We are under attack, but we are together

Today I joined colleagues on the NGO Delegation to the UNAIDS Board in publishing our communique, setting out our hopes and expectations for the Joint Programme’s response to the US Stop Work Orders.

In it, we recognise the substantial efforts made by the UNAIDS leadership so far, including their advocacy to secure a waiver from the US government, and ask for continued engagement with the US government until all partners impacted by the funding freeze receive notification that they can reopen their vital services.  

We heard from a Frontline AIDS partner that provides vital support for orphans and vulnerable children. Overnight, it had seen 90 per cent of its funding frozen

We also call for efforts to persuade the new US administration to rethink its opposition to HIV prevention and other aspects of an effective HIV response. We also urge UNAIDS to advocate assertively with other donors to ensure continued HIV financing, particularly for prevention programmes and services led by and for key populations, alongside comprehensive SRHR responses and services addressing gender-based violence.

Noting the work that UNAIDS is leading to convene national and regional level, we insist on the meaningful engagement of civil society and community-led organizations in identifying and filling the most critical gaps. We argue that as a longstanding champion for community leadership, UNAIDS must be accountable for facilitating truly meaningful engagement at this time of unprecedented crisis.   

For delegation members, this is not a crisis that is happening far away to other people or organisations. It is one that impacts directly on many members of the delegation itself, threatening their access to health services and their human rights, as well as their jobs, their colleagues and their organisations. We come together in each meeting filled with ideas, a sense of urgency and also a deep care for one another.    

Over recent weeks, I have seen that same care – and indeed, solidarity – reflected within the Frontline AIDS partnership. In a recent call, we heard from a Frontline AIDS partner that provides vital support for orphans and vulnerable children. Overnight, it had seen 90 per cent of its funding frozen, and the Executive Director was deeply worried about whether the organisation, which has been there for children affected by AIDS for more than two decades, would even survive.

Later that day I spoke with the Executive Director of another partner organisation, who told me that they had also lost funding for a vital advocacy programme focused on human rights and equity. They did not expect to receive a waiver. She hadn’t mentioned it in the wider call, because she was concerned about the other director facing the 90% cut, and wanted to focus on supporting them. This is what we mean when we say that together, we are stronger. 

Chairing a virtual gathering of all Frontline AIDS partners yesterday, Dr Khuat Thi Hai Oanh from Supporting Community Development Initiatives (SCDI) in Vietnam reminded the partnership that “not all of us are directly affected, but we must all act together in solidarity”. In response, Lucy Esquival from the REDTRASEX network in Latin America described how her organisation had lost vital support from the Robert Carr Fund. “This is going to have an impact on the lives of sex workers,” she explained. “We risk losing track of people, we need to keep HIV prevalence low, and we have many structural problems. Our victories are being set back, but our strength is we still have a voice.” 

Sharing the Alliance for Public Health Ukraine’s experiences, Andriy Klepikov pointed to the critical advocacy that the Frontline AIDS’ partnership is engaging with. He described a “collective wisdom and collective creativity”, in particular making the case for HIV prevention as well as mobilising donors to provide emergency funds. This means arguing for new sources of support for transgender people and other key population communities, as well as shaping long term solutions in what looks set to become a bigger crisis. 

While dealing with the immediate fall out of the funding freeze, Frontline AIDS is already thinking about what the US’s recent actions mean for the future of the HIV response. Already, we see examples of countries stepping up to protect HIV services. Perhaps this crisis could herald an opportunity for governments to assume fuller responsibility for financing their HIV responses and their wider health systems, using the framework of the UNAIDS Sustainability Road Maps to chart a long term plan towards greater domestic financing for HIV and health.

We may also see a much faster integration of HIV into wider health systems and a more integrated approach to tackling HIV alongside other key areas of health, including SRHR, TB and viral hepatitis. It is critical that Frontline AIDS partners are able to engage with their governments around these important transformations, and we’ll be providing space within our partnership to ensure that civil society and community organisations can share and learn from one another’s experiences.   

Vitally, this year will also see the development of a new Global AIDS Strategy, led by UNAIDS. In my role on the delegation, I’ll be pushing for that process to look at how these bigger shifts are likely to impact on the health and lives of people living with HIV, and those from key and marginalised populations, especially in the context of an anti-rights opposition that has been much emboldened by the Trump administration.    

We must ensure that the voices of people living with and affected by HIV, as well as civil society and community leaders, are heard louder than ever in this moment of crisis and at this vital juncture for the future AIDS response. 

With my colleagues on the NGO delegation, I will also be pushing to ensure a process that creates space for people living with and affected by HIV to come together, along with the civil society and community-led response, to ensure that their voices are heard louder than ever, in their moment of crisis, and at this vital juncture for the future AIDS response. 

Read the full communique from the NGO Delegation to the UNAIDS Board.