The Gboklè/Nawa/San Pedro region is the second largest economic hub in Côte d’Ivoire and one of the regions most affected by the HIV epidemic. The region attracts many workers because of its important economic and industrial activities, mainly related to the port and agriculture, as well as sex workers and other members of key populations.

A joint United Nations Development Programme (UNDP)/UNAIDS mission to the region from 16 to 20 April learned about the realities of the HIV response in the region in the context of COVID-19 and assessed how the response takes into account the needs of the most vulnerable.

The mission first paid a courtesy call on the region’s administrative and health authorities, and then quickly focused on the sites where services are offered to people living with HIV and key populations. In the health-care facilities visited, whether at the Regional Hospital of San Pedro, above, or at the health centre of APROSAM (Association pour la Promotion de la Santé de la Femme, de la Mère et de l’Enfant) nongovernmental organization, the mission team saw the commitment and determination of the health-care teams and the administrations of the facilities. “We have set up a quality assurance team within the hospital to guarantee services centred on the needs of each patient,” said Alexandre Kissiedou, the Director of the Regional Hospital of San Pedro.

The visit to APROSAM was one of the most captivating moments of the mission. During the visit, the mission team had in-depth discussions with representatives of a dozen associations, who had come to APROSAM’s headquarters to meet the mission delegation. Useful discussions took place with representatives of associations of people living with HIV and associations representing key populations, as well as with representatives of nongovernmental organizations working with young people.

“It is the first time that civil society is honoured with the visit of the country representatives of two United Nations agencies,” said Odette Koffi, the Executive Director of APROSAM, an association involved in the response to HIV, tuberculosis and malaria in the region. She also noted that civil society is truly committed to the HIV response but lacks the means to meet the needs of all.

“Income-generating activities are no longer working as they used to. Today we can’t even feed ourselves properly and we can’t take antiretroviral medicines on an empty stomach,” said Maya Rose Nean, the head of the local CERBAS association for women living with HIV, when describing how COVID-19 had impacted women living with HIV in the country.

Brigitte Quenum, the UNAIDS Country Director for Côte d’Ivoire, speaking on behalf of the delegation, underlined the vital work of nongovernmental organizations in the HIV response and praised the commitment of civil society organizations, people living with HIV and key populations. She said that a dialogue between UNDP and UNAIDS will address some of the pressing needs discussed with civil society. A donation of 400 food and hygiene kits was made by UNDP and UNAIDS to vulnerable people living with HIV and key populations.

The last day of the mission focused on human rights, with a visit to the Elan d’Amour reception centre, above, which offers temporary accommodation to people living with HIV and people who are victims of stigma, discrimination and gender-based violence, including people who come from remote areas for care and/or to collect their antiretroviral therapy. The delegation then visited a legal clinic supported by UNDP. These visits allowed the delegation to get a good understanding of the realities of human rights in the region, but also to understand their implications for specific HIV-related vulnerabilities. As a result of these two visits, the two agencies agreed to consider a joint project to better address HIV and human rights issues in the region.

For both teams, this mission was a success. The various needs identified will be the subject of concerted action either between UNDP and UNAIDS or by working with other Cosponsors that can provide relevant solutions.

Brigitte Quenum, the UNAIDS Country Director for Côte d’Ivoire, above left, met with the Prefect of the San Pedro department. 

The Global Fund to Fight AIDS, Tuberculosis and Malaria, the Government of Congo and health partners have announced two new grants worth more than US$ 64 million to strengthen prevention and treatment services to respond to HIV, tuberculosis and malaria and to build resilient and sustainable systems for health in Congo.

The two grants are a 97% increase from the previous allocation against the three diseases and will be spent from 2021 to 2023.

“UNAIDS looks forward to continuing to work closely with all partners to accelerate the elimination of vertical transmission of HIV and paediatric AIDS in Congo and to improve access to HIV/tuberculosis programmes, sexual and reproductive health, and legal services for young women and adolescent girls and all groups at higher risk of contracting HIV,” said Winnie Byanyima, Executive Director of UNAIDS.

The HIV grant will significantly increase the number of people living with HIV who know their HIV status and will expand access to life-saving antiretroviral therapy, particularly for pregnant women. In 2019 in Congo, only 51% of people living with HIV knew their HIV status and only 25% of people living with HIV were accessing antiretroviral therapy. Only 10% of pregnant women living with HIV in Congo were offered antiretroviral medicine to prevent the virus being passed to their babies.

