Interventions by civil society observers
Agenda 1.5 Report by the NGO Representative
Intervention by Marcus Oda (Eurasian Coalition on Male Health)
On behalf of the Eurasian Coalition on Male Health, I would like to commend the report by the NGO representative on the sexual and reproductive health and rights of people most affected by HIV. Access to quality information and services related to sexual and reproductive health and the ability to live free from violence, discrimination, and stigma are essential to ensuring that MSM, trans* people, and members of other key populations are able to enjoy the full realization of their rights and live healthy and productive lives.
MSM are 19 times more likely to be living with HIV than the general population. In the region of Eastern Europe and Central Asia, in particular, MSM and trans* people are disproportionately affected by the HIV epidemic, with the HIV incidence rising above 20% among these populations in certain major cities of the region. Stigma, discrimination, and legal and social barriers very frequently prevent these populations from accessing the HIV and SRH services that they require. In our region, MSM and trans* people face discrimination in their public and private lives on a daily basis. Laws purporting to ban the distribution of “homosexual propaganda” among minors infringe on the freedoms of expression and assembly and directly adversely affect the sexual and reproductive health and rights of MSM and trans* people. Unfortunately, healthcare service providers and law enforcement officals frequently lack the necessary knowledge to adequately address the specificities of MSM and trans* health and rights. In addition, trans* people often lack access to gender reassignment procedures and hormone therapy and may encounter problems when wishing to change their legal gender in official documents. Even more worrying is that these issues are usually the least of trans* peoples’ worries, as they are attacked and murdered on an alarmingly frequent basis due to their gender identity.
On a more positive note, I would again like to underscore the importance of the role of communities in advocating for their interests and in fighting stigma and discrimination in order to realize their own sexual and reproductive health and rights. Representatives of MSM, trans*, and other key populations are best situated to advocate for their own interests and for the services and support they need. There have been a number of examples of MSM and trans* communities advocating for their rights in countries in the EECA region. Community groups have successfully combated proposed anti-homosexual propaganda bills in Ukraine, have worked to enact anti-discrimination bills in Moldova and Georgia, and have helped to pass reproductive rights legislation in Kyrgyzstan. These positive examples may be seen as best practices for other key populations wishing to engage in advocacy and underscore the progress that can be made when communities are engaged and involved in formulating the policies that affect their lives and their health.
Intervention by Robin Montgomery (Interagency Coalition on AIDS and Development)
Thank you, Mr. Chair.
This statement is made on behalf of a loosely formed coalition of the STOP AIDS Alliance, the Interagency Coalition on AIDS and Development (ICAD), the South African AIDS Trust, the Canadian Positive People Network, and the Global Network of People Living with HIV (GNP+)
We thank the NGO delegation and strongly applaud the articulate, deeply grounding, and affecting NGO report. We call upon UNAIDS and Member States to ensure strong political support for integrated sexual and reproductive health and rights in the HIV response with concrete targets, indicators and dedicated funding at the community-level to protect and propel the gains we have made thus far.
This report raises a number of critical opportunities where we together are able to make significant advances in ending HIV as a public health threat by 2030 namely, through integrated, rights-based approaches to protect and promote the sexual and reproductive health and rights of people most affected by HIV. Through this statement, we highlight three key areas where we call upon UNAIDS for its strong voice and leadership:
First, the importance and centrality of intersectionality. The reality is, that people in all their diversity, rarely, if ever experience their identity in one linear, singular way. As an example, understanding the health concerns of key populations and women and girls must reach beyond the lens of gender to also consider the full range of dynamic social and cultural categories such as class, sexual orientation, race, age, etc. and how these impact on the range of health concerns, needs and priorities of women and transgender women. Intersectionality also contextualizes the multiple forms and layers of stigma and discrimination that remain a leading driver of the HIV epidemic and inhibit access to critical services, including rights-based sexual and reproductive health services. Adopting a rights-based, person-centred approach to health-service delivery meets the sexual and reproductive health needs of all people in all their diversity.
Similarly, ensuring that women and girls most affected by HIV are well-informed and empowered to make positive choices about their sexuality, their health and well-being through greater rights-based health literacy across the life-course, including comprehensive sexuality education, means that in fact – we are protecting children born free from HIV from acquiring HIV later in their life.
Secondly, accelerate efforts to ensure that inclusive societies and enabling environments flourish and fully enable personal and individual identities and expression as being key to sexual rights — free from violence. This includes changing restrictive policies and other structural barriers that prohibit people, especially young people from accessing comprehensive SRHR and HIV information and services.
Third and finally, there is now wide recognition that community responses must play an increasing role in addressing the epidemic, including in providing integrated SRHR service delivery, in the years ahead. In particular, it is critical that community responses are led by and involve those most affected by the epidemic and those most inadequately served by health systems. Community mobilization and community system strengthening are essential pillars for strategic investment in healthy societies. As a social enabler, it must be adequately resourced and funded.
Sexual and reproductive health and rights is an essential human right, and we ask all Member States to ensure such rights are protected as we work towards ending HIV by 2030.