Key population and community leadership

Definition

Peo­ple liv­ing with HIV should be placed at the cen­ter of HIV responses, rep­re­sented in deci­sion mak­ing bod­ies, and influ­ence deci­sions that affect their lives. Peo­ple liv­ing with HIV should also have access to tech­ni­cal sup­port for com­mu­nity mobi­liza­tion, strength­ened orga­ni­za­tional capac­i­ties, and lead­er­ship devel­op­ment. Com­mu­nity lead­er­ship refers to the fact that com­mu­ni­ties should be placed at the cen­ter of responses and exer­cise this type of lead­er­ship. Key pop­u­la­tions for instance must play a sig­nif­i­cant role in design­ing, imple­ment­ing and eval­u­at­ing HIV ser­vices which in turn pro­vides the oppor­tu­nity to make HIV ser­vices more peo­ple-cen­tered. It fur­ther encour­ages co-cre­ation of inno­v­a­tive HIV ser­vices tai­lored towards address­ing the needs of Key Pop­u­la­tions. Cau­tion should be made to avoid tokenis­tic involve­ment of key pop­u­la­tions in HIV ser­vice deliv­ery as this dimin­ishes authen­tic key pop­u­la­tion - led ser­vices deliv­ery.

With or with­out offi­cial recog­ni­tion, com­mu­ni­ties have often led their own responses to counter neglect, dis­crim­i­na­tion and crim­i­nal­i­sa­tion with mutual aid strate­gies of com­mu­nity pre­ven­tion, treat­ment and care in sub­sti­tu­tion for denied or inad­e­quate health sec­tor pro­vided ser­vices as well as through advo­cacy and orga­nized resis­tance against the laws, poli­cies and prac­tices which abridge their sex­ual and repro­duc­tive rights. Com­mu­nity lead­er­ship has always been and will always remain indis­pens­able to effec­tive responses to HIV, related and sex­ual and repro­duc­tive health chal­lenges, and the drive towards uni­ver­sal health cov­er­age.

Sev­eral inter­na­tional agree­ments rec­og­niz­ing the need to place com­mu­ni­ties at the cen­ter of HIV responses already exists and are reflected in the Lan­guage Com­pendium.

Precedents

2023 Resolution on community-based primary health care: a participatory and inclusive approach to universal health coverage

• “Under­lin­ing the impor­tance of devel­op­ing effi­cient and inno­v­a­tive approaches, such as com­mu­nity-based pri­mary health care, includ­ing through com­mu­nity and pri­vate sec­tor engage­ment, to address the health needs of those in vul­ner­a­ble sit­u­a­tions, and by build­ing strength­ened and resilient health sys­tems to achieve uni­ver­sal health cov­er­age” (p. 2)

• “Rec­og­niz­ing that com­mu­nity-based health ser­vices include access to basic med­i­cines, screen­ing and tests for dis­ease, help in man­ag­ing chronic con­di­tions, includ­ing com­mu­ni­ca­ble and non-com­mu­ni­ca­ble dis­eases, neglected trop­i­cal dis­eases, rou­tine immu­niza­tion, sex­ual and repro­duc­tive health-care ser­vices, mater­nal and child health, men­tal health and psy­choso­cial sup­port, and refer­rals to higher-level health facil­i­ties when nec­es­sary, as well as basic health infor­ma­tion and edu­ca­tion, nutri­tion ser­vices, and treat­ment for pre­ventable blind­ness” (p. 2)

• “Rec­og­nizes the impor­tance of com­mu­nity-based health ser­vices as a crit­i­cal com­po­nent of pri­mary health care and as a means of ensur­ing uni­ver­sal and equi­table access to health for all” (p. 3)

• “Calls upon Mem­ber States to allo­cate ade­quate resources, includ­ing human and finan­cial resources, and build syn­er­gies with other devel­op­ment pri­or­i­ties, to sup­port the strength­en­ing of com­mu­nity-based pri­mary health care and explore inno­v­a­tive approaches in their respec­tive coun­tries” (p. 3)

• “Reaf­firms that health financ­ing requires global sol­i­dar­ity and col­lec­tive effort, and invites inter­na­tional finan­cial insti­tu­tions, mul­ti­lat­eral and regional devel­op­ment banks and donors to pro­vide appro­pri­ate resources, espe­cially for devel­op­ing coun­tries, to strengthen com­mu­nity-based health ser­vices towards the full imple­men­ta­tion of the 2030 Agenda for sus­tain­able Devel­op­ment” (p. 4)

2022 Resolution on Violence Against Women Migrant Workers

• “Urges States to rec­og­nize the sig­nif­i­cant con­tri­bu­tions and lead­er­ship of women in migrant com­mu­ni­ties and to take appro­pri­ate steps to pro­mote their full, equal and mean­ing­ful par­tic­i­pa­tion in the devel­op­ment of local solu­tions and oppor­tu­ni­ties, and to rec­og­nize the impor­tance of pro­tect­ing labour rights and a safe envi­ron­ment for women migrant work­ers in all sec­tors, includ­ing those in infor­mal employ­ment, includ­ing through fair and eth­i­cal recruit­ment and the pre­ven­tion of exploita­tion, and to ensure safe, orderly and reg­u­lar migra­tion, as well as labour mobil­ity.” (para­graph 27)

2021 Global AIDS Strategy 2021-2026

• “30% of test­ing and treat­ment ser­vices to be deliv­ered by com­mu­nity-led orga­ni­za­tions, with focus on: enhanced access to test­ing, link­age to treat­ment, adher­ence and reten­tion sup­port, treat­ment lit­er­acy, and com­po­nents of dif­fer­en­ti­ated ser­vice deliv­ery, e.g. dis­tri­bu­tion of ARV (anti­retro­vi­ral treat­ments).” (annex 2, 2025 tar­gets)

• “80% of ser­vice deliv­ery for HIV pre­ven­tion pro­grammes for key pop­u­la­tions to be deliv­ered by com­mu­nity-led orga­ni­za­tions” (annex 2, 2025 tar­gets)

• “80% ser­vices for women, includ­ing pre­ven­tion ser­vices for women at increased risk to acquire HIV, as well as pro­grammes and ser­vices for access to HIV test­ing, link­age to treat­ment (ART), adher­ence and reten­tion sup­port, reduc­tion/elim­i­na­tion of vio­lence against women, reduc­tion/elim­i­na­tion of HIV related stigma and dis­crim­i­na­tion among women, legal lit­er­acy and legal ser­vices spe­cific for women- related issues, to be deliv­ered by com­mu­nity-led orga­ni­za­tions that are women-led” (annex 2, 2025 tar­gets)

