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WorldWeWant2015 Content
on Thu, January 17, 2013 at 01.25 pm

Lead Theme 1: The unfinished HIV agenda

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( French and Spanish Versions below) 

Hello everyone,

Thanks for joining this discussion.As we are starting the second week of this consultation, some questions have arisen from the discussions and we would like to hear your input regarding those issues. Do let us know what you think and make sure your voice is heard ! 

The global AIDS response has seen unprecedented progress over the past decade. Yet globally, HIV remains among the leading burdens of ill health and early death, and is both a driver and consequence of inequality and social injustice.

1. What are the barriers and challenges that you face while working in the field of HIV/AIDS? How can we overcome those barriers in the future?

2. How can we make sure that HIV remains a priority after 2015? Any success stories or experiences to share?

3. What actions, campaigns or strategies need to be implemented in the post-2015 agenda in order to sustain and improve the response to HIV/AIDS?

4. How do we ensure that a human rights-based approach is a reality for the HIV response among key populations (Men who have sex with Men, Sex workers and Injecting Drug Users)? What has worked in the past and what do you think was not efficient?

 

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Français

Bonjour tout le monde,

 

Merci d'avoir choisi de rejoindre cette discussion.

Comme nous entamons la deuxième semaine de cette consultation, certaines questions ont surgi des discussions et nous aimerions avoir vos avis sur ces sujets.

Faites-nous savoir ce que vous pensez et assurez-vous que votre voix soit entendue! 

La riposte mondiale au sida a connu des progrès sans précédent au cours de la dernière décennie. Pourtant, au niveau mondial, le VIH demeure parmi les causes principales de la morbidité et de la mortalité précoce, et est à la fois un pilote et une conséquence de l'inégalité et de l'injustice sociale.

1. Quels sont les obstacles et les défis auxquels vous êtes confrontés en travaillant dans le domaine du VIH / SIDA? Comment surmonter ces obstacles dans le futur?

2. Comment  s'assurer que le VIH demeure une priorité après 2015? Avez-vous des expériences réussies à partager?

3. Quelles actions, campagnes ou des stratégies doivent être mises en œuvre dans l'agenda post-2015 afin de soutenir et d'améliorer la réponse au VIH / SIDA?

4. Comment s'assurer qu'une approche fondée sur les droits de l'homme soit une réalité pour la riposte au VIH parmi les populations clés (hommes ayant des rapports sexuels avec des hommes, les travailleur(se)s du sexe et les utilisateurs de drogues injectables) ? Qu'est ce qui a fonctionné dans le passé et que pensez-vous ne pas être aussi efficace?
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Espanol

Hola a todos,

Gracias por unirse a esta discusión. Como estamos comenzando la segunda semana de esta consulta, algunas preguntas han surgido de las discusiones y nos gustaría escuchar su opinión con respecto a estas cuestiones. Háganos saber lo que piensa y hacer que su voz sea escuchada! 

La respuesta mundial al SIDA ha sido testigo de avances sin precedentes en la última década. Sin embargo, a nivel mundial, el VIH sigue siendo una de las principales cargas de enfermedad y muerte prematura, y es a la vez un conductor y una consecuencia de la desigualdad y la injusticia social.

1. ¿Cuáles son los obstáculos y desafíos que enfrentan mientras trabajan en el campo del VIH / SIDA? ¿Cómo podemos superar esas barreras en el futuro?

2. ¿Cómo podemos asegurarnos de que el VIH sigue siendo una prioridad después de 2015? Los casos de éxito y experiencias para compartir?

3. ¿Qué acciones, campañas o estrategias deben implementarse en la agenda post-2015 con el fin de mantener y mejorar la respuesta al VIH / SIDA?

4. ¿Cómo nos aseguramos de que la respuesta por VIH se base en el enforque de Derechos Humanosal  entre poblaciones clave (hombres que tienen sexo con hombres, trabajadores sexuales y usuarios de drogas inyectables) Lo que ha funcionado en el pasado y lo que crees que no era eficiente?


Thematic papers:

 

 

 


The moderators are:

Imene Ben Ameur Othoman Mellouk Steave Nemande
Imene Ben Ameur is a medical doctor from Tunisia and is currently an MPH candidate. She worked as a consultant with UNAIDS for the national AIDS report, and is one of the founding members of the Tunisian Center for Public Health (TUNCPH), which provides health professionals with in-depth learning about HIV clinical management. An orthodontist by profession, Othoman Mellouk joined the Association de Lutte Contre le Sida (ALCS) in Morocco in 1994, where he participated in the development of the first prevention program targeting men having sex with men in North Africa and the Middle East. He now serves as an Advocacy Officer for ITPC in North Africa and is a co-chair of the MSM Global Forum. He has published several articles and reports about access to medicines in Morocco and the MENA region. Steave Nemande is a physician, director of a health organization called Evolve. In 2008, the Access Centre - a clinic proposing HIV and health services to men who have sex with men - was opened on his initiative. He is a gay activist, cofounder of Alternatives-Cameroun, and represents vulnerable groups at the Cameroonian Country Coordinating Mechanism. He sits on the management board of Amsher and the Msmgf Steering Committee. Steave is recipient of the Alison Des Forges Award by Human Rights Watch.
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Association for abolition of child labour
Fri, August 8, 2014 at 07.53 am

MY HIV HEALING TESTIMONY
My mouth is short of words, i am so so happy because Dr.Aluta has healed me from HIV ailment which i have been suffering from the past 5years now, i have spend a lot when getting drugs from the hospital to keep me healthy and alive, i have tried all means in life to always become HIV negative, but there was no answer until i found Dr ALUTA the Paris of African who provide me some healing Medicinal spell that he uses to help me, i never believe in spell doctor for the healing of HIV but i decided to take a step to see if it could save me from this deadly disease. behold it work out in a way i could never believe after sending me the herbal medicine i took it and went for test after the first Month it was HIV Negative my doctor could not believe until i went for the second text on the 3 month it was still Negative there my doctor told me that this was a miracle. now i am glad telling everyone that i am now HIV Negative, i am very very happy, thank you Dr.Aluta for helping my life comes back newly without any form of crisis, may the good lord that i serve blessed you Dr.Aluta. so i will announce to everyone around the world having HIV positive and also the cure of cancer in any part of the body to please follow my advice and get healed on time, because we all knows that HIV disease is a deadly type,he can also cure any kind of cancer you can contact him for your healing. contact Dr.aluta for your HIV healing spell today at: traditionalspellhospital@gmail.com or you can call his personal line on +2347066601812 He will be always happy to assist you online and ensure you get healed on time.

