Cities

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.

Implementation of the joint UNAIDS–International Association of Providers of AIDS Care (IAPAC) Fast-Track cities project started in 2018 under the management of UNAIDS and IAPAC, with financial support from the United States Agency for International Development. Recognizing the important role that cities play in achieving national and global HIV targets and in ending AIDS by 2030, the project aims to provide essential and strategic technical support to 15 high-burden cities to accelerate their HIV responses. The 15 cities (Blantyre, eThekwini, Jakarta, Johannesburg, Kampala, Kigali, Kingston, Kinshasa, Kyiv, Lagos, Lusaka, Maputo, Nairobi, Windhoek and Yaoundé) account for about 3 million people living with HIV. The project is implemented in close collaboration with local governments and stakeholders and takes into account the local contexts, epidemics and priorities. Technical support is provided for the development and implementation of city HIV strategic plans, creating an enabling environment for optimized HIV service delivery, strengthening data collection, analysis and use and building clinician and community capacity to facilitate service optimization and to eliminate stigma in health-care facilities.

Implementation over the past four years has achieved important results and led to significant changes at the city level. With the sustained support and commitment of mayors and city leaders, the project has catalysed action at various levels. Improved coordination, strengthened partnerships, civil society engagement and innovation to reach key and vulnerable populations have led to an increased uptake of HIV services, and cities have showed leadership during the COVID-19 pandemic to ensure that services continued to be delivered. Improved strategic information and monitoring and evaluation systems are now allowing cities to track the HIV response and to report on their epidemics. Close to 10 000 people have been reached with IAPAC-led training activities.

During a recent UNAIDS webinar, UNAIDS country staff providing support to four of the participating cities shared some of their experiences.

The city of Kingston, Jamaica, home to 35% of all people living with HIV in the country, is implementing activities to address some of the remaining challenges related to laws and policies that have affected society.

“One of the routes that we have taken through the Fast-Track cities project is to work more closely at the community level, as this is where we see the biggest challenge related to stigma and discrimination,” said Ruben Pages Ramos, UNAIDS Community Support Adviser for Jamaica.

In an attempt to address stigma, UNAIDS, in partnership with the Jamaica Network of People Living with HIV, initiated stigma-free spaces to sensitize the public and to ensure that places of business, health, education, justice, entertainment and worship are respectful, inclusive and transformative. Kingston municipality has been declared as the first stigma-free space in Jamaica and the mayor is committed to make Kingston a stigma-free city.

In eThekwini (Durban), South Africa, the National Association of Child Care Workers was contracted as part of a community project to support children and young people in Inanda, the largest township in Durban. The main objective was to reach children and young people with HIV services, ensuring that people living with HIV remain in care, and to address stigma in the community.

“This catalytic project achieved amazing results, and if taken to scale we could do amazing things,” said Miriam Chipimo, UNAIDS Fast-Track Adviser, South Africa.

Key results during a short, five-month, period of implementation included the initiation of four community action groups for young people to provide counselling and behaviour change communication support, reaching close to 2500 young people with HIV testing services (with people who are HIV-positive initiated on antiretroviral therapy), while close to 2000 community members were reached with anti-stigma messages on HIV, tuberculosis and COVID-19.

Through the mayor’s office and the department of health, key stakeholder engagement and linkages to United States President’s Emergency Plan for AIDS Relief and community-based organization activities in Inanda were also supported.

In Lusaka City, Zambia, the Fast-Track cities project has been catalytic in strengthening the coordination mechanisms for a multisectoral approach to the HIV response in the city. Lusaka has established a Project Technical Committee with representation from the District HIV and AIDS Committee, the District Medical Team, civil society, HIV implementing partners, networks of people living with HIV and the Key Population Consortium.

“Given the legal environment in Zambia, it’s very difficult to bring the lesbian, gay, bisexual, transgender and intersex and sex worker communities to the table, but under the Lusaka City Fast-Track project they have been brought together and they engage with civic leaders, the management teams and various stakeholders,” said Kenneth Mwansa, UNAIDS Community Support Adviser for Zambia.

Recognizing the need for innovative approaches to reach populations at higher risk of HIV, Lusaka City has also established and capacitated an Innovations Team, with representation from sex workers, lesbian, gay, bisexual, transgender and intersex people, people living with HIV and adolescent and young women organizations.

Linked to the development of a five-year strategic action plan to guide the city’s HIV response, a functional monitoring and evaluation unit was established, for the first time in the city, to coordinate HIV data collection at the district level and to better monitor the HIV epidemic and response.

