A critical look at the outcomes of the 2021 High-Level Meeting on AIDS

A critical look at the outcomes of the 2021 High-Level Meeting on AIDS

By Marielle Hart, Aidsfonds Head of Policy U.S. (follow her on Twitter)
 

It’s the 21st century, but where is the global consensus on how to end AIDS?

 

A new Political Declaration

Over the past months, Aidsfonds was heavily involved with civil society coordination around the negotiations on the 2021 UN Political Declaration on HIV and AIDS which was adopted by UN Member States on 9 June at the UN General Assembly High-Level Meeting on HIV/AIDS that took place from 8-10 June.
 

We at Aidsfonds, alongside many other advocates and activists, breathed a sigh of relief when the vast majority of Member States (165) voted in favour of the declaration with only four against. It came as a complete surprise that the declaration was even put to a vote, as this had never happened before with such a UN Resolution. It tragically means that there is no global consensus on the approach needed to end AIDS by 2030 and to adequately address the persistent inequalities underlying the epidemic.
 

The culprit was Russia who had forced the vote despite the no less than 73 concessions made to this country during the negotiations on wording and commitments. This led to an already significantly watered-down document as compared to the zero draft and provisions related to harm reduction, rights-based programming and key populations were deleted. Belarus, Nicaragua, and the Syrian Arab Republic also voted against the Declaration, while many countries that voted in favour disassociated themselves from paragraphs that addressed the rights of key populations, young people and sexual and reproductive health and sexuality-related issues.

 

Politics winning from public health

It is shocking that in this day and age, with all the science and data to our disposal as to what is needed to end AIDS and with our shared experience in relation to COVID-19 and the global suffering it has caused, politics is still winning from protecting public health. Reaffirmation of autonomy and sovereign rights of Member States, protection of national laws even if they are detrimental the rights of key populations, and self-interest in terms of protecting access to essential medicines and technologies took precedence over a global consensus on an evidence-based response to HIV. This doesn’t give much hope for successfully protecting the world and its most vulnerable and marginalized populations against other current and future global health threats as well!

 

Accountability

However, the Political Declaration does provide us with a powerful advocacy tool to hold governments accountable for the commitments outlined in the declaration as well as in the Global AIDS Strategy 2021-2026. The declaration is broadly aligned with the priorities of the strategy, names key populations and includes strong language around community leadership and combination prevention. For the first time ever, it includes transformative and measurable targets on societal enablers (the 10-10-10 targets [1]) and a commitment to fully fund the AIDS response, including through enhanced global solidarity.
 

The 2021 High-Level Meeting should not be considered the end, but the start of the coming 5 years. Together with our civil society, community and activist colleagues and partners we will continue our critical work to pressure governments to implement the commitments made and fight for progressive and evidence-based policies to guide national HIV responses. A functional accountability mechanism and data reporting on resource flows for HIV programming in general and for key populations and community-led responses in particular is still absent and must be organized to be fully prepared for the 2026 High-Level Meeting on HIV/AIDS.

 

Learn the evidence and tactics to protect what works

What we have learned from this year’s negotiations around the Political Declaration is that both civil society actors and progressive member states were sometimes unprepared for countering the push back by conservative member states and not sufficiently equipped with the technical arguments or evidence to back up the progressive language. It will be critical to develop a stronger knowledge base on previously agreed UN language on contentious issues and on effective influencing and negotiations strategies and tactics on HIV and related issues.
 

The building and sustaining of capacity for a more effective engagement with an extremely polarized UN where it comes to health, human and sexual rights, harm reduction, TRIPS, debt relief, commitment to ODA etc. will be of utmost priority to not lose further ground to those countries that are not able or willing to see that the HIV epidemic is as much a human rights issue as a public health issue. As so boldly stated by the Dutch Minister of Foreign Affairs, Minister Kaag: “after 40 years of the HIV response, we know what works, recognizing reality and respecting human rights. We must acknowledge the right of people to be who they are, wherever they are”.


We must be progressive if we are the generation to end AIDS

_____

 

[1]10-10-10 targets:  less than 10% of countries have punitive legal and policy environments that deny access to justice; less than 10% of people living with HIV and key populations experience stigma and discrimination; and less than 10% of women, girls, people living with HIV and key populations experience gender inequality and violence. Achieving these targets require enabling laws, policies and public awareness campaigns that help to eliminate the stigma, discrimination and marginalized faced by people living with and vulnerable to HIV and empower women and girls to realize their sexual and reproductive health and rights. For more details on the targets and commitments, see the multistakeholder taskforce statement in response to the adoption of the declaration. 

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