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A Shot in the Arm Podcast
2024 UNAIDS World AIDS Day Report: The Rights Way to End the Epidemic?
00:47:24
In this first of a set of special World AIDS Day 2024 episodes, host Ben Plumley chats with Christine Stegling, Deputy Executive Director of UNAIDS, as they delve into the key themes of this World AIDS Day’s UNAIDS report, "Taking the Rights Path to End AIDS", which profiles the critical role of human rights in tackling the HIV/AIDS epidemic.
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- [00:01]
A
Welcome to A Shot in the Arm podcast. I'm Ben Plumley and this is a podcast about innovation and equity in global health. Well, it's end November, early December, which means it's a very special time of the year. And no, I'm not talking about Advent and I'm not talking about Hanukkah. It's all the events that take place around World AIDS Day on December 1st. And we got a few episodes for you this year to cover a range of issues that are going on in the response to aids. But the highlight and to kick us off, we have friend of the pod who is one of the deputy executive directors of unaids, Christine Stegling. Christine, welcome back to A Shot in the Arm podcast.
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B
Thank you. Happy to be here.
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A
Love the red ribbon. For those of you who are listening and not able to see Christine, she is sporting a very glitzy. Could I even say sequined red ribbon?
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B
Yep. Pretty.
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A
Yeah, it's very pretty. And I, of course, stored all my red ribbons in a safe place where I wouldn't forget them. And can I find them? Can I? Buggery. Anyway, it's that time of the year and UNAIDS is launching a new report just in advance of World AIDS Day to Day, Take the rights Approach. Could you tell us what it is and what UNAIDS is seeking to do with it?
- [01:31]
B
So we are calling the report this year, Take the Rights Path to End aids. And really what we're shining a light on in this report is to say, look, we know what to do. We know what we need to do to end AIDS as a public health threat by 2030. We're now in the the Countdown to 2030. But what we also know, and we have increasing evidence of, is that you need to protect people's human rights to ensure that they can actually make use of the services and the biomedical interventions that we have to prevent new HIV infections, but also so that people do well on treatment. And that's what the report is about. Remember last year we talked about putting communities at the center on World AIDS Day. And this is almost like a sequence to this to say, yes, communities need to be at the center and yes, human rights have to be protected.
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A
So I'd really love to sort of get into why you picked Take the rights.
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Approach.
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To this year's report. Back in the summer of this year, 2024, you reported on the global AIDS data, HIV data from 2023. And while we saw a sort of a sustaining of people on treatment, there were clearly some areas where we weren't seeing the progress that we needed to do if we were going to reach the goal of ending AIDS as a global health threat by 2030. And I guess the first question, Christine, is.
- [03:16]
Why did you pick rights rather than say, some of the biomedical interventions that is now really so urgent to bring us to a point where we could truly tackle HIV prevention as well as treatment from a biomedical perspective?
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B
Yeah. And I think here, even the way you're asking the question is where the problem is. Right. It's not an either or. And we were very vocal mid year when we saw the really incredible opportunity that would come with some of the new prevention tools, such as long acting injectable prep. But we all know that no matter what biomedical interventions we have, they don't matter if people don't access them and if they don't have access to them. And we also know that we are flatlining on new infections. So yes, we have been successful in particular in Africa. We have seen incredible reductions in new HIV infections, but we have come to a point where we hover at 1.3 million new infections each year. We need to ask ourselves what is going to change that? What is turning that around? And part of that are biomedical interventions. But as I say, they will be no good if people don't use them. And so we decided this year to really shine a light on saying we need to create that enabling environment that allows people to come forward, to use prep, to demand condoms, to do all the things that we know, avert new infections. So it might sound like we have chosen one over the other, but we have always said as unaids, and I think that makes us unaids, that it is people at the center of what we do and people don't live in a vacuum and they need to be able to come forward to make use of what is there on offer. And yes, these new interventions might be game changers and might be extraordinary in terms of how we will, you know, how they will change the trajectory of hiv. But it won't work unless we make sure that people will come forward and use them.
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A
That makes a lot of sense. But I guess just to press you on this a bit more, Chrissy.
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The goal is to end AIDS as a public health crisis by 2030. And.
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UN AIDS is rightly shining a light on the interventions, sort of systemic interventions that don't have.
