Global Policy Paper on Priorities for Action for African and Black Populations in the Diaspora Wangari Tharao Co-Chair, African and Black Diaspora Global Network on HIV and AIDS The African Elephant in the Room: Global Dialogue on HIV and AIDS In the Context of African and Black Populations Living in the Diaspora Satellite, Mini Room 2 Vienna, Tuesday, July 20 th, 2010

Purpose of Policy Paper: To inform research, policy and programmatic decisions To describe the current situation in developed countries, gaps in responses, and program and policy directions at domestic and international levels To summarize key themes, identify gaps, priorities for action, and strategic directions

African and Black Diaspora Population Composition ABDGN defines “African and Black Diaspora” as: – people of African descent who are living outside of the African Continent and represent or are impacted by HIV/AIDS within the context of developed countries. Mixture of willing and unwilling migration from the African continent People of Sub-Saharan African (SSA) descent number at least 800 million in Africa and over 140 million in the Western Hemisphere, representing around 14% of the world's population (World Bank, 2010).

HIV Rates within the African and Black Diaspora EU27 plus Norway and Iceland: in 2006, of those with known geographical origin, 77% AIDS cases and 60% HIV infections were from SSA. Canada: up to 2005, 12.2% of HIV infections attributed to the HIV-endemic exposure subcategory, and this proportion is now around 16% annually United States: in 2006, 45% (510,000) of the HIV/AIDS cases in the USA among Black/African Americans Australia: , people born in SSA accounted for 6.4% (2004) to 9.5% (2008) of new HIV cases New Zealand: , 10% of all reported HIV cases were in people of African descent

Key Discussion Themes... Intersectionality: overlapping forms of exclusion and oppression Gender, race and poverty intersect with HIV/AIDS-related stigma, denial, fear and discrimination Overlapping and intersecting issues of risk and vulnerability faced by ABD populations, regardless of geographic locale

Key Discussion Themes… Social Exclusion Gender and Sexuality Patterns of Sexual Behaviour Cultural Practices and Beliefs Racism Homophobia Barriers to Disclosure

Key Discussion Themes… Barriers to Accessing Services Incarceration Youth Immigration Policy Funding Inadequate Surveillance & Migrant Data

Analytical Lenses HIV policy directions must adopt analytical lenses that put various forms of oppression at the forefront. To effectively address these multiple vulnerabilities, any strategic directions should be guided by human rights-based approaches, gender-based analysis, anti- oppression frameworks, and population- specific approaches

Strategic Directions Increased Surveillance and Standardization – Better definitions of ABD populations and all their heterogeneity – More research on migration patterns – Improved and standardized HIV surveillance with more defined ethnicy markers, transmission categories crossed with ethno-racial data – Monitoring MIR access to and update of prevention, treatment and care services – Development of data collection models that avoid stigmatization and discrimination – Production of country specific reports – Development of mechanisms for sharing lessons between countries, regions and globally

Strategic Directions Community-Based Research and Evaluation – More research and evaluation to determine effectiveness of interventions targeted to ABD – More research on access to HIV-related services by ABD communities – More research attention on ABD population e.g. youth including children infected prenatally, drug users, incarcerated and LGBTQ populations within ABD – Building systems for knowledge mobilization and sharing of promising best practices

Strategic Directions More Diverse and Culturally Appropriate Programming – Heterogeneity of ABD populations and their cultural world view needs to be integrated into HIV programming – Creation of comfortable and safe environments – Comprehensive programs that address intersecting issues – Collaboration with social cultural and faith organizations – Building and strengthening the capacity of social and healthcare providers

Strategic Directions Policy Changes – Development of national policies and strategies that are specific to the needs and diversity of ABD populations with dedicated funding – Analysis of intersections between HIV, discrimination, criminalization and deportation issues – Assessment of policies, legislations and laws that negatively impact on ABD populations

Strategic Directions Mobilizing and Involving Migrant Communities: – Supporting greater involvement, participation and input from people living with HIV/AIDS from ABD populations – Building partnerships with community leaders (formal and informal) – Engaging community organizations and cultural leaders in planning and implementation of interventions – Building and supporting mechanisms to improve sharing of resources, expertise and information about HIV/AIDS and services for MIR populations with ABD

Conclusion ABD communities: have many diverse stories of settlement, but common challenges of oppression and social exclusion Regardless of geographic location, ABD communities have a disproportionately high burden of HIV incidence and prevalence. We need international, cross-sectoral and cross- jurisdictional knowledge sharing and partnerships We need coordinating mechanisms to keep global attention on the ABD issues

Acknowledgements San Patten, San Patten and Associates Paul Kwaku Adomako for the policy paper developmental process Women’s Health in Women’s Hands Community Health Centre, Toronto, Canada Governing Council Members, ABDGN Frantz Brent-Harris, Graphic design and art Ford Foundation and International Affairs Directorate, Health Canada