• “ 60% of the pro­grammes sup­port­ing the achieve­ment of soci­etal enablers, includ­ing pro­grammes to reduce/elim­i­nate HIV-related stigma and dis­crim­i­na­tion, advo­cacy to pro­mote enabling legal envi­ron­ments, pro­grammes for legal lit­er­acy and link­ages to legal sup­port, and reduc­tion/elim­i­na­tion of gen­der-based vio­lence, to be deliv­ered by com­mu­nity-led orga­ni­za­tions.” (annex 2, 2025 tar­gets)

• “With its new tar­gets for soci­etal enablers, the Strat­egy demands that the same com­mit­ment and atten­tion to tech­ni­cal detail that has char­ac­ter­ized the HIV response’s pro­gram­matic efforts be applied to the urgent busi­ness of address­ing the social and struc­tural fac­tors that slow progress against AIDS. The Strat­egy pri­or­i­tizes lessons from recent suc­cesses and applies them more broadly, espe­cially in coun­tries where inequal­i­ties are enabled by puni­tive legal and pol­icy frame­works. Com­mu­ni­ties of peo­ple liv­ing with, affected by, or most at risk of HIV must be sup­ported and effec­tively resourced to gal­va­nize actions that can reduce inequal­i­ties in the response and to ensure that responses meet the needs of all peo­ple.” (para­graph 131)

• “If we are to reduce HIV-related inequal­i­ties and get the response on-track to end AIDS by 2030, com­mu­ni­ties liv­ing with or affected by HIV must lead the way. Com­mu­ni­ties liv­ing with and affected by HIV have been the back­bone of the HIV response at every level, from global to national to com­mu­nity. They advo­cate for effec­tive action; they inform local, national, regional and inter­na­tional responses regard­ing com­mu­ni­ties’ needs; and they plan, design and deliver ser­vices. They also advance the real­iza­tion of human rights and gen­der equal­ity, and sup­port the account­abil­ity and mon­i­tor­ing of HIV responses. Com­mu­ni­ties give voice to peo­ple who are often excluded from deci­sion- mak­ing processes. Effec­tive com­mu­nity-led HIV responses must be ade­quately resourced and sup­ported to enable com­mu­ni­ties to play their vital roles as equal, fully- inte­grated part­ners in national sys­tems for health and social ser­vices.” (para­graph 132)

• “Progress in recent years demon­strates the essen­tial role of com­mu­nity-led HIV responses in global efforts to end AIDS. Com­mu­ni­ties have led efforts to iden­tify and address key inequal­i­ties; expanded the evi­dence base for action to end AIDS as a pub­lic health treat; sup­ported the plan­ning and imple­men­ta­tion of national HIV responses; iden­ti­fied key issues and gaps for national and mul­ti­lat­eral gov­er­nance and coor­di­na­tion bod­ies; expanded the reach, scale, qual­ity and inno­va­tion of HIV ser­vices; and played a vis­i­ble role as defend­ers of human rights. As of 2019, com­mu­nity and key pop­u­la­tion-led HIV pre­ven­tion pro­grammes that exceeded 80% cov­er­age in many coun­tries were among the most effec­tive. With acute resource con­straints, it is crit­i­cal to pri­or­i­tize HIV pro­grammes that deliver opti­mal results in pre­ven­tion, test­ing, link­ages to treat­ment, treat­ment lit­er­acy and adher­ence sup­port that are led by peo­ple liv­ing with HIV, key pop­u­la­tions and women.” (para­graph 133)

• “As seen dur­ing COVID-19 pan­demic, under-uti­liza­tion of the poten­tial of com­mu­ni­ties is com­pounded by an acute short­age of resources for com­mu­nity-led responses. Shrink­ing space for civil soci­ety in many coun­tries, as well as per­sis­tent social and struc­tural fac­tors, exac­er­bate the pres­sures on com­mu­nity-led HIV responses and increase the risk of vio­lence against orga­ni­za­tions that serve key pop­u­la­tions or other mar­gin­al­ized groups.” (para­graph 135)

• “Fully imple­ment the GIPA (Greater Involve­ment of Peo­ple liv­ing with AIDS) prin­ci­ple to put the lead­er­ship of peo­ple liv­ing with HIV at the cen­tre of HIV responses, ensure that net­works of peo­ple liv­ing with HIV and key pop­u­la­tions are rep­re­sented in deci­sion-mak­ing bod­ies and can influ­ence the deci­sions that affect their lives, and have access to tech­ni­cal sup­port for com­mu­nity mobi­liza­tion, strength­ened orga­ni­za­tional capac­i­ties, and lead­er­ship devel­op­ment.” (para­graph 137(a))

• “Efforts to anchor HIV responses in human rights prin­ci­ples and approaches, includ­ing the pri­or­ity actions out­lined below, can only be achieved through strong polit­i­cal lead­er­ship and the active engage­ment and lead­er­ship of com­mu­nity-led responses that are ade­quately resourced to advo­cate for, mon­i­tor and imple­ment rights-based responses.” (para­graph 141)

• “Cre­ate an enabling legal envi­ron­ment by remov­ing puni­tive and dis­crim­i­na­tory laws and poli­cies, includ­ing laws that crim­i­nal­ize sex work, drug use or pos­ses­sion for per­sonal use and con­sen­sual same-sex sex­ual rela­tions, or that crim­i­nal­ize HIV expo­sure, nondis­clo­sure or trans­mis­sion. Intro­duce and enforce pro­tec­tive and enabling leg­is­la­tion and poli­cies, and end the overuse of crim­i­nal and gen­eral laws to tar­get peo­ple liv­ing with HIV and key pop­u­la­tions.” (para­graph 144(c))

• “Invest in women-led responses to HIV and in ini­tia­tives to sup­port and build women’s lead­er­ship––par­tic­u­larly net­works of women and girls liv­ing with HIV, and women in key pop­u­la­tions––in the design, bud­get­ing, imple­men­ta­tion and mon­i­tor­ing of the HIV response at regional, national, sub­na­tional and com­mu­nity lev­els.” (para­graph 153(i))

2021 Resolution on ensuring equitable, affordable, timely and universal access for all countries to vaccines in response to the coronavirus disease (COVID-19) pandemic

• “Rec­og­niz­ing that the COVID-19 pan­demic requires a global response that is peo­ple-cen­tred, gen­der-respon­sive, with full respect for human rights, mul­ti­di­men­sional, coor­di­nated, inclu­sive and inno­v­a­tive, based on unity, sol­i­dar­ity and mul­ti­lat­eral coop­er­a­tion, to ensure that all States, in par­tic­u­lar devel­op­ing States, includ­ing the least devel­oped coun­tries, have unhin­dered, timely, fair and equi­table access to safe diag­nos­tics, ther­a­peu­tics, med­i­cines, vac­cines and essen­tial health tech­nolo­gies and their com­po­nents, as well as equip­ment, bear­ing in mind that immu­niza­tion against COVID-19 is a global pub­lic good for health in pre­vent­ing, con­tain­ing and stop­ping trans­mis­sion, and in bring­ing the pan­demic to an end” (p. 5)

2021 CSW Report on women and HIV/AIDS

• “The mean­ing­ful par­tic­i­pa­tion and engage­ment of women, includ­ing women liv­ing with HIV and young women, in the devel­op­ment, imple­men­ta­tion and mon­i­tor­ing of national HIV strate­gies, poli­cies and pro­grammes is essen­tial for ensur­ing that national HIV responses meet their needs.” (para­graph 12)

• “The Com­mis­sion may wish to encour­age Mem­ber States to give mean­ing­ful sup­port to the voices, par­tic­i­pa­tion and deci­sion-mak­ing of women, par­tic­u­larly young women and ado­les­cent girls, in all their diver­sity, includ­ing women liv­ing with HIV and women in key pop­u­la­tions, as inte­gral part­ners in national HIV coor­di­nat­ing bod­ies, national dia­logue and com­mu­nity-led processes, includ­ing by strength­en­ing the capac­i­ties of their orga­ni­za­tions and by ensur­ing for­mal par­tic­i­pa­tion in the design, deliv­ery and mon­i­tor­ing of all strate­gies, pro­grammes and inter­ven­tions that affect them.” (para­graph 57(b))

• “The Com­mis­sion may wish to encour­age Mem­ber States to increase inter­na­tional and domes­tic financ­ing to reach the goal of $29 bil­lion in annual invest­ment by 2025 to meet the needs of low- and mid­dle-income coun­tries in the HIV and AIDS response, with greater allo­ca­tions for women-led orga­ni­za­tions, for pre­ven­tion and for soci­etal enablers that pro­mote human rights and gen­der equal­ity.” (para­graph 57(f))

• “The Com­mis­sion may wish to encour­age the United Nations sys­tem and other inter­na­tional actors to facil­i­tate the active engage­ment, rep­re­sen­ta­tion and deci­sion-mak­ing of women liv­ing with, at risk of or affected by HIV and their net­works in inter­na­tional, regional, national and com­mu­nity-led processes related to the HIV and AIDS response.” (para­graph 58(d))

2021 Political declaration on HIV and AIDS

• “Using dif­fer­en­ti­ated ser­vice deliv­ery mod­els for test­ing and treat­ment, includ­ing dig­i­tal, com­mu­nity-led and com­mu­nity-based ser­vices that over­come chal­lenges such as those cre­ated by the COVID-19 pan­demic by deliv­er­ing treat­ment and related sup­port ser­vices to the peo­ple in great­est need where they are.” (para­graph 61(b))

• “

  Com­mit to the Greater Involve­ment of Peo­ple Liv­ing with HIV/AIDS prin­ci­ple and to empower com­mu­ni­ties of peo­ple liv­ing with, at risk of and affected by HIV, includ­ing women, ado­les­cents and young peo­ple, to play their crit­i­cal lead­er­ship roles in the HIV response by:

  (a) Ensur­ing that rel­e­vant global, regional, national and sub­na­tional net­works and other affected com­mu­ni­ties are included in HIV response deci­sion -mak­ing, plan­ning, imple­ment­ing and mon­i­tor­ing and are pro­vided with suf­fi­cient tech­ni­cal and finan­cial sup­port;
  (b) Cre­at­ing and main­tain­ing a safe, open and enabling envi­ron­ment in which civil soci­ety can fully con­trib­ute to the imple­men­ta­tion of the present dec­la­ra­tion and the fight against HIV/AIDS;
  (c) Adopt­ing and imple­ment­ing laws and poli­cies that enable the sus­tain­able financ­ing of peo­ple-cen­tred, inte­grated, com­mu­nity responses, includ­ing peer-led HIV ser­vice deliv­ery, includ­ing through social con­tract­ing and other pub­lic fund­ing mech­a­nisms;
  (d) Sup­port­ing mon­i­tor­ing and research by com­mu­ni­ties, includ­ing the sci­en­tific com­mu­nity, and ensur­ing that com­mu­nity-gen­er­ated data are used to tai­lor HIV responses to pro­tect the rights and meet the needs of peo­ple liv­ing with, at risk of and affected by HIV.

  ” (para­graph 64)

2020 Resolution on comprehensive and coordinated response to the coronavirus disease (COVID-19) pandemic

• “Calls upon Mem­ber States to build, strengthen and pro­mote health sys­tems, includ­ing pri­mary health care, that are strong, resilient, func­tional, well gov­erned, respon­sive, account­able, inte­grated, com­mu­nity-based, peo­ple-cen­tred and capa­ble of qual­ity ser­vice deliv­ery, sup­ported by a com­pe­tent health work­force, ade­quate health infra­struc­ture and essen­tial pub­lic health func­tions and capac­i­ties, enabling leg­isla­tive and reg­u­la­tory frame­works, as well as suf­fi­cient and sus­tain­able fund­ing, calls upon donors and other rel­e­vant stake­hold­ers to sup­port coun­tries that lack the capac­ity to imple­ment such mea­sures, rec­og­nizes the value of an inte­grated One Health approach that fos­ters coop­er­a­tion between the human health, ani­mal health and plant health, as well as envi­ron­men­tal and other rel­e­vant sec­tors, and under­lines the urgent need for con­tin­ued close work between the long-stand­ing Tri­par­tite, together with other rel­e­vant parts of the United Nations sys­tem and rel­e­vant stake­hold­ers in this regard” (p. 12)

2020 Resolution on global health and foreign policy: strengthening health system resilience through affordable health care for all

• “Rec­og­niz­ing that peo­ple’s engage­ment, par­tic­u­larly of women and girls, fam­i­lies and com­mu­ni­ties, and the inclu­sion of all rel­e­vant stake­hold­ers is one of the core com­po­nents of health sys­tem gov­er­nance, to fully empower all peo­ple in improv­ing and pro­tect­ing their own health, giv­ing due regard to address­ing and man­ag­ing con­flicts of inter­est and undue influ­ence, con­tribut­ing to the achieve­ment of uni­ver­sal health cov­er­age for all, with a focus on health out­comes” (p. 5)

