No room for complacency
Communities are a core component in our ability to fight HIV/AIDS; we need to recognise their invaluable role and fund them accordingly, writes Tanja Fajon.
"Communities make the difference” is this year’s theme for World Aids Day. On 1 December we can recognise and celebrate the role that communities have played in the fight against HIV at local, national and international levels.
From prevention programmes ensuring access to treatment for people living with HIV to broader advocacy work, communities work hard to ensure that no one is left behind in guaranteeing the right to life and health.
According to UNAIDS, men who have sex with men, sex workers, transgender people, people who inject drugs and prisoners are key populations that not only are particularly vulnerable to HIV but also frequently lack adequate access to services.
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These groups face high levels of inequality, violence, discrimination and stigmatisation. Punitive and restrictive policies imposed on these groups are a key obstacle to HIV response and explain why the number of new infections within these populations is rising, despite global progress.
The lack of inclusive sex education, of LGBTI-friendly health provision and the pervasive discrimination and violence that LGBTI people face is leading to men who have sex with men and trans people falling through the cracks of the HIV response.
“Communities will continue to make a difference as long as HIV/AIDS remains high on our political agenda”
The LGBTI community is doing tremendous work on the ground, from prevention campaigns to providing treatment. They understood the necessity of a rights-based approach to HIV - one that would integrate prevention, treatment and broader advocacy for equality - long before UNAIDS and other key international stakeholders.
Communities do make the difference, but their work will not be enough to curb the current worrying HIV/ AIDS trends. HIV is both preventable and treatable, yet the number of new infections is rising in some Member States. According to the ECDC, nearly 160,000 people were diagnosed with HIV in the European Region in 2017, including 25,000 in the EU/EEA.
Sex between men remained the predominant mode of HIV transmission in EU/EEA countries, accounting for 38 percent of all new HIV diagnoses.
In Europe we have no systematic information on the HIV/AIDS burden among trans populations, as the majority of countries do not view trans people as a key population and do not provide them with targeted programming or funding; we currently risk leaving an entire group behind in our fight against HIV/AIDS.
However, our focus should not stop at European borders. Outside Europe, trans people, and in particular trans women, have an extremely high HIV/ AIDS burden.
In countries where people are jailed for being gay or trans - and where the levels of stigmatisation and social exclusion are high for LGBTI people in general - prevention, diagnosis and treatment provision become even more challenging.
“A shrinking space for civil society in Europe places all the collective efforts to end the HIV/AIDS epidemic in jeopardy”
When we as MEPs stand up against violations against LGBTI people worldwide, we contribute to more effective action against HIV/AIDS. Communities will continue to make a difference as long as HIV/AIDS remains high on our political agenda.We need a comprehensive and integrated policy framework to tackle the issue, reflecting the urgency of the situation.
Despite the 2017 European Parliament request for a comprehensive and integrated policy framework, to date the European Commission has only released a Staff Working Document on “Combating HIV/AIDS, viral hepatitis B and C and tuberculosis.”
We need the Commission to put HIV/ AIDS higher on the agenda, to promote rights and evidence-based policies and practices while adopting an intersectional perspective to include those most at risk.
When it comes to an HIV response for LGBTI people, the Commission should lead by example, by considering trans people as a key population, as recommended by UNAIDS.
Another example would be to advocate in favour of, and facilitate sharing of good practices, on PreP - a treatment that prevents infection for people at high risk of contracting HIV - and to support Member States in improving provision and access.
PreP, when appropriately reimbursed for users, has proven its efficiency both by reducing the level of new infections and by acting as a gateway for sexual health services beyond HIV.
We should also be able to count on the Commission to scale up its funding. A shrinking space for civil society in Europe places all the collective efforts to end the HIV/AIDS epidemic in jeopardy.
Funding should be both guaranteed and increased for organisations running awareness-raising and prevention campaigns, providing services and treatment, and undertaking advocacy work at local, national and international levels.
To date, 39 million people have died of AIDS - too many. The fight against HIV/AIDS should be everyone’s concern. Only by scaling up our action can we hope to reach – or exceed - the 90-90-90 international targets by 2020.
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