When zero is a good number
18 September 2014
By 2030 we want 3 things.
Zero new HIV infections; zero AIDS-related deaths; and 100% of people living with HIV accessing quality HIV treatment. These are three of our recommended targets for the post-2015 development framework, which will be discussed at the UN General Assembly this month.
In 2015, new sustainable development goals (SDGs) will replace the Millennium Development Goals (MDGs), which world leaders committed to in September 2000. To ‘combat HIV/AIDS, malaria and other diseases’ was among the eight MDGs. In this new framework however, we have worked hard to ensure HIV is factored into an overarching health goal. This means we must be explicit about the targets we need to achieve within these.
As Cecilia Kihara, the Alliance’s senior advisor for East and Southern Africa, points out in her blog, the risk is that without such targets many needs may simply be ignored, such as the needs of young people and other people most affected by HIV, including LGBT people, sex workers and people who use drugs.
Health for everyone
That’s why, in addition to the three targets above, another of our recommendations is for a HIV target which ensures people who are all too frequently marginalised or criminalised, are not left behind, and that leaders commit to HIV services for everyone. We suggest the following:
By 2030, ensure that no one is denied health care, including HIV prevention, treatment, care and support and sexual and reproductive health care, due to their HIV status, sexual orientation, gender identity, or any other status.
(updated 6 October 2014)
Young people are disproportionately affected by HIV. The WHO recently reported that among 10-19 year olds AIDS-related deaths are increasing, while deaths are decreasing in every other age group.
Combine being young with being marginalised for being LGBT, a sex worker, someone who injects drugs or living with HIV, and the associated health risks due to stigma are heightened even more.
That’s why we collaborated, as part of a post-2015 working group, to organise a side event hosted by the Government of Brazil at the Assembly. The event featured a panel of young people from marginalised communities in Ethiopia, Bangladesh, Uganda and Puerto Rico. The panel addressed the crucial role of community in meeting the needs and protecting the rights of young marginalised populations in the post-2015 agenda.
Julie Mellin, a Link Up coordinator from the Global Youth Coalition on HIV/AIDS (GYCA) was present at the meeting.
“Young people are experts on the issues that affect their lives, and they have the right to make the decisions that affect their bodies, lives, and relationships,” says Julie. “Those with the power and opportunity to create policies and programming at every level must listen to young people and create space for their participation. Young people know what they need and how to get it, and they must be considered experts, and included at the table.”
Despite that message coming through very clearly at the meeting Julie reports how Dr. Luiz Loures of UNAIDS highlighted: "What’s holding us back now is the exact same thing that [has always held] us back: discrimination, lack of access, inequality, intolerance."
This was echoed by S.M Shaikat, who has been an advocate for women and girls’ rights in Bangladesh since he was 16. He emphasized that young people’s participation must not be tokenistic. "We are [still] missing opportunities to hear from young people because of inequality.”
Mwewa Nkhoma, knows that peer-led services are effective, yet they are often under resourced. Mwena is living with HIV and works with the Treatment Advocacy and Literacy Campaign (TALC) in Zambia. She trains young people living with HIV on how to live their lives to the fullest while adhering to ARVs: "Most young people living with HIV who are on ARVs [anti-retrovirals] do not have full knowledge on how to use them and how to manage care long-term - TALC works to address this through peer education."
"The most active groups in these areas are groups of young people, yet they are the least likely to receive funding.”
To ensure world leaders commit to finishing the job to achieve universal health, no-one can be left behind. You can read our policy briefing and all of our recommendations in full here, Health in the post-2015 Development Framework: How to meet the needs of the most marginalised and excluded.