4 key takeaways from the launch of the Global HIV Prevention Coalition report

Following the launch, partners in our United for Prevention programme shared their reflections on the new report and what this means for the HIV response in their countries and their ongoing advocacy work.

1. Increase accountability between governments and civil society – let’s work together

“While prevention plans may identify the barriers, removing them requires overarching political will and multisectoral collaboration, which can be difficult to rally, especially in contexts where conservative political and cultural forces prevail.” – HIV Prevention: From Crisis to Opportunity 

Toyin Chukwudozie, Executive Director – Education as a Vaccine, Nigeria: There are some people who always take an accountability engagement from civil society as an attack. Let’s sit down [and discuss] where things are missing and where things need to develop.

For the Malawi HIV Prevention & Accountability report to be mentioned by the country’s National AIDS Commission (NAC) means the Malawian team are doing an amazing job. The report has struck a nerve.

Clare Morrison, Senior Advisor, HIV Prevention Advocacy, Frontline AIDS: The reports – HIV Prevention & Accountability reports and the GPC report – are meant to be complementary, neither one tells the full story. But together, they can be used to advocate for change.

What we are monitoring has improved. The official scorecards now track structural barriers, like parental consent for HIV testing for adolescents and policies on life skills education, which wasn’t the case in earlier versions. This is encouraging, but there’s a long way to go.

2. Prioritise enabling environments for marginalised communities

“New research indicates that, globally, the share of new HIV infections among key populations and their sexual partners increased from 44% of all new HIV infections in 2010 to 55% in 2022.” – HIV Prevention: From Crisis to Opportunity 

Amrita Sarkar, Advisor: Transgender Wellbeing & Advocacy, Alliance India: The meaningful participation of key populations at every level is crucial, though it will be an ongoing process., Transgender experts [in India] worked with NACO (The National AIDS Control Organisation) to prepare a transgender health white paper to integrate HIV services with other healthcare needs.

Clare: The repeated call to “invest in structural barriers, laws, and policies” has become a broken record over the past seven years. We need to find new ways to engage decision-makers and turn rhetoric into action.

We know there are still huge problems in obtaining data for these communities, be that accurate size estimates or coverage data. These data gaps hinder effective programming and need to be addressed.

3. Fund communities to deliver services

Action 5 – Strengthen and expand community-led HIV prevention services and set up social contracting mechanisms – “…progress has been mixed for action point 5, which covers key elements that can facilitate the delivery of HIV prevention services by community-led organisations.” – HIV Prevention: From Crisis to Opportunity 

Dr Lilian Benjamin, Executive Director, DARE, Tanzania: We can’t talk about community ownership when a lot of our countries haven’t even started conversations on social contracting this. Let’s brainstorm what we can do to speed up the process. We can’t talk about community ownership if we can’t implement our priorities.

Amrita: We know that funding for communities should not be limited to testing and treatment. Advocacy is an important component of what we do.

Toyin: Yes, communities are doing their part, even where frameworks for meaningful community engagement are missing. Governments must ensure that communities can make their vital contributions.

4. Provide access to HIV prevention technologies quickly and at scale

“PrEP [pre-exposure prophylaxis] coverage is very low in the focus countries where the epidemic is primarily affecting key populations and their partners.” 12 focus countries had either granted regulatory approval for use of the vaginal ring option or authorised its importation. Plus CAB-LA [injectable PrEP] had been registered in 13 focus countries.” – HIV Prevention: From Crisis to Opportunity 

Janet Mugambi, Monitoring and Evaluation Officer, LVCT Health, Kenya: “We still need to lobby for the introduction of different PrEP technologies. We have the dapivirine ring which we have introduced in the study and now we’re lobbying for the introduction of CAB-LA. We need to ensure that everybody is covered when it comes to prevention options.”

Toyin: There has been progress [in Nigeria]. Even though people are hesitant about CAB-LA, its introduction is moving and we’re happy about that.

At the same time, we know investments and social marketing for condoms are declining and distribution figures are down. We [civil society] need to add our voices to this conversation. Choice matters.