• “Urges Mem­ber States to strengthen national health sys­tems through ensur­ing afford­able health care for all, with a focus on pri­mary health care, as well as the avail­abil­ity, acces­si­bil­ity and afford­abil­ity of qual­ity health ser­vices and qual­ity, safe, effec­tive, afford­able and essen­tial med­i­cines, vac­cines, diag­nos­tics and health tech­nolo­gies, with a view to imple­ment­ing the most effec­tive, high-impact, qual­ity- assured, peo­ple-cen­tred, with full respect for human rights, gen­der- and dis­abil­ity- respon­sive and evi­dence-based inter­ven­tions to meet the health needs of all through­out the life course” (p. 5)

• “Fur­ther encour­ages Mem­ber States to pur­sue effi­cient health financ­ing poli­cies, includ­ing through close col­lab­o­ra­tion among rel­e­vant author­i­ties, includ­ing finance and health author­i­ties, to respond to unmet needs and to elim­i­nate finan­cial bar­ri­ers to access to qual­ity, safe, effec­tive, afford­able and essen­tial health ser­vices, med­i­cines, vac­cines, diag­nos­tics and health tech­nolo­gies, reduce out-of-pocket expen­di­tures lead­ing to finan­cial hard­ship and ensure finan­cial risk pro­tec­tion for all through­out the life course, espe­cially for the poor and those who are vul­ner­a­ble or in vul­ner­a­ble sit­u­a­tions, through bet­ter allo­ca­tion and use of resources, with ade­quate financ­ing for pri­mary health care, in accor­dance with national con­texts and pri­or­i­ties” (p. 5)

2020 Resolution on consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2030

• “Affirms that close col­lab­o­ra­tion with com­mu­nity lead­ers and imple­ment­ing part­ners, includ­ing non-gov­ern­men­tal orga­ni­za­tions, health work­ers and vol­un­teers, is an essen­tial fac­tor for suc­cess in com­bat­ing malaria, and calls upon Mem­ber States to intro­duce inte­grated, peo­ple-cen­tred com­mu­nity ser­vices, in coor­di­na­tion with health-care providers in the pub­lic and pri­vate sec­tors, and to con­tinue efforts to col­lab­o­rate with non-gov­ern­men­tal part­ners, health work­ers and vol­un­teers in imple­ment­ing com­mu­nity-based approaches to reach pop­u­la­tions in remote and hard- to-reach areas” (p. 8)

2020 Resolution on violence against women migrant workers

• “Urges States to rec­og­nize the sig­nif­i­cant con­tri­bu­tions and lead­er­ship of women in migrant com­mu­ni­ties and to take appro­pri­ate steps to pro­mote their full, equal and mean­ing­ful par­tic­i­pa­tion in the devel­op­ment of local solu­tions and oppor­tu­ni­ties, and to rec­og­nize the impor­tance of pro­tect­ing labour rights and a safe envi­ron­ment for women migrant work­ers in all sec­tors, includ­ing those in infor­mal employ­ment, includ­ing through fair and eth­i­cal recruit­ment and the pre­ven­tion of exploita­tion, and to ensure safe, orderly and reg­u­lar migra­tion, as well as labour mobil­ity.” (para­graph 25)

• “Encour­ages Gov­ern­ments, in accor­dance with their applic­a­ble legal oblig­a­tions, to for­mu­late national poli­cies con­cern­ing women migrant work­ers that are based on up-to-date, rel­e­vant sex-dis­ag­gre­gated data and analy­sis, in close con­sul­ta­tion with women migrant work­ers and rel­e­vant stake­hold­ers through­out the pol­icy process, and also encour­ages Gov­ern­ments to ensure that this process is ade­quately resourced and that the result­ing poli­cies have mea­sur­able tar­gets and indi­ca­tors, timeta­bles and mon­i­tor­ing and account­abil­ity mea­sures, in par­tic­u­lar for employ­ment agen­cies, employ­ers and pub­lic offi­cials, and pro­vide for impact assess­ments and ensure multi-sec­tor coor­di­na­tion within and between coun­tries of ori­gin, tran­sit and des­ti­na­tion through appro­pri­ate mech­a­nisms.” (para­graph 40)

2019 Political declaration of the HLM on UHC

• “Rec­og­nize the need for health sys­tems that are strong, resilient, func­tional, well gov­erned, respon­sive, account­able, inte­grated, com­mu­nity-based, peo­ple-cen­tred and capa­ble of qual­ity ser­vice deliv­ery, sup­ported by a com­pe­tent health work­force, ade­quate health infra­struc­ture, enabling leg­isla­tive and reg­u­la­tory frame­works as well as suf­fi­cient and sus­tain­able fund­ing.” (para­graph 10)

• “Rec­og­nize that peo­ple’s engage­ment, par­tic­u­larly of women and girls, fam­i­lies and com­mu­ni­ties, and the inclu­sion of all rel­e­vant stake­hold­ers is one of the core com­po­nents of health sys­tem gov­er­nance, to fully empower all peo­ple in improv­ing and pro­tect­ing their own health, giv­ing due regard to address­ing and man­ag­ing con­flicts of inter­est and undue influ­ence, con­tribut­ing to the achieve­ment of uni­ver­sal health cov­er­age for all, with a focus on health out­comes.” (para­graph 20)

• “Expand the deliv­ery of and pri­or­i­tize pri­mary health care as a cor­ner­stone of a sus­tain­able peo­ple-cen­tred, com­mu­nity-based and inte­grated health sys­tem and the foun­da­tion for achiev­ing uni­ver­sal health cov­er­age, while strength­en­ing effec­tive refer­ral sys­tems between pri­mary and other lev­els of care, rec­og­niz­ing that com­mu­nity-based ser­vices con­sti­tute a strong plat­form for pri­mary health care.” (para­graph 46)

