Day: July 31, 2022

MONTREAL/GENEVA, 30 July 2022 — Global AIDS leaders have joined forces in issuing a strong warning that derailing of progress to end AIDS is putting millions of people in danger. They came together to launch UNAIDS Global AIDS Update 2022, ahead of the opening of the 24th International AIDS Conference currently taking place in Montreal, 29 July to 2 August.

“The data we are sharing brings painful but vital news,” said Winnie Byanyima, Executive Director of UNAIDS. “The latest findings reveal that the response to the AIDS pandemic has been derailed by global crises, from the colliding pandemics of HIV and COVID, to the war in Ukraine and the resulting global economic crisis. Progress has been stalled, inequalities have widened, resources have shrunk, and millions of lives are now at risk.”

Her concerns were echoed by Dr Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases and the Chief Medical Advisor to the President of the United States, who stated that the new data are a “wakeup call” and a reminder that the “global plague of HIV continues to rage.”

“There has, without a doubt, been backsliding in the HIV response amid the COVID-19 pandemic,” said Dr Fauci. “Testing and hence HIV diagnoses decreased in many countries including in my own country, harm reduction services to people who use drugs and other vulnerable people have been widely disrupted. Reduced access to TB diagnoses and treatment resulted in an increase in TB deaths among people living with HIV from 2019 to 2020. What UNAIDS new report calls “faltering progress” means that 1.5 million people were infected with HIV last year, tragically three times the global target that we had hoped for. As the global HIV community meets, the conference theme of re-engage and follow the science could not be a better fit. I am sure that I speak for all my US government colleagues when I say that we remain fully committed to the kinds of engagement needed to get us on a course to reach our goal of a world where HIV infections are uncommon and HIV deaths rare.”

Keren Dunaway from the International Community of Women Living with HIV set out her struggles as a young Latin American woman who was born with HIV, and those of other women living with HIV in her network. She shared the story of a young pregnant woman from Nicaragua who, when she was diagnosed with HIV, was blamed for having HIV by medical staff who even asked her how many men she had been with, and said her baby was already HIV positive without any prior testing.

“The findings in the UNAIDS report and the data we have uncovered are much, much more than numbers, they are the lived realities of young women living with HIV. Young women and key populations continue to confront political agendas that seek to turn the clock back on our fundamental human rights including our right to bodily autonomy,” said Ms Dunaway. “These regressive efforts place younger women in increasingly precarious situations. When women are deprived of our core rights to have a say about our bodies and our rights to sexual and reproductive healthcare, we will all pay the high price in terms of prevention of new infections, and progress towards all goals of the HIV response.”

Stating that thousands of younger women, like herself, are mobilizing and organizing to push back against regressive attitudes and policies and confront the damages inflicted by the pandemic, but also warning that they cannot do it alone. “As young women fighting for our futures, we call on all of you to step up and ensure the HIV response urgently recognizes the dangers that younger women and key populations face — always — but more acutely after the COVID pandemic,” she said.

Ambassador Dr John Nkengasong, United States Global AIDS Coordinator and Special Representative for Health Diplomacy, backed the call for transformative action saying, “the HIV response and struggle is at a crossroads. We are seeing remarkable progress in some regions, notably in southern and eastern Africa, but, in some areas of some countries, increases. The timing of this report couldn’t have been more appropriate to remind us that the AIDS pandemic — and I use the word pandemic purposefully – is not a pandemic of yesterday, it is a pandemic of today. We cannot wait to fight the AIDS pandemic until the COVID pandemic is over. It has to be a question of fighting them together. It’s time not only to know your gaps but to close those gaps.”

He said that PEPFAR looked forward to working with UNAIDS on rights; on addressing the structural determinants of HIV; on issues of stigma and discrimination of key populations; and on turning off the tap to stop new HIV infections, stating the staggering figure of 4000 new HIV infections every day in 2021.

