Udruga LET potpisnica je deklaracije koja je objavljena na IAS-ovoj konferenciji u Parizu.
Tekst deklaracije:
We, Key Affected Populations living with or
affected by HIV, proclaim that we are more
than just numbers.
We have essential needs
that must be met equitably. It is time to put
an end to our prosecution.
We demand
full commitment and respect from all the
stakeholders we address in this Declaration.
The definition of key populations may
change across different contexts: based on
epidemiological evidence and geographic,
social, legal and political environments.
People living with HIV, gay men and other
men who have sex with men (MSM),
sex workers, transgender people, people
who inject drugs (PWID) and prisoners
are considered the main Key Affected
Populations (KAP) within the global HIV
response.
However, we also consider
indigenous peoples and racialized groups,
women and girls, youth, migrants and
refugees, as affected populations that must
be taken into account as possible Key
Affected Populations in many contexts.
By this Declaration, we reclaim the power
of the Denver Principles (“Nothing for
us without us”) and the GIPA principles.
We insist they be honored in light of the
evolving epidemic and recent scientific
gains for successful responses to HIV/AIDS
and related mental and health conditions.
This will be done by integrating KAP, living
with or affected by HIV, in decision making
and funding in research, treatment and
care, policymaking and implementation.
We are essential agents in understanding
the drivers of the epidemic in all of
their subpopulation-specific variations,
in reaching out to the people that are
most affected and proposing appropriate
responses.
What we request from the international
organizations:
1. Recognize that the HIV/AIDS epidemic
will not end as long as key populations are
criminalized, discriminated against, rejected,
arrested, jailed and killed and advocate to
ensure the rights of KAPs are realized and
respected by all global, regional and national
organizations and governments.
2. Universally adopt the U=U Consensus
Statement on undetectability and
transmission risk through sexual contact and
utilize this scientific fact as a leverage for
increased investments into the global HIV/
AIDS response to realize universal access
treatment and care.
3. Urge UN agencies to step-up and advocate
for inclusion of KAP in decision-making,
board and staff structures, to strengthen
KAP country and local-level organizations,
and to strongly oppose all initiatives coming
from UN member states aiming at removing
any mention of key-populations in UN
official declarations
4. Advocate for universal access to effective
treatments, prevention options, diagnostic
tools and quality health services.
5. Focus attention on “hidden populations”:
those people and groups missing from
formal local and country data (e.g., MSM,
transgender people, sex workers, indigenous
people, migrants and refugees, PWID in
countries where they are criminalized) and
develop both data on these KAP as well as
relevant, evidence-based policies and laws
designed to engage and include them in local
affairs and decisions making.
6. Strengthen alliances and advocacy across
international organizations, especially
between international LGBT organizations
and global HIV activists, and among HIV,
TB, Hepatitis, Malaria and Universal Health
Coverage activists and their organizations.
7. Consider and associate Indigenous Peoples
as necessary actors in the global HIV response,
respect their rights to self-determination, and
adopt the International Indigenous HIV/AIDS
Community 10-point Statement (IIHAC 2017).
What we request from the political leaders
and governments:
1. Accelerate local, national and international
actions to end the HIV/AIDS, hepatitis,
malaria and TB epidemics by 2030. Ensure
the highest attainable standard of physical,
sexual and mental health for all people living
with or affected by HIV/AIDS.
2. Ensure people living with and affected by HIV
enjoy all human rights and equal participation
in civil, political, social, economic and cultural
life, without prejudice, stigma, discrimination
or persecution of any kind.
3. Take all measures to implement local and
country-specific policies and plans based
on the latest scientific evidence on HIV
and its related infections, including PrEP
and the acknowledgement that PLHIV who
take their ART effectively and whose viral load
is undetectable are no longer infectious.
4. Implement appropriate measures
for intellectual property rights in a manner
that promotes timely and affordable access
to quality diagnostics and treatments,
for HIV and related infections, for all.
5. Repeal all the laws discriminating against
and criminalizing KAP related to sexual
orientation, gender identity, race, residence
status, drug use, sex work, HIV status and
transmission to eliminate stigma and
violence towards KAP.
6. Ensure sustainable service delivery and
empowered leadership by key populations
by providing increased investment to local
and country-specific key population initiatives
and networks.
7. Accelerate progress toward universal access
to quality health-care services, including
sexual and reproductive health, mental health
and integrated services for HIV, TB, viral
hepatitis, and sexually transmitted infections.
What we request from the scientific community:
1. Expand and prioritize innovative research
– both medical and social science research –
in areas where there are still gaps in data,
e.g., a cure for HIV, vaccines and other new
prevention options, gender differences,
ageing, mental health, children/minors
living with HIV, specific key populations,
interactions with hormones and recreational
drugs, replacement therapy, MTCT and
breastfeeding, HIV coinfections and
comorbidities especially relative to ageing
populations.
2. Develop research programs with a focus on
achieving the best attainable health for KAPs
from various geographic regions and cultures,
and including migrants, women, MSM,
sex workers, prisoners, PWID, transgender
and intersex people.
