In a briefing co-hosted by the Organisation of African First Ladies for Development (OAFLAD) and UNAIDS, technical advisers to the first ladies renewed their commitment to the HIV response in Africa. Capitalizing on the convening, leadership and advocacy role of African first ladies, they highlighted the need to align national and regional efforts to the new Global AIDS Strategy 2021–2026: End Inequalities, End AIDS and the targets in the 2021 United Nations Political Declaration on HIV and AIDS: Ending Inequalities and Getting on Track to End AIDS by 2030.  

The briefing focused on presenting the outcomes of the United Nations High-Level Meeting on AIDS, including the Political Declaration on AIDS, the Global AIDS Strategy 2021–2026 and its new targets, the Education Plus initiative and the Common Africa Position on the High-Level Meeting on AIDS. It highlighted the unfinished business of the HIV response and the continued efforts to meet prevention and treatment targets and adopt a rights-based approach that leaves no one behind.

In her welcoming remarks, Berthilde Gahongayire, the UNAIDS Country Director for Ethiopia and the Director, a.i., of the UNAIDS Liaison Office to the African Union and the United Nations Economic Commission for Africa, reiterated the instrumental role played by African first ladies in putting previous United Nations political commitments into action. She also extended appreciation to the first ladies, who continued to invest in the HIV response during the COVID-19 pandemic in Africa. “We appreciate the support by first lady offices during the COVID-19 emergency in providing socioeconomic support to those vulnerable and marginalized, including protecting services for people living with HIV,” she said.  

The technical advisers expressed interest in participating in the Education Plus initiative and integrating the new political declaration targets in their national plans and in the OAFLAD 2019– 2023 strategic plan. Namibia, which was a co-facilitator of the High-Level Meeting on AIDS, shared information on the political declaration and called on the technical advisers to be champions for ending AIDS as a public health threat by 2030.

“I call on all technical advisers to support the popularization, dissemination and alignment of the political declaration and the global AIDS strategy in national programmes,” said Steven Bernardus Harageib, the Technical Director of the Office of the First Lady of Namibia. He added that Namibia is committed to demonstrating leadership in accelerating the AIDS response in Africa.

Moustapha Zakari, from the African Union Commission, on behalf of Margaret Agama-Anyetei, the acting Director of Health, Humanitarian Affairs and Social Development for the African Union Commission, commended the OAFLAD leadership on building momentum after the High-Level Meeting on AIDS. He saluted the commitment of member states in advancing the HIV response through the adoption of a Common Africa Position on the High-Level Meeting on AIDS, which was instrumental in the negotiation of the continent’s priorities in the new political declaration.  

The meeting, which was chaired by Michel Mongo from Congo, was attended by more than 30 technical advisers. Mr Mongo closed the meeting by requesting support from UNAIDS to update strategic plans and to articulate the new targets at the country level.

The COVID-19 pandemic is threatening decades of hard-won development and public health gains. UNAIDS is committed to playing a pivotal role in ensuring that people living with and affected by HIV have the information and support they need during the COVID-19 pandemic and is promoting the development and support measures needed to ensure that access to HIV prevention and treatment services continues uninterrupted.

Launched in 2017, the Global HIV Prevention Coalition aims to bring fresh momentum and clarity to HIV prevention programmes, focusing on 28 countries carrying the highest burden of the HIV epidemic. The Global HIV Prevention Coalition has published a new report, Preventing HIV infections at the time of a new pandemic: a synthesis report on programme disruptions and adaptations during the COVID-19 pandemic in 2020, which provides a synthesis of the status of HIV prevention programming during the COVID-19 pandemic, identifies critical vulnerabilities, risks and major service disruptions and documents responses in a range of settings. The report places a significant focus on gathering information on programme innovations at the community level.

“The COVID-19 pandemic risks reversing the hard-won gains made in HIV prevention, including the 23% reduction in new infections since 2010. And this is at a time when much more still needs to be done to drastically reduce new HIV infections. Gaps and threats to progress show great inequalities, and HIV prevention services and societal barriers for the people most left behind, such as key populations and adolescent girls and young women, have been disproportionately impacted by COVID-19,” said Shannon Hader, the UNAIDS Deputy Executive Director for Programmes.

