Agenda Item 1.3 – Report of the Executive Director
Delivered by Kenly Sikwese, Africa NGO Delegate
Mr. Chair, the NGO Delegation supports the retargeting and fast track targets. It will indeed mean that no one is left behind and the end of AIDS is achieved by scaling up efforts to reach everyone and close the gap to HIV prevention and treatment services in this 5-year window. The 90-90-90 by 2020 targets launched in Melbourne will indeed lead us closer to ending AIDS through combination prevention approaches. But it will take more than this:
The NGO Delegation, like Michel, believe that we are at a pivotal point in the epidemic and that the next five years will be critical in its future evolution. It is important to build on the cornerstones of the current strategy while making sure we move forward by acting on more recent findings of what works. It will be important to develop the strategy through a rigorous process of consultation that involves civil society and is built from the bottom up rather than the top down.
The NGO Delegation believes we can end AIDS by 2030. We can meet the three zeros targets, and we can meet the 90-90-90 targets by 2020, but as the UNAIDS sponsored Political Scenarios workshops around the world are showing, right decisions must be made at each step. That is making right decisions for ending AIDS, for we know already what works, irrespective of the sensitivities the right steps might touch in some quarters, or the initial cost.
There will be an initial cost of course, but the return on investment is huge. Estimated figures of $15 returned for each $1 spent is a massive ROI that can hardly be equaled anywhere. Part of making the right decisions will be in not only making sure resources are allocated, but how and where they are allocated. It is clear, as Michel said, that success will depend on including and resourcing civil society as a critical component. The new UNAIDS global report, argues that achieving bold new global AIDS targets will require that community services become a significantly larger part of the AIDS response. Yet there are widespread and increasing reports of reduced funding for the civil society in the response. Reversing that trend is critical to progress. The report estimates the share of AIDS resources dedicated to community services and mobilization needs to more than triple in the next six years, from 1% today to 3.6% by 2020. We would like to see UNAIDS lead on this by example.
Investment must be made in PLHIV networks and those of KAPs, and their role in advocacy, programming, and service delivery must be encouraged and supported. As governments increasingly take responsibility for funding their HIV response the critical element of strengthening community systems must not be lost. For example there is no point in investing huge amounts of money in treatment if stigma and discrimination create barriers to retention and adherence. We have seen studies showing that women with HIV are more likely to see their ARV regimen fail when faced with gender-based violence. A partnership between PLHIV and KAP networks, community organizations and government is required to address issues such as this. Equally, addressing the HIV epidemic must occur in the context of addressing social drivers as a part of a multi-sector agenda that bring multiple multilateral and country resources to bear against the cross-cutting drivers of AIDS, poverty and inequality.
Many of the decisions that need to be made will be made by governments. If the wrong decisions are made, as the political scenarios show, there will be severe consequences. It will take longer to end AIDS, and cost more lives and more money. If enough wrong decisions are made we could see the progress made so far reversed and end up again in the dark days of the 1990s, but on an even larger scale.
The Delegation sees Fast-Track as playing an important role in guiding us all to make the right decisions on the path to ending AIDS.
Mr. Chair, the end of AIDS is not yet upon us. But we could get there quickly by ensuring that we do the things that we know to do now – quickly! The convening role of UNAIDS to mobilise communities of PLHIV, KAP, women and other multisector players will need to be strengthened, and UNAIDS is institutionally is over the next 10-15 years, fully supported and resourced.