During the 50th Programme Coordinating Board meeting held in Geneva, Thailand announced formally funding community-led health services (CLHS) as public health services. The National Health Security Board of Thailand has approved HIV prevention, treatment, and care to be directly reimbursed by the Universal Health Coverage scheme.

“This is a key milestone for Thailand regarding sustainable community-led service delivery and sustainable financing for community-based organizations. It is a model for the region and countries globally,” said Winnie Byanyima, Executive Director of UNAIDS.

The role of community-led organizations in providing HIV services is well recognized as an essential component leading to ending AIDS by 2030. Using people-centered, rights-based and stigma-free approaches by and for key population community and people living with HIV has shown to lead to   an increased uptake of essential HIV services.

Since 2016, Thailand has started to fund project-based community-led HIV services through the Universal Health Coverage scheme. The allocation of the national budget has increased over time to support community-led organizations (CLO) working with people living with HIV and key populations.

However, until now, year-to-year contracting mechanisms led to operational gaps affecting the provision of HIV services. The formal recognition of community-led health services under the UHC scheme will allow for faster access to funding, continuity of service delivery, and increase CLOs capacity for greater coverage of HIV services. 

“To reach the ambitious goal of ending AIDS, we have partnered with community-based organizations who play a vital role in HIV service provision to hard-to-reach populations and marginalized communities,” said Anutin Charnvirakul, Deputy Prime Minister and Minister of Public Health of Thailand.

Organizations led by communities who are eligible to provide HIV and STI services in their communities can register as service providers under the National Health Security System. To get this recognition, they need at least one year of service experience and require an accreditation by the Ministry of Public Health or other certified bodies. Community health workers with relevant experience also have to be certified by a government agency or accredited organization.

The UNAIDS Thailand office has been working with different partners to support the scale-up of   community health workers' certification and other accreditations as well as strengthening the sustainability of the community response. 

In attendance at the 50th PCB were Dr Jadej Thammatacharee, Secretary General, National Health Security Office, Dr Opart Karnkawinpong, Director General, Department of Disease Control, Ministry of Public Health, Dr Suwit Wibulpolprasert, Advisor to the Office of the Permanent Secretary, Ministry of Public Health and the entire three day meeting was chaired by H.E. Mr Anutin Charnvirakul, Deputy Prime Minister and Minister of Public Health.

On 20 June during a signing ceremony at the City Hall, Oslo became the second Nordic city to join the Fast-Track Cities initiative by signing the Paris Declaration on cities ending the AIDS epidemic. 

Oslo is joining a network of over 400 cities and municipalities around the world who are working to drive forward locally the global goal of ending AIDS as a public health threat by 2030.

Over half of all people living with HIV in Norway live in Oslo, and it is also the city where most new infections in Norway are being diagnosed.

Robert Steen, Vice Mayor for Health, Ageing and Municipal Services in The City of Oslo, remarked:

“By signing this agreement, the City of Oslo acknowledges that to end the epidemic we need a holistic approach that provides everyone access to HIV prevention and life-saving and life-improving treatment, care and support services for HIV. It is not enough only to treat people for HIV if they still have poor health and quality of life. I am proud to say that the City of Oslo stands with cities around the world in the fight to eradicate this disease.”

The civil society organisation of people living with and affected by HIV in Norway, HIVNorge, advocated with the City Council in Oslo to become a part of the Fast-Track Cities initiative for more than three years, and are excited about the new partnership.

Addressing the event in the Oslo City Council, the Secretary General of HIVNorge Anne-Karin Kolstad said that “Stigma and self-stigma is a major problem for those among us who live with HIV in Oslo. It reduces the quality of life and makes people less able to protect themselves and others. We need new instruments to eliminate stigma for people who live with HIV.”

HIVNorge will encourage the city to assess and prepare a status report on the HIV epidemic and response in Oslo, which can form the basis for the city's multistakeholder strategy to achieve the goals and objectives of the Fast-Track Cities initiative. To adequately prioritise the HIV response, the city will first assess access and barriers to service uptake and provision, as well as measures supporting the HIV response under the auspices of both municipal and state actors together with non-governmental organisations.

The Fast-Track Cities initiative was launched in 2014 with support from four core partners: UNAIDS, the International Association of Providers of AIDS Care (IAPAC), UN-Habitat and the city of Paris. Signatories to the initiative commit to ending AIDS at the municipal level, through an accelerated HIV response, by providing leadership, putting people at the centre, addressing the causes of risk and vulnerability to HIV, using the AIDS response for positive social transformation, and mobilizing resources for integrated public health and sustainable development.    

