Blows to the HIV response
21 June 2016
It has been a difficult couple of weeks in the development world and in the wider response to HIV.
In our preparations for the United Nations High Level Meeting on Ending AIDS we feared that one of the biggest risks was the conservative mood of UN member states. This combined with a power vacuum left by progressive states’ de-prioritisation of HIV, was a major concern for us.
So it was a sickening blow, within hours of rubber stamping a political process that weakened the key population agenda whilst simultaneously excluding LGBT voices, to wake to news of the killing of 49 people in Orlando, US. It has become clear that this was a targeted killing aimed at the LGBT community.
It was soon followed by news of the street killing of Jo Cox, a Member of Parliament in the United Kingdom with strong roots in the development sector who was a friend of mine, of the International HIV/AIDS Alliance and an early advocate of the establishment of the Global Fund.
Jo would have understood the significance of this year's HLM coming as it did within the context of a set of newly defined Sustainable Development Goals focused on articulating a way of mobilising knowledge, resources and tools to fast-track the end of AIDS by 2030.
So how do I feel about the Political Declaration that was finally adopted by the UN last week? The declaration itself is underwhelming. In spite of everything we know, governments missed an opportunity to prioritise key populations; LGBT civil society groups were excluded from the meeting and states missed a chance to unambiguously attack discrimination and promote human rights.
In the end, our rallying call to ‘Leave No one Behind’ rang hollow as, one-by-one, member states abdicated leadership.
Breaking the silence
It is not easy to get member state consensus on Political Declarations. Drafts go back and forth, words are pored over, red-lines get drawn and horse-trading (not all of it relevant to HIV) commences.
In the final days before a UN meeting like the HLM, the bargaining ceases and diplomatic missions go silent amid respective calculations of what can be gained by continuing to negotiate. A so-called ‘silent procedure’ is invoked by those facilitating the meeting.
With 48 hours to go before the HLM we were concerned that too little had been won in this Political Declaration. In those slow disappointing hours, it felt like a dark cloud had covered the earth.
The compromises in the Political Declaration - mostly a result of bigotry and religious and cultural ideology - were on critical issues such as naming key populations and affirming their rights. Other compromises related to harm reduction where language was watered down.
For us, this meant the declaration was weak and possibly unfit for the purpose of ending AIDS. The document was further undermined by the standard caveats of “national sovereignty” which, in plain English, give member states carte blanche to pick and choose the policies they agree with whilst continuing to enact terrible or unhelpful laws and deny rights to key populations.
Civil society groups themselves started to weigh up the options: Do we lobby progressive member states to re-open the discussions? Others talked openly of rejecting the process outright.
After some member state lobbying it became clear none of the progressive blocs were minded to break the silence in favour of stronger commitments. While we worked to persuade progressive governments to change their minds, rumours circulated that Russia might be ready to step in to re-start the negotiations in a different direction.
The irony of Russia once again taking a proactive interest in HIV policy, a situation reminiscent of the recent UN General Assembly Special Session on Drugs (UNGASS) where Russia played a regressive and intransigent role, should not be lost on us.
What was also interesting was that Russia’s move to break the silence was merely ‘procedural,’ leading some to interpret it as a ‘shot across the bow’ of civil society. The message seemed to be “You might not like this political declaration, but it could be much worse.”
Away from the machinations of the so-called “world powers” my focus had been on influencing and engaging African governments. Africa remains the focus of the epidemic and it was heartening to see adolescent girls and young women high on the HLM agenda.
But even here it felt like we had taken a backwards step with some African governments viewing the discussion as an opportunity to rebrand women and girls as the only morally acceptable “key populations” of note. It was revealing in all of this to note the rhetoric of states who have reluctantly set up key population programmes – doubtless in order to secure Global Fund investment – become suddenly very vocal in framing girls and women alone as a “key population”.
I had many low moments in the lobbying sessions. Several times I was told that the things I was advocating for were “un-African”. Some government representatives I spoke to left me cold by their strong and undisguised hatred of key populations. Others left me bewildered as they doggedly rejected evidence about the protective effect of comprehensive sexuality education and the need to give young people access to information on sex and sexuality. Some even tried to contest the link between gender-based violence and HIV in the face of huge amounts of evidence to back it up.
All in all, it has been a difficult process, not made any easier by the events that took place in Orlando and in England. It betokens difficult times ahead if we are to come close to ending AIDS by 2030.