Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Are we any closer to universal access?


Aids Alliance

In 2011, 30 years after the first diagnoses of AIDS, an estimated 34 million people are living with HIV.

Last month (June 2011) the global community came together in New York for the UN High Level Meeting (HLM) on AIDS and committed to tackle what remains a devastating global epidemic. But does the new agreed political declaration go far enough? And will it achieve what it sets out to?

Bold targets

The political declaration commits to reaching 15 million people with antiretroviral therapy (ART) by 2015, which would mean providing life saving treatment for 80% of those in need of treatment in low- and middle-income countries in 2015.

Other headlines from the declaration include the commitments to eradicating HIV transmission from mother to child, and halving HIV transmission through injecting drug use and through sexual transmission among young people worldwide.

Promises, promises?

These ambitious targets are welcome; as were the commitments made in 2001 and in 2006. Today, when nearly two-thirds of people who require treatment still have no access* it’s critical to keep Universal Access firmly on the table – but what is going to make the difference this time round?

Important progress has been made; a third of people who need treatment are accessing it and this is thanks to an unprecedented global effort, particularly from the US Government, the United Kingdom, the Netherlands, France, Brazil, Kenya, South Africa and others, resulting in 5.2 million people* living longer, caring for families, contributing to their communities and local economy. To treble this in the next four years the international community must not falter to uphold these new commitments.

What’s new?

For the first time ‘key population’ groups who are most at risk from HIV have been mentioned explicitly in the political declaration, i.e. sex workers, men who have sex with men, and injecting drug users.

The inclusion of these groups is based on the overwhelming evidence that you need to reach these and other marginalised groups with services to reduce the spread of HIV. This approach is backed up by the important commitment to use evidence-based approaches to HIV prevention.

We welcome these additions, but in the same vein there are some glaring omissions. Transgender people did not receive a mention, which Javier Belloq, Alliance representative in Latin America, describes as akin to being ‘left to the lions’ in his opinion piece The Roman Circus, believing ‘that to omit them is, in some way, to kill them; to leave them at the mercy of the lions in this Roman circus.’

Involvement of marginalised groups

The HIV response will not make significant progress without the involvement of drug users, sex workers, men who have sex with men, and transgender people, including the recognition that marginalised groups are not separate to society. For example LGBT adolescents are not separate to targets on reducing sexual transmission among young people, and pregnant women who engage in sex work are not apart from targets to eradicate HIV transmission from mother to child.

We welcome DFID’s new position paper Towards Zero Infections which outlines its ambition to ‘be a voice for key populations internationally.’ You can download the paper here (981 KB).

DFID demonstrated this commitment by co-hosting, with the South African government, a side event at the High Level Meeting entitled ‘A dialogue on HIV and human rights’.  Organised jointly with the Alliance, IFRC in collaboration with civil society partners, this event provided a platform for representatives from the global community of men who have sex with men, sex workers, transgender people to outline to government representatives and UN agencies the main challenges they face in responding to HIV. See photos from the event.

Seven inspirational key population representatives from around the Alliance were also part of an interactive Guardian feature AIDS 30 years on: Voices from the Frontline, including Andy Mulraine from Trinidad and Tobago.


The declaration is a result of many compromises, but despite push back from some quarters including the Holy See, the Arab block and Iran, the declaration provides an opportunity to hold national governments to account and work together to ensure smart investments are made which are rooted in evidence and rights to ensure we reach the targets set out in the political declaration.

References in the declaration to respecting national sovereignty and national laws may, in certain countries, be used to avoid meeting the commitment to uphold international human rights and act on evidence-based approaches; but the reality is that if countries are going to achieve the targets these commitments must be upheld.

The crucial next step in-country, which some have already started, is the process of using the declaration commitments to outline a way forward. Read how MONASO, the Alliance Linking Organisation in Mozambique, has been successfully using national laws to campaign for the rights of people living with HIV.

Our contribution

Through our commitment to scale up integrated HIV services through a community-based approach, and advocating for engaged, inclusive societies, the Alliance will continue to contribute to the targets set out in this declaration.

Visit our new impact site to see how in 2010 Alliance Linking Organisations supported communities to work towards our vision of a world in which people do not die of AIDS.

Read the full Alliance response to the UN Political Declaration on AIDS.

*5.2 million people currently receive ART; 10 million people living with HIV who are eligible for treatment under the new WHO guidelines are still in need. (Source: UNAIDS 2010 Global Report)