GENERAL DISCUSSION - QUESTION 3
How can UNAIDS improve the quality of the way it works, across the UN and the AIDS ecosystem to deliver results for people in the era of Agenda 2030?
You are encouraged to include your name, age, gender, and location when you participate, for statistical analysis purposes. Anonymous inputs are also welcome.
By engaging all major stakeholders beyond the Joint Programme in joint programming; mapping current resources and identifying needs for strategic responses for impact at country, regional and global level
ReplyDeleteby better cooperation with national and regional stakeholders (especially form the community) UNAIDS is not very visible in my country (at country level: Germany) - much more could be done here, saying that: cooperate if you want to improve your impact; listen to the communities, invest more into regional offices (raise their capacities) get communities engaged by employing members from the communities (and not only public health experts)- you might as well cooperate better with the Global if you want to end Aids, TB and Malaria by 20130: its often said that you both cooperate and complement one another - you might explain to the communities on how this happens (please use concrete examples) to raise awareness that both entities are needed and useful (some might not be aware of it)
ReplyDeleterr communities, - almost abstent eder UNAIDS should
Be Inclusive, inclusive, inclusive: with partners, with communities of PLHIV, key populations, LGBTI groups, women, young girls, and the disabled. Be collegial and inclusive with the Co-Sponsors. Celebrate community and co-sponsor successes – do not appropriate these. Be accountable to communities first, second and last. Challenge governments to do more, put money into services for people who need them most – including for LGBTIQ, key and vulnerable populations. Support co-sponsors and highlight their work related to law, human rights, world of work, etc. A lot has been done, but as we all had been saying since the late 1990s, even in generalized epidemics; the poor, the vulnerable, the key populations, young people, incarcerated populations, are all more vulnerable and need access to prevention, testing, care and treatment. UNAIDS need to focus more on the affected communities rather than on big jamborees with first ladies and queens...In this era of donor indifference, UNAIDS need to demonstrate greater evidence related to the economic sense of addressing HIV through a rights-based approach. Lastly, it needs to engage more on the issue of access to cheap and good quality medicines and biologicals for HIV and as well as Hep. C, TB, etc.
ReplyDeleteThis should be done through a joint programming and joint implementation that goes beyond the joint program. Through inclusion of all major stakeholders in mapping of the gaps and stocktaking at a horizontal level to explore in a participatory manner the most effective way that the needs can be addressed. This would also include the technical and human resource requirements at the global, regional and country levels.
ReplyDeleteUNAIDS should exercise more technical leadership. It needs to generate, compile, analyze, and provide data and new knowledge across the UN system, always taking into account that many agencies may not have access to the type and quality of data on HIV and HIV related problems that UNAIDS does.
ReplyDeleteI believe there is no more need to keep the UNAIDS Secretariat in its present structure, at global, regional and country level. In 1995 when UNAIDS was established, the idea was to have a harmonized joint UN response to HIV and ensure that all areas of HIV interventions are addressed by various UN agencies especially when it comes to human rights and socio economic aspects. At the time, there was a need for a strong effective input from all UN agencies to be coordinated by UNAIDS. However, UNAIDS was supposed to be a small coordinating structure, that will exist for few years until the UN co-sponsors have successfully integrated HIV into their core business. After 22 years, UNAIDS has expanded immensely, and has taken a prominent role in implementing technical activities, sometime even competing with the UN cosponsors.
ReplyDeleteToday, there is no need for an expansive UN programme on AIDS. There is no need to differentiate HIV from other public health problems. However, there is a great need to maximize resource effectiveness and utilization, and enhance integration of health programmes. UNAIDS should be transformed into a partnership programme like STB and RBM. A small secretariat could be kept in Geneva and all staff should be absorbed into various UN agencies to reinforce UN HIV capacity at country level.
Part 1: On the HIV response for people who inject drugs, UNAIDS produces high-quality reports and data. Its 2016 report Do No Harm: Health, Human Rights and People Who Use Drugs, for example, put forward a courageous set of policy and operational recommendations, calling for the inclusion of public health and human rights pillars in the outcome document of last year’s UNGASS on Drugs, and urging governments to ensure that all people who inject drugs (including those in prisons) have access to harm reduction services, to ensure that people who use drugs do not face punitive sanctions for the personal use or possession of drugs and to rebalance investments in drug control to ensure that public health services, including harm reduction, are fully funded.
ReplyDeletePart 2: More recently, its report Get on the Fast Track: The life cycle approach to HIV and AIDS published much-needed data showing that new HIV infections among people who use drugs had increased from 114,000 in 2011 to 153,000 in 2015.
