Progress, Powerful Advocacy and Plentiful Challenges as the UN General Assembly Grapples with AIDS

September 26, 2014

This week the 69th United Nations General Assembly (UNGA) met under the theme Delivering on and Implementing a Transformative Post-2015 Development Agenda. There have been many conversations throughout the week – from climate change, global security, to Ebola and of course HIV/AIDS at these deliberations in New York City.

The governments of Ghana and Switzerland in collaboration with UNAIDS led a high-level panel on September 25 focused on fast tracking the end of AIDS by 2030. The packed session included presidents and other global leaders, leading scientists and advocates, donors and technocrats. This meeting was designed to build momentum and political support for the still-lofty goal of ending the epidemic—and to raise awareness of the new UNAIDS “90-90-90” targets which call for 90 percent of people with HIV to know their status, get initiated on ART and achieve virologic suppression.

The current goals have heavy emphasis on treatment, and an emphasis on the biomedical. So it was both necessary and energizing to hear remarks from Kenyan advocate, Teresia Otieno, an HIV positive mother of two, chairperson of the International Community of Women Living HIV/AIDS and a 2014 AVAC Advocacy Fellow, about what it will take to achieve these goals. Otieno spoke from the heart – challenging the UN Secretary General, represented by his deputy Jan Eliasson, to ensure that commitments made by governments, development partners and other key players are fulfilled. She emphasized the need for prevention targets alongside treatment goals.

“I do not want to come back here in 2030 and talk about the same thing,” said Ms. Otieno. “In 2030, I’ll be 56. It is my dream that I will still be alive. I dream of a world where I’ll have access to cheaper and better treatment; where my husband, who is seated in this room, will still be HIV negative; where my 22-year old daughter will have the prevention she needs and also not have to face gender based violence; and a world in which if she does not want to have children, she would have tools for that,” said Ms. Otieno. She urged leaders to put women and girls at the center of the response, if this dream of ending AIDS by 2030 is to be realized.

Ms. Otieno was one of the panelists at this high-level panel, along with President John Dramani Mahama (Ghana), President Didier Burkhalter (Switzerland), President Jacob Zuma (South Africa), Secretary John Kerry (US), UN Deputy Secretary General Jan Eliasson, Clinton Health Access Initiative (CHAI) CEO, Ira Magaziner, Chad First Lady Hinda Deby and UNAIDS Executive Director Michel Sidibe.

At the same session, South African President Jacob Zuma announced a new Global Access Program launched by Roche Diagnostics that will bring the cost of viral load testing using Roche’s program, down to less than USD$ 10 per test. South Africa is the largest purchaser of viral load tests in the world, and the country’s National Health Laboratory Service has the largest viral load program on the continent.

The program reflects work and partnership between the South African government, the Clinton Health Access Initiative (CHAI), UNAIDS, PEPFAR and the Global Fund. According to CHAI CEO, Ira Magaziner, who also gave remarks at the meeting, South Africa won’t be the only country to benefit from this price reduction. Magaziner said that 83 countries would benefit from this price reduction—which is key to tracking progress towards the goal of having 90 percent of individuals on ART achieving virologic suppression.

Dropping diagnostic prices is key—but the best and most affordable technologies and medicines won’t end the epidemic if people cannot access them. For some people, the access challenge may be the distance to the clinic; for others it may be the fear of judgmental care and/or violations of confidentiality that could happen in the clinic. Ensuring access means addressing the environments of stigma, discrimination and criminalization that hinder many people from seeking or staying on care. This is particularly true for LGBT individuals, sex workers, injection drug users—and for many women.

In another critical step in the right direction, on September 26, the UN Human Rights Council adopted a resolution against LGBT discrimination and violence. The resolution, which passed by a 25-14 vote, expresses “grave concern at acts of violence and discrimination, in all regions of the world, committed against individuals because of their sexual orientation and gender identity”. The resolution affirms one of the United Nations’ key principles—that everyone is equal in dignity and rights.

UN meetings generate plenty of headlines and important precedents. The proof of the utility of this UNGA meeting will play out in countries around the world. AVAC looks forward to working with partners on implementation of ambitious prevention and treatment goals within a rights-based framework. Please join us to learn more and get involved.