The tuberculosis component of the grant aims to boost the national tuberculosis response, increase the notification of new tuberculosis cases and reach a 90% treatment success rate by 2023, in line with the World Health Organization’s End TB Strategy. The grant will also support the country’s efforts to improve treatment success for people with multidrug-resistant tuberculosis. The malaria grant will support the country’s goal to distribute 3.5 million mosquito nets by 2023 and expand access to quality malaria diagnostics and treatment tools.

“In the context of the country’s financial crisis, exacerbated by the COVID-19 pandemic, the grants allocated to Congo are a breath of fresh air. They provide renewed impetus to the government’s action in favour of populations affected by HIV, tuberculosis and malaria,” said the Prime Minister of Congo, Clément Mouamba.

The United Nations Development Programme will implement the HIV and tuberculosis grant, while Catholic Relief Services will implement the malaria grant.

NEW YORK, 23 September 2020—The World Health Organization (WHO) together with the UN, specialised agencies and partners today called on countries to develop and implement action plans to promote the timely dissemination of science-based information and prevent the spread of false information while respecting freedom of expression. 

WHO, the UN, UNICEF, UNAIDS, the UN Development Programme (UNDP), UNESCO, the International Telecommunication Union (ITU), the UN Global Pulse initiative and the International Federation of the Red Cross and Red Crescent Societies  (IFRC), together with the governments of Indonesia, Thailand and Uruguay held a webinar on the margins of the 75th UN General Assembly to draw attention to the harm being done by the spread of misinformation and disinformation, the latter being deliberate misinformation to advance an agenda.

“As soon as the virus spread across the globe, inaccurate and even dangerous messages proliferated wildly over social media, leaving people confused, misled and ill-advised”, said UN Secretary-General António Guterres. ”Our initiative, called “Verified”, is fighting misinformation with truth. We work with media partners, individuals, influencers and social media platforms to spread content that promotes science, offers solutions and inspires solidarity. This will be especially critical as we work to build public confidence in the safety and efficacy of future COVID-19 vaccines. We need a ‘people’s vaccine’ that is affordable and available to all.”

“Misinformation and disinformation put health and lives at risk, and undermine trust in science, in institutions and in health systems,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “To fight the pandemic we need trust and solidarity and when there is mistrust, there is much less solidarity. False information is hindering the response to the pandemic so we must join forces to fight it and to promote science-based public health advice. The same principles that apply to responding to COVID-19 apply to managing the infodemic. We need to prevent, detect and respond to it, together and in solidarity.” 

“On top of the immediate impact on pandemic responses, disinformation is undermining public trust in democratic processes and institutions and exacerbating social divides”, said UNDP Administrator Achim Steiner. “It’s one of the most concerning governance challenges of our time. UNDP is actively collaborating with Member States, fellow UN agencies, and other partners to find holistic responses which respect human rights.”

“Misinformation is one of the fastest growing challenges facing children today,” said Henrietta Fore, UNICEF Executive Director. “It takes advantage of the cracks in trust in societies and institutions and deepens them further, undermines confidence in science and medicine, and divides communities. In its most pernicious forms, such as when it convinces parents not to vaccinate their children, it can even be fatal. Because misinformation is more a symptom than a sickness, countering it requires more than just providing truth. It also requires trust between leaders, communities and individuals.” 

“We can beat COVID-19 only with facts, science and community solidarity,” said Executive Director, Winnie Byanyima. “Misinformation is perpetuating stigma and discrimination and must not come in the way of ensuring that human rights are protected and people at risk and those marginalized have access to health and social protection services.”

“Since the start of the pandemic, UNESCO has mobilised its international networks of media partners, journalists, fact-checkers, community radio stations, and experts, to give citizens the means to fight against false information and rumours — phenomena that have been exacerbated by the pandemic,” said Audrey Azoulay, the UNESCO Director-General. ”Collective mobilisation to promote quality and reliable information, while strictly ensuring respect for freedom of expression, is essential. A free, independent and pluralistic press is more necessary than ever.”

