Uncertainties on sustaining Key Population-led services in the PEPFAR Asia Regional Operational Plan 2022

By March 31, 2022 Advocacy, Regional

As the PEPFAR Asia Region’s Regional Operational Plan (ROP) 2022 meetings have now come to an end, Key Populations communities groups and stakeholders are questioning how the planned activities will get us toward the shared goal of achieving and sustaining epidemic control of HIV while country and regional budgets are being cut, ignoring gains that were made which disproportionately impact Key Populations service delivery including forcing cuts and discontinuation of new KPIF and ASAP developed sites designed specifically to advance and saturate programs. We are particularly concerned about issues that were raised and were not addressed by the Chairs during the ROP.  In particular, concerns in Thailand, Laos and the Philippines are a regrettable stain on the PEPFAR commitments and progress focused on addressing the MSM and transgender populations in the region, despite achieving major progress – this is not the time to slow down.

This is the third time that the ROP — focused on finalizing the plans for all 12 countries covered under the PEPFAR Asia Region — has been held virtually due to the COVID-pandemic. Participants were from PEPFAR country and headquarters teams across the local and headquarters U.S. government, partner government leadership, private sector and multilateral stakeholders, and civil society and key population representatives.

Meeting Objectives: 

  • Identify and agree on critical solutions, including services, policies, and systems efforts, to advance each country’s ability to accelerate and sustain epidemic control and HIV impact.  
  • Engage in robust dialogue and develop a shared country-driven understanding with Partner Country Government, multilateral partners and civil society for ROP 2022 direction. 
  • Identify the best ways to maintain treatment gains through improved retention and viral suppression of clients on treatment, increased case finding (where necessary), improved linkage, and the highest impact prevention activities. 
  • Finalize ROP 2022 activities, budget, and targets.

Laos

“We look forward to having conversations with stakeholders to ensure that as CLM is being taken up by PEPFAR in Laos, it is truly a community-led and own model, and also using the tools developed under the multi-country Global Fund SKPA grant.”

Vieng Souriyo, Executive Director, CHIAs, Lao PDR

Indonesia 

“I would like to bring attention to the PEPFAR program in Indonesia not to leave the five key population networks behind. Key population networks in Indonesia such as GWL-INA, Inti Muda, JIP, PKNI, and OPSI are even more critical to get to the PEPFAR Vision 2025, and their sustainability has to be ensured.”

Slamet, Executive Director, GWL-INA, Indonesia

Myanmar

“We urgently request implementing partners in Myanmar who are working on activities for key populations with PEPFAR funding, that they listen carefully to the voices of KPs and work in collaboration with KPs to ensure that the services they are doing are effective and sustainable for KPs. Doing so will achieve the short-term and long-term national goals of KPs as well as empower the KPs community.”

Nay Lin, Executive Director, Myanmar MSM and TGW Network, Myanmar

Papua New Guinea

“We have incorporated the importance of ‘family’ values into the PEPFAR program which has really strengthened our HIV program. We anticipate with enthusiasm that PEPFAR will strengthen the investment of the Community Led Monitoring initiatives for the KP Advocacy Consortium PNG so that we can achieve creating an enabling environment with good quality services for our Key Population and People Living with HIV.  If we are given more than one year, we can really measure impact and changes in structural barriers.”

Lesley Bola, Executive Director, KP Advocacy Consortium, PNG

Philippines 

“…because of cuts, we are concerned about the coming years. Service delivery programs like ours rely heavily on PEPFAR for HIV testing, PrEP demand generation, and collaboration with the local government. We understand that there is no expectation that PEPFAR will remain for a long time, and we are determined in identifying and developing a sustainable model that will work for us.” 

Johann De Leon, Social Media and Communications Officer, HASH, the Philippines 

Thailand

“I would like to make a strong plea to PEPFAR for a longer transition plan – as the sudden funding cut to supporting the key population-led health services means that all the previous investments will be lost, and we will now not get to ending AIDS in Thailand. Four sites of our key population-led health services, the model that we and Thailand are so proud of as a good practice for the region, will sadly now have to shut.”

Surang Janyam, Executive Director, SWING, Thailand

The ending of the Key Population Investment Funds (KPIF) in Thailand (USD 1.5 million for two years) on top of funding cuts to base funding levels has led to the hard fact that clinics and services that were only started under KPIF funding will be cut. The cut to Thailand and key population programming, which is a regional model for KP-led approaches which are being institutionalized toward epidemic control, is serious, and truly upsetting given that this may be the first country where MSM are just beginning to see a plateau in new cases thanks to the support from PEPFAR which brings much needed technical leadership, innovation and technical support to optimize the GF and host country responses.  Rather than finish the job in what has been a success story for Thailand, that can be shared through the regional support, PEPFAR punishes the KP programs and networks with cuts.  It is these KP-led programs that need to be prioritized – but that is not what has happened as the proportion of funding has shifted.

The Regional KPIF funding (USD 1 million for two years) provided critical technical assistance for KP-led services and strengthening activities including mitigating the impact of COVID-19. It is critical for regional funds for key population networks to be prioritized now and in the future for key population CSOs, key population CSO TA, and key population CSO regional capacity strengthening. 

The loss of the Accelerate and Scale the Asia Program (ASAP) funding (USD 55 million over two years) for India, Indonesia, the Philippines, and PNG, added significant cuts beyond the base country level cuts to these countries.   While country teams made efforts to minimize these major cuts (approx. USD 30 million per year) on top of base budget cuts this impacts KP programs in Thailand and the Philippines worst, while all programs reported slowing progress and it makes us questions PEPFAR’s commitment, consistency and vision for the region and to Key Populations.

Surely PEPFAR should be planning a softer landing rather than harsh cuts to allow programs to find new resources.  Building sustainability takes time and consistent support.

As the next PEPFAR Strategy: Vision 2025 moves forward, with the aim to support the international community’s efforts to put countries on track to reach the Sustainable Development Goal 3 target of ending the global AIDS epidemic as a public health threat by 2030, key population community in the Asia Pacific region are questioning the decisions being made at the Asia Region ROP 2022, and sees this as a rollback of PEPFAR’s commitment to ending AIDS in the region, and sustaining the key population-led services that has been proven to save lives for the most vulnerable and marginalized, particularly during the COVID-19 pandemic.

#KeyPoPAsiaCOP22 

APCOM Executive Director delivered remarks at PEPFAR ROP/COP 2022 Opening session

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#KeyPoPAsiaCOP22: Let Key Population Lead

#KeyPoPAsiaCOP22: Let Key Population Lead

Protecting and Sustaining Key Populations-led Interventions: PEPFAR ROP/COP 2022 Engagements in the Asia Pacific Region

Protecting and Sustaining Key Populations-led Interventions: PEPFAR ROP/COP 2022 Engagements in the Asia Pacific Region

APCOM extends sincere gratitude to our community partners in the countries. Without your trust and confidence in the work that we do, we are not able to continue to provide useful resources and technical assistance. We acknowledge the contributions and inputs of our key populations and community partners into these processes. 

APCOM would like to thank the following regional key population networks for their active collaboration:

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