Ending HIV: UN slogans vs the voices of civil society

Last week’s UN meeting exposed the deep divide about whether HIV responses should commit to respecting, protecting and fulfilling human rights rather than blaming those who are most affected.

Susana T. Fried
15 June 2016

Steve Mmapaseka Letskie speaking at the UN Opinion Leaders Dialogue on what it will take to end AIDS. Photo: UN

The week of activities connected to the UN high level meeting on ending AIDS was a week of dramatic contrasts.  On Wednesday 7 June, the formal opening of the meeting, Member States at the high level meeting (HLM) adopted an underwhelming Political Declaration on Ending AIDS.  The title far more forward-looking than the words it contains.

As I wrote in my article published on openDemocracy last week, the meeting was a study in exclusion and misrepresentation of many of the characteristics of HIV epidemics. While the declaration itself fell victim to UN political ping-ponging, the gap between the relative weakness of the commitments and the level of need was repeatedly noted by Member States and civil society alike, as well the visible presence of the very groups who were barely mentioned in the declaration. The urgency of greater attention to “key populations” (i.e. gay and other men who have sex with men, transgender people, sex workers, drug users and prisoners) was a fortunately common topic in both side event, formal panels and in many Members States formal statements. 

Several issues were hotly contested as noted in a Civil Society and Communities Declaration. In this “alternative” declaration, civil society and communities of people living with and affected by HIV declared their outrage “with language that highlights victimization and blames key populations and fuels discrimination.  Euphemisms have no place in evidence-based HIV responses, and leave the door open for HIV responses that are driven by ideology, rather than informed by evidence and rights-based obligation. People in vulnerable contexts are the people leading the fight against the epidemic, and should be recognized for their leadership role and as subjects of rights.” 

Member States also zeroed in on some of these gaps: in an HLM panel entitled “Leaving no one behind: ending stigma and discrimination through social justice and inclusive societies," the representative of Ecuador, Sra. Verónica Espinosa, noted that in the area of intellectual property, it is essential to weigh the right to health against the privileges of intellectual property, with greater weight given to health and rights.  The representative of Cuba, Ms. Mariela Castro (from a country not always known for its warm embrace of LGBTI communities), in her statement at the same panel stressed that “sexual and reproductive rights and with the full participation of civil society,” were key to effective HIV responses, and referred to their strategy of comprehensive sexuality education [including] the sexual rights of LGBTI people.”  The former president of Fiji, HE Mr. Ratu Epeli Nailatikau, co-chaired the first panel, calling for using AIDS as a pathfinder for social transformation and social justice, including everyone’s entitlement to enjoy basic human rights.  He delineated the steps that Fiji has taken in the fight against HIV including the decriminalization of same sex conduct and lifting travel restrictions on people living with HIV “in order to pave the way to a more inclusive society.” In the same panel, the representative from Switzerland proudly described the country’s harm reduction practices.  Noting that 25 years ago, Switzerland had the highest prevalence of HIV because the large number of users in the country, emphasizing removing discrimination and expanding access to treatment for drug users.  Further, she stressed the importance of multi-stakeholder strategies, including the police force, health workers and civil society.

Statements such as those from Ecuador, Cuba, Switzerland and Fiji focused attention on many of the very topics that were skimmed over in the declaration:  the right to health over intellectual property privileges, the importance of comprehensive sexuality education, the affirmation of sexual and reproductive rights, and the critical fact of recognizing the rights of LGBTI people. Encouraging as the recognition by Member States of key populations, human rights and sexual and reproductive rights was, ultimately, civil society speakers rocked the house.

Speaking at the "Opinion Leaders Dialogue on what it will take to end AIDS", Steve Mmapaseka Letskie stressed that "Leadership goes hand in hand with accountability, which both requires a framework that is shared and respected by all Sectors. The HIV response needs shared responsibility and leadership between Government, Civil Society, Private Sector and Development Partners. South Africa is a great example of multisectoral response to HIV, TB and STIs. We as Civil Society join in the call to lead and as well as to hold each other accountable".

Capturing many of the sentiments of civil society speakers in a panel on “Breaking the Silos:  integrated services for adolescent girls and young women” on 7 June, L’Orangelis Thomas Negron demanded that Member States implement “comprehensive education on sexual and reproductive health and rights, and to ensure the access to every women, young woman, adolescent and girls, in all our diversity, including key populations…I make this call because at this point of the game, coming here to share my experiences and stories, share our pain, without having concrete compromises and actions, is another way of  tokenisms. You don’t get to use our pain to do what is right.”  She continued, noting “Times have changed, and so have generations. e must now speak about sex – oral sex, vaginal sex, anal sex, sexual pleasure and freedom. It’s outrageous that many young women living with HIV are not able to enjoy their sexual lives. We need government that provide for us instead of controlling us, controlling our bodies and controlling our autonomy.”

Bold words, sadly not matched by bold commitments to action. As the Civil Society Declaration proclaimed, “Slogans and simple answers will not end the AIDS epidemic. The diversity of today’s HIV epidemics demands diverse, evidence-informed, rights-based and gender-transformative responses. Political leaders at the community, national, regional and global levels must recommit to take real steps to end this epidemic.”  Maybe by 2021 Member States will get it right.

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