“Trust is a cornerstone of our digital world,” said Houlin Zhao, Secretary-General of the International Telecommunication Union. “Building on the long-standing WHO-ITU BeHe@lthy BeMobile initiative, ITU has been working with national ministries of telecommunications and health and mobile network operators since the beginning of this crisis to text people who may not have access to the internet, providing them with science- and evidence-based COVID-19 health advice directly on their mobile phones.”

WHO and partners urged countries to engage and listen to their communities as they develop their national action plans, and to empower communities to build trust and resilience against false information. 

“Engaging communities on how they perceive the disease and response is critical to building trust and ending outbreaks,” said Jagan Chapagain, IFRC Secretary General. “If our response does not reflect the communities’ concerns and perceptions, we will not be seen as relevant or trusted by affected populations, and the epidemic response risks failure.  More than ever, local responders are at the forefront of this crisis. We need to recognize the incredible role they play in understanding and acting on local knowledge and community feedback.”

The co-hosts also called on the media, social media platforms, civil society leaders and influencers to strengthen their actions to disseminate accurate information and prevent the spread of misinformation and disinformation. Access to accurate information and the free exchange of ideas online and offline are key to enabling effective and credible public health responses.

"UN Global Pulse was set up a decade ago inside the UN System to pioneer the use of real-time and predictive insights to protect vulnerable communities in times of crisis”, said Robert Kirkpatrick, Director of UN Global Pulse, the United Nations Secretary-General’s initiative on big data and artificial intelligence (AI). “During this pandemic we have seen a tremendous increase in requests for advanced analytics from across the UN System and Member States. We will continue to work with WHO and other partners to help identify and combat mis- and disinformation.” 

Note to Editors

WHO defines an infodemic as an overabundance of information, both online and offline. It includes accurate information as well as mis- and disinformation. 

In May 2020, WHO Member States passed Resolution WHA73.1 on the COVID-19 response at the World Health Assembly. The Resolution recognises that managing the infodemic is a critical part of controlling the COVID-19 pandemic: it calls on Member States to provide reliable COVID-19 content, take measures to counter mis- and disinformation and leverage digital technologies across the response. The Resolution also called on international organisations to address mis- and disinformation in the digital sphere, work to prevent harmful cyber activities undermining the health response and support the provision of science-based data to the public. 

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.

NEW YORK/GENEVA, 22 July 2020—Launching today, the COVID-19 Law Lab initiative gathers and shares legal documents from over 190 countries across the world to help states establish and implement strong legal frameworks to manage the pandemic. The goal is to ensure that laws protect the health and wellbeing of individuals and communities and that they adhere to international human rights standards.

The new Lab (at covidlawlab.org) is a joint project of United Nations Development Programme (UNDP), the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the O’Neill Institute for National and Global Health Law at Georgetown University.

Well-designed laws can help build strong health systems; evaluate and approve safe and effective drugs and vaccines; and enforce actions to create healthier and safer public spaces and workplaces. Critically, they are key to effective implementation of the WHO International Health Regulations: surveillance; infection prevention and control; management of travel and trade; and implementation of measures to maintain essential health services.

“Laws and policies that are grounded in science, evidence and human rights can enable people to access health services, protect themselves from COVID-19 and live free from stigma, discrimination and violence,” says Achim Steiner, UNDP Administrator. “The COVID-19 Law Lab is an important tool for sharing good practices on laws and policies.”

The COVID-19 pandemic has seen a vast increase in urgent legislative action to control and reduce the pandemic.

"Strong legal frameworks are critical for national COVID-19 responses," said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. “Laws that impact health often fall outside the health sector. As health is global, legal frameworks should be aligned with international commitments to respond to current and emerging public health risks. A strong foundation of law for health is more important now than ever before.”

However, laws that are poorly designed, implemented, or enforced can harm marginalized populations, entrench stigma and discrimination, and hinder efforts to end the pandemic.

“Harmful laws can exacerbate stigma and discrimination, infringe on people's rights and undermine public health responses," according to Winnie Byanyima, Executive Director of UNAIDS. "To ensure responses to the pandemic are effective, humane and sustainable, governments must use the law as a tool to uphold the human rights and dignity of people affected by COVID-19.”

The COVID-19 Law Lab is a database of laws that countries have implemented in response to the pandemic. It includes state of emergency declarations, quarantine measures, disease surveillance, legal measures relating to mask-wearing, social distancing, and access to medication and vaccines. The database will continue to grow as more countries and themes are added.

