This text contains some exerpts from ICASO, UNAIDS, AIDSMAP, & C Beyrers et al (published in The Lancet) which I have mixed and matched with my own text in order to inform you on the story so far…(Thanks to these authors & organisations)
We have received some good news at INPUD recently regarding our battle to increase the voice of people who use drugs in global HIV/AIDS policy, including a seat on the Civil Society Task Force on HIV/AIDS. To help create a small picture of what this means and why it’s happening, I have included a bit of background.
The Task in Hand
Back in 2006, the UN adopted Political Declaration on HIV/AIDS mandated the UN General Assembly to undertake a comprehensive review in 2011 of the progress that had been achieved in realizing the Declaration of Commitment on HIV/AIDS (from 2001) and the Political Declaration on HIV/AIDS (2006). You can read an ICASO summery of the 2008 Review of these documents here)
It is now 30 years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS where the world adopted the first Declaration of Commitment on HIV/AIDS.
In June 2011, the world will come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8 –10 June in New York.
Member States are now expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response and to firmly position AIDS in the broader global health and development context, including the Millennium Development Goals.
The 2011 Comprehensive AIDS Review is important for a number of reasons. It comes at a turning point in the AIDS response; It is a critical opportunity to identify progress, account for underperformance, renew the political commitment to sustain the response, and to chart the way forward.
Of particular significance is that at the end of 2010 the goals and targets agreed by Member States in 2001 and 2006 to guide and monitor the AIDS response will expire. In addition, 2011 marks:
– 30 years of AIDS;
– 10 years since the landmark UN General Assembly Special Session on HIV/AIDS (UNGASS) and the Declaration of Commitment on HIV/AIDS;
– 5 years since the 2006 High Level Meeting commitment to universal access by 2010 and adoption of the Political Declaration on HIV/AIDS.
The Political Declaration was originally drafted in 2001, and was an eloquently worded statement that committed the world’s nations to take concrete action to halt and reverse the spread and impact of the HIV/AIDS epidemic. It was the first such commitment that the UN had made on HIV/AIDS, it paved the way for the establishment of the Global Fund for HIV/AIDS, Tuberculosis and Malaria, and ushered in a new era where access to treatment and care became a real possibility (although far from being universally implemented) in even the most resource-constrained settings.
In 2006, Civil society came to the UN high level meeting on HIV/AIDS with the expectation that they could build upon the earlier declaration and encourage delegations to develop an even more progressive blueprint detailing, and committing countries to take, actions required to provide universal access to prevention, treatment and HIV and AIDS care. They had good cause to hope for this, since it was what had been promised by the leaders of the G8 industrial nations at the summit at Gleneagles in 2005, and earlier in 2006 in Abuja, African leaders had also reached an agreement to push for universal treatment by 2010.
Instead, treatment and prevention advocates found themselves fighting to keep the most conservative country delegations from removing many of the commitments made in 2001 from the new declaration. For example, some countries wanted to remove all references to human rights, vulnerable groups, generic drugs, or access to condoms, sterile injection equipment and harm reduction efforts related to drug use.
In addition, several counties want to strip the document of any reference supporting the empowerment of women — even though it is now well-recognised that the social, political and economic disadvantages faced by women are one of the major drivers of the pandemic. The UN member states for the most part resisted civil society’s call for expanding the declaration of commitment. For example, the activists wanted the specific vulnerable populations most at risk or impacted by HIV/AIDS to be spelled out in the declaration, but aside from one new reference to injecting drug users (IDUs), the document made little progress in this area. Also, although the declaration does mention access to sterile injecting equipment and harm reduction (both also in the original declaration), it does not call specifically for access to substitution drug treatment (such as methadone), which is not provided in Russia and continues to put IDUs at risk.
In a press conference held several hours prior to the final adoption of the declaration, President Eliasson commented on the advocates frustration. “Vulnerable groups are in there. They are different in different countries. We all know who they are. This was a negotiation. That’s where we ended up.” However, he added, “We must not allow the best to be the enemy of the good….An alternative would be to write something very lofty to which no one paid attention…”There are always things that you want to add or do more ambitiously, but if you look at this text we have a reaffirmation of everything that was said in 2001 [in paragraph 18] and the need to ensure that everything in it is achieved, and that’s the bottom line.”
What role will INPUD play?
We have an INPUD representative on the Civil Society Task Force to bring the voice of people who use drugs to the group which will act as a mechanism to facilitate input of civil society and the private sector in the 2011 Review, including the preparatory process.