ReplyDeleteA key challenge for the Joint Programme appears to be in maximising the impact of these reports and data (alongside media/ social media initiatives such as the recent Hands Up for HIV Prevention campaign and thematic segments at the Programme Coordinating Board) and their contribution to the programme’s wider strategic and advocacy goals, both at the point of and after their release.
Taking the Get on the Fast Track data cited above as example, these new figures show a one third increase in HIV infections among people who inject drugs, during a period in which UN member states had pledged to halve HIV transmission among this key population. They represent an important opportunity for UNAIDS Secretariat and Cosponsors to sound the alarm about countries’ failure to tackle HIV among people who use drugs and about the funding crisis facing harm reduction.
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ReplyDeletePart 3: Instead they were buried in a 150 page report and did not appear in any accompanying publicity, in the UNAIDS World AIDS Day campaign or in presentations made by UNAIDS during the PCB. UNAIDS Secretariat did not flag them to civil society organisations who could have used them for advocacy.
ReplyDeleteThe Joint Programme needs to improve the way in which its staff plan data launches, reports, campaigns and other such initiatives. Working across the Secretariat, with its leadership and with Cosponsors, UNAIDS needs to have clearer objectives for such initiatives, situated in the context of wider goals and targets, and needs to ensure that they are implemented in a way that maximises their impact.
In the context of harm reduction advocacy and the HIV response for people who use drugs, UNAIDS Secretariat also needs to improve its cooperation with civil society and networks of people who use drugs. The position of focal point on people who use drugs with a dedicated portfolio and decision making powers should be re-established at the UNAIDS Secretariat. The post was previously held by two consecutive secondees and was left vacant for a period after the second of these returned to their previous post. Since July 2016 a new focal point on people who use drugs already has in theory been in place but in practice the post holder has a large portfolio and an excessive number of other duties, limiting their capacity to really lead this work - the result of inadequate allocation of staff capacity.
We understand the challenging funding environment at UNAIDS at present, but by allocating just one part of one person’s role to addressing HIV in people who use drugs, UNAIDS Secretariat is effectively deprioritising this population at a time when they face a growing HIV burden and in some countries, an increasing hostile legal environment.
Part 4: A further area where UNAIDS Secretariat could improve – again in part by working more closely with civil society and networks of people who use drugs – is in terms of the quality and/ or relevance of its HIV and resourcing data and estimates. The Do No Harm report for example, estimates the global resource need for harm reduction to be US $1.5 billion, a figure which excludes high-income countries and assumes that upper-middle income countries will meet their resource needs. By calculating resource needs in this way, UNAIDS Secretariat has excluded countries such as Russia, where harm reduction is extremely limited and where HIV infections among people who use drugs have increased rapidly. By working with civil society ahead of publishing these figures, rather than after the fact, UNAIDS Secretariat could significantly enhance their advocacy impact.
ReplyDeleteA key challenge for the Joint Programme is in the impact of their reports and data as advocacy tools after their release. For example, the "Get on the Fast Track" report included important data showing that new HIV infections among people who use drugs had increased from 114,000 in 2011 to 153,000 in 2015: a 33% increase during a period in which governments had pledged a 50% fall. This should have been an important opportunity for UNAIDS to sound the alarm about countries’ failure to fund HIV services for people who use drugs - but instead the data were buried and not even flagged to the co-sponsors or civil society partners. This is unacceptable.
ReplyDeleteIn the context of harm reduction, UNAIDS must urgently re-establish a dedicated, senior-level focal point for people who use drugs - in order to ensure cooperation with civil society and networks of people who use drugs, and to ensure that this key population does not get left behind.
There is currently just part of one person’s role assigned to this issue - meaning that the UNAIDS Secretariat has effectively deprioritised this population at a time when they face a growing HIV burden and increasingly hostile legal environments.
Involving all the stakeholders working on the HIV response. The JURTA for West Africa is not just the meeting of the Joint UN Team on AIDS but it also includes partners organisations like USAID or NGOs such as AIDS Alliance, Solthis or MSF. This should be replaced at country level.
ReplyDeleteSecondly, UNAIDS needs to be stronger on strategic information and knowledge management. A lot of data on prevalence come from different actors and it's not always easy to know which is the official one or the most recent. Country reports on country webpage should be reflected in the results webpages along with the JPMS reports. All the studies done by UNAIDS or other agencies on PMTCT, nutrition, education need to be incorporated along with key data.
UNAIDS can improve the quality of its operations by fielding high quality technology based training programs, beginning with the induction of new organizational personnel and spreading through the incorporation of agreements with local and regional partners/agencies, such as the African Union.
