OUR
IMPACT IN

HIV,
HUMAN
RIGHTS
& JUSTICE

Outreach workers from SIDC share sexual health information with passers by in Beirut, Lebanon.



©Frontline AIDS/Diego Ibarra Sanchez/2023

our mission:
ending aids
for
everyone,
everywhere

Frontline AIDS has been on the frontline of the world's response to HIV and AIDS for 29 years, working with marginalised people who are denied HIV prevention and treatment simply because of who they are and where they live.

global
partnership
footprint

Together we are stronger:
the power of our partnership.


In 2022 the Frontline AIDS global partnership:

Reached over

10.8 million
people

with sexual and reproductive health and rights interventions (54% female, 45% male, 0.5% non-binary)

and provided financial or technical support for

1,163
community-
based
or
community-led
organisations

60
PARTNERS

spanning
more than

100
COUNTRIES

frontline
aids’
impact
in 2022

5  COUNTRIES

Improved national laws and policies that respect, protect and fulfil the rights of the most marginalised

10  COUNTRIES

Civil society increasingly holding governments, donors and the private sector to account – examples from 11 organisations

8  COUNTRIES

Sustainable, inclusive and evidence-informed national government responses

5  COUNTRIES

Most marginalised experience less violence, are safer and are more supported by communities and duty bearers – 10 examples

188,986

people reached with mental health interventions

SRHR education should be compulsory in schools. It would help abolish myths and lies which put girls at risk.



© Naskmariz/Frontline AIDS/PhotoVoice/2018

ADDRESSING
THE CRISIS
IN
HIV
PREVENTION

The HIV epidemic is not over – far from it. Data in 2022 revealed that 1.5 million people acquired HIV the previous year, one million more than the global target. Women and girls accounted for 49% of new infections, rising to 63% in sub-Saharan Africa. (UNAIDS data report, 2021)

SOME challengeS WE FACED IN 2022

  • The criminalisation of marginalised communities, which stops many people from accessing HIV prevention services
  • A global backlash against the rights of women and LGBTQ+ people
  • Misunderstandings and a lack of awareness of the importance of comprehensive sex education (CSE) for HIV prevention
  • Waning investment in HIV prevention

How Frontline AIDS and the partnership is making an impact

A teacher leads a sexual health session at a school in Zambia.



© Frontline AIDS/Nell Freeman/2006

Holding governments to account

Frontline AIDS has not only sounded the alarm with donors and governments but transformed this concern into action. As a result of our collective advocacy work, there has been a marked shift in the prioritisation of prevention by critical actors in the global HIV response.

In 2022, Frontline AIDS worked with community-based organisations in seven countries to develop country-specific milestones under the HIV Prevention Road Map 2025. These milestones were discussed with National AIDS Councils to include in new or updated plans that hold governments responsible for progress.

Throughout 2022 our advocacy focused on getting national governments to provide:

  • Access to pre-exposure prophylaxis (PrEP)
  • Lowering the age of consent
  • Providing CSE in schools
  • Addressing structural barriers to receiving healthcare services

With the support of Frontline AIDS, partners in South Africa influenced the government’s multi-sectoral strategies for young women and girls to address South Africa’s gender-based violence epidemic. Partners also continued to advocate for the decriminalisation of sex work which, if passed, will be a first for Africa.

The dapivirine ring can provide women with another HIV prevention option giving them more choice to suit their lifestyle and needs.



© IPM

Driving equitable access to new prevention technologies

In 2022, we advocated for improving the availability and affordability of new prevention technologies such as the dapivirine ring and Cabotegravir-LA (CAB-LA).

In collaboration with UNAIDS and civil society partners, we urged ViiV, the pharmaceutical company producing CAB-LA, to lower the medication cost for marginalised populations. ViiV responded by announcing a patent pool for CAB-LA, enabling generic manufacturers to produce affordable versions of the drug. Frontline AIDS will continue to provide input on ViiV’s access strategy.

Continued
investment in research is
needed to fill the HIV prevention gap for women and give them the options they need to protect themselves from HIV.