It will also feature research on different legal frameworks for COVID-19. These analyses will focus on the human rights impacts of public health laws and help countries identify best practices to guide their immediate responses to COVID-19 and socioeconomic recovery efforts once the pandemic is under control. It builds off the work of the UHC Legal Solutions Network, which was established to help countries achieve universal health coverage through the implementation of rights-based legal frameworks.

"We need to track and evaluate how laws and policies are being used during the Pandemic to understand what works," said Dr. Matthew M. Kavanagh, faculty in Georgetown University's Department of International Health. Katie Gottschalk, Executive Director of the O'Neill Institute for National and Global Health Law at Georgetown University Law Center added, "We must learn lessons from the early stage of pandemic policies to implement the most effective laws going forward – the COVID-19 Law Lab allows us to do just that."

UNDP

The United Nations Development Programme is the leading United Nations organization fighting to end the injustice of poverty, inequality, and climate change. Working with our broad network of experts and partners in 170 countries, we help nations to build integrated, lasting solutions for people and planet. Learn more at undp.org or follow @UNDP.

WHO

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing. For updates on COVID-19 and public health advice to protect yourself from coronavirus, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube

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.

O’Neill Institute for National and Global Health Law and Georgetown University

The O’Neill Institute, housed at Georgetown University, was established to create innovative solutions to the most pressing national and international health concerns, with the essential vision that the law has been, and will remain, a fundamental tool for solving critical health problems. The Georgetown University Department of International Health is home to scholarship in public health, economics, political science, and medicine. Georgetown’s Global Health Initiative serves as a university-wide platform for developing concrete solutions to the health challenges facing families and communities throughout the world. Read more at oneillinstitute.org and connect with us on Twitter and Facebook.

UHC Legal Solutions Network

The COVID-19 Law lab is a product of the UHC Legal Solutions Network is a collaboration between the World Health Organization (WHO), the United Nations Development Programme (UNDP), the Joint United Nations Programme on HIV and AIDS (UNAIDS), the Inter-Parliamentary Union (IPU), and the O'Neill Institute for National and Global Health Law at Georgetown University. The initiative aims to support countries to achieve universal health coverage by working with policymakers, civil society groups and other stakeholders to craft laws ensure that all people and communities have the right to access the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

The United Nations system in Nigeria joined the fight against COVID-19 shortly after the first case was detected in the country in late February 2020.

UNAIDS’ lessons learned and expertise in facilitating, linking and bringing stakeholders together have been instrumental in guiding the United Nations multi-agency response, led by the Resident Coordinator, Edward Kallon. And by proactively mobilizing its political capital and goodwill in the country, UNAIDS has helped to bring resources and better lines of communication, coordination and accountability to the national COVID-19 response.

In mid-March, the Presidential Task Force was established to develop a COVID-19 response plan for how organizations should work together. Appointed as the only development member of the task force, the Representative, a.i., of the World Health Organization (WHO), Fiona Braka, provides the overall United Nations technical leadership to the government. Lessons learned from the HIV response fed into the development of the “four ones” guiding principles for the national response to the COVID-19 pandemic—one national COVID-19 multisectoral pandemic response plan, one COVID-19 national coordinating authority, one COVID-19 monitoring and evaluation system and one COVID-19 financing and investment platform.

“The “four ones” principles will simplify and clarify roles, responsibilities and relationships, including within the government,” said the Minister of Health of Nigeria, Osagie Ehanire.

Another lesson learned from the HIV response was the importance of ensuring that marginalized and vulnerable people are given consideration at every step of the development of a response to a pandemic. The potential impact of COVID-19 on people living with HIV, key populations and the poor also had to be at the centre of decision-making.

“UNAIDS regularly coordinated with the networks since the beginning of the COVID-19 outbreak, providing technical guidance and ensuring synergy with the efforts of the government,” said Abdulkadir Ibrahim, the National Coordinator of the Network of People Living with HIV/AIDS in Nigeria.

Working with the United Nations Development Programme, UNAIDS liaised with the wider United Nations system and the government and facilitated the handover of US$ 2 million worth of emergency medical commodities to the government, ensuring that the supplies and equipment were prioritized for use in public health facilities and by health-care workers.

