Measuring HIV stigma and discrimination

To better understand the status of HIV-related stigma and discrimination and progress towards their elimination, support advocacy for addressing HIV-related stigma and discrimination and highlight data gaps, UNAIDS is coordinating the development of summary measures of HIV-related stigma and discrimination.

Starting on 19 August 2019 for a period of three weeks, various elements of the draft measures will be discussed. A few key questions will guide the moderated discussion each week. Inputs and recommendations from each week will be shared at the start of the following week and used to inform the next element of the measures to be discussed.

The virtual consultation is open to everyone. They aim to encourage broad participation, particularly of people living with and affected by HIV, gay men and other men who have sex with men, transgender people, young people, sex workers, people who use drugs and women, from all regions. Contributions through this consultation will be used to inform the development of the measure(s) and ensure they are people-centred, reflecting the lived experiences and realities of people, and meaningful to inform programmatic action.

To get more information and participate in the consultation follow this link>>>

UNAIDS calls for greater urgency as global gains slow and countries show mixed results towards 2020 HIV targets

Taken from a UNAIDS press release

The pace of progress in reducing new HIV infections, increasing access to treatment and ending AIDS-related deaths is slowing down according to a new report released on 16 July 2018 by UNAIDS. UNAIDS’ Global AIDS Update, Communities at the centre, shows a mixed picture, with some countries making impressive gains while others are experiencing rises in new HIV infections and AIDS-related deaths

We urgently need increased political leadership to end AIDS,” said Gunilla Carlsson, UNAIDS Executive Director, a.i., “This starts with investing adequately and smartly and by looking at what’s making some countries so successful. Ending AIDS is possible if we focus on people, not diseases, create road maps for the people and locations being left behind, and take a human rights-based approach to reach people most affected by HIV.”

The report shows that key populations and their sexual partners now account for more than half (54%) of new HIV infections globally. In 2018, key populations – including people who inject drugs, gay men and other men who have sex with men, transgender people, sex workers and prisoners – accounted for around 95% of new HIV infections in eastern Europe and central Asia and in the Middle East and North Africa.

However, the report also shows that less than 50% of key populations were reached with combination HIV prevention services in more than half of the countries that reported. This highlights that key populations are still being marginalized and being left behind in the response to HIV.

Globally, around 1.7 million people became newly infected with HIV in 2018, a 16% decline since 2010, driven mostly by steady progress across most of eastern and southern Africa. South Africa, for example, has made huge advances and has successfully reduced new HIV infections by more than 40% and AIDS-related deaths by around 40% since 2010.

However, there is still a long way to go in eastern and southern Africa, the region most affected by HIV, and there have been worrying increases in new HIV infections in Eastern Europe and Central Asia (29%), in the Middle East and North Africa (10%) and in Latin America (7%).

Disconcertingly, the report shows that the gap between resource needs and resource availability is widening. For the first time, the global resources available for the AIDS response declined significantly, by nearly US$ 1 billion, as donors disbursed less and domestic investments did not grow fast enough to compensate for inflation. In 2018, US$ 19 billion (in constant 2016 dollars) was available for the AIDS response, US$ 7.2 billion short of the estimated US$ 26.2 billion needed by 2020.

To continue progress towards ending AIDS, UNAIDS urges all partners to step up action and invest in the response, including by fully funding the Global Fund to Fight AIDS, Tuberculosis and Malaria with at least US$ 14 billion at its replenishment in October and through increasing bilateral and domestic funding for HIV.

Progress is continuing towards the 90–90–90 targets. Some 79% of people living with HIV knew their HIV status in 2018, 78% who knew their HIV status were accessing treatment and 86% of people living with HIV who were accessing treatment were virally suppressed, keeping them alive and well and preventing transmission of the virus.

Communities at the centre shows however that progress towards the 90–90–90 targets varies greatly by region and by country. In Eastern Europe and Central Asia for example, 72% of people living with HIV knew their HIV status in 2018, but just 53% of the people who knew their HIV status had access to treatment.

