Statement of UNAIDS at the 74th Session of the Economic and Social Commission for Asia and the Pacific
Ladies and gentlemen,
UNAIDS welcomes ESCAP’s theme topic of “inequality in the era of the 2030 Agenda for Sustainable Development”. Inequalities affect all socio-economic aspects of development and are key drivers of new HIV infections. UNAIDS works with the marginalized among us. Day-to-day we see the negative impact of inequalities on all aspects of their lives, and the increased vulnerabilities that push them further behind. We believe, however, that the HIV/AIDS response model can also be transformed into a pathfinder for addressing structural inequalities and vulnerabilities in many different fields.
When in September 2015 the world’s leaders adopted the 2030 Agenda for Sustainable Development, they pledged to leave no one behind. The agenda sets out a vision for sustainable development grounded in international human rights standards, to ensure healthy lives and build inclusive societies. It puts respect for equality and non-discrimination at the centre of its goals.
UNAIDS applauds the call of Ms Shamshad Akhtar, Executive Secretary of ESCAP, for “greater investment in our people.” Indeed, access to healthcare and education must be improved because only a healthy population can study, work and become more prosperous. The universal basic healthcare schemes established by Bhutan and Thailand are success stories to build on. “Universal” means “all”, not “some”. That inclusiveness is essential to leave no one behind.
Universal Health Coverage (UHC) is defined as “ensuring that all people obtain the health services they need, of good quality, without suffering financial hardship when paying for them”. Universal basic healthcare schemes are much more than making a package of services available. The ultimate measure of our success must be whether the poorest, the most marginalized and the most vulnerable people enjoy health and well-being. This requires going upstream and assessing and addressing – in specific contexts, and for specific populations – the causes of exclusion and ill health. It is time to address the critical linkages between health, injustice, inequality, poverty and conflict.
HIV and AIDS is an outstanding example of health conditions that affect certain population groups disproportionately, in terms of its health impact, but also it adverse socio-economic effects, and overall progress in development. Addressing equity is central to the concept of UHC, making it a crucial consideration if we are to make any further progress in stopping new HIV infections and bringing an end to AIDS.
In order to leave no one behind to access universal basic healthcare, legal and policy barriers have to be lifted. One massive barrier is the barrier that stigma and discrimination places on the most vulnerable people who seek access to health care. Discrimination in health-care settings remains widespread and takes many forms. Discrimination prevents the attainment of universal basic healthcare. It leads to poor health outcomes and hampers efforts to end the AIDS epidemic and achieve healthy lives for all. Thailand has been a leading force in the region to tackle stigma and discrimination in healthcare settings and UNAIDS applauds Thailand’s leadership on this issue.
Persistent gender inequalities and gender-based violence contribute to women’s HIV risk and vulnerability. Evidence suggests that strategies to foster equitable gender norms, strengthen legal and policy frameworks, and support women’s education, access to decision-making, employment opportunities, food and economic security have a meaningful impact on HIV and sexual and reproductive health outcomes and reduce gender inequality. Women and girls, particularly those living with HIV and from key populations, must be empowered to engage meaningfully and spaces must be secured for them to participate in the HIV response at all levels.
Ladies and gentlemen,
In 2016 countries agreed to a historic and urgent agenda to accelerate efforts towards ending the AIDS epidemic as a public health threat by 2030. The 2016 UN General Assembly Political Declaration on Ending AIDS provided a global mandate to Fast-Track the AIDS response. The Political Declaration further recognizes that progress in protecting and promoting the human rights of people living with, at risk of and affected by HIV has been far from adequate, and that human rights violations remain a major obstacle in the response to HIV. Member States pledged to review and reform legislation that may create barriers or reinforce stigma and discrimination and to promote access to non-discriminatory health-care services, including for populations at higher risk of HIV, specifically sex workers; men who have sex with men; people who inject drugs; transgender people; and prisoners.
The Political Declaration affirms that the AIDS response will spur progress across the entire 2030 Agenda for Sustainable Development. It calls for universal health coverage and access to social protection. Adopting targets beyond HIV, Member States emphasized the continued importance of an integrated approach to a range of health issues, including tuberculosis, hepatitis B and C, cervical cancer, human papillomavirus, noncommunicable diseases and emerging and re-emerging diseases.
In January 2015, the Asia-Pacific Intergovernmental Meeting on HIV and AIDS took place here in Bangkok. One of the main goals of the meeting was to enhance regional cooperation to achieve universal access to HIV prevention, treatment, care and support in Asia and the Pacific beyond 2015. The Meeting endorsed the Regional Framework for Action on HIV and AIDS beyond 2015. This included the continuation of national reviews and multisectoral consultations on legal and policy barriers; national stakeholder consultations to promote access to affordable medicines, diagnostics and vaccines; and evidence-based national HIV investment cases and sustainability plans.
Ladies and Gentlemen,
Eleven months after the Asia-Pacific Intergovernmental Meeting on HIV and AIDS, UN ESCAP and UNAIDS jointly organized the Regional Expert Consultation on Developing Evidence-Based National HIV Investment Cases and Sustainability Plans. The Consultation was attended by national-level experts from Governments, civil society and the United Nations system, as well as regional networks of civil society organizations, development partners and representatives of the United Nations Regional Interagency Team on AIDS.
Participating countries, including Bangladesh, Indonesia, Myanmar, Cambodia, and Thailand underlined the need to ensure sustainability of the AIDS response through an efficient use of existing resources, integration of HIV and AIDS services into Universal Health Coverage schemes and increasing multi-sectoral collaboration. They identified the need for active involvement of CSOs, effective advocacy and increasing support from external development partners. They also raised the need to close service gaps in rural areas and to reduce out-of-pocket expenditure for people living with HIV.
Through this joint UN ESCAP and UNAIDS initiative, significant country-level work has been started. UNAIDS is determined to sustain the gains and achieve the Sustainable Development Goals. UNAIDS remains firmly committed to support UN Member States in their commitment to end AIDS by 2030.