Opinion

Failing global response

JVR Prasada Rao | Updated on May 18, 2021

Challenges before the High Level UN meeting on AIDS

In the midst of the unprecedented Covid-19 surges around the globe, a landmark event connected with the global response on HIV/AIDS – the High Level Meeting (HLM) in the UN General Assembly from June 8-10, 2021 is virtually going unnoticed.

This meeting is expected to review the progress on number of targets set for 2020 to achieve the ultimate goal of ending AIDS as a public health concern by 2030.

The preparatory process for the HLM has started quietly with the UNAIDS, the joint UN programme on AIDS releasing a new 10-year strategy for 2021-2030 to lay the road map for the global response on AIDS. The UN Secretary General’s report setting the agenda for the HLM was released on Monday. A multistakeholder hearing (MSH) with various civil society partners was held on April 23.

The zero draft of the political declaration has since been released and will form the basic document for negotiations.

The inter-country consultations will be impacted by the Covid-19 pandemic. Only the permanent missions of the countries to UN in New York are likely to participate in the consultations. They may have to depend upon briefs sent from the countries’ national AIDS programmes. Participation of civil society in country delegations may not happen because of Covid restrictions.

There is serious concern whether the content of the political declaration would honestly reflect on the performance of the countries on the AIDS front in the last five years and commit political will and financial resources for intensifying the global action to put the programme back on rails.

Yes, the global AIDS response has indeed got derailed in the last five years. The political declaration of 2016 failed on the first day after it was adopted as civil society was given a back seat and key populations were not even named in the declaration. The next five years have seen steady decline of political commitment and financial resources to the national programmes, even in high disease burden countries.

The result of the collective failure in keeping the AIDS response on track was evident from the Secretary General’s report which states that the 1.7 million infections that occurred in 2019 are more than three times higher than the global target of less than 500,000 new infections in 2020. An estimated 150,000 new HIV infections among children (aged 0–14 years) occurred in 2019, compared to a 2020 target of less than 20,000.

Apart from lack of political will, the biggest hindrance for prevention of HIV among key populations is the adverse legal environment which has in fact worsened in some high burden countries of sub-Saharan Africa. Asia and Eastern Europe.

And political commitment is not an abstract concept. It has to be effectively translated into improved governance structures and delivery systems for programme implementation. Social contracting of community based organisations a unique feature of national AIDS programmes in earlier years has almost been discontinued. Neither the UNAIDS strategy nor the SG’s report lay emphasis on the key role of AIDS governance and efficiency in programme implementation. And resources always follow improved governance and not the other way.

Next two months are crucial as all stakeholders need to focus on the inter-country negotiating process to get a strong and effective commitment from the country leadership on prioritising AIDS response and not to water down the commitment for the sake of consensus in the world body. It is a huge challenge to get this commitment in the middle of the raging Covid-19 epidemic. But losing this opportunity will leave the programme off track for another five years which we can’t afford.

The writer is a former Union Health Secretary, and a former Special Envoy of UN Secretary, Geneva

Published on May 18, 2021

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