PMTCT

The First Lady of Kenya, Margaret Kenyatta, participated on 9 March in the First Lady’s half marathon to raise awareness and resources for the ‘Beyond Zero’ campaign—an initiative to stop new HIV infections among children and improve the lives of mothers.

More than 30 000 participants including cabinet secretaries, members of the parliament, governors and their spouses, professional athletes, diplomatic corps and United Nations representatives took part in the 21-kilometre run in Nairobi, Kenya.

The First Lady congratulated the participants for their commitment to ending new HIV infections among children and keeping their mothers alive. “Today we ran to make sure we have an HIV-free generation in this country,” said Ms Kenyatta.

The funds raised during the half marathon will be used to scale up maternal and child health services, including purchasing of mobile clinics for the 47 counties throughout Kenya.

Receiving the First Lady at the finish line was the President of Kenya, Uhuru Kenyatta, who stressed the government’s full support for the initiative. “We want to ensure that we bring about a complete end to maternal deaths and to infant mortality as a result of children and mothers being unable to access proper care,” said President Kenyatta.

Since its launch in January 2014, the First Lady’s ‘Beyond Zero’ campaign and its Foundation have raised more than US$ 1 million during several events. For example, ahead of the marathon, the First Lady hosted a fund-raising breakfast at the statehouse with approximately 20 private sector companies where she unveiled the first of the 47 mobile clinics. On 13 April, the First Lady will participate in the London Marathon to raise visibility at a global level and mobilise additional resources for the campaign.

According to the 2013 estimates and projections from the government of Kenya, an estimated 9 400 babies were born with HIV in the country in 2013. HIV-related complications accounted for 15% of all deaths among children under the age of 5 in the same year.

James Macharia, the Cabinet Secretary in the Ministry of Health, said that it was unacceptable that 15 mothers and 270 children below 5 years die every day in Kenya largely from preventable causes. He congratulated the ‘Beyond Zero’ campaign and Foundation for making meaningful contributions in advancing maternal and child health in the country.

Fifteen women die every day due to pregnancy related complications in Kenya and 20% of all deaths among mothers in the country are AIDS-related.

In order to improve maternal and child health outcomes in the country, the First Lady of Kenya, Margaret Kenyatta launched the ‘Beyond Zero Campaign’ on 24 January in Kenya’s capital Nairobi. The new initiative also aims to accelerate the implementation of the national plan towards the elimination of new HIV infections among children.

“I am deeply saddened by the fact that women and children in our country die from causes that can be avoided. It doesn’t have to be this way,” said Ms Kenyatta. “This is why I am launching the ‘Beyond Zero Campaign’ which will bring prenatal and postnatal medical treatment to women and children in our country.”

According to the Commission on Information and Accountability for Women and Children’s Health 2013 Update Report, in 2012 alone, more than 100 000 children died before their fifth birthday—largely due to preventable causes. In the same year, 13 000 new HIV infections occurred among children and 62% of children living with HIV did not access life-saving antiretroviral drugs.

“I wished that my mother had better access to maternal health care services that would have protected her from contracting HIV,” said Dorcas Kawira, a 21 year old HIV positive law student. She also stressed the challenges she experienced in accessing and using HIV treatment during her childhood. She highlighted that investing in the ‘Beyond Zero campaign’ would secure the necessary maternal and child health care to protect her and other young women living with HIV.

Donors and private sector organizations have already pledged funds to purchase mobile clinics that will provide integrated HIV, maternal and child health outreach services in the country. For example, James Mwangi, Chief Executive Officer of Equity Bank in Kenya, pledged US$ 580 000 during the launch event. The Ministry of Health will also invest in 2014 an estimate of US$ 400 million towards initiatives to reduce HIV transmission and maternal and child mortality, to increase the number of skilled health care providers and to equip the existing facilities with relevant supplies.

The ‘Beyond Zero campaign’ is part of the initiatives outlined in the Strategic Framework for the engagement of the First Lady in HIV control and promotion of maternal, newborn and child health in Kenya that was unveiled on World AIDS Day 2013. The framework aims to galvanise high-level leadership in ending new HIV infections among children and reducing HIV related deaths among women and children in Kenya.

The strategic framework focuses on five key areas: (i) Accelerating HIV programmes, (ii) Influencing investment in high impact activities to promote maternal and child health and HIV control, (iii) Mobilizing men as clients, partners and agents of change, (iv) Involving communities to address barriers to accessing HIV, maternal and child health services and (v) Providing leadership, accountability and recognition to accelerate the attainment of HIV, maternal and child health targets.

