With input from ICAD Coalition members provided during a consultation held 14 August, ICAD submitted feedback on the draft UNAIDS Strategy (2016-2021). Thank you to all members who provided input into this important document that will build on the progress achieved in the global AIDS response. The final version of the UNAIDS Strategy will be available in October, 2015.
August 20, 2015
Dear members of the UNAIDS Strategy Unit,
Re: Feedback on the draft UNAIDS Strategy (2016-2021)
We would like to thank UNAIDS and its strategy team for the opportunity to review and provide feedback on the draft UNAIDS Strategy for 2016-‐2021: Fast-‐tracking to zero. The following submission is made on behalf of the Interagency Coalition on AIDS and Development (ICAD), a coalition of approximately 100 Canadian AIDS service organizations, international non-‐governmental organizations, academic institutions and labour unions, faith-‐based organizations and community activists. Below, we have outlined key points of feedback on the draft strategy.
1) A Strong Role for Civil Society: We are pleased to see the draft strategy reflect the need for a stronger positioning of civil society and in particular, the call for the scaling-‐ up of direct financial support for political advocacy in order for civil society to hold national and global partners accountable. We also applaud the reference that civil society advocacy should be a global public good.
2) Gender-‐neutral language: The draft outlines ambitious targets meant to propel the global community in reaching the goal of 90-90‐90, including in areas of gender equality and human rights. To further emphasize and encourage these important advancements, we strongly urge UNAIDS to use gender-‐neutral language throughout the Strategy. We fully support pillar three of the 2016-‐2021 strategy, ‘Achieve gender equality and empower all women and girls’, and encourage UNAIDS to apply gender-‐neutral language across the Strategy narrative as opposed to the current use of gender binaries of he/she.
Similarly, we firmly believe in a broader concept of a ‘family unit’ as reaching far beyond the nuclear or heteronormative notion of family. It is in this vein that we strongly encourage UNAIDS to revise the language used in bullet point 1 of the visioning section (page 4), “We envision a world where… every child is born HIV-‐free to a healthy mother and father”. In its stead, we recommend, “… where every child is born into a healthy family” or “… born to a healthy parent”.
Recognizing the political importance of this Strategy as a reference that will help guide national, regional and local fast-‐tracking efforts, we believe the use of language is critical in the framing of HIV, particularly within the context of the Sustainable Development Goals (SDGs). An example of this is found in Goal 1: End Poverty, “Households affected by HIV are more vulnerable to falling into and remaining poverty, undermining economies” (page 5). In our opinion, the current interpretation wrongly places emphasis on ‘households affected by HIV’ as the source of underperforming economies rather than the impact of inequity, unemployment and ill-‐performing health systems. Poverty undermines economies, not people.
3) No one left behind: A key question arising from the 90‐90-90 goals remains: who will be the 10‐10‐10? Our review of the draft Strategy has identified the need to feature Indigenous People more prominently throughout the document, including within regional profiles, opportunities and accountability mechanisms.
In solidarity with the International Indigenous Working Group on HIV and AIDS (IIWGHA), we recall the principles of the UN Declaration on the Rights of Indigenous People (UNDRIP) especially utilizing the principles of Free, Prior and Informed Consent (FRIC), that UNAIDS will engage and formally partner with the United Nations Permanent Forum on Indigenous Issues (UNPFII) to consult and cooperate in good faith with Indigenous peoples in order to gather epidemiological HIV data, develop policy and programming, explore and develop best practices, identify and address Indigenous research priorities, build capacity and promote Indigenous-‐specific approaches to the social determinants of health.1
Similarly, we believe that further prominence should be given within the Strategy to the health and HIV-related needs of migrant, mobile and undocumented populations, particularly given our current global/regional/country economic crisis, the number of states/regions ridden with conflict, and the sky-rocketing levels of unemployment across many countries that has given rise to increased mobility within and across nation states.
4) Advocating for integrated and coordinated rehabilitation service delivery: In support of the submission made by our partner network, the Canadian Working Group on HIV and Rehabilitation, integrated and coordinated rehabilitation service delivery is a health systems innovation with significant potential to improve the lives of people living with HIV. This approach promotes multidisciplinary and cross-‐sectoral practice; increases healthcare system efficiency by eliminating duplication of services; enables patients to navigate the system more easily; and, fosters a culture of person-centred care. To address this priority, UNAIDS should encourage governments to: i) support inter-‐professional education and practice; ii) champion cross-‐sectoral partnerships; iii) promote understanding of the role of rehabilitation for chronic and episodic illnesses; and iv) address inequities in access to integrated rehabilitation services.
5) Metrics: The Strategy speaks to the need to address the complexity of the social drivers of HIV, such as influencing legal and policy reform; however, it is unclear how UNAIDS will measure its progress on these action areas. How will UNAIDS measure country-‐ level success in achieving policy change and enabling environments? How will it measure how we address and reach the gaps in our collective response to HIV and AIDS? While the renewed UBRAF will assist in providing clarity on the means and metrics of implementation, the draft Strategy has felt some‐what lopsided, if not lofty in the absence of indicators that uphold transparency and accountability in the delivery of the renewed strategy to fast-‐track to zero. We recommend that in the future, a high- level monitoring framework should accompany the public review of the next draft Strategy (2021‐2026).
These comments are not intended as an exhaustive list of edits and suggested revisions but rather, we felt it important to underscore a few key points that we hope will support the process of moving towards a renewed UNAIDS Strategy for 2016‐2021.
We look forward to our continued conversations with the UNAIDS team and would be pleased to discuss the above recommendations in greater detail, if helpful.
Sincerely on behalf of the ICAD Coalition,
Executive Director, Interagency Coalition on AIDS and Development (ICAD)
The Interagency Coalition on AIDS and Development (ICAD) is a coalition of approximately 100 AIDS service organizations (ASOs), non-‐governmental organizations (NGOs), faith-‐based organizations, educational institutions and labour unions, the Interagency Coalition on AIDS and Development (ICAD) is working to provide leadership in the response of Canadian international development organizations and Canadian HIV organizations in reducing the impact of the global HIV and AIDS epidemic.
1 UNDRIP articles 19, 21, 22, 23 and 24.