Last month I attended an important pan-African meeting organised by the World Health Organization (WHO) in Zimbabwe. The consultation’s theme was “Optimizing HIV Treatment Access and Retention in Care: Linking community level interventions with health care delivery systems.” WHO, which is mandated to advise governments on different interventions, has realised that providing antiretroviral (ARV) drugs alone is not enough. The community has to be involved if you want keep people living with HIV and AIDS in treatment.

For close to a decade now, VSO together with the Caregivers Action Network (CAN) has been seen as different from others in its HIV and AIDS advocacy in support of community and home-based care, a key pillar in strengthening health systems. But that is poised to change if the WHO meeting is anything to go by. I was there representing both VSO and CAN.

For far too long, governments and WHO framework have only been providing ARVs. The thinking behind this framework was that so long as ARVs were available, people living with HIV and AIDS would automatically access them and continue taking them as expected. VSO’s experience proved the opposite.

From our work with communities and especially caregivers, our advocacy has always emphasised the need to look at people living with HIV and AIDS not in isolation, but as members of a family and a community. This is because whatever affects the family and community has a direct and/or indirect impact on people living HIV and AIDS.

In circumstances where there isn't enough food to eat, can a mother on ARVs put herself before her children when serving food? In most cases, no! She would rather not eat, thus not take her drugs (some ARVs must be taken on a full stomach), for the sake of her children. VSO’s key message at the meeting was that livelihoods and social protection of the infected and affected must be a key component of successful treatment of HIV and AIDS.

So, how do we raise the number of people accessing and continuing in ARVs from 6 million to 15 million by 2015 while at the same time reducing and finally reversing the infection rates? By providing community support and mainstreaming the livelihoods of people living with HIV and AIDS. It seems as if our work has just begun!

When the Caregivers Action Network (CAN) finally gets down to nominating a goodwill ambassador, it seems to me that Stephen O'Brien,  the UK Minister for the Department for International Development, would be a good candidate. I say this because in an answer he gave on HIV/AIDS in the House of Commons on Wednesday, he said:  “In addition to prevention and treatment...we want to ensure that care and support, which has often been the neglected area of HIV campaigning, is addressed too.” So when I saw Stephen O’Brien at the High Level Meeting (HLM) in New York, the following day, I seized the opportunity to congratulate him for having drawn attention to caregivers.

Elsewhere at the HLM, in a session on women and girls and HIV, Dr Aaron Motsoaledi Minister of Health for South Africa pronounced that: “The future of any child depends on who the mother is”. This statement captures the mood at the HLM, which is really a breath of fresh air, given that over 50%  of people living with HIV are women.  Despite the tug-of-war between civil society organisations and governments on what their commitments should be, it is becoming clear that the likely winners from this meeting will be women and girls.

I also attended a meeting of  CSO representatives working on a draft statement on women and girls. Activists working for women’s organisations made it very clear that the trend of more women becoming infected had to be halted.

Governments welcome the Secretary-General’s Global Strategy for Women’s and Children’s Health that will  mirror  the Global Fund programme in terms of funding and implementation.  Its aim is to significantly reduce the number of maternal newborn and under-five child deaths “as a matter of immediate concern”.   This is one topic that both governments and CSOs fully agree and if implemented, will go a long way in injecting the much needed momentum in the system.

As one of the many NGO activists attending the UN High Level Meeting in New York, it was both with a sense of expectation and hope that I listened to the key speeches delivered at the opening plenary session today morning.

The upstairs auditorium of the Plenary Hall was packed to capacity by civil society organisations (CSO) representatives as governments occupied their designated places downstairs. We are hoping, expecting and working for something different! And for the Caregivers Action Network (CAN), of which VSO is a founding member, we are lobbying unceasingly to ensure “Care and Support” features prominently in the government commitments for the next 5 years.

Judging from the draft statements so far it seems it is still an uphill task for CSOs because governments still seem very reluctant to commit to providing more resources to HIV and AIDS by 2015 and semantics seem to play a key role here.

CSOs are determined to ensure the statement “governments commit to…” are made.  Governments on the other hand, seem stuck on “governments are working towards committing…”. And this has been and is still a tug-of-war so far!

What is clear is that the campaign for women and children  has started paying fruit. Both  the speech of  Mr Ban Ki Moon, the Secretary General of the UN and Mr Michele Sidibe, the Executive Director of UNAIDS,  put emphasis on the need to scale up interventions for women and children.

Of significance, Mr. Moon explained that a resolution was adopted yesterday by the UN Security Council, recognising the link between HIV and AIDS and conflict, and thus the need to include HIV and AIDS interventions in conflict situations and conflict resolution mechanisms by the UN. This will highly boost the gains of CSOs, especially those advocating for women and children.

But for us CAN members, we are still not sure whether to celebrate that Mr. Moon mentioned ‘care and support’ once in his opening speech; or to cry for the fact that Mr.Sidibe, did not mention it at all in his speech! What we are sure of  is that there cannot be ‘universal accesses to prevention and treatment without ‘care and support.’