UNAIDS is a partnership of international organisations and UN agencies. It guides the global response to the HIV epidemic and their defining goal is helping the world to get to zero: zero new HIV infections, zero discrimination and zero AIDS-deaths by 2030. This goal is also at the heart of MTV Staying Alive Foundation.
Last week, UNAIDS published a really interesting report. ‘Stronger Together’ is a guide for national governments to develop HIV plans, but we loved it because it celebrated the tireless work of community initiatives in the global fight against HIV. It also emphasised that local communities would need to play a central role if we are to get to zero.
The report tells us that, until now, some countries have relied on centralised health systems like hospitals and clinics for the delivery of HIV services. The problem is that these systems are often overburdened and that some populations cannot access them owing to stigma, discrimination, and a host of other reasons.
Crucially, these are the people that need the services the most. UNAIDS tells us that 40–50% of adults infected with HIV are from key populations: men who have sex with men, sex workers, people who inject drugs, prisoners, migrants. It’s an astonishingly high proportion and so if we are to end the epidemic, these populations have to be reached.
And that’s where community-responses come in. Community initiatives can access the populations that governments and national health services struggle to reach. Importantly, they are also capable of reaching those populations with tailored and culturally-relevant services, to ensure they have an impact.
So, for example, a homosexual man in Nigeria might not be able to walk into a clinic and access services because he will experience discrimination. But if there is a local group, made-up of other gay men, providing confidential education, condoms, and testing, then he is more likely to access those services. And they are more likely to be delivered in a relevant and effective way.
That’s the cornerstone of Staying Alive’s model. Instead of trying to create a one-size-fits-all approach to global HIV prevention, we invest in the creativity and flexibility of local communities. We provide grassroots, community initiatives with training, resources and mentoring, and enable them to develop their own unique solutions to the epidemic.
Working in this way we are able to reach those that have been bypassed by wider development: women and girls in India, migrants in DRC, young deaf people in Uganda. And since 2005 we have achieved meaningful results: 2.9 million people reached in 68 countries, 8 million condoms distributed, and 220,000 people tested for HIV.
There is a long way to go if we are to end the epidemic, and particularly amongst marginalised populations. But we are delighted that UNAIDS are highlighting the key role that local communities should play in the future. By trusting and investing in communities, we can empower them to build their own solutions, and work towards a future free from HIV.