38^th

UNAIDS PCB Meeting

Thank you, Chair.

The NGO Delegation appreciates the efforts of the Executive Director in ensuring that critical issues were put on the table at the High-Level Meeting. We appreciate UNAIDS’ role in being present behind the scenes, in the negotiations, and the work that you have put in working with Member States in having at least a very good First Draft.

Coming from New York, we share the frustration and disappointment that our fellow civil society colleagues feel with the Political Declaration; we may have few gains, but at the same time, we have a Declaration that watered down language on comprehensive sexuality education and sexual and reproductive health and rights. We have hoped for a document that will end the AIDS epidemic in a Fast-track approach; silencing key populations and our communities’ voices and issues in the Political Declaration will not Fast Track the response.

We support you, Michel, on your call to fully fund the UBRAF, and we are aligned with you on that. At the same time, we support you in recognizing sexual rights as essential to the response, and as Board members, we have to remind ourselves that guaranteeing sexual rights should neither remain a rhetoric nor a political position. In my region in Asia and the Pacific, these are the realities on the ground: a 14-year old girl is forced to marry an older male relative because she does not have a choice: an exercise of her sexual right. A young pregnant woman who uses drugs fears accessing contraception for fear of being arrested: access to health services that is her sexual right. A young transgender woman who also happens to be a sex worker is killed before her 35th birthday because her client was unable to accept her for who she is: a denial of her sexual right. A young gay man goes in hiding after his family disowns him after he came out: a refusal of his sexual right to live free from fear.

Whenever we deny the existence of sexual rights, we silence someone’s experience and deny his or her right to live free from stigma and discrimination.

I was at the High-Level Meeting in New York few weeks ago and it seems fitting to quote Hon. Tania Dussey-Cavassini, State Secretary for Health and Ambassador for Global Health of the Swiss Confederation who said that the only way to end the AIDS epidemic can only be found outside of our comfort zones.

The next five years is critical in changing the course of the AIDS epidemic. If we continue to turn our backs from accepting these realities, the epidemic will rebound. If the experiences I shared make you uncomfortable, then we have to ask ourselves why these issues keep on coming up; why these realities are being said over and over and over. Sexual rights matters to each of us in the room, but especially to many young people out there, to me, the future of this planet. Thank you.

Sexuality is a natural and beautiful aspect of our lives, an essential and fundamental part of our humanity. For people to reach the highest standard of health, we must first be empowered to make decisions in our sexual and reproductive lives; We have to feel confident and secure in being able to express our sexual identity.

Discrimination, stigma, fear and violence are real threats for many people around the world. These threats are made visible in heartbreaking stories, in imprisonment, and sometimes in death. Discrimination and the fear of talking openly about these issues limit us from being able to enjoy our sexual and reproductive rights.

As a Trans woman I have experienced what results when our rights are ignored. I have lived a life of invisibility where my right to identity is totally ignored due to the lack of commitments, which limits me from being able to buy insurance, open a bank account or access health services. I have had to migrate and resort to commercializing my body as a tool to survive. I was imprisoned for expressing my identity and to this day I continue to experience the ravages of stigma and discrimination at every airport because my legal documents are not consistent with my gender expression.

It is these reasons that have resulted in Trans women being so severely affected by HIV. Trans women are 49 times more likely to acquire HIV but I never wanted to be just a statistic, a simple vector of HIV. I am not the problem, I am part of the solution.

In Latin America and the Caribbean, trans women, gay men, sex workers, prisoners and drug users are disproportionately more affected by HIV and we cannot be forgotten. Not mentioning us, erasing us from strategies and documents is erasing us from existence, is condemning us to die in silence and shadows.

To maintain the achievements obtained so far in the region, continued financing is necessary or we run the risk of a rebound of the epidemic in our countries. The fast track has to be for everyone, everywhere. It is not enough to prioritize countries or territories. For us, the world is one. We must continue to work to stop HIV, stigma and discrimination everywhere, united in solidarity and mutual support. That is our mission: an equal and HIV-free world for all.

Thank you, Chair.

And thanks to the Secretariat for presenting the performance and financial report. On behalf of the NGO Delegation, I would like to acknowledge the work of UNAIDS, the Secretariat and all the partners in the Joint Program for their work and the efforts to maximize the performance in this challenging financial environment.

Having said that, the NGO Delegation, and the constituencies we represent: communities living with and most affected by HIV, and civil society in a broader sense is watching with growing concern the funding crisis of the Joint Program, one of the elephants in the room.

The UNAIDS Strategy for 2016-2021, approved by this Board, aspires to put the HIV-response on a fast track and now is threatened to be derailed due to lack of adequate and sustainable funding.

I could list endless examples of the costs of non-proper financing of the AIDS response from my region: a government admittedly forgetting to call for public bids in HIV prevention, forcing to shut down successful prevention programs that have been in place for decades. International donors such as the GF leaving a country, leaving a huge funding gap behind, resulting in stock-outs of HIV treatment or complete disappearance of harm reduction services.