AIDS-related deaths continue to decline as access to treatment continues to expand and more progress is made in improving the delivery of HIV/tuberculosis services. Since 2010, AIDS-related deaths have fallen by 33%, to 770 000 in 2018.

Progress varies across regions. Global declines in AIDS-related deaths have largely been driven by progress in eastern and southern Africa. In Eastern Europe and Central Asia however, AIDS-related deaths have risen by 5% and in the Middle East and North Africa by 9% since 2010.

Communities at the centre shows that the full range of options available to prevent new HIV infections are not being used for optimal impact. For example, pre-exposure prophylaxis (PrEP), medicine to prevent HIV, was only being used by an estimated 300 000 people in 2018, 130 000 of whom were in the United States of America. In Kenya, one of the first countries in sub-Saharan Africa to roll out PrEP as a national programme in the public sector, around 30 000 people accessed the preventative medicines in 2018.

The report shows that although harm reduction is a clear solution for people who inject drugs, change has been slow. People who inject drugs accounted for 41% of new HIV infections in Eastern Europe and Central Asia and 27% of new HIV infections in the Middle East and North Africa, both regions that are lacking adequate harm reduction programmes.

Gains have been made against HIV-related stigma and discrimination in many countries but discriminatory attitudes towards people living with HIV remain extremely high. There is an urgency to tackle the underlying structural drivers of inequalities and barriers to HIV prevention and treatment, especially with regard to harmful social norms and laws, stigma and discrimination and gender-based violence.

Criminal laws, aggressive law enforcement, harassment and violence continue to push key populations to the margins of society and deny them access to basic health and social services. Discriminatory attitudes towards people living with HIV remain extremely high in far too many countries. Across 26 countries, more than half of respondents expressed discriminatory attitudes towards people living with HIV.

The report highlights how communities are central to ending AIDS. Across all sectors of the AIDS response, community empowerment and ownership has resulted in a greater uptake of HIV prevention and treatment services, a reduction in stigma and discrimination and the protection of human rights. However, insufficient funding for community-led responses and negative policy environments impede these successes reaching full scale and generating maximum impact.

UNAIDS urges countries to live up to the commitment made in the 2016 United Nations Political Declaration on Ending AIDS for community-led service delivery to be expanded to cover at least 30% of all service delivery by 2030. Adequate investments must be made in building the capacity of civil society organizations to deliver non-discriminatory, human rights-based, people-centred HIV prevention and treatment services in the communities most affected by HIV.

To read full report follow this link>>>

DPNSEE have made an excerpt with the country data for 10 countries of the region, which you can download following this link>>>

LGBT survey on happiness, sex and quality of life

The LGBT Foundation and the United Nations (UNAIDS) partnered with the Universities of Aix-Marseille and Minnesota for this quick survey on happiness, sex and quality of life. Aim of the survey is to better understand social and legal environments and amplify voices, concerns and needs of these communities.

The survey is available in 17 languages. It takes 12 minutes to complete it.

You must be at least 18-year-old to perform this survey. Your responses are completely anonymous. You can choose to skip any question you would prefer not to answer.

To contribute to the survey, please follow this link>>>>

International Guidelines on Human Rights and Drug Policy

Responding to the harms associated with drug use and the illicit drug trade is one of the greatest social policy challenges of our time. All aspects of this challenge have human rights implications.

Drug control intersects with much of the 2030 Agenda for Sustainable Development. In line with the 2030 Agenda, the UNDP Strategic Plan 2018 – 2021 and the HIV, Health and Development Strategy 2016 – 2021: Connecting the Dots, the International Guidelines on Human Rights and Drug Policy provide a comprehensive set of international legal standards for placing human dignity and sustainable development at the centre of UN member states responses to illicit drug economies. The guidelines cover a diverse set of substantive issues ranging from development to criminal justice to public health.

The guidelines were developed by a coalition of UN Member States, WHOUNAIDSUNDP and leading human rights and drug policy experts. The Guidelines are an example of the support provided to practically integrate international human rights commitments into national, regional and global policy and programmes.