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Short term achievable targets. If I may. So maybe one of the ways of sort of approaching the question is, to your mind, what do you mean by ending AIDS as a public health crisis? By 2030, because by definition, it's not ending HIV. Therefore, it's not ending HIV infections per se. But is it perhaps ending.
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The progression of advanced HIV disease into the syndrome that we have historically called aids?
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B
Yeah, and I, you know, for me it means, you know, it means both. It means ending new HIV infections and it means ending mortality or reducing mortality. Right. So it does speak about new HIV infections. I think why it makes us all uncomfortable when we are saying ending AIDS and not wanting to say ending hiv. Obviously, we will not end HIV for many, many years and for decades. We have many people living with hiv and our other goal is that those people live well and have a good quality of life. And that is not only right for them, but it's also right for public health reasons. Right, we know that. And that goes into U equals U. So it is not ending HIV per se. But when we are talking about ending HIV or ending AIDS as a public health threat, we are talking about really and articulating it in the Sustainable Development Goals. We're saying reduce new HIV infections by 90% compared to the 2010 data and reduce mortality by 90% compared to 2010. And maybe with mortality, we're almost getting there. We're still a little off or quite a bit off the target, but with new HIV infections, we're quite a long way off the target. And that is why we, you know, we often articulate that we are in a prevention crisis. It's the one thing we haven't solved. And I think we are talking in, in, in, in circles. You know, we are always trying to find the next best thing that is going to do it. And as you know, from my own personal background, I, from the beginning of the HIV epidemic, have always said, you will need to really do better to protect people from stigma and from discrimination. That is what human rights means. Right. And looking at a country like Botswana that I know very well, even at the time when we were starting, yes, it was about getting people on treatment once we had it, but a lot of our work was around reducing stigma and discrimination in health facilities, reducing it at the workplace. And we know that is why we have been successful, because people go into clinics and into health facilities and don't fear to be stigmatized or outed or in any way discriminated. And people can continue going to work and having a normal life. And that was done by really making a very concerted effort to protect their rights at work and to ensure this. HIV is not a ground for discrimination. It's an accepted ground ramp for Non discrimination in the labor courts. All of that is human rights. All of that creates a space for people to participate. And so this ending AIDS as a public health threat, I think.
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Not everybody likes it. It's one of the goals that we have identified in the Sustainable Development Goals. But it is clumsy in some ways because it talks at a very high level. And I think what we're getting more and more into is also understanding is when we do that, what about the people that will not be reached, but we will still reach our target. And those are the people that we're leaving behind. And again, this is where we need to talk about human rights. Right?
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A
Right. But it's also why we need to be very careful about setting international targets. That I can say this. You can't setting international targets that may only have a slight relationship to the reality in countries and on the ground. One of the other things that UNAIDS has done that's been interesting, I think, for last year.
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B
Hang on. But I want to say something about the targets. I think you're right. But I also think we should not forget that targets are not just implementing targets. Now this is not a project proposal where we say these are the targets you need to reach. They are political targets. They motivate people to, to get to this higher target. Right. And they have very much to do with how they look at country level, because the UNA's targets get translated at country level to country targets. And so there is a political.
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Bit to it that we sometimes don't talk about. It's not a mechanical thing. This is what you need to do from an epidemiological point of view, but it's also a political motivator for countries and for governments to strive towards that target. And we shouldn't forget that because we have right now determining the targets for 2026-31. Right. We are in the process of doing the next set of targets. And we need to create that balance between what is practical, what can countries translate, but also what is ambitious and motivational for countries.
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A
Well, I get the motivational bit. And I guess the challenge is that.
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While it might be understood within the circles of the UN that these are political, motivational targets, the trouble is, I think many organizations, and not just national AIDS commissions and ministries of health, ministries of finance, we all look to UN AIDS to provide a very sensible, action oriented, evidence based.
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Approach to what we, we can and can't do. So while I'm very happy to hear you talk about what happens in 2031.
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So much of this is going to depend on the actions of government. Which leads us on to the. The question that I was going to ask until you rightly interrupted me, and that is.
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You know, UNAIDS has been.
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I think, laser focused on making sure that countries most affected by HIV are truly in the leadership seat, truly driving their response to their epidemics, and that donors, multilateral agencies.
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Joint programs like unaids, that they support that. And.
