この文書作成のための協議や討論に時間と労力を費やしてくれた多数のパートナー、友人たち。Annette Sohn, Ben Plumley, Cate Hankins, Ian Grubb, Jamie Forrest, Judy Auerbach, Karen O’Malley, Mauro Schecter, Mitchell Warren, Pedro Cahn, Rob Caruano and Stefano Vella, さらにフォーカスグループや個別インタビュー、調査に協力していただいた何百人ものIAS会員の皆さん。
BIG QUESTIONS TO DRIVE ACTION
From the AIDS 2016 conference hallways, plenary sessions and Global Village conversations to cabinet meetings, boardrooms and community groups, we urge all delegates to challenge each other and to get specific: “What must be done if we really are to end AIDS? How do we address the current AIDS fatigue environment? How can we ensure predictable and sustained financing to close the remaining gaps?”
Below are 10 sets of guiding questions we, as the IAS, will be asking – of ourselves, of global policymakers, of national politicians and health leaders, of development partners and of you, who ultimately will be the ones who make the end of AIDS a reality:
- Supporting frontline HIV workers
How can we ensure that frontline workers have easy access to the latest evidence and the ability to implement it? How can access to HIV prevention, care and treatment be seamlessly integrated with other priority health issues, including sexual and reproductive health and other comorbidities including tuberculosis, malaria and hepatitis?
- Realizing test and offer
What are we doing to move the latest World Health Organization treatment guidelines from goal to reality? Whose responsibility is it to ensure countries have what they need to expand access to treatment? How can we scale up differentiated models of HIV treatment delivery? What role should the private sector and workplace play in “getting to zero”?
- Reimagining prevention
What are national governments and donors doing to ensure comprehensive prevention is well-funded, implemented and evaluated? What steps can countries take to expedite regulatory review of PrEP? Are we adequately funding the HIV prevention research pipeline to ensure next generation prevention options are available as soon as possible? How do we continue to drive progress on new prevention tools without losing focus on other proven methods, like condoms, behaviour change programmes and peer-to-peer interventions?
- Foregrounding human rights
How can human rights approaches remain the key principle of HIV work? How can we move beyond fighting legislation to building environments that support the rights of all, including sex workers, men who have sex with men, transgender men and women and people who use drugs? How can the lessons of HIV be used to build a lasting legacy of social justice?
- Advancing a cure and a vaccine
How do we make sure there is continued support for the robust basic science needed to find a cure and a vaccine? How can researchers and private industry better collaborate to share knowledge and expedite the search for a cure and a vaccine? How are we promoting and sustaining careers for the next generation of researchers and ensuring young researchers have a place in the future of HIV science?
- Addressing the needs of women and girls
Where is our road map for ending the epidemic among all women and girls, including adolescents and those who are sex workers, transgender and/or who use drugs? How can we build on the promising findings of the recent vaginal ring trials to ensure women have access to additional female-controlled prevention options? How do we meaningfully address some of the gender norms that place women and girls at increased risk of HIV?
- Better serving the needs of infants and children
How can we accelerate the development of the next generation of paediatric formulations for HIV treatment? What is needed to incentivize industry and research institutions to develop high-quality screening tools and treatment options for children? How do we ensure that new technologies are affordable and rapidly reach all children living with HIV?
- Making health care meaningful for men and boys
How can HIV treatment expansion efforts be more strategically positioned to reach men and boys? How can we develop and implement adolescent-friendly services that more directly reach adolescent males – both HIV positive and negative? How can men and boys become agents of social change?
- Renewed and sustained focus on key populations
How can access across the HIV cascade for key populations (men who have sex with men, transgender people, sex workers and people who inject drugs) be improved? How should the meaningful engagement of key populations in policies and services that affect their lives be advanced in the health sector and across the workplace? Are we doing enough to reach adolescent key populations?
- Reinvigorating support for civil society and constituency-led agencies
How can we most effectively communicate the value of civil society and advocacy in the fight against AIDS? Which agencies, philanthropies and other institutions will commit to increase funding for civil society? How can we ensure that the GIPA (Greater Involvement of People Living with HIV) Principle is actively put into action by all agencies involved in the AIDS response? How can community-led services increasingly become part of the HIV tapestry?
THE IAS COMMITMENT
In an environment of increasingly constrained resources, it is more important than ever to prioritize the actions that will have the greatest impact. IAS’ strategic approach is to ensure that every action is grounded in science, respects the rights of key and priority populations and is adequately funded for success.
IAS has a unique ability to reach and support key stakeholders through our membership network and the advocacy platform we are building. Our convening power remains as strong as ever and is a catalytic force that is increasingly harnessed. Under the strategic vision of Science. People. Progress. we will match that strength with a representative voice for progressive change in the response to AIDS. Now more than ever.
Starting in 2016, IAS is taking its commitments forward with these five immediate actions:
Translate evidence to a regional context. Convene tailored scientific symposia across four regions: Latin America, West Africa, Eastern Europe and Southeast Asia. The meetings will be accessible to IAS members and national policymakers in order to lead practical discussions of the gaps between policy, implementation and what frontline workers need to realize their full potential. These efforts will support scientific advancements that positively alter the course of the HIV epidemic and promote greater understanding of new discoveries.
Provide direct access for frontline health workers to global- and national-level meetings. The newly created IAS Educational Fund will provide support to health clinicians and advocates that allows them to attend IAS-convened meetings and then bring that learning home in tangible ways to their community and workplace. This will include access to peer-learning tools, translational presentations and the latest scientific data to support the professionalization of the HIV workforce – particularly the next generation.
Improve treatment access and the meaningful engagement of adolescents. Identify and address gaps in adolescent HIV prevention and care programmes through increased cross-sector partnerships and a series of youth-run dialogues. By hosting these mechanisms, issue experts and adolescent voices will jointly inform the global HIV response, fill the research gaps that are not being addressed by existing global initiatives and build adolescent research capacity.
Support the adoption of patient-centred care for all people living with HIV. Develop a set of key tools to be used by implementers that will help reduce the burden on health systems and improve the quality of HIV care. To help resource-limited countries improve care access with greater efficiency in-country, we will focus our efforts on differentiating models of antiretroviral therapy delivery that will have far-reaching benefits across the HIV continuum of care.
Develop a road map for research towards an HIV cure. Under the guidance of a multidisciplinary International Scientific Working Group, IAS will launch an updated Global Scientific Strategy. The document will provide clarity on a realistic scientific timeline for cure research and contextualize it within the current landscape of options. The strategy will ultimately serve as a tool for researchers, donors and other stakeholders to drive funding and research to accelerate the search for a cure.
These immediate next steps are one part of IAS’ broader effort to strengthen and build its global advocacy platform, ensuring that the organization’s convening power motivates action across the globe and delivers concrete results on the ground.
Central to that effort is moving the new scientific evidence that will be presented in Durban from the conference halls to the local communities that disproportionately face the brunt of the epidemic.
Durban offers us that moment to gather as a global community and determine how to harness our past gains, build on bold scientific breakthroughs and ensure we’re making the right strategic choices for the future. Only then will we truly be able to contemplate the end of AIDS.
Many partners and friends contributed time and effort into consultations and discussions that led to this document. Briefly we would like to thank Annette Sohn, Ben Plumley, Cate Hankins, Ian Grubb, Jamie Forrest, Judy Auerbach, Karen O’Malley, Mauro Schecter, Mitchell Warren, Pedro Cahn, Rob Caruano and Stefano Vella, in addition to the hundreds of IAS members who participated in focus groups, one-on-one interviews and surveys.