51st PCB - Presentation - Agenda item 1.4 - Report by the NGO Representative
Delivered by Christian Hui, North America
Thank you Chair and esteemed members of the PCB. We thank civil society experts who served on the advisory for the NGO report and submitted case studies.
As a person with an undetectable viral load, it is with great honour to present this year's NGO Report on Undetectable = Untransmittable = Universal Access (U=U=U): A Foundational Community-led Global HIV Health Equity Strategy.
Today's presentation focuses on:
- Recognizing U=U as a global HIV health equity strategy and policy tool
- Leverage U=U as a SMART complement to the current Global AIDS Strategy
- Addressing the global inequalities gaps in U=U to the reaching of the global targets
Recognizing U=U as a global HIV health equity strategy and policy tool is immense:
U=U first gained the support of the global community in 2016, The science and benefits of U=U, as evidenced by large RCT trials HPTN052, large-scale longitudinal observational studies PARTNER 1 and 2, and population-specific studies such as the OPPOSITES ATTRACT Studies, has confirmed people living with HIV on effective treatment cannot pass on HIV sexually to others. This science is integrated into technical guidances, including the 2022 WHO Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations.
At the current juncture, the question we are asking is no longer about if U=U works, but how we can achieve U=U for all people living with HIV.
The community was the first to demand the science of U=U be widely shared, representing groups across 105 countries.
All people living with HIV, decision-makers and public health bodies, and the general population, need to know about the benefits of U=U as it is scientifically proven for implementation by countries
This past World AIDS Day, the world rallied to demand for solutions on how we can "Equalize" the dangerous inequalities hindering our collective progress. Thus it is encouraging to see countries recognizing the benefits of U=U in supporting them to advance the health and well-being for all people living with HIV.
The 2021 Political Declaration on HIV/AIDS recognized U=U as an integral component of the combination HIV prevention strategy and its use as an effective anti-HIV stigma intervention amongst people living with and affected by HIV.
Our report provides recommendations the Joint Programme, Member States, and Civil Society can leverage U=U as a foundational health equity strategy and policy instrument to reach the 95-95-95, 10-10-10, and 30-80-60 targets by 2025, and the SDG goal to eliminate HIV as a global public health threat by 2030.
We request everyone present to go beyond taking a business-as-usual approach by applying U=U as a SMART complement to the current Global AIDS Strategy to end inequalities. We must start with common clinical standards on viral load suppression and policy definition of U = U.
Through amplifying the anti-HIV stigma benefits of U=U, we can dismantle systemic and structural HIV stigma and discrimination, including efforts on criminalization reform.
All people living with HIV, especially young women and girls, transgender people, youth, key and priority populations, clinicians, allied health care providers, and the public can all benefit from learning, and leveraging U=U to dismantle inequities.
By linking U=U with Universal Access, we call on all stakeholders present to reconsider how we can reach universal access to affordable, quality life-saving HIV treatment, viral diagnostic and testing and access to differentiated care.
We seek commitment from all to work towards the ending of systemic and structural HIV stigma and discrimination and persecution of people living with HIV which continue to violate the human rights and dignity of people living with HIV.
As we move towards embracing U=U as a global HIV health equity strategy and policy tool, we must also apply community-led innovations we have gained through the global HIV and COVID-19 pandemics.
Incorporating U=U as a foundational community-led global HIV health equity strategy adds immense value to tackling global inequalities. The proposed decision points we have tabled will support Member States and the UNAIDS Joint Programme in fulfilling the global targets.
We thank members of the PCB for supporting our proposed decision points for the NGO Report.
Call for Case Study Submissions: Undetectable = Untransmittable NGO Delegation Report to the UNAIDS PCB
Dear Colleagues,
The NGO Delegation to the UNAIDS Programme Coordinating Board (PCB) produces an annual NGO report that is presented during one of the biannual PCB meetings. The NGO Delegation decides by consensus on the topic of the report. The highest priority is given to a topic that is relevant and requires urgent action at the global level.
This year, the NGO report will focus on U=U: Undetectable = Untransmittable and will be presented at the 51stmeeting of the UNAIDS PCB in December 2022. The working title for the report is “U=U: A foundational, community-led, global HIV/AIDS health equity strategy”. We are seeking examples of good practices at country, regional and global levels where community-led U=U has demonstrated increased and more equitable access to and improved uptake in treatment and care services within diverse communities across low, middle and high-income settings. Examples could include:
- Documented evidence of effective and innovative U=U interventions, such as:
- Examples of community-driven collaboratives (e.g., involving multiple stakeholders including community, civil society, health care providers, researchers, the private sector and government)
- Examples of U=U initiatives that work with other sectors across the SDGs to address the socioeconomic and structural drivers of HIV
- Address the gender disparities in risk of HIV and access to prevention, treatment, and care
- Others
- Examples and documented evidence of how U=U has contributed to facility-based and community health systems strengthening:
- result in improved access to and retention in treatment and care
- result in increased demand for and access to information, technology, treatment and care for people living with HIV in diverse and marginalized communities
- HIV care cascade: community case finding with early case detection and linkage and retention in care
- work in other sectors to reduce the impact of HIV e.g., education, comprehensive sexuality education, food security, etc.
- address the legal environment for HIV to reduce the barriers to prevention, treatment and care
- protect and promote human rights, the right to health and universal health coverage
- Others
- Effective U=U advocacy strategies and information, education and communication campaigns that:
- address stigma and discrimination as barriers to accessing diagnosis, treatment and care
- meaningful community and civil society engagement and advocacy
- address the legal environment for HIV to reduce the barriers to prevention, treatment and care
- Others
The submissions must be made using the online submission form by COB Friday August 15, 2022.
The English version of the submission form can be accessed here: https://forms.gle/CQTNWzK7zTcwr9px6
For any questions, please contact: Robin Montgomery at robin.k.montgomery@gmail.com.
Thank you for your time, consideration and response.
Survey for our 2021 NGO Report "Left Out: The HIV Community & Societal Enablers in the HIV Response"
This online survey will provide information, including quotes/anecdotes and data, for the annual report of the NGO Delegation to the UNAIDS Programme Coordinating Board (PCB). The report will be titled Left Out: The HIV Community & Societal Enablers in the HIV Response and it will be presented at the 49th meeting of the UNAIDS PCB in December 2021. Your opinions and ideas provided through this survey will help the NGO Delegation produce a report that will dispel doubts about the centrality of societal interventions in the HIV response for Key Populations (KP) and other vulnerable groups such as women and girls, adolescents and young people (AYP), and migrants. The report will define societal enablers and explore in-depth the importance of four societal enablers in particular - education, employment, healthcare, and laws and policies. It will argue the case that societal enablers can significantly improve access to HIV prevention, treatment, and care for KP and other vulnerable groups. Below are examples of societal enablers:
- Education: Inclusion of comprehensive sexuality education (CSE) in school and university curriculums to educate AYP on human rights, sexuality, gender equality, and sexual and reproductive health.
- Employment: Government training programs for KP and other vulnerable groups that increase their marketable skills and knowledge.
- Healthcare: KP community-led HIV prevention, testing, and treatment services.
- Laws and policies: Anti-discrimination laws that cover HIV status, drug use, gender identity, sexual orientation, immigration status, and/or other categories.
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