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You know, how do you get to a point, what's UNAIDS strategy to help countries both take the reins from the policy level, but of course it's also going to be from the financial level as well.
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B
Yeah. And I think that is going to be the big question for the next five years. And we've spent a year now really thinking about what that looks like. We are working with over 30 countries to develop their own sustainability roadmaps, as we call them. And we're working closely with PEPFAR and with the Global Fund, the two big multilateral funding mechanisms, not multilateral in the case of pepfar. And we are really thinking about what does it take at country level to first of all describe what. What is. Then describe where do we want to get and what are the elements of how to get there. And very importantly, what we keep on telling people is this is not just about the finances. Right. Almost equally important is how do we create efficiencies, how do we create integration of HIV programs into broader health, broader social protection, broader gender programs to make sure we don't lose the multisectoral kind of approach that we know has been at the center of our success? And how do we ensure that it is equitable.
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And equal in terms of how all populations are accessing both prevention and treatment programs? And then the second part of those roadmaps, the second.
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Strategy, the priority is around how do we break down the barriers and what needs to be done? And that goes to the human rights question. How do we ensure that people can access.
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Those programs? And it looks different in different countries. Right. Sometimes it's about gender equality and women and girls being able to access programs. And in some countries, it is much more about key populations. And then the third question is, how do we fund sustainably? And that needs to be based on also the question of integration. What are we integrating to? What are the elements that are carried by a Ministry of Health, but also what are the other elements that could be carried by other ministries in countries or the gender Ministry, the Ministry of justice, the Ministry of Youth?
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And that is how we are progressing with countries to really ask ourselves, what are the steps that are involved so that you get in the long run to a place where you can fund your own response and that the response doesn't lose the quality. It will be different. I'm entirely sure it will be different and different in different countries. But how do we not lose the quality that keeps people at the center, that protects human rights and that keeps communities there? That's the, the process that we are in. And then we get to a point that becomes a bit more complicated because it's about the fiscal space that countries are in and how do we help with creating the right fiscal space. And some of that in some parts of the world is about looking at indebtedness and how that can be changed. And that is a much bigger political and financial conversation. But as you will see in the two reports that we launched this year on the sidelines of.
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At the Munich Conference, actually, it is also about looking at taxation and how do we help countries to guide them to, you know, change their own taxation to create bigger fiscal space for health programs and social development programs. So that's how we are thinking about it. It's complex. It won't be from now to tomorrow. But what I keep on saying to people is that my biggest.
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Or the reason why I feel quite hopeful and I feel quite encouraged that that will happen is that most countries are actually really engaged and want to do it because ultimately they want to pay crop programs for their own population. Though, as we all know, there may be areas where for many years to come, we will need some outside support. And that might be around human rights, it might be around people populations, and it might be about community engagement.
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A
So I deliberately didn't interrupt you during that. There's a lot to unpack. But it feels. Christine, there's one tension that underpins the strategies that you're describing because on the one hand, country ownership, leadership, responsibility, they call the shots. They set the priorities that are right for them. But on the other hand, we're in an environment where rights are being rolled back. And we can certainly see that across Africa. Obviously, Uganda is the unfortunate poster child for that, but it's not restricted to Uganda. And so if you accept that countries drive the agenda, they can drive the agenda in ways that are not rights based.
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So what do you do in those circumstances? And again, perhaps it speaks to what kind of strategies, advocacy strategies UNAIDS needs to take to.
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Try and rebuild that sense of.
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Building an HIV response that really doesn't care what marginalized population you're coming from. So how do you build a Rights based approach in the context of increasing anti rights legislation and political environments.
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B
Look, I think we need to, to be, you know, I think there's many, many answers to that question. One of them from my perspective would be this is why you need the un. You might have lots of criticism about the UN and we are too bureaucratic or too slow or too big or there might be many things that are wrong with the un, but that's one of the roles the UN will have to play and has always played. And that's the role that the Joint Program on HIV has played in country. Right. So, so you might for example, find a situation where many countries will.
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In the first instance start paying for treatment. That's a very easy, inadvertent.