The host of AIDS2022 and President of the International AIDS Society Dr Adeeba Kamarulzaman stressed that the world cannot afford to lose more ground in the global response to HIV. “70% of new HIV infections in 2021 occurred among key populations and their partners,” she said. “This illustrates that the most marginalized are also the hardest hit. We urgently need to make resources available, close research gaps, and eliminate the stigma that still pervades thinking. Most crucially, we must ensure that scientists, policymakers and activists come together to achieve progress. It’s time to re-engage and follow the science.”

Andriy Klepikov, Executive Director of the Alliance for Public Health in Ukraine emphasised that, “this is the first time UNAIDS has released a global AIDS report with such an alarming title – In Danger. In danger means that we need to act boldly, immediately and with a solid response. Current crises are pushing back the AIDS response. In order to get on track, we need more resources. And the report shows a fundamental mismatch. When new HIV cases are going up in some regions… funding is going down. We need to address this, and we need to fully fund the Global Fund. The success of the AIDS response over the next few years will depend on how successful the Global Fund replenishment will be. Will we raise 18 billion dollars to save 20 million lives or not?”

He added that key factors for a successful response to HIV were supporting human rights, and gender equality. He stressed that it was impossible to support people who use drugs when they are criminalized and put in prison rather than being offered treatment. He warned that much depends not only on funding, but on policy change saying that it was “critical to put science and evidence over ideology and prejudice.”

Champion of women and girls, Ms Anita Vandenbeld MP, Parliamentary Secretary to the Minister of International Development (Canada) said, “As UNAIDS new Global AIDS Update 2022 shows, an emphasis on women and girls, on intersectionality, on equality and on the most vulnerable is more important than ever to stopping the spread of HIV. I find it particularly shocking and unacceptable that adolescent girls and young women make up 76% of young people newly infected with HIV in sub-Saharan Africa. This is an area where we need to double down and do more. The global AIDS response is under threat and that is something that we as political leaders need to respond to. Canada remains firmly committed to ending AIDS using our feminist international assistance policy to guide us.”

Source: UNAIDS

Northern Uganda suffers from a development gap with the rest of the country, with high rates of poverty and unemployment. UN News spoke to Dmitry Pozhidaev, head of the UN Capital Development Fund (UNCDF) office in Uganda, to find out what the agency is doing to improve funding access to individuals and businesses, and put them on the right path to success.

Dmitry Pozhidaev Many UN agencies have a very specific thematic focus: they are dealing with women, children, health care, or other important issues. However, the UNCDF can get engaged in a variety of various thematic areas, provided that there is a financial solution that can be used to address a specific challenge, anything from education to agriculture.

Uganda has a lot of promise. For example, 50 per cent of all the arable land in East Africa is in Uganda; 75 per cent of Uganda’s population are young people below the age of 30.

So, this potentially creates the conditions for Uganda to move towards the achievement of the Sustainable Development Goals, and its own development objectives.

But to unlock that potential, you need to invest into building the systems that would allow the country to use that potential and, among other things, to find and apply various financial solutions and make sure that there is adequate financing for those development plans.

UN News Do small businesses in Uganda find it hard to get access to finance?

Dmitry Pozhidaev Yes. We know that there is a lot of unaddressed demand. The real problem is that in the context of the private sector, we are talking about very inexperienced and very rudimentary business processes and business structures. They do not create enough confidence with the potential financiers –such as banks and equity providers – that those entities will be able to use the funds in the best possible ways, and be able to service their debts.

UN News How are you able to address this problem in the north of the country?

Dmitry Pozhidaev In northern Uganda, we are engaged in several areas. One is supporting local governments and the public sector, in particular at the district level, to find the financial solutions to various public projects. Those public projects may be in the area of climate change adaptation, local economic development, or in the area of forced displacement.

Agriculture employs around 75 per cent of all Ugandans, so it’s important that we move agriculture to the next level, in terms of productivity and competitiveness.