ReplyDeleteThis training would have to be highly visual in nature, but also possess the ability to be fielded in a modular fashion targeting areas with limited technology access or connectivity.
This modular training can take advantage of the most cutting edge technology (which will allow it to keep its relevance for longer than traditional training methods) while maintaining the edge that modular training can bring, that is, being responsive to the challenges of new crises without incurring significant capital costs as a matter of retooling in order to address those crises.
We need strong, impassioned leadership and advocacy from UNAIDS. UNAIDS needs to lead the way in advocating for more resources to fight AIDS around the world and to keep the epidemic at the top of the global development agenda. There needs to be a re-newed sense of urgency about AIDS, 1.1 million deaths and 2.1 million new infections per year is unacceptable. To remain relevant, UNAIDS needs to take a bold position and be willing to openly criticize governments that are not doing their part.
ReplyDeleteRegarding UNAIDS estimate of 18.2 million people on ART: Overstating the number of people on treatment around the world is detrimental because it understates the amount of resources that is still needed to fight AIDS. It creates a sense of progress toward the 90-90-90 goals even though there are still huge gaps on the ground like ARV stockouts, test kit and condom shortages and discriminatory policies that haven’t been addressed.
ReplyDeleteJOrge Beloqui, Brazil
ReplyDeleteBy giving voice to the most affected by HIV, in ALL regions, and respecting the LOCAL epidemics. As I stressed before, Latin America has been largely forgotten in the international AIDS scenario.
By establishing again the importance of Human Rights in the struggle against this epidemics. In this sense, I think only UNAIDS can currently do so. I think this is clearly established in its mission.
I read recently the Report of the High Level Panel created by the UNSG, for access to medicines, patents and human rights. UNAIDS has to use this Report as a tool, opposing WHO which rejected the inclusion of this Report for some meetings, though many countries backed the inclusion (among them Brazil and India). I think UNAIDS is less contaminated by pharmaceutical industry interests than WHO, and therefore has to persist in this behaviour. Access to treatment is a human right, and theright to health and life of people should precede the right of individuals to patents and to extorsion protected by the TRIPS and similar agreements.
UNAIDS needs to have a clear flow of focus and accountability from its fast Track Strategy and Test and Treat right down to workplans at the country level.
ReplyDeleteHow much of the work done by UNAIDS offices supports the strategy, and how do we know?
We need:
1) Clear work plans that reflect the strategy, and this should flow into outcomes and clear KPIs for all employees. They should be very specific and they should be reviewed rigorously. Not being part of UNAIDS it is hard to know whether this happens, but from the outside at best one gets the impression that only lip service is paid to the process.
The effectiveness of UNAIDS at the country level is highly dependent on the staff in the country office. In many cases there is a lot of dead wood that sits there taking a fat salary and not being very effective. UNAIDS needs to look at the criteria for employing people (skills, knowledge, experience) and ensure that their staff are capable of implementing plans and taking a strong leadership position on HIV with the Joint Programme and with other stakeholders such as governments.
Unless UNAIDS has in place a strong management system driven from Geneva, the impact and ouputs at the country level will not be either effective or efficient.
The only way forward for the joint programme is joint programming at every level – Global, Regional and country. We know that non-comprehensive and silo implementation does not yield the best results and we have left behind many communities gravely affected due to this approach. The Joint programme needs to do a better job at understanding the stakeholders on the ground. The participation of a wider of stakeholder needs to be privileges and ramped-up in planning, implementation, monitoring and evaluation. We often engage the same stakeholders that speak for under-represented or under-engaged communities and omit that their voices are what will enable us to curb the epidemic in these communities. Delivering on the 2030 agenda requires a shift in how we do business - I have yet to see that happening on the ground. How do we prioritize and assign human (technical) and financial resources according to the burden and challenges at the global, regional and country level. Unfortunately, the attribution of resources to tackle challenges if at times not driven by importance and concerns, but by donor priorities. Some area of the UNAIDS and cosponsor mandates remain largely underfunded to make a real dent in some concentrated epidemic and actually meet the 2030 objectives.
ReplyDeleteUNAIDS should make its work visible, well-planned, measurable (develop very specified indicators), aimed at results, rather than process. UNAIDS should avoid description the processes and focus on results, achievements, indicators.
ReplyDeleteUNAIDS should seek to reform its results framework to incorporate attributable results delivered by both the Secretariat and Co-Sponsors. This will strengthen understanding of who is responsible for the achievement of what, both within and outside the Joint Programme. Reporting should be provided to the Board on what the Co-Sponsors have achieved with their core Joint Programme resources. At the moment it is hard to tell what the Co-Sponsors contribution is to the Joint Programme’s results.