The drugs issue cuts across the 2030 Agenda for Sustainable Development and multiple Sustainable Development Goals, including ending poverty, reducing inequalities and, of course, improving health, with its targets on drug use, HIV and other communicable diseases. Goal 16 on peace, justice and strong institutions is particularly important, requiring attention to human rights across the Sustainable Development Goals. Since the late 1990s, UN General Assembly resolutions have acknowledged that ‘countering the world drug problem’ must be carried out ‘in full conformity’ with ‘all human rights and fundamental freedoms’. This has been reaffirmed in every major UN political declaration on drug control since, and in multiple resolutions adopted by the Commission on Narcotic Drugs.The reality, however, has not always lived up to this important commitment.

The Guidelines are based on both ‘hard law’ and ‘soft law’ sources – those that are legally binding and those that are authoritative but not binding per se. With very few exceptions, the general descriptions of rights are drawn from binding treaty provisions.

However, since very few human rights treaty provisions address drug control directly and since the application of general rights to specific groups requires a more in-depth analysis, much of the guidance presented throughout the document is based on UN resolutions and declarations, the general comments and concluding observations of UN human rights treaty bodies and the work of UN human rights Special Procedures. Findings of regional human rights courts and national courts are also cited. Such jurisprudence, which is binding for the relevant countries, is cited in the Guidelines as being persuasive of a particular application of a right.

The Guidelines are not a ‘toolkit’ for a model drug policy. The Guidelines are a reference tool for those working to ensure human rights compliance at local, national, and international levels, be they parliamentarians, diplomats, judges, policy makers, civil society organisations or affected communities.

This longer version of the Guidelines will be available on an interactive website where readers may search by specific rights, drug control themes, and other key words, as well as follow links to source material.

To read and download Guidelines on human right and Drug policy follow this link>>>

62nd CND Session – Day 2

The second day of the 62th CND was full of side events and sharing with participants.

An overviews of the side events we participated in today includes:

Psychoactive substances and the Sustainable Development Goals – Towards a comprehensive approach in the era of the 2030 Agenda

Organized by the Government of Slovenia, Utrip Institute for Research and Development, the Pompidou Group of the Council of Europe and IOGT International. Jože Hren started his presentation reminding that for 20 years already the approach in Slovenia is that drug use is primarily a health problem and that possession of small quantities is a misdemeanour also since 1999. Those who are caught in possession of drugs get a fine of 40 Euro, but there is a process to change it to an oral warning or referral to treatment in more complex situations. Representative of the Pompidou Group spoke about the bi-annual prize the Group awards to innovative prevention programmes created by young people for young people. Another Slovenian representative presented their work emphasizing the need to invest in mental health programmes for adolescents. Cost of mental health disorders in Europe take 3 to 5 percent of GDP. There is a need for a reallocation of resources for more sustainable and impactful outcomes in tackling harmful substances and behaviours. Medical help is not enough – it has to be combined with comprehensive and long lasting prevention. They have a programme called “This is me”, which is in line with the Goal 3 of the SDGs. Kristina Sperkova, president of the IOGT International (international network of Templar organisations) works on prevention of alcohol and other drugs harm world-wide. Sanela from Utrip Institute advocated for a community approach to prevention. Notes from the side event are available at the CND Blog following this address>>>.

Leaving no one behind: People at the centre of a harm reduction, human rights and public health approach to drug use

