Written by Kevin Osborne, Project Director of LINKAGES

LINKAGES burst into the global scene with big and bold goals but no one imagined in its second year LINKAGES would be this big or this bold.  We did not anticipate this pace of growth or the sizeable interest that would be sparked. Now, entering our second year, LINKAGES has 27 global partners and 50 sub-partners, and these numbers will continue to grow. Twenty-four countries have bought into LINKAGES, and these will increase. The project has collaborated to create seven toolkits, frameworks, and resources, which will continue to expand. LINKAGES is moving full steam ahead, scaling up, working with acceleration teams and following the words of the late Nelson Mandela, “there is no passion to be found in playing small.” This rapid growth shows the sense of urgency that exists around addressing the needs of key populations. The demand is high and the need is great, going far beyond LINKAGES, far beyond our partners. This is bigger than us.

LINKAGES is a designed beauty of synergy that is about passion, partnership, and rethinking the way we address HIV, with the end goal that all members of key populations from Jamaica to Juba will have access to comprehensive health care services that are respectful of human rights and will enjoy a high quality of life regardless of who they are, what they do, or who they have sex with. This is a big goal.

The passion behind this work is evident with all LINKAGES partners. Partnership is something often talked about but rarely brought to scale at its potential. This project requires deep, meaningful, broad partnerships among national governments, international organizations, civil society, as well as the private sector. LINKAGES will continue to form and expand existing partnerships, meaningfully engaging members of each key population group as principal decision makers. This is a big task.

In every country where LINKAGES is present, we are fighting to increase access to and demand for HIV services while strengthening accountable, community-based prevention, treatment, and adherence programs. As work begins in the field we are witnessing numerous promising practices take shape:

• A LINKAGES-supported drop-in center in South Sudan has provided HIV testing services for more than 1,200 female sex workers, where 26% tested HIV positive and have been linked to care and treatment services.
• The LINKAGES HIV Cascade Framework has been completed and will serve as the backbone for the program and as a roadmap for the development of future HIV programming.
• The LINKAGES South2South toolkit is being launched in Malawi and the LINKAGES Health Care Workers Manual is in the final stages of completion, addressing stigma and discrimination and the unique needs of each key population group in health care facilities.

In addition, LINKAGES is working to make PrEP available to members of key populations and while there is still ambiguity in the arguments for using Prep, we know that ending the epidemic is only possible if recent scientific advances, interventions, and tools are available to everyone who needs them. This is big ambition.

Despite these successes and opportunities, LINKAGES and its partners will continue to face formidable hurdles to addressing the deep-rooted, complex set of issues that members of key populations face. We will continue to face legal barriers, lack of resources, and stigma and discrimination. But across the globe, members of key populations are organizing in the struggle to leap over these hurdles and we will continue to join and support these efforts, for often times with something so big there will be great struggle. But without struggle there will not be progress.

LINKAGES is big and it is bold but with this type of size, growth, and excitement comes great responsibility: a responsibility to leave a global legacy for key population work; to have wisely invested resources to create a sustainable, relevant impact; to have formed meaningful partnerships; and to have pioneered new strategies and opened doors for purposeful engagement of all key population groups in civil society, leaving a road map that will exist long after the 5 years of LINKAGES has ended.

LINKAGES, along with its partners, is working to leave an impact and acting with the sense of urgency that exists around addressing the needs of key populations. We have tremendous work ahead, for the demand is high and the need is great, going far beyond LINKAGES, far beyond our partners. This is bigger than us and there is no passion to be found in playing small.