As a core technical partner to the Fast-Track Cities initiative, IAPAC is supporting member cities and municipalities in their efforts to optimize equity-based, data-informed HIV responses. Having worked with local stakeholders to facilitate Oslo becoming a Fast-Track City, Tanja Dittfeld, IAPAC’s Regional Director for Europe will work with HIVNorge to develop and implement a strategy aimed at closing gaps in HIV testing, prevention, and treatment, as well as addressing HIV and intersectional stigma and discrimination.

“We warmly welcome Oslo as the second Nordic city to join the global network of Fast-Track Cities committed to ending their urban HIV epidemics by 2030,” said Dr. José M. Zuniga, President/CEO of IAPAC and the Fast-Track Cities Institute. “We look forward to working with Oslo’s political, public health, and community stakeholders to advance an equitable and inclusive HIV response that leaves no person behind as the city aims to attain Fast-Track Cities objectives and targets.”

Cooperation and exchanges of experience with other European cities, including increasing support to cities in Eastern Europe, is critical at this point. In addition to a lack of resources, stigma and discrimination are major barriers to preventing new HIV infections and ensuring people living with HIV can access treatment and quality care. 

 UNAIDS Executive Director Winnie Byanyima said

“We are at a critical time in the HIV response where  we need determined leadership from communities, CSOs, governments and the UN, together. The role of cities is key. With the brilliant facilitation by IAPAC, more and more cities are becoming Fast Track Cities. I congratulate Oslo and look forward to its engagement in the Fast-Track Cities initiative.  Well done HIVNorge for this success in Oslo joining. Communities are the drivers of bold action to end inequalities.”

One year after adopting a new Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, United Nation’s Member States have highlighted the need to work together to speed up progress on implementation.

In advance of the meeting, the UN Secretary General released a report entitled Tackling inequalities to end the AIDS pandemic on the implementation of the political declaration on HIV/AIDS. The report sets out how inequalities and insufficient investment “leave the world dangerously underprepared to confront the pandemics of today and tomorrow”

The AIDS pandemic is responsible for more than 13,000 deaths every week.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) data show that HIV infections and AIDS-related deaths are not currently declining fast enough to end the pandemic by 2030 as pledged.

The Secretary General’s report highlights solutions including (a) HIV prevention and societal enablers; (b) community-led responses; (c) equitable access to medicines, vaccines and health technologies; (d) sustainable financing for the AIDS response and wider pandemic prevention, preparedness and response; (e) people-centered data systems and (f) strengthening global partnerships.

The UN Secretary General’s statement to the General Assembly, delivered by Chef de Cabinet Courtenay Rattray, outlined three immediate steps to reverse current trends and get back on track. “First, we need to tackle intersecting inequalities, discrimination and the marginalization of entire communities, which are often exacerbated by punitive laws, policies and practices”. He called for policy reforms to reduce the HIV risks of marginalised communities including sex workers, people who inject drugs, prisoners, transgender people and gay men. He noted how stigma is obstructing public health: “Stigmatization hurts everyone. Social solidarity protects everyone”.

The second step is ensuring the sharing of health technologies, including long-acting antiretrovirals, to make them available to people in all countries of the world.

The third step is to increase the resources made available to tackle AIDS. “Investments in AIDS are investments in global health security. They save lives – and money.”

In his opening remarks, the President of the General Assembly, Mr. Abdulla Shahid, noted that “equal access to healthcare is an essential human right to guarantee public health, for all. No one is safe until we are all safe. Striving to achieve the 2025 AIDS targets is an opportunity to work together to increase investments towards public health systems and pandemic responses, and to draw on the hard-learnt lessons from the HIV/AIDS crisis for our recovery from COVID-19, and vice versa.”

Over 35 Member States and Observers made statements during the AIDS review, which included contributions on behalf of the Africa Group, the Caribbean Community and the Central American Integration System and the European Union.

Statements emphasised the urgency of stepping up collective action to get on track to meet the 2025 targets, and the importance of an inequalities lens to ensure a successful HIV response.

The President of the General Assembly, the Secretary General, the Africa group, the EU and several Member States stressed the importance of fully financing the HIV response and strengthening investment in Global Health.