The One UN COVID-19 Basket Fund was launched on 6 April. Part of one of the “four ones”, the one COVID-19 financing and investment platform, the Basket Fund channels the contributions of donors to the COVID-19 response. UNAIDS played a critical role in its establishment, working with the United Nations Resident Coordinator and the United Nations Development Programme to ensure that the financing platform put people and communities at the centre. UNAIDS, UN Women, WHO and the United Nations Population Fund helped to mobilize US$ 6.5 million for civil society and community engagement, social protection for vulnerable households, community-led surveillance and monitoring of COVID-19 and HIV and the documentation of community best practices.

In announcing a €50 million contribution to the Basket Fund, the Head of the European Union delegation to Nigeria, Ketil Karlsen, said, “The COVID-19 Basket Fund gives us the opportunity to cooperate and act rapidly in the deployment of assistance that can help to enhance health-care services and cushion the most vulnerable.” 

Perhaps the most important contribution by UNAIDS to the COVID-19 response in the country, however, has been advocating to harness the vast HIV infrastructure in the country for the fight against COVID-19.

“We must leverage HIV assets on the ground, including not just laboratory facilities but community health workers and volunteers. To fight COVID-19 effectively we will have no choice but to engage communities to own the response,” said Erasmus Morah, the UNAIDS Country Director for Nigeria.

In a joint effort, the United States Government, the National Agency for the Control of AIDS, the United Nations Children’s Fund, WHO, UNAIDS and the Presidential Task Force mapped and initiated the engagement of approximately 100 000 community health-care workers and volunteers to undertake risk communication, social mobilization, contact tracing and home care.

COVID-19 is far from over in the country, with cases steadily rising, and United Nations staff have not been spared. However, as Mr Kallon, said, “The United Nations must stay open for business and deliver for the people while ensuring that staff members and their dependents are provided with the necessary environment for their protection against COVID-19.” Following this, a COVID-19 isolation and treatment centre as an extension of the United Nations clinic was established for staff as frontline workers, together with their dependent family members. 

Moving forwards with the COVID-19 response, in addition to the continued support for the Presidential Task Force, the United Nations Country Team, including UNAIDS, is gearing up to support Nigeria to address the major gaps in subnational preparedness. Key issues such as the loss of livelihoods, heightened vulnerabilities and food insecurity, the increased risk of gender-based violence and limited access to essential health services will also be addressed in the coming months.

Statement of the Joint UN Programme on HIV/AIDS (UNAIDS) Interagency Working Group on Key Populations on the need to ensure access to quality, safe, and non-discriminatory services for HIV key populations and migrants in the context of the COVID-19 pandemic

The rapid spread of COVID-19 continues to impact billions of lives around the world. Unprecedented human and financial resources are needed to address this pandemic. UN entities, NGOs, communities of people living with HIV, sex workers, gay men and other men who have sex with men, people who use drugs, transgender people, and people in prisons and their sexual partners, as well as civil society all have a role to play in fighting COVID-19, saving lives, and tackling far-reaching social and economic consequences. Critical moments like this remind us more than ever that inequality can be a matter of life and death and that everyone is born free and equal in dignity and rights, including to the highest attainable standards of health.

Lessons learned from the global HIV response should inform COVID-19 responses: HIV has taught us that it is a shared responsibility and we need to empower communities and involve them in the response; we should never compromise on human rights; we need to remove all forms of stigma and discrimination; and we need to support vulnerable and marginalized groups.

UNAIDS estimates that 62 % of the new HIV infections are among key populations and their sexual partners. Key populations experience particular forms of exclusion, criminalisation, inequality and discrimination that render them particularly vulnerable to HIV and again now to COVID-19. People in prisons and closed settings, where physical distancing is not always an option, are extremely vulnerable to COVID-19. People in prisons also have a higher prevalence of HIV and TB which poses a higher risk of complication if infected with SARS-COV 2, as do migrants, who also face greater HIV vulnerability. LGBT people are reporting an elevated risk of domestic and family violence, increased social isolation and difficulties in accessing crucial HIV treatment and gender-affirming health services. Leaving key populations behind at this critical moment could have a grave impact on health and human lives. It could reverse the gains in the global HIV response as well. 

We call on all Governments and partners to join us in,

Making quality, non-discriminatory HIV prevention, treatment, care and support services, and health services in general, available for key populations and migrants in the context of the COVID-19 pandemic.