Sarah Gold from
Tue, February 5, 2013 at 01.56 am

Part 1 of 2
Despite the highly gendered nature of the HIV/AIDS pandemic (women represent over half of all people living with HIV globally), most prevention and treatment programming fails to account for the social determinants—violence against women, limited access to sexual and reproductive health (SRH) services, early and forced marriage, etc.—which make women and girls particularly vulnerable to the virus. The International Women’s Health Coalition believes that effectively curbing the spread of HIV/AIDS relies fundamentally on the integration of sexual and reproductive health and rights (SRHR) with HIV/AIDS programming. The post-2015 development agenda must address the particular susceptibility of women and girls to HIV as well as the fundamental role that gender inequality plays in the spread of the virus.
Integrating SRH and HIV/AIDS services is a proven strategy for reducing new infections. When men and women have access to HIV testing and treatment in the same spaces they seek out family planning and maternal health services, they are more likely to find out their status, learn about prevention methods, and explore treatment options. Research has also shown that the availability of HIV services alongside other SRH services can reduce the stigma typically associated with HIV-specific programs. Because the availability of treatment services for other STIs has been proven to reduce new HIV infections, expanding access to all forms of contraception and sexual health services through voluntary, rights-based, client-centered, and cost-effective programming is imperative.
Comprehensive Sexuality Education (CSE) should equip young people with protective sexual behaviors, the skills to effectively use condoms and other contraceptive methods, and should address gender and power, human rights and healthy relationships. While male and female condom use is proven to reduce new HIV infections, the distribution of condoms alone is not a sufficient prevention method. CSE should ensure that young people know how to use condoms correctly and should equip girls in particular with the tools to negotiate condom use and refuse unwanted sex. In addition to equipping young people with scientifically sound and culturally appropriate information about sexuality, health, and rights, CSE should introduce empowering life skills to help young people navigate healthy and rewarding relationships, influence leaders in their community, and exercise their rights.

Sarah Gold from
Tue, February 5, 2013 at 01.55 am

Part 2 of 2
It is critical to invest in prevention efforts that target the most at-risk and overlooked populations of women and girls—adolescent girls, married girls and women, sex workers and women who use drugs. We must also ensure that treatment options are available and accessible to those living with HIV/AIDS, and that prevention and treatment efforts do not infringe on the rights of women living with the virus. Women living with HIV/AIDS have a number of unique needs, and are particularly vulnerable to coercive sterilization practices, violence and discrimination. They still often provide the bulk of care and support for their families, they face unmet need for contraception, and they need support to prevent vertical transmission. Prevention of Mother to Child Transmission efforts play an important role in reducing new HIV infections, but these programs tend to focus far more attention on the infant than the mother. The rights of HIV positive mothers must be fully protected and realized, including the right to informed consent and to choose the treatment regimens that best meet their needs.
The post-2015 development agenda must commit to addressing HIV/AIDS through targeted evidence-based prevention and treatment methods that account for the unique needs of women and girls. Curbing the spread of HIV hinges on the transformation of discriminatory gender norms and practices, and the expansion of SRHR programming and policies. When women are able to refuse sex, live free from violence, insist on condom use, and avoid early marriage, they are able to reduce their risk of HIV infection (not to mention attend school, participate in civic affairs, and engage in healthy and respectful relationships). Like so many of our development priorities, addressing the HIV/AIDS pandemic is inherently linked to issues of gender equality. We must focus not only on the direct determinants of HIV infection, but also the profound gender inequalities and resulting discriminatory practices which make women more vulnerable to the virus and which stand squarely in the way of addressing its spread.

Carlo Oliveras from
Mon, February 4, 2013 at 08.12 pm

Accountability on each government to truly address the necessities of marginalized populations worldwide. In the Caribbean region we keep having a 1% general population prevalence but 30% prevalence in key affected populations. Most of our countries which although they share a same sea are very culturally different and each approach for each population has to be in sync the needs they express. An AIDS free generation will not be achieved if we are not all on the same boat. For this it is very important we prioritize on men who have sex with men, sex workers, transgender , intravenous drug users and women. This needs to be put in practice and each of this populations needs a space in the desition making table.

On the other hand vertical transmission needs to be a priority in all countries now and after 2015. It's incredible that we have the tools to prevent it and funding is not going to were it's supposed to go in order to have no more children born with HIV.

For us to make sure that HIV is still a priority we need to re strenghten our activism and support and help youth worldwide in order for them to have the tools necessary to address the issues that a globalized world presents particularly when it comes to health financing and community mobilization.

We need to focus right, programmatic spending is important, renewal of leaderships is important and getting funding to communities is important. The work done at the community level is the most important and we need to provide community the tools to adress the issues.

Guiselly Flores from
Mon, February 4, 2013 at 01.13 pm

Un gran obstáculo en la respuesta al VIH y sida es la discriminación, no solo de la sociedad civil en las calles, en la escuelas, también de los que toman decisión. Partir de estigmatizar a las sociedades para responder en exclusividad a una de las comunidades es discriminación. En los países existen diferentes actores, diferentes sectores y cada uno de ellos debiera responder a cada una de las comunidades. En VIH y mujer en nuestros países se ha fortalecido la respuesta a la transmisión vertical, dejando de lado todos los derechos de las Mujeres que viven con VIH, las mujeres no somos artículos de reproducción. Sin embargo existe mucha violencia y aumenta en las mujeres que viven con VIH. El acceso a la salud sexual y reproductiva no está garantizado para las mujeres que viven con VIH, el estigma y la discriminación es muy marcado en los operadores de justicia, poco o nada se ha hecho por los niños y niñas huérfanas, en realidad no se ha hecho mucho por la mujeres básicamente por tomar en cuenta el VIH desde el perfil "epidemiológico" donde las poblaciones de alto riesgo son prioridad en la respuesta, aunque tampoco se está respondiendo como se debe en estos grupos de alto riesgo, menos se está respondiendo a la problemática Mujer y VIH.

Es necesario: el empoderamiento ciudadano con mayor participación de las mujeres viviendo con VIH a través de observatorios. Estructuras y órganos en funcionamiento con igualdad de género, garantizar desde el estado mecanismos de apoyo para el respeto de los Derechos Humanos.Erradicar el estigma y la discriminación. Las personas viviendo con VIH deben tener acceso a la salud integral (con incidencia en salud mental y salud sexual y reproductiva) en todos los niveles de atención, y a los antirretrovirales de última generación. TODAS Y TODOS, Mujeres, niños, niñas, HSH, Trans,....

Anonymous from
Mon, February 4, 2013 at 12.43 pm

Although the response in access to treatment is on the right track, we are lagging behind guaranteeing equality of rights and non disdcrimination for populations most affected by HIV. The specific response to HIV in all the dimensions of citizenship, such as access to appropriate sexuality education, judiciary system, social housing, schooling, friendly and appropriate sexual health services, protection from LGBT-bullying in schools, labor skills training for jthese marginalized groups are essential. There are examples of friendly health services for LGBT and sex workers, labor training for trans women, unionizing of sex workers and egalitarian marriage (for LGBT), gender identity law (providing protection, state-subsidized gender reassignment and access to social services) and decriminalization of drug consumption in Argentina, and similar attempts in other South American countries. These initiatives address the inequalities leading to HIV and must be part of the P2015 development agenda in all the world, where work must start by decriminalizing these populations, followed by equal protection under the law and from discrimination, leading to fully equal rights and, in general equity and equality. HIV and human rights for LGBT, sex workers and drug users must be in the same agenda, not in different or, worse, competing ones. And all this must be part of the gender equity agenda at large.

