City leaders unite to regain momentum in urban HIV response

UNAIDS

Mayors from four cities, together with a representative of civil society and the core partners of the Fast-Track cities initiative-UNAIDS, the International Association of Providers of AIDS Care (IAPAC), the United Nations Human Settlements Programme (UN-Habitat) and the city of Paris-participated in a virtual side event on urban settings on 10 June, held during the United Nations High-Level Meeting on AIDS.

The participants reflected on the progress made in urban HIV responses and disruptions related to COVID-19, the importance of sustained political leadership and commitment during public health crises and the critical role of communities in strengthening HIV and other health services.

“A Fast-Track city is a city embracing human rights and advocating for more equality and freedom. The freedom to be true to yourself, to live where you want, to live free of prejudice, and with equal chance to stay healthy,” said the Mayor of Paris, Anne Hidalgo, in her opening address.

In her message, Maimunah Mohd Sharif, the Executive Director of UN‐Habitat, highlighted that, “Reducing inequalities is central to both UN-Habitat’s mission broadly and to ending urban HIV epidemics given the unacceptable disparities we see with respect to HIV among sexual and ethnic minorities, including the LGBTQ+ populations, migrants and refugees, and other marginalized populations, such as those in slums and informal settlements.”

Sibongile Tshabalala, the national Chairperson of the Treatment Action Campaign in South Africa, emphasized the importance of community leadership if we want to end AIDS, and called for communities to be at the centre of the HIV response within the context of ending social marginalization and health inequalities.

Attending mayors from Baton Rouge, Johannesburg, Kyiv and Quezon City presented their experiences in exercising public health leadership in HIV responses at the city level and in mitigating the impact of the COVID-19 pandemic. Many cities have made significant progress in accelerating their urban HIV responses since the beginning of the Fast-Track cities initiative on World AIDS Day 2014. In Kyiv, for example, according to national data the percentage of people who know their HIV status and are on antiretroviral therapy rose from less than 50% in 2015 to 83% in 2019, with 95% of those being virally suppressed. In Paris, according to national data the number of new HIV infections dropped by 16% between 2015 and 2018. And in Johannesburg, a targeted testing approach during the COVID-19 pandemic led to an increase in the percentage of people living with HIV knowing their status, from 86% in March 2020 to 91% in 2021, according to national data.

Josefina Belmonte, the Mayor of Quezon City, called on mayors to use the “Power and resources at their disposal towards the common good, including eradicating HIV and addressing issues that others are afraid to address because they are controversial or they may not be acceptable or not be politically sound.” She added that, “It is every person’s right to live freely, humanely and justly in the world they were born in and it is our duty as mayors elected by the people to make that happen for them.”

The moderator of the event, IAPAC President/Chief Executive Officer José M. Zuniga, recognized the progress made by Fast-Track cities, even within the context of the COVID-19 pandemic. “City public health leadership is translating into countless lives saved and enhanced, including as Fast-Track cities grapple with an emerging COVID-19 pandemic and simultaneously work to maintain a continuity of HIV and other essential health services for all of their citizens,” he said.

In many cities, the 90-90-90 targets for 2020 were not achieved, partly because of COVID-19-related disruptions, but also due to persistent inequalities and social exclusion. A prioritization of social enablers is therefore required to regain momentum against HIV across the Fast-Track cities network.

In her closing statement, Winnie Byanyima, the UNAIDS Executive Director, called on cities and municipalities around the world to recommit to accelerated urban HIV responses, to exercise public health leadership to achieve the 2025 targets, to end inequalities and social exclusion and to end AIDS as a public health threat by 2030.

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