Breaking Barriers, Advancing Rights

Before joining Frontline AIDS, I cut my teeth as a human rights practitioner at the Botswana Network on Ethics, Law and HIV (BONELA). BONELA had just received funding from the Global Fund in 2004 to implement human rights programmes within the country grant.

Back then, organisations like ours had a lot of space to explore unique initiatives to address HIV-related stigma and discrimination. We trained health care workers on patient’s rights; we galvanised support groups of people living with HIV to know their rights; we trained legal practitioners, parliamentarians and the police in law reform. We helped develop national policies around HIV and the Law and Routine HIV Testing. We helped people living with HIV get legal help. We advocated against criminalisation of HIV transmission. We partnered with organisations like the AIDS and Rights Alliance of Southern Africa, to train up literally hundreds of activists to deliver high quality human rights projects across sub-Saharan Africa.

Despite all our hard work, human rights-related barriers persist. Governments across the world have made political commitments to address such barriers to achieve the ‘end of AIDS’ by 2030.[1] But human rights-related barriers, such as punitive laws and gender inequality, continue to be a key driver of the epidemic. Through government commitments to the Sustainable Development Goals (SDGs), governments and global leaders acknowledge the critical need for human rights programming interventions.

Why won’t governments invest in rights-based programmes?

Yet not a single country has scaled up human rights responses. What’s the issue? And why is this so important now?

There are many factors for this, but here I wish to highlight the most significant: resources. Governments haven’t demonstrated their political will by putting their money where their mouths are, and investing the funds needed. Despite the rhetoric in support of human rights responses, UNAIDS estimates that only 0.13% of HIV spending in low- and middle-income countries is allocated to the human rights response to HIV[2], most of which is from external donors.

Human rights responses have always been advocated for and implemented by civil society activists. Without adequate funding, projects are typically too small-scale and too short term. As a result, civil society hasn’t been able to demonstrate the impact of their work. It appears that governments often use rights language to attract donor funding, but then don’t actually fund rights-based responses. The implication? Rights-based responses are often relegated by governments.

The rhetoric alone won’t convince governments to invest in rights-based programming. We need to show that rights-based programmes are necessary to end AIDS using reliable and sound evidence.

We will have to show them how. We need to work together to design strategically sound, rights-based programmes that are comprehensive and at scale.

As we were thinking through all of this at Frontline AIDS in 2017, we realised that we weren’t alone. In its 2017-22 strategy, Investing to End Epidemics, the Global Fund committed matched funds worth 45 million USD to 20 select countries. The impetus was to incentivise governments to increase funding towards rights-based programmes and scale them up.[3]

This initiative is needed. In my mind, this is a great opportunity to demonstrate what we for so long as civil society activists were not able to: the impact of rights-based responses.

However, we also realise that if it fails, we all lose. We would have nothing to show to push our governments to fund this important work. It became clear that technical support was crucial to give this the best chance of success.

We need to show impact

A scan of the technical support environment left us feeling uneasy. Sure, governments and civil society could access funding from a number of sources, including the Global Fund and UNAIDS. But most funding is at the request of countries themselves. Country actors – technocrats designing programmes and implementers – had to know that they needed help. We were worried that countries with this money wouldn’t make technical support requests, simply because they wouldn’t know what to ask for. Or at least, not until they had failed, and again: failure simply isn’t an option.

What needed to happen, and were we, as Frontline AIDS, in a good position to contribute? Three areas stood out:

• Technical Guidance: We have the history of human rights programming to develop this.
• Technical Assistance: Through Frontline TA, we have a network of experts ready to provide support.
• Convening Global Learning: As a convener of the global HIV movement, we can bring civil society together to share their experiences.

With support from GIZ Backup Health and in partnership with the Global Fund Community Rights and Gender Department, this year Frontline AIDS launched the Breaking Barriers, Advancing Rights programme in order to deliver this support to Uganda, Ukraine, South Africa and Cote D’Ivoire. In various ways, it is delivering on all three aspects.

As part of this project, I recently joined a Global Fund meeting in Durban that brought together Global Fund and bi-lateral organisations in an effort to galvanise support and align our efforts. The response from the audience was overwhelmingly positive. Some even asked why it has taken this long to do this. This reassured me that we are indeed on the right path.

The window of opportunity is closing. Frontline AIDS are playing a key role in providing the tools required and technical assistance but we need others to join us. No single organisation or government will be able to put an end to human rights challenges that continue to persist.

[1] General Assembly, 2016. Political Declaration on HIV and AIDS: On the Fast-Track to Accelerate the Fight against HIV and to End the AIDS Epidemic by 2030. Available from: https://www.unaids.org/en/resources/documents/2016/2016-political-declaration-HIV-AIDS  (Accessed 23 October 2018); UNAIDS, 2018. Miles to Go: Closing Gaps, Breaking Barriers, Righting Injustices. Available from: https://www.unaids.org/en/resources/documents/2018/global-aids-update (Accessed 23 October 2018); Global Commission on HIV and the Law, 2018. HIV and the Law: Risks, Rights and Health – 2018 Supplement. New York, NY: UNDP.

[2] UNAIDS, 2015. Sustaining the Human Rights Response to HIV: Funding Landscape and Community Voices. Available from: https://www.unaids.org/sites/default/files/media_asset/JC2769_humanrights_en.pdf (Accessed 9 November 2018).

[3] https://www.theglobalfund.org/en/funding-model/funding-process-steps/catalytic-investments/#matching-funds – Global Fund matching funds explained.