The Africa Group, along with many others, spoke about addressing stigma and discriminatory laws which keep people from accessing health care and social services.

The debate made clear that the end of AIDS is possible, but only if countries worked together and were courageous in addressing inequalities. “The most important message today,” noted the Secretary General’s conclusion, “is that if we work together to tackle the inequalities that perpetuate HIV/AIDS, we can still end it as a public health threat by 2030.”

All said in under one minute. This is huge and unequivocal.
The Chef de Cabinet delivers to the UN General Assembly the urgent insistence from the UN Secretary-General that the technologies for new long-acting HIV medicines must be shared globally now. There is no time to lose. pic.twitter.com/t1DWlPsdB3

— Ben Phillips (@benphillips76) June 10, 2022

A poster exhibition entitled YES…BUT! highlights the disparities existing in the HIV response in eastern Europe and central Asia (EECA). Some posters display important key facts and figures on the progress made as well as the current gaps hindering progress in the region. Others focus on the impact that AIDS-related stigma and discrimination has on people living with HIV in eastern Europe and central Asia.

For example, one poster highlights that while all people living with HIV are eligible to start HIV treatment immediately regardless of their CD4 count, there has been a 32% increase in AIDS-related death in the region since 2010. Another one focuses on the fact that, even though HIV self-testing and free anonymous HIV testing are available and accessible in most countries, every second an HIV diagnosis is made late—and one in three is made very late.

Tahmina Khaidarova, Director of the Tajikistan Network of Women Living with HIV is convinced that one of the reasons for widespread late diagnosis and increased number of deaths is the stigma that continues to prevent people from accessing HIV testing. “I told my story to help women who live in a vicious cycle of stigma. Stigma makes us vulnerable. We must fight. And first of all, we fight our own fears.” says Mrs Khaidarova in one of the posters.

The EECA region has the fastest-growing HIV epidemic in the world. The war in Ukraine places under huge strain the hard-won gains made in recent years in the HIV response in the countries involved and in the entire region.  

“We must keep the HIV epidemic in the region in the spotlight and support the resilience of people, community-led organizations, and countries to ensure the AIDS response succeeds,” said Eamonn Murphy, Deputy Executive Director, Regional Director for Eastern Europe and central Asia a.i. 

The posters will be shown at the UNAIDS Regional Cluster Meeting for eastern Europe and central Asia to take place in Geneva, from 14 to 17 June 2022.

From the beginning of the COVID-19 pandemic, it was clear that life would be even more difficult for people living with HIV.  

“When experts identified how COVID-19 affected people, it was clear that people with compromised immune systems needed to get a heightened level of care and attention,” said Fardad Doroudi, the UNAIDS Country Director for the Islamic Republic of Iran. “We needed to be quick and agile to mobilize our resources and expertise to make sure that no person living with HIV was left behind.”

Throughout the multiple waves of COVID-19 in the country, UNAIDS has provided critical support to people living with and affected by HIV, providing personal protective equipment and medicines, supporting nongovernmental organizations with small grants to help communities, developing information, education and communication materials and developing a community-based monitoring and evaluation framework.

Personal protective equipment, such as masks, shields, gloves and sanitizer, is a key tool in preventing the spread of viruses such as the virus that causes COVID-19. UNAIDS provided 95 tonnes of personal protective equipment to the Ministry of Health and Medical Education and the State Welfare Organization to be distributed through HIV-related nongovernmental organizations. Items provided included 1.8 million face masks, 60 000 bottles of hand sanitizer and 40 000 boxes of latex gloves, among other equipment.

Multimonth dispensing, ensuring that people living with HIV who are on HIV treatment receive enough treatment to last several months in order to avoid frequent visits to health centres, is a key pillar of an HIV response in humanitarian crises and was at the centre of UNAIDS’ efforts during the pandemic in the Islamic Republic of Iran.

To ensure that people on HIV treatment received their life-saving medicines, UNAIDS procured and delivered more than 650 000 doses of Vonavir, which covered the needs of more than 7000 people living with HIV for nearly three months, and more than 520 000 doses of Truvada, which covered the needs of nearly 3000 people living with HIV for six months. The more than 10 000 people helped with treatment received their medicines through treatment centres across the country.

