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Today there is a vast amount of scientific literature about how to effectively treat and prevent HIV, including many articles focused specifically on what it will take to end the epidemic. But the realm of peer-reviewed papers isn’t reality. And there is a real danger that some or all of the potential benefits of today’s strategies will be lost because of an unbridged gap between the science and human rights- based agendas for the global AIDS response. That’s why one of our top recommendations and priorities for 2015 is: Align high-impact strategies with human rights and realities.
What’s needed today is a fundamental shift in the conceptualization and implementation of components of a biomedically-oriented approach to ending the epidemic. As the science advances, more money needs to flow to civil society groups—not less. And the programs that deliver these combination packages need to be deeply embedded in, informed and led by people living with and at risk of HIV. Without these close connections, the programs will not reach the people most in need. In addition to shifting funding and program design to include civil society, and particularly people living with and most at risk of HIV, here are three key recommendations:
- Pursue high levels of ART coverage, while addressing issues of choice and coercion. Having the option to choose to start ART—including at high CD4 cell counts and in order to preserve health and reduce risk of onward transmission—ought to be the reality for every person living with HIV.
- Revise the “rights versus HIV” rhetoric and reality that’s splitting LGBT groups and other key potential allies from those on the frontlines of the fight against HIV.
- Remember that culture and community views often can’t be modeled—but they can’t be ignored, either. Whether it is determining the appropriate age range for delivering VMMC or developing efficiency-oriented approaches to treatment delivery, there are models that suggest the right way to proceed. But these models are only as good as the data that go into them.