Inevitably, significant disruptions on HIV prevention services have been observed, and supply chains for crucial HIV prevention commodities, including condoms, lubricants and antiretroviral and other medicines, have been stretched. The report reflects on the early dips observed in the monthly numbers of people served by critical HIV prevention programmes, including huge drops in the number of voluntary medical male circumcisions performed compared to previous corresponding months.

At the same time, while it has vividly exposed and widened inequalities and health inequities, COVID-19 has also shown how to make health systems and other public institutions fairer, more inclusive and better able to meet the challenges of ending the AIDS epidemic. Health-service providers and community organizations have responded to the crisis by changing how they provide HIV prevention services and minimizing disruptions of essential services.

The report highlights COVID-19 impact mitigation innovations and adaptations of HIV services, including multimonth dispensing of condoms, lubricants, needles, syringes and pre-exposure prophylaxis (PrEP), differentiated service delivery and self-testing approaches, alternative access points for prevention commodities such as condoms and PrEP, take-home dosages of opioid substitution therapy for people who inject drugs, the safe continuation of outreach services for key populations and adolescent girls and young women and virtual platforms for prevention interventions—and calls for their scale-up even beyond the COVID-19 pandemic. The report further highlights how the COVID-19 pandemic response has drawn from HIV experts and communities and has taken early decisive action to address critical vulnerabilities, maintain health services and build synergies between the colliding pandemics.

“In over 30 years of developing effective prevention approaches, we have gained substantial knowledge and experience that decision-makers and health programme implementers can use in low- and middle-income countries to make the best possible choices in preventing SARS-CoV-2,” said Dr Hader. “The most pressing needs we hear from communities are the protection of livelihoods: how do people eat, live, care for themselves and survive COVID-19. UNAIDS can help broker services for people,” she added.

The report will support all stakeholders in their preparation of Global Fund to Fight AIDS, Tuberculosis and Malaria COVID-19 Response Mechanism applications, ensuring that proposal writing teams identify key HIV prevention innovations and adaptations that could be supported and scaled-up to regain global HIV prevention momentum and mitigate the impact of the COVID-19 pandemic on HIV services.

By Jacek Tyszko, Senior Adviser for Faith Engagement, UNAIDS

It is with deep sadness that I received the news that the Reverend Phumzile Mabizela, the Executive Director of the International Network of Religious Leaders Living With and/or Personally Affected by HIV (INERELA+), passed away on 5 July. 

Her dynamic leadership championed the welfare of people living with HIV globally and equipped faith communities to face HIV, strive for justice and guide faith engagement in the HIV response. She played an important role in shaping and implementing the UNAIDS/United States President’s Emergency Plan for AIDS Relief Faith Initiative.

Her death is a deep and inconsolable loss for faith communities, as well as for human rights defenders. She was a dear friend, sister and teacher to many of us.

She died from COVID-19 while serving on the front line of the HIV response, leading and calling for an end to AIDS and inequality.

We send our condolences to her family.

Migrants, refugees, internally displaced as well as crisis-affected and mobile populations who are living with HIV must have equitable access to COVID-19 vaccines, said the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the International Organization for Migration (IOM).

People on the move are often more vulnerable to diseases, including COVID-19 and HIV. In addition, people living with and/or affected by HIV and migrants often experience significant inequalities. They frequently face health hazards due to sometimes perilous migration processes, substandard living situations, dangerous working conditions, as well as general lack of information, stigma, discrimination and isolation.  Migrants and displaced people also face a great number of administrative, financial, geographic, social and cultural obstacles in accessing health care with regularity or continuity of care across borders – including access to HIV treatment.

During the pandemic, against a backdrop of rising xenophobia and discrimination, some migrants living with HIV found themselves facing a triple stigma related to (1) testing positive for COVID-19, (2) having a positive HIV status, and (3) being a migrant, all of which also often had serious negative consequences on their mental health. For many migrants and displaced persons living with HIV and other autoimmune diseases, or at risk of contracting HIV, risk exposure went up while availability of HIV services went down.

