World AIDS Day: Cuts are threatening progress made on HIV/AIDS
The last few weeks have been a roller coaster of excitement and concern about the future of HIV and AIDS. On one hand, we have heard world leaders declaring the ‘End of AIDS’ and science has told us that this is possible. We are seeing a decrease in the number of new HIV infections in some parts for the world and effective treatment for those who can access it, preventing more AIDS related deaths than ever. On the other hand, the view regarding funding doesn’t look positive and it has become even worse in the last few days.
Just one week ago I would have mentioned the results of a Kaiser Foundation study which shows that aid for AIDS at the Global level has declined by 10% in the last year, and that funding mechanisms like the Global Fund to fight AIDS, TB and Malaria still provide much of the resource needed to sustain this. However, things changed dramatically last week.
The conclusions of the last Global Fund Board meeting came as a shock to us all. For the first time in its 10 years of existence, the Global Fund does not have enough resources to release another round of funding. Round 11 has effectively been cancelled and with it the hopes of many people affected by the epidemic, like the Latin American Network of Transgender people, whose members invested great efforts in preparing a regional proposal, which for the first time would have been specifically aimed at preventing the epidemic on transgender people, the population with the highest prevalence in Latin America.
This grant, if approved, would have been very different from any other because this time, the funding would have been managed by transgender leaders themselves. Although Latin America has low HIV prevalence the burden of the epidemic is carried by groups highly marginalised and discriminated like gay men and other men who have sex with men (12% to 25%), sex workers (3.5% to 7%), people living with HIV and transgender people who have a dramatic HIV prevalence rate of 35%. Now the Global Fund has announced that the renewals of existing grants will ONLY fund essential services and this puts Latin America and most Caribbean countries effectively out of the funding picture.
The Global Fund is yet another
donor leaving a region which faces huge inequities between rich and poor. The UK government’s Department of International Development (DFID) discontinued its funding for Latin America and closed all its country offices in 2010.
Unfortunately, most Latin American Governments are still not up to the challenge of ensuring that equality and inclusion are the highest priorities in national social policies. Still in Latin America, people are marginalized and discriminated against on the basis of their sexual orientation, and gender violence is widespread and enjoys impunity. Basic human rights are violated everyday and justice is not accessed by all. Children are marginalized in schools because they have a relative living with HIV, HIV positive people loose their jobs because of their status, and sex workers are subject of illegal detention and abuse.
Now more than ever, the scarce resources for HIV and AIDS should be focused to invest in community responses. And I would say even more, that an important part of those resources should be put in the hands of those communities affected by HIV if we want to make a real difference. Health systems need to be strengthened in different ways but also by community action. Health services need to increase their capacity to treat all human beings as equals and to encourage people to be tested, to use condoms, to stick to treatment courses, amongst many other things.
Organisations like AMMAR (Asociación de Mujeres Meretrices del Argentina), the Sex workers Union in Argentina, which has existed for 17 years, have made a big difference, challenging the stigma of society and carrying out HIV prevention work in public places. AMMAR are a key member of the Latin American and the Caribbean Network of Sex Workers (Retrasex), which last year won a Global Fund grant to work on AIDS prevention and human rights with sex workers in 15 countries. In light of the reduction of Global Fund resources, there is now a real risk that they will not receive all the funds to implement the work in full.
It is time for Governments like the UK to show leadership and stand by the pledges they have made to combat HIV and AIDS. The HIV and AIDS response has shown results but resources are urgently needed to consolidate them. We have evidence and the know-how. Huge progress has been made but we must not loose the momentum or that progress may be lost.