These services must be based on respect, protection and fulfilment of human rights, regardless of existing punitive laws, policies and practices. They must be free from stigma and discrimination, based on evidence and science, and compliant with the most recent international guidance. Services must be equitable, based on informed consent, confidential and safe - for communities, as well as healthcare workers.

Rapidly adapting service provision to take into account the new realities of the COVID-19 pandemic.

Examples of adapted services are safe access to home HIV testing and remote counselling. Where possible, 3 to 6 months’ supply of ARVs, TB and viral hepatitis treatment should be supplied to ensure continuity of treatment, reduce transmission of HIV and co-infections, as well as the risk of COVID-19. People who use drugs should have access to harm reduction, including, where applicable and as advised by medical professionals, access to multiple opioid substitution doses to reduce OST site visits and COVID-19 exposure risk. Alternatives to imprisonment, where allowed, for non-violent offences could save lives, particularly for crimes not recognised under international law. Measures of early release should be taken for specific categories of people who are at particular risk of being affected by COVID-19, such as the elderly and individuals affected by chronic diseases or other health conditions, as well as pregnant women, women with dependent children, prisoners approaching the end of their sentence and those who have been sentenced for minor crimes in prisons, in-line with national policies and without compromising public health and safety. Emergency social protection measures for key populations are needed since they are often excluded from social services, including, but not limited to, housing and health insurance, and are often in precarious work situations. Service provision must continue to take into consideration intersectionality, gender and age diversity. It must be properly resourced with people, funding and materials. In order to be effective and efficient, these services must include key populations, their communities and organizations in their design and implementation.

Ensuring COVID-19 responses do not lead to the proliferation of punitive laws and measures to enforce restrictions or to criminalise transmission and exposure.

The gravely detrimental effect of such punitive measures on already marginalized or criminalized people has been well-documented in the HIV response, including by the Global Commission on HIV and the Law.

We won't stop COVID-19 if some people can’t afford or access testing or treatment. We must ensure that responses to COVID-19, or any other pandemic or health emergency, do not leave key populations, migrants and other vulnerable groups behind. As the Interagency Working Group on Key Populations we stand ready to work with all partners to ensure safe and rights-based access of key populations to quality HIV and COVID-19 services.

The Interagency Working Group on Key Populations is established under the UNAIDS Division of Labour and is co-convened by the United Nations Development Programme (UNDP), the UN Population Fund (UNFPA), and the United Nations Office on Drugs and Crime (UNODC) in partnership with the Global Network for and by People Living with HIV (GNP+), the International Network of people who Use Drugs (INPUD), MPact Global Action for Gay Men’s Health and Rights (MPact), Global Network of Sex Work Projects(NSWP), IRGT, and the UNAIDS Secretariat.

Signed by Ghada Fathi Waly, Executive Director, UNODC; Tedros Adhanom Ghebreyesus, Director-General, WHO; Winnie Byanyima, Executive Director, UNAIDS; Michelle Bachelet, United Nations High Commissioner for Human Rights. — * We thank UNDP for their contributions to this statement.

We, the leaders of global health, human rights and development institutions, come together to urgently draw the attention of political leaders to the heightened vulnerability of prisoners and other people deprived of liberty to the COVID-19 pandemic, and urge them to take all appropriate public health measures in respect of this vulnerable population that is part of our communities.

Acknowledging that the risk of introducing COVID-19 into prisons or other places of detention varies from country to country, we emphasize the need to minimize the occurrence of the disease in these settings and to guarantee that adequate preventive measures are in place to ensure a gender-responsive approach and preventing large outbreaks of COVID-19. We equally emphasize the need to establish an up-to-date coordination system that brings together health and justice sectors, keeps prison staff well-informed and guarantees that all human rights in these settings are respected.

Reduce overcrowding

In the light of overcrowding in many places of detention, which undermines hygiene, health, safety and human dignity, a health response to COVID-19 in closed settings alone is insufficient. Overcrowding constitutes an insurmountable obstacle for preventing, preparing for or responding to COVID-19.

We urge political leaders to consider limiting the deprivation of liberty, including pretrial detention, to a measure of last resort, particularly in the case of overcrowding, and to enhance efforts to resort to non-custodial measures. These efforts should encompass release mechanisms for people at particular risk of COVID-19, such as older people and people with pre-existing health conditions, as well as other people who could be released without compromising public safety, such as those sentenced for minor, non-violent offences, with specific consideration given to women and children.

