Setting Advocacy Priorities: PEPFAR Country Operational Plans 2017

April 20, 2017

This week in Johannesburg, South Africa, MSMGF, Health Gap, and AVAC gathered 15 advocates from Botswana, Cote d’Ivoire, Kenya, Uganda, Unites States, and Tanzania to prepare together to advocate for gay men and other men who have sex with men in their national HIV programs. This workshop came before US President’s Emergency Plan for AIDS Relief (PEPFAR) Country and Regional Operational Plan review meetings where officials from 23 countries will review and finalize PEPFAR-supported programs that will be implemented next year.

PEPFAR is the largest funder of HIV programs for key populations in Africa. The review meetings will be a critical opportunity for activists to voice their concerns and recommendations, and strengthen the way that their countries’ HIV programs respond to the epidemic among gay men and other men who have sex with men and funding to reach the right populations with the right services in the right places, right now. They come at a critical moment as the current US Administration’s proposal could potentially cut PEPFAR’s budget, signaling a dangerous diversion in the global AIDS response that will come at a great cost to human lives.

“The US contribution to PEPFAR and the Global Fund to Fight AIDS, Tuberculosis and Malaria grew to $6.81 billion per year in 2016, making the United States the single largest contributor to the global fight to end AIDS. We all need to advocate tirelessly for the US to maintain its budgetary commitments to foreign assistance, the reversal of which could dismantle over a decade of progress,” said Matthew Kavanagh from Health GAP, United States.

“Over the past three years, PEPFAR country programs, have really improved. There are still gaps that we have to address, but we have seen that being involved early on can really strengthen the plans so that they are more effective at reaching men who have sex with men.” said Nana Gleeson from Bonela, Botswana.

Over one and a half days, participants priorities to advocate for in their own Country Operational Plans (COPs). These priorities will be raised in the next two weeks with their respective PEPFAR country teams. In addition, they identified the following common priorities which will be raised with the U.S Office of the Global Aids Coordinator (OGAC):

  • PrEP (Pre-Exposure Prophylaxis) should be included in the minimum package of services for men who have sex with men, and clear targets should be set for PrEP enrollment among this key population.
  • Data that describes the HIV treatment and prevention cascade for key populations should be collected and used in programing. Data should be based on reasonable population size estimates: Where population size estimates are implausibly low or unavailable, an estimate of 2-3 percent of the adult male population should be used in program planning.
  • There should be increased funding for community-led HIV responses among men who have sex with men.
  • Health care professionals should be trained to reduce stigma against gay men and other men who have sex with men, and to provide competent and tailored services to this group.
  • There should be increased engagement and participation of key populations such as men who have sex with men at appropriate entry points in PEPFAR processes.
  • Size estimate and epidemiology studies are critical, but researchers must recognize that in many countries MSM face criminalization and state-sponsored violence. Protecting human rights during research therefore often means avoiding the use of identifiers like biometrics that require MSM to disclose their identities in order to be counted in these contexts.

Over the next two weeks, MSMGF, Health GAP, AVAC and other global, regional and local civil society organizations will participate in PEPFAR regional review meetings, carrying forward the advocacy priorities that were generated in the meeting, and amplifying the voices of communities in the response to HIV. Together with our partners, we will continue to advocate that PEPFAR ensure that global health investments from the US Government to remain responsive to the unique HIV-related needs of gay men and other men who have sex with men living around the world.