Are we really committed to ending AIDS?

“There seems to be an agreement and consensus on targets in order to fast track the end of AIDS. But do we do really everything to get there?” With a strong and dedicated speech Sini Pasanen, co-Chair of the EU HIV/AIDS Civil Society Forum for AIDS Action Europe, addressed the audience of the EU-Presidency technical meeting in Malta.

Do we have needles and syringes in prisons? Are we offering services and HIV treatment to migrants with irregular status? Is there sexual education starting at early age? Can we say that we are doing something that children from early age on have enough information about sexuality, enough age-specific information that they are able to choose when to have sex, what kind of sex, with whom and how to protect themselves?

One priority is to make prevention, testing and treatment accessible and acceptable

So, we know what works and how to end AIDS. Then, how are we going to make high-impact, evidence based and cost effective combination prevention measures available for key populations or everyone in need? It is always good to ask the people themselves. The communities know what kind of information is needed and what the best way is to get the necessary information. We have highly effective prevention strategies. One of them is PrEP. If we are serious about preventing HIV among gay men and other MSM there has to be access to PrEP. And we have to say it. Maybe we could also ask what message pharmaceutical companies are giving to us with non-affordable prices.

Although the HIV community is in agreement on what works and what does not, that up-scaled prevention (including harm reduction services and PrEP) would avoid costs for treatment and care and early treatment is reducing morbidity and mortality, the obstacles that are faced when it comes to implementation of these evidence based instruments are immense, often based on moral grounds and, in these times, fuelled by the uprise of populist movements. Every country is different but in every country the biggest threat to community-led work and advocacy is the country´s political environment. Civil society needs political support and funding, not legal systems that make its existence impossible. In some countries communities cannot perform and deliver services because they or their behaviour is criminalized. I’m sure that no country can reach the first 90 from 90-90-90 targets without active involvement of civil Society.

Where we need to work hardest

• Stigma has a negative effect on everything: prevention, testing and treatment. Therefore fighting stigma and discrimination against people living with HIV and key populations remains high on the agenda.
• There is serious need for political leadership to ensure that human rights, also concerning sexual and gender minorities, people who use drugs, sex workers, people in prison, migrants and people with irregular status. At the moment it seems that defending these fundamental rights, also the right to health, the right to live, the freedom to move, the freedom of speech should be a top priority.
• Legal and regulatory barriers to universal access to prevention, testing and treatment need to be removed.
• There will be no “end of AIDS” without an integrated approach in the response to HIV, TB and viral hepatitis. We need political leadership. We also need to show solidarity and partnership to Eastern Europe and Central Asia.  
• We must have affordable and accessible quality treatment for everyone in need without interruption
• And we need to have PrEP as an additional tool in the prevention toolkit.