The NGO Delegation's Communiqué for the 51st UNAIDS PCB Meeting

The NGO Delegation's Communiqué for the 51st UNAIDS PCB Meeting is already out. The Communiqué contains the following sections: Report of the Executive Director; Report by the NGO Representative; Follow-up to the thematic segment from the 50th PCB meeting; Final Report on community-led AIDS responses based on the recommendations of the Multistakeholder Task Team to the UNAIDS 51st PCB; Update on the Global Partnership to eliminate all forms of HIV-related stigma and discrimination; Report of the PCB Bureau to provide recommendations to the Bureau on UNAIDS funding situation (immediate and sustainable); Evaluation and Management Response to the Annual Evaluation Report; Next PCB Meetings; Election of Officers; and Thematic Segment

You may download the PDF version of the Communiqué (with photos from the hybrid PCB meeting) here.

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Chapeau

Xavier Biggs, incoming Latin America and the Caribbean Delegate

The 51st PCB meeting took place from 13 to 16 December in Chiang Mai and was the first in 14 years to happen outside of Geneva. It was hosted by the Government of Thailand in their capacity as the current chair of the PCB. Ahead of the formal meeting, the Thai Government invited the PCB members to participate in a number of field visits to HIV programmes and facilities in and around Chiang Mai.

The meeting itself was in a hybrid format and stretched out over 4 half days. It could only be attended in person by members of the PCB and their delegations. Observer Member States and NGO Observers could only participate virtually through a secured platform. Therefore direct contact between the Delegation and NGO Observers during and after meetings was difficult.

The 51st PCB meeting focused primarily on the need to close major identified gaps in HIV programming, the UNAIDS funding crisis and the need for a fully funded UBRAF if we are to actively advance the cause of ending the AIDS epidemic.

Seven key agenda items were posited and the NGO delegation made interventions for each one in a bid to ensure that the voice for key and marginalised communities was aptly represented.

The chair called on the Member States to arrive at consensus on the way forward and to give their commitments to increased (or continued) funding as needed and to improve the situations of those affected by HIV.


Agenda 1.3 Report by the Executive Director

Jumoke Patrick, Latin America and the Caribbean Delegate

The report of the Executive Director Winnie Byanyima focused on the equalising and sustaining of various connecting issues affecting the global HIV response e.g., the increasing human rights barriers and violations, the equalising issues for women and girls, for children, for key populations, and equalising access to scientific advances in HIV etc.

Her report shared extensively the utilisation of funds and resources of UNAIDS to support and work on behalf of national HIV response planning and implementation in countries. The executive director emphasised also the importance of keeping the ending of aids high on national political agendas through constant dialogue and technical support but, more importantly country ownership and robust dialogue with all stakeholders, including communities.

Winnie gave a breakdown of the financial outlook of UNAIDS following up on the 50th PCB meeting and provided updates and information on strategic decisions on this matter. She shared that the top ten donors have maintained their level of funding and the USA, Netherlands, Germany and Australia and other partners have all increased their financial commitment to UNAIDS.

The NGO Delegation’s intervention for this report focused on meaningful partnerships with all UN agencies of the Joint Programme, Member States and communities for better results and to improve UNAIDS’ financial situation. Critical to this intervention was for communities affected by HIV to be dignified, respected, and acknowledged for who they are and not be assigned labels for stigmatisation and criminalisation which continues to be the bane of our existence as people living with and affected by HIV.


Agenda 1.4 Report by the NGO Representative

Christian Hui, North America Delegate

The NGO report was one of the more contentious agenda items at the meeting. The report stands to further promote the science and untapped potential of U=U following the inclusion of U=U in the 2021 Political Declaration on HIV/AIDS.

While the Joint Programme and a majority of the Member States welcomed the recommendations put forth by the report, including Kenya, Canada, China, Germany, the Netherlands, Thailand, UK and US, a small number of Member States, such as the Russian Federation expressed reservations about the validity of the science of U=U, and as a result had proposed for the deletion of a majority of the report’s original proposed decision points. Meanwhile, Member States such as Cameroon made an intervention that called for the support of local production of generic ARVs to support the realisation of U=U within the African context.

After consulting multiple stakeholders, the Delegation presented a set of condensed decision points. Amidst the heated debates in the drafting room, the science of U=U was substantiated with confidence by the WHO. The negotiation process had not led to consensus by all Member States in the drafting room. On the last day of the PCB the Russian Federation requested to have a footnote added to the Decision Points to express their disassociation of the report. Due to an ambivalent translation of this request by the interpreter it first appeared as to be a mere request to express concerns on the report.

