Title

HIV in armed conflicts

Code

PR02

Session Type

Prime session

CME accreditation

Yes

ROOM/CHANNEL

Room 220 d/e/Channel 1

Date Time

30 July 13:00 - 14:00

Chair

Joanne LIU, McGill University, Canada

Armed conflicts aggravate and accelerate the vulnerabilities of populations that are already exposed to risks, uncertainties, and instabilities. The availability and accessibility of health services, as well as harm reduction strategies, are heavily jeopardized in these precarious contexts.

Current conflicts are an immediate cause for broken health systems and will evidently raise mortality rates amongst people living with HIV or TB. In addition, millions of people on the move have an impact on health systems in the countries they move towards.

The current crisis in Ukraine shows the lack of policies that address, recognize and support people on the move. These populations are not identified as a key population by UNAIDS, adding complexities in the much-needed provision of support and services, resulting in blurred responsibilities within the international community and difficult funding environments.

The session will critically review the policies addressing HIV service provision for refugees and people on the move due to armed conflicts. It will highlight policy shortcomings and propose actions to ensure a human rights- and evidence-based response to the needs of people living and affected by HIV who are impacted by armed conflicts.

13:00 2 min	Welcome and introduction Joanne LIU, McGill University, Canada

13:02 40 min	Panel discussion Andriy KLEPIKOV, Alliance for Public Health, Ukraine Vinay SALDANHA, UNAIDS U.S. Liaison Office in Washington D.C., United States Peter SANDS, Global Fund to Fight AIDS, Tuberculosis and Malaria, Switzerland Erin ANASTASI, United Nations High Commissioner for Refugees (UNHCR), Switzerland	Slides

13:42 10 min	Q&A

13:52 2 min	Closing remarks Joanne LIU, McGill University, Canada

13:54 8 min	Prudence Mabele Prize Yvette RAPHAEL, APHA, South Africa Khourtney OTIENO, Men For Positive Living, Kenya	Slides

AUTHOR

Dorlim Moiana Uetela

SUMMARY

The first part was a panel discussion of the current situation of HIV in Ukraine and the proposed actions to better respond to it, from the perspective of the refugee aid programs, United Nations and funding agencies, followed by the presentation of the AIDS 2022 Prudence Mabele prize winner.

HIGHLIGHTS

Andriy Klepikov from Alliance for Public Health, Ukraine, presented the current situation in Ukraine, highlighting the needs and asking the pharmaceutical companies to share the medicine and the funding agencies to be flexible in the fund’s disbursement and accountability process. When questioned about people living in armed conflict and other disaster zones not being classified as key population, Vinay Saldanha from The Joint United Nations Programme on HIV/AIDS (UNAIDS), United States Liaison Office in Washington D.C., answered that although they are not officially identified as key population based on the current definition, they are recognized as vulnerable and address as such. Peter Sands form The Global Fund to Fight AIDS, Tuberculosis and Malaria, Switzerland recognized the large contribution of infectious diseases in the mortality of people in the conflict zones and proposed 1) investing in the resilience of health systems by building capacity to absorb socks, 2) respond quickly and flexibly to situations that emerge, 3) build relationships with other organizations before the emerging situation, and 4) be innovative when creating strategies to address these situations. In the second part, Kenyan Khourtney Otieno was awarded the AIDS 2022 Prudence Mabele prize.

CRITICAL ASSESSMENT

The session highlighted the vulnerability of people living in conflict zones and need to be considered as key population for HIV acquisition or susceptibility to suboptimal HIV care. Innovative and flexible ways of funding disbursement and service provision were deemed necessary as part of the response in these situations.

AUTHOR

Stefan Baral

SUMMARY

This was a panel discussion of current strategies being implemented to ensure continuity of HIV care and other health services in conflict zones. Ongoing challenges to service delivery in these contexts was identified. The war in Ukraine and on the ground responses were highlighted. Session summary by Lillian Shipp.

HIGHLIGHTS

Andriy Klepikov presented on the conflict in Ukraine and the Alliance for Public Health’s efforts to address the needs of displaced people in the country. During the war, APH has maintained continuity of HIV services for over 200,000 Ukrainians by implementing mobile healthcare services and delivering ART, opioid substitution and gender affirming care to services in conflict zones. Erin Anastasi emphasized the need to focus on access to HIV care for groups often forgotten in conflict settings, including adolescent girls, children, women, and individuals who are trafficked. Vinay Saldanha of UNAIDS addressed the question of whether people on the move due to conflict should be classified as a key population. While acknowledging increased vulnerability in conflict settings, Saldanha noted that this group does not currently meet the behavioral risk-based criteria used by UNAIDS to classify key populations. Peter Sands discussed the importance of building relationships and trust with implementing partners before conflicts occur, rather than after a conflict has begun. The session ended with the Prudence Mabele Prize being awarded by Yvette Raphael to Khourtney Otieno, a trans person living with HIV whose work focuses on creating supportive environments for peer to peer support among trans people living with HIV.

CRITICAL ASSESSMENT

Armed conflicts may increase over the coming years, which highlights the urgent need for replenishment of the Global Fund and increased support for comprehensive health services in these settings, including HIV and psychosocial care. Long-acting HIV treatment and prevention options were proposed as a means to provide more holistic care that includes life-saving HIV interventions but also looks beyond HIV to address other health needs. LGBTQ+ needs and challenges related to mobility of displaced populations when considering the implementation of long-acting methods was not addressed. Increasing access to HIV services and innovations is essential to addressing vulnerabilities in conflict settings.