The Ministry of Foreign Affairs of the Netherlands has reserved € 35 million so that gay men, people who use drugs and sex workers in 16 countries can get easier access to information, condoms, antiretroviral treatment and care.
Never before has a country launched such a large HIV program aimed at these vulnerable groups. It could mean a huge turnaround in reducing the number of HIV infections in the 16 countries.
The program will start in September 2011 and be implemented by seven Netherlands based organizations including GNP+. As well as the grant from the Ministry of Foreign Affairs, the program has been made possible by € 11.7 million from other sources.
The 4.5-year program has been judged the best by the ministry.
Earlier this year there was a call for proposals for development cooperation projects aimed at vulnerable groups. The Dutch government’s decision to reserve funds for this project is highly important. It means a continuation of the ‘Dutch approach’ within international AIDS relief where access to prevention and care in combination with the decriminalization of drug use, homosexuality and sex work is central. This is the only way gay men, people who use drugs and prostitutes can get the care they need.
A good example of this care is the integrated needle exchange program for injecting drug users. Many HIV infections are prevented as a result. The great success of the Dutch approach is recognized internationally.
Vulnerable groups are 10 to 20 times more likely to become infected with HIV than the general population. Only 8% has access to prevention, care, HIV treatment and support.
Many countries have legislation that makes access to care difficult or impossible. Examples include laws that make homosexuality a criminal offence or ones that are used to prosecute sex workers.
Offering HIV/AIDS care developed for and by these vulnerable groups must therefore go hand in hand with political pressure to change such legislation. This is precisely the aim of this program. It is also aimed at partners of gay men, drug users and sex workers. Because of the taboo related to homosexuality, in many countries men also have a relationship with a woman or are married.
The program will be run in 16 countries: Georgia, Kirghizstan, Tadzhikistan, Ukraine, Botswana, Uganda, Kenya, Zimbabwe, South Africa, Nepal, Pakistan, Vietnam, Indonesia, Brazil, Costa Rica and Ecuador.
The program builds on work carried out in recent years. This work can now be continued and expanded. This new program will involve a lot more collaboration in order to be as effective and efficient as possible.
Gaps in existing projects will also be tackled. For example, most prevention programs along ‘truck routes’ in Africa are aimed at drivers. Until now, they have not benefited sex workers. This has meant that a great many infections still take place along these routes.
The Dutch program will be carried out by seven organizations: Aids Fonds/STI AIDS Netherlands, Aids Foundation East-West, COC, Global Network of People living with HIV, Health Connections International, Mainline and Schorer.
Together with 102 partner organizations in the 16 countries listed, they will ensure that in the coming years 400,000 gay and bisexual men, transsexuals, people who use drugs and sex workers get access to HIV prevention, treatment, care and other support.
New Report Shows Major AIDS Funders Fail to Track Investments for Gay Men and Transgender People
A new report indicates that most major bilateral, multilateral and private philanthropic funders that focus on HIV do not consistently track their investments targeting men who have sex with men (MSM) and transgender people. Produced by the Global Forum on MSM & HIV (MSMGF), the report also examines tracking of domestic government funding dedicated to these populations in all UN Member States, revealing that only 25% these countries recorded levels of HIV prevention spending for MSM in 2010 and no country tracked spending for transgender people.
“With overwhelming evidence for the need to prioritize MSM and transgender people in the global fight against AIDS, it is shocking that so few funders actually know how much money they are spending on these populations,” said Dr. George Ayala, Executive Officer of the MSMGF.
“Funders often talk about the importance of investing in key affected populations, but budgets offer a clear reflection of what their priorities actually are. HIV investments must be accounted for in order to ensure that MSM and transgender people are getting the support they need.”In the few countries that did track HIV prevention spending for MSM, the report indicates expenditures fell far below the amount required to achieve universal access. According to country reports made to the United Nations in 2010, an average of 2% of national HIV prevention budgets was dedicated to MSM in the 42 low- and middle-income countries that tracked spending for this population – $15.8 million in total. Nearly 75% of that sum came exclusively from international sources, highlighting the role of bilateral, multilateral and large private philanthropic funding in service provision for MSM in low- and middle-income countries.
The report follows a number of recent publications arguing in favor of targeted investments for most-at-risk populations like MSM and transgender people. In June of this year, the World Bank issued a report demonstrating that increased access to HIV prevention and treatment for MSM can change the trajectory of a national epidemic. That same month, the Lancet published a new global HIV investment framework that emphasizes the importance of targeted investments for key affected populations.
“After 30 years of diffused investment, the world is realizing that a focused approach is the only one that will work,” said Dr. Ayala. “It is time for funders to reflect that in their budgets and track their investments by population. Donor agencies must communicate and coordinate to ensure adequate coverage without duplication, and we must all aim for a higher level of accountability to the people we serve.”