A swift and firm response aimed at ensuring healthy and safe custody, and reducing overcrowding, is essential to mitigate the risk of COVID-19 entering and spreading in prisons and other places of deprivation of liberty. Increasing cleanliness and hygiene in places of deprivation of liberty is paramount in order to prevent the entry of, or to limit the spread of, the virus.

Compulsory detention and rehabilitation centres, where people suspected of using drugs or engaging in sex work are detained, without due process, in the name of treatment or rehabilitation should be closed. There is no evidence that such centres are effective in the treatment of drug dependence or rehabilitation of people and the detention of people in such facilities raises human rights issues and threatens the health of detainees, increasing the risks of COVID-19 outbreaks.

Ensuring health, safety and human dignity

All states are required to ensure not only the security, but also the health, safety and human dignity, of people deprived of their liberty and of people working in places of detention at all times. This obligation applies irrespective of any state of emergency.

Decent living and working conditions as well as access to necessary health services free of charge form intrinsic elements of this obligation. There must be no discrimination on the basis of the legal or any other status of people deprived of their liberty. Health care in prisons, including preventive, supportive and curative care, should be of the highest quality possible, at least equivalent to that provided in the community. Priority responses to COVID-19 currently implemented in the community, such as hand hygiene and physical distancing, are often severely restricted or not possible in closed settings.

Ensuring access to continued health services

Prison populations have an overrepresentation of people with substance use disorders, HIV, tuberculosis (TB) and hepatitis B and C compared to the general population. The rate of infection of diseases in such a confined population is also higher than among the general population. Beyond the normal infectivity of the COVID-19 pandemic, people with substance use disorders, HIV, hepatitis and TB may be at increased risk of complications from COVID-19.

To ensure that the benefits of treatments started before or during imprisonment are not lost, provisions must be made, in close collaboration with public health authorities, to allow people to continue their treatments without interruption at all stages of detention and upon release. Countries should embrace a health systems approach, where prisons are not separated from the continuity-of-care pathway but integrated with community health services.

Enhancing prevention and control measures in closed settings as well as increasing access to quality health services, including uninterrupted access to the prevention and treatment of HIV, TB, hepatitis and opioid dependence, are therefore required. Authorities must ensure uninterrupted access and flow of quality health commodities to prisons and other places of detention. Staff, health-care professionals and service providers working in closed settings should be recognized as a crucial workforce for responding to the COVID-19 pandemic and receive appropriate personal protective equipment and support as necessary.

Respect human rights

In their responses to COVID-19 in closed settings, states must respect the human rights of people deprived of their liberty. Restrictions that may be imposed must be necessary, evidence-informed, proportionate (i.e. the least restrictive option) and non-arbitrary. The disruptive impact of such measures should be actively mitigated, such as through enhanced access to telephones or digital communications if visits are limited. Certain fundamental rights of people deprived of their liberty and corresponding safeguards, including the right to legal representation, as well as the access of external inspection bodies to places of deprivation of liberty, must continue to be fully respected.

Adhere to United Nations rules and guidance

We urge political leaders to ensure that COVID-19 preparedness and responses in closed settings are identified and implemented in line with fundamental human rights, are guided by World Health Organization (WHO) guidance and recommendations and never amount to torture and other cruel, inhuman or degrading treatment or punishment. In prisons, any intervention should comply with the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules).

People deprived of their liberty exhibiting symptoms of COVID-19 or who have tested positive should be monitored and treated in line with the most recent WHO guidelines and recommendations. Prisons and other places of detention must be part of national COVID-19 plans with dedicated participation of affected populations. All cases of COVID-19 in closed settings should be notified to responsible public health authorities, who will then report to national and international authorities.

In line with our mandates, we remain available to provide support in the rapid deployment of the recommendations outlined above.

This document is available in Arabic, Chinese, French, Portuguese, Russian and Spanish. 

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.

Ahead of the opening of the Nairobi Summit on ICPD25, the Executive Director of UNAIDS, Winnie Byanyima, and Peter Eriksson, the Minister for International Development Cooperation of Sweden, co-hosted a ministerial breakfast meeting with key donors and partners to highlight the need for a strong UNAIDS to lead the global response to HIV.

