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UNAIDS

On 12th August 2020, the world united in its commemoration of International Youth Day. This year’s theme - Youth Engagement for Global Action – seeks to highlight the ways in which the engagement of young people is enriching national and multilateral institutions and processes, as well as draw lessons on how their representation and engagement in formal institutional politics can be significantly enhanced.

Simultaneously, the year of 2020 has been marked by the COVID-19 pandemic, which indeed aggravates many of the challenges already faced by young people in Africa. Including lack of access to integrated HIV/sexual and reproductive health and rights (SRHR) and gender-based violence (GBV) information, services and commodities, loss of livelihoods and education opportunities, just to mention a few.

It is against this background that UNAIDS Regional Support Team for Eastern and Southern Africa in partnership with the SADC Parliamentary Forum, UNFPA, UNESCO, Restless Development, AfriYAN and the African Population and Health Research Center, have joined forces in convening a series of online engagements with Speakers of National Parliaments, parliamentarians and young people in all their diversity.

Now more than ever decision-makers, including parliamentarians, need to be informed about the specific needs of young people in order to take adequate measures into response and recovery plans.

Invited key speakers to the webinar convened on 12th August in commemoration of International Youth Day included the Honorable Deputy Speakers of Parliament of South Africa and Botswana.

It is correct that we must infuse some urgency in the implementation when we have heard from young people’s voices and contributions so that we accelerate our responsiveness to their conditions”, said the Deputy Speaker of the National Assembly of South Africa, Hon. Solomon Lechesa Tsenoli, in his remarks on creating conditions for effective attention to young people’s situation and needs.

The webinar series seeks to advance the commitments set out in the groundbreaking Tshwane Declaration, adopted by the SADC Parliamentary Forum Assembly in December 2019, building on the outcomes of a regional Youth Indaba that same year. The Tshwane Declaration focuses on domestication, harmonization and implementation of laws and policies concerning young people’s SRHR.

My belief is that if we work very hard as a country, in a time not very far away from us, we should have recognized different definitions of children’s laws in this country”, said the Deputy Speaker of the National Assembly of Botswana, Hon. Mabuse Mopati Pule, on the subject of providing a clear age of consent to medical care in legislative provisions for the benefit of adolescents, as well as service providers.

The engagements provide a unique platform for young people to share experiences, ideas, and possible solutions with decision-makers with the ultimate goal to strengthen young people’s ability to exercise accountability while advocating for the fulfilment of their right to health and education.

The youth can influence incremental change, and the interface between youth and parliaments can bring enhancement towards social transformation in the field of sexual and reproductive health and rights (SRHR). The relevance of youth in relation to implementation of SRHR cannot be overemphasized, given that it is the youth that are primarily affected by issues such as lack of contraception and safe abortion”, said the Secretary General of the SADC Parliamentary Forum, Ms. Boemo Sekgoma, in her introductory remarks.

We do often say: Nothing about us, without us – as young leaders we need to carry this statement as part of our accountability call to seek political spaces and in making sure to voice the actual needs of our fellow young people focusing on improving SRHR in our local communities”, said Hussein Melele, Vice President of AfriYAN Eastern and Southern Africa, in his closing remarks.

As the world scales up public health responses to the COVID-19 pandemic, countries are being urged to take decisive action to control the epidemic with containment and service provision as central pillars.

However, as in all acute epidemics, especially where person-to-person transmission occurs, there is a need to ensure that the response is grounded firmly in human rights and that the vulnerability of certain groups is not exacerbated, including women and girls.

The UNAIDS Regional Support Team for Eastern and Southern Africa recently co-hosted a high-level webinar with the Southern African Development Lawyers’ Association (SADC-LA) to discuss the challenges being faced in the region due to the COVID-19 pandemic and its implications on social justice, human rights and gender-based violence.

“A primary lesson from the HIV response is that restrictive, stigmatizing and punitive measures can lead to significant human rights abuses. These come with disproportionate effects on already vulnerable communities, including key populations”, said Aeneas Chuma, interm Director of the UNAIDS Regional Support Team for Eastern and Southern Africa, in his opening remarks.

Mr Chuma recommended an approach that moves away from compulsory restrictions towards a focus on reaching and serving those who are most vulnerable, empowering people with knowledge and tools to protect themselves and others, and the removal of barriers, which mirrors learnings from the HIV response.

Across the region governments have declared states of emergencies and enforced restrictions to tackle the COVID-19 pandemic. In many instances this has been followed by reports on increased violations of human rights and police brutality.

“We need vigilance in ensuring that the restrictions of human rights in the quest of saving lives does not become an incentive to undermine the rule of law and increase in violence. We need to pursue advocacy with respect to the vulnerability of women, LGBTQI people and sex workers during this period”, said Maxwell Xolani Boqwana, President SADC-LA.

One of the main aims of the webinar was to provide practical and substantive guidance to policy makers and executives on the best ways to preserve human rights and the rule of law in the wake of COVID-19.

In her remarks, Yvonne Dausab, Minister of Justice Namibia, cited examples on how this has been tackled in Namibia.

