GENEVA, 18 May 2020—A cornerstone of the response to HIV, community-led health service delivery has become even more critical in the context of COVID-19, as the needs of marginalized community members and the burden on the health sector are increasing, making it vital that continued provision of HIV, tuberculosis and other health services is secured. Community-led organizations are providing a lifeline to underserved, marginalized and hard-to-reach populations around the world.
Physical distancing restrictions have created significant challenges for those needing to access essential services, creating an increased burden on community organizations, which are at the centre of service delivery.
UNAIDS recognizes that community organizations have an unparalleled depth of experience in creating and delivering responses to health and human rights crises within their communities. The many community-led networks and groups that emerged to respond to HIV possess immense practical experience, organizational strength and unparalleled community access for facilitating the delivery of life-saving support, and for influencing people’s real-life practices to better protect their health.
Community-led networks and organizations have also developed important working relationships and roles within health and community systems, including in coordination and task-shifting functions. As evidenced in many countries, these capacities can, with proper support, be deployed to facilitate the provision of COVID-19 information, prevention, testing and linkages to care. Yet without formal recognition of the essential nature of their work, they face significant barriers to continuing to provide services. It is the view of UNAIDS that it is critical to the COVID-19 response and to mitigating broader health impacts of the pandemic that community-led organizations be supported to continue to provide essential services and have the protective equipment and safe policy environment necessary to do so.
The role of community-led organizations must be appropriately recognized and supported in the context of COVID-19. They must be factored into all aspects of planning, design and implementation of interventions to combat both COVID-19 and the efforts required to mitigate the impact of COVID-19 on other health areas, including HIV and tuberculosis. In particular, and as first steps in this effort, UNAIDS urges COVID-19 crisis committees at the national and district levels to:
- Include the workforce of community-led health care services into the lists of essential service providers and treat them as equivalent to health-care providers.
- Design physical distancing restrictions and policies in ways that allow community-led services to continue operating safely. Essential services include, but are not limited to, the physical provision of HIV, tuberculosis and COVID-19 and other health services that include prevention commodities, including condoms, lubricants, clean needles and opioid substitution therapy, contraceptives, hygiene kits, test kits, medication, triage and linkage to care, adherence support, packages of food and other essentials, the provision of legal services and protection for survivors of gender-based violence and other forms of violence and discrimination. Particular attention needs to be paid to people with physical disabilities.
- Provide special authorization to relevant community-led service providers to move freely, with appropriate personal protective equipment, to deliver the services when and where needed.
- Ensure that community-led organizations, networks and groups be provided with personal protective equipment and training in order to protect themselves and their clients in the course of service delivery.
- Take urgent measures to ensure the security, and expansion, of existing funding for community-led organizations, so that those organizations can continue to provide services.
- Ensure inclusive and transparent governance of COVID-19 responses, with decision-making bodies that include representatives of community-led organizations, including those focused on gender, equity and human rights, to ensure that COVID-19 policies are designed to support the range of service providers and activities necessary for an effective and equitable response.
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.
