The Diaspora Declaration: Development of a Global HIV and AIDS Framework for Change Wangari Tharao Women's Health in Women's Hands Community Health Centre African and Black Diaspora Global Network on HIV and AIDS Toronto, Canada

Conflict of Interest Statement This presentation is supported through a research grant from the Canadian Institutes for Health Research (CIHR). I have no other actual or potential conflict of interest to declare.

Overview Who are we? Where are we now? Promising Frameworks for a Coordinated Response The Diaspora Declaration

Who are we? The African and Black Diaspora (ABD) are populations of Black Africans and their descendants who are dispersed through a mix of forced and willing migration and who may or may not maintain strong ties to their African origin. The ABD broadly encompasses populations of: –Recent migrants; –Second generation and multi-generational populations; –Refugee and asylum seekers; and –Mobile populations (e.g. temporary migrant workers).

Growing Recognition of ABD Communities as a Key Population Australia ( ): 8.2% of all HIV diagnoses were in people born in Africa, although Africans are only about 1.4% of the total population (Kirby Institute, 2013). Canada (2008): ABD populations had an estimated HIV infection rate 8.5 times higher than other Canadians (PHAC, 2012). United States ( ): Black populations were 62% of new HIV infections amongst women; 64% of transmission via heterosexual contact; and 66% of infections among children under 13 (CDC, 2010). In 2011, African Americans had the largest estimated percentage of HIV diagnoses among gay and bisexual men (11,805 or 39% ) (CDC, 2012). Caribbean Region (2009): 53% of people with HIV were female. This is the only other region, besides sub-Saharan Africa, where women and girls outnumber men and boys among people living with HIV (UNAIDS, 2010). EU/EEA ( ): Migrants represented 39% of reported HIV cases, most were from sub-Saharan Africa (ECDC, 2014).

Some Gains at the International Level 2011 UN Political Declaration on HIV and AIDS: Intensifying our Efforts to Eliminate HIV and AIDS 1 Para. 84. “Commit to address, according to national legislation, the vulnerabilities to HIV experienced by migrant and mobile populations and support their access to HIV prevention, treatment, care and support.” 2013 UN Secretary-General Report - A life of dignity for all: accelerating progress towards the Millennium Development Goals and advancing the United Nations development agenda beyond 2015 Post-2015 discussions recognize diasporas as key contributors to development. Migrants’ contributions are undermined by experiences of discrimination and denial of their human rights at various stages of the migration process. 1 General Assembly resolution 65/277 adopted June 2011

Promising Frameworks for a Coordinated Response ABD Typology (Fenton, 2010) Treatment Cascade Framework (CDC, 2012) Understanding Integration: A Conceptual Framework (Ager & Strang, 2008) Health of Migrants: The Way Forward (WHO, 2010) Migration and Health: A Framework for 21 st Century Policy-Making (Zimmerman et. al., 2011)

Health of Migrants: The Way Forward Source: WHO (2010). Health of migrants: the way forward - report of a global consultation, Madrid, Spain, 3-5 March

ABD Typology TYPE I: Post-Slavery Black Majorities TYPE II: Post slavery, Black Minorities TYPE III: Post- Colonialization Black Minorities TYPE IV: Recent economic and social migrants Caribbean region Populace mainly of African descent Political, social power structures and networks largely governed by those of African descent Social and economic trajectories heterogeneous and determined by economic, political and social Caribbean region Populace mainly of African descent Political, social power structures and networks largely governed by those of African descent Social and economic trajectories heterogeneous and determined by economic, political and social North, Central and South America Populace mainly of European or Mixed descent with varied proportion of blacks Political, social power structures and networks largely governed by ethnic majority Civil rights heterogeneous North, Central and South America Populace mainly of European or Mixed descent with varied proportion of blacks Political, social power structures and networks largely governed by ethnic majority Civil rights heterogeneous Western Europe Populace almost entirely of European descent Black migration in mid-late 20 th Century Political, social power structures and networks largely governed by ethnic majority Civil rights influence minimal and heterogeneous Western Europe Populace almost entirely of European descent Black migration in mid-late 20 th Century Political, social power structures and networks largely governed by ethnic majority Civil rights influence minimal and heterogeneous Western Europe, Canada, United States, Intra-Africa Level of integration into society heterogeneous Display general characteristics of economic migrants Political, social power structures and networks largely governed by ethnic majority Western Europe, Canada, United States, Intra-Africa Level of integration into society heterogeneous Display general characteristics of economic migrants Political, social power structures and networks largely governed by ethnic majority Source: Fenton, K. (July 2010). Ties that Bind-HIV/AIDS in the African Diaspora. [PowerPoint Slides] Retrieved from African and Black Diaspora Global Network on HIV/AIDS website:

The Diaspora Declaration: One Framework for Global Action Health of Migrants: The Way Forward (WHO, 2010) Migration and Health: A Framework for 21st Century Policy-Making (Zimmerman et. al., 2011) ABD Typology (Fenton, 2010) Understanding Integration: A Conceptual Framework (Ager & Strang, 2008) Treatment Cascade Framework (CDC, 2012) Diaspora Declaration

How do we get there? Literature review –Review and synthesize available evidence Global consultations –Including ABD people living with HIV, government and health surveillance representatives, service providers, advocates and academics Leverage web-based platforms to mobilize communities and disseminate results  Get involved - follow us on Twitter & visit  Visit us at the African Diaspora Networking Zone at AIDS 2014: Twitter or facebook (Under the Baobab at AIDS 2014)

The Diaspora Declaration: One Framework for Global Action The Diaspora Declaration will provide: Evidence-informed recommendations for a coordinated global response to ABD migration, HIV/AIDS, and health inequities. Actions across policy, advocacy, research, and service delivery. An advocacy tool that links grassroots efforts to national and international action.

Acknowledgements ABDGN Governing Council Member Organizations The Diaspora Declaration is funded by: The Robert Carr Fund through: