Ending AIDS by 2030: Reframing AIDS response in the Asia Pacific Region
(Remarks by Dr Joe Thomas at the opening ceremony of the 12th International Congress on AIDS in Asia Pacific (ICAAP12) in Dhaka, 12th March 2016.)
Excellencies, Distinguished Delegates, Colleagues and Friends,
We are meeting here today in Dhaka at a historical juncture of AIDS response. Today End of AIDS is in Sight.
But, still AIDS is an unfinished agenda. AIDS agenda is still about the rights of people . who are vulnerable to and made vulnerable by HIV infection . to survive and contribute to the society.
Bangladesh society and the government could have all the reasons to be proud about Bangladesh being a low HIV prevalence country.
This Congress could provide necessary skills and conditions for Bangladesh to become the first country in this region to “End AIDS by 2030″.
Many of the achievements in the Health Sector in Bangladesh are called a miracle.
However, these are not accidents. These achievements are a product of careful planning, multi sectorial partnership, a high level of political commitment and the good will of many.
With a carefully planned road map, Bangladesh could end AIDS by 2030 as Bangladesh.s commitment to the Sustainable Development Goals (SDGs).
However, the changing nature of AIDS response from .AIDS Exceptionalism. to the need to mainstream AIDS response is presenting unique challenges to AIDS policy makers, service providers, community based organizations, civil society and agencies of people living with and affected by AIDS in the Asia Pacific region and elsewhere.
The 12th International Congress on AIDS in the Asia Pacific (ICAAP12) in Dhaka, will identify and address some of these issues.
Let me congratulate the Leadership of Bangladesh Government, Ministry of Health and Family Welfare and the Civil Society for Hosting ICAAP12 in Dhaka.
‘AIDS Exceptionalism’ is the term given to the trend to treat HIV/AIDS differently from other diseases . including other sexually transmitted infectious diseases . in law, policy and resource allocations. ‘AIDS Exceptionality’ is ensured through a combination of activism and policy approaches.
Today, there is a greater understanding in Public Health. The need for facilitating the representation and agency of people who are vulnerable to and infected by any disease is integral to developing policy and program responses.
A rights-based approach in health is increasingly a norm.
‘AIDS Exceptionalism’ drove public health policy for nearly 2 decades. Though this idea has served its purpose as a useful tool to analyse and develop policies and programs, now it is the time to move on.
In order to identify the challenges of ‘Post AIDS Exceptionalism’ in Ending AIDS by 2030, I have considered four conceptual frameworks
- MDG frame of reference
- Vulnerable populations vs key populations
- Sustainable Development Goals (SDGs) and End of AIDS by 2030
- Mainstreaming of AIDS response frame of reference.
One of the critical challenges of ‘Post Exceptionalism’ in Ending AIDS by 2030 is how to retain and preserve the space of civil society and the services provided by them.
Another critical challenge is the need for reform of health care financing, so that everyone with a serious, chronic illness has access to decent medical care and services.
Closely monitoring the trade regimes that prevent access to essential ARV drugs and commodities reaching the needy, greater understanding about health as an essential right of people and the States. responsibility to ensure adequate health care investment are some of the gains of AIDS response that need to be preserved, nurtured and facilitated.
Some observers of AIDS policy argue that the legacy of AIDS exceptionalism has results in the exclusion of HIV/AIDS Civil Society Organization in the framing of the post-MDG Agenda.
HIV/AIDS Civil Society Organizations should be an active partner in SDG related dialogue. And AIDS response should be linked with overall effort to develop responsive health systems.
Populations vulnerable to HIV infection were identified early on in the response to AIDS. However, an inclusive concept of ‘vulnerable populations’ was overshadowed by the “AIDS Exceptionality” and replaced with the concept of the ‘key populations’.
‘Key populations’ approach indicates that an exclusive group of populations are key to HIV/AIDS response, and yet not necessarily that all the ‘vulnerable groups’ are key to the HIV response.
This approach may not assist the policy makers in developing appropriate response to End AIDS BY 2030.
All individuals and communities vulnerable to and made vulnerable by HIV infection must be part of the solution.
SDGs and end of AIDS by 2030 frame of reference provides a clear vision for Ending AIDS journey.
Ending AIDS by 2030 is an integral part of the Sustainable Development Goals (SDGs) that were unanimously adopted by the United Nations Member States in 2015.
Sustainable Development Goal (SDG) 3 aspires by 2030 to end the epidemics of AIDS, tuberculosis, malaria and neglected communicable diseases. To match this goal, UNAIDS proposed an ambitious target to help end the AIDS epidemic by 2030:
- By 2020, 90% of all people living with HIV will know their HIV status.
- By 2020, 90% of all people diagnosed with HIV infection will receive sustained antiretroviral therapy.
- By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression.
However, this ambitious target needs a country specific road map, which is not yet in place in many countries.
The lessons learned in responding to HIV will play an instrumental role in the success of many of the SDGs, notably SDG 3, good health and well-being, and the goals on gender equality and women.s empowerment, reduced inequalities, global partnerships and just, peaceful and inclusive societies.
5 Key messages:
- Ensuring rights of most vulnerable populations is one of the major core concerns of Post AIDS Exceptionalism.
- Reaching out to the unreached population requires integrating HIV response with Primary health care, strengthening health systems and ensuring a supportive environment.
- Ensuring access to non-stigmatising and non-discriminatory services to all vulnerable populations as a priority
- Linking AIDS response with other SDG goals.
- Aligning of Health System Strengthening, fair trade in drugs and assess to essential drugs and essential commodities with advocacy for financing AIDS response is a must.
Conclusion
The UN General Assembly will convene a high-level meeting on HIV/AIDS in June 2016 at the UN Headquarters in New York.
The HLM will undertake a comprehensive review of the progress achieved so far.
The Member Countries. message must be clear: “AIDS Exceptionalism” must End and they should draw up a country specific Road Map to End AIDS by 2030, mainstreaming AIDS response to primary health care and strengthening the health systems for ensuring the rights of people affected and vulnerable to HIV infection and provide non-stigmatising and non-discriminatory services.
I wish the 12th International Congress on AIDS in Asia Pacific is a critical milestone in AIDS response and .Be the change. to End AIDS by 2030 in Asia Pacific region.
Thank you for your attention.