2018 Political declaration of the HLM on the fight against TB

• “Rec­og­nize the enor­mous, often cat­a­strophic, eco­nomic and social impacts and bur­den of tuber­cu­lo­sis for peo­ple affected by the dis­ease, their house­holds, and affected com­mu­ni­ties, and that the risk and impact of tuber­cu­lo­sis can vary depend­ing on demo­graphic, social, eco­nomic and envi­ron­men­tal cir­cum­stances, and, in order to make the elim­i­na­tion of tuber­cu­lo­sis pos­si­ble, pri­or­i­tiz­ing, as appro­pri­ate, notably through the involve­ment of com­mu­ni­ties and civil soci­ety and in a non-dis­crim­i­na­tory man­ner, high-risk groups and other peo­ple who are vul­ner­a­ble or in vul­ner­a­ble sit­u­a­tions, such as women and chil­dren, indige­nous peo­ples, health-care work­ers, migrants, refugees, inter­nally dis­placed peo­ple, peo­ple liv­ing in sit­u­a­tions of com­plex emer­gen­cies, pris­on­ers, peo­ple liv­ing with HIV, peo­ple who use drugs, in par­tic­u­lar those who inject drugs, min­ers and oth­ers exposed to sil­ica, the urban and rural poor, under­served pop­u­la­tions, under­nour­ished peo­ple, indi­vid­u­als who face food inse­cu­rity, eth­nic minori­ties, peo­ple and com­mu­ni­ties at risk of expo­sure to bovine tuber­cu­lo­sis, peo­ple liv­ing with dia­betes, peo­ple with men­tal and phys­i­cal dis­abil­i­ties, peo­ple with alco­hol use dis­or­ders and peo­ple who use tobacco, rec­og­niz­ing the higher preva­lence of tuber­cu­lo­sis among men.” (para­graph 17)

2018 Political declaration of the third HLM on NCDs

• “Pro­mote mean­ing­ful civil soci­ety engage­ment to encour­age Gov­ern­ments to develop ambi­tious national mul­ti­sec­toral responses for the pre­ven­tion and con­trol of non-com­mu­ni­ca­ble dis­eases, and to con­trib­ute to their imple­men­ta­tion, forge multi‐stake­holder part­ner­ships and alliances that mobi­lize and share knowl­edge, assess progress, pro­vide ser­vices and amplify the voices of and raise aware­ness about peo­ple liv­ing with and affected by non-com­mu­ni­ca­ble dis­eases.” (para­graph 42)

2016 HRC Resolution on civil society space

• “Empha­sizes that cre­at­ing and main­tain­ing a safe and enabling envi­ron­ment in which civil soci­ety can oper­ate free from hin­drance and inse­cu­rity assists States in ful­fill­ing their exist­ing inter­na­tional human rights oblig­a­tions and com­mit­ments, with­out which equal­ity, account­abil­ity and the rule of law are severely weak­ened, with impli­ca­tions at the national, regional and inter­na­tional lev­els.” (para­graph 1)

• “Empha­sizes the impor­tance of civil soci­ety space for empow­er­ing per­sons belong­ing to minori­ties and vul­ner­a­ble groups, as well as per­sons espous­ing minor­ity or dis­sent­ing views or beliefs, and in that regard calls upon States to ensure that leg­is­la­tion, poli­cies and prac­tices do not under­mine the enjoy­ment by such per­sons of their human rights or the activ­i­ties of civil soci­ety in defend­ing their rights.” (para­graph 5)

2016 Outcome Document of the Session on the World Drug Problem

• “Inten­sify, as appro­pri­ate, the mean­ing­ful par­tic­i­pa­tion of and sup­port and train­ing for civil soci­ety orga­ni­za­tions and enti­ties involved in drug-related health and social treat­ment ser­vices, in accor­dance with national leg­is­la­tion and in the frame­work of inte­grated and coor­di­nated national drug poli­cies, and encour­age efforts by civil soci­ety and the pri­vate sec­tor to develop sup­port net­works for pre­ven­tion and treat­ment, care, recov­ery, reha­bil­i­ta­tion and social rein­te­gra­tion in a bal­anced and inclu­sive man­ner.” (para­graph 1(q))

2016 Resolution on Women, the Girl Child and HIV and AIDS

• “Also urges gov­ern­ments to pro­mote the active and mean­ing­ful par­tic­i­pa­tion, con­tri­bu­tion and lead­er­ship of women and girls liv­ing with HIV, civil soci­ety actors, the pri­vate sec­tor, youth and young men and women’s orga­ni­za­tions, in address­ing the prob­lem of HIV and AIDS in all its aspects, includ­ing pro­mot­ing a gen­der-respon­sive approach to the national response.” (para­graph 20)

2016 Political Declaration on HIV and AIDS

• “Note with alarm the slow progress in reduc­ing new infec­tions and the lim­ited scale of com­bi­na­tion pre­ven­tion pro­grammes, empha­siz­ing that each coun­try should define the spe­cific pop­u­la­tions that are key to its epi­demic and response, based on the local epi­demi­o­log­i­cal con­text, and note with grave con­cern that women and ado­les­cent girls, in par­tic­u­lar in sub-Saha­ran Africa, are more than twice as likely to become HIV-pos­i­tive than boys of the same age, and not­ing also that many national HIV pre­ven­tion, test­ing and treat­ment pro­grammes pro­vide insuf­fi­cient access to ser­vices for women and ado­les­cent girls, migrants and key pop­u­la­tions that epi­demi­o­log­i­cal evi­dence shows are glob­ally at higher risk of HIV, specif­i­cally peo­ple who inject drugs, who are 24 times more likely to acquire HIV than adults in the gen­eral pop­u­la­tion, sex work­ers, who are 10 times more likely to acquire HIV, men who have sex with men, who are 24 times more likely to acquire HIV, trans­gen­der peo­ple, who are 49 times more likely to be liv­ing with HIV, and pris­on­ers, who are 5 times more likely to be liv­ing with HIV than adults in the gen­eral pop­u­la­tion.” (para­graph 42)

• “Com­mit to build­ing peo­ple-cen­tred sys­tems for health by strength­en­ing health and social sys­tems, includ­ing for pop­u­la­tions that epi­demi­o­log­i­cal evi­dence shows are at higher risk of infec­tion, by expand­ing com­mu­nity-led ser­vice deliv­ery to cover at least 30 per­cent of all ser­vice deliv­ery by 2030, through invest­ment in human resources for health, as well as in the nec­es­sary equip­ment, tools and med­i­cines, by pro­mot­ing that such poli­cies are based on a non-dis­crim­i­na­tory approach that respects, pro­motes and pro­tects human rights, and by build­ing the capac­ity of civil soci­ety orga­ni­za­tions to deliver HIV pre­ven­tion and treat­ment ser­vices.” (para­graph 60(d))