Civil Society interventions included those by MPACT which reiterated the importance that the implementation of U=U should not create a viral divide between those who are able to achieve viral suppression and those who are not. This framing would ensure decriminalisation efforts for people living with HIV would continue to advance not based on one’s viral suppression or undetectability, and that all seropositive people would not be subjected to laws that violate the human rights of people living with HIV.


Agenda item 2: Follow-up to the thematic segment from the 50th PCB meeting

Midnight Poonkasetwattana, Asia and Pacific Delegate

The report of the thematic segment of the 50th PCB came with an extensive set of decision points trying to push the boundaries on several contentious topics. The goal of the NGO Delegation was to ensure that CSE, SRHR and gender remain visible in the decision points, and they were expanded to include sexual and gender-based violence (rather than just violence), and to also have data disaggregated by sex and gender.

It took a long time to come to an agreement during the negotiation process, ultimately with some language changes that unfortunately did not meet all the goals the NGO Delegation had set out to reach:

comprehensive education and information, relevant to cultural contexts, on sexual and reproductive health and HIV prevention, or comprehensive sexuality education, as set out in the Global AIDS Strategy.

sexual and reproductive health and rights, and reproductive health

data collection disaggregated by sex and other relevant population characteristics to better understand educational participation, progression and learning, and use gender-sensitive data for policymaking and planning while recognizing national capacity

The main addition to the decision points was a footnote on the definition of key populations as defined on page 8 of the Global AIDS Strategy 2021-2026.

The NGO Delegation’s intervention remarked that recommendations from the 50th Thematic Segment are also relevant for the 51st Thematic Segment as well.


Agenda Item 4: Final Report on community-led AIDS responses based on the recommendations of the Multistakeholder Task Team to the UNAIDS 51st PCB

Mubanga Chimumbwa, Africa Delegate

The Multistakeholder Task Team on community-led AIDS responses presented the final report based on its recommendations. To fully leverage the impact of community interventions requires adapting and implementing laws and policies that enable the sustainable financing of people-centred and integrated community responses, including through social contracting and other public funding mechanisms.

In 2016 UN Member States made a series of commitments in the Political Declaration on Ending AIDS. In addition to recognizing the important leadership roles played by community organisations, Member States committed to ensure that at least 30% of all service delivery is community-led by 2030.

The NGO Delegation raised concerns with commitments by member states to invest at least 6% of HIV resources are allocated for social enabling activities, including advocacy, community and political mobilisation, community monitoring, public communication, and outreach programmes for rapid HIV tests and diagnosis, as well as for human rights programmes such as law and policy reform, and stigma and discrimination reduction.

The Delegation also emphasised the necessity of leadership of the HIV response around mechanisms to assess community-led AIDS response data around the world despite the commitments made by member states to support communities in developing standardised tools that will assess community-led AIDS responses in order to align with national policies and communities, including cost-effectiveness.

By taking note of the report, the PCB laid the technical foundation for UNAIDS to be able to benchmark well-funded community-led AIDS responses that drive the agenda of community voices at country level.


Agenda Item 5: Update on the Global Partnership to eliminate all forms of HIV-related stigma and discrimination

Cecilia Chung, North America Delegate

It is commendable that the Global Partnership has been working hard to empower people living with HIV and key population communities. The report also highlighted a total of 33 countries that have joined the effort and pledged to eliminate HIV-related stigma and discrimination.

It is extremely alarming that the report pointed to gender inequality, human rights violation and punitive laws against sex work and HIV non-disclosure that were documented in 88% of the member states. Are the 10-10-10 targets a fantasy and lip service?

There is no doubt the monitoring and capacity building provided by GNP+ must continue with more resources invested in the work. However, there must also be accountability to countries that continue to act against what was laid out in the Global AIDS Strategy.


Agenda Item 6: Report of the PCB Bureau to provide recommendations to the Bureau on UNAIDS funding situation (immediate and sustainable)

Aleksey Lakhov, Europe Delegate

The decision to form the Informal Multistakeholder Task Team consisting of PCB members, observers, cosponsors, the PCB NGO Delegation, and other stakeholders to explore options for resolving the immediate funding crisis of UNAIDS was made at the 50th PCB meeting. Since then, the task team has held 5 online discussions and developed a set of recommendations and options for addressing the Joint Programme's funding crisis. These included, among others: addressing currency fluctuations, requesting 11 donor Member States to increase their 2022 contributions by USD 1,000,000 or more (than their current planned or anticipated contributions), requesting 11 non-donor Member States from lower or lower and middle income countries to contribute USD 500 000, etc.

