Key populations—gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs, prisoners and other incarcerated people and migrants—and their sexual partners account for 40% of new HIV infections in western and central Africa.
However, key populations still have insufficient access to HIV prevention, treatment and care services. Fragile health systems, stigma and discrimination, sexual and gender-based violence and lack of supportive policies are some of the barriers that key populations face.
While high-quality programmes for key populations do exist in western and central Africa, there are limited opportunities to learn from each other and to strengthen South–South capacity. Monitoring of commitments made by all stakeholders, including governments, is also an issue. Three regional meetings took place in November to address those shortcomings.
The West Africa Health Organisation (WAHO), the United Nations Development Programme and ENDA Santé, a civil society organization, in collaboration with UNAIDS, met in Dakar, Senegal. The meeting brought together representatives of national AIDS commissions or programmes from 14 Economic Community of West African States (ECOWAS) countries and members of the Africa key populations expert group to chart the process for the development of a regional strategy on HIV/tuberculosis and sexual and reproductive health and rights for key populations, scheduled to be finalized in early 2020.
In 2015, under the leadership of WAHO, and in collaboration with UNAIDS and USAID, ministers of health, heads of national AIDS commissions, public prosecutors and inspectors general of police of ECOWAS Member States signed the Dakar Declaration on Factoring Key Populations in the Response to HIV and AIDS in ECOWAS Member States. The declaration aims to better take into account key populations in the response to HIV in the ECOWAS region in core areas, including strengthening of strategic information, health systems and community services and addressing stigma and discrimination.
In November, WAHO, UNAIDS and USAID commissioned a review of the progress made against the declaration and organized a regional progress review workshop attended by country representatives of 13 countries. The declaration has created a significant momentum, coupled with a number of achievements, innovations and good practices at the country level.
Ending AIDS in West Africa, a five-year cooperative agreement funded by USAID and led by FHI 360 and its core partners, Johns Hopkins University and ENDA Santé, facilitated the fourth key population regional meeting in western Africa, in partnership with the Government of Togo and partners.
The meeting was a key opportunity to bring together members of key populations, government officials, donors, academics and representatives of implementing partners and United Nations agencies to share lessons learned and promising practices from implementation, relevant and novel research and programmatic data, and to build networks and platforms for technical exchange. Country delegates also formulated country action plans to improve the quality, efficiency and scale of HIV-related programmes for key populations.
“The more the response to HIV is multisectoral, multidisciplinary and inclusive, the more impactful results we will have,” said Vincent Palokinam Pitche, Coordinator of the Permanent Secretary of the National AIDS Commission in Togo.
“There is a need to support the collection and analysis of strategic information to guide efforts to facilitate access by key populations to prevention, care and treatment services, to intensify services that are evidence-informed and rights-based and to invest in programmes for an enabling legal and social environment,” said Christian Mouala, UNAIDS Country Director for Togo.
