Human-Rights Focused Advocacy Is More Critical Than Ever

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We are at an interesting and uncertain time in global health. The political climate is, to put it mildly, dynamic. One need only look at the United States, historically the largest donor to the global AIDS response, to see how precarious progress is at the moment. The Trump administration outlined devastating budget cuts that, if enacted, could erode progress, lay the groundwork for further inequities, and hurt those who are already most vulnerable to the HIV/AIDS epidemic.

Source: FCAA (Funders Concerned About AIDS) Data Spotlight: HIV Philanthropy for Advocacy & Human Rights, April 2017

While the United States is not the only global donor, other bilateral and multilateral HIV and AIDS funding has been flat lining in recent years. A recent Henry J. Kaiser Family Foundation/UNAIDS study indicates that donor government funding for HIV declined by 7 percent in 2016, falling to its lowest level in six years.

In the fight against HIV and AIDS, advocacy is more critical than ever. Often, advocacy is the strongest lever to address the kinds of challenges we now face. It is also an arena in which philanthropy has made important contributions.

Since the early days of the AIDS epidemic, philanthropic efforts have helped to drive scientific and therapeutic advancements, change policies and public opinion, and raise the voices of, and increase protections for, those most vulnerable to HIV and AIDS. For example:

  • Through the M•A•C AIDS Fund, M•A•C Cosmetics dedicates 100 percent of the selling price of Viva Glam products to programs supporting men, women, and children affected by HIV and AIDS around the world. More than a third of these resources were directed toward advocacy and human rights in 2015 alone.
  • In 2004 the Levi Strauss Foundation became the first corporate foundation to support expanded access to sterile syringes, the only proven method (needle exchange) of preventing HIV among the intravenous (IV) drug users who are particularly vulnerable to infection.
  • The Robert Wood Johnson Foundation’s (RWJF’s) landmark 1986 contribution of $17.2 million supported the scale-up of community responses to HIV and AIDS. Through the AIDS Health Services Program, the RWJF awarded grants in eleven cities over a period of four years and helped establish the platform upon which the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, enacted in 1990, was built.

Though philanthropic funding comprises only 2 percent of global resources in the fight against HIV/AIDS, its contributions are critical. In fact, philanthropic dollars are often the only resources allocated to advocacy. Such funding has helped to reduce stigma surrounding HIV and AIDS, expand legal services for victims of discrimination and of unfair criminalization laws, inform policy, protect the rights of those most vulnerable, and combat widespread discrimination. However, as a recent data spotlight from Funders Concerned About AIDS (FCAA) shows, this powerful weapon—advocacy—in the fight against HIV and AIDS is dramatically underfunded.

Consider that in 2015, 41 percent of HIV philanthropy for advocacy and human rights was distributed to organizations supporting key populations—including sex workers, people who inject drugs, transgender people, and gay men and other men who have sex with men. This is certainly impressive; however, many communities all over the world continue to be both heavily affected and woefully underfunded.

Source: FCAA (Funders Concerned About AIDS) Data Spotlight: HIV Philanthropy for Advocacy & Human Rights, April 2017

NOTE: MSM is men having sex with men.

In addition, while Eastern Europe and Central Asia comprise 19 percent of new infections among key populations globally, these regions receive only 5 percent of HIV-related philanthropy for the advocacy and human-rights efforts, resources that are critical to fighting the epidemic among those most at risk.

Source: FCAA (Funders Concerned About AIDS) Data Spotlight: HIV Philanthropy for Advocacy & Human Rights, April 2017

The US South faces a similar resource gap. Though home to 44 percent of all people living with HIV/AIDS (PLWHA) in the United States, this region receives less than 20 percent of overall philanthropic funding to combat the disease. In recent years, only $31 million in HIV-related philanthropy, annually, was directed to this region—roughly $59 a year per person with HIV/AIDS. Compare this at the national level, where the level of funding is nearly double, with $116 per person with HIV/AIDS allocated each year.

Source: FCAA (Funders Concerned About AIDS) Data Spotlight: HIV Philanthropy for the US South, September 2016

The good news is that, between 2014 and 2015, HIV-related philanthropy directed toward advocacy and human rights increased 35 percent. But that is far from enough to fuel the required level of work. Equally concerning, the vast majority of resources came from a small number of funders, leaving the field vulnerable to the decisions of a relatively limited group. In addition, only 18 percent of advocacy grants went for general operating funding—the dollars needed to support critical activities such as education, capacity building, and legal support.

It is a daunting time in the fight against HIV and AIDS. But there are tools we know work. Though private philanthropy alone won’t fill the potential gap left by large global donors, its contributions will have a greater impact if they are focused on the things that have proven to be effective. That is why dollars allocated toward advocacy must be maximized like never before. With an expanded pool of funders and increased resources, we can be successful in ensuring continued progress in the fight against HIV and AIDS.

Related reading:

“Are Foundations Still Interested In HIV/AIDS?” by Lee L. Prina, Health Affairs, May 2017.

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