In most parts of the world, the number of people who are newly infected with HIV is continuing to decline and progress to stop new HIV infections is significant, according to the latest UNAIDS data. However, three out of five people living with HIV are still not accessing antiretroviral therapy. The most-at-risk groups who bear the brunt of the epidemic — such as men who have sex with men, sex workers, transgender people and injecting drug users — are among the most marginalized people in the world and continue to be overlooked altogether — or even worse, stigmatized and criminalized.
If we are going to take the new post-2015 development framework’s goals and targets seriously, especially where they relate to health and HIV, every person in society must be able to access the services they need to lead a healthy life, free from stigma, discrimination and exclusion. This means that no one should be left behind, regardless of age, gender, religion, disease status, income, sexual orientation or gender identity.
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For the past two years, United Nations member states, U.N. agencies, civil society and other stakeholders have been discussing the post-2015 development framework to replace the Millennium Development Goals. The International HIV/AIDS Alliance has been actively engaged in the myriad of official post-2015 consultations and civil society discussions at a global, regional and country level, with two overarching messages:
1. Ending AIDS is crucial post-2015 business, and a major opportunity for global leaders, governments and affected communities.
2. We will not achieve this goal unless we include everyone in the global response to HIV/AIDS. Equity is key.
There is widespread consensus that the post-2015 framework should address the unfinished business of the current MDGs, with renewed and more ambitious targets, while also addressing emerging health priorities. There’s a strong call by a large number of member states — supported by civil society — that this new global development framework should be guided by principles of equity and human rights, both missing from the MDGs.
The reality, though, is that in many countries across the world, social inequalities are growing and human rights violations are worsening due to deep-rooted fear, cultural notions and homophobia, as well as the criminalization and exclusion of people who are perceived to be “different” and considered as a “threat” to society. Marginalized and excluded populations continue to be the ones being most affected by poverty, by diseases such as HIV and by poor health outcomes overall. The ultimate success of the post-2015 framework must be measured by the extent to which the structural drivers of inequality have been addressed.
This requires, first and foremost, equal and meaningful participation of all marginalized populations at all levels of the post-2015 process: in the shaping of the new goals, targets and indicators; in global and national implementation strategies; and in the new monitoring and accountability frameworks to measure progress and hold governments to account.
Secondly, this means that the post-2015 framework must include a focus on the health needs and rights of marginalized populations and include specific strategies to address stigma, discrimination and human rights violations, including legal reform and decriminalization.
And last but not least, it needs dedicated effort and investment to build the capacity of marginalized groups and communities to become sustainable partners in the development and health response and powerful advocates to realize their human rights and ensure equal access to the services they need.
Ever since the MDGs were adopted in 2000, the world has failed marginalized people. The post-2015 framework gives us an opportunity to do it right. Let’s leave no one behind this time and — in doing so — achieve the end of AIDS.
The International HIV/AIDS Alliance is a unique alliance of national civil society organizations dedicated to ending AIDS through community action. The alliance works on HIV, health and human rights through local, national and global action with communities in over 40 countries on four continents.
Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.