Durban then and now: Human rights funding in the AIDS response

It’s human nature to compare AIDS 2000 to the convening happening in Durban, South Africa, this month. The progress we’ve made is clear. In 2000, fewer than 700,000 people received antiretroviral medicines; today, 15 million people have access to this lifesaving treatment, and HIV infections have declined 35 percent. These are no small feats.

However, that same then-and-now comparison serves to highlight persistent blind spots in the global response to HIV and AIDS. For example, inequality of access — and the human rights issues that are often at the root of it — continues to be a glaring need that prevents progress from happening as quickly as it should.

Policymakers, scientists and implementers agree that an effective HIV response must be viewed through the lens of human rights. Yet overall AIDS funding for human rights is remarkably low. Resources in some countries are woefully inadequate, and harmful legislation aims to further marginalize and oppress those at greatest risk of HIV. The most marginalized groups — women, young people, sex workers, gay men and other men who have sex with men, transgender people, people who use drugs, prisoners, and migrants — are often directly and indirectly excluded from lifesaving health services.  

Without adequate funding, not only will we halt further advancements, we may backslide.

Last month, the Political Declaration stemming from the United Nations High Level Meeting on HIV and AIDS fell significantly short in addressing the critical needs of key affected populations. Already, advocates are pushing back on what many see as a failure of the HLM. But advocates don’t have the resources they need. And they are fighting an uphill battle.

Here is where philanthropic resources can make a difference.

The philanthropic response in the global fight against HIV and AIDS is just a small part of total resources. But it is mighty. When public, private and philanthropic resources are brought collectively to bear on the global response to HIV and AIDS, remarkable progress is possible. One such example is the Global Plan: In 2011, members of a global steering group including NGOs, international organizations, and Ministry of Health representatives, as well as private philanthropic organizations such as Johnson & Johnson, the M.A.C AIDS Fun and Elizabeth Glaser Pediatric AIDS Foundation, joined together in an effort to eliminate new HIV infections among children in the 22 countries hit hardest by the epidemic. In a recent report on progress, the results were clear: these collaborative efforts have contributed to 58 percent fewer new HIV infections among children since 2000.

Philanthropic funders also have a history of providing critical support for people and issues that are under- or unfunded by governments. Because private donors are subject to far fewer restrictions in what and where they are able to fund, theirs are often the only resources available to support advocacy.

Dollars spent at the intersection of HIV and advocacy, bolstering efforts to keep national and international funders accountable, is money well spent. Advocacy yields tangible results in financing, policy change and service delivery.

The Elton John AIDS Foundation’s investment in the Stop AIDS campaign, a U.K. advocacy network, provides a useful illustration. Though historically focused on direct services, EJAF UK invested in the Stop AIDS campaign in a crucial bid to secure a renewed commitment to The Global Fund to Fight AIDS, Tuberculosis and Malaria — the world’s largest global health financier — from the U.K. government.

Roughly one-third of EJAF U.K.’s resources were spent on the campaign between 2010-2013, ultimately resulting in a 1 billion pound investment from the U.K. Department for International Development in the Global Fund. If this grant had been made for direct services, it would have saved 270 lives; by leveraging the resources for advocacy instead, it helped save 300,000.

The $76 million in philanthropic support for key populations provided in 2014 strengthens not only the HIV response, but also the human rights’ movement writ large. For our part, Funders Concerned About AIDS, in partnership with Open Society Foundations and the Robert Carr Civil Society Networks Fund, is hosting the “Funding for National HIV Advocacy and Rights Programming — A Gap in the Response” on July 17. By helping to advance the conversation, our hope is that programming and associated funding will follow.

There are many pressing items to discuss at the AIDS conference. But it’s encouraging to see portions of the agenda dedicated to those groups that are too often left behind in the response. Without addressing inequality of access now, we may well be having the same conversation in another 15 years. Instead, we need to have the tough conversations and identify the resources needed to address the intransigent challenges while we’re in Durban. And let’s plan to meet back here in another 15 years to celebrate the end of AIDS.

For more information about philanthropic funding for HIV-related human rights, please see FCAA’s recent infographic.

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