The Programme Coordinating Board (PCB) is the governing body of UNAIDS and it is made up of Member States, UN agencies and NGO Delegates. Our mission as the PCB NGO Delegation is to ensure that the priorities and interests of affected people, constituencies and communities are considered in UNAIDS decisions and policies.

34th PCB Meeting

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The upcoming 34th PCB Meeting will take place on 01 – 03 July 2014 in Geneva. A topic for 34th PCB Thematic Segment has been decided on “Addressing Social and Economic Drivers of HIV Through Social Protection”

More information & documents for meeting will posted as soon as they become available.

Governance Key Documents:

UNAIDS Midterm Review of the Unified Budget, Results, and Accountability Framework (UBRAF)

Blog15 April 2014   [PDF] [print]

By Laurel Sprague, NGO Delegate from North America

On March 27, members of the NGO Delegation joined the UNAIDS Secretariat, cosponsors, and Member States in Geneva as part of a multi-stakeholder consultation to review progress in meeting the goals of the UNAIDS 2011-2015 Strategy. Since 2011, the mechanism used to detail, track, and report on progress toward meeting UNAIDS’ goals is the Unified Budget, Results, and Accountability Framework, known as UBRAF. This consultation was designed to gather input on the midterm review of the UBRAF; which will be presented in full at the 34th PCB in July.

The consultation opened with an overview of the context of the global HIV epidemic, with particular focus by Michel Sidibe on emerging political challenges to the protection of basic human rights. Sidibe spoke of the need to reach those who have been left behind in access to prevention, treatment and care as a major challenge for 2015 and beyond. Echoing the NGO Report presented to the PCB last December, he called for better data that is disaggregated so we know what works for different populations. He spoke against rising conservatism and fundamentalism that threatens the sexual and reproductive health rights of women and young and the safety and health of lesbian, gay, bisexual, and transgender people, specifically pointing to laws in Uganda, Nigeria, Russia, and India. Noting the twenty African countries without homophobic laws and the approximately forty non-African counties with homophobic laws, Sidibe warned that we need to support the African countries that don’t have homophobic laws rather than label and attack the entire continent as homophobic. He argued that fundamentalism and lack of human rights for LGBT people is not an African problem, but rather a global problem, and needs to be understood and discussed as such. Further, Sidibe argued that making the link between violence against women, economic security, and HIV should be made central to the HIV response.

Further challenges described by Sidibe included the need for a stronger debate about intellectual property and public goods (the topic of the upcoming NGO Report in December 2014) and the movement of countries with large populations of people living with HIV into middle-income status. He noted that 87% of people living with HIV will be in middle income countries in the next 5-10 years and that approaches to development assistance need to be adjusted to account for this context. Sidibe expressed the conviction that countries must be supported to scale up their own funding for health programs and be less dependent on international assistance. He highlighted the new partnership between UNAIDS and the World Bank to focus jointly on addressing social drivers and inequality in order to end new infections and HIV-related illnesses and deaths.

Sidibe’s opening remarks that the Joint Programme has reduced expenditure by 48 million dollars, through, among other cuts, reducing consulting and contractual services by 35% and travel costs by 30% and cutting headquarters staff positions in Geneva.  As a result, 70% of UNAIDS staff are in the field.

Sidibe’s remarks were followed by a lively Q&A session in which member states asked for more detailed information, including baselines, measurable indicators, outcomes, and analyses of gaps, as well as reporting on how technical assistance work is conducted and shared between UNAIDS and cosponsors, such as WHO, and how UNAIDS can be a catalyst for communication between governments and civil society. The NGO Delegation as about the effects of diverting so many staff members to the field. Sidibe responded by indicating his feeling that too many people remain in the central office and that, although he finds the change successful, they need to find further ways to become leaner and rely more on the leadership of the cosponsors.

