During more than 10 years of presence in Brussels, SAA has established a firm presence at EU level, substantially contributing to keeping AIDS on the EU agenda (as highlighted in the SAA external evaluation 2012) and having become the key interlocutor of the EU institutions on HIV in development cooperation and hosted by the Red Cross EU Office. .
In the coming years, we will continue to advocate for a strong and coherent EU response to HI, at a time when EU development cooperation is changing substantially, with implications both in terms of policy and funding priorities. The EU has just reviewed its overall development policy with the adoption of the 'Agenda for Change on Increasing the Impact of EU Development Cooperation' and is in the process of adopting its overall budget for and new financing instruments for 2014-2020, with important implications for the EU AIDS response at the country and global levels. The Agenda for Change has for instance introduced country differentiation, meaning that the EU will stop providing direct financial support to middle-income countries such as India or China but also to most of the Latin American countries and in a limited number of cases, African countries that have reached that level of development. However, the EU has committed to continue supporting human and social development through allocating at least 20% of EU aid to social protection, health and education. Despite this financial commitment, when it comes to health, the EU is suffering from a lack of political vision: whereas the EU programme for action on AIDS, TB and Malaria 2007-2011 was supposed to be ‘renewed' through the adoption of a programme for action on "The EU Role in Global Health", two years later, this policy document still hasn't been developed and it is unclear when and if the Commission will launch this process. SAA, working notably with Action for Global Health, will continue advocating for a strong programme for action to be developed, in close coordination and with input from civil society. In parallel, SAA will continue working on the programming of EU support to partner countries and mobilise partners to ensure that AIDS is an integral part of EU health assistance - it is interesting to note that from preliminary information from the field, health is being selected as a priority sector in a large number of African countries.
Social protection is gaining momentum in EU development policy, following the adoption of a dedicated strategy on Social protection in EU Development Cooperation last year. SAA worked closely with the Alliance and STOP AIDS NOW! to ensure that HIV-sensitive social protection is part of the EU's vision and we will continue being involved in this field to make sure that political commitments are translated into funding allocations, notably in the new thematic instruments for 2014-2020. This will include influencing in particular the new thematic programme Global Public Goods and Challenges to ensure that it strongly contributes to meeting the 20% for social protection and health, including support to HIV and a strong allocation to the Global Fund. The European Commission is a founding member and among the main donors of the Global Fund, with a contribution of more than € 1,2 billion between 2001-2013. SAA will advocate for the EU contribution to the Global Fund to remain at least at the same level of support as it has been in the past years(e.g € 110 million a year).
Finally, SAA will continue advocating for specific EU human rights based initiatives contributing to the global AIDS response, especially in relation to harm reduction, LGBT rights and SRHR. This will include advocating for and influencing the development of the new EU LGBT guidelines and ensuring that the new financial instruments for CSOs and on Human Rights dedicate a share of their resources to supporting CSOs work in these areas.
Geneva is the world's global health and human rights capital. Headquarters of the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Global Alliance for Vaccines and Immunisation (GAVI) are located here. In addition, Geneva hosts key human rights bodies, including the Human Rights Council and the United Nations High Commissioner for Human Rights. 174 Countries and 11 intergovernmental institutions are represented in Geneva through their permanent missions.
This makes Geneva a strategic location for SAA to engage and influence global policy and technical debates related to HIV, global health and human rights. Hosted by the International Federation of the Red Cross, SAA is doing this by sharing intelligence with other NGOs and locations and bringing the voices from the south to the global arena; strengthening the HIV networks and coalitions in Geneva to advocate towards UN agencies and human rights bodies; and getting involved in technical working groups and consultations to influence policies and technical guidances.
SAA engages in the policy and technical debates relating to the Global Fund New Funding Model and health and community systems strengthening strategies, the WHO's and UNAIDS's post-2015 agenda and in the UNAIDS PCB in particular in the field of human rights, gender and civil society involvement. SAA also participates in the NGO Delegation to UNITAID and follows and engages with the WHO World Health Assembly and Executive Board.
