This letter was initiated by ICASO with contributions from MSMGF.
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Letter to Mr. Michel Sidibé
Executive Director UNAIDS
Your tenure at UNAIDS has been marked by remarkable leadership in the global fight against AIDS, particularly the courageous way you have promoted rights-based HIV strategies for vulnerable groups and key populations, efficient management of HIV funds, and greater awareness of the benefits of HIV treatment.
Over the past year however, UNAIDS’ advocacy has included a more “congratulatory” tone, with emphasis on “ending” and “getting to zero” and “fast track” when referring to the future of AIDS. While we understand that your intention is to promote hope, the framing of these campaigns – when reported in the press and shorthanded into conversations, imply to the broader world that we are near the end of the epidemic, and that efficiencies in health service delivery will get us there alone. Further, these overly simplified campaign slogans give dangerously short shrift to the ongoing needs of persons living with HIV for the foreseeable future.
We fear that the growing impact of this language by UNAIDS in its campaigns is resulting in apathetic leadership by countries most impacted by HIV and continued shortages in bilateral and global network support. One example of this is the text of the UNAIDS publication just released in the run up to the High Level Meeting:
“Analysis of global data shows that the world has a narrow five-year window of opportunity in which to front-load HIV investments and deliver focused and effective action. Strong leadership from communities, cities and countries will be required. Adopting a Fast-Track approach over the next five years will close the gaps faster and reach the people who are being left behind. By using investments more efficiently, annual HIV resource needs will begin to decline after 2020. From this point the world will be firmly on course to end the AIDS epidemic as a public health threat by 2030.”
We are stunned UNAIDS makes no reference in this document to unfinished business worldwide in meaningfully and respectfully addressing persistent HIV epidemics among women and girls in Eastern and Southern African, and gay, bisexual men/men who have sex with men, sex workers, people who inject drugs, and transgender women worldwide. There is still a critical need for significant additional funding to meet accelerated global HIV-related targets. Our response in the next 5 years will require modern, bold approaches more honestly aligned with up-to-date, evidence-based understandings of today’s HIV epidemic. Poorly worded, political euphemisms invisibilize the truths about HIV and the communities HIV are impacting the most. The recently released UNAIDS publication suggests accelerated global HIV targets can be achieved through further efficiencies alone, and that declining resources after 2020 are to be expected and welcome. This serves no one, least of all, women and girls in Eastern and Southern African, and gay, bisexual men/men who have sex with men, sex workers, people who inject drugs, and transgender women.
Text from the recent UNAIDS publication runs counter to your own strong leadership on the need to fully fund targeted, tailored, evidence-informed, and rights-based responses. We fear that language used in the document will likely deter heads of state from feeling compelled to attend the HLM or to commit to anything significant through their surrogates who may attend, and concerns us greatly.
Plainly put, this document undermines advocacy efforts currently taking place in the lead up to the High Level Meeting. UNAIDS could better serve the needs of the global movement by collaborating and consulting with civil society more carefully and by sharing respected modeling of long term HIV resource needs, particularly for groups that continue bearing the brunt of the HIV epidemic (e.g., those contained in the UNAIDS Lancet Commission on HIV Report).
UNAIDS has calculated that we need US$ 31.3 billion in 2020 to reach the UNAIDS 2020 fast track targets. At current levels, this means a gap of US$ 9 billion globally. Sustaining and scaling up investments from multilateral, bilateral and domestic resources is a critical priority to end AIDS by 2030. This should include a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria. This Global Fund Replenishment Conference this year offers a critical opportunity for donors to start mobilizing at least 13 billion for its Fifth Replenishment.
The timing of the release of this document could not have been worse, as the AIDS movement prepares for the High Level Meeting, Durban and the Global Fund Replenishment.
While many have misgivings about the feasibility and over-simplicity of the 90 90 90 Fast Track Goals, there can be no question of the ambition and enthusiasm of these targets. So much so, that most have embraced them, in solidarity with your leadership. But our support is being fractured by UNAIDS’ consistent oversimplification of what needs to be done to ensure the success of the HIV response and support the health and well-being of persons living with HIV in the longer term. We feel UNAIDS positioning on this issue undermines the larger goals of the HIV response. We stand ready to support UNAIDS in developing clear, evidence-driven and human –rights based implementation strategies.
As friends and supporters of the UNAIDS mission, we strongly urge you to withdraw this document and replace it with a more appropriate call for the significantly greater resources and political leadership still desperately needed to ensure the success of the AIDS response.
A rights-based, evidence-informed global AIDS response must be fully funded. Without decisive action to counter this harmful narrative, our collective achievements, countless lives and the future are at risk. Not to do so, would enable governments, who are already backtracking and lacking commitment, to deprioritize AIDS even further. We simply cannot afford to let this happen.