The campaign, ‘Where history is made,’ invites guests to make history and make a pledge for an AIDS-free generation

GENEVA, 16 December 2013—UNAIDS and the hotel InterContinental Genève have come together in a public-private partnership to advance efforts to ensure that all children can be born free from HIV, that their mothers have access to life-saving medicines and that all children living with HIV can lead healthy lives.

Countries have committed to eliminating new HIV infections among children by 2015. Although great progress has been made—with new HIV infections among children having been reduced by 53% since 2001—there is still a major push needed to help countries reach their goals. In 2013, just 28% of children in need of treatment had access.

“By keeping children free from HIV we are not only saving lives, we are investing in a healthier future for generations to come,” said Michel Sidibé, Executive Director of UNAIDS. “I am honoured that the hotel InterContinental Genève is partnering with us to provide more people with the opportunity to join our efforts in making an AIDS-free generation possible.”  

One of the first initiatives of the joint partnership is the launch of a campaign to raise both awareness and funds for an AIDS-free generation. The campaign, Where history is made, launched at a special event held at the hotel on 16 December, invites guests to make history and a pledge for an AIDS-free generation. Hotel staff will play an integral role with AIDS-awareness training and will be able to share information with guests about the importance of keeping children free from HIV. Hotel guests will be able to join the campaign by making a donation as they check out or when they visit the hotel restaurant or bar.

“The hotel has a longstanding history and relationship with the UN in Geneva, and we are excited to have formed this partnership with UNAIDS,” said the General Manager of the hotel InterContinental Genève, Jürgen Baumhoff.

The hotel InterContinental Genève is an important landmark in Geneva, standing at the intersection of the city and the United Nations. In 2014 the hotel will mark its 50th anniversary over which time it has welcomed world leaders and played host to the historic brokering of deals and forging of partnerships. The campaign between UNAIDS and the hotel InterContinental Genève is part of the hotel’s 50-year celebrations and captures the essence of this major milestone by joining efforts to achieve an AIDS-free generation.  

“Building healthier societies begins with children,” said UNAIDS International Goodwill Ambassador and internationally acclaimed musician Toumani Diabaté who performed at the special launch event. “We can all be part of history by making sure that women living with HIV and their children have access to HIV, prevention, treatment and care services.”

UNAIDS and the hotel InterContinental Genève are entering into a new partnership. The collaboration comes as the landmark Geneva hotel will celebrate its 50th anniversary.

The Memorandum of Understanding was signed at a ceremony on the 21 November at UNAIDS headquarters in Geneva. During the ceremony, UNAIDS Executive Director, Michel Sidibé discussed the importance of the active involvement of the private sector in the response to HIV with the General Manager of the hotel InterContinental Genève, Jürgen Baumhoff.

The public-private partnership will focus on a number of issues including ensuring children are born free from HIV and that their mothers can continue with antiretroviral therapy. Another important aspect is ensuring children living with HIV have timely access to life-saving treatment.

One of the first initiatives of the joint partnership will be the launch of a campaign to raise awareness and funds for an AIDS-free generation. The campaign will be launched on 16 December 2013.

The Lucrecia Paim Maternity Hospital is one of Angola’s model clinics in providing access to antiretroviral therapy for pregnant women living with HIV to prevent the transmission of the virus to their babies. The Executive Director of UNAIDS Michel Sidibé visited the facility in Luanda on 8 October and called for greater efforts in reaching all pregnant women living with HIV and ensuring that all babies are born free of HIV in Angola. This came after several Angolan ministers made a strong commitment to scaling-up prevention of mother-to-child transmission of HIV (PMTCT) and treatment services.

Angola is one of 22 priority countries included in the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. While data from the Angolan government shows the percentage of pregnant women testing for HIV increased by 55% between 2009 and 2012, Angola is the only priority country where the number of new infections among children increased between 2009 and 2012. 

Mr Sidibé met jointly with the ministers of Health, Education, Women, Defence, Youth and Sports, and Social Affairs and encouraged a multi-sectorial leadership to rapidly expand Angola’s response to HIV. The ministers committed to scaling-up HIV programmes to ensure all babies are born free of HIV and people living with HIV have access to treatment in Angola.

During his official two-day visit to Angola, Mr Sidibé also met with representatives of civil society and the private sector to discuss the challenges and opportunities in the Angolan AIDS response.

Obstetricians and gynecologists, ministers, public health specialists and civil society organizations convened in Addis Ababa, Ethiopia from 2-5 October at the First International Federation of Gynecology and Obstetrics (FIGO) Africa Regional Conference to discuss ways of improving maternal and child health in Africa.