Anonymous from
Mon, February 4, 2013 at 11.51 am

The AIDS response is advancing correctly regarding access to treatment and PMTCT. However, facilitating access to prevention, treatment, care and support for gay men, trans women, other MSM, drug users and sex workers still has large gaps. This fact is fueled by the fact that in many countries these populations are criminalized or are not given equal protection under the law and from discrimination. HIV is a pathfinder and an example of how to streamline work around inequalities, access to full employment, housing, justice, and education for these marginalized populations. HIV is the door through which these rights can be accessed and demanded.

Anonymous from
Mon, February 4, 2013 at 04.54 am

AIDS is an unfinished business. -full stop- Humanity must lern from past experience, when it assumed that a serious disease was on the way to be controlled. I refer to Tuberculosis. We loosened the grip we had back then. We faltered. We assumed that further investing was not warranted. What a mistake. Today TB-HIV co- infection is not only reported world-wide, but multiple-drugs resistant Tuberculosis thrives!
Successes with treatment to date must not blind the path of prevention. Just as we saw for the MDGs, many of the already proposed SDGs have a direct relationship with AIDS. it will not go away on its own.
In a time of financial crisis and challenges, a thorough review of investments from domestic sources can lead to more strategic investing with quite rewarding results. My call is for a full endorsement of ending AIDS as a target of the World We Want after 2015!

Anonymous from
Mon, February 4, 2013 at 12.35 am

Some of the challenges of national AIDS responses includes:
- pervasiveness of socio-cultural practices that fuel stigma and discrimination against PLHIV, women and girls and other key populations, which in turn limits access to HIV prevention, treatment, care and support services to these groups
- The global economic downturn coupled with misapplication and inefficient investment in critical aspects of the national response remains a challenge. The inability of African countries to their committment to substantially increase domestic financing of the national still persist.

The inability of African goverments and regional grouping to take advantage of the TRIPS agreement has limit the number of people who have access to treatment
- the pausity of data and strategic information has affected the planning, reporting and effective decision making on national response

To ensure that we END AIDS in post 2015; HIV &AIDS must feature as one of the key priorities areas for the post 2015 Agenda

Anonymous from
Sun, February 3, 2013 at 10.26 pm

Gay men and other men who have sex with men (MSM) continue to shoulder a disproportionate HIV disease burden in virtually every country that reliably collects and reports surveillance data. This fact has been true since the epidemic began in the early 1980s.
In many high-income countries, HIV epidemics among MSM continue to climb even while overall HIV epidemics are in decline. In the United States, new HIV infections among MSM have been increasing 8% per year since 2001. In low- and middle-income countries across Africa, Asia, the Caribbean, and Latin America, HIV rates among MSM are skyrocketing, far exceeding those of the general population.
Due to stigma, discrimination, and crimi¬nalization, the HIV epidemic among MSM continues to go largely unaddressed in many countries. As of December 2011, 93 countries had failed to report any data on HIV prevalence among MSM over the previous 5 years, and reports indicate that less than 2% of global HIV prevention funding is directed toward MSM.
Of the numerous and varied inequalities faced by LGBT people, disproportionate rates of HIV infection are among the most striking. In nearly every country around the world, gay men and other men who have sex with men (MSM) face higher rates of HIV than the general population.
These statistics and on-the-ground reality illustrate the unfinished HIV agenda among MSM. Therefore, it is imperative for the Post-2015 MDGs to ensure the continued prioritization of tackling the HIV epidemic as a development issue to turn the tide against this epidemic.

Anonymous from
Sun, February 3, 2013 at 09.41 pm

The response to HIV/AIDS has seen many successes, reviewed comprehensively by others during this consultation. Yet despite these advances, the AIDS pandemic continues to outpace our ability to treat it, with five new infections for every three people gaining access to treatment. A lack of effective, appropriate, affordable tools (particularly for women, children and key populations) remains one of the key impediments in the response to HIV/AIDS. New and improved health solutions are needed if we want to control and ultimately end HIV/AIDS.
There has been promising news on that front. For example, recent studies demonstrated that antiretroviral therapy given preventatively can reduce risk of HIV infection, through pre-exposure prophylaxis and microbicides, and vaccine studies have demonstrated for the first time partial success in reducing the risk of HIV infection. Currently, oral pre-exposure prophylaxis has been approved in the US, several microbicide formulations are in late-stage trials, and new vaccine combinations are being prepared for advanced testing. The likely availability of these tools during a new Development Framework can help to meet people’s health needs, save lives, reduce healthcare costs and ultimately end the HIV/AIDS pandemic.
Therefore, within a Health and Development goal post-2015, we ask for: 1) an international commitment to ensure sufficient resources for the development of new prevention technologies including vaccines; 2) enabled by policies to accelerate their development, distribution and equitable roll-out, backed by meaningful North-South and South-South collaborations ; 3) as part of an international commitment to control and ultimately end the HIV/AIDS pandemic through rights-based and equitable access to proven prevention, treatment and care options and sustained support for innovation to prevent infections, save lives, reduce burden (including resulting from stigma and discrimination) and cut costs; 4) with a particular focus on meeting the health needs of women, children and key populations – for whom adequate health interventions do not exist or who are unable to fully benefit from already available health interventions.

Anonymous from
Sun, February 3, 2013 at 05.12 pm

Public health, education, and research need to go hand in hand. This point cannot be emphasised adequately enough when considering progress in developing countries in which the spread of HIV is most rampant.
More specifically there is a definite need to do more research on different strains of the HIV virus, as they vary across different geographical regions.
Unfortunately, many companies and institutions remain risk averse when it comes to funding long term research projects in developing countries. Resources go primarily towards funding research on HIV virus strains found in developed countries, and not strains found in the developing world. Furthermore, many of the developing countries are ill equipped with the requisite infrastructure and proper human resources/skills necessary in order to sustain research activities.
Fundamental changes in operations management and strategic long term financial collaborations will be necessary to maneuver the next big breakthrough in our war against HIV worldwide. Bottom-line: we need to overcome our fear of failure and adopt a long term perspective in taking the first steps to build the necessary healthcare and research infrastructures in the developing world in order to help people who are in dire need of our specialised expertise and help.

Anonymous from
Mon, February 4, 2013 at 05.19 am

Early in the HIV epidemic, at one of the International AIDS conferences, there was a debate between two senior researchers/epidemiologists as to whether the response to HIV should be "targeted" or "general." Even then, the two scientists threw up their hands and said it had to be both--targeted to prevent transmission for those at highest risk, find cases, get those with HIV into treatment and provide support if the disease had progressed; general because we never know who will be in the new "risk group" or, as we have learned to better state it, what will be the new "risk practice", because nearly everyone (whether they realize it or not) will come to know someone with HIV, and because we have an obligation to empower individuals to protect themselves. Without a strong cultural commitment to open discourse about health, especially sexual health, youth are a continually emerging new "risk group." With continued definition of some individuals--whether through age, poverty, gender, minority status, marginalization--as less worthy of protection from health threats, we will continue to harm all of us by perpetuating an epidemic. As Nelson Mandela said in announcing his own son's HIV "What is the point in keeping silent?" Yes, we may have to confront cultural constraints, but nearly every culture has a leverage point to use in addressing HIV. And we have to talk to one another to find it. In short, we can no longer justify stigma and discrimination, because they will turn back on us, as nearly a century of research on discrimination has shown. But that also means, even when resources are scarce, we have to be careful not to pit one affected group against another, but rather all rally for all, thus demonstrating our own resilience against stigmatizing and putting one group's dignity above another. We should all be mentioning all the people and regions at risk, and asking for both targeted and general response. Oh, to hear someone say something like, "I am a PLWHA who got HIV through injected drug use and I am here to advocate for women at risk, children, sexual minorities, other IDUs, those at risk because of separation from loved ones through migration, and all friends and loved ones affected by HIV. I am here for the highly affected regions of sub-Saharan Africa, the Caribbean, and all the countries of the world together where 34 million men, women and children are living with HIV/AIDs."