ReplyDeleteThe Secretariat should continue to ensure that their staff have the requisite technical skills to deliver their jobs. The quality of UNAIDS staff in county is critical to the institutions performance.
Secretariat should continue to strengthen its work on data collection and dissemination ensuring that it is done to a high standard
This should be done through a joint programming that goes beyond the joint program. Through inclusion of all major stakeholders in mapping of the gaps and stocktaking at a horizontal level to explore in a participatory manner the most effective way that the needs can be addressed. This would also include the technical and human resource requirements at the global, regional and country levels.
ReplyDeleteUNAIDS can improve the quality of the way it works through a joint programming that goes beyond the joint program. Stocktaking of the needs in a participatory and inclusive manner including the resource needs at global, regional and country level to address the gaps in the most effective way.
ReplyDeleteEnsure that the joint programme works and strategizes with PLHIVs, KPs, civil society, and other multilateral bodies such as the Global Fund and UNITAID for a coordinated AIDS ecosystem. UNAIDS should also hold countries accountable to recommendations made in the High Level Panel on Access to Medicines utilizing TRIPS flexibilities so the WHO start guidelines for ARV and PrEP can be actualized in all countries, and help disseminate globally the new scientific evidence that PLHIVs who are virally suppressed and on treatment for six months cannot transmit HIV to their sexual partners.
ReplyDeleteUNAIDS and other UN organizations must get rid of some of its employees that get high salaries, but cannot even use modern communication tools, are not collaborative and are not really committed to AIDS work.
ReplyDeleteThis would help cut costs and recruit - via real competitive recruitment process innovative, young and top talents.
As a social worker and the experienced acivist combating HIV/AIDS in Eastern Europe, Ukraine, I have been working in the HIV field and cooperating closely with the local UNAIDS representatives for a very long time.
ReplyDeleteI have noticed a huge problem that constantly worsens the cooperation of UNAIDS staff with communities in our region. Several UNAIDS people let their political views interfere with their activities for effective HIV response. In my opinion, ending epidemic has to remain a common goal of every single community in our region, but some of local UNAIDS people do not seem to do their best for creating a harmonious regional collaboration network.
Perhaps, some checkings have to be conducted to find out if every UNAIDS worker considers political matters important only when they are indeed relevant.
I hope strongly that in the near future, UNAIDS staff will make more effort to support the HIV-focused initiatives in our region and will be more eager to cooperate and seek for new approaches. I believe, that the only way to real approach is the partnership. This is our common response.
Thank you very much for your attention. UNAIDS can accomplish wonderful things for our region, and I look forward to contributing in them as well.
В первую очередь, организация должна стать более гибким инструментом в продвижении профилактических программ. Меньше бюрократических проволочек, которые порой сильно мешают реагировать на срочные кейсы.
ReplyDeleteНеобходимо иметь чёткую политическую позицию, которая должна быть отражена в методологическом подходе.
ЮНЭЙДС должен обратить внимание на наш регион и стараться вкладывать ресурсы в научно-методологическую базу.
Айнагуль Осмонова, ОФ «Аракет Плюс», Кыргызстан
ReplyDelete1. Давать четкие послания донорам, странам и исполнителям по основным приоритетам.
2. По согласованию с донорами способствовать концентрации финансовых потоков только на наиболее приоритетные программы.
3. Работать с главами государств и правительств через авторитетные международные площадки: Генеральную ассамблею ООН, Евросоюз, Европарламент, другие союзы и прочие – по вопросам достижения цели – окончания эпидемии СПИДа к 2030.
4. Способствовать продвижению этой цели в государственных политических документах, включая ЦУР и другие программы устойчивого развития при поддержке ко-спонсоров ЮНЭЙДС.
1. Развивать прозрачность и подотчётность профилактических программ.
ReplyDelete2. Улучшить работу в медиа, включая SMM, краудфандинг и социальную мобилизацию. На данный момент, медиа компонент активно продвигается только к 1 декабря, а нужно, чтобы о проблеме ВИЧ говорили всегда.
3. Вовлечение молодёжи не говорящей на русском или английском языках, должно стать приоритетом участия молодых людей в проф.программах.
4. Сама организация должна стать более мобильной и эффективной, которая очень оперативно реагирует на внешние и внутренние изменения.
UNAIDS presence at Senior and Executive level in all existing high level UN decision making bodies and Committees at HQs particularly in NY is key to influence and leverage the contribution of agencies and governments towards the goal of ending AIDS. A survey of all mechanisms the UNAIDS can use to advance its agenda among the UN agencies and governments need to be assessed and a data base created for all senior managers.
