I write this from Cambodia, a country that in spite of ranking 137 in the Human Development Index has already achieved its Millennium Development Goal target of halving HIV prevalence. This is a country that despite a weak health infrastructure has managed to provide antiretroviral treatment to over 90% of those who need it.
The secret of this success? It’s been done through the strongest partnership I’ve come across in my travels for the Alliance. A coalition of affected communities, expert patients, health professionals, NGOs, government, donors and researchers who have come together to fight the epidemic.
Unprecedented partnerships have been formed all over the world in our efforts to tackle HIV and it is paying off. The latest data shows new HIV infections are down by 17% with the greatest progress made in the hardest hit region of sub-Saharan Africa. HIV prevention programmes are making a difference and thanks to the availability of treatment more people are living longer and AIDS-related deaths are down.
But the global economic crisis and conflicting priorities are putting these partnerships and this progress at risk. Funding for HIV prevention is still the smallest proportion of national AIDS budgets and many programmes are not targeting those most in need or most at risk. There are also worrying signs in some countries that governments might be about to put in place legal frameworks that further institutionalize discrimination against groups most at risk. Discrimination against sex workers, drug users and men who have sex with men violates human rights, fuels the epidemic, and undermines cost-effective interventions.
The economic crisis might provide the incentive for a scenario of increased solidarity to emerge. One in which NGOs focus on developing more efficient and sustainable responses, work with committed political leaders to create policy space for focused prevention interventions and introduce legal frameworks that reduce long-term vulnerability; a scenario where donors and the international community find creative ways to close the financial gap that countries are facing and resource health systems, through innovative financing, such as introducing a currency transaction levy or other forms of financial taxes.
But the other extreme scenario isn’t appealing. It is one in which donors and political elites reduce their financial commitments, are unwilling to take the difficult decisions that efficient, focused HIV prevention requires, and row back on commitments to universal access to HIV prevention, treatment, care and support; a scenario in which NGOs take to confrontation and people living with HIV abandon their active involvement and solidarity that has been crucial to our response to HIV.
What is in no doubt, is we are going to have a ‘new’ response emerging from the economic crisis. Whether it is a creative one that builds on increased solidarity or a destructive one that weakens these partnerships depends on the leadership each one of us shows.
World AIDS Day is a good opportunity to remind us to continue to show dynamic, innovative and courageous leadership. The fantastic integration between healthcare services with NGOs and faith-based organisations running home and community care programmes that I see here in Cambodia and elsewhere around the world can inspire the vision we all need.
Let’s make this World AIDS Day an opportunity to recommit ourselves to continue to fight the spread and impact of HIV, and to hold governments to account for any failure to protect their citizens’ human rights.
Alvaro Bermejo, Executive Director
What is in no doubt, is we are going to have a ‘new’ response emerging from the economic crisis