“To end inequalities and get the global response to HIV on-track to reach the 2030 target of ending AIDS as a public health threat, we must act immediately to reduce the inequalities experienced by migrants and mobile populations. This includes full access to HIV prevention and treatment services and to COVID-19 vaccines,” said Winnie Byanyima, Executive Director of UNAIDS ahead of the 48th UNAIDS Programme Coordinating Board Meeting taking place next week in Geneva, Switzerland. A progress report on HIV services for migrant and mobile populations as well as refugees and crisis-affected populations will be presented at the meeting.  

“Both the global AIDS response and the COVID-19 response are leaving millions of people behind, including many migrants and forcibly displaced persons,” stated IOM Director General António Vitorino. “We’ve seen that neglecting the health needs of marginalized groups can be devastating for communities. Together, all countries should pledge not to let it happen again.”

On 8 June, the United Nations General Assembly adopted the 2021 Political Declaration on HIV and AIDS, which specifically mentions migrants, refugees and internally displaced persons, and commits governments to ensuring that “95 per cent of people living with, at risk of and affected by HIV are protected against pandemics, including COVID-19.” To mitigate and treat COVID-19 and HIV, maintaining high standards of health care and protection, along with sharing disseminated and accessible information are crucial.

IOM and UNAIDS urgently call on governments to take concrete action to ensure that national COVID-19 vaccination campaigns include all migrants with co-morbidities such as HIV, in line with WHO’s prioritization recommendations, and that every effort is made to remove the barriers many of them still face in accessing health services, including stigma and discrimination. 

The two organizations, who have been formal partners since 2011, are expanding their longstanding partnership to address multiple forms of exclusion faced by migrants, refugees, crisis-affected and other mobile populations living with HIV, and stand ready to support countries in their efforts to recover from COVID-19 and the global commitment to end AIDS by 2030, through equitable and inclusive health programmes in line with principles of universal health coverage.

ACON, one of Australia’s largest HIV organizations, working to promote HIV prevention strategies among gay men and other men who have sex with men in New South Wales, Australia, has recently launched a new campaign video that enlists some of Asia’s most popular social media influencers.

The campaign aims to raise awareness and promote the uptake of pre-exposure prophylaxis (PrEP), particularly among Mandarin-speaking gay men and other men who have sex with men. The campaign addresses frequently asked questions about PrEP and features Fufu and Josh, also known on social media as FJ234, YouTube personalities with a following of 350 000 subscribers. The pair appear alongside a leading doctor and PrEP advocate, Stephane Wen-Wei Ku, who in the campaign breaks down information on PrEP through relatable and humorous conversations.

“PrEP is a good tool to protect yourself, even if you are not ready to talk about sex with your partner. So, we could all have a great sex life without worrying about HIV,” Josh and Fufu explained.

In Asia and the Pacific, civil society organizations in countries such as Thailand and the Philippines have turned to social media platforms and other innovative solutions to offer new ways to link communities to PrEP and other prevention options. For example, in Thailand, the PrEP in the City campaign, launched by the Institute of HIV Research and Innovation and supported by the UNAIDS Regional Support Team for Asia and the Pacific and other key partners, aimed to increase PrEP uptake among transgender women by challenging negative perceptions. Likewise, in the Philippines, civil society organizations used innovative programmes to deliver antiretroviral therapy to clients, and PrEP and condoms were frontloaded to community champions for distribution.

“Raising awareness of PrEP, which is an extremely effective strategy for preventing HIV transmission, is fundamental to our efforts in eliminating the virus,” said Nicolas Parkhill, the Chief Executive Officer of ACON, reflecting on the critical role of the campaign in scaling up PrEP among Mandarin-speaking gay communities in New South Wales.