Coordination of the HIV response in Kampala, Uganda, has improved owing to the full functionality and involvement of the Division AIDS Committee, while strong partnerships have been built with the Kampala Capital City Authorities (KCCA) and the Alliance for Mayors and Municipal Leaders on AIDS in Africa.

As part of the activities to reach and engage key populations and young people in Kampala, maps were produced on key population-friendly HIV services within the city, and a mobile app was launched in 2021 to increase the uptake of HIV prevention and treatment services among key and vulnerable populations. KCCA staff and key population representatives participated in the development of the app and were trained in its use. The app is hosted on the official city website to ensure sustainability. “In addition to the mapping of services, the app includes a section on recommendations and review of services. It also provides information by type of services, such as pre-exposure prophylaxis, for example,” said Tseday Alemseged, from the UNAIDS Country Office for Uganda.

Additionally, activities are ongoing in Kampala to sensitize the community around HIV prevention, vulnerability to severe COVID-19, equity and stigma and discrimination.

Good practices and strategic information from the other participating cities are being published on the Fast-Track cities interactive map, available at https://fasttrackcitiesmap.unaids.org/.

The project will continue until mid-2023. Lessons learned from the project will be used to inform the development of an action framework to guide and support the HIV response in urban settings, in line with the Global AIDS Strategy 2021–2026: End Inequalities, End AIDS.

A resolution calling on the Kingston and Saint Andrew Municipal Corporation to declare World AIDS Day as a commemorative day for the City of Kingston, received unanimous approval by the City’s Councilors today.

The resolution, which reaffirms Jamaica’s commitment with the Sustainable Development Goals, the Fast Track City Initiative, and the 2021 Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030, resolves that on December 1^st of every year, the City of Kingston, in partnership with the public and private sector and affected communities, will commemorate World AIDS Day.

The Mayor of Kingston, Senator Councilor Delroy Williams lauded the resolution as an important step towards transforming Kingston into a stigma-free city. “This resolution stems from a commitment by the Municipality to keep contributing to the end of AIDS, which will only be possible if we effectively tackle the root causes, including stigma, discrimination, and violence that put Jamaicans at risk of acquiring HIV and not adhering to their medications”, stated Mayor Williams.  

Acknowledging that “ending discrimination, stigma and marginalization will result in more persons getting tested, accessing treatment and reducing HIV in the municipality”, the resolution further resolves that “events be held each year within the Municipality of Kingston and St Andrew to raise awareness and to end discrimination, stigma, and HIV related violence”.

According to Jamaica’s latest People Living with HIV Stigma Index, launched in 2020, a third of people living with HIV have experienced at least one form of stigma and/or discrimination due to their HIV status in the last 12 months. Furthermore, more than half of the participants reported experiencing self-stigma, and the majority expressed that they find it difficult to tell others about their HIV status.

“Strong partnerships and commitments from local governments are critical to enhance our efforts to end discrimination. As we continue to work towards an equitable and enabling Jamaica for our brothers and sisters living with HIV who continue to be marginalized, I am heartened and welcome this move by the Municipality, led by the Mayor. The passing of this declaration brings awareness and local buy-in,” stated Jumoke Patrick, Executive Director of JN+.

Manoela Manova, UNAIDS Country Director, highlighted these commitments are a step in the right direction. “We have a lot of work to do to end inequalities, discrimination, and AIDS. The commitment shown by the Municipality and the Councilors, through the passing of this resolution, are both a gesture of solidarity and leadership that must be nurtured and replicated across all levels of government.”  

The Bangkok Metropolitan Administration (BMA) in Thailand has been awarded the inaugural Circle of Excellence Award at the Fast-Track cities 2021 conference, held recently in Lisbon, Portugal. The Circle of Excellence Award showcases outstanding work in fast-tracking the HIV response and advancing innovative programming to end the AIDS epidemic in cities by 2030.

“To receive the Circle of Excellence Award for Bangkok is a great honour. It demonstrates not only the past achievements but, moreover, the future commitment to accelerate the HIV response and towards ending AIDS in Bangkok. We are proud that innovations have produced remarkable results, particularly same-day antiretroviral therapy and key population-led health services, such as specialized and holistic services for transgender people and the scale-up of pre-exposure prophylaxis (PrEP) programmes. These innovations are not only applied in Bangkok but have become models for the region,” said Parnrudee Manomaipiboon, the Director-General of the Department of Health, BMA, during the award ceremony.

