Remarks by U.S. Ambassador Natalie E. Brown for the 2022 Y+ Beauty Pageant Launch September 30, 2022 Kampala, Uganda
(as prepared for delivery)
Good morning. I am deeply honored to join you today for the launch of the 2022 Young Positives Beauty Pageant.
For the past two years, it has been a delight to have participated in the Young Positives Beauty Pageant Grand Finale. In fact, the Grand Finale was my first public engagement after arriving in Uganda in 2020. This was a great way to start my work here, and it has allowed me to meet amazing young advocates changing the community – including all of you here today. Youth make up the vast majority of Uganda’s population and are a group that will continue to be crucial to this country both now and in the future.
Young people and adolescents remain an important group with unique needs. HIV prevalence among adolescent girls and young women aged 15-29 is more than double that of boys the same age. Even more concerning is the fact that the rate of NEW infections remains twice as high among adolescent girls and young women than among boys and young men. Girls and women are at increased risk of HIV infection due to both their biology, as well as complex social dynamics. Other challenges affecting young people and adolescents include diminishing caregiver oversight, lack of youth-friendly services, and inadequate preparation for the transition to adult HIV treatment. The need to address these challenges is well aligned with your 2022 theme, “We Have Got the Voice; Pass Us The Mic”. This theme highlights the fact that you have the answers and we all need to listen.
The Uganda Network of Young People Living with HIV and AIDS has been innovative in responding to the needs of young people. Noting that youth are the most technologically connected age group, UNYPA has advocated for adherence support and differentiated service delivery models leveraging technological resources, thereby providing an excellent way to engage adolescents and young people living with HIV both during and following the COVID-19 pandemic. This included web-based applications for peer support groups, improving youth and medical provider communications, and identifying local youth-friendly services.
Last year, the theme of the 2021 Y+ Beauty pageant Grand finale was “Opening Opportunities.” At the event, I mentioned the need to help young people living with HIV set aside shame, fear, and stigma, and work to rewrite the story of the future. And how this story should be of living … growing up healthy with a suppressed viral load; experiencing the joy and wonder of being a child; finishing school; finding passions in life that lead to fulfilling careers; and delving into open, honest, and meaningful relationships with others that can lead to lifelong partnerships, marriages, and healthy families. This should be the opportunity for every young person living with HIV … but it is up to all of us to make that opportunity and narrative the celebration of life that it should be. UNYPA’s 2021 theme also addressed the “how” of making the young person’s story possible, and this year’s theme, “We Have Got the Voice; Pass Us The Mic” addresses the challenge of partnership and engaging young people living with HIV – not merely as beneficiaries or a “priority population” – but as equal stakeholders.
And what I just described inspires U.S. engaged in Uganda. The United States government recognizes that a healthy population is the foundation for a country’s social and economic development. Therefore, every year we invest over $500 million in Uganda’s health sector—the bulk of which goes to supporting HIV programs through the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, and activities to support HIV response programs—with a focus on prevention through elimination of Mother to Child Transmission, Voluntary Medical Male Circumcision, the DREAMS program for adolescent girls and young women aged 10 to 24, in 24 districts in Uganda, provision of pre-exposure prophylaxis, and implementation of care and treatment services―including managing TB co-infection.
While PEPFAR may be the most significant and successful global health initiative ever undertaken, our team recognizes the challenges PEPFAR faces in Uganda and globally. Throughout our planning, we have kept the need to accelerate progress toward epidemic control in the context of global public health challenges, as well as focused on supporting and strengthening country ownership and sustainability; addressing the needs of young women and adolescents, as well as key populations; and leveraging partnerships with the public and private sectors, at the forefront of our country strategy.
On October 1st we will begin a new year of implementing the PEPFAR country operation plan – or COP22. We are focused on supporting local partners, making progress toward our goal to have 70% of funding allocated to local partners rather than international organizations. To ensure this target is achieved, our team is providing mentorship and building local partners’ capacity to manage all the requirements and accountability that come with implementing this funding. We are monitoring progress with specific, measurable, and time bound benchmarks, which will culminate in the transition to local partner implementation.
We must improve access to services, particularly the services that make living possible. To live a healthy life, young people must have access to HIV testing to know their status, as well as access to the appropriate treatment to suppress their HIV viral load. This is a simple formula that we are all familiar with, but we often don’t realize how difficult accessing these things can be for young people, with or without movement restrictions due to COVID-19.
It is not uncommon for young people to seek these services only to be chastised and told that seeking an HIV test indicates they have been taking part in “immoral” behavior. Judgment and stigma are unacceptable everywhere, but under no circumstances should they have a place in a medical facility. A young person seeking an HIV test owes no one an explanation for needing the test. These services need to be readily available and safe for young people to seek privately and with dignity, regardless of age or gender.
Young people and adolescents living with HIV also experience poorer health outcomes compared to other age groups. PEPFAR program data indicate that only about half of the young people who start HIV treatment continue on treatment after two years. Boys and young men are also less likely to seek testing, treatment, and to adhere to treatment. Adolescents and young people need to know that it is important to stay in care, and by achieving viral load suppression by taking HIV medication as prescribed, they cannot sexually transmit the virus to others. “U = U” is an easy way to remember that an undetectable viral load means the virus is untransmissible.
Moreover, young people need good information from people they trust. Not having access to information in this day and age might seem like a paradox, but the reality is that young people in Uganda often do not have access to GOOD information from sources they can trust. Social media is notorious for spreading misinformation worldwide. Many societies and cultures across the globe struggle with serving as a source of information for their youth, with a disconnect between traditional values and a lack of communication between parents, elders, and the youth. However, despite the discomfort that many feel around the topic of HIV and sexual and reproductive health, our children and youth rely on us as trusted sources of reliable information. If we don’t make ourselves available to listen and discuss these topics, young people will be exposed to misinformation from other sources. Civil society, government, and other partners need to keep this in mind as we plan and implement programming, and train health care professionals. This is one of the many reasons that all partners must meaningfully engage young people – because they have got the voice; so, we just need to pass them the mic.
The U.S. Mission in Uganda supports efforts to strengthen the capacities of adolescents and young people living with HIV/AIDS in leadership and advocacy–and I am delighted to foster continued U.S. government participation in youth-led programs such as this Y+ beauty pageant.
I commend the Y+ Beauty pageant campaign for focusing on empowering young people living with HIV to serve as role models for their peers. I wish to urge the media houses present here today to lead in promoting correct information about the pageant and to act as advocates to increase acceptance and understanding of young people living with HIV in society. It is often said that education is the vaccine against HIV. Many media organizations are rising to the challenge by promoting awareness of HIV and educating listeners and viewers about the facts of the epidemic and how to stop it. Please, keep this up!
To other partners implementing HIV and other health programs, it’s important to proactively and sustainably involve young people—right from program inception in line with the “nothing for us without us” principle. I urge us to embrace community-led monitoring and the central role of communities in monitoring the impact of PEPFAR-supported programs.
As I close, I want to take this opportunity to congratulate in advance the outstanding finalists in this pageant, and I want to acknowledge all of the participants. Regardless of the outcome, you are all winners! Again, I commend the Uganda Network of Young People living with HIV & AIDS, for its unique campaign strategies such as the “Y+ Beauty pageant” that has inspired over 800 ambassadors. These ambassadors are a part of a generation of young people living with HIV advocating for and working towards an HIV stigma-free Uganda. Indeed, you have the voice and we better pass over the mic!