Ten nongovernmental organizations working on HIV were awarded 26 small grants to increase community engagement and help people living with HIV adapt to life during the COVID-19 pandemic, and reached more than 14 000 people. Some of the activities funded by the grants include income generation schemes, home-care services, online sales and commerce, mental health support, the development of e-learning platforms, the distribution of hygiene kits, food and medicines and holding virtual events and forums for awareness-raising and stress reduction.

UNAIDS also helped in creating impactful information, education and communication material to enhance knowledge and build awareness of the COVID-19 pandemic. In collaboration with the national AIDS programme, UNAIDS supported the production and dissemination of a series of animations by a local nongovernmental organization. The 16-minute animation series, split into three episodes, covers topics such as the basics of HIV in relation to COVID-19, prevention of the virus in the context of HIV, the importance of continuing HIV treatment and addressing stigma and discrimination. The videos were featured across a number of online channels and platforms, receiving more than 15 000 views to date.  

UNAIDS also developed and piloted a community-based monitoring and evaluation framework. This was born out of field monitoring activities carried out together with government partners and civil society organizations.

Online training sessions were organized for more than 200 people living with HIV and service providers. The sessions covered the basics of monitoring and evaluation of HIV-related COVID-19 programmes for nongovernmental organizations. The goal was to improve the effectiveness of monitoring and evaluation practices for HIV within the framework of the national strategic plan in order to improve the quality of HIV programmes in the country. 

“Relying on strong collaborations and partnerships was key for our fast response during a rapidly changing time,” said Mr Doroudi. “With the support of donors, a strong liaison with national counterparts and effective collaboration with other United Nations agencies, we managed to be a part of the overall support to people living with HIV, who had to deal with the health, social and economic challenges associated with the COVID-19 pandemic.”

UNAIDS’ response to COVID-19 in the Islamic Republic of Iran was funded by the European Union’s humanitarian aid budget and was facilitated in partnership with the United Nations Children’s Fund. The Islamic Republic of Iran’s Ministry of Health and Medical Education and the State Welfare Organization were the key governmental partners for the wide range of activities undertaken as part of the project.

On 25 November 2021, the city of Kryvyi Rih, the fourth largest city in Ukraine, signed the Paris Declaration to end the AIDS epidemic in cities. The city is an important economic and industrial centre, a major transport hub and the birthplace of the Ukrainian President, Volodymyr Zelensky.

A group created by the city administration to develop and implement the Paris Declaration determined the main areas of work, which included the expansion of HIV prevention services for key populations through community organizations and the scale-up of HIV testing through family doctors, among others.

Physicians across the city were trained in HIV, while Gennady Kruglenko, the chief doctor at the Kryvyi Rih municipal AIDS centre, visited Odesa and Dnipro to learn about their experience with implementing the Paris Declaration.

“We were seriously preparing to start this work,” said Mr Kruglenko. “But the war slowed down our plans. Our region borders the areas of active military operations, but our centre continues providing full-scale HIV services, and we are not going to stop. And we have not abandoned the main goal of the Paris Declaration: ending the AIDS epidemic.”

The Kryvyi Rih AIDS centre has been operating since 1994, and today there are about 10 000 people living with HIV accessing HIV treatment from it. People can get HIV treatment from five different sites, which makes it much easier for people living in different parts of Kryvyi Rih. Kryvyi Rih is the longest city in Europe, the length of which exceeds 120 km.

The AIDS centre continues to work as a reference laboratory for several regional centres. Its modern equipment allows the performance of all necessary tests, including diagnosis confirmation, CD4 counts, viral load and others, to be performed. People living with HIV with complex cases, for example opportunistic infections, that require the attention of experienced doctors are referred to the centre.

Marina Baidachenko, an infectious diseases doctor at the AIDS centre, says that the centre currently also provides services to people who have fled the war. “There are people who move within the country, who apply for services through a network of our social workers. The system in Ukraine is such that no matter where the patient is, he or she can receive treatment through the general system,” she said.

Each doctor providing specialized HIV care in Ukraine has access to the medical records of patients in a general electronic registry, with strict confidentiality measures in place. This ensures that the records of people living with HIV who move from one region to another can be accessed in the new region, thereby allowing the maximum number of displaced patients to remain on antiretroviral therapy, despite the war.

According to Ms Baidachenko, the war is felt every minute. “Air raids are very frequent, missiles are flying,” she said. The employees of the AIDS centre must go to the first floor or basement, which have been adapted as bomb shelters, every time the air raid siren sounds.

