Blogs & Opinions
Charting a Path Forward for Sustainability in the HIV Response: A Blog by Emmanuel Onwe, A Young Emerging Leader from Love Alliance
The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) has been a crucial program in the fight against HIV/AIDS for almost two decades. The recent PEPFAR Sustainability Meeting held in Washington D.C., USA, from 11-15 September 2023, brought together key stakeholders and experts to discuss the future of this vital program towards sustaining the gains in HIV response.
Emmanuel Onwe, one of the Young Emerging Leaders from Love Alliance, which GNP+, Y+ Global and Aidsfonds support, participated in the meeting and spoke on a panel, ‘Civil Society Organisations' Perspectives and Roles in HIV Sustainability.’ This is their account of what transpired at the meeting.
The Role of Civil Society Organisations in the Sustainability of the HIV Response
PEPFAR has played a crucial role in reducing new HIV infections, increasing access to antiretroviral therapy, and providing care and support to more than 25 million people and children worldwide who are living with HIV/AIDS. Development interventions, particularly in public health, have been extensively carried out in our countries in the Global South. However, the exclusion of people with diverse lived experiences in interventions is the reason why there is a lack of substance, importance, and commitment in many of these interventions.
It's crucial for civil society programs and interventions that aim to support young people living with and affected by HIV to have favourable laws and policies in place. Sadly, some countries partnering with PEPFAR still have outdated laws that go against basic human rights principles. These laws prevent organisations from offering vital services to marginalised groups, such as sex workers, transgender individuals, gay men, other men who have sex with men, and people who use drugs. This leads to limited access to resources and impacts the effectiveness of these programs.
Together, we can sustain the gains we have made in the HIV response. By developing a multi-stakeholder-led sustainability roadmap approach that includes CSOs in PEPFAR countries, we can ensure that the communities they serve are not left behind. To achieve this, we must first address the laws that restrict the existence of CSOs and the criminalisation of key populations. We should advocate for the full decriminalisation of sexual and gender minority groups as part of our plan to sustain the HIV response. By engaging in co-creation with CSOs and the communities they represent, we can employ community-led solutions and monitoring processes, ensuring that their voices are heard. Let us work together to end AIDS by 2030.
Maintaining PEPFAR's Current Gains in Ending AIDS
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PEPFAR's Sustainability Meeting resulted in a commitment to create a detailed plan for shifting to a locally-driven initiative. Collaboration with partner countries, CSOs, and the private sector is essential. Sufficient investments are needed to accelerate HIV prevention and ultimately end AIDS. In response,
- Governments must strategise and develop plans that generate revenue locally through domestic resource mobilisation and allocate more resources to address AIDS and reduce dependence on international donors. Social contracting models can also help to revitalise investments;
- Governments, the private sector, and CSOs should work together to establish a robust and diversified service delivery approach targeting the unmet needs of key populations that are often marginalised;
- Governments must support CSOs in creating safe havens for key population members to access care without fear of stigma and discrimination. Relying solely on government hospitals is not sufficient, mainly when policies restrict the existence and expression of transgender people, gay men, and other key populations.
But then again, is it really sustainability without young people?
Meaningful engagement of CSOs must be accompanied by the involvement of the communities they represent. If we aim to promote country ownership, co-creation, and community engagement, then the presence of CSOs and the communities they represent must be ensured in such meetings. It is vital to create more seats at the table to include the voices of our communities, especially young people living with HIV, in the development and implementation processes of the roadmap. Only with their meaningful engagement can the future of HIV response be sustained.
I strongly believe that with the right approach, progress towards a future where HIV/AIDS is no longer a global emergency is possible. By prioritising sustainability, country ownership, innovation, and inclusivity of CSOs and young people living with HIV, we can create a world where young people play a meaningful role in shaping health outcomes that work for them. It is also imperative that PEPFAR transitions from being a perpetual emergency response to a sustainable, long-term solution. With these critical steps, I believe that we can transform the response to HIV/AIDS into a managed and controlled health issue, bringing hope and inspiration to those affected by this disease.