Moving The HIV Trajectory To Access And Equity For All

The response to the global HIV epidemic has made significant strides towards stabilizing it. But can we say we've seen the end of it? No, that would be premature. If anything, with funding decreasing and attention given to other health priorities, progress is slow.
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The response to the global HIV epidemic has made significant strides towards stabilizing it. But can we say we've seen the end of it? No, that would be premature. If anything, with funding decreasing and attention given to other health priorities, progress is slow.

The global picture shows that some are more at risk of HIV transmission than others. Key populations such as sex workers, men who have sex with men, transgender people, migrants, prisoners and people who use drugs are the least likely to have access to HIV prevention, testing and treatment services.

So it seems wholly appropriate that the theme for this week's International AIDS Conference in Durban is Access Equity and Rights now. The conference is bringing together policy makers, scientists, public health experts, researchers and people living with HIV to discuss key scientific advances and structural drivers of HIV. There is a lot to discuss.

17 million people are on life saving ARV treatment but another 20 million people still need access to it. The numbers are unacceptably high for these key population groups. In many countries these are people are left out of national HIV plans, and discriminatory laws and policies are major barriers to access.

If anything the picture shows that our efforts need to change trajectory if we are truly committed to leaving no one behind. We at the International Planned Parenthood Federation (IPPF) believe that these populations need to be at the front and centre of the HIV response.

Our efforts look at the HIV response from all angles; a strong focus on key populations, on human rights, on gender, and on youth and on the integration of HIV and sexual and reproductive health services. This includes removing barriers to accessing services and reducing loss to follow-up, in order to hit the UN's 90/90/90 targets, and in particular eradicating mother-to-child transmission of HIV.

Stigma and discrimination against people living with HIV and key populations remain a fundamental barrier to accessing services. We need to remove punitive laws and create a more enabling environment.

A comprehensive response to HIV must include initiatives that are stigma free and respond to the needs of all those at risk. Countries should prioritize their HIV responses to focus on the populations who are most vulnerable, experience the greatest burden of HIV and who are currently underserved.

We need to follow the example of Cuba and others who've moved towards the full eradication of mother-to-child transmission of HIV. It can be done.

If we are to reach the 20 Million who are without treatment, not only do we require approaches that are rights-based and inclusive, but there also needs to be funding to match ambition.

As a leading sexual and reproductive health and rights advocate and service provider, we call on donors to support the full replenishment of the global fund and meet the target of $13 billion at the replenishment meeting in Canada in September.

The human rights of key populations, people living with HIV and women and girls must be the fundamental principle on which our response is predicated. It is only then efforts to achieve access, equity and rights now can become a reality.

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