Stepping Up Community Leadership
Feature: Midnight Poonkasetwattana, Executive Director of APCOM
Community responses to HIV are essential to ending the HIV epidemic. When HIV first surfaced three decades ago, communities were among the first responders. Today they remain a vital lifeline for all those at-risk or have HIV by advocating and advancing for basic human and healthcare rights, delivering HIV care and services, and tackling important issues such as stigma and discrimination.
However, the work of community-based organizations alone are limited without government and corporate partners willing to join the fight against HIV/AIDS. Government’s support and endorsement of holistic policies that help prevent, treat and raise HIV awareness at the national level will be required; while the private sector can help broaden community outreach initiatives and scale up programs through funding and resource contribution.
As we look to 2030 as the next target to eliminate HIV, read on the Q&A below featuring Midnight Poonkasetwattana, APCOM’s Executive Director, on the challenges and opportunities that lie ahead in the fight against HIV/AIDS in Asia Pacific in order to reach the 2030 elimination goals.
Q: Despite unequal progress made towards the UNAIDS triple 90’s targets across Asia and the Pacific, the latest UNAIDS report shows that Thailand and Cambodia are among the three countries to achieve the 90–90–90 HIV treatment targets, what do you think are the key success factors?
Midnight: It is a shame that the targets will not be met across the world, and it demonstrates that we still have a long way to go. However, we must celebrate Cambodia and Thailand’s achievements. The unity of actors, together with supportive policies that work effectively together are crucial, and we’d like to see more countries step up their political will to reach the targets. Cambodia and Thailand demonstrate leadership on treatment coverage and are early adopters of innovations such as community-based HIV self-testing, and prevention methods.
Q: The COVID-19 pandemic is impacting the AIDS response and is disrupting the health resources; how do you think community-based organizations such as APCOM can get involved to continue to meet the needs of the people living with HIV?
Midnight: APCOM has been collecting the voices of the community and turn them into a regular COVID-19 series newsletter since April. We have also seen tremendous examples of community resilience in the face of the pandemic. They have been able to pivot quickly to meet community’s needs during emergencies; continuing to provide both offline and on-line services, distribution of food packages and PPEs, etc. We provide a platform to connect the communities across Asia Pacific to share and learn from each other. We continue to advocate to ensure that those who are left behind can access health services, and that antiretroviral therapies (ART) can reach those who are living with HIV.
Governments must explore effective partnerships with key population-service community organizations. Allocation of resources for community organizations and endorsing their role in areas of policy, advocacy engagement and community mobilization is fundamental.
Q: Can you share with us your thoughts, how community resilience and innovation can help mitigate/reduce the impact of COVID-19 on HIV?
Midnight: At APCOM we have been able to continue condom and lubricant distribution, harm reduction messaging by mail through on-line orders, provide on-line information on HIV services as the number of requests have increased during this time.
We have collected stories of how COVID-19 has affected the community, set up coordination webinars with the community and documented best practices at the community level on resilience and innovation to share in the region.
For those who have not been able to quickly adapt or run the risk of being left behind, we set up an emergency fund for the community #CoronaAPCOMpassion to support the gaps that the community in the region face.
Q: In your opinion, what are the key barriers in this region to achieve the UNAIDS targets?
Midnight: The lack of financial support to the community, and community-based service delivery is a major key barrier. Community models reach the most marginalized and those left behind, and without sufficient financial support it is difficult to achieve any targets. Making domestic financing accessible to the community and continued support to middle-income economies will help the community play bigger role in education, prevention, treatment and care and support services as part of the health and community system.
Q: Many countries in the region are still lagging behind in preventing new HIV infections, what can these countries learn from those that have achieved the 90-90-90 targets to step up their HIV response?
Midnight: Governments must explore, develop and maintain effective partnerships with key population-led and key population-service community organizations. Allocation of resources for community organizations, and endorsing the role of community-led organizations, in areas of policy and advocacy engagement, quality assurance/watchdog roles, and community mobilization is fundamental.
My closing remarks at the Closing Plenary during the 2016 High-Level Meeting on Ending AIDS at the UN, 5 years ago still resonate:
“If we want to achieve fast-track to 90-90-90 by the year 2020, the time is now for urgent and increased investments in innovative regional and national approaches and programs for and led by key populations to break down structural barriers that affect and make them vulnerable to HIV, especially of young gay men and other men who have sex with men, and transgender people in our region.”
Based in Bangkok, APCOM Foundation is a not-for-profit organization representing and working with a network of individuals and community-based organizations across 35 countries in Asia and the Pacific. It works to improve the health and rights of gay men, other men who have sex with men, and people and communities of diverse sexual orientation, gender identity and expression, and sex characteristics (SOGIESC).