Miles Greenford from
Sun, February 3, 2013 at 11.00 pm

HIV is an important issue, I can't agrue against that. Death from starvation, poor water quality, lack of shelter, lack of fuel sources, lack of infrastructure, lack of international and national law & order; is the greater issue. This is what is meant by an unhealthy planet Earth. Not unhealthy for the planet itself, as evolution will continue no doubt. But, for the first time in the story of the Earth, one of it's species is in the rapidly increasing process of creating a global ecological niche on a scale unfathomable! HIV will burn out due to the lack of available hosts for transmission, if a Healthy Earth - healthy for humanity that is, continues to go down the political priority escilator. It is by far above and beyond the importance of any other single or multiple issue the UN, or any other body has had to deal with since the early dawn of humanity itself. Research needs to be undertaken on multiple fronts in this field including: establishing a Healthy Earth criteria, monitor progress of change against these criteria, study the validity of these criteria, adding to, subtracting from, adapting or maintaining them as the research evidence dictates. Simultaniously, raise awareness of the importance and adoption of such a tool globally, internationally, nationally, locally and individually. This will take more research to generate the evidence of methods effective politically at having these recognised and effectively adopted. And finally, by far the biggest part of this is to identify effective evidence-based treatment programmes and how also effectively they can be implemented and monitored. Millions are already dead because we to date have not done something like this. Poverty is merely a symptom of this. Once, poverty was enough to be recognised as needing tackling, now another criteria has to be met first; extreme. Then this too will be pushed back as we learn to adapt to accepting what today we call extreme. And still the fundimental issue of an unhealthy Earth will continue to go 'unrecognised' as the cause.

Miles Greenford from
Sun, February 3, 2013 at 10.59 pm

HIV is an important issue, I can't agrue against that. Death from starvation, poor water quality, lack of shelter, lack of fuel sources, lack of infrastructure, lack of international and national law & order; is the greater issue. This is what is meant by an unhealthy planet Earth. Not unhealthy for the planet itself, as evolution will continue no doubt. But, for the first time in the story of the Earth, one of it's species is in the rapidly increasing process of creating a global ecological niche on a scale unfathomable! HIV will burn out due to the lack of available hosts for transmission, if a Healthy Earth - healthy for humanity that is, continues to go down the political priority escilator. It is by far above and beyond the importance of any other single or multiple issue the UN, or any other body has had to deal with since the early dawn of humanity itself. Research needs to be undertaken on multiple fronts in this field including: establishing a Healthy Earth criteria, monitor progress of change against these criteria, study the validity of these criteria, adding to, subtracting from, adapting or maintaining them as the research evidence dictates. Simultaniously, raise awareness of the importance and adoption of such a tool globally, internationally, nationally, locally and individually. This will take more research to generate the evidence of methods effective politically at having these recognised and effectively adopted. And finally, by far the biggest part of this is to identify effective evidence-based treatment programmes and how also effectively they can be implemented and monitored. Millions are already dead because we to date have not done something like this. Poverty is merely a symptom of this. Once, poverty was enough to be recognised as needing tackling, now another criteria has to be met first; extreme. Then this too will be pushed back as we learn to adapt to accepting what today we call extreme. And still the fundimental issue of an unhealthy Earth will continue to go 'unrecognised' as the cause.

Anonymous from
Sun, February 3, 2013 at 11.30 am

Drawing from consultations toward the 2011 High Level Meeting on AIDS – it is clear that:

 The HIV agenda and development frameworks have yet to fully tap women’s potential: Women seek and are eager to be engaged and viewed as equal, active stakeholders and agents of change rather than as subordinate, passive recipients. Despite a decade of rhetoric about AIDS having a “woman’s face”, women still seek an HIV response that is deeply rooted in human rights, equitable, holistic, gendered, and shared sector-wide.

Key priorities and unfinished business as identified by women around the world:

1. Ensure comprehensive and inclusive HIV services that address the visions, life-long needs, and rights of women and girls in all their diversity.

2. Eliminate stigma and discrimination, and ensure full protection of the human rights of all women and girls, including their sexual and reproductive rights.

3. Strengthen, invest in, and champion women’s leadership and gender equality, to ensure the full and meaningful participation of women and girls, in particular those living with and affected by HIV, in the HIV response.

4. Empower women and girls to be catalysts of social justice and positive change, and eliminate all forms of gender-based violence.

5. Ensure full access to information and education, including comprehensive sexuality education for all women and girls.

The full action agenda can be found at http://womeneurope.net/resources/InWomen%27sWordsFinal.pdf

Patrick Brenny from
Sun, February 3, 2013 at 10.28 am

Malawi -- like many other countries in this region -- is severely affected by HIV, which is the leading cause of mortality for adults as well as the cause of 30% of Maternal Mortality. With an estimated 1 million out of a population of 16 million people living with HIV infection, the daily reality of HIV will need to be a priority for the Malawian people which will continue to be addressed well beyond 2015.

In order to do that effectively, our Post-2015 agenda will need to continue addressing HIV, sexual and reproductive health and rights, gender inequalities which continue to make women and young girls more vulnerable to HIV infection, and the broader poverty, social inequality and human rights dynamics which continue to marginalize too many people, both those living with as well as without HIV infection.

Patrick Brenny from
Sun, February 3, 2013 at 10.28 am

Malawi -- like many other countries in this region -- is severely affected by HIV, which is the leading cause of mortality for adults as well as the cause of 30% of Maternal Mortality. With an estimated 1 million out of a population of 16 million people living with HIV infection, the daily reality of HIV will need to be a priority for the Malawian people which will continue to be addressed well beyond 2015.

In order to do that effectively, our Post-2015 agenda will need to continue addressing HIV, sexual and reproductive health and rights, gender inequalities which continue to make women and young girls more vulnerable to HIV infection, and the broader poverty, social inequality and human rights dynamics which continue to marginalize too many people, both those living with as well as without HIV infection.

Anonymous from
Sun, February 3, 2013 at 09.10 am

I would like to answer the first and third question. In Kyrgyzstan the lack of funds, the negative attitudes, but most importantly the lack of knowledge and correct information make working in the field of HIV/AIDS extremely challenging. There are some fragmented training programmes on HIV/AIDS as well as on safe sex, but institutionalized nation-wide approach is lacking including sex education in schools and universities. To improve the response to HIV/AIDS in the post-2015 period, it is necessary to train teachers, doctors, students and pupils at all levels on how to avoid risky behaviours and how to relate to HIV+ individuals. Currently, it is usual, for instance, for schools to not to accepts pupils with HIV, since there are wide-spread misconceptions about how people get infected.

