31st UNAIDS Programme Coordinating Board Meeting
NGO Delegates for Asia and the Pacific
3. Strategic investment (pdf)
Thank you for the report and case study presentations which provide practical examples on steps countries are taking to apply the new investment approach. We are encouraged to learn that many countries are moving forward with translating the investment dialogue into specific, tangible and concrete strategies and programmes.
The NGO Delegation would like to commend the Cosponsors for their work in helping countries to re-focus their investment using multiple tools such as National AIDS Spending Assessments, the MDG Acceleration Framework and human rights costing tools, among many others. We would like UNAIDS to ensure that moving forward, UNAIDS will play a more active role in leading the coordination of these processes by: a) providing adequate planning and coordination at country level; b) ensuring coherent interpretation of the terms and principles; and c) undertaking strategic advocacy to ensure broad participation of all sectors, particularly key affected populations in all 4-step investment processes.
The NGO Delegation would also like to use this opportunity to highlight the centrality of human rights and that the implementation of the investment framework must at all times be inherently a rights-based process. For example, we have just seen two ostensibly successful case studies of SIF. What is not disclosed in the Cambodian case study is that simultaneous with the development of SIF, the Cambodian government was implementing a draconian program of indefinite detention of sex workers as an HIV prevention strategy. Such policies completely violate basic human rights and do not advance the SIF. We want to re-iterate the concerns expressed by the UNAIDS Human Rights Reference group that it would be a significant step backward for the investment framework to promote the idea that economics and efficiency supersede human rights and dignity in the response to HIV. Most importantly, in the country dialogue on integrating SIF, the rights-related critical enablers should not be seen as discretionary or context-specific as they are indeed critical to ensure human rights are protected and respected in the context of HIV and to enable basic programmes.
As confirmed by the UNAIDS World AIDS Day 2012 report, programs to reach key affected populations currently only receive 4% of investment in basic HIV prevention and treatment globally. Strategic Investment represents unique opportunities to put greater emphasis on the recognition of critical enablers as high funding priorities, and that greater and more predictable funding is needed if effective community mobilization is to be realized. According to the Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa, UNAIDS role in “putting more focus on social and legal enablers which are for effective scale-up of basic programmes”, must be far more prominent. This is also in alignment with the outcome of the global consultation on SIF in countries with concentrated epidemics held in Bangkok in November, which strongly suggests that actions on law reform be one of the core activities.
We are highly appreciative of the efforts by the UNAIDS Secretariat to determine evidence-informed cost-effective gender transformative interventions, as part of the strategic investment approach. We believe this is in line with the UNAIDS Strategy 2011-2015, which identifies gender equality – together with human rights – as the third pillar of an effective HIV response. We urge UNAIDS and partners to strengthen the evidence base, including its implementation.
The NGO Delegation urges UNAIDS and Cosponsors to advance the investment approach as follows:
- Intensify its effort to focus on helping countries to develop country-specific financial sustainability plans (or country investment case) with clear targets through a partnership approach which includes PLHIV and key affected populations;
- Support further dialogue to help refine the role of civil society in different contexts and include civil society in all elements of strategic investment approach adoption in countries. It is certainly important that civil society, particularly those that are disproportionately affected by HIV and that traditionally are not fully engaged due to structural and social barriers, such as key populations, be included in a meaningful way and to also take the need for accountability of meaningful inclusion of civil society into consideration.
- Advocate with and for civil society to highlight the importance of community mobilization in service delivery, including: demand creation for HIV testing; linkages to and retention in care; advocacy for sustainability of civil society sectors; and community system strengthening and its added values in the HIV response.
- Recalling decision point 5.3 of the NGO report presented at the 30th PCB that “requests UNAIDS, in collaboration with Member States, to advocate that existing funding for civil society be continued”, ensure development partners and donors meet existing financial commitments while continuing to encourage low and middle-income countries to increase their domestic spending on HIV and health. In countries where decreased commitment from international sources is anticipated (such as South Africa), UNAIDS can help to leverage additional or alternative support to prevent the discontinuation of essential services and operations carried out by community-based groups and NGOs.
The main concern of the NGO Delegation is also centred on the understanding as to how UNAIDS will focus on progress monitoring related to the investment approach (para 73). Given the UN agencies’ assistance to countries in the context of SIF is an investment process in itself (as it requires intensive financial and human resources), the consultation processes must be equipped with proper criteria and measures that can be used to monitor progress on how countries are understanding their epidemic, designing and delivering evidence-based programmes as well as sustaining the efficiency gains. We urge that civil society meaningful engagement and participation in all 4-steps of investment cycle be one of such measures.
Thus, we would like to take note of the report and further suggest UNAIDS helps countries, that have declared their interest to gaining UNAIDS technical support in this area, to develop country investment cases with meaningful participation of civil society, particularly key affected populations
We further propose the following decision point:
Request the UNAIDS Secretariat, Regional Support Teams and, most importantly, the UNAIDS County Coordinators to continue to actively lead the coordination of technical support provided in the context of Strategic Investment and for the UNAIDS Secretariat to report back at the PCB meeting in June 2014
To align with the full roll-out of the Global Fund new funding model.