The NGO Delegation’s intervention focused on how a fully funded Joint Programme is a prerequisite for the very survival of different communities – such as people living with HIV, sex workers, gay men and other men who have sex with men, transgender persons, women and girls, people who use drugs, people in closed settings, as well as other priority populations. On their tables, at the start of the meeting, the PCB Member States found envelopes with the cheques inside for USD 500,000 or 1,000,000, in line with the Task Team recommendations. In addition, the intervention mentioned the daily expenses (gleaned from the open sources) of some Member States on issues that hamper HIV responses such as waging the war in Ukraine or maintaining the functions of the court that effectively ended the sexual health and reproductive right to an abortion for millions of women.

After the NGO Delegation’s intervention, one of the Member States used its right to reply directly to the Delegation and urged it not to “politicise the HIV issues.” It shows the importance of the Delegation’s voice at the PCB meetings.


Agenda Item 7: Evaluation and Management Response to the Annual Evaluation Report

Erika Castellanos, Europe Delegate

The report provided an account of the execution of the UNAIDS 2022–2023 evaluation plan in accordance with decision points 7.3–7.4 at the 49th PCB Meeting, where the evaluation plan was agreed upon. The modifications that have to be made owing to financial restrictions set the tone and dominated the report. The joint program's evaluation function still lacks sufficient funding. It was decided at the 49th PCB that 1% of expenses would go toward evaluation tasks. This was not conceivable.

In addition, a 30% budget cut had to be made to the Evaluation Office. As a result, the quantity and range of the assessments undertaken were decreased. It should be noted that the impact of COVID is now integrated into the scheduled evaluations rather than being undertaken as a separate evaluation.

The NGO delegation complimented the accomplishments and appreciated the Annual Evaluation Report. Despite the many difficulties, chief among them UNAIDS's financial predicament, we observed progress being made in the review plan. The fragile financial position has limited the human resources to 2 staff members without any administrative assistance and precluded the 1% allocation for evaluations. We urged Member States to think about the value of assessment and how it might have an influence on nations, healthcare systems, and—most crucially—human lives. We approved the planned consultation procedure used to create the evaluation plan that is forthcoming. We requested UNAIDS to ensure that communities affected by and living with HIV have a significant part in the consultations.


Agenda Item 8: Next PCB Meetings

Midnight Poonkasetwattana, Asia and Pacific Delegate

The agreed themes for the Thematic Segments for the PCB meetings in 2023 are as follows:

52nd PCB: Priority and key populations, especially transgender people, and the path to 2025 targets: Reducing health inequities through tailored and systemic responses (27-29 June 2023 in Geneva, Switzerland)

53rd PCB: Testing and HIV (12-14 December 2023 in Geneva, Switzerland)

The PCB Delegation welcomes the explicit mention of transgender people as part of the priority and key population for the next thematic segment in June, as there will be varying support within the PCB members. We look forward to wider engagements with transgender activists and organisations for this important topic to highlight the particular needs, health inequities and human rights issues transgender people face when accessing HIV services.

The PCB Bureau was requested to take timely steps to ensure that due process is followed in the call and agreement for the thematic segments for the 54th and 55th PCB meetings in 2024.

The dates and venue for the 56th and 57th PCB meetings in 2025 were also approved as follows:

56th PCB meeting: 24-26 June 2025, Geneva, Switzerland

57th PCB meeting: 9-11 December 2025, Geneva, Switzerland


Agenda Item 9: Election of Officers

Martha Clara Nakato, incoming Africa Delegate

The 5Ist UNAIDS PCB meeting came along with new changes in the composition of the PCB. Each December meeting, the PCB elects new officers from Member States. The NGO delegation informs the PCB of its recruitment process to replace outgoing delegates. This time the Delegation also informed the PCB of a replacement of a delegate by an alternate delegate from the same organisation due to personal circumstances.

The composition of the elected officers for 2023 is as follows; Germany as Chair, Kenya as Vice-chair and Brazil as Rapporteur.

The NGO Delegation also presented two new incoming delegates: Martha Clara Nakato, representing Sexual Reproductive Health and Rights (SRHR Alliance Uganda) and Xavier Biggs, representing Jamaica AIDS Support for Life (JASL). Furthermore, the Delegation informed the PCB that Erika Castellanos, representing Trans United Europe, is the alternate delegate replacing Dinah Bons.