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Cost that countries will take. It's about death, it's about keeping their citizens alive and so forth. The trick here is how will they do it in a way that they can still benefit from the same kind of systems we have built up over the years through PEPFAR and the Global Fund so that we do it at a cost that is acceptable and affordable to countries. That to aside, the next bit is going to be more difficult, right? There might be countries and often. And that's our biggest challenge. I think it's not the ministries of health.
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That are not on the same path with us. They are often our allies. They do know that stigma and discrimination is not helping them overall. They want everybody to come to their services. They don't care who you are, they want to serve you because you are a patient or you are a potential patient. So it is about that multi sectoral response. And I think that's where the UN and where the multilateral system and outside donors will play a role in different countries to a different degree. Right. And so I think we just need to be realistic about how we are doing it over time. It's not going to work like this and it's not about handling programs all over of, you know, here you go, now you do it. And they will look different. I think we need to be honest about that. And that's okay too, right? I think we need to find different ways of running our programs, but that still really uphold those fundamentals. That is why maybe at a complex time to have a World AIDS Day report to talk about using a human rights approach to ending aids. But we think it's important because that is the critical thing that we need to figure out. We can endlessly talk about biomedical interventions. They're really important. But like I said at the beginning, they're not going to get us where we need to get to at country level. And in fact, I think what might happen if we lose sight of what we really trying to do is we will see resurgence of epidemics. And we are already seeing it in some parts of the world. Right. So, yes, it will be complex. I think it needs about. And one of the things that we are thinking a lot more about is who are the other allies around the table? I think we have for many years worked with the faith based sector, faith based community. We should do a lot more of that. They are often very good allies.
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And want to do the right things for marginalized populations. How do we bring new partners on board? Because that is about change at country level. Right.
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A
Well, let me interrupt you there and let's see where the rubber hits the road. When Uganda introduced its.
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Very draconian anti LGBT legislation, the fear was that.
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People who might be from these communities that tried to access HIV services, either treatment, prevention services, or even just getting an HIV test and answering the question, you know, why do you think you might be at risk of hiv? That this was actually putting them in danger. And while the Ministry of Health and National AIDS Commission had argued, no, we can keep that separate, it undoubtedly sent a chill throughout the LGBT communities.
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And I don't know if you can answer this, but have you seen in Uganda.
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Any movement.
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That dissuades that chills, particularly the gay community, from accessing services? Or to your mind, is this still a theoretical risk or something that you feel under the auspices of different government departments that, you know, won't actually materialize?
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B
No, it's a definite chill. And it has an impact. And we have seen it. I think the easiest way where we can see it is that we have seen a real decline in the uptake of prep, of oral prep provision. And that is why UNH decided after.
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Advocating together with the Global Funda and pepra with the government and saying, look, this is not. It undermines your public health response. Right. And when it still went ahead, we did enter the courtroom as an amicus curie, as a friend to the court. It's not a usual role that we play. We have done it in the past, but we were the only amicuscuri that was allowed in the court. And they listened to our arguments. And our arguments were all public health arguments. We said, look, what you're doing is. And it's not about just these groups. It is going to be about everybody. Because once people feel that some people will be marginalized, then other groups start feeling that it might not be safe to enter health facilities. And those provisions that we particularly named in our application were taken out of.
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The legislation. That doesn't make the legislation good now. It's still terrible from many perspectives and it is now at the higher court, at the court of appeal stage to look at that can speak to that. I'm still convinced and I think we have seen evidence that those kinds of legislation are not helpful for the HIV response for everybody, not just for the groups that you're trying to target. And obviously from UNH point of view, we don't want any groups to be targeted. But I think the argument we have been making with the Ministry of Health, but with other parts of government is to say it is not helping you and what you might find is your epidemic might research. And that is coming at a great cost, human and financial, to your country. And I think that's what we need to keep on coming back to what is a public health.
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Argument that we.
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A
Are making here now. The other country that has seen a very significant increase in infections is the Philippines. That's a country that's come out of with the previous Duterte administration, a equally draconian, possibly even extrajudicial approach to harm reduction and drug users. What are you seeing driving that epidemic and what role do you see UNAIDS playing in helping the country address it?
