Youth at the center of universal access to sexual and reproductive health rights (SRHR) and HIV response

Youth at the center of universal access to sexual and reproductive health rights (SRHR) and HIV response

Nairobi, KENYA- As world leaders, policy makers, and civil society congregated in Nairobi in November 2019 to mark the 25th anniversary of the International Conference on Population and Development (ICPD), youth committed to push for the fifth commitment on access to sexual and reproductive health rights.

During its inception in Cairo, the leaders present committed to ensuring that young people have access to inclusive, comprehensive and age-specific information and services that are required to protect themselves from unintended pregnancies, sexually transmitted infections and HIV/AIDS.

Every individual has a right to the highest possible standard of health. Undeniably important to the sustainable development of any country or region is a population which enjoys good health and the gratification of their dignity and human rights. The ICPD Programme of Action that was launched in Cairo in 1994 recognized the significance of sexual and reproductive health and rights (SRHR) to health and development. Due to the fact that sexual and reproductive health and rights touch the lives of both women and men, they offer individuals and couples the right to have control over their reproductive health. SRHR also allows young people to freely decide and take responsibility on matters health without violence and compulsion. The achievement of universal access to sexual and reproductive health and rights depends greatly on strengthening the health systems capacity by expanding their reach and inclusiveness.

During the conference, youth and world leaders engaged in a fervent concurrent session on ‘Young People at the Center of the Universal Access and Global HIV Response’ led by the Africa Youth Advocacy Network (AfriYAN) in partnership with Y-ACT Youth in Action. Youth championed the SRHR and HIV/AIDS conversation in order to influence policy and decision-making processes in favor of improving the standard of living for young people. AfriYAN is a participatory platform with the aim of being a network recognized for its excellence in tracking progress at national, regional and international commitments on SRHR and sustainable development. In 2014, the comprehensive ICPD Beyond-2014 review unanimously agreed that investing in individual human rights, capabilities and dignity across multiple sectors throughout life is the foundation of sustainable development.

The concurrent session had several panellists including Ms Evalin Karijo-Director of Y-ACT Youth in Action, H. E. Kgalema Motlanthe-former president of the Republic of  South Africa, Senator Nikoli Edwards from Trinidad and Tobago and Ms Karabo Ozah-Attorney and Director at the Centre for Child Law, South Africa who shared their views and discussions on Universal Access to SRHR in the context of UHC.

Ms Karijo had a resounding message to share during the session. The world still celebrates legends like Martin Luther, Professor Wangari Maathai, Nelson Mandela because they addressed core issues and drove change in their time, touching the hearts of the people who really needed to hear their voices. She triggered the audience into thinking about the next 25 years, asking if the participants of the conference were going to convene there again and talk about the same issues. She proposed an elucidation, “The solution is for us to step out of our comfort zones. We cannot continue having discussions in these areas if we are not mobilizing at grass-root level. The reason is that we will be able to gather and address issues from the village level to the national level, even to the global level.” She emphasized on the need for CSOs to empower our leaders of tomorrow starting at the grass-root level, because the power of change lies in empowering communities from the grass-root level, ensuring that every individual, regardless of their age, geographical location and socio-economic status has a voice. She added that “The moment we start seeing young people as partners and as leaders in this conversation, and ensuring that young people have that space to articulate issues, to be able to provide solutions to the challenges that affect us, that is when we are going to see change. The biggest gap is how we deal with young people, and we need to change that. We need to realize that young people are not disadvantaged by being young. We have the skills, capacity and knowledge to sit like other leaders and provide solutions to the problems that affect us.”

Mr Nikoli Edwards, a youth advocate, social activist and communications professional from Trinidad and Tobago said that “…young people’s involvement especially in this area of SRHR, HIV and AIDS has to do away with the traditional thinking that locks young people out of the decision-making process.” He asserted that that traditional mentality that young people should be seen and not heard has to be transformed because young people are the primary owners of the future, seeing as it is that young people in 2019 are much more advanced than those of 2009 or 1999.