• “Call for increased and sus­tained invest­ment in the advo­cacy and lead­er­ship role, involve­ment and empow­er­ment of peo­ple liv­ing with, at risk of and affected by HIV, women, chil­dren, bear­ing in mind the roles and respon­si­bil­i­ties of par­ents, young peo­ple, espe­cially young women and girls, local lead­ers, com­mu­nity-based orga­ni­za­tions, indige­nous com­mu­ni­ties and civil soci­ety more gen­er­ally, as part of a broader effort to ensure that at least 6 per cent of all global AIDS resources are allo­cated for social enablers, includ­ing advo­cacy, com­mu­nity and polit­i­cal mobi­liza­tion, com­mu­nity mon­i­tor­ing, pub­lic com­mu­ni­ca­tion and out­reach pro­grammes to increase access to rapid tests and diag­no­sis, as well as human rights pro­grammes such as law and pol­icy reform and stigma and dis­crim­i­na­tion reduc­tion.” (para­graph 64(a))

2016 Resolution on the girl child

• “Urges States to for­mu­late or review as needed com­pre­hen­sive, mul­ti­dis­ci­pli­nary and coor­di­nated national plans, pro­grammes or strate­gies to elim­i­nate all forms of dis­crim­i­na­tion and vio­lence against women and girls, which should have ded­i­cated resources, be widely dis­sem­i­nated and pro­vide tar­gets and timeta­bles for imple­men­ta­tion, as well as effec­tive domes­tic enforce­ment pro­ce­dures through the estab­lish­ment of mon­i­tor­ing and eval­u­a­tion mech­a­nisms involv­ing all par­ties con­cerned, includ­ing con­sul­ta­tions with women’s orga­ni­za­tions, giv­ing atten­tion to the rec­om­men­da­tions relat­ing to the girl child of the Spe­cial Rap­por­teurs of the Human Rights Coun­cil on vio­lence against women, its causes and con­se­quences, and on traf­fick­ing in per­sons, espe­cially women and chil­dren, and of the Spe­cial Rep­re­sen­ta­tive of the Sec­re­tary-Gen­eral on Vio­lence against Chil­dren.” (para­graph 22)

2012 Resolution on women in development

• “Encour­ages Mem­ber States to ensure inclu­sive and more effec­tive par­tic­i­pa­tion of national mech­a­nisms for gen­der equal­ity and women’s empow­er­ment in the for­mu­la­tion of national devel­op­ment strate­gies, includ­ing strate­gies aimed at erad­i­cat­ing poverty and reduc­ing inequal­i­ties, and calls upon the United Nations sys­tem to sup­port national efforts in this regard.” (para­graph 12)

• “Urges Mem­ber States, the United Nations sys­tem and non-gov­ern­men­tal orga­ni­za­tions to accel­er­ate their efforts and pro­vide ade­quate resources to increase the voice and full and equal par­tic­i­pa­tion of women in all deci­sion-mak­ing bod­ies at the high­est lev­els of gov­ern­ment and in the gov­er­nance struc­tures of inter­na­tional orga­ni­za­tions, includ­ing through elim­i­nat­ing gen­der stereo­typ­ing in appoint­ments and pro­mo­tions, to build women’s capac­ity as agents of change and to empower them to par­tic­i­pate actively and effec­tively in the design, imple­men­ta­tion, mon­i­tor­ing, eval­u­a­tion and report­ing of national devel­op­ment, poverty erad­i­ca­tion and envi­ron­men­tal poli­cies, strate­gies and pro­grammes.” (para­graph 5)

• “Encour­ages Mem­ber States to con­tinue to increase, as appro­pri­ate, the par­tic­i­pa­tion of civil soci­ety, includ­ing women’s orga­ni­za­tions, in Gov­ern­ment deci­sion-mak­ing in national devel­op­ment pol­icy areas.” (para­graph 6)

• “Encour­ages Mem­ber States and the United Nations sys­tem to ensure sys­tem­atic atten­tion to, recog­ni­tion of and sup­port for the cru­cial role of women in the pre­ven­tion and res­o­lu­tion of con­flict, in medi­a­tion and peace­build­ing efforts and in the rebuild­ing of post-con­flict soci­ety, inter alia, through pro­mot­ing women’s capac­ity, lead­er­ship and engage­ment in polit­i­cal and eco­nomic deci­sion-mak­ing.” (para­graph 7)

2011 Political Declaration on HIV and AIDS

• “Rec­og­nize the role that com­mu­nity orga­ni­za­tions play, includ­ing those run by peo­ple liv­ing with HIV, in sus­tain­ing national and local HIV and AIDS responses, reach­ing all peo­ple liv­ing with HIV, deliv­er­ing pre­ven­tion, treat­ment, care and sup­port ser­vices and strength­en­ing health sys­tems, in par­tic­u­lar the pri­mary health­care approach.” (para­graph 44)

• “Com­mit to con­tinue engag­ing peo­ple liv­ing with and affected by HIV in deci­sion­mak­ing and plan­ning, imple­ment­ing and eval­u­at­ing the response, and to part­ner with local lead­ers and civil soci­ety, includ­ing com­mu­nity-based orga­ni­za­tions, to develop and scale up com­mu­nity-led HIV ser­vices and to address stigma and dis­crim­i­na­tion.” (para­graph 57)

2010 HRC On the rights of the child: the fight against sexual violence

• “Urges all States to ensure the mean­ing­ful par­tic­i­pa­tion of chil­dren in all mat­ters and deci­sions affect­ing their lives through their expres­sion of their views, and that those views are given due weight in accor­dance with their age and matu­rity, includ­ing in all admin­is­tra­tive and judi­cial pro­ceed­ings, and that dis­abil­ity-, gen­der- and age-appro­pri­ate assis­tance is pro­vided to enable the active and equal par­tic­i­pa­tion of all chil­dren.” (para­graph 2(l))

• “Urges all States to ensure an active engage­ment of chil­dren in the devel­op­ment of mea­sures of pre­ven­tion, response and mon­i­tor­ing of sex­ual vio­lence and abuse against them, includ­ing through the pro­mo­tion and devel­op­ment of child-led ini­tia­tives.” (para­graph 2(m))

2010 HRC Resolution on the elimination of discrimination against women

• “Calls upon States to ensure full rep­re­sen­ta­tion and full and equal par­tic­i­pa­tion of women in polit­i­cal, social and eco­nomic deci­sion-mak­ing as an essen­tial con­di­tion for gen­der equal­ity and the empow­er­ment of women and girls and a crit­i­cal fac­tor in the erad­i­ca­tion of poverty.” (para­graph 9)