Following the opening remarks, examples of achievement, lessons learned, and cooperation between the Secretariat, cosponsors, countries, and civil society were shared by various partners and cosponsors. Speakers focused again on the growing dangers for key populations and the need to address violence against women, expressing the need, in the words of Luis Loures, UNAIDS Deputy Executive Director, to “focus our resources on this growing crisis”. They noted the successes of the three zeroes campaign and reduction in vertical transmission and also the work still ahead in even such basic areas as condom access, given that some countries have only 8 male condoms per man available per year and only one female condom for every 8 women. Further critical gaps include real treatment access that sensitively and competently meets the needs of HIV-positive women who are pregnant, for whom loss to follow can be as high as 89%, and for children, when overall, only 34% of children (and 67% of adults) in 21 priority countries who need ART have access toit. Finally, the situation of HIV in humanitarian emergencies was highlighted as a critical gap with the needs of people living with HIV seemingly invisible in the emergency responses.

In Sidibe’s opening remarks and in comments from member states, the post-2015 agenda was raised as an area in which the PCB members need to strategize and work together closely. Saraswathi Menon, UN Women, Director of Policy, noted that the post-2015 agenda provides opportunities to address issues using the language of rights that were not addressed before, includingunpaid care work, violence against women, and sexual and reproductive health rights, which was a weak target in the MDGs.

In the comments period, the NGO Delegates emphasized the importance of joint collaboration among the various co-sponsors and the secretariat’s role of accountability, and specifically requesting that UNICEF work jointly with UN Women in UNICEF’s programs for pregnant mothers to address violence against women.The NGO Delegates further stressed that it is critical to explain to local communities why key populations, such as gay men and other men who have sex with men and women and men who use drugs, are important. We must ensure that medical, parliamentarians and other opinion makers are informed so they don’t just react from an emotional perspective.  We called for support to strengthen advocates from key populations so that they can advocate for themselves and not just have us talking about them. 

UNICEF Statement on Anti-Homosexuality Laws

Blog8 March 2014   [PDF] [print]

PRESS RELEASE

Today 78 countries around the world have laws that subject their citizens to severe criminal penalties for homosexuality.  Such laws not only undermine human rights – they can also fuel discrimination, stigma, and even violence against people on the basis of their perceived sexual orientation and gender identities.  And the impact of these laws can be even more severe on children and adolescents, who are especially vulnerable to bullying, violence, and stigma.

All people have a right to live a life of dignity, free from discrimination – irrespective of their gender identity or sexual orientation.  Any law which heightens the risk of harm to children is counter to the principles established in the Convention on the Right of the Child, and the universal human instinct to protect children.

UNICEF will continue working to protect all children from discrimination, including those who identify as LGBT (Lesbian, Gay, Bisexual, or Transgender), and we urge governments to safeguard their youngest citizens from violence or threat of reprisal for exercising their rights.

JOINT POSITION ON POST-2015: What a Stand-alone Health Goal Needs to Deliver for Highly Marginalized & Stigmatized Young People

Blog5 March 2014   [PDF] [print]

 

Dear colleagues and advocates,

In advance of and parallel to upcoming high-level events and meetings in New York (the High-Level Event on The Contributions of Women, the Young and Civil Society to the Post-2015 Development Agenda, the 58th Session of the Commission on the Status of Women, and the 47th Session of the Commission on Population and Development), it is imperative that civil society and government express the importance of prioritizing young people, especially those most marginalized and stigmatized, in the post-2015 agenda.

We hope you can and will join us in this effort.  Please lend your organization’s support by March 28th as we will re-release this statement for the Commission on Population and Development.

Stand with us and send your organization’s endorsement to mhart@stopaidsalliance.org

JOINT POSITION ON POST-2015:

What a Stand-alone Health Goal Needs to Deliver for Highly Marginalized & Stigmatized Young People

For consideration in the development of the final report of the Open Working Group on Sustainable Development Goals, the discussions and outcomes of the High-Level Event on the Contributions of Women, Youth and Civil Society to the Post-2015 Development Framework, and in the discussions and outcomes of the Commission on the Status of Women and the Commission
on Population and Development.

Young people living with and affected by HIV – especially young women and girls living with HIV, young people who engage in sex work, young men who have sex with men, young transgender people and young people who use drugs – belong to the most  marginalized and stigmatized groups across the world. In many countries, the existence of lesbian, gay, bisexual and transgender (LGBT) people and men who have sex with men is ignored or denied. This denial, in combination with discrimination, violence, punitive legislation, and harmful attitudes and norms around “appropriate” sexual behavior, poses a major barrier to young people’s ability to access quality health services and fully realize their human rights – including their sexual and reproductive health and rights (SRHR).