Speaking at the opening, UNAIDS Deputy Executive Director, Programme, Luiz Loures highlighted the link between HIV and maternal and child health. He called for women’s health and HIV communities to closely work together to increase access to life-saving health services to reach the most marginalized in society.  He also stressed the need to uphold the sexual and reproductive rights of women living with HIV. 

In sub-Saharan Africa, women are more likely to be living with HIV than men, accounting for 58% of the 22.1 million adults who were living with HIV in the region in 2012. Young women are particularly at risk of HIV infection–– around 28% of all new adult HIV infections in sub-Saharan Africa are among young women between the ages of 15-24. HIV is also a leading cause of death among women of reproductive age and has a major impact on child health and mortality, mainly through the transmission of HIV from mother to child.

Dr Loures congratulated FIGO on its visionary and bold work on women’s sexual and reproductive rights. He also underscored UNAIDS commitment to strengthening its collaboration with FIGO to raise political visibility and engage women’s networks on HIV and sexual and reproductive rights issues to reduce AIDS related maternal and child mortality.

The African Union international conference on maternal, newborn and child health is being held in Johannesburg, South Africa from 1 to 3 August. Credit: UNAIDS

In 2012, more than 200 000 children were newly infected with HIV among the 21 countries in sub-Saharan Africa where almost 90% of the world’s HIV transmissions to children occur.  While this was a 38% decline from 2009, it still means that nearly 600 children were newly infected each day.

As part of on-going efforts to improve the health of women and children across Africa, the African Union recently convened an international conference on maternal, newborn and child health in Johannesburg, South Africa. The conference, which runs from 1 to 3 August, addresses a number of important issues including service delivery and quality of service, access to medicines, family planning and task shifting. It also looks specifically at the impact of HIV on women and children and how to ensure increased access to essential HIV services.  

“As leaders we have the power to ensure that no woman dies giving life. We also have the power to ensure that no child dies from an avoidable cause,” said the President of South Africa, Jacob Zuma during the opening ceremony of the conference.

Stopping new HIV infections among children and ensuring their mothers have access to HIV services including treatment for their own health is a top priority for UNAIDS. In 2011, UNAIDS and PEPFAR spearheaded a new initiative which has been embraced by the global community. The Global Plan to eliminate new HIV infections among children and keeping their mothers alive (Global Plan) has set the ambitious goal for 2015 of reducing new HIV infections among children by 90% and reducing AIDS-related maternal and paediatric mortality by 50%.

To highlight the urgent need to scale up progress, UNAIDS held a special session at the conference to build on momentum around the Global Plan and address bottlenecks in the African countries where most new HIV infections among children occur. During the session UNAIDS reported that while seven countries have shown a rapid decline in new HIV infections (50% or more decline between 2009 and 2012), six others are showing signs of stagnation (less than 30% decline), and the remaining seven show moderate performance (30-49% decline).

“We need to reflect on how we shift the paradigm of how we are working today. The paradigm is a disease approach, but we need a holistic approach. We cannot afford to have women coming in to the facility and being addressed for TB on one day; HIV on another day... We need to consider her as a woman – a whole human being – who needs holistic support,” said UNAIDS Executive Director, Mr Michel Sidibé.

The African Union is a strong supporter of the Global Plan and has actively advocated for increased efforts to expand access to HIV services for women and children.

“The focus on maternal, newborn and child health is not expenditure, it is an investment. It is an investment in our common humanity and our common survival… We can do it, we must do it. We have no choice,” said African Union Chairperson, Dr Nkosazana Dlamini Zuma.

The Executive Director of UNAIDS, Michel Sidibé, has appointed the First Lady of Mozambique as a Patron of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

A long-standing champion of the response to HIV, Maria Dia Luz Guebuza has advocated for zero new HIV infections among children for a number of years. In 2012, at the 32nd Summit of Heads of State and Government of the Southern Africa Development Community (SADC) she was instrumental in convening a powerful meeting of First Ladies. During the meeting the 15 First Ladies developed the ‘Maputo Declaration on the Elimination of Mother-to-Child Transmission of HIV’ which Dr Guebuza presented to heads of State who officially adopted the declaration at the Summit.

As a Patron of the Global Plan, Dr Guebuza will highlight the need to expand both HIV prevention and treatment services to women and children not only in Mozambique but across the region, which has been most affected by the AIDS epidemic.

The Global Plan is focusing particular efforts on these 22 countries to achieve two main targets for 2015: a 90% reduction in the number of children newly infected with HIV and a 50% reduction in the number of AIDS-related maternal deaths.

Mozambique is one of the Global Plan’s 22 priority countries and according to the latest progress report Mozambique has made major strides in providing HIV prevention and treatment services for women and children. The number of women receiving antiretroviral therapy to prevent transmission to their children increased from just 38% in 2009 to 86% in 2012 (under 2010 guidelines). Subsequently the number of new infections among children fell in the same time period from 26 000 to 14 000.