Olfa Lazreg from
Sun, February 3, 2013 at 08.09 am

1) Parler sexualité demeure toujours un sujet tabou dans plusieurs pays et surtout les pays musulmans.
Parler de rapports sexuels hors mariage ou de l’usage de préservatif est encore un sujet sensible, vu que plusieurs personnes pensent que le fait d’en parler ça encourage les jeunes à faire des rapports sexuels,
Il faut faire comprendre les personnes, que le fait de parler de l’usage de préservatif entre dans le cadre de la politique de « Réduction du risque », l’usage de préservatif vient après l’abstinence et la fidélité et dans le cadre de la prévention complète il est impératif de parler des 3 moyens de protection.
Le débat sur la prévention du VIH/SIDA doit être un débat collectif incluant plusieurs intervenants (médicaux, religieux, sociaux) pour analyser la problématique dans sa totalité.

Un 2ème point, c’est le manque d’orientation et d’encadrement des jeunes des zones défavorisées, on remarque que se sont les jeunes d’une certaine catégorie socio-économique qui ont accès à l’information, en général, se sont les jeunes des régions favorisés, dans la plupart du temps (pour ne pas dire la majorité du temps) se sont des étudiants et des personnes qui peuvent avoir accès à l’information facilement. Il faudra penser à toucher les régions défavorables et partir sensibiliser les personnes qui n’ont pas accès à l’information, qui ne vont pas aux écoles et aux universités, qui n’ont pas accès aux outils d’information comme Internet ou la télé. Accentuer et renforcer le travail avec les jeunes étant eux-mêmes de futurs vecteurs de sensibilisation.
2) La politique adoptée pour la lutte contre le SIDA s’améliore de plus en plus, mais il reste beaucoup à faire.
Le travail avec les jeunes doit être plus appuyé et plus solidifié et structuré.
3) Il faut faire le plaidoyer pour inclure l’éducation sexuelle et l’éducation en matière de droits humains dans le cursus scolaire

DSW from
Sat, February 2, 2013 at 03.10 pm

In the post-2015 framework health should be included as a condition and a consequence of broader economic and social development. It is also very much linked to sociocultural aspects, acceptability and equity principles.

In order to prevent, and in the end eliminate HIV & AIDS, sexual and reproductive health and rights (SRHR) must be at the core of the HIV response – especially with regards to young people. In order to reach young people with information, prevention and care, access to youth-friendly services is key.

While education and awareness raising can help prevent further spread of HIV & AIDS, investments in research and development of new and improved prevention technologies, vaccines, microbicides, and treatment targeting poverty-related and neglected diseases is also direly needed.

All in all, the post-2015 framework must avoid the siloed approach in the current MDGs and instead ensure close links between health, gender, HIV & AIDS and SRHR -with a specific focus on young people. Please see the link below for more on our view on HIV in the post-MDGs.

http://www.worldwewant2015.org/bitcache/7e25b24b730e2f82e2db1c85fe70ad3e...

Anonymous from
Sat, February 2, 2013 at 11.45 am

The fight against HIV should definitely be a top priority in the post 2015 development agenda as despite the fulgurant progress made in the last three decades so much more needs to be done for us to truly see an aids free generation in Africa hardest hit in this fight. The biggest challenge my country faces is the heavy dependency on external aid to fund the national aids response. How can we possibly sustain our efforts if we are continuously at the mercy of external economies? Especially when it comes to providing ARVs to HIV infected people, it's heartbreaking to hear the regular stockouts my country faces, like many other african countries in the region, which put at risk thousands of lives. So yes, the question wether AIDS should be a priority shoudn't be a doubt in anyone's mind. The question we should all be asking is how we do it, what do we do differently and/or better after 2015 to win the fight once and for all.

1. Explore ways how to MAKE both governments and private sector to invest more resources in the response but more broadly in health servives to their population, cause an unhealthy individual can not contribute effectively to growing its economy
2. Integration, integration, integration, integration of HIV in health delivery services. We say it, we prone it, some countries have managed to effectively do it, but many other perpetuate the verticalisation of HIV. For instance why should ARVs be given in specific health centres (case in my country) which only contibutes to fueling stigma and discrimination?
3. Giving a greater voice to the youth is good, but given them the actual tools and resources to develop their extraordinary ideas for HIV prevention programmes is even better!

Anonymous from
Sat, February 2, 2013 at 09.39 am

As a medical NGO working on HIV/AIDS, we’re convinced this issue should remain on the post-2015 agenda not to lose all the progress that have been achieved so far. The development agenda has too often worked through waves or fashions that had left older priorities unfinished as new ones came up – a habit the post-2015 agenda should definitely avoid. In this regard, such a change in priorities should absolutely be averted in the fight against pandemics, since halting the efforts against these diseases would make all the gains achieved so far disappear and would even worsen the situation with the re-emergence of the disease in some areas or the development of resistances.

Therefore, we believe HIV treatments and fighting discriminations should be the top priorities of the HIV response in the next 15 years. First, access to treatment is an imperative both in terms of human rights and public health. Thus, investment for universal access to HIV treatments but also for research towards a cure should be a clear priority of the next agenda. Secondly, to act on the determinants of the HIV pandemic and given its transversal nature, the fight against the discrimination of vulnerable populations (MSM, women, drug-users…) should be led side by side with the fight against the discrimination of PLHIV.

Thus, in our opinion, the main challenges we’ll have to overcome in the fight against HIV/AIDS in the post-2015 are to ensure sufficient financing and civil society’s involvement. As other priorities rise in the global agenda, we’ll all have to guarantee funds for HIV/AIDS are increased to finally bring the pandemic under control. Such an objective requires a strong financial commitment from states both at the national and global level as well as new methods of resource mobilization like innovative financing. Additionally, we’ll have to ensure and support full participation of people affected by HIV/AIDS so that they can become the primary resource and source of proposals for action.

Anonymous from
Sat, February 2, 2013 at 06.41 am

There is poorly coordinated funding for civil society. In particular PLHIV and networks of PLHIV are often expected to participate and share their expertise without proper funding and this weakens their ability to fully engage, deliver and hold leaders accountable. The role of PLHIV networks is critical if we are to move towards improved and sustainable community based responses and they need to have secure funding and defined roles.

Guiselly Flores from
Sat, February 2, 2013 at 02.43 am

1. Obstáculos:
Falta de evidencias sobre el contexto real de la epidemia en muchos países. Aquí ni siquiera conocemos el % de niños, niñas huérfanas a causa del sida, seguirán en abandono?
La indiferencia, estigma y discriminación de parte de la sociedad y de las entidades del estado es muy grave, esto conlleva a no ampliar la visión de la epidemia a otros sectores: educación, trabajo, justicia, Inclusión social, entre otros.
Un obstáculo grave es el acceso a la salud, es grave la falta de atención y acceso, la salud en este país es muy cara.2.
Si logramos tener mayores evidencias relacionadas al impacto real de la epidemia y no solo enfocarnos en los grupos de alto riesgo, si no demostrar las causas más profundas,como la falta de educación inclusiva, la violencia como causa del VIH, la pobreza, entre otras, daremos a los tomadores de decisión verdaderas razones para priorizar esta agenda post 2015.

