The WHO Department of Global HIV, Viral Hepatitis and Sexually Transmitted Infections Programmes (HHS) convened 65 members of former civil society reference groups for HIV and hepatitis, the WHO advisory group of women living with HIV and community and civil society representatives who had formally engaged with the department in recent years to a virtual exchange of ideas on 16 October 2020.
The meeting provided an opportunity to share updates on WHO’s work on HIV, hepatitis and sexually transmitted infections (STIs) in 2020 and hear feedback from civil society and community partners on key issues and questions to be explored at the WHO Strategic and Technical Committee on HIV and Viral Hepatitis (STAC-HIVHEP) scheduled to meet virtually from 28-30 October. Participants were invited to share ideas around four areas:
- Mitigating the impact of COVID-19 on essential HIV, hepatitis and STI services;
- Proposing key elements, themes and principles for 2022-2030 strategies;
- Balancing the need for disease specificity and sustainability in health including through universal health coverage, primary healthcare and health systems strengthening; and
- Raising the profile of STIs.
During discussion meeting participants stressed the importance of WHO securing support for 2022-2030 strategies and described the impact of COVID-19 on the disruption of essential HIV, hepatitis and STI services exacerbated by the influence of populist challenges to science, community organizing and rights. WHO was also encouraged to be bolder in highlighting the countries, regions and populations were progress is unacceptably slow, including as a result of policy and financial barriers. Other issues raised during the meeting included:
- Future strategies must urgently prioritize key populations for all three disease areas, universal health coverage and should include further focus on criminalization, prisoners, social determinants and people in humanitarian crises including displaced and migrant populations;
- Re-focus on prevention, including primary prevention, across the disease areas with a clear focus on reaching priority populations first and enhancing support to innovation;
- The importance of raising the profile of HTLV1 as a sexually transmitted infection and encouraging expanded HTLV1 testing and prevention programming including through safer sex and condom promotion with links to other disease areas and sexual reproductive health and rights;
- COVID-19 mitigation approaches should continue to promote and support funding for community delivery of services including for testing, harm reduction and other prevention services and the distribution of medicines for HIV and viral hepatitis;
- WHO should ensure that guidance on all disease areas and on COVID-19 seeks to ensure women’s sexual and reproductive health and rights by maintaining essential services and ensuring an increased focus on gender based and intimate partner violence and mental health;
- Participants shared perspectives on how “COVID criminalization” was impacting on sex workers, people who use drugs and other key populations and called for further attention on the health of prisoners in context of COVID-19;
- WHO was asked to optimize all options to secure lower commodity prices including for middle-income countries and to apply the learning and expertise from HIV and hepatitis access strategies to emerging COVID-19 commodities;
- Essential HIV, hepatitis and STI services and interventions need to be included in all essential UHC packages in all countries with WHO support including through the planned UHC Compendium;
- WHO has an important role in ensuring that community-based data generation and digital approaches are valued and supported and that funders see the value in community-based and community-led responses.
A number of community and civil society participants who joined the exchange on 16 October are also STAC-HIVHEP members including: Javier Hourcarde Bellocq from Argentina, Othman Mellouk from Morocco, Isabelle Andrieux-Meyer from Switzerland, Annette Sohn from Thailand and Oanh Khuat Thi Hai from Viet Nam. Cary James from the UK will also attend as an observer. All agreed to ensure that key points, including detailed points not captured here, raised during the consultation are shared at the STAC-HIVHEP meeting for consideration.