And I am sure that my colleagues from the NGO Delegation, and our NGO observes have their own dear lists, the price of which is not measured in dollars or euros, but in people’s lives and health.

And so will be measured the price of non-action now: lost lives and health of people. Our communities.

The question whether the strategy is too ambitious has been asked several times, including here, during this PCB meeting. From our point of view, the answer is crystal clear: no, it is not too ambitious; it is the right thing to do. We have all the means, now we need leadership commitment, as it is our obligation to fully fund all pillars of the response, program and activities that can realize the objectives of the strategy and we can end AIDS by 2030.

We call all member states, international organizations and the private sector to act now and fully fund all instruments of the AIDS response, including communities of key populations who have always and will always be there for one another.

Thank you.

The NGO Delegation acknowledges the Update on Strategic Human Resources Management Issues.

The NGO Delegation is primarily concerned with the departure of staff who deal directly with communities, whose deliverables have profoundly contributed to the UNAIDS gains in the recent past.

For example, although communities have the capacity and expertise to mobilise themselves including the rally for consistent and correct condom use, in regions like Sub Saharan Africa where only eight male condoms were available per year of reach sexually active individual, according to the UNAIDS GAP report 2014, the technical support from the dedicated staff member of the local UNAIDS office would be essential to promote the change.

Mr. Chair and EXD, the Joint Program will fail communities including young people and the broader HIV response, if it doesn’t have the right people on the ground.

Mr. Chair:

• In Malawi, Tanzania, Cameroon, Kenya, Zimbabwe and other countries in Africa , we have organized groups of adolescent and young people living with HIV..
• In Uganda, the first-ever minimum service and care package for adolescents living with HIV has been drafted.
• The involvement and full participation of the community, including young people in the PCB has and will continue to meaningfully contributed the Joint Programme’s work.

And I am convinced that my colleagues on the NGO Delegation have their own examples where the right people on the ground helped to make a difference.

All this wouldn’t have been possible without the unique organizing, mobilization and lobbying skills that the Joint Program demonstrates with the strong leadership of the EXD.

Mr. Chair, allow me to quote one of the finest sons that the world has ever produced – Nelson Mandela: “Vision without action is just a dream, action without vision just passes the time, and vision with action can change the world.”

In this regard, the NGO delegation is much worried that if the UNAIDS Strategy isn’t fully funded, we shall never see the end of AIDS, and the Joint Program will never be able to retain the adequate human resource to strive with civil society in initiating and maintaining the HIV political agenda needed in our countries.

Therefore the NGO delegation guided by the voices of those most impacted by the epidemic calls upon members states and all donors walk the talk now, not tomorrow.

If I’m to borrow the toothpaste slogan, “We need enough toothpaste, on the right toothbrush for all teeth right now”.

Thank you!

Thank you, Chair.

The statement from the UNAIDS Staff Association provides us with a human face on how the people who work under UNAIDS strive to meet the very high demands of the Fast Track Strategy, and for that we would like to express our appreciation.

We share the sentiment of the UNAIDS Staff Association in their concern about the current financial situation. This lack of funding will not only affect the work that the Secretariat does, but also in ensuring the presence of the UNAIDS Secretariat in countries where UNAIDS has been effective in its work. In our case in Asia and the Pacific, UNAIDS Regional Support Team facilitates technical support to young key population groups, sex worker groups, people who use drugs networks, transgender organizations, people living with HIV networks, and civil society organizations working on HIV. In collaboration with UN Co-sponsors, they also play a facilitating role between civil society and governments to enable programme implementation and advocacy for policy change.

The message is clear: we have a new UNAIDS Strategy and we have to fully fund it. We also have to keep the workforce alive in order to deliver these results. In the repositioning exercise, we need to keep the diversity of people at UNAIDS: people living with HIV, people who are part of, have worked for and with key populations, and civil society activists, in both its international and national staffing, in order to ensure that its mandate and work remain grounded in the realities of the communities it wishes to serve.

We heard at the Financing Dialogue and in yesterday’s interventions the commitment of some Member States in their continued support to meet the financial requirements of UNAIDS. In putting the money to where the epidemic is, we ask UNAIDS to ensure a careful and conscious approach in putting the right people with the right capacity to where they are needed, taking into consideration the environments where they can work effectively, for example, in the nationalization of some staff. We support UNAIDS and the Secretariat staff in its efforts to implement the Strategy in order to deliver better results in a faster manner, to meet the Fast Track Targets.

Thank you.

The NGO Delegation welcomes this Thematic segment. It is timely to have this discussion as many countries are in a funding transition period and many are facing a hard economic crisis. We must examine our best practices.