3. Acciones, campañas o estrategias:
Participación y escucha efectiva de las comunidades directamente afectadas (comunidades indígenas viviendo con VIH, mujeres viviendo con VIH, huérfanos del SIDA, comunidades claves....)
Empoderamiento de las comunidades de PVVS y afectados.
Fortalecer las mesas multisectoriales de respuesta al sida.
Erradicar el estigma y la discriminación desde el ámbito educacional, con educación inclusiva desde las escuelas, incluir formación de educación sexual desde la infancia.
Acceso a la salud: en el ámbito geográfico, económico, cultural.

4. Acceso a la justicia, disminuir las barreras engorrosas, promover instancias de resolución más rápidas y efectivas.
Sensibilizar a los operadores de justicia.
Realizar campañas masivas anti discriminatorias.

Anonymous from
Sat, February 2, 2013 at 12.58 am

Tuberculosis (TB), a preventable and curable disease, is the leading cause of death among people living with HIV. It is essential that TB and HIV services collaborate to prevent people living with HIV from getting TB. Three key activities are active TB case finding, provision of preventive therapy (isoniazid), and infection control in health facilities and communities. Another critical area is investment in the development of a point of care diagnostic for TB that works in people living with HIV and in children; and new TB drugs that work with ARVs.

Kouassi Kouassi from
Fri, February 1, 2013 at 08.49 pm

1. The specific challenge we face in our work here in Cote d'Ivoire is the extreme reliance on external funds. This makes that most of interventions are time framed and unsustainable. and I believe the only way to address this is to start mobilize internal resources so that our programs and interventions can last.

Zahra Benyahia from
Fri, February 1, 2013 at 08.01 pm

For me, the main challenge is to think of an innovative way to come with a response to HIV/Aids. 30years after the discovery of the epidemic, I feel that almost everything has been done and proposed. So what can be suggested yet,
The other challenge is sustainability that is presenting a true obstacle. Billion of actions are initiated but all come to an expiry date. Is HIV/Aids no longer that interesting for poeple to work on it?

Financial gaps also remains considerable
HIV will remain a priority if we succeed in mainting it highlighed in any other global issue (women's rights, economic growth, Education,...) because in each on of them, the dimention of the HIV infection is present and affecting in a way or another.

Anonymous from
Fri, February 1, 2013 at 07.34 pm

Since the launch of the Millennium Development Goals (MDGs) in 2000, there has been incredible progress in the global fight against HIV/AIDS. The political will and financial commitments within the MDGs led to remarkable gains within the HIV epidemic, evident in the statistics on the disease. Prior to the 2001 Commitment on HIV/AIDS, there were 5.4 million new infections each year. Thanks to the catalytic effects of the MDGs, this number has been more than halved. Additionally, the scale-up of prevention of mother-to-child transmission of HIV (PMTCT) services has averted hundreds of thousands of new infections with more than 57 percent of women now having access to these services.
But our work is not done if we want to see the end of AIDS in the post-2015 era. Nine hundred children are still born with HIV each day, and half of those will die by their second birthdays without treatment. Children eligible for lifesaving treatment are often unable to access it, with child ARV access rates lagging far behind those for adults – globally while 57% of eligible adults are on treatment, only 28% of children are. Eighteen million children have been orphaned due to AIDS, and HIV remains the number one killer of women of childbearing age. Fully implementing the Global Plan for the Elimination of New HIV Infections Among Children and Keeping Their Mothers Alive, especially on the individual country level, is going to be critical if we want to reach the last 50 percent of HIV positive pregnant women with PMTCT services.
To sustain current gains, and continue to make progress, HIV/AIDS must remain a high priority and a high profile piece of any post-2015 framework. There must be clear goals and targets that are time-bound and measurable to facilitate scale-up so that the most vulnerable – including women and children – are able to access the HIV prevention and treatment services they need, and so governments and civil society can be held accountable. New goals and targets centered around HIV, especially children and HIV, could be the focus the world needs to end AIDS in children, and we cannot let this opportunity pass us by. We are at the beginning of the end of AIDS, on the cusp of an AIDS-free generation, but global priority shifts could result in dramatic setbacks that will affect generations to come. With concerted global financial and political commitment, an AIDS-free generation can become the biggest global health triumph of the post-2015 era.

Denis LeBlanc from
Fri, February 1, 2013 at 06.47 pm

Part 3 (Final): The eradication of HIV must remain a named priority after 2015. It must be specifically named as a priority within the health sector’s development goal. The Global Fund must be renewed as the primary funding instrument to fight HIV, TB and Malaria given the substantial progress demonstrated by the Fund’s contribution to increasing global life expectancy. I believe the WHO paper got it wrong. Increasing live expectancy could be a key health indicator, along with the eradication of AIDS in one generation. But “universal health coverage” is not a reasonable development goal in the short term and by this, I mean in the next 20 years. Even the USA has not yet accomplished this. We must first virtually eradicate the primary communicable diseases before setting “universal health coverage” as a development priority. Unfortunately, the world does not have the resources at this time to accomplish the lofty goal of “universal health coverage”.

Denis LeBlanc from
Fri, February 1, 2013 at 06.45 pm

Part 2: “Around the world, lesbian, gay, bisexual and transgender (LGBT) people are targeted, assaulted and sometimes killed … More than 76 countries still criminalize homosexuality … it is an outrage that in our modern world, so many countries continue to criminalize people simply for loving another human being of the same sex … these laws must go. This is a State obligation …
… just because a majority might disapprove of certain individuals (does) not entitle the State to withhold their basic rights. Democracy is more than majority rule. It requires defending vulnerable minorities from hostile majorities. Governments have a duty to fight prejudice, not fuel it.” (Full text at: http://www.un.org/apps/news/infocus/sgspeeches/statments_full.asp?statID...)

This formidable and clear statement by the Secretary General can guide our discussions. It provides tangible hope that our goal to eradicate HIV through a rights-based approach can be achieved. We can measure the implementation of the human rights agenda through a tracking system and through tracking the participation of all the key populations named above at the nation level.

This consultation should consider the statement by the communities delegation of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Statement of the Communities, to the Global Fund consultation on the New Funding Model, issued January 25 and 26, 2013, in Amsterdam, The Netherlands. The statement is found at: http://www.gnpplus.net/images/stories/newsreleases/Statement_from_Commun...

Denis LeBlanc from
Fri, February 1, 2013 at 06.42 pm

Part 1: I comment only for myself as an HIV+ individual and not on behalf of any group. I wholeheartedly agree with the comment by Naomi Burke-Shyne dated January 31st. To put it perhaps more bluntly, prevention and treatment recommendations will be effective when nations understand that with full equality and human rights, we will finally eradicate AIDS through effective HIV treatment and prevention. And if Nations commit to a human rights approach, we can eradicate AIDS in one generation. The recently published GNP+ Global Advocacy Agenda emphasizes that “only through a rights-based approach to the HIV response…can positive public health outcomes be achieved…”

All states, nations and jurisdictions must act to add or adopt laws and/or regulations that include at least Sex, Sexual Orientation, Gender Identity, Disability, HIV Status or Health Status in a Human Rights Code, Law or Statute. In addition, real and accessible enforcement mechanisms must also be adopted to ensure human rights are in fact protected by the state. The full collaboration and commitment of nations to equal treatment and human rights for Key Populations is essential for the eradication of AIDS. Key Populations that should be targeted with prevention information and treatment include: women, children, transgender people, young people, gay men and other men who have sex with men, sex workers, persons who use drugs, prisoners, migrants and internally displaced people.

