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Twenty years ago, people living with HIV fought for and won access to affordable antiretrovirals (ARVs). ITPC was founded by activists who knew from the very beginning, that communities must be involved in every aspect of a health response, from understanding the science to designing the services to setting the policies. We put preparedness into our name and our mission — and we took action.

In this report, ITPC presents the evidence of the sizeable impact of community-led action. We share the data on how community-led monitoring at health facilities is linked to community resilience and return to full capacity after COVID-19; how ongoing work to secure affordable medicines drives cost savings that allow countries to make scant budgets go further; and how communities are the first to respond in crises, with astute analyses and actions that address and avert service disruptions and emergencies for community members in close to real time.

From this evidence, we move to the argument that community-led action must be considered a crucial countermeasure to address current health issues and prevent future outbreaks. To secure this access, community-led action must be understood, funded, and embraced beyond the HIV-impacted communities where it has been honed and practiced for years as part of transformative, fearless transnational activism.

While individual countries, communities, and/or programs are developing innovative, collaborative approaches in many settings, those with the most valuable insights and the greatest need are left out of high-level decision-making processes. This has to change. This report is a roadmap and an advocacy tool for moving from a piecemeal approach to a global access plan for community-led action, including securing high-level political commitment, robust, reliable funding for activist “technology transfer”, and an innovation agenda. All lead to necessary and transformative change.

We are intentionally launching this report as the world prepares to gather in New York for the opening of the 78th session of the United Nations General Assembly (UNGA 78) and with it, the convening of three UN High-Level Meetings (HLMs) on health: on Pandemic Prevention, Preparedness and Response (PPPR), on Universal Health Coverage (UHC), and on Tuberculosis (TB).

The findings of this report, and our recommended global action plan for community-led actions are applicable to and thread through each of these upcoming landmark UN high-level deliberations.

A countermeasure is a corrective, a remedy, or a cure. In medical terms, a countermeasure is “critical for minimizing morbidity and mortality in the event of a large-scale public health emergency”.  Community-led action meets these criteria. It always has.