Health in the post-2015 Development Framework: How to meet the needs of the most marginalised and excluded

For the past two years, UN Member States, UN agencies, civil society and other stakeholders have been discussing the post-2015 Development Framework, which will replace the Millennium Development Goals (MDGs). From the outset the International HIV/AIDS Alliance has engaged actively in the myriad of official post-2015 consultations and civil society discussions, recognizing that they will determine the global vision for health after the MDGs.

Building on our previous post-2015 position, which focused on HIV in the new framework, the first section of this briefing puts forward a proposal for a post-2015 health goal with targets relating to universal health coverage, health outcomes and human rights, including where appropriate HIV-related sub-targets.

Section two provides an analysis of universal health coverage as it concerns the most marginalized and excluded in the context of HIV. According to UNAIDS, sex workers, men who have sex with men and people who use drugs are 13, 19 and 22 times more likely to be living with HIV than the general population, while transgender women may be up to 49% more likely to contract the virus. These groups are also often simultaneously affected by poverty, gender inequality, stigma and discrimination, criminalisation, lack of access to employment or credit and other factors that increase their vulnerability to HIV and prevent them from accessing HIV and health services. The second section suggests ways to approach, measure and monitor universal health coverage in order to ensure access for these populations.

Finally, section three goes on to recommends a number of overarching principles which should both sit within the new post-2015 goals and cut across the entire framework.

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