We would like to thank Dr. Mayaki for his strong words in support of civil society and community-based approaches for addressing HIV. The NGO delegation shares the emphasis on the need to increase multisectorality. HIV teaches us how much we all need one another, across differences in economies, geographies, and ideologies.
We thank Alessandra Nilo for her brilliant and direct words that draw our attention to the political inequalities — between countries and within countries — that fuel the epidemic.
We say today that all health concerns are global health concerns. Viruses do not respect borders and passport control. Whether we like it or not, we are in this together. Those of us from high income regions need to say to our leaders: when higher income countries provide funds, this should be seen not as charity but as obligations as members of a global community. At home, when governments provide full funding for health, this is not charity. This is a human rights obligation. Similarly, it should be an obligation for high income countries to actively work against trade barriers to affordable medications and commodities, such as the barriers in the Trans-Pacific Partnership. As Ale stressed, countries have common but differentiated responsibilities.
Funding has been the elephant in the room. Communities hang on by a thread and this is not because of poverty – or poverty alone – but because governments have not prioritized support to communities. Sustainable change requires sustained support.
Poverty is not only across nations but within nations. Marginalized people are invisible in the macro data but absolutely visible in rights violations. The US is part of the Fast Track strategy. Even in our rich nation, there are pockets of vulnerability – even ’emergencies’ – that need urgent attention. Full funding is also for these.
One group pushed regularly to the margins in North America is Indigenous Peoples. Remarkable organizations like the Indigenous All Nations Hope Network in Sasketchawan, Canada, have the community knowledge and trust to address HIV – in a province with HIV prevalence that is three times the national average and where 74% of new diagnoses are among those who are Aboriginal. Led by Indigenous women, they build on indigenous ways and cultures, and design programmes to provide a sense of belonging, to restore cultural identity, and to teach how Indigenous ways are complementary to and reinforce mainstream/Western knowledge and approaches. Without empowered and supported civil society organizations, these kinds of work will not happen.
We have many examples of civil society driven change. We have good information on the funding needs. Now we need to have a reality check and immediately find the funding needed for communities to do what we are dying – and living – to do.
We look forward to participating in the conversations about committed funding structures for civil society that was mentioned so many times today and yesterday.