Organized by the Netherlands and Norway, UNODC, UNDP, UNAIDS, WHO, IDPC, AFEW International, Harm Reduction International, INPUD, Open Society Foundations, Aidsfonds and Frontline AIDS. Ann Fordham from IDPC highlighted that the new UNADIS report indicates that 99% of people who use drugs doesn’t have a proper access to health services. WHO representative reminded that half a million people worldwide die of drug related deaths, mainly overdose and blood borne diseases HIV/AIDS and Hepatitis C. People also suffer because they can’t access the medicines they need. The Netherlands has “put people first” in their approach to harm reduction. The right to health is fundamental to all people irrespective of whether they are using drugs. Drug policies should seek to reduce violence, promote the rule of law, support the most marginalized and vulnerable, lift up human rights. Prohibition and criminalization means a continuation of armed conflict supported by disproportionate spending. Naomi Burke-Shyne from HRI reminded that funding for harm reduction has flat lined from 2007 to 2016, which stands in shocking contrast to the estimated funding need by UNAIDS: existing funding represents only 13% of this estimated need. Judy Chang from INPUD stated that “Existing drug policies threaten security, democracy and the well-being of all, especially those most marginalized and vulnerable. The war on drugs and drug-free agenda undermines the SDG agenda.” Zaved Mahmood from ‎UN Office of the High Commissioner for Human Rights estimates that People who use drugs are not just left behind, they are kept out. The right to life includes the obligation to take measures where peoples’ lives might be threatened, including in relation to the use of drugs and HIV and hepatitis.

Drug prevention approaches that make a difference

Organized by the Governments of Iceland and Serbia, and the Pompidou Group of the Council of Europe. Serbian representative to the OSC made an introduction speech. The same like the Minister of Health on Thursday 14 at the Ministerial Segment, he said that the Drug Strategy has 5 chapters instead of 7, avoiding to say that Harm Reduction is one of them. Jelena Janković from the Ministry of Health presented the latest developments, including information about overdose deaths in 2018 and creation of the Ministerial Commission (for fighting narcomania in schools). She also presented the project the Ministry did with experiences and support from Israel. Iceland presented their project with are seen as the flagship project on prevention. Almost 2% of the alcohol and tobacco taxes go to prevention programmes! They see as the main risks and protective factors family factors, peer group effect, general well-being and extra-curricular activities and sports. Their learning is that the multidisciplinary collaboration is the key to success. The change thy achieved is different attitude of parents and society – don’t buy alcohol for children. It is not OK for adolescents to be drunk in public. It is not the amount of time that parents spend with their children – it is the quality of time. There are no unsupervised parties. Pompidou Group emphasised the role of police in prevention. Interventions from the floor were on offering more than just sports and having campaigns that cover illicit but also legal substances.

Other side events held today that may be of interest are:

Other events

The Vienna NGO Committee on Drugs (VNGOC) held regular Annual General Assembly. The Committee welcomed new members, reviewed and approved the VNGOC annual report and reflected on activities for 2018/19 including those of the Civil Society Task Force (CSTF), got information about the annual accounts for 2018, the latest financial status and audited accounts for 2018, Strategic Plan 2019-21 and Budget for 2019 and Voluntary Code of Conduct for NGOs at the CND and received an update on developments within UNODC. The Committee discussed the future organisation of the VNGOC, based on the background paper presented by the Board.

Following a governance review process undertaken in 2017, VNGOC agreed to stagger the elections for the VNGOC Board to ensure greater stability and continuity. In order to do this, three of the positions elected last year were given one-year terms, the other three positions were given the standard two-year terms. This year, the following three positions were up for re-election: Chairperson, Deputy Treasurer, Deputy Secretary. Our friend fro International Drug Policy Consortium Jamie Bridge was re-elected for the Chairperson. Congratulations!

An interesting webinar on social contracting

Health Policy Plus, APMG, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, UNAIDS, UNDP, USAID and others hosted a webinar on 6 March 2019 to discuss social contracting for HIV care, treatment and support. Presenters from around the world discussed how to plan for social contracting as part of a long-term sustainability strategy and how to advocate for it, touching on policy and regulatory challenges, how to develop mechanisms to put social contracting in place and how to implement and monitor social contracting’s success.

To view the recording of the webinar, follow this link>>>>

Slides from the webinar are available following this link>>>>

Health Policy Plus also prepared a factsheet Social Contracting: Supporting Domestic Public Financing for Civil Society’s Role in the HIV Response from which you can learn more about social contracting and how it can support domestic public financing for civil society’s role in the HIV response. You can find the factsheet following this link >>>>