I’d like to start by thanking the All Party Parliamentary Group on HIV and AIDS, and STOPAIDS for hosting this event and for inviting me to come and speak once again. I’d also like to thank our speakers so far; Dr Loures for your interesting overview of achievements and challenges, and Emma; thanks to you for reminding us all why we are here with your insightful and moving description of what it is to live with HIV.
This weekend sees the 25th World AIDS Day, so today we come together to show our support for people living with HIV and to commemorate the estimated 36 million who have tragically lost their lives to the virus.
The UK’s Contribution
Today I would like to reflect on the UK’s contribution to the HIV response, and invite you to join us in celebrating achievements so far also readying ourselves for the work that remains.
This Summer I visited the Dedza region of Malawi to see for myself the opportunities and challenges that we face in the HIV response. I was able to visit the region’s main hospital where, thanks to DFID support, HIV testing and counselling, and prevention of mother to child transmission services are being offered.
I also met the Umodzi support group; an inspiring network of people living with HIV who meet to support each other and provide HIV education activities in surrounding villages. One lady told me how the group has not only managed to reduce stigma within the community, but has shown its members that ‘there is still a life to live’. Involving communities and people living with HIV in our work is central in addressing stigma and structural barriers.
This year has included an important process of reflection on our HIV portfolio at DFID. With contributions and support from many of you here we have conducted an internal review of our 2011 HIV position paper and I am delighted to be launching the review here today.
HIV Position Paper Review
So what did the review highlight?
Two years on from the HIV Position Paper, DFID is making good progress against its expected results. Treatment related commitments have already been achieved, and the remaining targets set out in the HIV position paper are on track to be met by 2015.
Shift in Funding: Bilateral to Multilateral
Over the last two years we have been sharpening our focus. As the 2011 position paper predicted, the balance between multilateral and bilateral funding has shifted. This review demonstrates how we have focused our bilateral efforts to fewer countries where the need is greatest. We now have some exciting new programmes in Southern Africa, the region hardest hit by the epidemic. Given the urgent need to reduce new infections we have prioritised the critical prevention gaps.
Civil society have been, and remain, an essential partner for DFID in addressing these gaps.
We are also proud to be supporting key multilateral organisations to ramp up their efforts in the global HIV response. I hope you will all join us in celebrating the recent commitment of up to £1 billion to the Global Fund replenishment, and agree that it will go a long way in reaching many more countries at a much greater scale than the UK alone could help. This support depends on others joining us in ensuring the Fund meets its target of $15 billion and our contribution is 10% of the total replenishment; by doing this we hope to see a still greater total replenishment.
In addition, I am delighted to announce today we will be increasing our annual core contribution to UNAIDS by 50% to £15 million in 2013/14 and 2014/15. That’s an extra £5 million per year to support its critical role in co-ordinating the world’s response to HIV and AIDS.
These contributions secure the UK’s place as a leader in the HIV response and demonstrates our commitment in providing a considerable share of total global resources to universal access to HIV prevention, treatment care and support.
Areas of Focus Going Forward
The review paper highlights three areas of particular focus for DFID going forward: being a voice for key affected populations; renewing efforts on reaching women and girls affected by HIV; and the integration of the HIV-response within wider health system strengthening and other development priorities. This includes tackling the structural issues that are driving the epidemic.
Key Affected Populations
In countries with generalised epidemics, HIV prevalence is consistently higher among key affected populations: men who have sex with men, sex workers, transgender people, prisoners, and people who inject drugs. Over the years, DFID has spearheaded support to HIV programmes for key populations. They have been and will remain a policy priority for us. We will use DFID’s influence with multilaterals to be a voice for key populations and to push for leadership and investments. We will focus on evidence-based combination prevention services, such as condoms, HIV testing and counselling, and comprehensive harm reduction services. Of particular importance is supporting initiatives to reduce stigma and discrimination. Our ultimate vision for key populations is for their human rights and health to be recognised, respected, and responded to by their governments. The UK is proud to be a founding supporter of the Robert Carr Civil Society Networks Fund, through which we support these particularly vulnerable groups.
Valuable lessons have been learnt from the Fund’s first year and we are excited that this World AIDS day will see the second round of grant announcements by the Fund.
Increased Focus on Women and Girls
Putting women and girls at the centre of the HIV response is a second area of focus.
Gender equality and women and girls’ empowerment lies at the heart of DFID’s development agenda and we know that women and girls bear a disproportionate share of the HIV burden. Yet globally the pace of decline in new HIV infections among women and girls has slowed.
Since 2011, each of our bilateral programmes has seen a greater focus on HIV prevention that addresses the needs of women and girls.
We are supporting research to improve outcomes for women and girls, including the development of female initiated HIV prevention technologies, and into how gender inequality drives epidemics, with a particular focus on improving what works for adolescent girls in Southern Africa.
We know that in a crisis girls and women are more vulnerable to rape and transactional sex. The highest maternal mortality and worst reproductive health is in countries experiencing crisis. Contraception, prevention and treatment of HIV and other sexually transmitted infections and safe abortion are life-saving services, yet they are often ignored in humanitarian responses. That is why DFID is currently developing a new programme on sexual and reproductive health in emergency response and recovery. This will include services to reduce the transmission of HIV.
Integration within wider health system
Thirdly. We know that, for the response to be lasting, we must integrate HIV within other sectors and find concrete solutions to sustainable financing. We recognise that a strong health system is an important way to improve the reach, efficiency, and resilience of services. By integrating HIV services within TB services, sexual and reproductive health services, and the wider health system, people living with and affected by HIV, including children and people with disabilities, are treated holistically and not just as a series of health problems.
Addressing gender inequality, stigma, discrimination and legal barriers which prevent many people from accessing the prevention, treatment and care they need is an important step in this regard.
Conclusion: Leaving no-one behind
This review has given us the opportunity to highlight areas where DFID can add value, and where we need to work with partners to make progress. We will take forward the many lessons we have learnt so far from the HIV response, and from your valued contributions. We at DFID will strive to ensure that MDG 6 is not left unfulfilled. We remain firmly committed to the goal of universal access and the targets set out in the 2011 UN Political Declaration. Increasing both our funding and policy focus to where it is most needed, while addressing stigma and structural barriers can help to ensure that no one is left behind and getting to zero becomes a reality.