Xavier Biggs, incoming Latin America and the Caribbean Delegate
The 51st PCB meeting took place from 13 to 16 December in Chiang Mai and was the first in 14 years to happen outside of Geneva. It was hosted by the Government of Thailand in their capacity as the current chair of the PCB. Ahead of the formal meeting, the Thai Government invited the PCB members to participate in a number of field visits to HIV programmes and facilities in and around Chiang Mai.
The meeting itself was in a hybrid format and stretched out over 4 half days. It could only be attended in person by members of the PCB and their delegations. Observer Member States and NGO Observers could only participate virtually through a secured platform. Therefore direct contact between the Delegation and NGO Observers during and after meetings was difficult.
The 51st PCB meeting focused primarily on the need to close major identified gaps in HIV programming, the UNAIDS funding crisis and the need for a fully funded UBRAF if we are to actively advance the cause of ending the AIDS epidemic.
Seven key agenda items were posited and the NGO delegation made interventions for each one in a bid to ensure that the voice for key and marginalised communities was aptly represented.
The chair called on the Member States to arrive at consensus on the way forward and to give their commitments to increased (or continued) funding as needed and to improve the situations of those affected by HIV.
Report by the Executive Director
Jumoke Patrick, Latin America and the Caribbean Delegate
The report of the Executive Director Winnie Byanyima focused on the equalising and sustaining of various connecting issues affecting the global HIV response e.g., the increasing human rights barriers and violations, the equalising issues for women and girls, for children, for key populations, and equalising access to scientific advances in HIV etc.
Her report shared extensively the utilisation of funds and resources of UNAIDS to support and work on behalf of national HIV response planning and implementation in countries. The executive director emphasised also the importance of keeping the ending of aids high on national political agendas through constant dialogue and technical support but, more importantly country ownership and robust dialogue with all stakeholders, including communities.
Winnie gave a breakdown of the financial outlook of UNAIDS following up on the 50th PCB meeting and provided updates and information on strategic decisions on this matter. She shared that the top ten donors have maintained their level of funding and the USA, Netherlands, Germany and Australia and other partners have all increased their financial commitment to UNAIDS.
The NGO Delegation’s intervention for this report focused on meaningful partnerships with all UN agencies of the Joint Programme, Member States and communities for better results and to improve UNAIDS’ financial situation. Critical to this intervention was for communities affected by HIV to be dignified, respected, and acknowledged for who they are and not be assigned labels for stigmatisation and criminalisation which continues to be the bane of our existence as people living with and affected by HIV.
Report by the NGO Representative
Christian Hui, North America Delegate
The NGO report was one of the more contentious agenda items at the meeting. The report stands to further promote the science and untapped potential of U=U following the inclusion of U=U in the 2021 Political Declaration on HIV/AIDS.
While the Joint Programme and a majority of the Member States welcomed the recommendations put forth by the report, including Kenya, Canada, China, Germany, the Netherlands, Thailand, UK and US, a small number of Member States, such as the Russian Federation expressed reservations about the validity of the science of U=U, and as a result had proposed for the deletion of a majority of the report’s original proposed decision points. Meanwhile, Member States such as Cameroon made an intervention that called for the support of local production of generic ARVs to support the realisation of U=U within the African context.
After consulting multiple stakeholders, the Delegation presented a set of condensed decision points. Amidst the heated debates in the drafting room, the science of U=U was substantiated with confidence by the WHO. The negotiation process had not led to consensus by all Member States in the drafting room. On the last day of the PCB the Russian Federation requested to have a footnote added to the Decision Points to express their disassociation of the report. Due to an ambivalent translation of this request by the interpreter it first appeared as to be a mere request to express concerns on the report.
Civil Society interventions included those by MPACT which reiterated the importance that the implementation of U=U should not create a viral divide between those who are able to achieve viral suppression and those who are not. This framing would ensure decriminalisation efforts for people living with HIV would continue to advance not based on one’s viral suppression or undetectability, and that all seropositive people would not be subjected to laws that violate the human rights of people living with HIV.
Agenda item 2:
Follow-up to the thematic segment from the 50th PCB meeting
Midnight Poonkasetwattana, Asia and Pacific Delegate
The report of the thematic segment of the 50th PCB came with an extensive set of decision points trying to push the boundaries on several contentious topics. The goal of the NGO Delegation was to ensure that CSE, SRHR and gender remain visible in the decision points, and they were expanded to include sexual and gender-based violence (rather than just violence), and to also have data disaggregated by sex and gender.