3. Ensure improved collaboration among
researchers and allow more sharing
of anonymized and safe data. Engage
KAP representatives in research ethics
committees, protocol teams and in research
agenda-setting, and share research results
with the communities involved.
4. Develop stronger evidence bases and
disaggregated data for the added value
of prevention and treatment.
What we request from the medical community:
1. Universally adopt the U=U Consensus
Statement on undetectability and utilize this
scientific fact as a leverage for increased
investments into the global HIV/AIDS
response to realize universal access treatment
and care.
2. Strengthen the connections between KAPs
organizations and healthcare providers by
creating accessible and culturally-relevant
policies, services, treatments plans, research,
and reports for KAPs at the local, national and
international levels which respects different
worldviews.
3. For KAP groups to benefit from biomedical
approaches such as TasP, PEP and PrEP,
combined prevention and establish
a differentiated rights-based approach
to addressing HIV.
4. Uniformly end the psychiatrization of
transgender people and ensure they receive
quality, affirmative, discrimination-free health
care services and support through transition.
5. Enable universal sexual health education,
testing, and treatment access for members
of KAP groups, including differentiated
approaches, e.g., provide regular monitoring
for toxicities of those on ART or PrEP, access
to hormonal therapy to transgender persons,
and early treatment and PrEP for youth
and adolescents.
6. Ensure an inclusive and differentiated
approach to the care for KAP that includes
options for prevention, treatment, and care;
accounts for the person’s quality of life;
addresses aging and comorbidities; and
provides seamless service coordination.
7. Provide inclusive, sex-affirming, stigma-free
differentiated services and education to KAP
and their partners that respect their right
to self-determination and bodily autonomy.
What we request from the pharmaceutical
companies:
1. Stop evergreening the patent terms of the
drugs already on patent, do not claim patent
on non-innovative molecules, and remove
the patent on all pediatric HIV drugs
2. Set up a fair system on patent rights that
enables early access to innovative drugs
for countries that are unable to afford
the patented drugs.
3. Be transparent on R&D, be fair on pricing
for health care system to be sustainable and
make ARV readily available to all low and
middle income countries and to all vulnerable
populations
4. Scale up and expand early access programs
by e.g. providing voluntary licenses to all low
and lower-middle income countries and by
ensuring transparent price negotiations with
governments.
5. Actively work for Universal Access to
treatment, testing and prevention by making
medicines and diagnostics for HIV and
chronic coinfections much more affordable
and accessible to all vulnerable populations.
6. Pharmaceutical companies share the
responsibility with governments, health care
systems, international organizations and KAPs
to ensure access to treatment for PLHIV.
7. Set up dialogue with KAP communities
within all countries and increase investment
in local community-based HIV programs
and activities.
What we request from the donors:
1. Increase investment in policy change and
NGOs defending human rights of KAP with
a special emphasis on the decriminalization
of sex work, same sex relations, diverse gender
identities and expressions, and drug use.
2. Increase contributions from developed
countries to the Global Fund (in line with
the UNAIDS goal of ending the epidemic
by 2030) to ensure that it is fully funded
to support national HIV services and KAP
organizations.
3. Increase investment in HIV treatment,
cure and prevention research.
4. Increase investment in KAP civil society
groups, especially on core funding;
community development and community-led
interventions to foster leadership among
KAP and PLHIV; targeted local research
and advocacy; and quality prevention
service delivery.
5. Increase investment in care and support
of PLHIV including treatment of co-infection
and other health endemics such as mental
health and general well-being, and youth HIV
programs including programs on adolescent
sexual health and sexuality education.
What we request from our own communities:
1. Strongly fight against any discrimination
from within our own communities
(e.g., homophobia, transphobia, racism,
xenophobia, sexism, serophobia, against sex
workers and drug users) and promote sexual
and racial sub-population participation
in each of our communities.
2. All KAP organizations work in solidarity with
PLHIV to end AIDS and HIV/Hepatitis/TB
epidemics everywhere; put a stop to stigma
and discriminations; halt the criminalization
of HIV transmission; and advocate against
punitive laws that hinder access to HIV
services
3. Create partnerships and unifying efforts
among all KAP communities to lead the fight
to end AIDS and HIV/Hepatitis/TB epidemics
everywhere.
4. In order to promote equitable and sustainable
policies and design HIV programs at the
local, national, regional and international
levels, get involved in network initiatives and
participate in conferences to actively express
the priorities of the Key Affected Populations.
5. Ensure more innovative thinking about old
and new challenges, involve new members
and young activists in speaking up and
advocacy: listen to them, support them,
and provide training to them so they find
their places in the global movement.
6. Know your local HIV epidemic, its dynamics
and its social determinants, especially the
ways that different KAP are impacted, in order
to be able to spread correct information and
provide training among our communities,
e.g., on the latest scientific progress (e.g.,
TASP, PrEP); on holding our governments
accountable relative to policies and decision
making in terms of funding and access to
treatments; and on advocating to ensure
universal access to HIV treatments.