“In Namibia, the state of emergency is provided for by the Supreme Court under the Constitution which was further approved by the National Assembly. An additional safeguard is the fact that the various agencies and ministries had to provide directives on how to manage the state of emergency. There is a standing weekly session with law enforcement where the Attorney General and I are invited to provide updates and receive feedback on areas where they are acting in a manner that is not in accordance with our constitution,” she said.

With the spread of COVID-19, cases of gender-based violence (GBV) have increased substantially, especially in the eastern and southern Africa region where such violence is already widespread.

“In times of crises the gap between rich and poor increases, women are at the core of any negative impact. Most gender-based violence happens at home, meaning that women are locked down with abusers in a way that threaten their lives. As parliamentarians we have the mandate to make legislation and hold governments accountable to adopt measures on prevention and support, said Sylvia Mthethwa, Senator of Eswatini and Member of the Pan-African Parliament.

Some measures that have been put in place to protect women and children from violence include government hotlines, support to shelters (Zambia), free 24-hour emergency medical services (Kenya), and mobile GBV clinics (Mozambique).

“Malawi faces similar challenges to many other African countries. How are we supposed to carry out lockdown and practice social distancing in a context where people are living on top of the other and lack the preventative measures to spread this pandemic? We see worrying parallels with the HIV epidemic, including stigma and lack of access to information and the intersectional vulnerabilities of those that are already vulnerable such as women and girls. The prices for transport have doubled which especially affect women domestic workers and girl’s access to education,” said Sarai Chisala Tempelhof, Executive Director of the Gender Justice Unit in Malawi.

Plans were made for the platform to reconvene with engagement from more stakeholders to continue sharing information on shaping the COVID-19 response, taking into consideration its implications on human rights, social justice and GBV.

“This is a new normal and it is not going to go away, we have to embrace change and bring on innovation. We need to look at how to scale up good practices. We have to integrate the COVID-19 response with existing work on tackling HIV and GBV,” said Alti Zwandor, UNAIDS Country Director in Namibia.

Country Snapshots - Eastern and Southern Africa 2019 (UNAIDS 2020 ESTIMATES)

  pdf Download (1.30 MB)

 

Angola 1Angola
Botswana 1Botswana
Comoros 1Comoros
Eritrea 1Eritrea
Eswatini 1Eswatini
Ethiopia 1Ethiopia
Kenya 1Kenya
Lesotho 1Lesotho
Madagascar 1Madagascar
Malawi 1Malawi
Mauritius 1Mauritius
Mozambique 1Mozambique
Namibia 1Namibia
Rwanda 1Rwanda
South Africa 1South Africa
South Sudan 1South Sudan
Tanzania 1Tanzania
Uganda 1Uganda
Zambia 1Zambia
Zimbabwe 1Zimbabwe

Source: UNAIDS Data 2020

This progress report reviews recent gains, new developments and remaining challenges as countries approach the 2020 targets of the Start Free Stay Free AIDS Free framework.

UNAIDS report on the global AIDS epidemic shows that 2020 targets will not be met because of deeply unequal success; COVID-19 risks blowing HIV progress way off course.

Officially, she calls herself Juliana, but she also goes by the name Anna Morena and has an organization of the same name—the Anna Foundation Uganda.

The small, youth-led organization promotes sexual and reproductive health and rights, HIV prevention, advocacy, research, entrepreneurship and fundraising for the transgender community in central Uganda.

As a response to the malnutrition experienced by transgender people because of the COVID-19 outbreak, the foundation has raised US$ 1600 from a private donor to support transgender people and their dependents with food relief, which has reached more than 200 people.

Members of the foundation volunteer their time to conduct referrals for mental health and supply medical services, including deliveries of treatment and hormone therapy to transgender people who cannot currently access facilities due to the COVID-19 pandemic.

 

Ms Morena named herself and the foundation in memory of a friend who moved to Kampala, the capital of Uganda, at the age of 16 years. She was working as a sex worker to survive, met a man in a nightclub one night and was found dead the next day.

“I thought that maybe I could be “Anna” too, because she had a dream—to live as a normal person,” said Ms Morena wistfully.

Ms Morena doesn’t like labels, but she refers to herself as a “trans girl” because she wants people to know that she’s “not just a sex worker.”

She is open about being a sex worker so she can encourage others to come out and speak about it. She also volunteers to educate people about being transgender, which she does “out of love.” The sex work is to put food on the table.

“Most of the trans women I know are doing sex work. They are usually between the ages of 16 and 25 years, a time when hormones are high and one’s understanding of sexuality and gender identity is still developing,” she said.

Globally, transgender people are 12 times more likely to become infected with HIV than the general population. Nineteen countries worldwide, including Uganda, prosecute and/or criminalize transgender people.

In their daily lives, transgender people experience exclusion from family and society, barriers to employment and extreme forms of sexual, physical, emotional and psychological violence. According to Ms Morena, the COVID-19 pandemic is making things worse.