Lead Theme 1, at question 4 did not name all the Key Populations noted above. This is important because together, the Key Populations constitute the majority of the populations of all nations.

On December 11th, 2012, Secretary-General of the United Nations Ban Ki-moon made the strongest statement yet on LGBT rights. I feel his statement applies equally well to all Key Populations.

Humberto Hernández from
Fri, February 1, 2013 at 03.29 pm

Muchos países en América Latina han logrado avanzar en su respuesta por el acceso a tratamientos antiretrovirales. Pero, al mismo tiempo, muchos países siguen en deuda con una educación sexual que incluya la prevención del VIH, que supere la información biológica y se haga cargo de mensajes positivos respecto a la afectividad humana, al placer sexual y al respeto por las personas, su sexo, su orientación sexual y su identidad de género. Incluso cuando existen cambios jurídicos que reconocen la diversidad sexual se requiere avanzar en el cambio cultural que dignifique a las personas y les permita una integración social y una autoestima que reconozca su valor y potencie una sexualidad saludable. Si bien la respuesta del sector salud ha sido fundamental, en el futuro se requiere de un compromiso cada vez mayor de los otros sectores de la sociedad que se hagan cargo de la responsabilidad que les corresponde en difundir mensajes de prevención y de integración familiar, escolar y laboral

tinashe mutsonziwa from
Fri, February 1, 2013 at 11.31 am

Hi1 thank oyu for providing a platform that enables to discuss and come up with possible solutions to the challenges that we are facing with regards to the HIV pandemic. In my country over 80% of the medications currently in the National pharmacy are donor funded. that includes the life saving ARV drugs. hence I think it is important for HIV to remain on the agenda until countries have started to realise a significant decline in the HIV prevalence and they are able to support their population with the required ARV drugs from their own budgets. If HIV is no longer on the agenda it will result in less funds globally being directed to combating HIV and lead to dwindling donor funds in countries that need the greatest support in mitigating HIV. This puts the sustainability of most programs that have contributed to the decreasing prevalence rates in most countries. Therefore undermining the achievements that have been recorded so far.

Othoman Mellouk from
Fri, February 1, 2013 at 11.42 am

Hi tinashe,
definitely allocating domestic ressources to fund HIV treatment is important and key to ensure sustainability of treatment programs.
Any thoughs, examples on how having HIV in the MDG agenda has helped to mobilize national ressources? How this can be done properly in the post 2015 agenda?

Anonymous from
Fri, February 1, 2013 at 03.02 pm

It is really important that you define this lofty goal of sustainability. Often it is narrowed down to financial sustainability and translated as mainly depending on domestic budgets. This is quite dangerous and very pre-MDG I think.
I would question seriously if domestic budgets are necessarily more reliable than international ones, especially for patients and population groups that are stigmatised or excluded. Look at what is happening with priority for HIV patients in Middle income countries like Russia and China.
While national political will is important, it rarely emerges without serious public pressure, including from civil society and international actors.
It is simply irrealistic for many countries currently 'depending' on aid for an effective HIV response to shift to domestic resources in short or medium term.
'Sustainability' in that particular sense will thus elude most low income countries with a high burden of disease. Have a look at articles such as Hecht et al that contrast the needs with domestic resources constituting health budgets.
I think it's really dangerous to redirect the responsability to sustain funding for responses to the major killers to the country/community itself. This will lead rapidly back to adapting responses to the available limited resources and compromise quality, access and impact of health interventions. The starting point should be the needs and the response needed to make a sugnificant difference, not a fatal shortfall in resources determining what can be done.
I would suggest to use the term 'sustained' instead, with resources from whatever source.

Othoman Mellouk from
Fri, February 1, 2013 at 03.23 pm

Hi Mit, sustainability is not depending only on funding and increase on domestic funding does not necessary mean that ressources are targetted to those most in need especially in settings where there are serious human rights issues. In many countries, inceasing domestic funding has not always been sufficient to compensate funding received from international donors. Coming from the MENA region, I can give as an example Algeria, where after the departure of the GFATM, the government is now funding more than 90% of the AIDS response, but most CSO think that the situation was better by the past.
However, increasing domestic ressources is important. It's an accountability issue. The majority of African countries have not yet achieved their committment in the Abuja declaration to invest 15% of their national ressources to health.
Now how ti make sure national investments go to those who are really in need? How the post 2015 agenda can help achieving this?

Anonymous from
Fri, February 1, 2013 at 10.27 am

HIV has to remain a priority as in swaziland we see a transformation among the young boys who are very excited with the Male circumcision problem, however lack of coordination of efforts by different players in the response requires special attention if HIV effrots are to be successful. Gender mainstrwmaing is another issue less spoke off and yet gender inequality remains a silent driver of the epidemic in the country.

Anonymous from
Fri, February 1, 2013 at 06.26 am

How do we ensure that a human rights-based approach is a reality for the HIV response among key populations (Men who have sex with Men, Sex workers and Injecting Drug Users)?

As persons with disabilities make up a key population in regards to responding to the HIV epidemic. In this respect, the notion of a rights-based approach is of particular relevance to persons with disabilities, especially given the recent enforcement of the UN Convention for the Rights of Persons with Disabilities (CRPD). As stipulated in Article 33 of the CRPD, all projects and programmes, whether mainstream or disability specific, have to be compliant with the CRPD, and promote the rights and full and effective participation of persons with disabilities.

Placing this in the context of the post-15 year development agenda, it is essential that the new framework is inclusive of persons with disabilities and in line with the CRPD. In addition, there needs to be specific and measurable indicators in relation to the inclusion of persons with disabilities in the future HIV agenda. Furthermore, in order to ensure a rights-based approach, mechanisms should be put in place to enable persons with disabilities and their organizations to monitor their inclusion in all HIV and health legislation and service delivery.

Imene Ben Ameur from
Fri, February 1, 2013 at 10.14 am

Hi Paulic ! Thanks a lot for your contribution and for bringing this issue to the discussion.
It is absolutely true that people with disabilities or special needs, have to be invovlved in the AIDS response and in the decision-making processes. Do you know any examples of networks or bodies that assure the involvement of persons with disabilities in their HIV programmes ? How to make this involvement sustainable ?