2009 ECOSOC Resolution on UNAIDS

• “Acknowl­edges the crit­i­cal impor­tance of peo­ple liv­ing with HIV to all aspects of national AIDS responses, global advo­cacy efforts and the work of the United Nations sys­tem on AIDS, and encour­ages increased sup­port for the capac­ity of civil soci­ety to carry out pro­gramme imple­men­ta­tion and advo­cacy, directed towards the goal of ensur­ing uni­ver­sal access to pre­ven­tion, treat­ment, care and sup­port.” (para­graph 16)

2001 Declaration of Commitment on HIV/AIDS

• “Acknowl­edg­ing the par­tic­u­lar role and sig­nif­i­cant con­tri­bu­tion of peo­ple liv­ing with HIV/AIDS, young peo­ple and civil soci­ety actors in address­ing the prob­lem of HIV/AIDS in all its aspects, and rec­og­niz­ing that their full involve­ment and par­tic­i­pa­tion in the design, plan­ning, imple­men­ta­tion and eval­u­a­tion of pro­grammes is cru­cial to the devel­op­ment of effec­tive responses to the HIV/AIDS epi­demic.” (para­graph 33)

• “By 2005, develop and make sig­nif­i­cant progress in imple­ment­ing com­pre­hen­sive care strate­gies to: strengthen fam­ily and com­mu­nity-based care, includ­ing that pro­vided by the infor­mal sec­tor, and health­care sys­tems to pro­vide and mon­i­tor treat­ment to peo­ple liv­ing with HIV/AIDS, includ­ing infected chil­dren, and to sup­port indi­vid­u­als, house­holds,fam­i­lies and com­mu­ni­ties affected by HIV/AIDS; and improve the capac­ity and work­ing con­di­tions of health-care per­son­nel, and the effec­tive­ness of sup­ply sys­tems, financ­ing plans and refer­ral mech­a­nisms required to pro­vide access to afford­able med­i­cines, includ­ing anti­retro­vi­ral drugs, diag­nos­tics and related tech­nolo­gies, as well as qual­ity med­ical, pal­lia­tive and psy­choso­cial care.” (para­graph 56)

1995 Beijing Declaration and Platform for Action

• “Ensure the involve­ment of women, espe­cially those infected with HIV/AIDS or other sex­u­ally trans­mit­ted dis­eases or affected by the HIV/AIDS pan­demic, in all deci­sion-mak­ing relat­ing to the devel­op­ment, imple­men­ta­tion, mon­i­tor­ing and eval­u­a­tion of poli­cies and pro­grammes on HIV/AIDS and other sex­u­ally trans­mit­ted dis­eases.” (para­graph 108(a))

Expert precedents

2022 OHCHR Annual Report on Human Rights and HIV/AIDS

• “Rec­om­mend that States ensure that the devel­op­ment, imple­men­ta­tion and mon­i­tor­ing of all legal and pol­icy changes and pro­gram­matic inter­ven­tions are under­taken with the mean­ing­ful engage­ment and lead­er­ship of com­mu­nity-led orga­ni­za­tions.” (para­graph 15(c))

• “Rec­om­mend that as part of national bud­gets for HIV, States allo­cate and uti­lize resources for: Legal lit­er­acy pro­grammes for com­mu­ni­ties, key pop­u­la­tions and mar­gin­al­ized groups; and Fund­ing for com­mu­nity-led orga­ni­za­tions to sup­port and advo­cate for law reform.” (para­graph 15(d))

• “Rec­om­mend that vio­lence, abuse and dis­crim­i­na­tion against peo­ple from key pop­u­la­tions be mon­i­tored, reported and addressed with a view to pre­ven­tion and redress, in col­lab­o­ra­tion with key pop­u­la­tion-led orga­ni­za­tions; this includes pro­vid­ing HIV-sen­si­tive, read­ily avail­able, afford­able judi­cial, quasi-judi­cial and other mech­a­nisms toad­dress HIV-related human rights vio­la­tions. Bar­ri­ers such as cost, lack of legal lit­er­acy or legal rep­re­sen­ta­tion should be elim­i­nated.” (para­graph 15(e))

• “Rec­om­mend that for­mal par­tic­i­pa­tion struc­tures be made acces­si­ble to and inclu­sive of indi­vid­u­als and groups that are crim­i­nal­ized, mar­gin­al­ized or dis­crim­i­nated against, includ­ing key pop­u­la­tions, women and girls and young peo­ple. Spe­cific per­ma­nent mech­a­nisms for the par­tic­i­pa­tion of groups that have been his­tor­i­cally excluded, or whose views and needs have been inad­e­quately addressed in deci­sion-mak­ing processes, should be devel­oped.” (para­graph 41(b))

• “Rec­om­mend that finan­cial, human and other resources be allo­cated, on a sus­tain­able basis, to build the capac­ity of rights hold­ers to par­tic­i­pate and to claim their rights through edu­ca­tion, aware­ness-rais­ing, access to free legal aid and other sup­port, and to facil­i­tate reg­u­lar com­mu­ni­ca­tion between rights hold­ers and duty bear­ers at the com­mu­nity, local and national lev­els.” (para­graph 41(d))

• “Rec­om­mend that States allo­cate funds to com­mu­nity-led and com­mu­nity-based orga­ni­za­tions to lead on activ­i­ties to imple­ment soci­etal enablers, par­tic­u­larly those tar­get­ing key and vul­ner­a­ble pop­u­la­tions.” (para­graph 54(c))

2022 Report of the Special Rapporteur on the Right to Health

• “The oper­a­tional­iza­tion of the right-to-health approach requires a focus on national, regional and inter­na­tional legal frame­works, the strength­en­ing of health sys­tems, data and report­ing, clin­i­cal response and pre­ven­tion. It is also impor­tant to focus on the resourc­ing and financ­ing of com­pre­hen­sive solu­tions cen­tred around the restora­tion of dig­nity of all peo­ple, achieved when deci­sions include mean­ing­ful par­tic­i­pa­tion of com­mu­ni­ties and local fem­i­nist move­ments. Third-party financiers must not place con­di­tions on grantees such as pledges against other human rights.” (para­graph 93)

2011 Report of the Special Rapporteur on the right to health

• “The Spe­cial Rap­por­teur rec­om­mends that states take mea­sures to ensure that infor­ma­tion on the right to health frame­work, includ­ing the need for trans­parency, account­abil­ity and par­tic­i­pa­tion of indi­vid­u­als and com­mu­ni­ties in deci­sion-mak­ing that has a bear­ing on their health, is dis­sem­i­nated and its use pro­moted in devel­op­ment-related areas.” (para­graph 60(b))