Organized by the International Association of Providers of AIDS Care, in collaboration with UNAIDS, the Fast-Track Cities Institute and other partners, the Fast-Track cities conference highlighted successes achieved across the Fast-Track cities network, addressed cross-cutting challenges faced by local stakeholders and shared best practices in accelerating urban HIV, tuberculosis and hepatitis B and C responses.

“Bangkok has put in place a 14-year strategic plan for ending AIDS from 2017 to 2030, which is under the leadership of the Bangkok Fast-Track Committee,” said Pavinee Rungthonkij, the Deputy Director-General, Health Department, BMA. “During COVID-19, BMA and partners have introduced innovations such as multimonth antiretroviral therapy, an express delivery of antiretroviral therapy service, sexually transmitted infection self-sampling and PrEP,” she added. Among other achievements, Bangkok has expanded its PrEP services to 16 municipal public health centres and eight city hospitals and implemented citywide awareness campaigns. PrEP in the City was the first citywide PrEP campaign focusing on transgender people in Asia.

“Significant progress has been made in the HIV response since Bangkok joined the Paris Declaration to end the AIDS epidemic in cities in 2014. It shows that mutual commitments and a strengthened partnership between stakeholders at all levels are key to an effective HIV response. Bangkok will continue to leverage support, scale up innovations and Fast-Track solutions to achieve the 2025 targets and end AIDS by 2030,” said Patchara Benjarattanaporn, the UNAIDS Country Director for Thailand.

Fast-Track cities in South-East Asia have been stepping up efforts during the COVID-19 pandemic to ensure that HIV treatment and prevention services remain unaffected by the pandemic and to protect the gains made in the HIV response. The dynamic city-based infrastructures that have been built up around the HIV response are being leveraged to implement innovative programmes to safeguard people living with HIV and other vulnerable populations and contain the spread of COVID-19.

Jakarta, Indonesia, provides a clear example of how cities are accelerating their HIV responses, enabling continued progress while taking into account the effects of the COVID-19 pandemic. Since the first COVID-19 outbreak, Central Jakarta, with more than 10 000 people living with HIV on antiretroviral therapy, ensured treatment continuity with the implementation of multimonth antiretroviral therapy dispensing and community-led home-based delivery. In collaboration with partners, the Provincial Health Office of Jakarta developed the Jak-Anter service, which connects people living with HIV with health facilities across the metropolitan area, allowing for direct client-organized antiretroviral therapy delivery, benefiting nearly 30% of people living with HIV in the area.

This best practice was shared at an event, ASEAN Cities Getting to Zero: Protecting Fast-Track Cities’ Gains during the COVID-19 Pandemic, which brought together five cities from the Association of Southeast Asian Nations (ASEAN) on the margins of the Fast-Track cities 2021 hybrid conference in Lisbon, Portugal, on 21 October.

“Cities play a critical role in delivering on the United Nations Political Declaration on AIDS. As we make our collective steps towards the next phase of achieving the three zeroes, we must work in partnership to address the variety and complexity of HIV epidemics. Evidence-informed national regulations will ensure effective collaboration between national and subnational governments,” said Budi Gunadi Sadikin, the Minister of Health of Indonesia.

The event allowed ASEAN cities to share innovative practices in implementing HIV programmes amid the COVID-19 pandemic.

“ASEAN is committed to fast-tracking the HIV response to end AIDS by 2030. We must continue to work hand in hand and to ensure equitable access to HIV services and solutions, break down barriers and improve resource mobilization for efficient and sustainable HIV responses,” said Dato Lim Jock Hoi, the Secretary-General of ASEAN.

A recurring theme during the session was how quickly ASEAN cities utilized virtual platforms to scale up access to HIV services, especially during lockdowns. In the Philippines, Pasig City delivered quality services to key populations by increasing investments in HIV programmes and treatment facilities and the use of virtual platforms. Like Jakarta, Pasig City partnered with community-based organizations to deliver antiretroviral therapy, condoms and lubricants by establishing a service delivery network with service providers and health facilities to provide core packages of health-care services during the COVID-19 pandemic.

Can Tho, a city in Viet Nam, piloted a project to deliver self-test kits to key populations, in particular gay men and other men who have sex with men and people who use drugs, through virtual platforms. In collaboration with the World Health Organization and civil society partners, Can Tho quickly responded to COVID-19 by training community outreach workers to conduct community-based HIV rapid testing and by scaling up HIV self-testing.

Bangkok’s innovations included same-day delivery of antiretroviral therapy and the scale-up of key population-led health services. Bangkok, a regional leader in pre-exposure prophylaxis (PrEP) and a provider of specialized and holistic services for transgender people, expanded its PrEP services to 16 municipal public health centres and eight city hospitals during the COVID-19 pandemic.

