What Will It Take To Get To Zero?: Universal Access Regional Consultation in Asia-Pacific

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Asia Pacific Regional Consultation on Universal Access
Bangkok, Thailand, 29 March 2011

Call for Political, Financial & Operational Commitments


  30 years into the AIDS epidemic, in the spirit of activism and to honor all those lost to AIDS the participants at the Civil Society Pre-Meeting to the Universal Access Consultation held on 29 March 2011 in Bangkok, Thailand, taking into account the characteristics of the Asia Pacific's concentrated AIDS epidemics and the rights and needs of the Key Affected Populations of people living with HIV, men who have sex with men, sex workers, people who use drugs as well as the crosscutting populations including but not limited young people most at risk for HIV infection, women and girls, mobile and migrant populations, people with disability and prisoners call on the countries of the Asia Pacific to be accountable for by honouring and reinforcing commitments to achieve the Millennium Development Goal target of Universal Access HIV Prevention, Treatment, Care and Support for those who need it as agreed to in the Declaration of Commitment on HIV/AIDS (2001), the Political Declaration on HIV/AIDS (2006) and ESCAP Resolution 66/10. We urge the countries of the Asia Pacific to take strong position on FTA and come up with strategies to address FTA with different sectors and support different communities to understand the issues so that they can mobilize themselves and generate demands.
Furthermore, we urge all governments to:
·    Strive for higher levels of coverage for HIV treatment, care and support which includes treatment for co-infections of Hepatitis C and TB
·    Protect the manufacture, import or export of life-saving generic medicines
·    Provide human rights based effective HIV prevention interventions that are effective, appropriate and based on the needs of the country's epidemic
·    Develop and implement National Strategic Plans built around services that are human rights based ie equitable, accessible, affordable, comprehensive and responsive to the individual needs of people living with HIV, men who have sex with men, sex workers, people who use drugs and the cross-cutting populations including but not limited young people most at risk for HIV infection, women and girls, mobile and migrant populations, people with disability and prisoners taking into account relevant recommendations from the Commission on AIDS in Asia and the Commission on AIDS in the Pacific.
·    Develop and implement innovative financial mechanisms including a better use of $$ and greater allocations to the community organizations for advocacy and prevention efforts.
·    Eliminate the donor restrictions on some of the essential HIV programs, particularly related to sex work and people who use drugs such as the US pledge on sex work
·    Use indicators that are qualitative ie show impact not only quantitative
·    Act in equal partnership with civil society
·    Advocate that the Global Fund, UNAIDS and others measure grant performance not only based on target achievement and financial reports, but also on the quality of programs implemented. This should be reflected in the preamble.
I. PREVENTION: WHAT WILL IT TAKE FOR KAP TO GET TO 0 NEW HIV INFECTIONS?
National Governments, Donors and Key Affected Populations as well as Others from Civil Society must intensify efforts to meet the prevention and health needs people living with HIV, men who have sex with men, sex workers, people who use drugs and the cross-cutting populations including but not limited young people most at risk for HIV infection, women and girls, mobile and migrant populations by addressing the key economic, legal, social, cultural and technical barriers, which impede effective HIV responses, and to enhance the direct participation of these communities in national, regional and global HIV policy and programming.
1. Governments and donors must base their programming and fund allocations on evidence that is most effective and rights based
·    Ensure that HIV testing adheres to internationally accepted standards that include: informed consent, confidentiality, pre and post-test counseling, along with proper referral to treatment, care and support services
·    Eliminate compulsory detention centers
·    Promote and ensure access to harm reduction services
2. Establish a mechanism for partnership & discussion between lawmakers, civil society and governments.
3. Governments must use human rights approach in HIV prevention programs and policies and decriminalize the most effective HIV prevention strategies
4. Governments must support gender and sexual reproductive health and rights
·    Promote acceptance of sexual diversity in HIV programming and services including women and girls
·    Promote and facilitate the better linkages between sexual and reproductive health and HIV programming
·    Provide and ensure access to comprehensive and targeted sexuality education to young people who are in or out of school.
5. Be Accountable: Honour and reinforce the commitments made to achieve the Millennium Development Goal target of Universal Access HIV Prevention, Treatment, Care and Support for those who need it as agreed to in the Declaration of Commitment on HIV/AIDS (2001), the Political Declaration on HIV/AIDS (2006) and ESCAP Resolution 66/10.
II. TREATMENT: WHAT WILL IT TAKE TO GET TO 0 AIDS RELATED DEATHS?
People Before Profits: Access to Health and Medicine Must Be Taken Out of Profiteering Mentality. Medicines must be available, accessible, acceptable, and of good quality to reach ailing populations without discrimination throughout the world.
Treatment is prevention: Treatment access, including increased access to HIV, HCV, TB and STI diagnosis and treatment, remains foremost priority for an effective AIDS response. The paradigm of treatment has changed and treatment is now being recognized as one of the most effective prevention tools. Healthcare providers must make a radical change of taskshifting to communitybased sectors in terms of delivering a comprehensive package of treatment, care and support. Correspondingly, treatment literacy must also be scaled up to reflect this.
