Statement of Eastern Europe and Central Asia regional community networks to the United National General Assembly High Level Meeting on HIV and AIDS on key priorities in HIV and AIDS response
The Political Declaration on HIV and AIDS determines the directions of global and national policies, and the ways people and communities are able to protect their health and lives. In preparation of the new Political Declaration on HIV and AIDS, the regional networks representing the communities of key populations and people living with HIV in Eastern Europe and Central Asia, express our general expectations for the new Declaration:
● The Declaration should not only describe the vision, priorities, policies, and plans of governments, but above all be a reflection of the needs of people and communities most affected by the HIV epidemic;
● The Declaration should not only declare a general goal of ending the HIV epidemic but set up specific and measurable targets and results in protecting the health and social well-being of people and communities most affected by HIV;
● The Declaration should include commitments and mechanisms of political and financial support for its implementation;
● The Declaration should ensure the learning and dissemination of the best experiences and lessons learned by countries and communities over the four decades of working to protect human health and well-being from the HIV epidemic.
Taking into account the needs of communities and countries of Eastern Europe and Central Asia, we call upon inclusion in the new Political Declaration of particular positions as stated below.
- Look at us, see us
We are gravely concerned that Eastern Europe and Central Asia (EECA) is one of the only two regions in the world where the annual rate of HIV infections continues to rise at a concerning rate among key populations.
● We request that in the new Political Declaration, EECA be noted a global priority for urgent and exceptional actions required at all levels (global, regional, national) to accelerate the efforts.
- No one should be left behind. Nothing for us without us
The 2016 Political Declaration failed to clearly state the key populations of people who use drugs, gay men and other men who have sex with men, transgender people, sex workers, that bear the disproportionate burden of the HIV epidemic in EECA and around the world.
The new Political Declaration should:
● List all the key populations by name to stop the existing disregard, ignorance and discrimination of key populations, and improve the space for advocacy and other cooperation between governments and key populations, and for community-led monitoring as an important part of national M&E systems;
● Recognize all key populations including transgender people in national HIV strategies and programs in EECA and around the world;
● Ensure meaningful involvement of people living with HIV and key populations, including adolescents and youth, in decision-making and programs implementation at national and global levels.
- Chase the virus, not people!
Restrictive, discriminative, epidemiologically and economically unsound legal and policy frameworks, including criminalization of HIV exposure and transmission, criminalization of sex work, drug use and possession, same sex relationships, age of consent, are violation of human rights which discourage and prevent people from accessing prevention, treatment, care and support services. The new Political Declaration should:
● Call for decriminalization of HIV exposure and transmission, same sex behavior, drug use and possession of drugs for personal use, sex work, in EECA countries and around the world;
● Include development of mechanisms that ensure equity in access to justice and social protection for key populations and people living with HIV as a key element in reducing vulnerability and barriers for effective HIV prevention and treatment;
● Suggest approaches and international cooperation initiatives with a focus to changing the national policies in the countries that:
○ Criminalize people living with HIV – Belarus, Russian Federation, Tajikistan, and Uzbekistan.
○ Criminalize homosexuality – Turkmenistan, Uzbekistan; or penalize homosexuality – the Russian Federation.
○ Criminalize drug use and deprive people using drugs for medical or recreational purposes of the effective social and medical support and treatment – all countries in the EECA region.
○ Criminalize or penalize sex work and prevent access to justice, increase violence and prevent effective HIV prevention, treatment and care – all countries of EECA region.
- Let us work
Communities and civil society have proved their expertise and crucial role in the HIV response. However, we continue to face unnecessary barriers in our effective work. We demand that the new Political Declaration will:
● Ensure favorable legal environment, including freedom of association so that communities can freely create and register non-profit organizations, receive public and donors’ funds, and provide services aligned with the needs of our communities;
● Call for development and improvement of national and international mechanisms to ensure that community-led groups/organizations are funded;
● Ensure fair allocation of resources for the community-led response, including community-led monitoring and peer-led evidence-based services for key populations.
- Evidence is here. Ensure implementation
In four decades of the response to the HIV epidemic, we have learned what works and what does not. We need that the new Political Declaration will:
● Ensure access to sustainable, affordable and comprehensive services on sexual and reproductive health including elimination of vertical transmission of HIV, prevention, screening and treatment of cervical cancer;
● Focus on implementation of evidence-based, people-centered, human rights- and community-based integrated policies, practices and services on mental health and HIV for key populations;
● Support large-scale and rapid rollout of innovative PrEP prevention programs for men who have sex with men and transgender people with sustainable funding;
● Ensure implementation of evidence-based and age-appropriate comprehensive sexuality education curricula for children and young people;
● Support scaling up of interventions addressing structural and socio-economic inequalities and services to respond effectively to domestic and gender-based violence;
● Ensure to jumpstart immediate actions to accelerate progress towards gender equality and the empowerment of women and girls by investing in gender transformative approaches and ensuring gender mainstreaming at all levels.
- From words to actions
There have been too many declarations, policies, documents with sound appeals that remained only on paper. In order to move from words to actions and achieve real impact, the new Political Declaration should:
● Ensure transformation of commitments into fully funded actions implemented at international and national level with transparency, inclusiveness, and effectiveness;
● Propose concrete financial and technical tools, targets, and steps to strengthen community-led interventions integrated into national and international programs;
● Strengthen accountability, monitoring and reporting mechanisms and ensure regular feedback and communication with communities on delivering the outcomes of the Declaration.
Challenges: Lessons learned
Considering the experiences of lives and work of our communities, we are clear about obstacles we have faced in the past and might expect in the way of preparation and implementation of the new Declaration:
– High level of stigma and discrimination, and criminalization of people living with HIV, sex workers, people who use drugs, lesbian, gay, bisexual, and transgender people in EECA influence all aspects of decision making and program implementation.
– Space for civil society continues shrinking. The gap between political commitments to engage with and include civil society, and the reality confronting communities and key populations, is widening. So-called ‘Foreign Agents’ Laws introduced in some countries of the region, create new threats and vulnerabilities for civil society organizations.
– Political will, experience, and systems for integration of community-led responses as a component of national policy and program implementation either lack or are at a low level. Many governments in EECA remain skeptical or opposed to the role of NGOs and civil society in general in the HIV response, particularly those working in the area of human rights, with key populations, providing harm reduction services, and do not see them as reliable partners.
– Many governments continue reject or give low priority (and, thus, insufficient unsustainable funding) to evidence-based HIV prevention interventions – comprehensive harm reduction services for people who use drugs including access to opioid substitution treatment; protection of key populations from violence and discrimination; access to condoms and lubricants for sexually active people; and access to ARV treatment for migrants.
– National political leaders often prefer populist stigmatizing rhetoric instead of evidence-based public health policy. References to “national traditions”, “compliance with national legislation” and “appropriateness in the context of national programs” were and can be used as a pretext for ignoring the needs of key populations and avoiding the commitments of the Declaration.
We, the regional networks of key populations and people living with HIV in Eastern Europe and Central Asia, are committed to work on ensuring that the new Political Declaration on HIV and AIDS is not only developed as an effective guiding tool but also implemented in order for the words to turn into reality of saved lives and well-being of people and communities.
ECOM – Eurasian Coalition on Health, Rights, Gender and Sexual Diversity (ECOM)
Eurasian Harm Reduction Association (EHRA)
Eurasian Network of People Who Use Drugs (ENPUD)
Eurasian Union of Adolescents and Youth “Teenergizer”
Eurasian Women’s Network on AIDS (EWNA)
Sex Workers’ Rights Advocacy Network (SWAN)