Winnie Byanyima,
Executive Director of UNAIDS

A seat at the table for young people and high-risk groups:

Empowered for Change (E4C) are young advocates who are helping to address the prevention crisis. In 2022, they continued to be instrumental in securing positive changes in districts in Kenya and Uganda. In Uganda, there was a marked increase in the reporting of gender-based violence after E4C advocates held community and stakeholder sensitisation sessions, and there was a greater uptake of Sexual and Reproductive Health services in Kenya. In both countries, young people and people from marginalised groups most affected by HIV have been included in district-level health councils and meetings, giving them the power to oversee decisions that impact their health and well-being.

CSE has enabled me to make informed decisions and it gives me a level of control over my life, over my body and over my future.

Adek Bassey,
Youth Advocate, Nigeria

Martha Clara Nakato, a Ugandan youth advocate with SRHR Alliance Uganda.



© Martha Clara Nakato

Bringing community voices to the global stage

In 2022, Frontline AIDS engaged global institutions and UN agencies to address the HIV prevention crisis and prioritise community experiences. Martha Clara Nakato, an Ugandan youth advocate, successfully influenced the UNAIDS delegation to back a decision on comprehensive sexuality education (CSE) – the first time this has been achieved.

UNESCO asked Frontline AIDS to revitalise a regional group overseeing the implementation of the Eastern and Southern African Commitment to CSE and Adolescent SRHR. The first ESA Commitment on CSE was endorsed in 2013 and led many countries to introduce programmes and policies to improve sexual health education and increase the uptake of youth-friendly SRHR services. Reviving this commitment is a vital step to addressing the HIV prevention crisis in the region.

Mohammad Ali Ahmed Hares, a peer educator for men who sex with men with a client in Bangladesh.



© Frontline AIDS/ Syed Latif Hossain

SAFEGUARDING
HUMAN
RIGHTS:
COMMUNITIES
ON THE
FRONTLINE

Criminalisation, stigma and discrimination stop people from accessing lifesaving HIV prevention, treatment and care. In order to challenge the status quo and improve service delivery, marginalised communities most affected by HIV are best placed to monitor the rights-related barriers they are currently experiencing. Community-led monitoring (CLM) systems are effective because they use local knowledge and leadership to successfully implement human rights-based monitoring programmes.

SOME challengeS WE FACED IN 2022

  • A rise in attacks on LGBTQ+ people, particularly in Eastern Africa, where anti-rights rhetoric is often used as a political tool by leaders during election times.
  • Human rights abuses perpetrated by state actors, acting in line with criminalisation legislation and policy.
  • The challenge of scale-up due to limitations on domestic financing

How Frontline AIDS and the partnership is making an impact

A rainbow flag flies over Dzaleka refugee camp, Malawi.



© Frontline AIDS/Gemma Taylor 2017

Emergency and ongoing human rights responses

Our Rapid Response Fund (RRF) has been providing emergency grants since 2016, supporting LGBTQ+ people who are facing human rights abuses to continue accessing HIV services in times of crisis.

In 2022, Frontline AIDS provided emergency response grants to 16 organisations in 10 countries.

When it comes to sexual violence, there’s a time factor that is really critical. You want to get them as early as possible to a facility to get PrEP, to gather evidence […] If a response is not provided within the first 72 hours, that can be detrimental to the well-being of the survivor and their chance at getting justice.

Toyin Chukwodozie,
Executive Director of EVA, Nigeria

In Lebanon, sensitisation with religious leaders is helping play a crucial role in challenging negative attitudes and beliefs towards HIV/ AIDS and promoting acceptance and inclusivity for marginalised populations.



© Frontline AIDS/Diego Ibarra Sanchez/2023

Using REAct to advocate for policy and programming reforms

Throughout 2022, our partners were increasingly strengthening evidence about human rights barriers to inform their own programming and advocate for policy and programming reforms.

  • SIDC in Lebanon analysed its data collected through REAct, a community-led monitoring tool, and used it to set priorities, including making recommendations for policy reforms to address evidenced human rights violations.
  • CYSRA and PHAU in Uganda, BONELA in Botswana and LVCT Health in Kenya used their REAct data to sensitise state perpetrators of rights violations, such as healthcare providers and police officers, and to engage in legal literacy dialogues with community members on critical issues.
  • NESS in Tunisia conducted the first quantitative study on migrants’ access to healthcare services in the country, with support from the Global Fund Country Coordinating Mechanism and other national stakeholders. The study led to an advocacy note being developed on how to improve the access of people from vulnerable migrant groups to HIV prevention, care and human rights support services.

