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HIV Awareness 2019

Only communities can make Universal Health Coverage possible

Image supplied by UNAIDS

Mr Mike Podmore

Director, STOPAIDS

Pictured above: Mandisa Dukashe and her family live in Eastern Cape, South Africa. Mandisa is a trained nurse and works in the response to HIV to ensure quality control in health-care settings. She is living with HIV and encourages people to get tested for HIV. Her husband and two daughters are all HIV-negative.

Without Universal Health Coverage (UHC), there can be no end to AIDS by 2030, but without learning from the HIV response there will be no UHC for all.

This year has invigorated focus and commitments to achieve Universal Health Coverage (UHC). Many single disease sectors, such as HIV, are exploring the opportunities and potential risks of embracing its promise.

On one hand, it is true that we will never reach the end of AIDS by 2030 without meaningfully integrating HIV services and working towards the common goal of UHC.

On the other, progress towards ending AIDS will be lost, and UHC will never be successful, if the lessons of the HIV response are not mainstreamed.  

Lessons for the UHC movement to adopt 

Key components of successes in the HIV response include: political leadership at the national and global level, to drive ambitious commitments and funding; provision of services beyond treatment to include prevention, care and support and social enablers; data-collection and target-setting focused on ensuring services reach the most marginalised first; and, of course, the critical role of civil society and affected communities.  

It is the latter that is embodied in the theme of World AIDS Day 2019; ‘Communities make the difference.’ There is no health response where this has been better demonstrated.  

The theme of World AIDS Day 2019 is ‘Communities make the difference.’

Reaching the most marginalised 

Civil society and communities affected by HIV play a central role in delivering and monitoring services at local level. They are key in mobilising people to access these services, and advocate for removing barriers to access, improving quality, driving down costs, holding decision-makers to account, fighting discrimination and eliminating regressive laws.

One inspiring example of this is the collaboration between the Vietnamese Government and sex-worker-led networks to provide effective HIV prevention programmes and increase testing and treatment services for sex workers.  

A seat, and a vote, at the table 

Civil society and, crucially, communities affected by HIV must be meaningfully included in national and global health-governance mechanisms for planning and decision-making. This means having both a seat and a vote. It enables us to be watchdogs at all levels to ensure that programmes and funding are directed to where they are most needed.

One example of this is where civil society and communities on multilateral health boards have raised the alarm about the negative impact of donors pulling their funding from middle-income countries. This led to a greater focus on sustainability and, where necessary, more responsible transition so that communities are not abandoned.

Placing civil society and affected communities at the centre of the national and global UHC movement will be a prerequisite to its success. We hope to work hand in hand with communities, donors and all stakeholders to make this a reality. 

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