It took a long time to come to an agreement during the negotiation process, ultimately with some language changes that unfortunately did not meet all the goals the NGO Delegation had set out to reach:
comprehensive education and information, relevant to cultural contexts, on sexual and reproductive health and HIV prevention, or comprehensive sexuality education, as set out in the Global AIDS Strategy.
sexual and reproductive health and rights, and reproductive health
data collection disaggregated by sex and other relevant population characteristics to better understand educational participation, progression and learning, and use gender-sensitive data for policymaking and planning while recognizing national capacity
The main addition to the decision points was a footnote on the definition of key populations as defined on page 8 of the Global AIDS Strategy 2021-2026.
The NGO Delegation’s intervention remarked that recommendations from the 50th Thematic Segment are also relevant for the 51st Thematic Segment as well.
Agenda Item 4:
Final Report on community-led AIDS responses based on the recommendations of the Multistakeholder Task Team to the UNAIDS 51st PCB
Mubanga Chimumbwa, Africa Delegate
The Multistakeholder Task Team on community-led AIDS responses presented the final report based on its recommendations. To fully leverage the impact of community interventions requires adapting and implementing laws and policies that enable the sustainable financing of people-centred and integrated community responses, including through social contracting and other public funding mechanisms.
In 2016 UN Member States made a series of commitments in the Political Declaration on Ending AIDS. In addition to recognizing the important leadership roles played by community organisations, Member States committed to ensure that at least 30% of all service delivery is community-led by 2030.
The NGO Delegation raised concerns with commitments by member states to invest at least 6% of HIV resources are allocated for social enabling activities, including advocacy, community and political mobilisation, community monitoring, public communication, and outreach programmes for rapid HIV tests and diagnosis, as well as for human rights programmes such as law and policy reform, and stigma and discrimination reduction.
The Delegation also emphasised the necessity of leadership of the HIV response around mechanisms to assess community-led AIDS response data around the world despite the commitments made by member states to support communities in developing standardised tools that will assess community-led AIDS responses in order to align with national policies and communities, including cost-effectiveness.
By taking note of the report, the PCB laid the technical foundation for UNAIDS to be able to benchmark well-funded community-led AIDS responses that drive the agenda of community voices at country level.
Agenda Item 5:
Update on the Global Partnership to eliminate all forms of HIV-related stigma and discrimination
Cecilia Chung, North America Delegate
It is commendable that the Global Partnership has been working hard to empower people living with HIV and key population communities. The report also highlighted a total of 33 countries that have joined the effort and pledged to eliminate HIV-related stigma and discrimination.
It is extremely alarming that the report pointed to gender inequality, human rights violation and punitive laws against sex work and HIV non-disclosure that were documented in 88% of the member states. Are the 10-10-10 targets a fantasy and lip service?
There is no doubt the monitoring and capacity building provided by GNP+ must continue with more resources invested in the work. However, there must also be accountability to countries that continue to act against what was laid out in the Global AIDS Strategy.
Agenda Item 6:
Report of the PCB Bureau to provide recommendations to the Bureau on UNAIDS funding situation (immediate and sustainable)
Aleksey Lakhov, Europe Delegate
The decision to form the Informal Multistakeholder Task Team consisting of PCB members, observers, cosponsors, the PCB NGO Delegation, and other stakeholders to explore options for resolving the immediate funding crisis of UNAIDS was made at the 50th PCB meeting. Since then, the task team has held 5 online discussions and developed a set of recommendations and options for addressing the Joint Programme’s funding crisis. These included, among others: addressing currency fluctuations, requesting 11 donor Member States to increase their 2022 contributions by USD 1,000,000 or more (than their current planned or anticipated contributions), requesting 11 non-donor Member States from lower or lower and middle income countries to contribute USD 500 000, etc.
The NGO Delegation’s intervention focused on how a fully funded Joint Programme is a prerequisite for the very survival of different communities – such as people living with HIV, sex workers, gay men and other men who have sex with men, transgender persons, women and girls, people who use drugs, people in closed settings, as well as other priority populations. On their tables, at the start of the meeting, the PCB Member States found envelopes with the cheques inside for USD 500,000 or 1,000,000, in line with the Task Team recommendations. In addition, the intervention mentioned the daily expenses (gleaned from the open sources) of some Member States on issues that hamper HIV responses such as waging the war in Ukraine or maintaining the functions of the court that effectively ended the sexual health and reproductive right to an abortion for millions of women.
After the NGO Delegation’s intervention, one of the Member States used its right to reply directly to the Delegation and urged it not to “politicise the HIV issues.” It shows the importance of the Delegation’s voice at the PCB meetings.
Agenda Item 7:
Evaluation and Management Response to the Annual Evaluation Report
Erika Castellanos, Europe Delegate
The report provided an account of the execution of the UNAIDS 2022–2023 evaluation plan in accordance with decision points 7.3–7.4 at the 49th PCB Meeting, where the evaluation plan was agreed upon. The modifications that have to be made owing to financial restrictions set the tone and dominated the report. The joint program’s evaluation function still lacks sufficient funding. It was decided at the 49th PCB that 1% of expenses would go toward evaluation tasks. This was not conceivable.
