Sitting across from the bustling main Geneva train station, the lime-green block structure called Quai 9 stands out. The building houses a supervised drug injection centre run by the non-governmental organisation,  Première Ligne. Quai 9 (track 9 in English) also provides primary health care services as part of its harm reduction drop-in centre to people who use drugs.

On the occasion of UNAIDS 41^st meeting mid-December of the Programme Coordinating Board, the Switzerland government organized a visit for UNAIDS board members.

The visit highlighted how addressing the needs of injecting drug users through a public health and human rights-based approach,  considerably reduces the risks of  HIV infection and links people to health care.

The Swiss Ambassador to the United Nations, Mr Valentin Zellweger recalled how in the 1980s and 1990s, Switzerland had one of the highest incidence of HIV in Europe among people who inject drugs. In response to the crisis, Switzerland, introduced a “four pillars” policy, which focused on prevention, treatment, harm reduction and law enforcement.

One of the outcomes was setting up drug injection centres and increasing collaboration between the police and health care clinics.

As a result, HIV infections among people who inject drugs in Switzerland dropped precipitously.

Earlier in the week, Ms Ruth Dreifuss, former President of Switzerland, Health minister and current chair of the Global Commission on Drug Policy, had addressed UNAIDS board members. Ms Dreifuss, who spearheaded the four pillars policy during her tenure, said the evidence that harm reduction and decriminalization of drug use spoke for itself. She urged member states to leave no one behind by ensuring that drug use is treated as a public health issue. That call was further emphasized by members of the NGO delegation. 

UNAIDS Deputy Executive Director Luiz Loures commended Switzerland for its innovative, multi-sectoral approach to harm reduction. He said that UNAIDS would continue advocating for evidence-informed, human-rights based AIDS responses such as Quai 9.    

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Ayushi Tripathi is a student at Banaras Hindu University in Varanasi, a city in India’s northern state of Uttar Pradesh.

She explains that she comes from a family where talking about sex is taboo. “We never talk about it at home. Even seeing an advertisement about condoms is uncomfortable for my parents,” she said. But nonetheless, she was intent on attending a youth health workshop.

This week, she joined 27 other students for a three-day workshop to raise young people’s awareness of their sexual and reproductive health and rights. The training was led by the Dove Foundation, a youth-led organization based in Varanasi and supported by UNAIDS. The advocacy materials used were developed by the PACT, a global coalition of 25 youth networks working on HIV and sexual and reproductive health and rights.

“When I was younger, I didn’t have knowledge on where to get information and access to HIV services,” Ms Tripathi said. “Until I took this workshop, I had no idea that young people in India face challenges in accessing HIV testing and services.”

Monique Long from the Jamaica Youth Advocacy Network led the training, which provided youth and adolescents with the skills and information necessary to tackle the different barriers affecting their health.

“Working with this diverse group of intelligent and energetic young people reminds me of why we say youth are the future. This training also reaffirms that youth right here and right now have the capacity and the will to do amazing things to change the world,” Ms Long said.

Asia and the Pacific is the region with the largest number of young people in the world. In the region, people are starting sex at an increasingly younger age and having multiple sex partners, placing young people at higher risk of HIV.

During the training, the participants stressed how many countries are not tailoring their programmes to young people. For example, India requires people under 18 years old to have parental consent for HIV and other sexual and reproductive health services. Comprehensive sexuality education is often not taught in schools. The low levels of HIV knowledge and discrimination faced in health-care settings further exacerbate the situation.

The PACT and UNAIDS have been working with governments and other partners in advocating for the revision and reform of age of consent laws. The training provided young people with the techniques and skills needed for prioritizing advocacy issues, mapping different stakeholders, crafting key advocacy messages and lobbying.

“UNAIDS knows that the future of the HIV response lies in the hands of young people,” said Aries Valeriano, Youth Officer at the UNAIDS Regional Support Team for Asia and the Pacific. “We are working hand in hand with youth organizations and community groups to break down the barriers that young people face and that keep them from staying healthy and productive.”

After completing the workshop, Ms Tripathi said she plans to start a community of advocates at her university to push for ending the age of consent laws in India. As Ms Tripathi received her completion certificate, she beamed. “The workshop helped to open my eyes on social activism,” she said. “I am so inspired and hope to really influence policies in my university and beyond.”

UNAIDS is working to ensure that the target in the 2016 United Nations Political Declaration on Ending AIDS of ensuring that 90% of young people have the skills, knowledge and capacity to protect themselves from HIV and have access to sexual and reproductive health services by 2020, in order to reduce the number of new HIV infections among adolescent girls and young women to below 100 000 per year, is met.

On 19 July, a workshop was hosted at the 21st International AIDS Conference, being held in Durban, South Africa. Entitled “Common at its core: understanding the linkages for challenging the impact of criminal law across population groups,” the workshop highlighted the common root causes of the misuse of criminal law against people living with HIV, sex workers and lesbian, gay, bisexual, transgender and intersex people, as well as in the context of abortion.

The discussions noted that unjust criminal laws against those populations are due to prejudice, gender inequality and discrimination. The participants stressed that punitive laws against key populations lead to serious human rights violations, exacerbate vulnerabilities to HIV and other health issues and affect efforts to end AIDS.

To address unjust laws, the participants called for building synergies among populations affected by them. This will allow experience-sharing on successful approaches in addressing criminalization and will enable the development of joint strategies. Examples of collaborations between communities to address their common health and human rights challenges were highlighted.

The discussions were concluded with a call for more collaboration in addressing the criminal law and its impact on specific populations, including in the context of HIV. This should build on efforts to expand strategic litigation and the engagement of lawmakers, the police and the judiciary to end injustice and advance health for all.

The event was organized by UNAIDS, the Office of the United Nations High Commissioner for Human Rights, Amnesty International and the Global Health Justice Partnership at Yale University.

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