In her remarks, Ms Christine Stegling, an expert on HIV/AIDS, member of the Global HIV Prevention Coalition and UNAIDS reference group on human rights said that she was really impressed by the number of young people that were in the meeting, whom she was sure were not just there by chance. She had recently attended a ministerial meeting on HIV prevention and it was noted that five years ago, HIV activists came to this very space and said that young people and adolescents were increasingly being affected by HIV and that something needed to be done about it. In 2019, five years later, other activists have gathered in Nairobi and things have gotten worse; with 6,200 young people get infected each week. Her final remarks on the issue were that “We need to get spaces where we get to hold our leaders accountable and when we are not accountable. We should ask ourselves if we are going to be OK looking back and saying that actually not much has changed in the realities of young people and adolescents. Young people coming together to talk about real, uncomfortable issues in the presence of an international audience is how change happens.’

Ms Daisry Mathias, the presidential advisor in the republic of Namibia said that low, effective responsiveness to communicable and non-communicable diseases has undermined health in some countries and this has led to difficulties in HIV disease control. She gave the example of Namibia, which spent about 65% of public resources on HIV/AIDS policy management and implementation, with only 5% of it coming from donors and partners. In addition, Namibia has achieved a lot and is at 94% who know their HIV status, 96% of whom are on treatment and 95% of those on treatment are suppressed. The solution she proposed to the difficulties in HIV spread control was “The solution is within the problem, and I think the solution cannot be removed from the Universal Healthcare Coverage that put a strong emphasis on sexual and reproductive health rights, but also focuses on youth friendly services and inclusivity especially when reaching key populations. The more we deal with HIV/AIDS, the more we realize that marginalized communities are not accessing public healthcare facilities; that is the challenge and also an opportunity for African leadership.”

The new face of HIV infections in the world today is a young black female, so we need to respond very publicly to this segment of our population. And maybe one possible solution is looking into digital literacy because online gender based violence and harassment has become a real issue that has real consequences and that is disproportionally affecting young women and children. And what we need is just that a lot of the drivers that are feeding the risk to sexual behaviour are problematic mind-sets, perpetuating the culture of rape and harassment fuelled by the attitudes that form part of our lives, including the language we are using. So we need to teach young girls and children online to recognize this vulgar language, reject it and confront issues of body shaming, victim shaming, the disrespect of women and gender, mortification of women and bad attitudes that fuel and manifest as bad social behaviour. Also we really need to spend a lot in that area, especially to ensure that the right of young people are also protected online.

Young people are critical actors in accelerating the promise of the ICPD Agenda and meaningful engagement as a precondition for Sustainable Development or Agenda 2030. According to UNAIDS, young people aged 15 to 24 are more now than any other time in history. In 2015, the world made a commitment to a universal agenda for sustainable development, which included Target 3.3 to end the HIV/AIDS epidemic by the year 2030. However, the global community realized that this target would not be reached if the young people were not in the lead and fully engaged its achievement. For the HIV/AIDS epidemic to be eradicated, means the circumstances that put young people at risk of new infections need to be addressed. These circumstances include, but are not limited to gender and socio-economic inequalities, early and forced marriages, limited access to information, discrimination, social exclusion and violence.

By ensuring that basic humanitarian needs and rights of young people are addressed through access to comprehensive sexual and reproductive health information and education will significantly reduce sexual and gender-based violence, maternal mortality and ill health and unintended pregnancies.  Young people must play a critical role in demanding youth-friendly health services and ensuring their uptake by mobilizing peers to access HIV and sexual and reproductive health services. In addition, young people can make substantial contributions to stronger community responses. Their participation in demanding the creation of care and linkages to it also can occur through youth-led organizations or youth participation in community-based organizations that have a youth component.

Meaningful involvement of young people as beneficiaries in the development of HIV interventions, policies that affect their health and funding streams increases the effectiveness of the efforts. Young people drive social change when they are endowed with the resources and skills to participate as leaders in their own communities, and when they participate as leaders in the HIV response, they are enabled to initiate and direct their own interventions.

Figure 1: Senator Nikoli Edwards from Trinidad and Tobago with Ms Evalin Karijo, Director of Y-ACT Youth in Action