UNHLM HIV/AIDS Blog Series: Part 2

Integrating Mental Health is Critical to Overcoming Inequities and Ending AIDS


It was an honor to attend the 2021 UN High-Level Meeting on HIV/AIDS (UNHLM-HIV) as part of a   team representing the Global Alliance for Behavioral Health and Social Justice.  The virtual format allowed opportunities to pose questions and engage with panelists and presenters in a format uniquely different from previous UNHLM-HIV.  Although it is exciting to convene at the UN Headquarters, a virtual platform truly allowed participation from across the globe.  It also expands the number of opportunities for people to participate in panels and side-events that are normally limited to delegates or by room size and/or the ability to travel (due to finances or ability to secure a VISA).

Looking back to 2016, the UNHLM-HIV Political Declaration Fast Track made very few references to universal health coverage, social protection programs, and integrated care, and barely touched on the importance of integrated health and HIV services that include mental health care.  The 2021 UNHLM-HIV demonstrated an increased understanding of each of these areas and has taken a critical step to clearly state that mental health and psychosocial wellness services and resources are an equally  important  part of the commitment to Ending Inequalities and Getting on Track to End AIDS by 2030.    

For example, during the opening plenary, Winnie Byanyima, Executive Director of UNAIDS, noted that the way to ending unequal access to essential services is by ensuring universal access to services.   This is a critical step.  I would posit that to truly move forward, member states must commit to a holistic view of essential services.  This requires the full integration of mental health and psycho-social services (MHPSS) into the prevention, care, and treatment of HIV and AIDS.   This is an opportunity to build upon and align with the World Health Organization (WHO) Mental Health Action Plan target of “80% of countries will have integrated mental health into primary health care by 2030”.  And UNAIDS’ call for stakeholder-led participation in HIV services is certainly poised to partner with the  WHO Special Initiative for Mental Health, which commits to “Local champions, people who use mental health services, and their organizations are empowered to participate in the development and implementation of mental health policies, strategies, laws and services”.

 In another example of “getting on track”, the side-event, Social protection and Mental Health and Workforce, brought together critical components of addressing mental health and providing MHPSS.  The UNHLM-HIV 2021 Political Declaration commits member states to creating, 

Social protection systems that provide 90 per cent of people living with, at risk of and affected by HIV with people-centred and context-specific integrated services (to include) HIV and other communicable diseases, NCDs, gender-based violence, mental health, and substance use treatment….and other services they need for their overall health and well-being by 2025. 

In addition to panelists sharing examples of their work and  commitment to social protection, the side-event was designed for full participation which allowed for  a  robust dialog.   Panelists and participants alike addressed what must be included to reach the  90% target. Ideas included:  working to engage, strengthen, and support social welfare services sector; use all opportunities to build capacity through intersectoral initiatives that include governance, NGOs, and businesses; emerge from  governmental and non-governmental initiatives; the need and opportunity to bridge social protection programs to mental health and psycho-social services; and health systems strengthening .  I was pleased to have an open forum in which to share the GA’s position that health systems strengthening, must include strengthening social services systems which requires the development of a skilled, supervised, and adequately resourced MHPSS workforce.

I believe that all persons are entitled to accessible, resourced, and culturally relevant mental health and psycho-social services.  Mental health is a human right.  As referenced within the UNHLM-HIV 2021 Political Declaration, the UNAIDS Global AIDS Strategy identified human rights, gender equality and reduction of stigma and discrimination as cross-cutting issues.   The Political Declaration’s commitment to “realizing human rights and eliminating stigma and discrimination ”must equally address mental health stigma, violence, and discrimination.  Additionally, the commitment to “ensuring that all services are designed and delivered without stigma and discrimination, and with full respect for the rights to privacy, confidentiality and informed consent “must ensure that persons with mental, neurological, and substance use diagnoses are engaged with and have leadership in the design, provision, and evaluation of programs and services.  

Read our next blog, Now is the Time: Ending Stigma Around Mental Illness and Improving Mental Health by Erica L. Hamilton, focusing on the pressing issue of mental health stigma.  

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