Young people were noted as being at the forefront of the HIV response in ASEAN cities. In an effort to reduce the number of new HIV infections among young people in Langkawi, Malaysia, the Kedah State Health Department established the GLITZ project. The programme focuses on young people, including young key populations, through various outreach activities, mentor–mentee programmes and school and university visits to educate young people on HIV prevention. 

As the Fast-Track cities network continues to grow in the ASEAN region, the complexity of HIV in urban areas is better understood. The network offers a way for cities to share best practices and experiences at a time of increasing urbanization and globalization.

“It has been 10 years since the ASEAN Cities Getting to Zero project was initiated. Since then, the project has successfully expanded to 76 cities in the region. As we see more participating cities and significant signs of progress in the HIV response, I encourage avenues for South–South collaboration. Together, in partnership, we can end AIDS as a global health threat by 2030,” said Taoufik Bakkali, the Director, a.i., of the UNAIDS Regional Support Team for Asia and the Pacific.

UNAIDS fully backs calls made today by an eminent group of United Nations experts that Ghana should reject a proposed “family values bill” that targets the country’s lesbian, gay, bisexual, transgender and intersex community.

After analyzing the draft legislation, the independent experts appointed by the United Nations Human Rights Council concluded that adopting the legislation in its current or any partial form would be tantamount to a violation of a number of human rights standards, including the absolute prohibition of torture.

The experts said that the proposed law seeks to establish a system of State-sponsored discrimination and violence against the LGBTI community.

UNAIDS has already called for the law to be rejected as a gross violation of human rights. It has also warned that the legislation would be a grave setback for the HIV response in driving vulnerable people further away from essential HIV treatment, care and prevention services.

Ghana: Anti-LGBTI draft bill a “recipe for violence” – UN experts 

GENEVA, 12 August 2021 — UN human rights experts* urged Ghana’s Government to reject a proposed ‘family values’ bill, saying it seeks to establish a system of State-sponsored discrimination and violence against the LGBTI community. The first reading of the bill took place on 2 August 2021, and its consideration is expected to resume in October 2021.  

“The draft legislation argues that any person who deviates from an arbitrary standard of sexual orientation or gender identity is immediately to be considered dangerous, sick or anti-social,” said the experts. “Such laws are a textbook example of discrimination. 

“The proposed law promotes deeply harmful practices that amount to ill-treatment and are conducive to torture, such as so-called ‘conversion therapy’ and other heinous violations like unecessary medical procedures on intersex children, and so-called corrective rape for women,” they added. 

The independent experts, appointed by the Human Rights Council, presented an analysis of the draft bill to the Ghanaian Government, concluding that adopting the legislation in its current or any partial form would be tantamount to a violation of a number of human rights standards, including the absolute prohibition of torture.

For example, attempts to prevent human rights defenders from organising themselves to defend LGBTI people, and the absolute prohibition of public debate on sexual orientation and gender identity, raises grave concerns about rights to freedom of opinion and expression, and of association. Moreover, the bill in question would essentially legitimize the above instances of violence against LBTI women and reinforce existing gender stereotypes and discrimination against women, which are both cause and consequence of violence against women and girls.

“The consideration of this legislation is deeply perplexing in a country that has been regarded as a champion of democracy in Africa, with an impressive record of achieving certain Millennium Development Goals by 2015,” they said. They cited specific concerns about the MDG goals on health, education, employment, housing and gender justice. 

“The draft legislation appears to be the result of a deep loathing toward the LGBTI community. It will not only criminalise LGBTI people, but anyone who supports their human rights, shows sympathy to them or is even remotely associated with them.

“Given that LGBTI people are present in every family and every community it is not very difficult to imagine how, if it were to be adopted, this legislation could create a recipe for conflict and violence.” 

ENDS

*The experts: Victor Madrigal-Borloz, Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity; Reem Alsalem, Special Rapporteur on violence against women, its causes and consequences; Koumbou Boly Barry, Special Rapporteur on the right to education; Irene Khan; Special Rapporteur on the promotion and protection of the right to freedom of expression; Mary Lawlor, Special Rapporteur on the situation of human rights defenders; Nils Melzer, Special Rapporteur on Torture and other Cruel, Inhuman or Degrading Treatment or Punishment; Tlaleng Mofokeng, Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health; Elina Steinerte (Chair-Rapporteur), Miriam Estrada-Castillo (Vice-chairperson), Leigh Toomey, Mumba Malila, Priya Gopalan, Working Group on arbitrary detention Clément Nyaletsossi Voule, Special Rapporteur on Rights to Freedom of Peaceful Assembly and Association

The Special Rapporteurs, Independent Experts and Working Groups are part of what is known as the Special Procedures of the Human Rights Council. Special Procedures, the largest body of independent experts in the UN Human Rights system, is the general name of the Council's independent fact-finding and monitoring mechanisms that address either specific country situations or thematic issues in all parts of the world. Special Procedures' experts work on a voluntary basis; they are not UN staff and do not receive a salary for their work. They are independent from any government or organization and serve in their individual capacity.