“COVID-19 has led to an increase in gender-based violence and a scarcity in commodities such as condoms and lubricants. Most sex workers are still doing sex work so that they can survive and we are seeing a rise in infections,” said Ms Morena.

She said prices for essentials such as mobile phone data have risen, making it harder for community-based transgender organizations to stay connected to their members.

In the absence of funding for vocational training, the only choice for transgender people who want to make a difference is to volunteer, said Ms Morena, because there is limited donor funding for transgender organizations. “Donors are very specific about what they will support, meaning there is a lot of competition for funding,” she said.

In addition, there is limited data on transgender people in the eastern and southern African region and Ms Morena believes that donors are not primarily interested in funding community-led research. But, she said, research is critical. “It is a way to help our governments understand the specific needs we have; it helps influence change and policies.”

Influencing change is something that Ms Morena does every day. During workshops run by the foundation, in partnership with other transgender and female-led community organizations, she tries to educate people about what it feels like to live in a transgender body by getting them to draw a picture of their bodies on a piece of paper they place on top of their heads.

 

Drawing one’s body out of sight always guarantees that it comes out a mess. This is Ms Morena’s advocacy punchline.

She holds up the drawing and tells them, “This is the pain I have to go through daily. This is how the world sees a transgender person.”

“This is not the body I want. I want to transition, but I don’t have the support of my family. I honestly love them. At times I try to do what I can to make them comfortable, but I also need to be happy,” she said.

This is the reason why the transgender community is so important, said Ms Morena. Solidarity helps.

“Trans women need safe spaces, places to stay and access to mental health services,” said Ms Morena. “The Government of Uganda is not willing to facilitate such spaces, so community-based organizations must bring these services until the fight for decriminalization has been won.”

 

Read the full story here.

This publication marks the 25th anniversary of the Beijing Declaration and Platform for Action.

12 June 2020

COVID-19 & HIV

What people living with HIV need to know about HIV and COVID-19

These are difficult times for all of us. UNAIDS is urging people to act with kindness, not stigma and discrimination—people affected by COVID-19 are part of the solution and must be supported.

Governments must respect the human rights and dignity of people affected by COVID-19. The experiences learned from the HIV epidemic can be applied to the fight against COVID-19. As in the AIDS response, governments should work with communities to find local solutions. Key populations must not bear the brunt of increased stigma and discrimination as a result of the COVID-19 pandemic.

We know that COVID-19 is a serious disease that is set to hit the countries with the highest burden of HIV very soon. Everyone, including people living with HIV, should take the recommended precautions to reduce exposure to COVID-19:

  • Regular and thorough hand washing with soap and water or alcohol-based hand rub.
  • Maintain at least 1 metre distance between yourself and anyone who is coughing or sneezing.
  • Avoid touching your eyes, nose and mouth.
  • Make sure that you, and the people around you, follow good respiratory hygiene—cover your mouth and nose with your bent elbow or tissue when you cough or sneeze and dispose of the used tissue immediately.
  • Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.

UNAIDS recognizes, however, that in many countries, owing to weaker health-care systems, informal settlements, overcrowded cities and public transportation and a lack of clean water and sanitation, the current approaches to self-protection, social distancing and containment may not be viable.

COVID-19 and people living with HIV

COVID-19 is a serious disease and all people living with HIV should take all recommended preventive measures to minimize exposure to, and prevent infection by, the virus that causes COVID-19. As in the general population, older people living with HIV or people living with HIV with heart or lung problems may be at a higher risk of becoming infected with the virus and of suffering more serious symptoms. All people living with HIV should reach out to their health-care providers to ensure that they have adequate stocks of essential medicines.

Despite the scale-up of HIV treatment in recent years, 15 million people living with HIV do not have access to antiretroviral therapy, which may compromise their immune systems.

We will actively learn more about how HIV and COVID-19 together impact on people living with HIV from countries and communities responding to both epidemics. Lessons in rolling out innovations or adapting service delivery to minimize the impact on people living with HIV will be shared and replicated as they become available. Until more is known, people living with HIV—especially those with advanced or poorly controlled HIV disease—should be cautious and pay attention to the prevention measures and recommendations. It is also important that people living with HIV have multimonth refills of their HIV medicines.

What UNAIDS is doing

UNAIDS is working with governments and community partners to:

  • Carry out surveys to assess information needs, medication available and ability to access service support networks.
  • Find out if multimonth dispensing of antiretroviral therapy is being fully implemented, and, if not, identify how to implement it.
  • Assess the possibility of HIV service interruption and develop plans for access to those services.

What UNAIDS recommends

HIV services must continue to be made available for people living with and at risk of HIV. This includes ensuring the availability of condoms, opioid substitution therapy, sterile needles and syringes, harm reduction, pre-exposure prophylaxis and HIV testing.

To prevent people from running out of medicines and to reduce the need to access the health system, countries should move to the full implementation of multimonth dispensing of three months or more of HIV treatment.

There must be access to COVID-19 services for vulnerable people, including a targeted approach to reach those most left behind and removing financial barriers, such as user fees.


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