Anonymous from
Fri, February 1, 2013 at 01.01 pm

Thank you for your response Imene. In answer to your question, there are a number of programmes globally that are working towards disability inclusion in HIV services. My submission was also made on be half of the International Disability & Development Consortium (IDDC), which is made up of several organisations and can be found via http://www.iddcconsortium.net/joomla/index.php/hivaids

Anonymous from
Fri, February 1, 2013 at 06.22 am

In order to overcome the barriers towards persons with disabilities in the context of the post-2015 development agenda, the following suggestions are put forward:

• Refine monitoring systems: Given the lack of statistical evidence surrounding persons with disabilities and HIV and AIDS, there is a need to refine current monitoring methods in order to include disaggregated data surrounding disability. We cannot end HIV if we are not collecting data from 15% of the population. In collecting disaggregated data on disability, for monitoring purposes it is important that a universal definition of disability is applied such as that used in the UN Convention for the Rights of Persons with Disabilities.
• Change methods of approaching HIV: As outlined above, there is increasing evidence of the links between HIV and persons with disabilities , , . Furthermore, it is important to remember that people living with HIIV may develop some form of episodic/chronic disabilities overtime e.g. respiratory impairments, musculo-skeletal impairments, neuro-cognitive disorders, sensory disabilities, mental disorders and mental health problems , . In view of this, there is a need to link HIV services with rehabilitation services, in particular community-based rehabilitation (CBR) programmes. According to the WHO CBR Guidelines , CBR can be effective in responding to the needs of and supports the social inclusion and equalisation of opportunities for people living with HIV who may come to experience disability.
• Training of HIV/AIDS officials and mainstream organizations: In order to respond more effectively to meeting future MDG targets, it is recommended that HIV officials receive awareness training and capacity building in relation to the rights and inclusion of persons with disabilities in all international HIV policies as well as national initiatives. Although disability is often described as a collective identity, it is also important that officials are aware of the different experiences by persons with disabilities.

Anonymous from
Fri, February 1, 2013 at 06.18 am

Very little attention has been given to women, men and youth with disabilities who often face barriers such as poor access to healthcare, lack of accessible information on sexual and reproductive health and HIV/AIDS, poverty and marginalisation, and high rates of sexual abuse and exploitation , . Despite these increased risk factors, persons with disabilities are hardly being included in HIV and AIDS programming, because it is assumed that they are not at risk of HIV infection. Though their needs are increasingly being recognised as a vulnerable group as illustrated by UNAIDS’2009 Disability and HIV policy brief and 2012 Strategy for Integrating Disability into AIDS Programmes , persons with disabilities still are often excluded from AIDS development processes as well as programmatic HIV prevention, treatment, care and support services.
A further challenge relates to the limited involvement of persons with disabilities throughout the MDG processes in relation to HIV and AIDS. According to the WHO and the World Bank’s World Report on Disability , there are nearly 1 billion persons with disabilities in the world. This actually accounts for 15% of the global population. In view of this and the invisibility of persons with disabilities in the HIV global and national agendas, current MDGs cannot be achieved by excluding 15% of the world. It is hence of utmost importance that the post-MDGs address this “historical neglect” as stated in UNAIDS 2011-2015 Strategy.

Anonymous from
Fri, February 1, 2013 at 12.14 am

Tenemos una agenda inconclusa con muchos vacios legales, eduativos, de atencion integral con mucha violencia hacia la mujer , con poco trabajo en comunidades nativas o indigenas

Anonymous from
Thu, January 31, 2013 at 11.15 pm

What has worked in the past and what do you think was not efficient?

The health-related MDGs have served the world well, but only because they were measureable time-bound targets that could be used as a focus for national strategies, international funding, and ongoing monitoring and advocacy.

Furthermore, country ownership and accountability benefitted from the innovative strategies pioneered by the global effort against HIV, tuberculosis, and malaria. These have included country-level mechanisms such as Country Coordinating Mechanisms (CCMs), national civil society advocacy coalitions, and systematic investments in non-governmental organizations to reach into communities, link people to services, deliver services, and monitor the effectiveness and efficiency of health programs. Civil society role in ensuring country ownership and accountability works well.

What is NOT efficient is to issue international declarations that are vague and allow governments to evade obligation.

Anonymous from
Thu, January 31, 2013 at 11.14 pm

What actions, campaigns or strategies need to be implemented in the post-2015 agenda in order to sustain and improve the response to HIV/AIDS?

Post-2015 goals should aim to achieve any unfinished goals set in the MDGs and in the 2011 global commitments on HIV. Millions of people remain impacted by HIV, tuberculosis, malaria, and other diseases without access to adequate prevention, treatment, care, or support. Furthermore, millions face continued human rights violations which cause ongoing vulnerability to poor health and impede access to services.

Global goals should then focus on the leading causes of premature death and disability. These should include specific time-bound targets against HIV, tuberculosis and malaria and also targets against other diseases (including NCDs and vaccine-preventable infections) and for indicators of sexual and reproductive health, maternal and child health, mental health, harm reduction and prevention of deaths and disability due to substance use.

Anonymous from
Fri, February 1, 2013 at 03.08 pm

I agree very much with your contribution, Sam. The MDGs are about impact on the leading causes of mortality and morbidity. Measurable change for many real people. It is important to preserve this approach and continue the unfinished work for the MDGs, including in the fight against HIV.

Anonymous from
Thu, January 31, 2013 at 11.13 pm

How can we make sure that HIV remains a priority after 2015?

We should make three arguments:

1. The fight against HIV, tuberculosis, and malaria can be won. In targeting the world’s leading causes of early death, campaigns to end HIV, tuberculosis, and malaria have achieved significant progress and will benefit further from recently described new technologies and investment strategies to finish the job. Pulling back from these goals now would waste the profitable investments made to date.

2. The fight against HIV, tuberculosis, and malaria is a driver of improved health systems, including scale up of quality maternal and child healthcare, sexual and reproductive health, harm reduction services, management of chronic health issues, and affordable treatment access and treatment adherence.

3. The fight against HIV, tuberculosis, and malaria contributes to the advancement of the right to health. The response to HIV has provided the most cogent example of successful individual and community engagement in health care in recent history. These allied efforts have especially catalyzed attention and action about the necessity to involve people in decisions that impact their health, ensure equitable access to health services, and overcome gender inequality, discrimination, violence, and other barriers to health.

Anonymous from
Thu, January 31, 2013 at 07.58 pm

¿Cuáles son los obstáculos y desafíos que enfrentan mientras trabajan en el campo del VIH / SIDA?
El ´principal desafío es que no se reconocen las co-relaciones entre VIH y desarrollo y se sigue interviniendo en materia de VIH solo desde la optica de la Salud como mera ausencia o control de una enfermedad y no como un estado de bienestar integral, asi mientras miles de personas con VIH tienen ahora acceso a medicamentos no podemos decir lo mismo del acceso al aseguramiento en salud, a una vivienda saludable etc.


¿Cómo podemos superar esas barreras en el futuro?
Incorporando este tema como un eje transversal en la agenda futura de desarrollo y destinando recursos a programas integrales y consistentes de prevencion y atencion

2. ¿Cómo podemos asegurarnos de que el VIH sigue siendo una prioridad después de 2015? Los casos de éxito y experiencias para compartir?
Visbilizando las conexiones y el impacto del VIH en el desarrollo educativo, alimentario y laboral por ejemplo

3. ¿Qué acciones, campañas o estrategias deben implementarse en la agenda post-2015 con el fin de mantener y mejorar la respuesta al VIH / SIDA?
Es importante apuntar al aseguramiento universal en Salud para cada ser humano, eliminar las legislaciones que criminalizan el VIH y reforzar la educacion a los mas vulnerables

Anonymous from
Thu, January 31, 2013 at 05.14 pm

The HIV/Aids has to be adressed from a socio-cultural-political approach. There are some of the barriers.

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