“To issue antiretroviral therapy to a person, you need to open his or her electronic card in the computer, create an electronic prescription through the registry and send it to the warehouse where the medicines are issued. When there are 200–300 patients in the centre, it’s hard to tell them to wait until the alarm is over,” said Ms Baidachenko.

With the help of a UNAIDS emergency grant, the centre equipped additional workplaces with laptop computers, office equipment and Wi-Fi. Now prescriptions take only minutes and doctors can move to a safe place when the siren sounds and take their computers and continue to serve people.

Close cooperation with community organizations, such as the Public Health Charity Foundation of Krivyi Rih, has become even more important during the war.

“Each of our doctors has about 2000 people on antiretroviral therapy. Now with the war, there are only two doctors left. They have to give a prescription, check the tests, explain the medical aspects—they simply don’t have time for other important issues, such as psychological support,” said Mr Kruglenko.

According to Alexander Lee, the Project Manager of the Public Health Charity Foundation, the war has changed the format and scope of the organization’s work. “Many of our clients were left alone with their problems and fears because family members left Ukraine. The response required increased mobility of the organization’s employees for consultations and assistance to clients in remote areas of the city,” he said.

Social workers are also helping to connect medical facilities with people who use drugs, gay men and other men who have sex with men and members of other communities, who have become even more vulnerable.

“Therefore, in the chain of services, everyone does a small, but very “big”, thing,” Mr Kruglenko added.

Raman Khailevich, the UNAIDS Country Director for Ukraine, emphasized that UNAIDS supports the city’s efforts to continue providing all HIV services in close cooperation with civil society organizations. “Such interaction in peacetime was one of the most important components of the successful AIDS response in Kryvyi Rih, and in wartime it is the only way not to lose what has been achieved but also to continue moving towards the goal of ending AIDS, saving every life,” he said.

On 17 May, people around the world came together to celebrate the International Day against Homophobia, Transphobia and Biphobia (IDAHOBIT) to champion inclusion and build a better world for the lesbian, gay, bisexual, transgender and intersex (LGBTI) community. In many countries, lack of adequate legal protection against discrimination on grounds of sexual orientation and gender identity exposes many LGBTI people to violations of their human rights. This is even more the case within the context of war and humanitarian crisis, as currently experienced in Ukraine.

UNAIDS and ILGA-Europe co-hosted an event, moderated by Cianán B. Russell, Senior Policy Officer, ILGA-Europe, to mark IDAHOBIT. The event brought together LGBTI representatives and a wide range of thought leaders, policymakers and practitioners.

The panellists highlighted the multiple vulnerabilities and challenges facing LGBTI people in and fleeing from Ukraine during the war. These vulnerabilities and challenges were clearly articulated by two LGBTI representatives.

“Levels of discrimination, violation of rights and hate crimes have risen in Ukraine since the start of the war. Meanwhile, no regulations or specific measures have been put in place in shelters to protect key populations. LGBTI people have no safety net since the war started,” said Olena Shevchenko, from Insight. “Go to local organizations and ask them what they need if you are intent on helping Ukraine. Ensure the accountability of humanitarian missions to fulfil the needs of the local community,” she added.

Tymur Lysenko, a Ukraine crisis consultant working for Transgender Europe, spoke about the essence of leaving no one behind, saying ““Leave no one behind” should work, not just be empty words. Trans people in Ukraine should be provided with humanitarian support, safe evacuation and access to medical care, and functioning gender recognition regulation procedures. Foster direct connections that are strong and sustainable between local organizations and international humanitarian missions. Stick to organizations that have a track record in providing direct support to LGBTI people.”

Reflecting on their own work and experiences, the panellists also reviewed the actions taken to date to protect the human rights of LGBTI people in and fleeing from Ukraine and the existing gaps within the humanitarian response and concluded with recommendations and commitment to better protect the human rights of LGBTI people staying in Ukraine or who have left.

“Humanitarian agencies must ensure that civil society organizations with expertise are included in the planning and implementation of all humanitarian assistance and in recovery efforts,” said Victor Madrigal-Borloz, a United Nations Independent Expert on Sexual Orientation and Gender Identity.

This was echoed by Kate Thomson, Head of the Community, Rights and Gender Department at the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), who referred to the need for all partners to work collectively to build back resilient health and community systems. “All partners to work together to support access to HIV services in Ukraine, including those led by LGBTI communities, inside Ukraine and abroad. Let’s work collectively to help Ukraine build back better its health and community systems,” she said.