Communities from the very beginning of the AIDS response played a crucial role – we all remember the global story of activists and we somehow repeated it in every region and in every country, including in EECA region where I am from. When HIV first appeared, there was no understanding of what we were facing, and we were dying. We did our best to draw attention, refusing to die in silence, and we did it successfully. We were ‘permitted’ to exist, the need to provide treatment was recognized, and treatment programs appeared, along with services for key populations. Finally donors caught the attention of what was happening in my region – only then to see services start to disappear when the donors start to disappear. This has also happened in many other parts of the world. Political will can come and go, donors and international support can come and go. But we do remain.

As communities, many of us have only our passion and energy and we work on a voluntary basis. We ARE experts in survival of our organizations being underfunded, and we are experts on how our communities can survive the epidemic. So if the Joint Programme needs experts in budget cuts, you can talk to us.

Unfortunately, we need more than passion to get the results we want to achieve. We need resources; technical support; capacity; and an enabling environment. We can’t be equal partners when the environment is so aggressive as it is today; just today we have got news that one of the central community organizations defending the rights of PWUD in Russia was declared a ‘foreign agent’ and can’t operate any more.

All of our experiences teach us that rights are not things we easily get – we need to claim them, fight for them. We have a proverb in Russian: the rescue of drowning is the handiwork of those who are drowning. So we do understand who is the most responsible for our lives.

In this thematic day, we ask everyone to remember the diversity of civil society and communities. When we talk about the community led response – that is, in our understanding, we are not talking about governmental programs that hire a couple of HIV positive people as outreach workers, but who are not those who make decisions. Neither are we focused primarily on international NGOs. While we welcome the important role of all partners in the HIV response, what we need to focus on are the grassroots groups and organizations in which community plays crucial role in decision making. As we have emphasized throughout this PCB, it is these communities who will be there for each other.

Today at 2.30 pm here in Geneva a vote was scheduled at the UN Human Rights Council on the resolution entitled “Protection against violence and discrimination based on sexual orientation and gender identity (SOGI)”. This resolution proposes the establishment of an Independent Expert on SOGI.

This is a good example if we’re going to get to zero for investing in enabling environments.

The community cadres who are also better known as community based volunteers, behaviour change facilitators, nurse aids, community care givers, home based care givers, the list is endless…are the foot soldiers that have work hard in promoting demand generation to services. They offer their services for a very minimal fee that is next to nothing, and it’s because they know how it feels to be in a situation where other people view you from a different perspective. Passion drives them, they volunteer through organisations that are also volunteering services but operating on a shoe-string budget or none (toothpaste tube has since dried up ages ago).

The NGO delegation takes this opportunity to convey the sincere gratitude to all the community interventions that are happening, which are mainly passion-driven. We have been labelled negatively before, but today we have become a legitimate community that most of you here would want to be associated with. I founded Widows Fountain of Life — experience was my best teacher. After l lost my husband on 23^rd June 2000 due to AIDS, l went through a lot. I was negatively labelled, discriminated against to the extent of being demoted from a management position at my workplace. Through community based dialogues that helped us in identifying, sensitising and mobilizing communities at all levels, through shared learning, our communities are being transformed.

Be reminded that we have the epidemic still with us. Let us turn the tables and not continue to do business as usual. Let me recall again and remind the house that the toothpaste tube has dried up. Should we wait until the dentists knock at our doorstep to do dental care exercise? Networks of people living with HIV, and key populations are and should be at the centre of this. It’s high time that we discontinue unpaid care work among the very disadvantaged groups or organisations and take care of them. Therefore we are advocating for financial support to go to these groups and have their programmes supported.

Substantial amount of money to support community based organisations, networks of people living with HIV and key populations, together with passion, will turn the tide to end the AIDS epidemic.

Thank you!!

Thank You Chair.

We are hearing it loud in this session that communities must be involved in policy formulation, program design and service delivery. We are talking and making sure that we, key populations, are counted – this is about how wide our spaces are for us to participate.

The HIV epidemics are constantly changing and evolving globally and we need to stay vigilant – vigilance for possible emerging vulnerabilities to HIV. For instance, conflict situations, disasters and other humanitarian emergencies make people flee their homes, increasing their vulnerabilities in many aspects of their lives, including their health.

Specific HIV interventions for key populations vary from country to country, and region to region. Unfortunately the political environment can be unstable — and such political changes result to changes in policies, programming and financing. And as such, involvement of civil societies and communities is endangered and sometimes, being put under threat.

Having said that, there are positive examples. India has one of these good examples. The Indian National AIDS Control Organization, along with civil society organizations, have set up specific HIV prevention programs for communities, including those of key populations, aiming to to reduce new HIV cases.

The new Political Declaration, that we, civil society have our serious reservations and concerns about, has set the targets to allocate 30% of the global AIDS resources to community-led service delivery. This is a promising target and we do hope it will become a reality now. However, we remain vigilant that this allocation must not become an excuse for governments to put down their tools and forget their mandates and responsibilities in the AIDS response.

Community-led and community-based service delivery enable us to reach those who are left behind, that are very critical in reaching the Fast Track targets. For this, we ask the Joint Programme to develop indicators for community engagement on service delivery for the 2017-2021 GARPR indicator framework.

Thank you.