When the Margins Speak: MENA Voices in the Global AIDS Movement

Earlier this year, GFAN held its first-ever regional meeting for advocates from the Middle East and North Africa (MENA), marking an intentional step toward deepening engagement and inclusion from across the region. One of the participants in that milestone gathering, Maher Sleiman, joined us again at the GFAN Strategy Meeting in Ottawa, Canada, his first time at a global GFAN convening. We invited Maher to share his reflections from Ottawa, capturing the perspective of a first-time attendee and the growing presence of MENA voices within the GFAN network.

Bridging Worlds: My First GFAN Annual Strategy Meeting Experience

This year, I had the privilege of participating in three transformative gatherings that reshaped both my professional perspective and my personal commitment to global health: the GFAN MENA meeting in Marrakech, the GFAN Africa Strategy meeting in Johannesburg, and the GFAN Annual Strategy Meeting in Ottawa. Each of these spaces offered vital insights and connections, but Ottawa—my first experience at a GFAN Annual Strategy Meeting—stood out as a true turning point.

As an advocate based in Beirut, working within the Middle East and North Africa (MENA) region, I am deeply familiar with the layered complexities of our work. We often find ourselves navigating emergencies on multiple fronts: shrinking civic space, volatile donor environments, and political realities that can shift overnight. And while remote advocacy has become the norm, it can feel like shouting into a void—an uphill climb made heavier by a world increasingly fractured by overlapping crises. The cluster of horrors we face—across borders, systems, and institutions—can leave us feeling not only divided, but deeply isolated, as if the very structures meant to connect us are instead tearing us further apart.

A Beautiful Gathering in a Difficult Location

Walking into the Ottawa meeting, I was met with a powerful counterforce: a space sobered by the global reality of what is at stake, yet alive with collective energy, determination, and an unshakable belief in the possibility of change. But that power was not without its contradictions. I felt a tension between the inclusive vision we champion and the logistical realities that often undermine it.

Hosting such a pivotal strategy meeting in the Global North came with barriers that are all too familiar to advocates from the Global South. Many, particularly youth advocates, were unable to attend—not because of lack of interest or capacity, but due to increasingly exclusionary visa systems. The quiet irony wasn’t lost on us when a snowstorm swept through Ottawa upon our arrival, perhaps nature’s gentle way of questioning our choice of venue.

I appreciated the gestures made in recognition of those who couldn’t be there: a chair set aside on stage, a mention of visa barriers. But gestures, while meaningful, are not substitutes for structural solutions. A hybrid participation model, especially for a space that aims to shape global advocacy, should not be an afterthought. Inclusion cannot be optional.

Bridging Regions, Centering Power

While navigating a complex regional climate, civil society in the MENA region has historically fought—and continues to fight—for visibility and equitable access to global health resources, resulting in the region being left behind in the global fight to end AIDS (evident by the region’s increasing HIV prevalence rates). This context has shaped my advocacy deeply: it has taught me to be both persistent and innovative, and to find strength in community.

Over the past several years, I’ve worked closely with civil society partners across the region through my role with Frontline AIDS, the Principal Recipient of the Global Fund Multi-Country MENA grants. This experience grounded me in the realities of grassroots advocacy and regional coordination and affirmed the value of deep community partnerships.

Coming into Ottawa, I carried a clear mission: to ensure that MENA’s key population realities—our challenges, our resilience, and our hopes—were meaningfully part of the global conversation.

What struck me most was how intentionally GFAN fosters cross-regional solidarity. A standout moment was engaging more closely with GFAN Asia Pacific and colleagues from Latin America and the Caribbean (LAC). Despite our differing contexts, we found deep alignment in the structural inequities, political sensitivities, and funding gaps we each face. These were not just updates, they shared truths.

At the same time, I was reminded of the importance of how space is shared. Global advocacy is still too often shaped by familiar names and voices—people who, while incredibly committed, tend to circulate in the same rooms, on the same panels, with the same platforms. As someone who can be very loud when the occasion calls for it, let me be clear: I say this not from a place of resentment, but from observation. If we want to hear new voices, we must be intentional about making space for them—not just symbolically, but structurally.

The Power of Human Connection

Beyond the formal sessions, it was the human connections that left the most lasting imprint on me. I had the privilege of meeting advocates from every corner of the world, each one bringing fierce dedication, expertise, and most humbling of all, genuine kindness and openness. These were people who have worked tirelessly for years, often under harsh conditions, yet remain grounded, hopeful, and deeply committed to the cause.

What stayed with me were the small moments, the laughter over coffee, the quiet reflections during breaks, the knowing glances when someone said what we were all thinking. These moments reminded me that at the core of advocacy is not just work, but the relationships that sustain it.

On Contingency, Courage, and Clarity

One of the more sobering themes throughout the meeting was the uncertainty surrounding global health financing. As we explored the fragile state of official development assistance (ODA) and the possibility of the Global Fund falling short on replenishment, I couldn’t shake the question: What happens if we don’t meet the minimum required pledges?

This is not a theoretical exercise, it’s a very real possibility, and one we seem ill-prepared to confront. Contingency planning in these scenarios is not alarmism; it is responsibility. Advocacy must be brave enough to speak uncomfortable truths and prepared enough to act when ideals fall short of reality.

A Growing Concern: When ROI Replaces Rights

Threaded through many conversations was another trend I find deeply troubling: the increasing use of “return on investment” language in our advocacy. Of course, strategic framing matters—especially in donor spaces. But when the metric of success becomes almost exclusively about efficiency, outcomes, and business cases, we risk drifting away from our core purpose.

Human rights are not the cherry on top of effective programming; they are the foundation. Yet in too many spaces, they feel like an afterthought. I worry that we are bending too far, adjusting our language and priorities to fit into frameworks that were never built to center dignity, equity, or justice. And the more we adapt to that logic, the more distant our work becomes from the people it claims to serve.

Looking Ahead with Purpose

Returning to Beirut, I brought with me not just insights or connections—but a more complicated, more urgent understanding of what it means to advocate in this moment.

I am grateful to GFAN—not only for opening space, but for encouraging reflection, discomfort, and honesty. It is a rare kind of leadership that welcomes critique, and it gives me hope that our movement is not only growing, it is also maturing.

As we look to the future, let’s be brave enough to ask hard questions, bold enough to challenge what isn’t working, and grounded enough to keep people—not metrics—at the center of all we do.

This is how we move from advocacy to transformation.