There is a clear appreciation for the pivotal role that communities have played in the HIV response over the last 32 years, but it’s no surprise that critical gaps remain – particularly with respect to the ways communities are effectively and meaningfully engaged in their care and treatment.
Given the ambitious 90-90-90 goals, there is a need to maximize functional models of HIV service delivery to overcome widespread barriers to access. It is 2017 and people still face insurmountable barriers resulting from fragile health systems. We still hear stories of people walking 15-20km to pick up their ARVs every month. Prohibitive transportation costs, hour-long queues, day-long wait times at the clinic and often life-threatening lack of privacy remain issues.
So how do we move past this? By putting people living with HIV at the centre of solutions. At the most basic level, communities need to know what differentiated service delivery is and how it can work for them. Communities cannot demand what they don’t know. We need to convert “Geneva speak” into simple language and blend it with the lived experiences of people living with HIV. Resources like the “What Works for Me: Activist Toolkit on Differentiated Service Delivery”* (available in English and French) are a start. Initiatives that promote peer education, task-shifting, and more integrated services can also ensure that the health system serves the needs of communities.
At the regional and global levels, in forums like the 19th International Conference on AIDS and STIs in Africa (ICASA 2017) and 22nd International AIDS Conference (AIDS 2018), we need to bring stakeholders together to make sure that we rectify the existing disconnect between global policy and local implementation.
The bottom line is that HIV services should be provided in a way that suits the daily lives of people living with HIV. And the only way to do this is by reforming systems to put PEOPLE first.
*produced by ITPC and the AIDS and Rights Alliance for Southern Africa (ARASA)