Implement WHO Guidelines for treatment and access to care: Advocate for more effective ARV regimens with less side effects such as phrasing out d4T and using tenofovir for first-line regimens in addition to sensitizing the public health sector to assure access to testing, treatment and care for key affected populations, young people most at risk, people living with HIV, and their sexual partners.
1. Sustainable access to effective/ affordable/ quality drugs, diagnostics and services has to be assured, including for co-infections Hepatitis C and TB, etc.
2. Ensure sustainable funding stream for community groups to enable independent, meaningful community-driven processes resulting in;
a) Integration of community organizations and organizations of people living with HIV as key members of teams offering testing, counseling, treatment and care; and other modes of service
b) Development of community-driven frameworks for treatment and care.
3. Treatment Literacy 2.0 (A new kind of treatment literacy is needed, to enable community groups to develop more powerful advocacy skills and strategies as part of the move towards implementation of Treatment 2.0)
a) Increase Access to data and knowledge
b) Influence Policy through advocacy
4. Be Accountable: Honour and reinforce the commitments made to achieve the Millennium Development Goal target of Universal Access HIV Prevention, Treatment, Care and Support for those who need it as agreed to in the Declaration of Commitment on HIV/AIDS (2001), the Political Declaration on HIV/AIDS (2006) and ESCAP Resolution 66/10.
III. LEGAL AND HUMAN RIGHTS: WHAT WILL IT TAKE TO GET TO ZERO HIV RELATED STIGMA AND DISCRIMINATION?
Governments must eliminate HIV-specific restrictions on entry, stay and residence to ensure that people living with HIV are not excluded, detained or deported on the basis of HIV status. National laws must stop discrimination and ensure the rights and needs of people living with HIV, men who have sex with men, sex workers, people who use drugs and the cross-cutting populations including but not limited young people most at risk for HIV infection, women and girls, mobile and migrant populations. Countries must eliminate HIV-related stigma and discrimination and reduce gender inequality as called for in the Declaration of Commitment on HIV/AIDS (2001) and the Political Declaration on HIV/AIDS (2006). When this review is complete there is a need to develop a clear costed way forward to achieve this commitment.
1. In line with international HR norms standards and commitments: Governments must harmonize existing national laws and policies with existing protective laws on education, labour, health etc to ensure UA to HIV prevention, care, treatment and support for KAPs and those most vulnerable people living with HIV, men who have sex with men, sex workers, people who use drugs and the cross-cutting populations including but not limited young people most at risk for HIV infection, women and girls, mobile and migrant populations, people with disability and prisoners.
2. Decriminalization of behaviours: demand the removal of punitive laws that criminalize behaviours, identities, populations and HIV exposure, transmission and the removal of travel restrictions based on HIV status.
3. Protection of rights: protect the individuals rights to privacy, confidentiality, age of consent, access to services and mechanisms for legal assistance, and individuals right to opt out to say yes or no to treatment.
4. Countering Stigma and Discrimination, and Gender based violence: uphold and protect the individual's rights to privacy, confidentiality, consent and access to SRH services and information, and gender equality.
5. Human rights should be mainstreamed into programs, and not as separate initiatives. Specific indicators to measure the promotion of human rights and mechanisms to redress violations of human rights.
6. Empowering community: by ensuring meaningful, active and full engagement in policy and programme development and implementation and monitoring.
7. Be Accountable: Honour and reinforce the commitments made to achieve the Millennium Development Goal target of Universal Access HIV Prevention, Treatment, Care and Support for those who need it as agreed to in the Declaration of Commitment on HIV/AIDS (2001), the Political Declaration on HIV/AIDS (2006) and ESCAP Resolution 66/10.
IV. FINANCE: WHAT WILL IT TAKE TO BUILD AN EFFECTIVE AIDS RESPONSE IN ASIA PACIFIC?
1. Ensure that funding is allocated to where it will have highest impact: Current funding should be refocused to where evidence shows it will have the greatest impact (e.g. effective community programs for young KAPs)
2. Shift focus from capacity building to strengthening community systems. "We have the capacity, we need to share our knowledge".
3. Ensure that national governments commit to funding their fair share of national AIDS responses. External sources are not sustainable.
4. Accountability for all
·    Service provision must be allocative, technically sound and efficient
·    Provide for proper monitoring and evaluation of organizations, programs and services
·    All private sectors should uphold Corporate Social Responsibility (CSR)
·    Accountability mechanisms for private sector HIV program deliverers should be strengthened and applied
5. Create mechanisms for civil society to participate in national planning processes, including budget.
6. There must be community driven, comprehensive package of services and programs for effective HIV response.
7. Be Accountable: Honour and reinforce the commitments made to achieve the Millennium Development Goal target of Universal Access HIV Prevention, Treatment, Care and Support for those who need it as agreed to in the Declaration of Commitment on HIV/AIDS (2001), the Political Declaration on HIV/AIDS (2006) and ESCAP Resolution 66/10.
  

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Organization: UNAIDS Programme Coordinating Board

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