Agenda 7: NGO Report
No Ending AIDS without smart investment in key population communities
By Kene Esom
The African Men for Sexual Health and Rights, the Africa Sex Worker Alliance and the African Key Populations Expert Group welcome the report of the NGO Representative. As networks and representatives of key population communities in Africa, that is – sex workers, men who have sex with men, transgender persons and people who use drugs, prisoners and detainees – we understand too well the urgent need to address the issue of sustainable funding for community-led interventions to end AIDS.
For many years, we have borne the brunt of the AIDS response for our communities buoyed on by nothing more than the necessity to keep members of our communities alive especially while our existence was being vehemently denied by our governments. Key population communities continue to show extraordinary resilience and sacrifice in the AIDS response. ‘Community action translates into results. It can achieve improved health outcomes, mobilize demand for services, support health systems strengthening, mobilize political leadership, change social attitudes and norms, and create an enabling environment that promotes equal access.’ [NGO Report, para 9]. I could not agree more.
However, repressive legal and political environment is the biggest threat to community-led interventions. Criminalisation of key populations and people living with HIV and sensationalisation of key population communities by political leaders are costing the AIDS response far too much. Earlier this year, 7 members of our communities were convicted on homosexuality-related charges and one unused condom found in the house where they were arrested was tendered in evidence. Across Africa, sex workers are being arrested and charged under prostitution provisions for carrying condoms. Misogyny, homophobia, transphobia and sexism are impacting severely on community-led interventions and creating barriers to health and rights access for key populations.
Investment in condom and lubricant programmes alone without a concurrent investment in community-led advocacy and multi-stakeholder partnerships for the removal of legal and cultural barriers that impede the response will not get us to the end of AIDS. Smart investment is required.
We commend those donor agencies that are investing more smartly in the AIDS response and piloting alternative mechanisms to support community-led interventions. In the atmosphere that this funding crisis has engendered, smart investment that challenges the status quo is absolutely critical.
We also commend the efforts of a few African States who are engaging key population communities to create a more positive legal and political environment for the response. Little wonder that we are seeing some of the greatest achievements in the AIDS response on the continent from these countries. It is not rocket science; it is evidence-based evidence smart investment.
Investment in communities also requires the Joint Programme to strengthen its presence and engagement with communities, particularly communities of key populations. In the fight to end AIDS, UNAIDS and the co-sponsors are our most important partners. The technical support you provide to our Government particularly on key populations issues has been very useful and remains so. We commend you. However, we need to see stronger and more visible engagement with key population communities at country level. Headquarter commitments need to translate to coherent country office action and solidarity with our communities. This is the strongest link in ending AIDS and must be reinforced. We need more, not less, country presence of UNAIDS and the co-sponsors.
In conclusion, I wish to bring attention to a segment of our key population community that has been relegated to a footnote in the AIDS response globally. For structural reasons, namely our incarceration and the stigma that hounds us even after incarcerations, our voices are often not as loud decision-making spaces. For years, we have advocated for a rights-based response to HIV in prisons yet, subjective morality rather than evidence continues to hamper interventions. According to data from the International Centre for Prison Studies, a majority of African countries have pre-trial detainees consisting more than 50% prison population, in a few the figure is as high as 80%. When we refuse to provide HIV services and commodities including condoms, lubricants and PrEP, to our prison communities, we are hurting the general response. I urge us to do better with all key population communities, including our communities in prisons and pre-trial detention.
There is no ending AIDS without smart, sustainable investment in communities. The time for smart investment is now. Thank You.