UN Human Rights, country page: Ghana

For more information and media requests please contact Catherine de Preux De Baets (+41 22 917 93 27/ cdepreuxdebaets@ohchr.org) or write to ie-sogi@ohchr.org

For media enquiries regarding other UN independent experts, please contact Renato de Souza (+41 22 928 9855 / rrosariodesouza@ohchr.org).

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Mayors from four cities, together with a representative of civil society and the core partners of the Fast-Track cities initiative—UNAIDS, the International Association of Providers of AIDS Care (IAPAC), the United Nations Human Settlements Programme (UN-Habitat) and the city of Paris—participated in a virtual side event on urban settings on 10 June, held during the United Nations High-Level Meeting on AIDS.

The participants reflected on the progress made in urban HIV responses and disruptions related to COVID-19, the importance of sustained political leadership and commitment during public health crises and the critical role of communities in strengthening HIV and other health services.

“A Fast-Track city is a city embracing human rights and advocating for more equality and freedom. The freedom to be true to yourself, to live where you want, to live free of prejudice, and with equal chance to stay healthy,” said the Mayor of Paris, Anne Hidalgo, in her opening address.

In her message, Maimunah Mohd Sharif, the Executive Director of UN‐Habitat, highlighted that, “Reducing inequalities is central to both UN-Habitat’s mission broadly and to ending urban HIV epidemics given the unacceptable disparities we see with respect to HIV among sexual and ethnic minorities, including the LGBTQ+ populations, migrants and refugees, and other marginalized populations, such as those in slums and informal settlements.”

Sibongile Tshabalala, the national Chairperson of the Treatment Action Campaign in South Africa, emphasized the importance of community leadership if we want to end AIDS, and called for communities to be at the centre of the HIV response within the context of ending social marginalization and health inequalities.

Attending mayors from Baton Rouge, Johannesburg, Kyiv and Quezon City presented their experiences in exercising public health leadership in HIV responses at the city level and in mitigating the impact of the COVID-19 pandemic. Many cities have made significant progress in accelerating their urban HIV responses since the beginning of the Fast-Track cities initiative on World AIDS Day 2014. In Kyiv, for example, according to national data the percentage of people who know their HIV status and are on antiretroviral therapy rose from less than 50% in 2015 to 83% in 2019, with 95% of those being virally suppressed. In Paris, according to national data the number of new HIV infections dropped by 16% between 2015 and 2018. And in Johannesburg, a targeted testing approach during the COVID-19 pandemic led to an increase in the percentage of people living with HIV knowing their status, from 86% in March 2020 to 91% in 2021, according to national data.

Maria Josefina Belmonte, the Mayor of Quezon City, called on mayors to use the “Power and resources at their disposal towards the common good, including eradicating HIV and addressing issues that others are afraid to address because they are controversial or they may not be acceptable or not be politically sound.” She added that, “It is every person’s right to live freely, humanely and justly in the world they were born in and it is our duty as mayors elected by the people to make that happen for them.”

The moderator of the event, IAPAC President/Chief Executive Officer José M. Zuniga, recognized the progress made by Fast-Track cities, even within the context of the COVID-19 pandemic. “City public health leadership is translating into countless lives saved and enhanced, including as Fast-Track cities grapple with an emerging COVID-19 pandemic and simultaneously work to maintain a continuity of HIV and other essential health services for all of their citizens,” he said.

In many cities, the 90–90–90 targets for 2020 were not achieved, partly because of COVID-19-related disruptions, but also due to persistent inequalities and social exclusion. A prioritization of social enablers is therefore required to regain momentum against HIV across the Fast-Track cities network.

In her closing statement, Winnie Byanyima, the UNAIDS Executive Director, called on cities and municipalities around the world to recommit to accelerated urban HIV responses, to exercise public health leadership to achieve the 2025 targets, to end inequalities and social exclusion and to end AIDS as a public health threat by 2030.