George on his motorbike that he uses to bring clients their HIV medicine in Kampala, Uganda.



© Frontline AIDS/Karel Prinsloo/2022

BREAKING
DOWN
BARRIERS
THROUGH
INNOVATION

Innovation is at the heart of how the Frontline AIDS global partnership is working to end AIDS by 2030. Our global partnership is continually exploring, adapting and evolving the way we work to break down the multiple and often intersecting barriers experienced by marginalised people most affected by HIV.

SOME challengeS WE FACED IN 2022

  • Economic hardship, driven by Russia’s invasion of Ukraine and the enduring impact of the COVID-19 pandemic
  • The complex challenges that many young people face, related to relationships, mental health, HIV treatment, contraceptive choices and stigma, leading to rising HIV infections
  • Escalating mental health crises in many parts of the world

The Innovation Hub

Frontline AIDS designs and generates evidence about innovative approaches, so that lessons can be applied at scale within our partnership, by national governments, donors and other civil society actors. Innovation can take the form of a new action. Or it can be a new way of scaling up an existing intervention, making it more effective or adapting it to new contexts, in new combinations or for different populations.

In order to share this evidence more effectively we launched an online platform called the Innovation Hub in November 2022, in collaboration with strategic partners NACOSA from South Africa and LVCT Health in Kenya. The hub currently features 58 innovations from 30 partners.

EXPLORE THE innovation hub

The Innovation Hub is exciting because it really showcases the work that’s happening across the globe. You have this network of partners who are identifying the challenges and are responding to them – and then communicating their responses to others, so the learning continues.

Yolaan Andrews,
Key Populations Programme Manager, NACOSA, South Africa

The READY Academy trains and funds youth advocates to advance the health and rights of young people.



© Tafadzwa Aurthur Samungure

READY Academy:
training tomorrow’s leaders

Young people are the driving force of the READY movement. We use an innovative, youth-centred model to identify adolescents and young people then train them as peer supporters and advocates. It is these young people who drive the programme.

In 2022, Frontline AIDS launched the READY Academy, which in its first year strengthened the capacity of 26 promising young advocates whose lives are affected by HIV. Being part of the READY Academy has enabled these youth advocates to make vital connections and build movements. All are working on global advocacy issues aligned with important SRHR strategies, such as the UNAIDS Global AIDS Strategy, the regional Embassy of the Kingdom of the Netherlands SRHR strategy, the Southern African Development Community SRHR Strategy and the ESA Commitment.

But this is just the beginning. In the years to come, the READY Academy will be a crucial tool in fostering a network of highly-skilled, highly motivated young people working towards critical global advocacy issues.

Through the READY programme, we have reached over 36,000 adolescents and young people living with HIV, through evidence-based interventions.

My life has changed for the better [since becoming involved with READY+] because now I’m recognised and meaningfully engaged in national, regional and global activities for young people living with HIV. READY+ has opened many doors for me as a country focal point to advocate for the rights and needs of my peers. And thanks to READY+ I’m pursuing my dream of becoming a qualified psychologist at the University of Eswatini.

Ntsiki Shabangu,
Community Adolescent Treatment Supporter

Nguyen Duy Tung, 17, a peer educator and beneficiary checks in when he arrives at the Lighthouse clinic in Hanoi, Vietnam.



© Frontline AIDS/Quinn Ryan Mattingly/2021

BUILDING A
safe and
SUSTAINABLE
FUTURE

COVID-19 showed how important it is for community perspectives to be included in public health decision-making, and decades of experience from the HIV movement provides valuable lessons on the importance of a community-led response . By involving communities in shaping the global health architecture, we can ensure that future global health challenges are met with a coordinated, effective and equitable response

SOME challengeS WE FACED IN 2022

  • A lack of civil society representation in global and national discussions on pandemic prevention, preparedness and response (PPPR)
  • Vaccine inequity and the disparities in healthcare infrastructure and resources highlighted by the COVID-19 pandemic
  • The growing impact of climate change on marginalised people and its intersections with HIV

Jackline Njeri Kiarie (Amref Health Africa — Global South Interim Representative) and Elisha Dunn-Georgiou (Global Health Council — Global North Interim Representative), and alternates Nitish Debnath (One Health Bangladesh) and Olya Golichenko (Frontline AIDS, United Kingdom) attend the World Health Summit 2022 in Berlin, Germany.