Matthew Kavanagh, UNAIDS Deputy Executive Director, a.i., spoke about the importance of maintaining and increasing the funding for the AIDS response. “We stand with the Ukrainians who are fighting so hard to make sure that their responses—the AIDS response, the community response, the rights response, the LGBTI response—are not destroyed by the moment that we are in now. There is an urgent need to move funding towards that, and an urgent need to fund the Global Fund at the same time. We cannot choose between these two things or we will end up in a less safe world—we have to do both,” he said.

Joanna Darmanin, Head of the Humanitarian Aid Thematic Policies Unit, European Union Directorate-General for European Civil Protection and Humanitarian Aid Operations, reiterated the European Union’s commitment for an inclusive humanitarian response. “Supporting Ukraine and neighbouring countries remains the priority for the European Union, and we remain committed to providing humanitarian support in an inclusive manner, taking into account the specific needs and vulnerabilities faced by the LGBTI community,” she said.

This commitment was re-echoed by Katalin Cseh, Member of the European Parliament Committee on Foreign Affairs, who pledged to fight for inclusiveness of the LGBTI community. “I pledge to fight with all my means to ensure better consultation with the LGBTI communities on the ground in Ukraine and also within the European reception area.”

Maria Arena, Chair of the European Parliament Subcommittee on Human Rights, highlighted the need to position the humanitarian response to the needs of LGBTI people, saying, “The conflict zones are putting at risk people with these vulnerabilities, so we have to be really aware of the situation and to adapt our answers for the needs of these people, including with traceability of these funds.”

Marc Angel, Co-President of the European Parliament LGBTI Intergroup, emphasized the importance of ensuring that promises made correspond with funding. “Action and money must follow words and promises,” he said.

Valeriia Rachynska, from the Global Partnership against All Forms of HIV-Related Stigma and Discrimination, spoke about the Global Partnership’s commitment to fight for and save all lives, saying, “Our main target is to save and fight for life; we will do everything in our power to save the lives of LGBTI people in Ukraine.”

Indeed, to champion and build a better world for the LGBTI community, and to end inequalities for an effective AIDS response, especially in a humanitarian crisis context, institutional actors with differing responsibilities must ensure that no one is left behind. This among others, includes directed action to: combat discrimination targeting LGBTI people and people living with HIV, rebuild or reinforce the HIV response system, meaningfully engage LGBTI civil society both in crisis planning and in crisis response systems, ensure that LGBTI-led humanitarian efforts are adequately resourced and ensure that human rights violations faced by LGBTI people are documented, investigated and result in access to justice. 

As part of the Education Plus initiative, young women advocates in Senegal have met with key female figures in the region to discuss the education of girls in sub-Saharan Africa and the challenges they face.

A social work student in her second year of professional training said young women like her who are living with HIV still face stigma and economic marginalization in most spheres of life “Sometimes, the medicines are not in stock, and young women living with HIV often have to share their medication with each other while waiting for a new supply.” According to her, education guarantees a better future for young people, as it did for her in helping her to overcome the challenges she faces because of her HIV status and her difficult upbringing.

Another participant, Maah Koudia Keita (known as Lady Maah Keita), a Senegalese woman with albinism, and a musician, said that women with albinism are victims of harassment and the majority of them have experienced rape and sexual violence.

She is one of three professional female bass players in Africa and the only one in Senegal. She said, “People like me who were lucky to get an education now have to do the work of dispelling myths around women with albinism that drive the violence.” According to Ms Keita, the more educated and aware the community is, the better women and people with albinism can defend themselves.

Adama Pouye, a feminist activist and member of the Senegalese feminist collective that led the Buul Ma Risu (Don’t Mess with Me) movement, spoke at length during the meeting about raising awareness on sexual assault on public transport.

“Every day, you hear violent words and women come to believe that’s what they deserve,” she said. “You are told how far you can go by standards put in place by a patriarchal society, by men, and by religious standards, but our religious interpretations cannot be about oppressing women,” Ms Pouye said.

Young women are key advocates who the Education Plus initiative is working with to rally political leadership, development partners and communities in order to fulfil every adolescent girl’s right to education and health by enabling all girls to complete a quality secondary education in a violence-free environment.

As UNAIDS Executive Director Winnie Byanyima stressed at the meeting, “In this region of western and central Africa, the vulnerability of girls is high.”

