On World AIDS Day , which falls on 1 December, UNAIDS called on governments around the world to unleash the power of local communities to lead the fight to end AIDS.
A new UNAIDS report, Let Communities Lead , shows that AIDS can no longer be a public health threat by 2030, but only if frontline communities receive all the necessary support from governments and donors. .
“Communities around the world have demonstrated that they are ready, willing and able to lead the way forward. But they need to remove the barriers that hinder their work and have the right resources to expand their contribution,” said Winnie Byanyima , Executive Director of UNAIDS.
“Too often, decision-makers treat communities as problems to be managed, rather than recognized and supported as leaders. Communities do not stand in the way forward, but rather illuminate the path to ending AIDS,” she added.
The report, launched in London during a World AIDS Day event led by civil society organization STOPAIDS, shows how communities have been the driving force for progress.
From UNAIDS they affirmed that community advocacy from the streets to the courts and parliaments has guaranteed revolutionary changes in politics. The community campaign helped open access to generic HIV medications, leading to significant and sustained reductions in the cost of antiretroviral treatment from $25,000 per person per year in 1995 to less than $70. in many of the countries most affected by HIV today.
That communities lead shows that investing in community-led HIV programs has transformative benefits. Establishes how programs delivered by community-based organizations in Nigeria were associated with a 64% increase in access to HIV treatment, a doubling of the likelihood of use of HIV prevention services, and a fourfold increase in consistent condom use. among people at risk of contracting HIV. It also points out how among sex workers, reached by a package of peer interventions in the United Republic of Tanzania, the HIV incidence rate was reduced by more than half (5% compared to 10.4%).
“We are the vehicle for change that can end the systematic injustices that continue to drive HIV transmission. We have seen revolutionary developments with I=I, we have improved access to medicines and made great strides in decriminalisation,” said Robbie Lawlor , co-founder of Access to Medicines Ireland.
“Yet we are expected to move mountains without any financial support. We are supposed to fight for a more equitable world and have the task of dismantling stigma, but we are left out of crucial debates. We are at a turning point. Communities can no longer be relegated to the periphery. Now is the time for leadership,” she added.
The report highlights how communities are at the forefront of innovation. In Windhoek, Namibia, a self-funded project by the Youth Training Group is using e-bikes to provide HIV medication, food and support to young people to ensure they are following the necessary rules, as they are often unable to attend clinics due to their school schedules. In China, community organizations developed smartphone apps that facilitate self-diagnosis, contributing to a nearly four-fold increase in HIV testing nationwide between 2009 and 2020.
The report reveals how communities are also holding service providers accountable. In South Africa, five community networks of people living with HIV surveyed 400 centers in 29 districts and conducted more than 33,000 interviews with people living with HIV. In the Free State province, these results led provincial health officials to implement new appointment protocols to reduce clinic wait times and dispense antiretroviral medications for three- and six-month periods.
UNAIDS lamented that despite clear evidence of community-led impact, community-led responses are unrecognized, under-resourced and, in some places, even targeted. Repression of civil society and the human rights of marginalized communities makes it difficult for communities to provide HIV prevention and treatment services. Underfunding community-led initiatives makes it difficult for them to continue operating and prevents them from expanding. By removing these obstacles, community-led organizations can add even greater momentum to ending AIDS.
In the 2021 Political Declaration to End AIDS, United Nations Member States recognized the critical role that communities play in providing HIV services, especially to people at highest risk of contracting HIV. However, while in 2012, when more than 31% of HIV funding was channeled through civil society organisations, ten years later, in 2021, only 20% of HIV funding was available, an unprecedented setback in commitments that has cost and continues to cost lives.
“Right now, community-led action is the most important countermeasure in the AIDS response,” said Solange Baptiste , executive director of the International Treatment Preparedness Coalition. “However, surprisingly, it is not a cornerstone of global plans, agendas, strategies or financing mechanisms to improve everyone’s pandemic preparedness and health. It’s time to change that,” she added.
Every minute a life is lost to AIDS. Every week, 4,000 girls and young women become infected with HIV, and of the 39 million people living with HIV, 9.2 million do not have access to life-saving treatments. There is a path that ends AIDS. AIDS can be ended by 2030, but we will only achieve it if communities lead.
UNAIDS calls for putting community leadership roles at the heart of all HIV plans and programmes; fully and reliably fund community leadership roles; and remove barriers to community leadership roles.
The report includes nine guest essays from community leaders, in which they share their expertise on the achievements they have made, the barriers they face, and what the world needs to end AIDS as a public health threat.