© Amref Health Africa/Jackline Njeri Kiarie/2022

Championing civil society and communities

In 2022, Frontline AIDS together with partners has strongly advocated that civil society organisations (CSOs) with expertise in HIV were meaningfully engaged in global and national discussions on pandemic prevention, preparedness and response (PPPR) and included in the new mechanisms and funds being developed.

The Pandemic Fund was established in 2022 to provide a dedicated stream of additional long-term financing to strengthen PPPR capabilities and address critical gaps in low- and middle-income countries. Frontline AIDS contributed to ensuring that civil society and communities have a minimum of two voting seats on the fund’s governance board, and that the fund itself builds on the learnings from the Global Fund (and the HIV response in general) about the key role CSOs and communities need to play in any pandemic response. As a result of this advocacy the Pandemic Fund is one of a handful of Financial Intermediary Funds to have voting seats for civil society on its board.

A nurse administers a COVID-19 vaccination to a client at GSNP+’s vaccination camp in Gujarat, India.



© Frontline AIDS/Rahul Tiwari/2021

Challenging vaccine inequity

The COVID-19 pandemic exposed global healthcare disparities, causing unequal access to vaccines. This has led to economic and social disruptions, worsened inequalities, and hampered global recovery. Vaccine equity is crucial for pandemic response and controlling infectious diseases. Frontline AIDS, as a fiscal host for the People Vaccine Alliance, has played a vital role in advocating for changes in global intellectual property rules, local manufacturing, and public-private partnerships (PPPR). Notably, the US Government now supports temporarily suspending intellectual property rights for vaccinations. Frontline AIDS has also provided small grants to Botswana and Ecuador, facilitating the development of PPPR partnerships and coalitions, strengthening governance and accountability.

HIV AND
THE
CLIMATE
CRISIS

Lilian, a young woman from Kenya, has accessed FGS services. She is now keen to raise awareness in her community.



© Frontline AIDS/Denis Mwangi/2023

A 1°C increase in global temperature has been associated with an 8.5% increase in the proportion of the population with HIV. It is estimated that climate change will lead to over 11.6 million additional HIV infections by 2050.

THERE ARE SEVERAL
REASONS FOR THIS:

Climate-related disasters restrict access to SRH services and supplies, damaging health facilities and infrastructure and disrupting medical supply chains and records.

Food insecurity and displacement linked to climate change heightens gender disparities and can drive risky sexual behaviours

Denial of SRHR reduces people’s engagement in climate action by limiting education and livelihood opportunities, access to information and services and participation in politics and community affairs.

This is why we commissioned a study in 2022 to understand more specifically the intersections of HIV and the climate and environment crisis, and to explore how Frontline AIDS and the wider partnership can better adapt to these crises and mitigate the impacts wherever we can, focusing on:

1 KNOWLEDGE
AND
EVIDENCE

Build the knowledge base internally and then externally of Frontline AIDS’ partner experience in integrated climate-HIV programming

2 FUNDING
AND
ADVOCACY

Expand sources of funding for integrated HIV and climate work, advocate to include HIV, health and rights included in country climate plans and ensure impacted communities are in leadership roles of climate response planning.

3 Programme
integration

Integrate climate adaptation into HIV programmes to address migration, nutrition, economic impacts and increased risk of violence during crises; and integrate HIV, health and rights into humanitarian crises planning.

4 MITIGATION

Reduce health system carbon emissions in emission-producing countries

“I wish someone had to talked to me about my sexual health - I wouldn’t have ended up pregnant and unprepared at such an early age.”



Youth-friendly services in Uganda designed and implemented by youth.