2009 Report of the Special Rapporteur on the right to health

• “LDCs and devel­op­ing coun­tries should actively pro­mote the par­tic­i­pa­tion of indi­vid­u­als and com­mu­ni­ties in deci­sion-mak­ing processes relat­ing to TRIPS and TRIPS flex­i­bil­i­ties and con­duct impact assess­ments of the same.” (para­graph 107)

Evidence

2022 WHO Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations

• “Com­mu­nity empow­er­ment was empha­sized across all key pop­u­la­tion-led net­works par­tic­i­pat­ing in the qual­i­ta­tive research project. Par­tic­i­pants dis­cussed the impor­tance of key pop­u­la­tion-led responses, includ­ing peer out­reach and other peer-based ser­vices, aware­ness-rais­ing, advo­cacy, drop-in-cen­tres, capac­ity-build­ing and resource mobi­liza­tion to ensure sus­tain­able, com­mu­nity-led pro­gram­ming. These ini­tia­tives were seen both as a means to improve access to ser­vices, as well as an essen­tial mea­sure for address­ing struc­tural bar­ri­ers under­min­ing key pop­u­la­tions’ health and human rights.” (p. 17)

• “Evi­dence, mainly among sex work­ers, shows that com­mu­nity empow­er­ment has a mea­sur­able impact on key pop­u­la­tionsʼ health, includ­ing reduc­tions in STI inci­dence, HIV inci­dence, high-risk sex and increased uptake of fam­ily plan­ning.” (p. 21)

• “Finally, sev­eral effec­tive inter­ven­tions which pre­vent and treat HIV, STI and viral hepati­tis in key pop­u­la­tions are cost effec­tive and cost sav­ing, but with­out ade­quate fund­ing their impact can­not be real­ized. Fund­ing needs to be sus­tain­able, pre­dictable and focused on sup­port­ing com­mu­ni­ties.” (p. 5)

• “Com­mu­nity-led ser­vices with peers as providers have a pos­i­tive impact on HIV, STI and viral hepati­tis, with increased access, avail­abil­ity and accept­abil­ity of ser­vices. Peers have an impor­tant role in reach­ing other key pop­u­la­tions through out­reach, giv­ing infor­ma­tion, pro­vid­ing com­modi­ties (such as con­doms, lubri­cants, nee­dles/syringes, PrEP, PEP and nalox­one) and pro­vid­ing ser­vices, includ­ing test­ing and treat­ment.” (p. 63)

2022 WHO Guidance on Differentiated and Simplified PrEP for HIV Prevention

• “To scale up peer-led mod­els, struc­tural and legal bar­ri­ers to access PrEP and other health ser­vices by key pop­u­la­tions must be addressed. Equally impor­tant is the endorse­ment of key pop­u­la­tion-led ser­vices in national guide­lines, estab­lish­ment of sys­tems to accredit the ser­vices, fund­ing and inte­gra­tion into national health sys­tems.” (p. 23)

• “A review of PrEP deliv­ery for peo­ple who inject drugs found that inte­grated PrEP ser­vices with com­pre­hen­sive com­mu­nity-based harm reduc­tion pro­grammes are likely to be most effec­tive in reach­ing peo­ple who inject drugs, and harm reduc­tion ser­vices are key to increas­ing aware­ness of and link­age to PrEP ser­vices.” (p. 24)

2021 WHO Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring

• “Com­mu­nity-based ser­vice deliv­ery, includ­ing through peers, has shown to be more effec­tive in many set­tings, espe­cially where laws crim­i­nal­ize same-gen­der sex, sex work or drug use.” (p. 346)

• “A study among female sex work­ers in the United Repub­lic of Tan­za­nia found that those receiv­ing com­mu­nity ART ini­ti­a­tion were more likely to have started treat­ment and be retained in care and less likely to have inter­rupted treat­ment or feel high lev­els of inter­nal­ized stigma.” (p. 355)

• “A sys­tem­atic review and net­work meta-analy­sis iden­ti­fied 85 ran­dom­ized tri­als of inter­ven­tions to improve adher­ence. The review found mod­er­ate-cer­tainty evi­dence that peer coun­sell­ing results in improved adher­ence and sup­pres­sion of viral loads. Peer-based inter­ven­tions are gen­er­ally well accepted, espe­cially among ado­les­cents who find that hear­ing expe­ri­ences and learn­ing from oth­ers fac­ing the same chal­lenges are crit­i­cal for sup­port­ing adher­ence and engage­ment in care.” (p. 361)

• “Peer-dri­ven mod­els of care have demon­strated impact on improv­ing health-seek­ing behav­iour and HIV treat­ment out­comes for ado­les­cents liv­ing with HIV, such as link­age, adher­ence to ART, reten­tion in care and viral sup­pres­sion.” (p. 400)

• “Com­mu­nity-led mon­i­tor­ing and related advo­cacy engen­ders account­abil­ity of ser­vice providers and local and national offi­cials to stan­dards of high-qual­ity health care, includ­ing the avail­abil­ity and acces­si­bil­ity of ser­vices; such account­abil­ity leads to improved health out­comes. HIV mul­ti­lat­eral donor and nor­ma­tive agen­cies (PEP­FAR, Global Fund to Fight AIDS, Tuber­cu­lo­sis and Malaria, L’Ini­tia­tive and UNAIDS) have increas­ingly acknowl­edged the impor­tance of com­mu­nity-led mon­i­tor­ing and the related advo­cacy and have required recip­i­ent coun­tries to include com­mu­nity-led mon­i­tor­ing in costed work­plans.” (p. 419)

• “Com­mu­nity engage­ment and com­mu­nity-based ser­vices play an impor­tant role in sup­port­ing HIV-exposed infant care. These clear and highly con­text-spe­cific ser­vices play a boost­ing role in sup­port­ing facil­ity-focused ser­vices and include com­mu­nity-based HIV test­ing. The engage­ment of net­works of women liv­ing with HIV has been effec­tive in sev­eral coun­tries and has been used to improve com­mu­nity HIV lit­er­acy to cre­ate demand, form sup­port groups at the facil­ity and com­mu­nity lev­els, strengthen link­age to care by escort­ing newly diag­nosed clients to treat­ment clin­ics, con­duct­ing defaulter track­ing and pro­vid­ing active fol­low-up of mother–infant pairs. In sev­eral set­tings, these inter­ven­tions led to reduced loss to fol­low-up among mother–infant pairs.” (p. 96)