African Civil Society Groups Demand Increased HIV

Windhoek, 18 April, 2011 African civil society organisations responding to HIV across eastern and southern Africa; west and central Africa; the Indian Ocean region and North Africa have called for political will and commitment, evidenced by the allocation of adequate funding and bold action to ensure the achievement of universal access to HIV and AIDS prevention, treatment, care and support in Africa. African Civil Society Declaration on the Review of Progress towards Universal Access to HIV and AIDS Prevention, Treatment, Care and Support in Africa We, representatives of civil society groups responding to HIV and AIDS in Eastern and Southern Africa; the Indian Ocean region; West and Central Africa; and Northern Africa met on 14 and 15 April 2011 in Windhoek, Namibia to consolidate an African civil society position on achieving zero new HIV infections, zero AIDS-related deaths and zero discrimination through universal access to HIV and AIDS prevention, treatment, care and support as well as the Millennium Development Goals by 2015. We recognise the progress made by many African countries in stabilising and/or decreasing the incidence of HIV infections and increasing the number of people accessing antiretroviral treatment. However, we are alarmed that Africa remains the epi-centre of the HIV epidemic and are convinced that an ambitious response to HIV is required to achieve the Millennium Development Goals on the continent. We are further concerned that, despite overwhelming evidence that the provision of antiretroviral therapy contributes to millions of lives saved and infections averted, prevention and treatment programmes still fall far below what was called for in the Abuja Declaration and the African Common Position on Universal Access to HIV and AIDS prevention, treatment, care and support by 2010. We are deeply concerned that the gains made during the past decade are under threat due to weak health and community systems; the frequent interruption of services, in particular stock-outs of antiretroviral and other drugs; and the lack of long-term, sustainable funding from international actors, bilateral partners, and African governments. In addition, women, girls, youth, persons with disabilities and other key populations at higher risk of HIV such as sex workers, people who inject drugs, men who have sex with men, lesbian, gay, bisexual, transgender and intersex people are still disproportionately infected and affected by HIV and AIDS. We are gravely concerned that these populations continue to be marginalised and face high levels of stigma and discrimination, which contribute to social and legal barriers to accessing effective, quality and sustainable HIV services for all those who need them. Now more than ever, political will and commitment, illustrated through allocation of adequate funding and bold action, is needed to ensure the achievement of universal access to HIV and AIDS prevention, treatment, care and support in Africa. Therefore, we call on African governments to ensure the following in order to achieve zero new HIV infections, zero AIDS-related deaths and zero discrimination and begin to reverse the HIV epidemic in Africa: Gender and Human Rights Ensure the effective and meaningful involvement of people living with HIV, women, girls, youth, persons with disabilities and other populations at higher risk of HIV including sex workers, men who have sex with men, people who inject drugs, lesbian, gay, bisexual, transgender and intersex people, in the design, implementation and evaluation of integrated HIV responses and sexual reproductive health programmes; Address the underlying causes of vulnerability of women and girls to HIV by ensuring their economic and other empowerment through allocation of resources to interventions, which engage men to address gender-based violence, gender inequality and harmful cultural, social and gender norms; Undertake law reform to ensure equal access for women and girls to property and inheritance as well as the protection of the rights of people living with and at higher risk of HIV from discrimination, harassment and violence by removing laws and policies that criminalise HIV transmission, restrict entrance into countries or territories due to HIV status and hamper access to services for people living with and at higher risk of HIV including sex workers, men who have sex with men, people who inject drugs, lesbian, gay, bisexual, transgender and intersex people; Integrate and fund human rights programmes in national health, development and HIV policies and plans to address discrimination and homophobia in the communities, workplaces and healthcare facilities. This should also ensure the full integration of patient protections into biomedical interventions; Develop and implement programmes which enable people living with HIV, women, children, young people, persons with disabilities and key populations at higher risk of HIV infection to know their rights and seek legal redress when facing discrimination and other rights violations; and Ensure that civil society organisations have the political space in which to operate, as well as the capacity to effectively plan and implement human rights programmes and to hold governments accountable for the realisation of rights. Service Delivery: HIV Prevention; Treatment; Care and Support Set ambitious targets, along with appropriate indicators that are disaggregated by gender and age, at the national level; informed by evidence, based on the realities on the ground and focused on an annual increase in the number of people accessing services and the number of public health facilities offering services, with the goal of reaching 100% coverage. These targets should be costed and developed in consultation with people living with HIV, women, children, young people, persons with disability and other populations at higher risk of HIV including sex workers, men who have sex with men, people who inject drugs, lesbian, gay, bisexual, transgender and intersex people; Address the disparity, which exists in access to quality, uninterrupted services between various population groups including sex workers, men who have sex with men, women, young people and sexual minorities as well as the rural and urban areas; Ensure that the scale up of services is driven by stronger linkages between all levels of care across the continuum of HIV; and a commitment to strengthen health and community systems through effective decentralisation that is focused on people living with HIV and those most vulnerable and at risk; Invest in the development of new HIV and TB prevention and treatment technologies suitable for the region, along with universal access to existing prevention technologies by exploring options for producing essential medicines in the region and making use of the flexibilities inherent in the Doha Declaration on the TRIPS Agreement and Public Health while enacting and using legislation and agreements that work to ensure increased and uninterrupted access to high-quality generic medicines; and Ensure that no African child is born with HIV by scaling up access to prevention of vertical transmission services as well as ensuring that mothers are treated comprehensively for HIV, and not just in the context of vertical transmission. Country Ownership; Accountability and Funding Ensure inclusive country ownership of a multi-stakeholder HIV response by government, local and traditional authorities, civil society, private sector and other stakeholders by renewing the commitment to universal access and incorporating the HIV response into all key national strategies and budgets and ensuring that it is resourced adequately; Ensure that the realities on the ground and determinants of the epidemic inform the response and the allocation of resources; Significantly increasing domestic funding for HIV programmes by fulfilling commitments in the Abuja Declaration through innovative financing mechanisms such as taxes, levies and the involvement of the private sector while instituting mechanisms to track and monitor the use and impact of funds through internal audit, monitoring and early warning systems; Call on international partners to show solidarity by meeting commitments to Overseas Development Assistance with contributions totalling 0.7 % of gross national income and contributing their fair share to the replenishment of the Global Fund to fight AIDS, TB and Malaria; and Increase access to core and project-based funding for civil society organizations and empower young people, women’s groups and groups of key populations most at risk of HIV at the country level to engage fully in the ownership of the HIV response; and Pay more attention to the specific needs and concerns of the North Africa and Indian Ocean regions, particularly as it pertains to surveillance and technical capacity to address the needs of people living with HIV and most at risk of HIV infection. In return, African civil society organisations responding to HIV and AIDS are committed to implementing the following strategic actions: Mobilising communities to access services and contributing to the provision of prevention, treatment, care and support services; Promoting the human rights of people living with HIV, women, children, young people, persons with disability and other key populations at higher risk of HIV such as sex workers, men who have sex with men, people who inject drugs, lesbian, gay, bisexual, transgender and intersex people; Acting as a watchdog to ensure accountability, good governance and more efficient management of programmes and resources for all stakeholders, including civil society organisations; and Encouraging governments, citizens, donors and the private sector to contribute significantly to funding health and development interventions, in general, and the HIV response in particular. Using our experience in the HIV and AIDS response to support the achievement of Millennium Development Goals. Windhoek, Namibia 16 April 2011