She also said that four out of 10 young women are married before the age of 18 years, saying that children becoming brides is a gross violation and a failure to harness the full potential of girls.

“Keeping girls in a classroom, if she stays and completes secondary school, has a protective effect for girls from HIV. What we fought and won for primary school is what is needed for secondary education,” Ms Byanyima said.

Fatou Nar Mbaye Diouf, the Deputy Executive Secretary of the National AIDS Council, Senegal, could not agree more. “We know that allowing girls to complete secondary education protects them from HIV and improves many other health and development factors,” she said.

Sharing key data from Senegal, Ms Nar said the level of comprehensive knowledge about HIV increases with the level of education. “Among young women, it is 10% among those with no education and 41% among those with secondary education or higher, while among young men knowledge of HIV varies from 9% among those with no education to 51% with education,” she said. “Education is key.”

The Regional Director for West and Central Africa for UN Women, Oulimata Sarr, concluded the intergenerational dialogue by saying that girls’ education is not a threat, nor should it be seen as that. “We want to move the needle and move it together with young women,” she said.

Ms Sarr wants the next generation to be supported as they seek more space in decision-making. “We need to pass the baton to young people, who organize differently from us, create an intergenerational legacy with young people holding us to account.”

Iranilde Pereira Fonseca and Michele Almeida are two middle-aged women who come from different parts of Brazil but share a common childhood memory: they used to collect scraps of cloth to make dresses for the few dolls they had. It was a way to revive their handmade toys since their families rarely had spare money for new ones.

But it was not until the COVID-19 pandemic that they had the opportunity to reconnect with their past and use it as a source of survival and income. They are among the 35 women who participated in the Mulher Empreendedora (Women Entrepreneur) project, a social entrepreneurship project implemented by the Movimento Nacional das Cidadãs Posithivas (MNCP) Brazilian HIV nongovernmental organization as a part of the UNAIDS Solidarity Fund. Along with Ms Fonseca and Ms Almeida, they were trained in artisanal doll techniques and in entrepreneurship, so that they could sell their products and obtain resources to address the impact of COVID-19 on their household incomes.

“I used to get scraps of cloth from my mother and loved to make clothes for the dolls I had, but I had not done any of that for many years,” remembered Ms Fonseca. “Now, with the MNCP project, I learned the process of making a doll completely from scratch. With the isolation imposed by COVID-19, it was important to be able to connect, even if only virtually, with women from various parts of Brazil and exchange ideas and experiences through this initiative.”

Of the initial group, 28 women are already selling their handmade dolls independently. The initiative was funded by the Solidarity Fund, launched in 2020 by UNAIDS to support entrepreneurship activities led by people living with HIV and key populations.

Ms Almeida agrees on the importance of connection and mutual support. “I really enjoyed meeting and interacting with the group of women participating in this project. In addition to reconnecting with my origins and my childhood, the techniques I learned helped me to develop a product that people enjoy. I sell my dolls to relatives and friends and through social networks,” she said.

The initiative emerged from the realization that the COVID-19 pandemic had a disproportionate impact on women. The pandemic has especially affected the service sector, such as hospitality, food, beauty and domestic services, for which the majority of the workforce is female. In 2020, the absence of jobs in those areas reduced the active participation of women in the workforce in Brazil to less than 45%.

“The project was extremely important for women living with HIV, as many of them were unable to access the job market, lived with an overload of domestic work, experienced situations of violence and had to deal with the interruption of specialized health services,” said Fabiana Oliveira, the MNCP Secretary of Communication and Technical Coordinator of Mulher Empreendedora.

Claudia Velasquez, the UNAIDS Country Director for Brazil, highlighted that the Solidarity Fund’s support to MNCP is in line with the strategic vision of putting people and communities at the centre of the HIV response while building sustainable income-generating mechanisms. “This approach is particularly important for the most vulnerable populations, such as these women living with HIV served by the MNCP, who have strongly felt the drop in income caused by the COVID-19 pandemic. Providing these women with their own access to financial resources and financial security ends up having a positive impact on their adherence and permanence in the HIV monitoring and treatment processes,” she said.

Ms Oliveira highlighted that Mulher Empreendedora had created an opportunity for participants to restructure and rewrite their personal stories. “Rag dolls have this power to stimulate imagination and creativity and even offer the equivalence of a real hug,” she said.