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April 6, 2016

The Honorable Ban Ki-moon

Secretary General to the United Nations

Ambassador Mwaba Kasese-Bota

Permanent Representative of Zambia to the United Nations

His Excellency Mogens Lykketoft

President of the General Assembly

Ambassador Jrg Lauber

Permanent Representative of Switzerland to the United Nations

Dear Sirs and Madam,

We write as members of civil society to call for the inclusion of the social, structural, and political drivers of HIV,
poverty, and inequality as a topic of discussion at the 2016 United Nations High-Level Meeting (HLM) on
HIV/AIDS and for a commitment to address these drivers in the Political Declaration agreed to during the HLM.
We commend the effort to unite all United Nations member states at the HLM in order to put the global HIV
response on the Fast-Track and end the AIDS epidemic by 2030. Ending the AIDS epidemic is integral to achieving
the Sustainable Development Goals, and we are at a critical moment in the fight, but we cannot end AIDS through
biomedical interventions alone.
It is now established that social and structural deprivation are key drivers of the HIV epidemic including poverty,
inequality and exclusion, income shocks, mental health distress, stigma, criminalization, homelessness and
dislocation, and interpersonal violence and that the impacts of HIV responses depend on multi-sectoral
investments to address these barriers to prevention and care. Likewise, the effectiveness of social protection systems
and economic empowerment strategies to tackle poverty, vulnerability and social exclusion in countries and for
populations heavily impacted by AIDS depends critically on complementary investments in the HIV response.
Broader intersectoral approaches that address key social and structural determinants of vulnerability will be required
in order to end the AIDS epidemic. Available evidence demonstrates the effectiveness of a range of structural
approaches in simultaneously strengthening HIV prevention and treatment while bolstering other development aims
(e.g. gender equality, food security, and poverty alleviation). These approaches range from economic empowerment,
harm reduction strategies, social protection programs, to transformative approaches such as decriminalization, antidiscrimination laws and campaigns to change social norms. Cross-sector, rights-based responses are particularly
critical for members of disparately impacted key populations experiencing substantial rights violations and barriers
to accessing services.
To achieve our shared goal to end AIDS as an epidemic by 2030 we must act to address key social and structural
drivers of vulnerability. The political declaration agreed to at the HLM on HIV/AIDS must reflect commitments to
evidenced-based programming to address the social drivers of HIV, poverty, and inequality.
We look forward to working with you on a successful HLM.
[List in formation. To add your organization, contact Farnaz Malik at]
Access Chapter 2
AIDS Action Baltimore
AIDS Alabama
AIDS Foundation of Chicago (AFC)
All-Ukrainian Network of People Living with HIV, Kiev

Alliance for Public Health, Ukraine

American Medical Student Association
Desmond Tutu HIV Foundation, South Africa
European and Central Asian Network of HIV Positive Women, Ukraine
Forum for African Women Educationalists, Malawi Chapter (FAWEMA)
Fundacin para Estudio e Investigacin de la Mujer (FEIM)
Gay Men's Health Crisis (GMHC)
Global Health Council
Hispanic Health Network
HIV Positive Justice Alliance (HIV PJA)
Housing Works, Inc.
Intercambios Puerto Rico
International Association of Providers of AIDS Care (IAPAC)
International Presentation Association
Latino Commission on AIDS
Latinos in the Deep South
Medical Mission Sisters
National Federation of Immigrant Women Association, Sweden
Network of Zambian People Living with HIV (NZP+)
One in Four Chronic Health
Partners in Health
Planned Parenthood Federation of America
Project Inform
Salesian Missions
San Francisco AIDS Foundation
Sisters of Charity of Nazareth
The Center for HIV Law and Policy
The National Alliance of State and Territorial AIDS Directors (NASTAD)
The Rights Initiative
Widows Fountain of Life, Zimbabwe
Womens Legal Resources Centre (WOLREC)