The PCB was also informed that UNODC will chair the Committee of Cosponsoring Organisations (CCO) for the coming year.

The executive director welcomed the 3 new Delegates for Latin America and the Caribbean, Africa and Europe and gave special thanks to the outgoing delegates.

The outgoing officers and serving member states were applauded for the benevolent leadership exhibited during their service term. Thailand, the outgoing chair was in a special way commended for upholding the vision and aspirations of the UNAIDS PCB.


Agenda Item 10: Thematic Segment

Gastón Devisich, Latin America and the Caribbean Delegate

The thematic segment for the 51st PCB Meeting addressed the topic of “HIV and men, in all their diversity: how can we get our responses back on track?”.

It featured two panels with speakers from different backgrounds and regions, however, one thing was missing: the prioritisation of the needs of these groups being left behind on the HIV response. An indispensable focus that can be particularly ensured by having the community speak their truth in first person.

Nonetheless, the expertise of men in all their diversity was relegated to a secondary role while the discussion centred on what the system was already doing for men in general. Everyone in the room ‘already knew everything’, so there was little room for learning. By the time the first panel had ended, the NGO Delegation had left the room by a unanimous, collective decision.

We believe that this undesirable and unwanted outcome was the perfect example of what communities go through every day and how UNAIDS is not immune to it. As the Joint Programme should lead by example, this constitutes the perfect opportunity to shed light on how to deal with the inclusion of the voices of populations living with, affected by and most at risk of HIV, especially those groups who are currently being left behind by the HIV response. Community stakeholder engagement turned out to be the biggest lesson of the day, one the NGO Delegation will continue to follow up in the Programme Coordinating Board.

51st PCB - Intervention by Gastón Devisich - Agenda item 10 "HIV and men, in all their diversity, how can we get our responses back on track?"

Delivered by Gastón Devisich, Latin America and the Caribbean, on behalf of the NGO Delegation

Thank you, Moderator.

Before getting to our wonderful intervention, I would like to thank the wonderful female speakers, who so kindly have mansplained manhood to us.

We have missed the mark and I wonder what would have happened should it have been the other way around having a predominantly men panelist addressing the needs of women being left behind. This only proves that this is not a matter of just gender or misogyny but one of ownership. Allowing people to speak out for themselves is an issue we need to work on.

The NGO Delegation commends the celebration of this very needed Thematic Segment.

This is an opportunity to shed light to those who have no voice, but not because they can’t speak but because they are not listened to. People who our societies often wish not to see, people who are made responsible for their outcomes, who have it coming for stubbornly “choosing a way of life they could easily avoid”. They resist and for that they’re made to pay. They’re to blame for their failures, while the system takes pride in any of their accomplishments.

This is also an opportunity to learn. But in order to incorporate knowledge, space needs to be made for it. We can’t learn when we are convinced we already know it all. The course of the HIV response won’t be corrected by repeating the same mistakes again and again and expecting a different result. Today, we got to hear how men in all their diversities are stepping up to the challenge and setting the example themselves . They are survivors, but not because of overcoming HIV but for navigating poor health-systems that are actively trying to exclude them on a daily basis.

Nonetheless, getting the HIV response back on track depends on much more than having these experiences highlighted, it requires the commitment of all of us in this room to do better and really be there for those who need it. We need to do what it takes to tackle the societal barriers that are distancing these and all people from accessing the quality of life we deserve.

But now, if you want to program for men being left behind, summon us. Invest in us, perform research with us, prioritize us. Involve us meaningfully in your interventions addressing us across their design, development, implementation, monitoring, evaluation and dissemination.

We need you walking side by side with us. Here, throughout the Joint Programme and in every single country.

Thank you,

51st PCB - Intervention by Erika Castellanos - Agenda item 7 Evaluation Annual Report and Management Response


Delivered by Erika Castellanos, Europe, on behalf of the NGO Delegation

[translated from Spanish]

Thank you Chair.

The NGO delegation welcomes the Annual Evaluation Report and celebrates progress made in the crucial role of evaluations. We note the progress made in the evaluation plan despite the multiple challenges, including and most crucially the financial situation of UNAIDS.

The precarious financial situation has prevented the 1% allocation to evaluations and has limited the human resources to 2 staff with no administrative support. We would like to stress that the financial situation goes beyond the evaluation office and what is required is for Member States to stand up for the challenge not only to have a fully financed evaluation office but a fully resourced UNAIDS.

