Final Thoughts

This was quite a different meeting to UNGASS 2006 - it was only two days instead of three, there were fewer delegates, and there seemed to be a lower energy level. There was also no clear document coming out of this - the UN General Secretary having released the progress report and recommendations prior to the meeting. This meant that there was a slow 'fizzle out' rather than an energetic series of negotiations to find an agreement that all UN members states could sign up to.

Maybe the main issues coming out were the need to lift international travel restrictions for people living with HIV. Human rights issues in general were to the fore, and concerns that criminalisation of some at risk groups and those living with HIV was becoming more common. This can make access to prevention, care and treatment very difficult.

Overall, the huge treatment gap, and the failure to keep pace with rates of new infection were highlighted. And maybe evidence of a swing in emphasis in the global response back towards prevention after so much energy has gone in to treatment over the last four or five years.

However, I think it is even more interesting what was not talked about - e.g. multiple concurrent partnerships as a major factor in rapid spread of the pandemic in Southern and Eastern Africa in particular, the fact that a generalised heterosexual pandemic does not seem to be emerging outside of Africa, and how these two facts should influence where prevention initiatives need to be focussed. Globally the need to engage heterosexual men in any prevention effort has also been barely mentioned, and yet we constitute at least half the problem in Africa, and are a major contributory factor where HIV is most prevalent among commercial sex workers.

There is an ongoing, and maybe mounting feeling among some commentators that the UN bodies and the traditional Civil Society networks are focussing more on politically correct navel gazing than in engaging with these emergent issues. This may be harsh, but it comes from many who have been on the inside of the UN system, some of whom are now suggesting that UNAIDS has had its time and a more generalised response to global health issues is needed. This is certainly a debate that needs opening up, if only so that we can make sure that resources are being targeted on prevention and treatment strategies that actually work.

Furthermore, apart from two farcical half hour caucuses on June 11 that were hi jacked by well meaning but ignorant (and bigoted) American Conservatives, there were very limited discussion on orphans, children and families. Surely the support of families, both those free of the virus in areas where there is a major heterosexual epidemic, and those affected by the virus, are vital in limiting the spread, caring for the affected, supporting and empowering a future generation to remain AIDS free, and ensuring that vulnerable children and adults are care for. Not engaging and supporting families is as big a deficit in the current conversation on prevention as not engaging with heterosexual men.

Finally, another key issue that has not really be debated is the engagement and empowerment of local communities in scaling up responses to HIV & AIDS. This is something that churches and FBOs are particularly good at, and which is increasingly proving to be effective in both care and prevention strategies.

Empowering local communities, engaging with and supporting families and heterosexual men, tackling head on the attitudes and behaviour that leads to multiple concurrent sexual partnerships among men and women, are all issues that need addressing along with the more familiar strategies to do with empowering women and girls, increasing access to condoms, family planning, voluntary testing and counselling for HIV and STDS and ARV therapy.

Recommendations for CHAA and its members
From the FBO side of things, one thing CHAA should be doing is getting out the stories of what our members are doing, encouraging member to put forward and develop spokespeople, and make sure that the good news and success stories get heard by our governments, the UN and other civil society and faith based organisations.

We should be advocates for work that is actually making an impact, and at the same time scrutinising the policies and practices of the British Government and holding it to account for the commitments that it has made. For that reason we need to be looking at new avenues of engagement with government and wider UK Civil Society with respect to HIV and AIDS strategies (both domestic and global).

If we can get at least one FBO representative on to the UK delegation for 2010, that will be a major step forward in gaining recognition for the work our members are actually doing, and ensuring that the voices of FBOs are being heard in the global as well as national arenas.