HIV 2020 Online:Where is the money for Key Population?

                                                         HIV 2020 Online

                                 Where is the money for Key Population?

The discussion was held on 20th October 2020 via zoom platform. It was moderated by Phelister Abdalla Kenya Sex Workers Alliance National Coordinator. It was a global conversation as the participants were drawn from all over the world including bilateral and multilateral donors and other major donors who fund the key population.

It was discussed that donors are the providers of development assistance and ought to share decades of development knowledge and expertise and provide funding to foster support for key population especially in the developing countries.

The donor partners should assist tackle the world’s key population (KP) development challenges. By coordinating and working closely with other partners, this improves the delivery, impact, and sustainability of development assistance, thereby maximizing development results and promoting the journey to key population self-reliance especially during the pandemics.

Collaboration among multi-stakeholder partnerships or initiatives including bilateral and multilateral organization donors and other assistance providers, along with civil society and private sector partners can foster a well sustained support for key population

Engaging in effective multi-stakeholder partnerships allows to leverage the comparative advantages — the knowledge, expertise, resources and capacities — of all key population development actors, which is critical to making key population communities more resilient and self-sufficient.

It was discussed that the fast-track or off-track report highlights that only 2% of funding goes to the key population.

Grace Kamau ASWA Regional coordinator asked how much of the 2% went to the communities? She added that 2% is absolutely a contradiction of the talk about “leaving no one behind”

She added that its clear why exactly more than half of HIV new infections are among KP. She further alluded that in Africa, sex workers have been left without funded HIV programs and some are not even able to access Global Fund (GF) monies. This repeats the mistakes that lead to the outbreak of HIV among sex workers in Africa even when the funders leave without a clear transition plan in place. She called for  a stronger and seamless  Global Fund (GF) and other donors  transition strategy.

Grace added that it’s not just about funding on key populations but also about supporting community led responses including technical assistance and capacity building. Many key populations networks have shown their ability to respond with sensitivity and speed in response to COVID-19.

Phelister Abdalla Kenya Sex Workers Alliance National Coordinator called for equality in funding.

It was further discussed that the Key population Organizations must be United and discourage working in isolation, and to build each other, strengthen networks and uplift each other for them to achieve a common goal. It was further noted that Male sex workers have been neglected and left with very few or no donor support while they are at a greater risk of H.I.V

Criminalization leads to sex workers hiding; thus, no data is gathered that accurately reflects their needs, and absence of evidence is used as evidence of absence.

It was said that UNAIDS had said that all governments must give 30% out of all resources for HIV to community led services. But the result is not seen. The question isn’t only about money. The main point for us is how this money is to work for the key population community. Today our community, even after 20 years have been working in HIV prevention program and among sex workers community, we are still without drop-in-centers and shelters thus today they are in economic crisis and so we need program for survival.

Ruth Morgan Thomas The Global Coordinator of Global Network of Sex Workers Projects (NSWP) said that in 2019, 62% of new HIV infections were among key populations and our sexual partners. Every year the percentage keeps increasing. She asked how are bi-lateral and multi-lateral donors going to respond to the urgent needs of key populations who are left behind in HIV prevention, treatment and care and face criminalisation across the world?

Key Population funding in some countries like Kenya has not been equitably distributed, where some regions have always been discriminated or left out. Some regions are funded such as Nairobi, Coast and Nyanza while others are left out such as Eastern region despite of these regions having numbers. something needs to be done in these regions.

A big gap is we have sex work values and know what we need, but we don’t have enough expertise -researchers, sociologist, manager who really understand the sex work values and sex workers rights. That’s why you give resources to people who have those skills but mostly don’t have the sex work values. We should invest time to transform the attitude of HIV program experts toward sex work values.

A question arose on how would the Global Fund encourage Governments to fund community-led responses particularly when supporting transitions in the Global Fund’s critical sex work in Africa.

It was also discussed about how to define and measure ‘community led’ interventions, and also for community groups to engage with the wider discussions about health financing and also on how to unpack these definitions.

It was shared that direct sex work funding would be reduced significantly from 2021 onwards, with no funding in some African countries. The lifesaving work that had been built up and flourished in these regions would disappear. What role would the donors have in ensuring the continuation of sex work health services in these regions e.g. Mauritius? It was asked how would GF, USAID, and other funders hold themselves accountable for this long -term failure? We would need reform. It couldn’t be business as usual going forward.

How could Global Fund (GF) Country Coordinating Mechanisms (CCMs) be encouraged to have more key population members? Could there be stipulations, incentives, quota systems, or epidemiologic criteria for ensuring CCMs are more representative of local country epidemics

As the push to increase country led funding continues and country led responses a concrete plan to ensure the funding situation for KP doesn’t suffer and the response worsen should be put in place.

It was discussed that COVID -19 had narrowed the focus of funding for UHC (Universal Health Coverage) and that more challenges for KPs had emerged in the context of UHC.

For a long time, the HIV Programme at the country level had evolved into a separate and a vertical Programme and while this was an advantage for the HIV, key populations and those living with HIV had become excluded in the UHC processes, and the intersecting health and non-health issues that key populations face, including issues of criminalisation, are not being addressed. COVID-19,  had really crippled funding for UHC.

It was recommended that the key population should get funding to support non-clinical needs for the Key Populations community.

Activism and not advocacy changed the course of the HIV epidemic in the US and elsewhere. Today we only talk about advocacy as if it is our only resource. COVID-19 forced us to change how activism is done, now we need masks & physical distancing. As economies are broken, financing for HIV prevention, care, treatment and research would dry. When would we talk on how we would maintain the levels of fundraising today and go beyond so we don’t have to shuffle funds from areas which need it?

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