We invite Member States to consider the importance of evaluations and how evaluation can lead to a measure of impact on countries, on health systems and most importantly in human lives.

We welcome the planned consultative process to develop the subsequent evaluation plan and request that civil society and communities living with and affected by HIV play a central role in the consultations.

The NGO Delegation would like to stress the importance of evaluating the impact of the Joint programme and particularly UNAIDS offices at country level and look forward to results of the evaluation. I invite you to listen to communities on the ground on the impact that UNAIDS has had in policy change, access to treatment, in decriminalization efforts, in giving us a voice where our governments criminalize us and society kills us, and in improving the quality of life of people living with HIV.

To conclude, we ask that you Open your ears and listen, open your hearts to the call of communities but most importantly open your wallets to make the difference.

51st PCB - Intervention by Aleksey Lakhov - Agenda item 6 Report of the PCB Bureau on UNAIDS’ funding situation based on the recommendations of the Informal Multistakeholder Task Team


Delivered by Aleksey Lakhov, Europe, on behalf of the NGO Delegation

Thank you, Chair.

I speak on behalf of the NGO Delegation.

We would like to thank members of the Informal Multi Stakeholder Task Team for their work and contributions.

“Core and non-core funds”, “UBRAF” and “resource mobilization” may seem like technical jargon but a fully funded Joint Programme is a prerequisite for the very survival of our communities - such as PLHIV, sex workers, gay men and other men who have sex with men, transgender persons, women and girls, people who use drugs, people in closed settings, as well as other priority populations. That is why PCB Member States will find envelopes on their tables, with the cheques inside for half a million or 1,000,000 US Dollars. We kindly urge you to sign them and make transfers to UNAIDS before the end of 2022, in line with the Task Team recommendations for Member States to step up and show up!

And it's just one of dozens ongoing humanitarian crises globally. 1,000,000 US Dollars is also less than 5 percent of the DAILY spend on the court that effectively ended the sexual health and reproductive right to an abortion for millions of women. According to the International AIDS Society statement, “the right to abortion is a critical link to HIV services."

Behind every dollar, euro, yuan, rupee, ruble, pula, franc, peso, rial, yen, shilling, krone, baht, dinar, and pound spent on HIV prevention, treatment and care, there is a story of a life saved. A story of Jumoke, and Xavier, and Gaston, and Mubanga, and Joyce, and Martha, and Midnight, and Charan, and Cecilia, and Christian, and Erika. And my own story.

Every minute during the last year, we have been losing a life due to AIDS-related causes. 650,000 stories have ended too soon. It is up to us to not let it happen again.

Thank you.

51st PCB - Intervention by Cecilia Chung - Agenda item 5 Update on the Global Partnership to eliminate all forms of HIV-related stigma and discrimination

Delivered by Cecilia Chung, North America, on behalf of the NGO Delegation

Dear Chair

The NGO delegation is heartened that through the Global Partnership and in-country offices, progress has been made to counter stigma and discrimination against people living with HIV and key populations. We applaud the Global Partnership’s commitment in working with member countries to strengthen the capacity in community-led interventions in HIV response.

Yet as a transgender woman living with HIV who migrated from Asia to North America and a survivor of violence, I am keenly aware of the humanitarian crises that continue to hinder the efforts by civil society and communities on the ground.

If we skim the recent headlines, we will find the following:

  1. The UN estimated 45,000 women and girls killed by a family member in 2021.
  2. The denial of access to PrEP, contraceptives, SRHR, and comprehensive sex education In the name of Religious Freedom and traditional values.
  3. The UN's own expert noted the rights of LGBTIQ+ are being ‘deliberately undermined’ in my own backyard. It is 2022 and there are still countries actively persecuting women and girls in all their diversity and key populations, and passing new laws to punish them.
  4. Globally, one in eight people today are migrants, a group which is often overlooked and continues to face discrimination due to xenophobia and racism.

HIV-related stigma and discriminations do not exist in a vacuum, they intersect with many other issues such as gender inequality, racial inequity, homophobia, transphobia, food insecurity and climate crisis. Addressing systemic and structural stigma and discrimination requires all of us to passionately respond with evidence-base programs and through radical law reform so that key populations, including sex workers and people who inject drugs, are not criminalised, The HIV pandemic will not end until everyone can access HIV prevention and treatments safely.

The NGO delegation believes that we must protect all the gains we achieved and increase the investment to design and scale up and implement effective services - and these can happen through a global strategic partnership. After all, how can we put a financial value on human lives and dignities.

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