PrEP has had an enormous impact on HIV transmission rates in New South Wales and Australia as a whole since it was first made available in 2016 through various state-based trials, and later in 2018 when it was subsidized under the national Pharmaceutical Benefits Scheme. Currently, there are three main ways to access PrEP in Australia. The most common is through the Australian health-care system at a subsidized cost. Other options include purchasing PrEP from a pharmacy using a private prescription from a doctor or purchasing it from a reputable pharmacy and importing it into Australia under the Personal Importation Scheme. These last two options are particularly important for people who are not covered under the Australian health-care system, such as international students.

“PrEP is now the most commonly used HIV prevention strategy for gay men, but if we are to realize its full potential on reducing HIV transmission in New South Wales, we need to break down barriers and ensure that PrEP is easily accessible to all men in every community. By working with Fufu, Josh, Stephane Wen-Wei Ku and Hotline, we hope the video will be able to help raise awareness and show how effective it is, how easy it is to get and its benefits,” Mr Parkhill added.

The campaign video was developed in partnership between ACON and the Taiwan Tongzhi Hotline Association, a sexual health organization. A vital feature of the campaign was that the content was developed with the Mandarin-speaking community, so that the messaging is authentic to Mandarin-speaking men. The video is available in Traditional and Simplified Mandarin, with English subtitles.

“To close the gaps and ensure that no one is left behind, we must foster innovation and scale up access to HIV prevention and treatment services. Strong national commitment to scale up PrEP, adopting national PrEP policies and guidelines, setting ambitious PrEP targets and allocating sufficient resources for PrEP will help countries across the region to get the HIV response back on track. We have the tools to end AIDS. Now we must use them,” said Eamonn Murphy, Director, UNAIDS Regional Support Team for Asia and the Pacific.

In 1999, when he started working for UNAIDS, Samuel Larkai committed himself to using his driving experience to contribute to ending AIDS by 2030. He started his career in driving as a shipping assistant in a timber firm, after which he moved to the United Nations Development Programme to serve as a driver. He was then recruited by the UNAIDS Country Office for Ghana as a chauffeur. He has driven not only the length and breadth of Ghana but also neighbouring countries, Togo, Benin and Burkina Faso, on official assignments.

Mr Sam, as he is affectionately called, recalls how Ghanaians received the news about HIV in Ghana in the early 1990s. “At the onset, most people heard about HIV via television and radio education. Also, education in schools was intense,” he said.

Looking back, he attributes the rise in new HIV infections to the non-adherence of people to the education they received on HIV prevention. “I also recollect the opposition of religious institutions to condom usage among young people. They felt young people were being encouraged into promiscuity, but of course this was not the case. What they failed to realize was that the spread of HIV needed to stop urgently!” He added that, “Condom negotiation should be encouraged, as having protected sex remains one of the ways to prevent the transmission of HIV.”

Over the years, one issue has continued to cause him sleepless nights—HIV stigma. He recollects an experience at the Korle Bu Teaching Hospital, where he was refused entry into the HIV clinic, while the UNAIDS country director was allowed in. An official at the clinic explained that his status as an indigen, a native of the town, might allow him to identify some of the people living with HIV locally, with a risk of stigma for anyone he could identify. Reflecting on the negative effects of HIV stigma, Mr Sam believes in the value of education on sexual and reproductive health, which can be an effective weapon in fighting HIV stigma.  

Having worked with UNAIDS in Ghana for such a long time, Mr Sam has seen the progress that has been made. “I am filled with joy when I see people living with HIV exude confidence and power after all they have been through. Many now serve as examples and mentors to the younger generations. This is the way to go!” he said with a smile.

Mr Sam applauds the strides made towards ending AIDS as a public health threat and is confident that it can be achieved by 2030, if everyone keeps trying their very best.

Since key populations and their sexual partners account for 69% of new HIV infections in western and central Africa, reaching 95–95–95 among key populations will result in a significant impact on the overall HIV epidemic in the region. However, programmes focusing on key populations are insufficient. In western and central Africa, funding for programmes for key populations represented only 2.4% of the region’s overall HIV funding between 2016 and 2018, according to Frontline AIDS.

