There was praise for the bold goals in the political declaration adopted by the 193-national General Assembly at the United Nations High-Level Meeting on Ending AIDS on 8-10 June, but there was also widespread condemnation of the decision to include only limited references in the declaration to those most at risk of contracting HIV – men who have sex with men, sex workers, transgender people, and people who inject drugs – and to services for these populations.
The problems started before the conference even got underway when, as reported by the Associated Press, Russia, Cameroon, Tanzania and 51 Muslim countries blocked 22 NGOs representing key and vulnerable populations, primarily of gay and transgendered groups, from attending the conference.
In the declaration, countries pledged to end AIDS by 2030. They committed to ensuring that 30 million people living with HIV have access to treatment by 2020. They also committed to reducing the number of new HIV infections to below 500,000 a year by 2020, down from 2.1 million in 2015, and bringing the number of annual AIDS-related deaths to under half a million in 2020, from 1.1 million last year.
Matthew Kavanagh, senior policy analyst for the AIDS and human rights activist group Health Global Access Project (HealthGAP), told AP that while he welcomed the bold targets, he was disheartened over efforts by countries like Russia, Iran, Poland, and several Gulf states who managed to strip language from an earlier draft of the political declaration that would have called for the decriminalization of homosexuality and drug use and urging they be treated instead as human rights issues.
“So there's one reality that bold targets have been set,” Kavanagh said. “Then there's this other reality that we will never reach those targets so long as critical populations like men who have sex with men are criminalized and stigmatized, because when they are they can't and won't access treatment.”
“No one at the high-level United Nations conference devoted to ending the AIDS epidemic by 2030 denies serious scientific and financial challenges remain,” the AP said, “but cultural sensitivities may prove the toughest stumbling block on the way to achieving that goal.”
The political declaration is not legally binding, but it is used as a tool, particularly in developing countries, by activists who can point to it to support calls for certain services to be made available.
A CSO Declaration released at the high-level meeting, and signed by 163 civil society and community organizations, said that “the draft Political Declaration misses the mark… We declare our profound dissatisfaction… The diversity of today’s HIV epidemics demands diverse, evidence-informed, rights-based and gender-transformative responses…. We are especially outraged with language the highlights victimization and blames key populations and fuels discrimination…. 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.”
In a statement published on 8 June, the Global Network of Sex Work Projects, the Global Network of Trans Women and HIV, Global Action for Trans Equality, and The Global Forum on MSM & HIV called the political declaration “a significant set-back in our work to end AIDS, particularly among key populations.”
They said that the declaration “damagingly excludes and misrepresents key populations. It also lacks an explicit commitment to support and finance key population-led and tailored prevention, care, and treatment services. Likewise, it is woefully misses the mark in highlighting legal and policy frameworks that stigmatize and criminalize our communities worldwide.”
What happened at the U.N. stands in stark contrast with recent developments at both The Global Fund and the (U.S.) President’s Emergency Plan for AIDS Relief (PEPFAR). In November, The Global Fund adopted a new Strategy for 2017-2022 which emphasizes the importance of promoting and protecting human rights and gender equality, as well as scaling up coverage of key populations (see GFO articles here and here).
And at the U.N. conference itself, PEPFAR announced a $100 million investment fund to expand access to HIV prevention and treatment services for key populations. In an announcement, The Global Fund said that “the Key Populations Investment Fund will aim to close the gap that exist for key populations in the HIV response by supporting investments that reduce stigma and discrimination, empower communities in the design and delivery of services and increase data quality on key populations.”
The U.N. is a highly political forum. This is not the first time that a block of countries has objected to the participation of certain organizations representing key populations in discussions on HIV, and to the inclusion of language related to these populations and to human rights in the U.N.’s declarations on HIV. In addition, in February 2016, the more than 50 members of the Organization of Islamic Cooperation and the 25-member Group of Friends of the Family led by Belarus, Egypt, and Qatar protested six new U.N. stamps promoting LGBT equality.
Moves to blackball key population organizations from UN negotiating tables present a significant barrier to global efforts to end AIDS. As one UNAIDS document put it, “The voice and leadership of people living with HIV and other key populations remains essential to these efforts.”