It was Ms Byanyima’s first face-to-face meeting with some of UNAIDS’ key donors and partners in her capacity as the Executive Director of UNAIDS, during which she pledged to take a feminist approach in taking the organization forward.

“UNAIDS is at a critical juncture as it emerges from the challenges of the past two to three years, and the staff will be my first priority; we need healing, trust-building and closure. I want to bring back the joy in the great work of UNAIDS,” said Ms Byanyima.

Katherine Zappone, the Minister for Children and Youth Affairs of Ireland, Christopher MacLennan, Canada’s Assistant Deputy Minister of Global Issues and Development, and other heads of delegations applauded UNAIDS’ intention to make meaningful culture change happen at UNAIDS.

“UNAIDS has been at the frontline of the AIDS response for years. Canada has been a strong supporter and we are so pleased that Winnie has joined,” said Mr MacLennan.

Ministers and representatives of Australia, Belgium, Canada, Finland, Germany, Ireland, Luxemburg, the Netherlands, Norway, Sweden and Switzerland encouraged UNAIDS to continue its leading role in promoting community-led solutions and responses. They also highlighted the need to leverage the unique capacity of UNAIDS and build on its human rights expertise to address the social and political barriers that are hindering progress on HIV.

“We must integrate sexual and reproductive health and rights better into the HIV response in order to reach our targets,” said Mr Eriksson. “The Joint Programme has a very important role in driving sexual and reproductive health.”

The meeting was also attended by representatives of several UNAIDS Cosponsors―the United Nations Population Fund and the United Nations Development Programme (UNDP). “UNDP is committed to working with UNAIDS in supporting governments to establish enabling legal, policy and regulatory environs for effective and rights-based HIV responses,” said Achim Steiner, the Administrator of UNDP.

UNAIDS, donors and partners agreed on the need to forge partnerships with the Global Fund to Fight AIDS, Tuberculosis and Malaria to ensure a sustainable response to HIV.

The meeting was the first in a series of events planned as part of UNAIDS’ enhanced collective engagement and strengthened collaboration as it embarks on the process of developing a new strategic plan on HIV.

Zarah Ali (not her real name) remembers how things changed for the better. “In 2014, I received a loan of 40 000 Djiboutian francs (US$ 250) that I used to develop and improve my garment business. I was also trained in business entrepreneurship, including marketing and customer satisfaction. I import clothes from Dubai and Somaliland and earn a decent income that helps me support my 25-year-old son, my 16-year-old daughter in secondary school and my three-year-old adopted son. I am able to pay for my rent, electricity and water and have decent meals.”

Ms Ali’s loan came from an income-generation programme established by the World Food Programme in collaboration with the United Nations Development Programme, UNAIDS and the national network of people living with HIV in Djibouti (RNDP+). The programme supports the long-term empowerment of, and provides regular incomes to, women living with HIV in Djibouti City. It helps them to achieve financial security and have access to food and improves their access to health-care services. Income-generating activities such as those supported by the programme have a powerful potential to help people living with HIV adhere to antiretroviral therapy and optimize health outcomes. 

The loans, ranging from US$ 141 to US$ 438 per person, are for starting or building retail businesses. The beneficiaries, who are selected from among two networks of people living with HIV affiliated to RNDP+ (ARREY and Oui à la Vie – Yes to Life), also receive training on how to run their business. Government support in the form of favourable policies and legislation has been vital to the success of the programme. 

Dekah Mohammed (not her real name) now lives a fulfilling life after receiving help from the income-generation programme. Ms Mohammed, who lost her husband to AIDS, lives with six children. After she lost her job in the hospitality sector owing to her deteriorating health and to stigma and discrimination, she started her own clothing business and received a loan of 50 000 Djiboutian francs (US$ 313) to expand her business. The loan was repaid within 10 months. Her business has since expanded into furniture and electronics and she has recruited an employee. “I am no longer a desperate woman. I make enough to take care of my family and dependants,” she said. 

The programme has improved the quality of life of many Djiboutian women, allowing them to regain dignity and ensure their financial security. It empowers women and girls to protect themselves from HIV, make decisions about their health, live free from violence and be financially independent. 

Building on the belief that empowering women living with HIV and their households to be financially independent strengthens adherence to treatment and leads to more fulfilling and dignified lives, the programme contributes to the World Food Programme’s broader strategic contribution towards ending AIDS as a public health threat by 2030.