Having strategic information—quality data and analysis—is vital for an HIV response, for ensuring accountability and since it allows ambitious and measurable time-bound targets for monitoring progress to be set. 

“The old adage “What gets measured gets done” may be a cliché, but it is still very true for the HIV response. Over the years, data collection, analysis and dissemination have led to a better understanding of the HIV epidemic and helped programmes to reach the right people in the right place at the right time,” said Marie Engel, Adviser at the UNAIDS Regional Support Team for Western and Central Africa.

In order to strengthen their skills in building and analysing data on the location and size estimates of key populations, approximately 30 people from four countries—Senegal, Côte d’Ivoire, Guinea and Guinea Bissau—and who were mainly from organizations for key population recently attended a training session in Saly, Senegal. During the training, which was part of a subregional project called RECCAP, funded by Expertise France, the Enda Santé nongovernmental organization, in collaboration with Johns Hopkins University, trained the participants on basic statistical analysis methods, population size estimation, health mapping tools and the analysis and presentation of collected data. UNAIDS and the World Health Organization sponsored the participation of several participants.

“The development of local capacities will allow for programmes that are best adapted to contextual changes by locating the dynamics of HIV vulnerability and analysing how sociospatial combinations influence epidemiological data. The diversity of the selected participants’ profiles and the plurality of the training team’s experiences guarantee a transfer of know-how and true sharing,” said Daouda Diouf, Enda Santé’s General Manager.

It is hoped that the training will empower key populations to exercise leadership—an essential mainstay of HIV responses to ensure that they are inclusive, equitable, effective, efficient and sustainable.

More than a quarter of the world’s population is between the ages of 10 and 24 years—and in some parts of the global South the proportion is two thirds or higher. This is a generation caught between biology and society—between curiosity, questions and concerns about their emerging sexual and reproductive selves and the controls, constraints and conditions imposed by laws, policies and community practices.

On the sidelines of the United Nations High-Level Meeting on AIDS, a group of young activists, government representatives and experts came together in a virtual event on 10 June to discuss the Facts of Life: Youth, Sexuality and HIV.

The meeting, co-hosted by UNAIDS and the International Planned Parenthood Federation (IPPF), brought home the urgency of action. Nearly half of all new HIV infections worldwide occur among young people aged 15 to 24 years, with young women being twice as likely to become infected. Globally, AIDS-related illnesses are the second leading cause of death among young people (aged 10–24 years) and the most common cause of mortality of young people in Africa.

The new Global AIDS Strategy 2021–2026 highlights the urgent need to empower young people to build today’s and lead tomorrow’s HIV response—for themselves and their communities. Nipun Srivastava, a young HIV activist from India, pointed to the challenges ahead. “We have an ambitious target to end AIDS by 2030, but it is not achievable with these regressive policies on sex and sexuality. We lost a lot of people in the 1980s and 1990s because we didn’t talk about sex. We need to stop talking about cows’ and goats’ and bees’ reproduction and speak about sex.”

Efforts to help young people reach their potential in public life need to be mirrored in their private, intimate lives. Alvaro Bermejo, the Director-General of IPPF, emphasized the connection between the physical and emotional well-being of adolescents (including those living with HIV)—and their societies—and access to accurate, age-appropriate sexual and reproductive information and services, allowing them to avoid unwanted pregnancy and unsafe abortion, sexually transmitted infections, including HIV, and all forms of sexual violence and coercion.

And yet, young people’s sexual and reproductive health and rights remain highly controversial. “Case-in-point is the High-Level Meeting on AIDS itself,” said Shereen El Feki, the Director of the UNAIDS Regional Support Team for the Middle East and North Africa. “Some of the most contentious negotiations, and pushback from Member States, on the United Nations Political Declaration on AIDS was on sexual and reproductive health and rights and comprehensive sexuality education.” 

