40 years of community leadership

Celebrating 40 years of community leadership in the fight against AIDS is bittersweet. Despite the fact that community leadership is considered to be of great political importance - including the goals of the UN General Assembly Political Declaration - there is still insufficient funding for action. At the same time, communities are under attack in some countries and civil society space is restricted in many places, partly due to a lack of funding. This makes real ownership and leadership impossible. However, we also see vulnerability and resilience. In some countries, the new conservative governments are deliberately closing down all spaces where communities were previously based. Against this backdrop, the evidence for the effectiveness and necessity of community leadership is growing.

Francisca Boenders, Managing Director, Sexuelle Gesundheit Zürich SeGZ

The presentations by Mandisa Dukashe from South Africa, Veriano de Souza Terta Jr. from Brazil and Tetiana Deshko show how important it is for communities to be strong and work together to achieve the common goal. Not only national, but also international solidarity is needed.

Be it on the one hand to stand up for human rights, to maintain the achievements already made in order to enable access to prevention and medical services for all people, but on the other hand also to obtain money from international global funds for the implementation of all programmes and services.

South Africa showed how important the communities are in closing the gaps so that prevention and medical services reach the people. It is of great importance that the key groups concerned demand and stand up for what is important and right for them. The activists have fought big battles for this. Each key group (young people, MSM, women, sex workers, etc.) is also an expert on how prevention and medical services should be implemented. South Africa has made great efforts to ensure that ART and PrEP can be used on a large scale, but this is only possible because the key groups concerned have stood up for this and have also shown the ways to achieve this (for example, they have provided data, shown how to obtain international funds, fought with the government, shown what problems people have to struggle with depending on their living situation, etc.).

In Ukraine, state funding and aid for prevention, medical services and care have been cancelled since the start of the war. Civil society organisations and the communities have taken the lead in prevention and medical care for HIV and AIDS. This is thanks to great international solidarity and international funding. Despite the prevailing war, thanks to innovative projects (e.g. online services, mobile medical health centre), great progress has been made in prevention and access to medical services for HIV and AIDS, e.g. a 130% increase in PrEP users has been recorded since the start of the war. It was emphasised how important it is for innovative projects to be implemented quickly so that the people affected can access prevention and medical services easily and free of charge.

The representative from Brazil formulated challenges such as the fact that there is less and less funding and donations for HIV/AIDS, as the challenges worldwide are prioritised differently, e.g. war, global warming, etc.

But also the concern of how to involve young people to take the lead so that the achievements can be maintained and expanded in order to achieve the goals that have been set.

The symposium showed that even though resources are distributed differently around the world and different governments promote HIV/AIDS prevention, research and treatment differently, we all still have in common, even after 40 years, that communities are the experts. Communities and civil society organisations must continue to advocate for human rights - be it for recognition and/or implementation, closing gaps in care and making access to prevention and ART as low-threshold as possible for all people. We must all continue to launch innovative projects and fight for funding so that people can receive free or low-cost prevention or ART.

Aids-Hilfe Schweiz and the cantonal Aids-Hilfe organisations will be celebrating their 40th anniversary next year. Despite what we have already achieved, we will not run out of work - because we are the experts! It's worth fighting for funds with the FOPH, the canton and the big cities so that we can launch innovative projects. Our many years of expertise help us to remain innovative so that we can reach people in Switzerland for HIV prevention and ART. Our longstanding struggle for funding has made us resilient, let's keep at it. On the one hand, so that we can expand and develop our programmes, but also so that these services become free or less expensive for key groups.

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