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B
So interestingly so I went on the invitation of the Minister of Health, I went to the Philippines not long ago, maybe in June. We're seeing a 420% increase in new infections compared to 2010. I met the Minister here during World Health Assembly. We had a very good conversation. He said, why don't you come? Because we need help. We literally need help to figure out what's going on and what is going on. What is good is we still have good data systems in the Philippines and we have a very supportive and ambitious Minister of Health or Ministry of Health that want to do the right thing here. The epidemic has entirely shifted. It has shifted from what used to be a drug user injecting drug user epidemic into a young gay man epidemic. And what we're seeing is a very Catholic or conservative country where it is very hard.
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To be open about your sexual orientation and young men. And actually you're not just seeing infection rates. You're also seeing mortality rising in very young people because people haven't actually tested it and they haven't gotten onto treatment and therefore they're dying. So the Ministry is very keen to figure out two things. One, I think the first thing they did was to change the.
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Age of consent for testing because they realized people were not testing without parental consent. They have fixed that. Now they see people coming for testing so at least they know who is infected. And but then the next hurdle was people still need parental consent when they're under 18 to get onto treatment. And so they're trying to solve that through here. Again, we are back into policies, human rights, right? The biomedical intervention is there, the treatment is there. The ministry is willing to give treatment to everybody, but they are not getting people to the services because of age of concern. It doesn't always have to be as dramatic as an anti homosexuality act. Sometimes it's age of consent. And they're trying to solve this through changing their policies to say we want to move. We not only want to know who's HIV positive because we know the burden is to. The obstacle is too high for these young men to go to their parents to say, not only am I sexually active in a country where I shouldn't be, the moral norms say you shouldn't be. I'm also gay and I'm infected with a sexually transmitted infection and I now need lifelong treatment. That is just too much for young people. And so that's where they're, where they are getting help to, trying to make that happen. And it's because it is young people. You know, it's a particular group of young people who are affected in this moment and that is not the same group that was affected five or 10 years ago.
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A
Now, another key group that is under the spotlight is the trans community, particularly trans women.
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Many of those that are critical of.
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Trans rights are not really aware of the concept of trans men, but there we are. But trans women, particularly in what for the un, our major donor countries, are really coming under the spotlight. And I'm going to push you, I don't know how far you can answer this, but there's a change of government coming in the United States and.
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The Republicans want a trifecta, they say the presidency, the House of Representatives and the Senate. And one of the arguments of why they've achieved this is that they pushed the anti woke agenda, particularly playing on people's fears about trans rights and trans women in particular.
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How is UNAIDS preparing for the Trump administration? I mean, there are a whole range of things that we are all going to have to think about, from conspiracy theories and misinformation to a reprioritization away from donor aid.
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How are you approaching it? And I guess I would also add a plea in a favor that. I think one of the reasons why the UNAIDS model has worked so well from a bipartisan perspective in the US Is because it is about country coordinating and convening. And I really would hope that that is a central piece of your work as you consider engaging the new administration.
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B
Look, as strange as that sentence might be for me, I am an international civil servant. I work for the United Nations. We are the United nations of all countries. And we work with a lot of different governments. And we work with governments in the different ways they show up. And they often show up differently every four years or every five years, whatever.
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It might be. I think the important bit is to really make. Create a narrative for all the governments that we're working with that is based on the principles that we stand for as the un and that's why I joined the UN because we have certain principles that I think in this particularly complex geopolitical world that we find ourselves in, it's really important that we keep having that place in the center that says these are the principles we all agree to. And then you think about.
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Doing the best you can to ensure that. You make your argument about why support from a variety of donor countries, and I'm not going to single out only that part particular one continues to be important. And I think one of the areas that we keep on trying to, with all countries, keep on trying to make with them, is to say, look, you made an extraordinary investment in the case of the US but there's also others. But the US Is exceptional in the investment they have made since the early 2000s. Right? Always with bipartisan support, always going across different presidents. It's an extraordinary achievement and something that we should really celebrate and celebrate maybe more than we have in the past. But it also goes for other countries, right? There are countries that, compared to their economic status, have made extraordinary contributions to the global fight against aids. And what we are seeing now is, and that's why the sustainability agenda or conversation is so important, we're almost there. We can see the end. We don't often get that in public health that we can actually say, look, we could actually do this. And that's why we, we named our report in July when we looked at the data at the crossroads where we say, you can either go this way and get to the end or you go this way where you de invest, you lower the volume on global solidarity, you lower the volume on all these things, and then you will not, you will not win it. And you will also possibly create a much bigger problem in the future.