Many countries have championed SRHR during Open Working Group negotiations, the ICPD Beyond 2014 review, and in the 2012 Bali Global Youth Declaration and the 2011 Political Declaration on HIV/AIDS. Many civil society organizations have likewise called for prioritizing SRHR for young people, especially those of young people living with and most vulnerable to HIV. The final negotiations on the post-2015 development framework must reflect this strong support for promoting the health and human rights, including the SRHR, of young people living with and affected by HIV.

A UNIFYING HEALTH GOAL FULLY DRIVEN BY EQUITY AND RIGHTS
We strongly support the wide consensus that the unfinished business of the health MDGs (4, 5 and 6) must be incorporated in the new framework and unified under a single health goal. We also support the wide consensus that a stand-alone health goal must include cross-cutting commitments to ensuring gender equality and eliminating all forms of gender-based violence, realizing social justice and universal access to health, and promoting human rights, including SRHR. The right to health with its implied imperative of narrowing health inequalities should be central to the post-2015 health agenda. In accordance with international human rights law and standards, everyone has the right to the enjoyment of the highest attainable standard of health, free from violence, coercion, stigma and discrimination.

Link Up aims to advance the sexual and reproductive health and rights of one million young people affected by HIV across five countries in Africa and Asia. The programme is being implemented by a consortium of partners led by the International HIV/AIDS Alliance. For more information visit the Link Up Project website.

We firmly believe the health goal should be outcome-focused and account for all factors that affect health and wellbeing at all ages of life. Given the higher vulnerability of young people to poor sexual and reproductive health, and in particular that of the most marginalized and stigmatized, a stand-alone health goal must support young people’s rights to control all aspects of their sexuality and their reproduction.

At minimum, a health goal should include targets on:
Universal health coverage, including a) universal and equitable access to quality health care, in particular for young people and adolescents, that includes comprehensive sexual and reproductive health care and rights information; universal comprehensive sexuality education that promotes respect for human rights, freedom, non-discrimination, gender equality and nonviolence; prevention and treatment of sexually transmitted infections (STIs) and HIV prevention, treatment, care and support services; contraceptive and family planning commodities, including emergency contraception, safe abortion and post-abortion care and services, and b) financial risk protection, including comprehensive social protection for people living with HIV;

Health outcomes, including ending preventable newborn, child and maternal morbidity and mortality, especially for young women, and preventable morbidity and mortality from communicable and non-communicable diseases, including working towards zero AIDS-related deaths and zero new cases of HIV both through sexual transmission and drug use;

Addressing structural drivers of inequality, which includes ensuring that no one is denied quality health care, including HIV prevention, treatment, care and support and sexual and reproductive health care, due to their age, gender, HIV status, or sexual orientation and identity and eliminating all discriminatory laws that contradict the right to health.

All new health investments and the development and implementation of post-2015 goals, targets and indicators must be firmly based on human rights, including sexual and reproductive rights.

DISAGGREGATED DATA
Data to measure progress towards any new post-2015 goal, including the health goal, should be disaggregated at minimum by age, gender, ethnicity, location, disability, sexual orientation, gender identity and other factors that drive marginalization and increase health risk. There is a lack of evidence-based data on many marginalized groups, including young people under the age of 20, rendering marginalized groups invisible and lacking access to health and social services. The post-2015 framework must support a “data revolution”, as proposed by the UN Secretary General’s High Level Panel on post-2015 to ensure no one is left behind.

However, to avoid increased risk for certain populations, data on sexual orientation and gender identity must be collected voluntarily and through strictly monitored confidential systems that employ sound informed consent processes. This requirement helps ensure respect for the privacy and rights of those who choose to disclose their sexual orientation or gender identity. It is, furthermore, in accordance with global human rights standards and ratified treaties.

STRONG AND INCLUSIVE ACCOUNTABILITY MECHANISMS
Strong and inclusive accountability mechanisms at the country level are critical and complementary aspects of promoting the
health and human rights of the most marginalized and most stigmatized. These mechanisms must oversee human rights and health commitments and secure broad participation of communities, including young people living with and most affected by HIV, along with transparency and accountability in health resource allocation and spending.