The participants heard that the same governments praised for initiatives on young people’s employment or civic engagement often founder when trying to bring the same spirit of youth empowerment to access to youth-friendly sexual and reproductive health and rights services or sexuality education. Amery Browne, the Minister of Foreign and CARICOM Affairs for Trinidad and Tobago, spoke about the delicate act that governments face in balancing conservative forces and youth voices, and urged those working for greater openness to continue their struggle.

Among them is Nadia Abdalla, the Chief Administrative Secretary at the Ministry of ICT, Innovation and Youth in Kenya. A young person herself, she spoke about her country’s efforts to help young people to organize and mobilize for their intimate rights, including their ability to prevent, or live with, HIV. Half-a-world away, sexual and reproductive health and rights activist Ponny White described her work with Advocates for Youth, a nongovernmental organization in the United States of America that lobbies state governments for legal reform to enable young people to access their full sexual and reproductive rights. “A lot of young people are experiencing sexual encounters they don’t understand because someone else is introducing it to them,” she warned, “We want to equip young people with tools and education so they can be autonomous and living a fulfilling life.”

The Internet is one such tool of empowerment. Abir Sarras, the co-founder of Love Matters Arabic, a pioneering social media platform reaching millions of young people across the Middle East and North Africa, pointed to the importance of sex-positive messaging—emphasizing the pleasures, rather than just the problems, associated with sex—as a key means of communicating with young people. But not all young people yet have access to such online resources—Stefania Gianinni, the Director-General for Education at the United Nations Educational, Scientific and Cultural Organization, described the successes and setbacks faced in implementing the United Nations guidance on comprehensive sexuality education in school curricula. “There is no knowledge pill we can give young people,” she said. “But education, hand in hand with access to youth-friendly services, is the most powerful tool for ending AIDS as a public health threat and giving rights to the new generations.”

School-based comprehensive sexuality education plays a vital role in promoting the health and well-being of children and adolescents, both now and in their future. It improves sexual and reproductive health outcomes, including for sexually transmitted infections and HIV, promotes safe and gender equitable learning environments and improves access to and achievement in education.

In a preview of the upcoming global report on the status of comprehensive sexuality education, more than 700 people joined an online event opened by Stefania Giannini, the Assistant Director-General, Education, for the United Nations Educational, Scientific and Cultural Organization (UNESCO). While some progress has been made, she noted that there’s still a long way to go and underscored comprehensive sexuality education as one of the key priorities for action to achieve gender equality.

People attending the event heard the perspectives and recommendations of young activists for sexual and reproductive health and rights and case studies from Sweden, Tunisia and Namibia, together with engagement from policy-makers on how they are working towards ensuring quality comprehensive sexuality education for all young people. 

“Like all journeys, the road towards comprehensive sexuality education is long, and sometimes winding, but it is leading us on the path to brighter, healthier futures for our young people,” Ms Giannini said.

The panel of young people collectively called for the recognition of education as a fundamental right, the need for strong implementation with proper financing and sufficient monitoring and evaluation and truly comprehensive curricula that respond to the needs of all young people.

Shannon Hader, the UNAIDS Deputy Executive Director, Programme, addressed the meeting, referring to the new Global AIDS Strategy 2021–2026 and the 2021 United Nations Political Declaration on AIDS and the importance of comprehensive sexuality education to both. “Comprehensive sexuality education is a necessary core intervention—to prevent HIV among young people and also to empower young people to recognize and address issues of violence, sexual abuse and elements of their overall sexual health and well-being. Importantly, gaps in comprehensive sexuality education knowledge are not equal. Inequalities exist based on where young people live, levels of family income or education, digital access and degrees of gender inequality in the community. The global AIDS strategy recognizes we must end inequalities to end AIDS.”

The comprehensive sexuality education global status report is a collaboration between UNESCO, UNAIDS, the United Nations Population Fund, the United Nations Children’s Fund, UN Women and the World Health Organization (WHO), with support from governments and civil society. The report provides a snapshot of the status of school-based comprehensive sexuality education around the world, which can help to inform advocacy and resourcing efforts, as governments and partners work towards the goal of ensuring that all learners receive good quality comprehensive sexuality education throughout their schooling.

