Friday, 10 June 2016

Report back: UN High Level Meeting on AIDS

L-R: Darryl O'Donnell, Sharon Lewin,
Cipri Martinez.
It’s been an intense few days in New York, as government heads of state, ministers of health and civil society congregated in New York for the High Level Meeting on Ending AIDS (HLM).

The Australian Delegation to the meeting included AFAO CEO Darryl O’Donnell; President of the National Association of People with HIV Australia (NAPWHA), Cipri Martinez; and leading Australian HIV cure researcher and head of the Doherty Institute, Professor Sharon Lewin.

AFAO's Finn O'Keefe reports.

The key business of the HLM formally concluded with the adoption of 2016 Declaration to End AIDS at the opening plenary on 8 June. However, this was not seen as a good thing by everyone; during the plenary, members of civil society (CS) walked out en masse in protest at weak language in key areas of the declaration.

The last few weeks leading up to the adoption of the Declaration have involved tense negotiations between UN member States and civil society to gain consensus on the final wording of the Declaration text.

In the lead-up to the meeting, civil society expressed grave concerns that draft text had become watered down during negotiations, with few references to key populations or explicit naming of population groups – such as gay men, men who have sex with men, transgender people, sex workers, and people who use drugs.

As one delegate noted on Twitter 'the first 10 paragraphs support an end to stigma and discrimination of key populations, the next 50 erase them.'

During the week, UN negotiations on the draft text were operating under a silence procedure, which meant that a deadline was set for responses to the amended text. Under this procedure, if no-one 'breaks the silence' consensus is assumed. That time limit was initially Monday, but it was extended to Tuesday night. 

During the week civil society lobbied hard to get UN members to 'break the silence'. At a meeting of CS delegates the pros and cons of breaking the silence were discussed.

On the one hand, if the silence was broken it would provide opportunities to suggest amendments to the text, but this could equally run the risk that new text may be introduced which civil society may not want included, or run the risk that more text would be opened for revision. It was an interesting and complex debate.

In the end, the silence was broken by Russia expressing concern around three paragraphs mentioning key populations in the context of harm reduction and SRHR (sexual and reproductive health and rights). Late on Tuesday night, news filtered back that Russia’s bid to open the text had been denied, and the Declaration was indeed approved the following morning.

Civil society have produced a 'shadow declaration' which outlines negatives and positives in the Declaration from CS perspectives. 

On the positive side, the Civil Society and Communities Declaration acknowledges many areas of advancement, including:
  • Increased attention to children, adolescents and young people
  • Attention to addressing social and economic drivers of HIV
  • Strong references to the connection between gender-based violence and HIV
  • Explicit positive references to harm reduction as an important HIV strategy
  • Consistent attention to stigma and discrimination as significant challenges
  • Meeting replenishment goals for the Global Fund to Fight AIDS, TB and Malaria
  • Recognition of the need to use existing TRIPS flexibilities to their fullest and ensure that intellectual property provisions in trade agreements do not undermine existing flexibilities
  • Bold treatment targets, including the goal of achieving 30 million people on treatment by 2020 and a target of 25% funding for prevention.
But they also cautioned that without funding and political support, these targets will not be achievable, and called on political leaders at community, regional and global levels to recommit to take real steps to end this epidemic.

The Global Network of People Living with HIV (GNP+) media release stated, 'the Declaration has been almost completely stripped of explicit commitments to reduce discrimination, remove punitive laws and address other legal, social and political barriers to HIV prevention, treatment, care and support for people from key populations affected by HIV'.

Protests and side events

In response to the 'watering down' of the Declaration, civil society protests were staged outside the UN on Tuesday and Wednesday.

This gallery shows photos from the high level meeting, protests and related events. To see captions, view on SlideShare.

On Tuesday, a special side event featured a panel of five civil society representatives who were excluded from attending the HLM. Each gave a powerful account why key affected populations need to be at the heart of response to HIV.

Panellists were:
  • Kath Khanpiboon (Aisa Pacific Transgender Network)
  • Daria Mogucheva, Eurasia Network of People Who use Drugs
  • Dane Lewis (J-Flag)
  • Serge Doumong Yotta (Affirmative Action)
  • Tia Gwenjeng (NAP+ Central African Region)
A number of respondents also reflected on the importance of involving civil society, including Mandeep Dhaliwai (UNDP), Vitaly Djuma (Eurasian Coalition of Male Health) and Gift Trapence (African Men for Sexual Health and Rights - AMSHeR). People commented that the United Nations and Institutions like to Global Fund were built because of the efforts of civil society, so it is ironic that some CS members are now again being excluded.

Although when the Declaration was formally accepted, civil society delegates walked out of the meeting in protest, it was extremely heartening to hear a number of country delegates, including those from Australia, Canada and the US, make passionate speeches calling for greater inclusion of key populations, the naming of individual communities. These delegates also voiced support for important measures such as harm reduction and an environment free from criminalisation and stigma. Australia’s speech, made by Sharon Appleyard from the Department of Health, was particularly strong.

Download Australian Statement

In AFAO’s media release following the announcement of the Declaration, NAPWHA President Cipri Martinez summed up the mood well. We certainly didn’t get everything we wanted in this Declaration, but it contains some powerful statements, and the alternative could have been that we ended up with no Declaration at all.

Cipri stated: ‘People with HIV stand in solidarity with key populations affected by HIV globally ­-  including indigenous communities, women and girls, young people, sex workers, people who use drugs, transgender people and gay men.

‘We are disappointed this Declaration has not significantly increased the visibility of key affected populations. As people with HIV, we know the critical importance of a strong and visible voice in advancing progress for our communities. This is particularly critical for our near neighbours in the Asia-Pacific region, who face additional challenges accessing cheap, modern medication and health care monitoring, and routinely experience stigma, discrimination and criminalisation.

‘However, we also recognise it has been a long and difficult process to gain consensus among all UN member states. The 2016 Political Declaration on Ending AIDS is an important step towards ending HIV. We thank our present and past Australian governments for their bipartisan commitment to working collaboratively with all our communities to end HIV in Australia and to support the global response.’

Read joint media release

It seems unbelievable that 35 years into the HIV epidemic, civil society is still having to fight for greater representation and inclusion in official policy documents. The nature of the UN system means it is not possible to achieve the kinds of document that would have the vision and strength of action that we want to end HIV. 

Devastatingly, this also means that we don’t have the global leadership we need. AFAO has no doubt that the advocacy of civil society in the lead up to the meeting, and at it, has helped progressive UN Member States, including Australia, achieve a better document. We should be under no illusions that there is a strong global consensus for the kind of action and ambition required to end HIV. Their simply isn’t.

Issues of values, justice, human rights, criminalisation, financing and stigma and discrimination are recognised by the Declaration, but are not addressed in ways that can lead to the outcomes we want and need. For the time being, this is the Declaration we have. We must leverage its strengths, and find ways to fight harder for the gains we still need if we are to achieve our goals.

We remain hopeful that the passion displayed during the meeting by civil society and many UN delegates bodes well for the future.

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