The Global Fund will remain the biggest part of SAA's work in the coming years, closely monitoring the implementation of the new Global Fund Strategy 2012-2016 and the New Funding Model. The transition phase of the new Funding Model was launched in February 2013, which gives special consideration to countries most in need, such as programs that are underfunded or at risk of service interruptions, as well as programs which are in a position to achieve rapid impact. Full implementation of the New Funding Model will begin in 2014, after the 2013 Replenishment Conference has established the level of available funding for the next three-year cycle. In addition, the new Global Fund Strategy includes a strong emphasis on the promotion and protection of human rights, which will provide opportunities for stronger human rights based Global Fund programs and support for key populations.
This means that SAA will have to advocate both for adequate funding of the Global Fund as well as for quality implementation of its programs. SAA because of its global networks has a key role to play in mobilizing civil society around the Replenishment of the Global Fund. SAA will continue to actively engage with the Global Fund Advocacy Network and help mobilize advocacy efforts in Brussels, the Netherlands and the UK. In addition, SAA in Geneva will continue to influence the development and roll out of the Health Systems Strengthening and the Community Systems Strengthening guidances, by ensuring these guidances include Alliance and SAN! messages and best practices and ensure their contents are well understood by Alliance LOs and SAN! Southern partners.
Since October 2010, SAA has established a firm presence in Washington DC, hosted by the Alliance U.S. Office and sharing office space with Marie Stopes International. SAA's main focus in DC is policy influencing and intelligence gathering; linking up U.S and EU policy in global processes such as post-2015 and engaging with both U.S policy makers in the Office of the Global AIDS Coordinator and USAID, as well as with U.S. based civil society. President Obama's second term has seen a change in leadership at many different levels: within the Administration a new Secretary of State as well a new dual role for Eric Goosby as Global AIDS Coordinator and Global Health Coordinator, reflecting the new U.S Government's commitment to elevate global health as a new diplomatic priority. And within the U.S. Congress, 83 new Members of the House and 12 new Senators. This means that SAA as part of the broader HIV community in DC has to increase and expand advocacy efforts to ensure that HIV continues to receive the same dedicated political and financial attention it received from the U.S Government in the past decade.
This is increasingly difficult in a time with budget austerity and sequestration. The President's Budget request for FY 2014 however does include an allocation of 1.65 million USD for the Global Fund, which will ensure that the U.S. Government can meet its three year, 4 billion USD pledge in the current replenishment cycle if this number is retained by Congress. For PEPFAR bilateral funding, the picture is less positive, as funding for PEPFAR has fallen 12% since 2010 in the State Department HIV bilateral budget line. The President proposed an additional 50 million USD cut for 2014. When the mandated sequestration cut is taken into account, PEPFAR is now at its lowest funding level since 2007.
This is of particular concern as the funding does not match the political commitments made to HIV under President's Obama's first term. In November 2011, previous Secretary of State Hilary Clinton adopted the creation of an AIDS free generation as a U.S foreign policy goal following scientific and programmatic advances in AIDS, including Treatment as Prevention. This was followed by the development and adoption of a new PEPFAR Blue Print in December 2012 to implement this new foreign policy goal. The Blue Print includes a number of Roadmaps which outline PEPFAR's contribution to achieving an AIDS free generation and provides an action plan for the current and future Administrations, U.S. policy makers and implementers to help more countries move past the tipping point of the epidemic (the annual increase in new people on ART exceeds the annual new HIV infections). In addition, the U.S. Government committed to step up its efforts in global health diplomacy and political dialogue to promote increased attention for human rights and gender equality in the AIDS response.
At the moment it is unclear how this ambitious Blue Print will be implemented at the country level, especially now that PEPFAR is faced with further budget cuts. SAA will have a key role to play to monitor the implementation of the Blue Print and identify opportunities and challenges for country partners to engage with the U.S. Government around the Blue Print roll out in country.
However, it is clear that there are increased opportunities for local civil society to advocate for increased support for capacity building and strengthening of its programmes. The new USAID Forward Strategy and local procurement requires increased allocation of U.S.Government's budget to local civil society. The roll out of this new strategy also requires continuous monitoring by SAA. It will be crucial to see how the U.S will define and support health and community systems strengthening in the coming years and this is an area where SAA can play a strong role as well by bringing SAN! and Alliance's county experiences to the table.
Finally, the U.S. Government will be an important ally for ensuring AIDS remains a priority in the new post-2015 Development Framework. The U.S. Government has already indicated that it sees an AIDS free generation as a key issue in the new Framework, and we need to ensure this will be protected by the U.S. Government once UN Member State negotiations on the new Framework start.