“For governments and international stakeholders, we want you to stand up, speak out, change the rules and allocate resources for comprehensive sexuality education,” said Reuben Avila, the Director of Sin Control Parental and a She Decides young leader from Mexico.

The event was held in the lead-up to the Generation Equality Forum (GEF), which will be held from 30 June to 2 July and which will launch a series of concrete, ambitious and transformative actions to achieve immediate and irreversible progress towards gender equality.

”Bodily autonomy and sexual and reproductive health and rights” is one of six Action Coalitions that will be established during the GEF. Among the three actions agreed to for the Action Coalition, the first is to ”Expand comprehensive sexuality education”, with the goal of increasing the delivery of comprehensive sexuality education in and out of school to reach 50 million more children, adolescents and youth by 2026. The goal is fully supported by the Global AIDS Strategy 2021–2026, which has a target to reach 90% of all young people with comprehensive sexuality education.

“For meaningful engagement of young people, we have to make sure they have ears, eyes and teeth. The ears mean that young people are aware of their entitlements, voice means that they can advocate for these rights and entitlements to be met by duty-bearers and the teeth means that young people can hold the duty-bearers accountable for doing so,” said Marina Plesons, a technical officer on adolescent sexual and reproductive health and rights at WHO.

On 29 June, one of the largest non-profit organizations based in Saint Petersburg, Russian Federation, is celebrating its twentieth anniversary. Humanitarian Action provides comprehensive medical and social assistance to people who use drugs, including services for the prevention of HIV, viral hepatitis and tuberculosis, following the principle of working with everyone, regardless of their lifestyle.

Humanitarian Action is the successor to Doctors of the World, which worked in the Russian Federation in the 1990s during an economic crisis that saw an increase in drug use and HIV and other infections.

Today, the main mission of Humanitarian Action is to improve the lives and health of people who use drugs, restore their dignity and raise public awareness about drug use. Its vision is, “A world in which people who use drugs do not die from an overdose, HIV, hepatitis, tuberculosis or suicide, have equal rights and opportunities, are not stigmatized and discriminated against and do not experience self-stigma.”

A converted tourist bus, known as the Blue Bus owing to its colour, and a converted minibus, the Little Bus, allow Humanitarian Action to work as close as possible to where people who use drugs live and congregate. A joint project with the Saint Petersburg AIDS centre provides home visits via mobile units to seriously ill people living with HIV, many of whom are former drug users who have been left behind by mainstream services. 

The organization offers personal protective equipment against bloodborne and sexually transmitted infections, including sterile syringes and needles, condoms, etc., and exchanges syringes. In its medical centre—a first of its kind in the Russian Federation, since it provides help through low-threshold programmes—doctors provide anonymous and free medical services in a range of specialities for people who use drugs, sex workers, homeless people and migrants.

People also can also get psychological services from Humanitarian Action. Legal advice on the restoration of documents, guardianship or problems with the law and medical and social support for HIV, hepatitis or tuberculosis diagnosis and treatment are also available.

“Not everyone is ready to change their life immediately. We help people learn to take responsibility for their health and change gradually, moving from one tiny victory to another,” said Alexey Lakhov, the Development Director of Humanitarian Action. “We are a kind of bridge between people who use drugs and various government and nongovernment services. It’s just that with us, it becomes easier to get such help thanks to partnerships with multiple social and medical services.”

The process of helping people who use drugs is based on the principle of taking small steps and is aimed at gradually introducing safer behaviours: do not start using drugs; if you have started, stop; if you use drugs, stop injecting them; if you do inject drugs, always use a sterile syringe; if it is not possible to use a sterile needle every time, at least never use someone else’s; if using someone else’s syringe, always disinfect it.

Some of Humanitarian Action’s employees are themselves former drug users, who share their stories with clients, helping those who wish to quit by referring them to appropriate services.

“We congratulate Humanitarian Action on its twentieth anniversary. We hope that by its thirtieth anniversary we will also be able to celebrate the end of AIDS and the elimination of all forms of stigma and discrimination against people affected by HIV,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.