Ahead of World AIDS Day UNAIDS is calling for urgent support to Let Communities Lead in the fight to end AIDS

A new report by UNAIDS demonstrates the critical role communities play, and how underfunding and harmful barriers are holding back their lifesaving work and obstructing the end of AIDS.

LONDON/GENEVA, 28 November 2023—

As World AIDS Day (1 December) approaches, UNAIDS is urging governments across the world to unleash the power of grassroots communities to lead the fight to end AIDS. A new report launched today by UNAIDS, Let Communities Lead, shows that AIDS can be ended as a public health threat by 2030, but only if communities on the frontlines get the full support they need from governments and donors.

“Communities across the world have shown that they are ready, willing and able to lead the way. But they need the barriers obstructing their work to be pulled down, and they need to be properly resourced,” said Winnie Byanyima, Executive Director of UNAIDS. “Too often, communities are treated by decision-makers as problems to be managed, instead of being recognised and supported as leaders. Communities are not in the way, they light the way to the end of AIDS.”

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The report, launched in London during a World AIDS Day event organized by the civil society organization STOPAIDS, shows how communities have been the driving force for progress.

1. Community advocacy from the streets to the courtrooms to parliaments has secured groundbreaking changes in policy.
2. Communities’ campaigning helped open up access to generic HIV medicines, leading to sharp, sustained reductions in the cost of treatment.

Let Communities Lead shows that investing in community-led HIV programmes delivers transformational benefits. It sets out how programmes delivered by community-based organizations in Nigeria were associated with a 64% increase in access to HIV treatment, a doubling of the likelihood of HIV prevention service utilization, and a four-fold increase in consistent condom use among people at risk of HIV. It also notes how, among sex workers reached by a package of peer-based services in the United Republic of Tanzania, the HIV incidence rate was reduced to below half (5% vs 10.4%).

“We are the vehicle for change that can end systematic injustices that continue to fuel HIV transmission. We have seen groundbreaking developments with U=U, improved access to medicines, and have made great strides in decriminalisation,” said Robbie Lawlor, Co-Founder of Access to Medicines Ireland. “Yet, we are expected to move mountains without being financially supported. We are supposed to fight for a more equitable world and are tasked with dismantling stigma yet are side-lined in crucial discussions. We are at a tipping point. Communities can no longer be relegated to the periphery. The time for leadership is now.”

The report highlights how communities are at the forefront of innovation.

• In Windhoek, Namibia, a self-funded project by the youth Empowerment Group is using e-bikes to deliver HIV medicines, food and adherence support to young people who often cannot attend clinics due to their schooling hours.
• In China, community organizations developed smartphone apps that link people to self-testing which contributed to a more than four-fold increase in HIV tests across the country from 2009 to 2020.

The report reveals how communities are also holding service providers to account. In South Africa five community networks of people living with HIV inspected 400 sites across 29 districts and conducted more than 33,000 interviews with people living with HIV. In the Free State province, these findings led provincial health officials to implement new appointment protocols to reduce clinic wait times and three- and six-month dispensing of antiretroviral medicines.

“I am extremely concerned about the exclusion from health services of key populations like the LGBT+ community,” said Andrew Mitchell, Minister of State for Development and Africa. “The UK champions the rights of such communities, and we will continue to protect them, working closely with our partners in civil society. I thank UNAIDS for keeping us focused on the inequities driving the pandemic and I look forward to working with our partners to champion the voice of people living with HIV and end AIDS as a public health threat by 2030.”

Despite the clear evidence of community-led impact, community-led responses are unrecognized, under-resourced and in some places even under attack. Crackdowns on civil society and on the human rights of marginalized communities are obstructing communities from providing HIV prevention and treatment services. Underfunding of community-led initiatives is leaving them struggling to continue operating and holding them back from expansion. If these obstacles are removed, community-led organizations can add even greater impetus to end AIDS.

In the 2021 Political Declaration on ending AIDS, United Nations member states recognized the critical role communities play in HIV service delivery, particularly to people most at risk of HIV. However, whereas in 2012, when over 31% of HIV funding was channelled through civil society organizations, ten years later, in 2021, only 20% of funding for HIV was available—an unprecedented backsliding in commitments which has cost and is continuing to cost lives.

“At this time, community-led action is the most important countermeasure in the AIDS response,” said Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition. “Yet, shockingly, it isn’t a cornerstone of global plans, agendas, strategies, or financing mechanisms for improving pandemic preparedness and health for all. It is time to change that.”

Every minute, a life is lost to AIDS. Every week, 4,000 girls and young women become infected with HIV, and out of the 39 million people living with HIV, 9.2 million do not have access to lifesaving treatment. There is a Path that Ends AIDS and AIDS can be ended by 2030, but only if communities lead.

UNAIDS is calling for:

1. Communities’ leadership roles to be made core in all HIV plans and programmes;
2. Communities’ leadership roles to be
   

   SDGs, Targets, and Indicators

   1. SDG 3: Good Health and Well-being

      • Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.
      • Indicator 3.3.1: Number of new HIV infections per 1,000 uninfected population, by sex, age, and key populations.
      • Indicator 3.3.2: Tuberculosis incidence per 100,000 population.
      • Indicator 3.3.3: Malaria incidence per 1,000 population.

   2. SDG 10: Reduced Inequalities

      • Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard.
      • Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law.

   3. SDG 16: Peace, Justice, and Strong Institutions

      • Target 16.6: Develop effective, accountable, and transparent institutions at all levels.
      • Indicator 16.6.2: Proportion of population satisfied with their last experience of public services.

   Table: SDGs, Targets, and Indicators

   SDGs	Targets	Indicators
   SDG 3: Good Health and Well-being	Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.	Indicator 3.3.1: Number of new HIV infections per 1,000 uninfected population, by sex, age, and key populations. Indicator 3.3.2: Tuberculosis incidence per 100,000 population. Indicator 3.3.3: Malaria incidence per 1,000 population.
   SDG 10: Reduced Inequalities	Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard.	Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law.
   SDG 16: Peace, Justice, and Strong Institutions	Target 16.6: Develop effective, accountable, and transparent institutions at all levels.	Indicator 16.6.2: Proportion of population satisfied with their last experience of public services.

   Analysis

   1. Which SDGs are addressed or connected to the issues highlighted in the article?

   The issues highlighted in the article are connected to SDG 3: Good Health and Well-being, SDG 10: Reduced Inequalities, and SDG 16: Peace, Justice, and Strong Institutions.

   2. What specific targets under those SDGs can be identified based on the article’s content?

   Based on the article’s content, the specific targets identified are:
   – Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.
   – Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies, and practices and promoting appropriate legislation, policies, and action in this regard.
   – Target 16.6: Develop effective, accountable, and transparent institutions at all levels.

   3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

   Yes, there are indicators mentioned or implied in the article that can be used to measure progress towards the identified targets:
   – Indicator 3.3.1: Number of new HIV infections per 1,000 uninfected population, by sex, age, and key populations.
   – Indicator 10.3.1: Proportion of population reporting having personally felt discriminated against or harassed in the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law.
   – Indicator 16.6.2: Proportion of population satisfied with their last experience of public services.

   These indicators can be used to measure progress towards ending the epidemics of AIDS, reducing inequalities, and developing effective institutions.

   Overall, the article highlights the importance of community-led efforts in ending AIDS and calls for governments to support and fund these initiatives. It also emphasizes the need to eliminate discriminatory practices and ensure equal access to healthcare services. The mentioned indicators provide measurable criteria to assess progress towards the identified targets.

   Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.

   Source: unaids.org

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