© Naskmariz/Frontline AIDS/PhotoVoice/2018

ACHIEVEMENTS
AGAINST OUR
RESULTS
FRAMEWORK

We made good progress towards our achieving the changes set out in our results framework.
We fully achieved:

78%
of ‘expect to see’ changes
66%
of ‘like to see’ changes
44%
of the most ambitious ‘love to see’ changes

together
we
are
stronger

“We are extremely grateful for a meaningful and great partnership with Frontline AIDS. It is really doing development differently, engaging partners in decision making and finding solutions together.”
Dr Pasquine N. Ogunsanya, Alive Medical Services, Uganda

“We have been working together for more than 25 years and the partnership is very important to us. […] It means that if I don’t have experience of a specific aspect of good practice there might be someone else, in Ecuador or Ukraine for example, who does. Through partnership we can support each other and we can share our experience and processes with stakeholders, including government.”
Choub Sok Chamreun, KHANA, Cambodia

“There’s no substitute for collective working – and this Partnership Council brings us together. We can see that people from different regions are often having similar problems and we can work together to solve them, sharing our insight and understanding.”
Dr Sunil Mehra, MAMTA, India

Frontline AIDS employees pose for a photograph at staff conference.



© Frontline AIDS/Allie Liu/2022

OUR COMMITTMENT TO BECOMING AN ANTI-RACIST
ORGANISATION

We recognise that becoming an anti-racist organisation is a journey, and in 2022 we continued to hold ourselves accountable and work towards this goal, recognising the need for systemic change.

In 2022, Frontline AIDS conducted an anti-racism survey to evaluate staff experiences of the anti-racism work that had taken place and to measure any changes from 2021 levels of staff understanding, sentiment, and confidence.

100% of staff are confident that Frontline AIDS’ commitment to anti-racism is genuine, compared to 81% in 2021.

89.2% of staff feel more comfortable engaging in conversations on anti-racism with colleagues, compared to 53.1% in 2021.

78.4% of staff have confidence in leadership to create an anti-racist workplace, compared to 49% in 2021.

PLANS
for 2023

CHALLENGE LEADERS TO INVEST IN AND IMPROVE ACCESS TO HIV PREVENTION

1
  • As a key member of the Global Prevention Coalition, Frontline AIDS will prioritise accountability work by supporting coalitions in seven countries to develop milestones and hold their governments responsible for achieving their HIV Prevention Road Maps.
  • Participate in the Coalition for Long-Acting PrEP and collaborate with partners on new prevention technologies.
  • Focus advocacy efforts on global activities, such as collaborating with She Decides and Education+, and regional work on the ESA Commitment in Eastern Africa.
  • Support countries with the Global Fund upcoming grant cycle and engage in Global Fund governance processes from 2023 - 2025.

INTEGRATE HIV, SRHR, TB AND VIRAL HEPATITIS SERVICES THAT PUT PEOPLE AT THE CENTRE

2
  • Support partners to articulate the added value, lessons learned, and vision for a community-based integrated model for HIV/TB/Hepatitis-C co-infection.
  • Promote and seek further funding for this innovative approach, drawing on good practices and experience from other countries.
  • Engage civil society TB organisations, activists, and technical experts, implementing lessons learned and recommendations from partnership experiences and policy briefs.
  • Create a supportive policy environment that encourages national governments to politically support and fund effective models of care prioritizing marginalised communities.

FIGHT FOR HUMAN RIGHTS, GENDER EQUALITY AND ACCESS TO HEALTH AND JUSTICE

3
  • Understand the workings of anti-rights and anti-gender opposition movements and develop strategies to address them. integrated model for HIV/TB/Hepatitis-C co-infection.
  • dentify less contested entry points for our work in collaboration with partners.
  • Focus on comprehensive sex education (CSE), initiating dialogues on school-based gender violence and safeguarding.
  • Engage with policymakers to promote human rights, particularly for LGBTQ+ individuals and other marginalised communities.

DELIVER, SHARE AND SCALE UP INNOVATIONS

4
  • Bring government alongside when designing innovations to improve buy-in, collaboration and support when implementing.
  • Continue to work in partnership with governments to ensure fidelity in practice by supporting partners with evaluations, training and developing standard operating procedures.
  • Focus on innovations on Female Genital schistosomiasis (FGS), mental health, climate change and economic empowerment and their intersections with HIV.

STRENGTHEN AND SUSTAIN COMMUNITY HEALTH SYSTEMS

5
  • Demonstrate practical approaches for better health coverage through advocacy work on Pandemic Prevention, Preparedness and Response (PPPR).
  • Leverage Frontline AIDS’ expertise by strengthening the collaboration between formal health systems and community health systems.
  • Focus on priorities and effective influence, finding the right balance between global and national advocacy.
  • Build coalitions of different actors at the national level for greater advocacy impact.
  • Forge connections with civil society organisations working in different spheres as global health crises evolve.