Civil Society Hearing April 2011
The High Level Meeting will comprise plenary meetings and up to five thematic panel discussions. An informal interactive hearing with civil society will take place two months beforehand in April 2011. The one day informal interactive hearing with civil society will be chaired by the President of the General Assembly and organized with the active participation of people living with HIV and broader civil society.The objective of the hearing is to create a space where civil society, NGOs and the private sector can interact with Member States and offer input to the comprehensive review process.
To facilitate civil society involvement in the high-level meeting and ensure an open, transparent and participatory process, the President of the General Assembly, in partnership with UNAIDS and upon nominations by Civil Society Selection Committee (see below) has established a Civil Society Task Force comprising representatives from civil society and the private sector. The Task Force will, among other things, help determine the format, theme and programme of the civil society hearing, as well as help identify speakers for the civil society hearing and HLM plenary and panel discussions.
How did INPUD get here?
Background: It had been agreed that ICASO would facilitate a transparent selection process for recommendations to the General Assembly President on the membership of the Civil Society Task Force (CSTF). A group of people representing HIV/AIDS civil society organisations from around the world applied to become members to form a balanced selection committee (INPUD was asked to put forward 3 members of which one was chosen, congratulations Ruth!)
The Selection Committee then chose 12 individuals from a broad range of civil society representatives, with a remit to choose from geographically diverse countries, and comprising:
* Three representatives of networks of people living with HIV
* Three representatives from marginalized communities (men who have sex with men; sex workers; people who use drugs)
* At least one UNAIDS PCB NGO delegate
* A representative of the labour sector
* A representative of the private/business sector
* A representative from a women’s organization
* A representative from a youth organization
* A representative from a faith-based organization
(I applied and was accepted to represent INPUD and people who use drugs and as I am the main dudette who does the blogging, I will be aiming to consult with members and report back on this rather daunting but important process!).
The CSTF is a mechanism intended to facilitate input of civil society in the 2011 comprehensive review. This includes reaching out to community networks to ensure that they are consulted and that they are able to provide input.
The Task Force will lead on:
* Shaping and implementing the design for the Civil Society Dialogue in April 2011, including format, topics, messages and speakers
* Devising criteria and the call for nominations for civil society speakers
* Identifying, preparing and briefing civil society speakers for all formal sessions
* Briefing civil society participants in the High Level Meeting.
The Task Force will advise on things like:
* Linking to country level activities and advocacy in the lead up to June 2011, themes of the formal session discussions, Civil society participation in the formal session discussions, Proposed civil society plenary speakers, Recommendations to the chairs of the formal session discussions, Input into the development of key messages for the Review meeting to be used by UNAIDS at media and communications opportunities.
The initial consultations over the new declaration will begin in New York with members states in late February. A draft declaration (draft zero) is expected to be done by 19th April, which would then begin more detailed negotiations.
In preparation for the June 2011 United Nations General Assembly High Level Meeting (HLM) on AIDS, a comparison of regional and international consensus statements on key issues facing the AIDS response was undertaken. While the June HLM will undertake a comprehensive review of the progress made in relation to meeting previous commitments (see above) and a rigorous analysis of the rate-limiting factors to inform future action, the 2011 commitments need to build on commitments that have already been agreed by the international community.
The purpose of the document (link above) is to recall a manner in which the General Assembly, and other relevant bodies, have treated specific issues and proposed relevant commitments and action s regarding the AIDS response.
A word on our community
So! That’s a bit about the story so far. For the vast majority of people who inject drugs (but also other users of drugs such as snorters of drugs) HIV/AIDS still lives large. Significant HIV transmission factor in many regions of the world, driving fast-growing epidemics that affect users, particularly in in Eastern Europe & Central Asia, Asia & the Pacific, Latin America and North Africa. We know what prevents HIV, and we have a good handle on treating it these days, yet we still continue to see obstacle after obstacle put in place by the governments of the world who refuse to see people who use drugs as worthy of essential harm reduction and HIV and drug treatment. Cost-effective interventions, including needle and syringe exchange programmes, opioid substitution therapy, and expanded access to HIV treatment and care, are supported on public health and human rights grounds; however, only around 10% of people who use drugs worldwide are being reached, and far too many are imprisoned for minor offences or detained without trial and/or are suffering from horrific human rights violations -because they use drugs and/or have HIV and use drugs. To change this situation takes commitment, advocacy, and political courage to advance the ‘action agenda’.
The coming blogs that will appear here on this issue should be an interesting account on how the drug using community is able to assert its voice on the UN community but by having a voice on committees such as these can only be a step forward. Stay tuned and please, if you have any views or comments on HIV and how you see it affecting people who use drugs, I urge you to comment here or email me directly and I will do my best to incorporate your thoughts.
Until next time (I’m in New York on the 20th Feb for the first preparatory CSTF meeting),
- In From the Margins (inpud.wordpress.com)