Tapping into the potential of communities to end AID

All countries have committed to achieve the Sustainable Development Goals by 2030. This includes the commitment to end the AIDS epidemic as a public health threat. Yet with just 11 years to go, it is a mixed picture. In many countries, great progress continues to expand access to HIV treatment and prevention options that are, in turn, reducing AIDS-related deaths and new HIV infections. But there are still far too many countries where AIDS-related deaths and new infections are not decreasing fast enough, even rising in some cases, even though we know how to stop the virus.

So why are some countries doing so much better than others? The clue is in the title of UNAIDS’ new report ‘Communities at the centre’.

Success is being achieved where policies and programmes focus on people, not diseases, and where communities are fully engaged from the outset in designing, shaping and implementing health approaches that respond to the way people actually live their lives. This is how real and lasting change is achieved.

Adopting the latest scientific research and medical knowledge, strong political leadership and proactively reducing stigma and discrimination are all crucial. But without sustained investment in community responses led by people living with HIV and those most affected, countries will not gain the traction necessary to reach the most vulnerable, which is the only way to end the AIDS epidemic.

Community services play varying roles depending on the context. They often support fragile public health systems, filling critical gaps; they come from and connect effectively with key population factions including members of the LGBT community, sex workers, people who use drugs, or transgender people; they provide services that bolster clinic-based care and they extend the reach of health services into the community at large. They also hold decision makers to account.

By signing the 2016 United Nations Political Declaration on Ending AIDS, countries affirmed the critical role that communities play in advocacy, participation in the coordination of AIDS responses and service delivery. Moreover, they recognised that community responses to HIV must be scaled up and committed to at least 30% of services being community-led by 2030.

Most countries are nowhere near reaching that commitment and where investment in communities is most lacking, there is often weaker progress being made against HIV and other health threats.

All over the world, including in Asia and the Pacific, communities are demonstrating time and again that they can, and do, deliver results.

In Pakistan, for example, strong and sustained advocacy from civil society and transgender communities led to the passage of the Transgender Persons (Protection of Rights) Bill in 2018. The bill provides access to rights previously denied to this population and outlaws discrimination against them. The transgender community is now actively involved in the development of the Rules of Business to ensure a full and effective implementation of the Transgender Persons Bill.

Communities are making their voices heard. For the first time, a Civil Society Partnership Forum had been established, serving as a platform to deliberate on day-to-day issues faced by the communities and brainstorm on practical solutions to collectively address their needs and rights. The HIV response has started to unify what used to be a very fragmented civil society in Pakistan.

Our communities are a source of strength and they present so much untapped potential. Unleashing it is the key to gaining the momentum we need to make faster progress towards reaching the UNAIDS Fast-Track targets and getting every country firmly on the right path to end AIDS.

The more we invest in communities, the closer we get to ending the AIDS epidemic.

Published in The Express Tribune, July 18^th, 2019.

Like Opinion & Editorial on Facebook, follow @ETOpEd on Twitter to receive all updates on all our daily pieces.