ICASA 2023: Demands for equity and investment in the HIV response

December 6, 2023

By Jeanne Baron

At the ongoing International Conference on AIDS and STIs in Africa (ICASA), the struggle to sustain an evidence- and rights-based HIV response is heating up. HIV prevention and global health equity depend on continuing to build on the gains to date, to learn from mistakes, and to invest in scaling up now-proven solutions while developing additional ones. But all these principles are increasingly threatened by political reaction and short-sighted investment. AVAC and partners released four major calls to action at ICASA to confront these urgent challenges, which are imperiling the communities most burdened by HIV and other health inequities. Each of these resources set an agenda to address critical gaps. 

Upholding Civil Society Voices in Health International Conferences: A response to the suppression and cancellation of community voices at ICASA 2023

A permitted People’s March scheduled for December 5 in Harare was cancelled due to acute safety concerns following the arrest of conference attendees at a demonstration, and other intimidating police actions against civil society and key populations at the conference. AVAC is part of coalition that issued an open letter to the conference secretariat condemning the suppression of community voices and calling for the People’s March to go forward and future guarantees that ICASA host countries commit to allowing community voices to be heard and ensuring their activities are unhindered. 

The Global HIV Prevention Roadmap for Key Populations

This roadmap outlines a strategy for the equitable expansion and delivery of HIV prevention services to key populations (KPs) globally and regionally. It introduces a critical, coordinated approach led by KPs to accelerate the implementation of existing and new HIV prevention interventions. Developed by the Global KP HIV Prevention Advisory Group (KPAG) and allied stakeholders, this roadmap represents near-term priorities for funding, U=U, PrEP targets, the advancement of rights— particularly decriminalization of key populations and more for key stakeholders and regions to achieve by mid 2025. This roadmap is a terrific complement to the recently-released Choice Manifesto, led by women advocates throughout Eastern and Southern Africa.

“This is nothing new, we’ve been saying this for years, but now it is more urgent than ever: Funding to key populations must go beyond services to support our advocacy and our activism.  Decriminalization is imperative. We are not criminals, and with a stroke of the pen decriminalizing key populations could lead to lower incidence of HIV,” said KPAG member and former AVAC Fellow, Josephine Aseme at a press conference promoting the importance of this roadmap.

Mobilizing People of Faith to Build Networks to Protect Human Rights and Overcome Homophobia

Faith leaders from across the region convened by African Services Committee, AVAC, GALZ & Inerela joined in solidarity in defense of human rights and evidence-based HIV prevention, including for vulnerable populations. Among the pledges, participating faith leaders are committing to engage in cultural and legislative initiatives related to LGBTQIA+ issues that promote love, grace, compassion, equity and justice for all. 

Call to Action for Voluntary Medical Male Circumcision: The job is not done yet

Despite impressive achievements in bringing voluntary medical male circumcision (VMMC) to scale, the pace of funding and the expansion of programs delivering VMMC must intensify to reach 2030 global targets for HIV prevention. Modeling studies suggest the approximately 30 million VMMC’s conducted between 2008-2020 averted 615,000 new HIV infections. By 2030 that number could be 1.6 million infections averted, if the HIV response sustains and expands VMMC. This joint report was prepared by AVAC, Azali Healthcare, Bill & Melinda Gates FoundationJhpiego, the Coalition for Health Promotion and Social Development (HEPS-Uganda), Treatment Advocacy and Literacy Campaign (TALC), the Joint United Nations Program on HIV/AIDS(UNAIDS) and the World Health Organization (WHO). Find a two-page summary here and the full report here

“VMMC offers us an exceptional opportunity to get men into the healthcare system but we have gone off track. We can’t afford to lose momentum. The job is not yet done. New funding is needed now. Integration is needed now. Sustained commitment is needed now.” – Chilufya Kasanda Hampongo, TALC Zambi

All four initiatives launched at ICASA take aim at critical gaps in the HIV response. Each provide resources that outline next steps and roles for stakeholders across the field to advance equity, and in turn help the world reach global targets to end the epidemic.