With deepest regards and in solidarity,
Coalition of Asia-Pacific Regional Networks on HIV/AIDS (7 Sisters)
Asia Pacific Alliance for Sexual and Reproductive Health and Rights (APA) Stop AIDS Alliance
Instituto Vida Nova Integração Social Educação e Cidadania, Brazil MOPAIDS Movimento Paulistano de Luta Contra a AIDS, Brazil
Alliance India, India
Vivir. Participación, Incidencia y Transparencia, A.C., Mexico
Judge Martín Vázquez Acuña Court of Appeals, Argentina Instituto para el Desarrollo Humano, Bolivia Kimirina, Ecuador
Mujer Y Salud, Uruguay
Fundacion para estudio e Investigacion de la Mujer, Argentina
RedTraSex (Red de Mujeres Trabajadoras Sexuales de Latinoamerica y El Caribe)
Action for Health Initiatives (ACHIEVE), Inc., Philippines
GESTOS– Soropositividade, Comunicação e Gênero, Brazil
Latin American Council of AIDS Service Organizations (LACCASO)
Asia Pacific Council of AIDS Service Organizations (APCASO)
Centre of Integral Orientation and Investigation (COIN), Dominican Republic
Caribbean Vulnerable Communities Coalition (CVC)
Global Action for Trans* Equality
Youth Advocates Myanmar (Link Up), Myanmar
Fundacion Ecuatoriana Equidad, Ecuador
International Drug Policy Consortium
International Community of Women Living with HIV (ICW)
Network of Sex Workers Projects (NSPW)
Pangea Global AIDS, USA
Global Forum on MSM and HIV (MSMGF)
International Civil Society Support (ICSS)
Rose Alliance, Sweden
Osservatorio Italiano sull’Azione Globale contro l’AIDS, Italy
The Malawi Network of AIDS Services Organisations, Malawi
Coalition PLUS, France
Fundación Salud por Derecho (Right to Health Foundation), Spain
Uganda Youth Coalition on Adolescent Sexual and Reproductive Health Rights and HIV, Uganda Aye Myanmar Association (AMA), Myanmar
Kenya AIDS NGOs Consortium (KANCO), Kenya
Guyana Community of Positive Women & Girls (GCWAG), Guyana
Jamaica Community of Positive Women (JCW+), Jamaica
Women Organized to Respond to Life-threatening Diseases (WORLD), USA
Interagency Coalition on AIDS and Development (ICAD), Canada
Canadian Aboriginal AIDS Network (CANN), Canada
African Council of AIDS Service Organizations (AfriCASO)
Project Inform, USA
Amigos Siempre Amigos (ASA), Dominican Republic
Grupo DIGNIDADE, Brazil
Fundación Diversencia, Bolivia
Centro Amigos Contra el Sida (CAS), Guatemala
Red GAYLATINO – Latin America
Centro América Rediversa, Red Centroamericana de Hombres Gay y otros HSH (Organizations from Honduras, Guatemala, El Salvador and Nicaragua)
AIDS Healthcare Foundation (AHF), Mexico
Mecanismo Social de Apoyo y Control en VIH, Colombia SOMOSGAY, Paraguay
Gustavo Pecoraro, Argentina
Dr. Rafael Mazín, USA
André Mere, Perú
Regional Interagency Task Team on Children and AIDS (RIATT-ESA)
Regional Psychosocial Initiative (REPSSI)
Child Rights Network for Southern Africa (CRNSA)
Youth Voices Count (YVC), Trailand
Susu Mamas Papua New Guinea Inc, Papua New Guinea
Asian & Pacific Islander Wellness Center, US
Association Roumaine contre le Sida, Romania
Coalition des organismes communautaires québécois de lutte contre le sida), Canada Association de lutte contre le sida (ALCS), Morocco
Radanar Ayar Rural Development Association, Myanmar
Aye Nyein Metta Organization, Myanmar
Lotus MSM Network, India
Youth LEAD (Asia Pacific Network of Young Key Populations)
Global Network of People living with HIV (GNP+)
AIDS Accountability International
HIV Young Leaders Fund (HYLF)
Health GAP (Global Access Project)
International Indigenous Working Group on HIV & AIDS
UNAIDS PCB NGO Delegation
African Black Diaspora Global Network (ABDGN), Canada
Eurasian Coalition on Male Health (ECOM)
MSMGF has worked since 2006 to encourage targeted, tailored, better resourced, and rights-based sexual health services for gay men and other men who have sex with men (MSM) worldwide through its advocacy and technical support work. As a global network, MSMGF has successfully influenced HIV responses at the local level through shifts in global-level policies and has effectively utilized public health as an entry point for advancing the human rights of LGBT people. MSMGF currently supports programs in 15 countries.