ReplyDeleteUNAIDS has already set up target for 2030 which should be domesticated at national, country and regional level with clear and achievable indicators for monitoring. Such indicators should be inclusive to major key thematic issues.
UNAIDS should continue its leadership and good command in high level advocacy duties at global, country and regional levels. This may require sometimes expert’s trainings, guidance tools for staff who are performing such UNAIDS Ambassadorial function on behalf of its EXD.
The rationalisation of UNAIDS presence leading to reductions of presence in places where the impact is fairly limited need to be reviewed. Data collection and strategic information which identify the locations and populations as well as the collection and analysis of sex- and age-disaggregated data is needed during programme design, and monitoring and evaluation and periodic reporting especially in fragile countries to measure the effectiveness of implementation;
UNAIDS should strengthen its staff and resources in 'fast-track' countries and regions. Facing a growing epidemic in several countries in Eastern Europe and Central Asia, UNAIDS can play a pivotal role to halt and reverse these epidemics only if its has the staff and resources.
ReplyDelete•Play a stronger and more coherent role among the co-sponsors in delivering and supporting Member States, UN System and CSOs on the implementation of Agenda 2030;
ReplyDelete•Ensure that the HIV/AIDS agenda is taken into consideration by Member States when developing their national action plans to implement the agenda; and
•Strengthen and focus its work on the implementation of relevant goals and targets at the Agenda 2030 as well as the 2016 Political Declaration and UNAIDS Fast Track Strategy 2016-2021 essentially at the national and regional levels.
There should be reminded that the UN response to HIV/AIDS needs to keep people at the centre of the response. Neither visibility, nor the politically-correct approach will end AIDS in the era of SDGs. New and innovative alliances need to be created, unconventional methods need to be adopted. Despite being fundamentally pro-government and "bound" to work with state actors, UNAIDS should throw more attention and strategies to working with private sectors and the marginalized communities. The scarcity of funding and the real risk of closing have not made UNAIDS disappear and should not make it compromise to the core principles and values it was crated for: uniting the world against AIDS and defeating the epidemic. The accountability of UN agencies - having UNAIDS as the secretariat - remains an issue and the bottom up approach, i.e. getting the affected and those at risk be part and parcel of the decision-making at all levels and stages of the process would bring more outcome and change the mindset of decision makers who still act in denial of obvious realities of humanness of PLHIV, dignity and equality of criminalized populations and the need for conducive policies. The efforts seen at the high-level leadership of UN and UNAIDS still needs to be translated at the country level.
ReplyDeleteFinally, a question needs to be consistently asked: how much space do you give to those communities silenced, how much time and energy do you spend to take concrete actions and how sensitive are you to those desperately crying for help and how do you convene this call? It is still to be seen how far UN agencies can go to call a cat a cat and name the elephant in the room despite the risk of disgrace in the eyes of governments acting against their own.
ЮНЭЙДС обладает очень качественной информацией, необходимыми отчетами и инструментами, думаю что важно больше информировать как общественные организации так и сообщество но и госс. учреждения о данных ресурсах и инструментах, это не только весомые аргументы в пользу определенных стратегий но это также может значить экономию времени и финансов на решение определенной задачи. Может быть регулярные встречи сотрудников странового офиса с ключевыми сообществами сыграло бы огромную роль в их развитии и в активном вовлечении в национальном или даже региональном ответе.
ReplyDelete• UNAIDS should be able to prove outcomes/added value through developing robust M&E measures that evidence their impact
ReplyDelete• UNAIDS should be able to improve KP datas to guide programming and level of investment of programs targeting the most in need
• We need four transformative shifts named in UNAIDS strategy. Those shifts are: 1) front‐ loading an increasingly diverse bundle of interventions; 2) adopting a laser‐focus on the locations, populations, interventions that will deliver greatest impact; 3) catalyzing innovation for people who need it most; and 4) forging new cross‐sectoral partnerships that leverage the unique contributions of the private sector, faith‐ based communities, academia, and science alongside government and civil society organizations to defeat the determinants of vulnerability, including discrimination and gender inequality
One challenging area for the UNAIDS Joint Programme is that there can be inconsistencies between the vision and commitments at the global level and what some individual staff members are willing to do at country and regional levels. The most glaring examples relate to protections of LGBT people, people who use drugs, sex workers, and the rights of women and young people. Better accountability processes are needed to ensure country-level work, in particular, carries out the commitments of the Joint Programme without letting personal biases get in the way. Some approaches to improve this could include: 360 reviews of country directors and an ombudsman who can receive and respond to concerns from communities at country and regional levels.
ReplyDelete