Stefan Baral

This session refreshed the concept of sustainable financing by introducing a welcome change for how these mechanisms are applied in HIV programming, including considerations for community-led decision making, the importance and value of empowering people living with HIV, and multi-sectoral perspectives to address intersecting inequalities. This summary by Kalai Willis.

The definition of sustainability was expanded in this session to include that of social change, economic empowerment, health improvement, and strengthened human rights. Specifically, Abhina Aher (ITECH) raised the question, “Is sustainable financing only about money?” The answer: “No, it can be about opening the tap and the water coming out.” This perspective broadens our horizons of sustainable financing and speaks to the necessity of convergence between epidemics, communities, and policies. Jay Mulucha (Fem Alliance Uganda/EATHAN) supports this way forward by providing actionable priorities to ensure access to affordable and quality mechanisms that guarantee adequate budget allocations and sustainable financing for trans people living with HIV/AIDS (i.e., capacity building and sustained involvement in programmatic decisions of planning, implementation, and assessment). Joannah Davis (Frontline AIDS) illustrated a cycle of funding, composed of catalytic funding, large institutional funding, and social contracting. All of these funding mechanisms are situated to be additive in nature, building upon and supporting successful, sustained financing and resourcing of HIV programmes via accompaniment, assurance, accreditation, and shared leadership. This strategy of joint delivery was reiterated by Paul Richard Fife (NORAD), such that transitions from global to domestic funding takes all partners.

One sentiment: Empowering! This session was not only among the few at AIDS2022 to elevate trans people, but crowned trans women, trans men, and non-binary people as the focus. As re-quoted by Indian trans activist, Abhina Aher, “We [community] are not the subject, we are the subject matter experts.” It was also indicated that neither data nor policies exist on trans people living with TB in India. Thus, the call to action to move the health agenda on HIV towards policy echoes loudly… a message that strongly reverberates the theme: “Nothing about us without us.”