Lessons learned from the HIV response demonstrate that communities and community-based organizations contribute significantly to progress by increasing outreach and access to services, as well as by delivering direct and appropriately tailored services. They also help ensure the voices of the most marginalized are heard and their needs and priorities put forward and reflected in national policies, plans and budgets. The accountability mechanisms to be built into the post-2015 framework should draw from the experiences of the HIV response, and ensure the meaningful engagement of communities and community-based organizations, including organizations of women living with HIV, young people, young people living with HIV, sex workers, men who have sex with men, and other marginalized groups. Communities must be involved at all levels of the design, implementation and monitoring and evaluation of the post-2015 development agenda.

WE WANT TO SEE A STAND-ALONE HEALTH GOAL IN THE POST-2015 DEVELOPMENT FRAMEWORK THAT DELIVERS FOR HIGHLY MARGINALIZED AND STIGMATIZED YOUNG PEOPLE

SIGNATORIES
This paper was developed in collaboration with the following Link Up partners:

Click here to find out more about Link Up Project

Send your organization’s endorsement to mhart@stopaidsalliance.org

Communities Express Worry on The Principle Recipient’s Selection Process in Democratic Republic of Congo

Blog3 March 2014   [PDF] [print]

 By Kenly Sikwese – Africa NGO Delegate

Serious concerns have been raised relative to the stakeholders’ meeting that was held on 14-15 January2014 in the Democratic Republic of the Congo’s (DRC) capital Kinshasa. The meeting was the final country dialogue to validate the content and priorities of the country HIV concept note under the Global Fund’s new funding model (NFM). It included representatives from civil society, government, key affected populations and technical partners. The country dialogue was the first step in the grant application process under the NFM.

While the DRC dialogue bore all the hallmarks of a transparent and consultative process with input from a range of stakeholders into the country concept note for HIV programming, some community representatives have expressed concern at the choice of the principal recipients (PR). Concern has been expressed in both the selection process and the quality or capacity of the PRs. One community representative wonders whether the list of organizations selected to be PR ere closely evaluated for their ability and willingness to work with LGBTI groups. The representative explained that the organisations have apparently refused to work with men who have sex with men (MSM) groups for instance. This discrimination has been on religious grounds. There has also been doubt expressed at their managerial and leadership ability to unite all organizations and actors for ART scale up and for the three ‘I’s to reduce TB infections.

Another community leader also from the DRC recently observed: “but the real challenge is that we as the community of PLWHIV we do not trust any of the 4 PRs selected by Global Fund in DRC. The so called civil society (PR) which has been selected has no link with our community (of PLHIV)”. 

These concerns should not be taken lightly. Although there seems to have been an effective mechanism to input into the content of the concept note, there is no guarantee that all deliverables will be met nor will the stakeholders have any real influence on the programme management and coordination of the GF funding once secured. PRs enjoy a degree of autonomy and some may say, power. If they are of questionable repute, the global fund might do well to pay attention to the community concerns now than try to correct mistakes downstream. Experience has taught us that this can be a very expensive exercise and lead to colossal loss of resources.

UNAIDS has an important role in this matter. UNAIDS unique position provides it with a strong convening role to ensure that the issues creating anxiety about the PR are discussed and resolved satisfactorily. If whistle blowing communities as the ones in the DRC were taken seriously, millions of dollars could still be saved.UNAIDS could use its comparative advantage in-country to convene a further discussion to ensure DRC receives the full complement of prevention, treatment and care services.

Before any disbursements or negotiations with the CCM are started, all stakeholders might do well to resolve this matter of the four PRs in the DRC and ensure that they are reputable, led by men and women of integrity with a desire to serve its citizens across this beautiful vast land.

The DRC has set enormous targets for itself. But many years of conflict have meant financial resources to fight HIV and provide basic health care for its people have been scarce. The DRC targets are to put at least 50% of an estimated over 250,000 eligible people living with HIV on antiretroviral therapy by 2017, and a further 90% PMTCT reduction rate.  The country dialogue established priorities and strategies for prevention, treatment and care activities in line with the country’s national strategic plan for all vulnerable populations.

 

Representing Civil Society on the UNAIDS Programme Coordinating Board