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A
So I think there are two points and I get that. You know, I'm talking to Christine Stegling, the international civil servant and my God, thank God you were there at UNAIDS in this senior role. Two things strike me. First is that one way of squaring the circle, as it were, is that both UNAIDS and particularly African countries.
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Want to see greater ownership by individual countries. I think we're going to see that from the US perspective as well. And of course one of the big fears that we have in the US is that given that we no longer have a five year authorization schedule for pepfar, that the US may pull out rapidly of paying for life saving antiretrovirals. That's, you know, the American taxpayer through PEPFAR and the Global Fund truly is making a major investment in keeping people alive around the world. And.
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So there's perhaps something there that I think could speak to a unique role that the joint UN program could do. The other thing, and you mentioned other countries and I suppose you're going to give me exactly the same answer when it relates to the United Kingdom and why has it not reversed the decrease of overseas development aid? Well, you'd probably throw that right back at people like me and saying, ben, get your act together and you all should be advocating with the labor administration. But something is going on as it relates to the attitudes of countries towards development aid. Whether it's an upcoming election in Germany, whether it's attitudes of other key European states like France and Italy. The issues are the war in Ukraine, the threat Russia poses to the European Union, but also how countries themselves deal with immigration and the need to move investment from overseas development to again, probably more draconian approaches to managing migration. Without getting into the specifics of individual countries, how do you think the UN and UNAIDS in particular.
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Leverages its advocacy and its, it's, it's power of being able to speak truth to power in very delicate diplomatic ways.
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B
That's a very loaded question. But let me, I think, let me speak for UNAS rather than for the UN as all I think, you know, we have a very particular role to play in the next few years. And I think what we bring to the table as the joint program is.
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Especially in high impact countries, but also in countries where maybe the overall number of people living with HIV is not so high, but where we see epidemic trajectories that we would rather not want to see, whether that's in the MENA region or in Middle east and North Africa region or in Eastern Europe and Central Asia. But also in parts of Asia. Again, we have a particular role where we can bring not only the whole of the UN around the table, but also civil society and government. And that is really helpful and important in this particular situation. And I think we shouldn't underestimate it. It doesn't sound as convincing as, you know, we might have wanted it or we thought it sounded five years ago. But I think we need to decode it a little bit and say to countries, look, here is an opportunity if you really want this to work and if you want to be at a level with these countries that you want to engage with also on all sorts of other things. Here's a leverage point, right? We are bringing people together, we are coordinating and convening around a particular issue. But as we have all seen with hiv, the investment in HIV has also, you know, had other impacts for development and for health. So I think that's one, the second one is that we, we need to change that narrative that you just described that is unfortunately getting old everywhere, which is a very inward looking issue around how do we deal with migration and go back to where is, where is the root cause of migration? Why are people leaving where they're coming from? And again, you know, whether you like it or not, development aid has always had a role to play to say let's ensure that living spaces are, are the right ones for people so that nobody wants to leave their country if they don't need to. Right? So this national security and global security conversation, that also was very fundamental in the HIV response in the early 2000s, as you well know. I think there is something in here that we need to get back to and try to have this conversation again in a different way.
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A
Now I'm going to dive in again and I completely agree with you because.
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I really feel that.
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The development community has missed a beat here because dealing with migration and refugees, refugees particularly, but it also applies to migration. We have fought the draconian laws that try and prevent people from coming into countries. What we haven't done is speak to the critical role development aid plays in, in making sure that countries are secure. So as much as we want to prevent the disruption to the happy suburban towns across Europe and the United States, we have to make sure that those same happy suburban towns exist in countries around the world, whether it's Syria, whether it's Sudan, whether it's Myanmar. And I do think that the UN has a role to play there. Now, there's one other country that I wanted to try and get you to comment on, and it's in southern Africa and it's a country you know exceptionally well. And there has been an extraordinary election in Botswana.
- [40:03]
And I think your organization that you were deeply involved in from its early days, Bonella, has seen some of its.
- [40:14]
Governance leaders now playing major roles in the new government. Can you comment on that?
