAIDS Board meeting a panel of speakers on the outcomes of the UN General Assembly High Level Meeting and the 2011 Political Declaration approved in June in New York. Below is her speech. (download in pdf format)
As a member of the civil society delegation in the PCB and as a member of the LA social AIDS movement I would like to share with you three main ideas about the recent HLM held in NYC:
- About the process
- The achievements and limitations
I would like to acknowledge that the last HLM continues what began 30 years ago. Civil society, affected population and states have made a huge effort to respond to the epidemic. As we all know the Declaration of Commitment on HIV/AIDS from ten years ago defined time-bound measurable goals and targets. The Political Declaration on HIV/AIDS, adopted 5 years ago, committed to urgently scale up responses towards achieving the goal of universal access to comprehensive prevention programmes, treatment, care and support by 2010. There are many challenges that have to be achieved.
With this understanding, some of us participated in different spaces of preparation, such as the SC hearing in April and Regional consultations, with different degrees of success. In LA, Civil Society actors pushed for a workplan which defined clear steps for follow up. Member states as well defined a collective progressive agenda. The region was united and 13 countries included CS participants in their official missions. 98 LA CS representatives helped to make the 10th June 2011 formal declaration, which is what consider in my presentation.
The declaration achieved a consensus, which is an important effort of the UN, between NY country missions, national missions, CS actors and UN agencies.
Despite this, there were different styles and efficacy of communication, and in the final document there are some ambiguous terms that address sensitive issues.
First, I would like to emphasize some important achievements:
- The explicit reference to key populations: MSM, SW, people who inject drugs
- The commitment (77) to eliminate stigma and discrimination in the legal, social and policy frameworks
- The Commitment to promote national HIV and AIDS strategies that protect human rights. (80)
- The encouragement to Member States to consider identifying and reviewing any remaining HIV related restrictions on entry, stay and residence so as to eliminate them;
- The commitment to continue engaging people living with and affected by HIV in decision making, and planning, implementing and evaluating the response, (57);
- The commitment to redouble efforts to achieve, by 2015, universal access to HIV (51);
- Prevention, treatment, care and support as a critical step towards ending the global HIV epidemic, with a view to achieving Millennium Development Goal 6, in particular to halt and begin to reverse by 2015 the spread of HIV;
- The pledge to eliminate gender inequalities and gender-based abuse and violence (53);
- We also welcome the Human Rights Council Declaration on sexual orientation (June 2011).
The recognition that the global financial and economic crisis continues to have a negative impact on the HIV and AIDS response at all levels, including the fact that for the first time international assistance has not increased from the levels in 2008 and 2009, and in this regard welcome the increased resources that are being made available .. but we are concerned that the terms of the financial commitments are couched in such a way that there is no formal obligation established for the donor countries to supply the resources. Furthermore the need for funds for prevention programs is not formally expressed or dimensioned. Once more we are disturbed to note that the document makes no specific mention of Latin America which will make it very difficult to channel funds to our region and that will exacerbate the funding crisis already badly affected by the withdrawal of international cooperation from our countries.
It is good that many developed countries establish timetables to achieve the target of 0.7 per cent of gross national product for official development assistance by 2015, stressing also the importance of complementary innovative sources of financing, in addition to traditional funding, including official development assistance to support national strategies, financing plans and multilateral efforts aimed at combating HIV and AIDS; and 15 million people living with HIV on antiretroviral treatment by 2015.
It is important that the Declaration recognizes that countries should have access to low cost medicines including generics, to protect public health and foster access to medicines. That includes the commitment to eliminate obstacles that limit developing countries’ capacities to supply diagnosis, care, prevention and treatment materials as well as medicines and materials for HIV and other opportunistic diseases.
Also for the first time, international organizations like WIPO, UNIDO, UNDP, UNCTAD, the WTO and the WHO are being pressed to take steps to assist developing countries to create their own national capacity in order to increase access to medication and treatments, and that includes the adoption and activation of the flexibilities that already exist in the TRIPS agreements. However it does call for the early acceptance of article 31 of those agreements that impedes the concession of a compulsory license for the sole or main purpose of exporting to a country that needs medicines.
There is also a commitment to a comprehensive prevention approach which includes condom use, new technologies of prevention, for Member states to do better compiling and analysis of data on populations at greatest risk of infection, and to guarantee the provision of confidential, voluntary testing and counseling services.
The only goal that specifically concerns women is restricted to the issue of vertical transmission alone and as such does not consider women or girls or guarantee them access to health, and the enjoyment of their sexual and reproductive rights and to integral sexual education and a life free from violence.
There is evidence the most intensely affected populations are Trans groups (transvestites, transsexuals and transgenders); even so, they have not been included in the document as such and so their invisibility continues as before, due to the refusal to acknowledge their existence.
We believe that the language used to address the issue of migrant populations is too weak in view of the strong impact of the epidemic on them. Furthermore we must point out that indigenous and traditional peoples and users of drugs other than injecting drugs have not been considered.
There are some important goals specified for 2015, but there is not enough affirmation of follow up mechanisms. It is necessary to define these in order that we do not lose the responsibilities assumed by member states and to facilitate a practical translation of the declaration in the national, regional and global levels.
Finally we feel that the commitments made by the Member Countries must be seen as an opportunity to strengthen their follow up. The weakness of the follow up actions set out in the declaration is a source of great concern. Accordingly, we the civil society of Latin America and the Caribbean demand the following:
- That governments in the region, the United Nations Agencies and the International Cooperation Agencies fulfill the commitments made in the Regional Consultation and High-level Meeting on Universal Access held in Mexico (March 2011), making the necessary alignments with the Global Declaration (“Intensifying our Efforts to Eliminate HIV and AIDS”) that has been approved in the United Nations today;
- Regional plans and consultation for the evaluation of the achievement of goals among governments, civil society, United Nations and International Cooperation Agencies in the year 2014;
- The holding of a global High Level Meeting on HIV and AIDS in 2016.