The HIV response risks grinding to a halt. In 2019, 700,000 people died of an AIDS-related illness and new HIV infections remained stubbornly high at 1.7 million.
Stigma, discrimination and rights violations fuel this situation. Criminalised, marginalised and socially vulnerable people face the highest rates of infection yet the biggest barriers to testing and treatment.
Until the social and political landscapes that create these barriers are addressed, the HIV epidemic will continue. We know communities hold the key to bringing about changes to the services, laws, policies, practices and mindsets that affect them. But a lack of understanding amongst governments and donors means the value of community-led advocacy is not always recognised.
PITCH sought to change this. PITCH was the first large-scale HIV programme to invest solely in community advocacy. The five-year, nine-country programme worked with four marginalised and vulnerable groups to strengthen and connect community-led advocacy.
What did we achieve?
Through advocacy wins, big and small, marginalised people have created more enabling environments, and their access to HIV and sexual and reproductive health services has improved. United movements have pursued landmark legal cases and convinced governments to shift from punitive to supportive policies.
Community advocates have grown in skills and confidence. They are better equipped to conduct strategic advocacy, hold governments to account, capture and present evidence, fundraise and monitor progress.
By uniting and sharing evidence, communities have been able to influence regional and global policies on critical issues such as universal health coverage and human rights. Marginalised communities are also wielding greater influence nationally and are being more regularly consulted in national policy processes.
PITCH supported community advocates to:
• Bring about equal access to services for HIV and sexual and reproductive health and rights
• Further equal rights for marginalised people
• Develop and strengthen the skills, organisational structures and resources needed to carry out effective advocacy, generate evidence and improve policies and practices in the HIV response
We did this by building our partnership networks, enhancing the use of evidence and strengthening the capacity of civil society to advocate.
PITCH worked in nine low- and middle-income countries in Africa, Asia and Eastern Europe, all with high HIV prevalence. It supported over 100 community-led organisations, networks and platforms, including regional partners in Eastern Europe and Central Asia and Southern Africa.
The people PITCH supported:
• Adolescent girls and young women
• Lesbian, gay, bisexual, transgender, queer and intersex (LGBTQI+) people, and men who have sex with men
• People who use drugs
• Sex workers
PITCH helped individuals and organisations develop the technical skills, tools and strategies they needed to carry out effective advocacy. Through training and mentoring it has built capacities in key areas, such as political campaigning, evidence gathering, fundraising and communications, introduced rights monitoring and response systems and provided tailored technical support.
PITCH has helped to build movements between population groups by encouraging coalitions to form and set joint agendas. It has harnessed the power of community advocacy by uniting multiple voices – not just within countries but regionally and across the world.
Global funding for the HIV response is in decline. The political will to end AIDS is receding as governments deal with multiple challenges including nationalism, populism, conflict and instability. These challenges contribute to increasingly polarised societies. However, globally there are still 38 million people living with HIV and in 2019 there were 1.7 million new infections.
Key population groups (such as LGBTQI+ people, sex workers, people who use drugs) and their partners, and adolescent girls and young women are most affected by HIV, and account for the majority of new infections. Globally, the total number of new HIV infections has hardly declined for several years, stagnant at 1.7 million in 2018. This is far above the UNAIDS target of 500,000 per year by 2020 and reflects a worsening picture.
In 2019, for the first time, key population groups and their partners accounted for the majority (62%) of all new infections worldwide. In Eastern Europe and Central Asia, and the Middle East and North Africa, regions where the epidemic is expanding, key population groups accounted for almost all new infections.