Durban Reflections: Treatment for All Means Treatment for ‘Key Populations’ Too

In April of this year, a vocal minority of governments barred several organizations representing gay men and other men who have sex with men, trans people, sex workers and people who use drugs and from around the world from participating in the United Nations High-level Meeting on HIV.  A handful of UN Member States took this a step further by then blocking the inclusion of important language on addressing the epidemic among these key populations in the Political Declaration on HIV and AIDS. Both these occurrences provided yet another reminder for many activists around the world of how little progress has been made in protecting and advancing the legal and human rights of marginalized communities. These events sparked a renewed call from activists demanding that services for key populations be made a top priority of the global AIDS movement, just in time for the International AIDS Conference (AIDS 2016) in Durban, South Africa.

According to UNAIDS, new HIV infections among gay and other men who have sex with men, trans people, sex workers, and people who use drugs, accounted for 36% of all new HIV infections in 2015.  Without bold new approaches to delivering HIV treatment and prevention for these marginalized and criminalized populations, countries will fail in their efforts to end the AIDS epidemic and reach the UNAIDS 90-90-90 targets by 2020. Yet many governments and other decision-makers have been conducting business as usual when it comes to HIV service delivery for these populations.

A commitment to human rights demands that key populations have an undetectable viral load and that people have the capacity to protect themselves and their partners from HIV transmission. It demands an end to unnecessary death and the promise of quality care without fear of bigotry. This requires programs to set key population specific goals and targets, so that civil society can hold governments accountable for service delivery scale up in order to achieve widespread viral suppression. A focus on human rights depends on the capacity and means of key populations to advocate for safe access to services and a reduction in stigma and discrimination. A human-rights approach means adding support for key populations throughout the treatment cascades in order to address marginalization and to ensure their chances of viral suppression equal that of the general population. 

‘Treatment for all’ means ensuring quality treatment for key populations too, yet at AIDS 2016 we were reminded that the barriers to achieving are large. Many countries still criminalize and stigmatize key populations, resulting in additional barriers to access to quality services and placing these communities at greater risk of HIV infection. Around the world, key populations are seeking health services in hostile environments where they are not free to be who they are. At the same time, while there are several new streams of funding to support investment in advocacy and service delivery for key populations, some are gravely concerned that community-based and grassroots organizations led by key populations themselves will not be prioritized as funding recipients.

Health GAP is committed to advancing successful programs for key populations in our policy and advocacy work around the globe. We are working with key populations groups and networks in six high-burden countries, to ensure that donor and domestic funding for the AIDS response advances the rights of gay and other men who have sex with men, trans people, sex workers, and people who use drugs to quality, lifesaving care. Stay connected for regular updates about this and other work here.

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