Sini Pasanen, AIDS Action Europe Steering Committee Member and Executive Director, Positiiviset ry, HivFinland speaks about the role of community organisations in the fight against AIDS and adresses a strong appeal to the governments. The shorter version of the article has been published in the Government Gazette Vol 1; 2017, p. 58., the issue is dedicated to sustainable heathcare.
During recent years, we’ve seen biomedical advances against HIV. Advances, that are essential in reaching targets like 90-90-90: 90% of all people living with HIV know their status, 90% is on treatment and 90% has undetectable viral load. Unfortunately, these targets are not ambitious enough and in reaching the first 90, we already leave people behind. Setting a target where almost one third of people living with HIV has not medication and undetectable viral load is just not acceptable and leaves many challenges in ending AIDS.
How to fight the remaining challenges? There is no ultimate solution to HIV that fits all. Some of the remaining challenges are connected to lack of resources, prejudice and stigmatizing attitudes, and some to politics. Every country is different and there are differences inside countries. Every decision maker should know their HIV epidemic and interventions should be targeted where they are mostly needed. The epidemic is not stable, and therefore we need to ensure that our knowledge is updated and thinking current.
AIDS will not be ended unless key populations are meaningfully involved on all levels of interventions, prevention, testing, treatment and care. Community based organizations and their services have access to key populations. There is no state actor that can have access to key populations. Policy makers and scientists should promote community ownership. Solidarity, commitment and respect for differences need to be embraced between different stakeholders.
To reach the set targets that states have committed to, the leading role of communities and NGOs in the HIV response must be meaningfully recognized. Collaboration and meaningful involvement requires open and sincere communication, genuine interest and understanding the value of diversity in the HIV response.
Stigma and silence undermine prevention efforts
One key to success in reaching sustainable development goals and other commitments is the full respect for all human rights. We must end criminalization, discrimination and stigmatization of people living with HIV, men who have sex with men, injecting drug-users, sex workers, LGBTI-people, migrants and mobile populations. We need to work hard to change harmful and prejudiced attitudes within our societies.
Ending AIDS is not possible without the Eastern European and Central Asian countries, where access to medication is worse than in Africa and where human rights of most affected populations are systematically breached. According to WHO report Russia alone has 64% of new HIV infections in Europe.
Besides prevention, testing and treatment, we need strong and visionary declarations, fully funded NGOs and political will. Stigma, discrimination and denial undermine all efforts and achievements. So governments, speak up!
The Informal Council of EU Health Ministers in March in Malta agreed that more action is needed. Community and NGOs are ready to act. We all know how to end AIDS by 2030. Why not to take steps that make it possible to reach the set and agreed targets? Why not choose the right path?