Allow me join the world to congratulate PEPFAR on this 20th year of saving lives. Ambassador through you allow me appreciate the support of the Americans. Personally, without PEPFAR, I doubt I would be alive, and so are many more PLHIV out there– THANK you
The 1st of February 2023 Dar es Salaam Declaration for those who may not know, Governments, Countries and partners committed to ensure that mothers are protected from acquiring HIV during pregnancy and breastfeeding; to Ending stigma, discrimination, and gender inequities experienced by women, children, and adolescents affected by HIV; to Working with communities including men to prevent gender-based violence and counter harmful gender norms; to Ring fencing budgets for ending AIDS in children; to Partnering with people living with HIV and communities in all our work; to Monitoring and sharing our progress and learning for joint accountability and for the benefit of all.
The 12 country governments commit to join the alliance and to turn the commitments into action to end AIDS in children worldwide. Governments commit to build a legacy that allows children living with HIV to reach their full potential.
I want to be honest with you. One of the things that is most exciting about this new declaration is that it mentions women, adolescent girls and young women. It speaks about the unfinished business of gender-based violence and harmful gender norms, ending stigma and discrimination and human rights violations, the unmet prevention needs and the treatment gaps. I will tell you why this is: I am seeing, in many settings, an erasure of women and women’s issues from conversations. When we cease to mention AGYW as a high incidence group, when we erase, from history, the surge in gender-based violence, unplanned pregnancies, school drop outs, hunger and unemployment that happened in COVID, and which disproportionately impacted women and girls, we are erasing the people-the women-whose activism brought us to where we are today, and whose leadership is the only thing that will end AIDS in children. Practically speaking – I would like to be sure that in the discussions this week every room looks closely at the incidence rates in AGYW versus their age mates, and uses that data to decide how to spend their money. I would like to be sure that:
- every program that is serious about eliminating HIV in children has a specific plan, commitment and targets for delivering PrEP to pregnant and breastfeeding women,
- that, in line with the UNAIDS 30-60-80 targets, 60 percent of this prevention work is done by community-led women’s groups – and that PEPFAR and governments report back on this allocation at the midpoint review and in national plans; and
- that every country is on the pathway to supporting women’s choice – including access to the full range of prevention options and to family planning in all HIV prevention and treatment services – since the risk of HIV transmission is often higher in unplanned pregnancies, contraception is HIV prevention.
- That there is commitment to funding and resourcing programs that collect data on and respond to the human rights violations, stigma and gender-based violence that keep people from ever getting to the clinics. If you don’t track 10 10 10 targets you won’t succeed. I know Frontline AIDS and Uganda Key Population Consortium (UKPC) are here and they have an excellent model called React that does exactly this. We need to scale up these kinds of models and understand that your clinical programs only work for people who can get to the clinics.
These are measurable things that PEPFAR can and should track as part of its equity pillar. Ambassador and your team, will you commit to doing so? We are committed to working with you every step of the way.