We’re also engaged with the private sector on digital finance and digital economy, to get smallholder farmers, and village savings and loans associations connected integrate them with the formal banking system, and hence improve their access to finance.

UN News You have worked with companies selling solar power services in the north. Why?

Dmitry Pozhidaev Access to electricity is still a challenge in Uganda, and access to grid electricity in many places is not available, particularly in rural areas.

But even in Kampala and in the bigger cities, there are frequent blackouts and interruptions in electricity supply, which has multiple implications on businesses, individuals and government institutions.

Ensuring access to solar provides additional opportunities for businesses, particularly micro and small, and especially in rural areas. Having access to electricity allows those businesses to extend their working hours because now they can work beyond daylight hours.

For individuals, it means lighting, and it allows students to use electronic devices and study longer.

We are working with a company providing solar panels on a pay-as-you-go system. Their customers’ payments are tracked digitally, which means that they can build up a credit score, which will make it easier for them to get loans from the formal banking system.

This is very important in an economy in which 90 per cent of employment is in the informal sector: in the absence of formal records, it’s very, very difficult for someone to get access to the formal financial system.

UN News Some of your projects involve funding for MTM and Airtel, the biggest telecom companies in Africa. Why should they receive UN funding?

Dmitry Pozhidaev People often find this surprising. They think that a big company can afford extension into less traditional and more risky areas.

This is not the case, even for very big and financially sound companies like MTM and Airtel; unless the viability of the business case is demonstrated to them, clearly they will not go to areas where they are not currently engaged.

And this was the case with the refugee camps. The telecom companies have serious doubts about the capacity of refugees to buy the products that they offer.

But, by demonstrating the demand and the capacity of the refugees to pay, and facilitating through some relatively small grants, we enabled these companies to expand into refugee camps in northern Uganda.

UNCDF in northern Uganda

UNCDF has been present in Uganda since 1982, supporting the Government to create a functional planning and financial system for sustainable and inclusive local development. Today, Uganda houses the largest in-country team of UNCDF’s global footprint.

The Development Initiative for Northern Uganda (DINU) is UNCDF’s flagship programme in the country, designed to consolidate stability in Northern Uganda, eradicate poverty and under-nutrition, and strengthen the foundations for sustainable and inclusive socio-economic development.

Inclusive Digital Economies (IDE), is the in-house practice that deploys UNCDF’s global digital strategy, which is designed to empower underserved populations to access and use digital services that leverage innovation and technology to improve their wellbeing in support of the SDG.

Source: United Nations

Executive Summary

The Breaking Down Barriers initiative of the Global Fund provides financial and technical support to 20 countries to remove human rights-related and gender-related barriers to HIV, tuberculosis (TB) and malaria services. Midterm assessments of this work were conducted in each of the 20 countries, about 1.5 to 2.5 years into the initiative (depending on the country), to examine progress made and to highlight effective program interventions.

The midterm assessments focused on the scale-up of internationally recognized programs and interventions that address stigma and discrimination, gender-based violence and discrimination, punitive laws and policies, abusive law enforcement practices, disrespectful treatment in health services, and inadequate services for people in prison. Seven HIV program areas were assessed in all twenty countries. Ten TB program areas were investigated in thirteen countries.

Efforts to address human rights-related barriers to malaria services were assessed in two countries. The assessments scored programs on a 0-5 scale meant to reflect scale-up of the program and a qualitative sense of emerging impact of the interventions. Some countries were studied through desk reviews and a limited number of interviews with key informants; others were studied in greater depth with a wider range of interviews. Because of COVID 19, almost all assessments were carried out remotely.

