At the recent four-day World Urban Forum 11th Session (WUF11) in Katowice, Poland, more than 20,000 people gathered to discuss the impact of rapid urbanization on cities, economies, communities and policies. In an attempt to keep the HIV response and other health services in cities high on their agenda, UNAIDS, IAPAC and UN-Habitat co-organised a special session on Fast-Track Cities, focusing on innovation and the power of partnerships in accelerating the HIV response towards ending AIDS by 2030.
Eleanor Gouws, Senior Advisor at UNAIDS and Gonçalo Lobo, Vice-President at IAPAC, opened the session emphasizing the leading role cities have in addressing rights issues, reducing inequalities, protecting against risks and vulnerabilities, and keeping people healthier.
Five cities shared innovative examples to address HIV service gaps, more specifically how to reach key and vulnerable populations.
For example, in the municipality of eThekwini -Durban, South Africa, reaching and retaining in care young people infected with HIV remains a key challenge. A community-based project implemented in the high HIV burden district of Inanda, focuses on capacity building, peer education and support, as well as working with community leaders to reduce HIV-related stigma. Their goal has been to improve the uptake of HIV prevention, testing and treatment services among 10- to 35-year-olds. Close to 3,000 young people were reached and tested for HIV in the first six months of the project.
"A lot of effort has been put into building capacity of healthcare workers to ensure our project's sustainability," said Sibongile Mzulwini, Regional Manager at the National Association of Child [and Youth] Care Workers.
Similar efforts have been undertaken in Kenya. Since the city of Nairobi joined the Fast-Track Cities initiative, there has been a sharp increase in the number of clinics providing integrated care and drop-in centers where key populations and young people can access friendly and stigma free services. Testing uptake among young people increased by more than 5-fold between 2018 and 2021 in four informal settlements. Dr. Carol Ngunu, Deputy Director of Health at the Nairobi Metropolitan Services, highlighted the importance of, "understanding our local epidemics and gaps, knowing where the quick wins are and building ownership of communities in our local HIV responses."
In Jakarta, Indonesia, artificial intelligence is leading the way to reach young people, notably men who have sex with men. With a reach of over 4 million people on social media in a seven-month period, Tanya Marlo, is an interactive mobile application in the form of a chatbot that gives HIV information and can also link users to a trained counsellor. "Tanya Marlo creates a bridge between the healthcare system and key populations at high risk of HIV infection," said Tono Permana Muhamad, Program Director at the Kasih Suwitno Foundation. "These are people who usually do not access health services for fear of stigma and discrimination," he said. The foundation currently manages the application to ensure its sustainability.
Stigma and discrimination also affect the HIV response in Kingston, Jamaica. As a result, the Jamaica Network of people living with HIV (JN+), with support from UNAIDS, is implementing a stigma-free spaces project to ensure that places of business, health, education, justice, entertainment and worship are respectful, inclusive and transformative. "We are building a stronger city HIV response in Kingston, thanks to the inclusion of communities through community-led responses and monitoring," said Jumoke Patrick, the Executive Director of JN+.
Reporting from the host country's perspective, Magdalena Ankiersztejn-Bartczak, President/CEO of the Foundation for Social Education in the capital city of Warsaw, which recently joined the Fast-Track Cities Initiative said that, "the influx of Ukrainian refugees in Poland had posed many challenges, including the continuity of life-saving treatment and support to people living with HIV."
Despite the obvious challenges, Ms Ankiersztein-Bartczak said it has encouraged them to do more for people living with HIV and at high risk of HIV infection in Poland. "We count on the support of other Fast-Track Cities," she said.
Concluding the session, the moderator, Robert Ndugwa from UN-Habitat, reminded participants that, "Cities face a myriad of challenges but also hold the key to solutions. They can act locally but influence globally."
