Micheal Ighodaro, Executive Director and Co-Founder, GBGMC
Ron MacInnis, Technical Director, Health Practice, Palladium
Amita Mehrotra, Senior Technical Advisor, Capacity Development, FHI 360
The global HIV response, driven by programs like PEPFAR, has saved millions of lives by connecting people living with HIV (PLHIV) with lifesaving treatment. The world is now looking beyond what began as a donor-driven emergency response to HIV towards transforming HIV programming into a more sustainable and locally-led response. At the same time, global data show that key populations continue to face many barriers to safe, effective, and high-quality HIV services. These same communities face disproportionate levels of stigma, discrimination, violence, and criminalization. The next generation of HIV programming must ensure that key populations, including gay men and men who have sex with men, transgender people, sex workers, and people who inject drugs, are not left behind.
In 2023, Global Black Gay Men Connect (GBGMC) and the Key Populations Sustainability Caucus partnered with the PEPFAR- and USAID-funded Meeting Targets and Maintaining Epidemic Control (EpiC) project to lead a consultative process with a wide range of key population leaders around the world to articulate what sustaining the HIV response means for key population members. The consultations identified a range of issues key to the sustainability of the HIV response, including ensuring HIV services are person-centered; elevating key population leadership in the design, development, and implementation of HIV programming; increasing country government financing and accountability for HIV services, including the expansion of social contracting; and addressing structural barriers.
EpiC and GBGMC developed a report to summarize the findings from these conversations. The report shares key actions that can be taken by national and subnational governments, donors such as Global Fund and PEPFAR, and members of key population communities to address the systemic barriers that keep key populations from accessing lifesaving care. Other guidance documents also inform the ongoing conversation on sustaining the HIV response. UNAIDS developed a primer and guidance documents to support a new approach to ensure the sustainability of the HIV response, including by standing up an advisory committee with members of key population communities. At the 2024 International AIDS Conference, GBGBC launched a roadmap to “Making Rights a Reality”. During the conference, PEPFAR also announced a new action plan to advance access to quality HIV prevention, care, and treatment programs among key populations. At a satellite session, UNAIDS, PEPFAR, GBGMC and EpiC came together to advance the conversation on sustaining the HIV response for key populations.
While these actions are steps in the right direction, stakeholders have expressed concern about reduced donor funding for HIV and the growing threats to the safety and wellbeing of key population communities. Micheal Ighodaro, Executive Director and Co-Founder of GBGMC, noted, “We welcome the idea of government-led, country-owned HIV responses. It is inevitable—both PEPFAR and the Global Fund will not be here forever. But let’s not be naive: while donor funding will eventually phase out, stigma, criminalization, and the brutal killings of key populations will persist. This is why our destiny cannot be handed over to governments that seek to criminalize and silence us. The future must be ours to shape. The path forward must include a commitment to prioritize key populations.”
As conversations regarding the sustainability of the HIV response ramp up, the GBGMC and EpiC report can be used to inform planning and support efforts to ensure the leadership of key populations in shaping the next generation of sustainable HIV policies and programs. To learn more about this topic, please find a recording of GBGMC & EpiC’s recent webinar recapping the satellite session from the International AIDS Conference. The recording and associated resources are available here.