- [40:21]
B
I'll take my civil or international civil service hat off, but not entirely. Yeah, I mean, it's exceptionally so. I was the founder of an HIV and human rights organization, which also gives you a hint that, as I said early on in the conversation, I have always believed, even in the deepest and darkest times when we had so many people dying in Botswana, I always said it was not an access to treatment is also a human right, but it was also about creating the right environment for people living with hiv. And we just had an election in Botswana, and for the first time in the history of independent Botswana, the opposition has won the election. And the new President of Botswana.
- [41:08]
Mr. Duma Boko, used to be the chair of the organization I used to run in Botswana. He's a human rights lawyer, he's an advocate. And actually me and him were together at the University of Botswana before I did that work. So I think what we're seeing there is. I don't know, I'm not a political person, I don't support any particular party, but. But I think it will be interesting to see how a human rights advocate will carry that commitment and aspiration that he has always had in his academic, but also.
- [41:45]
In his life where he was supporting organizations such as Bonella. And he has been exceptionally committed always to understanding that you need a solid human rights approach to have good public health in a country. He's my age. He has gone through all of the same, you know, he has observed the same issues we all have observed, you know, a country that and even to this day has a fifth of the population living with hiv. Right. And so it will be interesting to see how he translates that into, you know, the reform in the Ministry of Health, the reform in how government works with civil society. And he's building on solid ground. Right. When I was leading this organization in Botswana, one of our big arguments with the government was always about social contracting. You're an upper middle income country, you should support civil society to do our work. And that has happened over the last 10 years. And civil society is getting social contracts with the government of Botswana. So he's building on solid ground of doing some of those good things that were already put in place by many other former presidents.
- [42:58]
A
See, in a way, I would really like to end the podcast here and now because we end on some good news or at least some interesting news. But there's one other thing I need to raise.
- [43:12]
Which makes this World AIDS Day perhaps more peculiar, more complex than.
- [43:21]
Than otherwise. And I really do hope it doesn't detract from the work. And it is that the executive director of unaids, Winnie Bina, her husband is incarcerated in a military jail in Uganda, and she's obviously over there doing everything that she can to.
- [43:44]
Ensure his, if not his release at least being held in a civil, not military, prison. And I again know that you can't comment on this. The UN spokesperson has expressed concern to ensure Winnie's husband's security and safety. But I guess two things. One, for us to just please pass on our best wishes and positive vibes to Winnie in what must be a really difficult time. And have you had a chance to talk to her? Is she okay in herself? I imagine if there's one person who is very single, focused on getting this sorted, it would be her. But I do hope that she's holding up okay.
- [44:36]
B
Thank you. We appreciate it. And as you say, I mean, it's not for me to comment on it, but I think as the spokesperson for the Secretary General's office said earlier in the week, this week, we are, as the UN we will always be concerned for a fair treatment and due process and ensuring that anybody, whatever the allegations and the accusations are, is treated fairly and is safe and secure in the way that they're being treated. And I think that is our biggest concern. And yeah, and Winnie, it's okay under the circumstances, but I will pass on your good wishes. And she has received many, many good wishes from all over the world in the last few days.
- [45:26]
A
Well, I guess, Chrissie, that then brings our conversation to a close.
- [45:33]
For this particular podcast. Now, as you know, my partner in crime from the global health diplomat, Eric Goosby, and I are going to be doing a series of episodes looking at the HIV agenda beyond 2030. And I'm no doubt we'll come back to UNAIDS with some questions, comments, and who knows, maybe even some suggestions. But in the meantime, just wishing you a very productive World AIDS Day. I'm sure you and the team are going to be all over the world fighting the good fight, raising the profile. Just thank you very much for giving us some time today.
- [46:15]
B
Lovely. Thank you. Thank you for having me. And yes, I hope that everybody will amplify our message in the next few days about taking the right path to end AIDS and the public health threat. So thanks, Ben.
- [46:28]
A
And we will include the link to take the rights path in the show notes so people can read the executive summary. Oh, and there we are. There we are. And again, if you are enjoying this podcast through the wonders of audio, you won't see Christine holding up the COVID But again, we'll have it in the show notes for everyone. Okay. Well, thank you, Christine. Well, that's it for this episode. Thanks to Christine Stegling. Thanks also to our director and producer, Eric Espera from news media. And finally, a big thanks to you. We hope you enjoy the series of podcasts around HIV that are coming now over the November, December period. And it just remains for me to wish you a a safe week and a happy week. Thank you.