Greater national HIV response hinges on better cooperation

The National AIDS Committee (NAC) says the outcome document of the recently-concluded UN high-level meeting (HLM) on HIV-AIDS does not provide as comprehensive a road-map to “zero death, zero new infections and zero discrimination” as anticipated.

The document, ‘Political Declaration on HIV/AIDS: Intensifying our Efforts to Eliminate HIV/AIDS,’ also indicated that country-led responses are to replace international leadership in the fight, according to the NAC.

“Divesting international leadership of the fight against HIV in this manner forces regional and country-led level leaderships to explore more robust and effective forms of cooperation to replace dwindling international resolve,” the NAC said in a press statement on Friday, noting this increases the need for new regional and in-country partnership.

The Political Declaration offers something for everyone without attempting to bridge long-standing differences, NAC continued, adding that rather than providing international leadership, the declaration represents compromise between the competing and conflicting regional, confessional and economic agenda present in the meeting.

References to global lists of priority vulnerable groups has been largely eliminated, in keeping with endorsement of a strategy encouraging evidence-based regional and national identification of priority sectors, the NAC statement said.

It said too that references to human rights in the document are ambiguous, on the one hand referencing the need to “eliminate discrimination and stigma against people living with and affected by HIV, including their families, including through sensitizing the police and judges, training health care workers in non-discrimination, confidentiality and informed consent, supporting national human rights learning campaigns, legal literacy and legal services, as well as monitoring the impact of the legal environment on HIV prevention, treatment, care and support,” to enforce sexual and reproductive rights and protect minorities and people with disabilities.

“Disappointingly, the Political Declaration fails to make clear that international human rights commitments take precedence over national laws and national development priorities. Reflecting the influence of the Holy See and the Islamic bloc of countries, the issue of identity rights is avoided altogether with no reference to ‘trans’ people (transvestites, trans-sexuals and trans-gender) nor to reform of laws governing sexual orientation,” NAC statement said.

Pointing to specific issues and what is called omissions of particular interest to Guyana and the Caribbean, NAC said that on the issue of universal access, sustaining the 51% coverage of antiretroviral medicines poses a major financial challenge for Caribbean governments.

And it called on regional governments to pay particular attention to operationalizing the call on pharmaceutical companies “to take measures to ensure timely production and delivery of affordable, good quality and effective antiretroviral medicines so as to contribute to maintaining an efficient national system of distribution of these medicines.”

In the context of assuming greater local responsibility in the fight against HIV, the document envisages extending the pivotal role Persons living with HIV/AIDS and vulnerable grouping play in combating the disease at the community level to “engaging people living with and affected by HIV in decision-making and planning, implementing and evaluating the response, and to partner with local leaders and civil society, …to develop and scale up community-led HIV services and to address stigma and discrimination.”

According to the Committee, this aspiration harmonizes well with the desires expressed by Caribbean organizations of PLHIV of assuming leadership roles in positive prevention in the Caribbean.

The document also recognized the need to focus on pre- and post pregnancy aspects of womanhood. NAC said the priority assigned to women in the Declaration vindicates those who for a number of years have struggled for the recognition of Caribbean women and girls as the sector overwhelmingly vulnerable to infection. However, it observed that the process of re-aligning regional and country priorities to reflect the goals on women constitutes a major challenge for Caribbean societies.

Recognition of the Convention on People with Disabilities in the Declaration coincides with the introduction of a new law on Disabilities in Guyana, the NAC stated, adding that and similar policies and legislation around the region needs to be reviewed with respect to access to protection of people with disabilities and HIV.

“In the context of Guyana a distinct focus on indigenous people as possibly the most vulnerable minority to HIV infection by virtue of isolation, itinerant miners, forced prostitution and labour exploitation would have been welcome,” the Committee added, noting that the sparse reference to indigenous people as a sub-set of migrant and mobile populations is inadequate.

Further, the NAC recalled that its lobbying contributed significantly to the Caribbean delegations securing inclusion of indigenous peoples as a vulnerable population in the draft text of the first UNGASS/HLM Declaration of Commitment in 2001.