HIV prevention shadow reports
25 July 2018
These reports analyse the performance on HIV prevention of some of the countries with the highest HIV burden in the world.
Developed by civil society and community organisations, they provide an assessment of how countries are meeting the targets on the 10-point action plan of the HIV prevention 2020 road map agreed by the Global HIV prevention coalition, and include specific recommendations to governments.
In India the report found that community-led programmes for MSM, transgender people, drug users and migrants are not being adequately funded and taken to scale. In addition to this, significant structural barriers, including high-levels of gender-based violence and punitive laws exist. Although the government is aware that these barriers exist, there are no clear action-plans outlining how they will be addressed. While the 2017 HIV Bill goes some way towards tackling underlying stigma and discrimination, success of this new legislation will be dependent on its implementation.
In Malawi there have also been delays developing the new national HIV prevention strategy. The country has made some significant progress, particularly around the development of new service packages for adolescent girls and young women and key populations. In part, this can be attributed to the consistent engagement of civil society in national prevention processes. Despite this, significant obstacles remain, especially around the lack of data and the perpetuation of punitive laws, and moral and religious values, which continue to limit access to vital services.
In Nigeria, a country with one of the highest rates of new HIV infections in Africa, controlling the epidemic requires concerted action from government, donors and civil society. While some large non-governmental organisations have been consulted during the implementation of the Road Map, the engagement of community-based organisations representing key populations and young people in national target setting processes has not been consistent. Despite the emergence of new, more supportive policies - including the adoption of a recommendation to lower the age of consent for HIV testing from 18 to 14 by the National AIDS Council - there is still inadequate funding and implementation of programmes to promote sexual and reproductive health and rights for young people and key populations.
In Uganda there are concerns that recent gains could quickly be reversed. However, the government has taken welcome steps, including launching the Presidential Fast Track Initiative, initiating new size estimation studies, developing an anti-HIV stigma policy and designing a national sexuality education framework. Civil society organisations are concerned that these actions do not go far enough towards addressing structural barriers that prevent people accessing services, and the shrinking space for civil society represents a real threat to organisations wishing to provide or advocate for effective HIV prevention services.
In Ukraine the government is also failing to prioritise tackling harmful laws and policies, which make it difficult for key populations to access HIV services. Such inaction comes at a critical time for the HIV response in Ukraine, as the government takes on full responsibility for funding HIV prevention programming from the Global Fund. Although the government’s plans to continue contracting non-governmental organisations to provide services are welcome - many of the commitments the government has made are yet to be implemented. As a result, civil society fear progress will remain stalled until the National HIV/AIDS Programme (2019-2023) and budget are finalised.
Zimbabwe is also making steady progress in reducing new HIV infections and has also taken the lead in Africa and beyond, by galvanising political commitment to HIV prevention. Again, civil society organisations are heartened by initiation of new size estimation studies and proposed minimum service packages, which show an increased focus on key and priority populations. Financing for HIV prevention programming remains an issue and the government has been reluctant to explore new social-contracting mechanisms that would allow for greater involvement of civil society in the monitoring and provision of prevention services.