Communities played a central role in the commemoration of World AIDS Day in South Africa, which was held in the rural community of Orkney, in the North West Province.

At the invitation of the Government of South Africa, the UNAIDS Executive Director, Winnie Byanyima, commemorated her first World AIDS Day as UNAIDS Executive Director in the local community. Ms Byanyima paid tribute to the role of communities in the AIDs response, including communities of people living with HIV and communities of women, girls and others at higher risk of, or affected by, HIV.

Ms Byanyima told the audience of several thousand people that it was an honour to mark World AIDS Day in South Africa—a country that was late to respond to HIV but that had made huge strides over the past decade and now had more than 5 million people on treatment. She noted, however, that there was still a long way to go, especially to protect women and girls.

“Enough is enough. All women and girls must have the right to choose if they have sex and with whom, and how they protect themselves. We need to bring power, equality and agency to all young women and girls,” she said.

Ms Byanyima said we must never accept that people living with HIV are still dying of AIDS. “It is not a question of science. It is a question of inequality, powerlessness and exclusion. The system is still failing for those who are marginalized,” she said.

South Africa’s Deputy President and Chair of the South Africa National AIDS Council, David Mabuza, told the World AIDS Day event audience that South Africa’s AIDS response had succeeded thanks to the work of communities and the contributions of activists and development partners.

“We could not achieve this without partnerships and support from our global partners,” he said. “That is why we must appreciate the contribution of the global campaign by UNAIDS that has galvanized political leadership, civil society and the private sector into coherent action. Community action remains an important pillar in making change happen, and in shaping the policy agenda and outcomes.”

He noted that there was still much work to be done, including intensifying HIV prevention and tackling contributing factors, including providing comprehensive sexuality education and ending gender-based violence.

Mr Mabuza also said he was pleased to be joined by Ms Byanyima. “She is an activist of note and a distinguished advocate for human rights and development,” he said.” We have no doubt that her vast experience in political leadership and human development will take us forward in the struggle to end the AIDS epidemic.”

In the days prior to the World AIDS Day commemoration, Ms Byanyima met with political and civil society leaders, women activists and others to hear their concerns and understand the challenges and opportunities facing South Africa.

She also visited a clinic in Soshanguve, outside Pretoria, to see in action the project Ritshidze (“saving our lives”), which aims to improve the quality of HIV and tuberculosis service delivery in South Africa by empowering people living with HIV to monitor the health services they receive and to advocate for changes needed. The project is funded by the United States of America with support from UNAIDS.

"We can spend billions building beautiful clinics to distribute millions of pills,” Ms Byanyima said. “But only if we empower communities at the grass roots to hold service providers accountable and call out injustices will we make a real difference for people."

Achieving universal health coverage in a country is an ambitious, but transformative, goal. Communities are essential to the AIDS response and will be essential to the successful roll out of universal health coverage (UHC). When national governments establish a committee to coordinate UHC, it is important to ensure that all relevant communities are involved—civil society, including people living with HIV, should be included in decision-making. If civil society is not engaged early in the development of initiatives for UHC, decisions will be made about health services without the voice of the people most affected by those decisions. The graph below shows four ways in which communities contribute to the design and implementation of UHC.

The Community, Health Education and Knowledge Building (CHECK) project in Ethiopia is a joint collaborative project between the Italian Agency for Cooperation and Development (IACS) and UNAIDS. The project aims to support awareness-raising on HIV prevention and increase demand for the uptake of HIV and other health services, including for noncommunicable diseases.

The project is run through four implementing partners in Hawassa, which lies in the Southern Nations, Nationalities and Peoples’ Region of Ethiopia. It focuses on women, young people and people living with HIV, including elderly people, female sex workers, prison inmates and the employees of private sector megaprojects.

On 7 February, Michel Sidibé, the Executive Director of UNAIDS, Tibero Chiari, the Director of IACS, and Seharla Abdulahi, the Ethiopian State Minister of Health, visited three CHECK project implementation sites in order to assess progress and meet people benefiting from the projects.

“HIV is a disruption of the social fabric that binds us together. But in Ethiopia, the community linkages hold the social antibodies to counteract HIV. When the community has the correct knowledge it can break the chain of HIV and create stronger linkages between people,” said Mr Chiari.

The Tilla Association of Positive Women runs an embroidery centre that supports women living with HIV in Hawassa through income-generating activities. At the centre, women living with HIV produce a range of knitted and embroidered items, such as school jerseys and uniforms for the security industry. Not only does the centre provide financial support for the women, it also provides a safe space and emotional support for the women who work there.

“Tilla is like your mother’s house,” said Aster Kebede, a woman living with HIV who works at the centre. “It is my home, my school, my work … my everything.”

The Medhin Elderly People Living with HIV Association is a short walk down the road from Tilla and has had the same impact on its members. Many of its members spoke of the impact that stigma and discrimination has had on their lives, especially as elderly people living with HIV, and the loss of husbands, wives, homes and incomes because of stigma. The association has also provided small grants to many of its members, who have used the catalytic funding to generate income, build small businesses and change their lives for the better.  

“Medhin has restored my self-confidence,” said Bizunesh Kensa, a 64-year-old woman living with HIV. “I don’t feel I am vulnerable anymore; nor do I worry.”

The Hawassa Industrial Park is a megaproject employing 28 000 people, 92% of which are young women and many of whom are from the rural areas of the region. Through the CHECK project, the Regional Health Bureau in Hawassa has produced and disseminated materials on HIV prevention and sexual and reproductive health for workers at the megaproject.

“These projects demonstrate that what matters most is the lives of people. They show the power of community-based projects to restore the dignity of people living with HIV and give them hope for the future,” said Mr Sidibé.

GENEVA, 11 January 2019—UNAIDS warmly welcomes the appointment of Rico Gustav as the Executive Director of the Global Network of People Living with HIV (GNP+). GNP+ has been working for more than 30 years to ensure that the people most affected by HIV are heard and listened to as an integral part of the response to HIV. GNP+ is a much-valued partner of UNAIDS and its work is critical to ending AIDS.   

“Rico Gustav is an excellent advocate for people living with and affected by HIV and a strong voice for all populations that have been marginalized,” said Michel Sidibé, Executive Director of UNAIDS. “He is a trusted activist, a skilled leader and a compassionate human being.”

Mr Gustav is a longstanding health and development activist and a leading voice in the community response to HIV. He is also a former staff member of UNAIDS, having worked for the UNAIDS Country Office in Indonesia and for the UNAIDS Regional Support Team for Asia and the Pacific in Bangkok, Thailand, building and strengthening links between community networks and regional stakeholders.

UNAIDS looks forward to working closely with Mr Gustav and GNP+ in advocating for, and supporting fair and equal access to, HIV prevention, treatment, care and support services for people living with and affected by HIV.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.