All 20 countries saw expansion and improvements in HIV programming to address human rights-related barriers compared to baseline measures. On the 0-5 scale, the average improvement was 0.9. All countries where TB was investigated were also found to have made progress, with an average 0.6-point improvement on the 0-5 scale. This result was achieved despite COVID-19, which undermined TB programs directly in many countries as COVID caused intensified stigmatization of TB symptoms. In all 20 countries, costed national plans for comprehensive responses to human rights-related barriers were developed with the participation of a wide range of stakeholders, and adopted as country-owned plans or strategies. In most cases, these plans were based on information from the baseline studies of the Breaking Down Barriers initiative.

With respect to both HIV and TB, considerable progress was made in scaling up programs to reduce stigma and discrimination. Programs featured many forms of raising community awareness of the harms of stigma, as well as more targeted efforts such as eliminating stigma in health services. Stigma related to being a member of a key population was also confronted.

Training of and engagement with health workers on a range of human rights and ethics issues faced in HIV and TB care were also markedly expanded in most countries. In addition to stigma, programs also focused on confidentiality of medical records and of TB or HIV status as part of engagement with health workers.

The midterm assessments found progress in improving access to justice, especially for criminalized key populations, as a means of enhancing access to HIV and TB services.

Promoting rights literacy – ensuring that people with HIV and TB and key populations know their rights to be able to claim them – and mobilizing community-based paralegal and legal services advanced significantly in most countries. Improving police practices through training and other forms of engagement with police was also undertaken. Good training practices included enabling dialogue between key population members and police and providing pre-service as well as in-service police training. In most countries, advocacy was undertaken to repeal or reform laws and policies that impede health service access, especially for key populations. In a number of countries, data from community-led monitoring of human rights-related barriers to health services were captured in national-level internet-based platforms that enabled the tracking of the extent, type and disposition of cases of violations.

Efforts to ensure that HIV, TB and malaria programs address gender equality and gender-based violence were highlighted in the midterm reviews. Gender sensitivity was often featured in the content of training of law enforcement officers, parliamentarians and health workers. Many programs pursued empowerment of women’s groups to know and claim their health rights and protect themselves from violence and other abuse. Programs for transgender persons remain insufficient, but several countries are making particular efforts at rights literacy and access to justice for this population.

A hallmark of the of Breaking Down Barriers initiative, as shown by the midterm assessments, has been the empowerment of people living with HIV and TB, TB survivors and other key populations. They have been mobilized as peer paralegals and as monitors of human rights violations. NGOs led by TB survivors have organized support groups for people with TB and their families. Some key population-led organizations have received significant financial and technical support for the first time.

The midterm assessments showed that there is much work to be done to raise awareness of human rights- and gender-related barriers to malaria services. Nonetheless, there is progress.

There are efforts in national malaria plans and programs to ensure women are empowered to confront barriers to their participation in prevention and treatment efforts. The assessments found that existing community mobilization for delivery of malaria services may provide a base on which to identify excluded populations in the future.

The midterm reviews show that COVID-19 slowed the progress of the Breaking Down Barriers initiative in many countries. But they also chronicle the ways in which human rights-related work on HIV contributed to rights-based approaches to COVID-19. In a few countries, support was provided to community-based paralegals to address human rights violations occurring in COVID raids or lockdowns. Many innovative measures were undertaken to ensure that key populations would continue to receive services in spite of lockdowns or quarantines. In a number of countries, community awareness-raising focused on prevention of gender-based violence during lockdown periods.

Cross-cutting challenges in reducing human rights-related barriers were also highlighted in the midterm assessments. Many program managers cited the need for both dedicated funding and technical support to sustain rigorous monitoring and evaluation activities. The need for stronger links between access to justice activities, and health services was also raised. Persuading governments to take financial responsibility for human rights-related programs remains challenging in many countries, as does attracting a wider range of donors to support these programs.

The midterm assessments highlighted examples of interventions in all program areas that have been particularly successful or have exemplified programmatic lessons. It is hoped that these examples and lessons will continue to inform progress toward the continued scale-up toward comprehensive responses to human rights- and gender-related barriers to services

Source: The Global Fund