DEVELOP AND CHAMPION A NEW GENERATION OF LEADERS

6
  • Utilise data gathered through community-led monitoring in advocacy to enhance services and address rights violations.
  • Harness the influence of youth advocates to drive local change and empower the next generation of leaders.

The
Frontline
AIDS global
partnership
is made up
of the
following
partners:

  • AIDS & Rights Alliance for Southern Africa (ARASA)
  • AIDS Care China
  • The AIDS Support Organization (TASO)
  • Africaid Zvandiri
  • African Sex Workers’ Alliance (ASWA)
  • Alive Medical Services (AMS)
  • Alliance Burundaise Contre le SIDA (ABS)
  • Alliance for Public Health (APH)
  • Alliance Nationale des Communautés pour la santé (ANCS)
  • Alliance Nationale pour la santé et le développement en Côte d’Ivoire (Alliance Côte d’Ivoire)
  • Associação Comunitária Ambiente da Mafalala (ACAM)
  • Association de Lutte Contre le SIDA Association Marocaine de Solidarité et Développement (AMSED)
  • Association tunisienne de lutte contre les maladies sexuellement transmissibles et le sida (ATL MST SIDA)
  • Anti-AIDS Association
  • Botswana Network on Ethics, Law and HIV/AIDS (BONELA)
  • Caritas Egypt
  • Centre for Supporting Community Development Initiatives (SCDI)
  • Co-ordinating Assembly of Non-Governmental Organisations (CANGO)
  • Corporación Kimirina
  • Education as a Vaccine Against AIDS (EVA)
  • Family AIDS Caring Trust Zimbabwe (FACT)
  • Forearms of Change to Enable Community Jordan (FOCCEC)
  • Frontline Global
  • Gays and Lesbians of Zimbabwe (GALZ)
  • Gender DynamiX
  • Global Network of Young People Living with HIV (Y+ Global)
  • Humsafar Trust
  • Initiative Privée et Communautaire pour la santé et la riposte au VIH/sida au Burkina Faso (IPC/BF)
  • India HIV/AIDS Alliance (Alliance India)
  • Instituto para el Desarrollo Humano (IDH)
  • Khmer HIV/AIDS NGO Alliance (KHANA)
  • LAMBDA - Mozambican Association for the Defense of Sexual Minorities
  • LEPRA Society
  • LVCT Health
  • MAHAMATE
  • MAMTA Health Institute for Mother and Child
  • Middle East and North Africa Harm Reduction Association (MENAHRA)
  • Networking HIV & AIDS Community of Southern Africa Organization for Social Services, Health and Development (OSSHD)
  • Paediatric AIDS Treatment for Africa (PATA)
  • Pakachere Institute of Health and Development Communication
  • Peer to Peer Uganda (PEERU)
  • Positive Vibes Trust
  • Promoteurs Objectif Zerosida (POZ)
  • Red de Mujeres Trabajadoras Sexuales de Latinoamérica y El Caribe (RedTraSex)
  • Red Latinoamericana y del Caribe de Personas Trans (RedLacTrans)
  • Red Nacional Sobre Droga & HIV/SIDA (UNIDOS)
  • Soins Infirmiers et Developpment Communautaire (SIDC)
  • Sexual Minorities Uganda (SMUG)
  • The SRHR Africa Trust
  • Uganda Harm Reduction Network (UHRN)
  • Uganda Network of Young People Living with HIV/AIDS
  • Uganda Youth Coalition on Adolescent SRHR and HIV (CYSRA)
  • Vasavya Mahila Mandali (VMM)
  • Via Libre
  • Youth Initiative for Drug Research, Information, Support and Education (YouthRISE Nigeria)
  • Zimbabwe Civil Liberties and Drug Network (ZCDN)

We would like to thank all our donors for their contributions:

  • The Elton John AIDS Foundation
  • Expertise France
  • Ford Foundation
  • The Government of the Netherlands (BuZa)
  • Gilead Sciences Inc.
  • Levi Strauss Foundation
  • The Global Fund to Fight AIDS, Tuberculosis, and Malaria
  • The Government of Ireland
  • Open Society Foundations
  • New Venture Fund
  • Rockefeller Brothers Foundation
  • The Swedish Government (Sida)
  • UNESCO