What would the world look like if we could end AIDS as a public health threat by 2030?
What would it take? This is the issue that United Nations Member States debated in the General Assembly earlier this month in New York from June 8 to 10, 2021.
Just two weeks ago at the UN General Assembly Special Session during the High-Level Meeting on ending AIDS (HLM), UN Member States adopted the 2021 Political Declaration Ending inequalities and getting on track to end AIDS by 2030. The HLM consisted of plenary sessions and thematic panel discussions. The opening plenary meeting featured statements by the President of the General Assembly, the UN Secretary-General, the Executive Director of UNAIDS, and people openly living with HIV.
However, in a report of the Secretary-General, António Guterres, he states that, “Six years after the General Assembly set an ambitious global goal to end AIDS by 2030, momentum is being lost.”
Indigenous Peoples couldn’t agree more.
Throughout four decades living with HIV, Indigenous Peoples of the world have been left behind. We have never been silent, but who has heard our call for a coordinated global response to HIV with Indigenous Peoples, particularly one that is uniquely designed and centered on the Indigenous world view and understanding of life? Indigenous Peoples predicted that without a specific push to work with us, we would be the 10-10-10 left behind from the effort to achieve the 90-90-90 goals by 2020.
Indigenous Peoples advocated successfully to gain inclusion on the Multi-stakeholder Task Force (MSTF), made up of 16 members representing civil society and the private sector, to facilitate civil society involvement in the HLM. An Indigenous person also was included in the Advisory Group to the Task Force to support the Multi-stakeholder Task Force. And still, Indigenous Peoples were only mentioned twice, and briefly at that, in the Political Declaration.
UNAIDS, many experts, and countless activists have said that the world already has all the tools and knowledge needed to end AIDS. The missing ingredient is political will.
There were intense negotiations between UN Member States on several divisive issues. Sexual Orientation, Gender Identity and Expression (SOGIE), Sexual and Reproductive Health and Rights (SRHR) and Comprehensive Sexuality Education (CSE) were very contentious issues. At the end of the negotiations, none of this wording made it into the final text.
Using TRIPS flexibilities (of the World Trade Organization (WTO) Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS)) to increase access to HIV treatment was also very contentious. Resource rich nations where many pharmaceutical companies are based do not want to allow lower income countries to be able to produce generic antiretrovirals using their formulas and techniques that are still under patent protection.
While the 2021 Political Declaration builds on the one from 2016, we need more progressive actions to end AIDS as a public health threat by 2030. Indigenous Peoples will continue to insist that there is a seat at the table for their issues but much more needs to be done.
What is really needed is the creation of regional Indigenous HIV and AIDS working groups of experts. These regional working groups across the globe would provide oversight, guidance, and assistance on establishing epidemiologic baselines to inform global, regional, and country-level goals and targets. There must be robust commitment and accountability mechanisms to ensure that Indigenous Peoples do not continue to be left behind. Where are the allies fighting alongside Indigenous Peoples to create an equitable evidence-based response to HIV?