World AIDS day on December 1 is always a global opportunity for people to unite in the fight against HIV. Back in 1988, World AIDS Day was the first ever global health day. As Hivos, we acknowledge our support and respect for people living with HIV and remember the many people we have worked with and those who have needlessly passed away.
The UN, WHO and PEPFAR (US) have recently launched global campaigns in which they highlight gaps in the current HIV response. These include the Right to Health (UNAIDS), Everybody counts (WHO) – advocating for affordable medicines – and an interesting take by PEPFAR, whose slogan is ‘Increasing Impact through Transparency, Accountability and Partnerships’. I have no doubt whatsoever that these global efforts will continue contributing to saving lives on the short and medium term. We applaud them and will take any opportunity to collaborate and identify synergies.
Will these initiatives work in the long term when other obstacles are at play?
The question, however, is whether – at implementation level – these initiatives will translate into sound policies and corresponding resources needed to end HIV and AIDS in the long-term, particularly among the people who are most affected by HIV.
Let’s look at this more closely. How can a person whose sexual identity is denied by the law in their country, for instance, freely access the health services and medicines they need, even if they are affordable? How can a sex worker or a drug user who faces imprisonment in a myriad of countries, attain their right to health? How will a young person know his or her HIV status, if first they need their parents’ consent for testing? And what about the quality of the service? Would you go back to any doctor who treated you with contempt?
Finally, let’s not forget that “people at risk” in many countries are not even allowed to organise or get their organisation officially registered when they want to obtain their right to health – or any other right for that matter. It’s clear that we are not only addressing a disease here, but a much bigger problem. A problem rooted in systematic and permanent exclusion of people who are denied their basic human rights and whose needs are seen as “irrelevant” or, even worse, as “out of order”.
We must address the root causes of HIV instead of its symptoms
That’s why as Hivos, the only way forward we see is to address the root causes of HIV instead of its symptoms. That’s why we push for legal reforms, generate debate around gender inequality, sexuality, sexual orientation and gender identity, support organisations to become strong and sustainable and help get them a seat at the table. A “transparent” table preferably, where stakeholders agree on common issues and understand what it takes to be accountable.
We should learn from the good examples at country level. For decades now, HIV has been set aside as a technical problem; it’s time to acknowledge that it takes political will, courage and commitment to do the right thing.