In addition, a 30% budget cut had to be made to the Evaluation Office. As a result, the quantity and range of the assessments undertaken were decreased. It should be noted that the impact of COVID is now integrated into the scheduled evaluations rather than being undertaken as a separate evaluation.
The NGO delegation complimented the accomplishments and appreciated the Annual Evaluation Report. Despite the many difficulties, chief among them UNAIDS’s financial predicament, we observed progress being made in the review plan. The fragile financial position has limited the human resources to 2 staff members without any administrative assistance and precluded the 1% allocation for evaluations. We urged Member States to think about the value of assessment and how it might have an influence on nations, healthcare systems, and—most crucially—human lives. We approved the planned consultation procedure used to create the evaluation plan that is forthcoming. We requested UNAIDS to ensure that communities affected by and living with HIV have a significant part in the consultations.
Agenda Item 8:
Next PCB Meetings
Midnight Poonkasetwattana, Asia and Pacific Delegate
The agreed themes for the Thematic Segments for the PCB meetings in 2023 are as follows:
52nd PCB: Priority and key populations, especially transgender people, and the path to 2025 targets: Reducing health inequities through tailored and systemic responses (27-29 June 2023 in Geneva, Switzerland)
53rd PCB: Testing and HIV (12-14 December 2023 in Geneva, Switzerland)
The PCB Delegation welcomes the explicit mention of transgender people as part of the priority and key population for the next thematic segment in June, as there will be varying support within the PCB members. We look forward to wider engagements with transgender activists and organisations for this important topic to highlight the particular needs, health inequities and human rights issues transgender people face when accessing HIV services.
The PCB Bureau was requested to take timely steps to ensure that due process is followed in the call and agreement for the thematic segments for the 54th and 55th PCB meetings in 2024.
The dates and venue for the 56th and 57th PCB meetings in 2025 were also approved as follows:
56th PCB meeting: 24-26 June 2025, Geneva, Switzerland
57th PCB meeting: 9-11 December 2025, Geneva, Switzerland
Agenda Item 9:
Election of Officers
Martha Clara Nakato, incoming Africa Delegate
The 5Ist UNAIDS PCB meeting came along with new changes in the composition of the PCB. Each December meeting, the PCB elects new officers from Member States. The NGO delegation informs the PCB of its recruitment process to replace outgoing delegates. This time the Delegation also informed the PCB of a replacement of a delegate by an alternate delegate from the same organisation due to personal circumstances.
The composition of the elected officers for 2023 is as follows; Germany as Chair, Kenya as Vice-chair and Brazil as Rapporteur.
The NGO Delegation also presented two new incoming delegates: Martha Clara Nakato, representing Sexual Reproductive Health and Rights (SRHR Alliance Uganda) and Xavier Biggs, representing Jamaica AIDS Support for Life (JASL). Furthermore, the Delegation informed the PCB that Erika Castellanos, representing Trans United Europe, is the alternate delegate replacing Dinah Bons.
The PCB was also informed that UNODC will chair the Committee of Cosponsoring Organisations (CCO) for the coming year.
The executive director welcomed the 3 new Delegates for Latin America and the Caribbean, Africa and Europe and gave special thanks to the outgoing delegates.
The outgoing officers and serving member states were applauded for the benevolent leadership exhibited during their service term. Thailand, the outgoing chair was in a special way commended for upholding the vision and aspirations of the UNAIDS PCB.
Agenda Item 10:
Gastón Devisich, Latin America and the Caribbean Delegate
The thematic segment for the 51st PCB Meeting addressed the topic of “HIV and men, in all their diversity: how can we get our responses back on track?”.
It featured two panels with speakers from different backgrounds and regions, however, one thing was missing: the prioritisation of the needs of these groups being left behind on the HIV response. An indispensable focus that can be particularly ensured by having the community speak their truth in first person.
Nonetheless, the expertise of men in all their diversity was relegated to a secondary role while the discussion centred on what the system was already doing for men in general. Everyone in the room ‘already knew everything’, so there was little room for learning. By the time the first panel had ended, the NGO Delegation had left the room by a unanimous, collective decision.
We believe that this undesirable and unwanted outcome was the perfect example of what communities go through every day and how UNAIDS is not immune to it. As the Joint Programme should lead by example, this constitutes the perfect opportunity to shed light on how to deal with the inclusion of the voices of populations living with, affected by and most at risk of HIV, especially those groups who are currently being left behind by the HIV response. Community stakeholder engagement turned out to be the biggest lesson of the day, one the NGO Delegation will continue to follow up in the Programme Coordinating Board.
Information on 51st UNAIDS Programme Coordinating Board can be accessed here