The Global Plan towards elimination of new HIV infections among children by 2015 and keeping their mothers alive is an initiative which was launched in 2011 by UNAIDS and the United States Presidents Emergency Plan for AIDS Relief (PEPFAR) at the UN General Assembly High Level Meeting on AIDS.

President of the United States of America, Barack Obama speaking with Archbishop Desmond Tutu during his visit to the Archbishop Desmond Tutu HIV Foundation (DTHF). Credit: DTHF

The President of the United States of America, Barack Obama stressed the feasibility to achieve an AIDS-free generation during his visit to the Archbishop Desmond Tutu HIV Foundation (DTHF) Youth Centre based in Cape Town, South Africa. President Obama toured the Foundation on 30 June as part of an official three-country visit to Africa—Senegal, Tanzania and South Africa.

“We have a possibility of achieving an AIDS-free generation and making sure that everyone in our human family is able to enjoy their lives, raise families, succeed and maintain their health here in Africa and round the world,” said President Obama.

Founded in early 1990s the DTHF provides HIV and Tuberculosis prevention, treatment, research and training as well as management services to communities of the Western Cape, particularly residents of townships who are at high risk of infection.

Its youth centre—opened in 2011 with help from several private sector and international partners including the United States President’s Emergency Plan for AIDS Relief (PEPFAR)—offers health services, life skills, and educational support to more than 2 000 registered young people.

“Thank you to the American people for the contribution that PEPFAR has made in our struggle against TB, HIV and malaria, not just here but in other parts of Africa,” said Archbishop Tutu. “Here in Africa we speak of ‘Ubuntu’—we say a person is a person through another person.”

In recent years, South Africa, which has the world’s largest HIV epidemic, made remarkable progress in its response to AIDS.  In 2011, South Africa recorded a 41% reduction in new HIV infections since 2001. The scale-up of HIV treatment programmes in the country enabled more than 2 million people living with HIV to access life-saving treatment and care services in 2012. And between 2009-2012, new HIV infections among children declined by 63% in the country.

“South Africa has faced a heavy burden from HIV but the great news is that the country is now leading the way in caring for its citizens—paving the way for a brighter future for South African people,” said President Obama.

New report also shows that access to treatment remains unacceptably low for children––only 3 in 10 children in need of treatment have access in most of the ‘Global Plan’ priority countries

GENEVA, 25 June 2013—A new report on the Global Plan towards elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) has revealed a marked increase in progress in stopping new infections in children across the Global Plan priority countries in Africa.

The report outlines that seven countries in sub-Saharan Africa—Botswana, Ethiopia, Ghana, Malawi, Namibia, South Africa and Zambia—have reduced new HIV infections among children by 50% since 2009. Two others—the United Republic of Tanzania and Zimbabwe—are also making substantial progress. It highlights that there were 130 000 fewer new HIV infections among children across the 21 Global Plan priority countries in Africa––a drop of 38% since 2009. 

“The progress in the majority of countries is a strong signal that with focused efforts every child can be born free from HIV,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “But in some countries with high numbers of new infections progress has stalled. We need to find out why and remove the bottlenecks which are preventing scale-up.”  

With a 76% decline since 2009, Ghana showed the greatest decline in the rate of new infections among children and South Africa showed a 63% decline (24 000 fewer new HIV infections in 2012 than in 2009). However, the pace of decline in some of the Global Plan priority countries has been slow and in Angola, new HIV infections have even increased. New infections among children in Nigeria––which has the largest number of children acquiring HIV (nearly 60 000 new HIV infections among children in 2012)––remained largely unchanged since 2009. Without urgent action in Nigeria the global target for 2015 may not be reached.

More pregnant women living with HIV were receiving antiretroviral medicines to prevent HIV from being transmitted to their children and for their own health in 2012 than in 2009, with coverage levels exceeding 75% in many countries. Increased coverage has reduced HIV transmission rates from mother to child in most countries. Botswana and South Africa have reduced transmission rates to 5% or below.

“We have the tools required to reach the Global Plan’s goals, and recent data show that we are moving ever closer to their realization,” said Ambassador Eric P. Goosby, U.S. Global AIDS Coordinator. “This month, as U.S. Secretary of State John Kerry announced, the one millionth baby will be born HIV-free due to PEPFAR’s support. Now, we must all continue working together to see the day when no children are born with HIV, which is within our reach,” he added.

The report however also reveals that only half of all breastfeeding women living with HIV or their children receive antiretroviral medicines to prevent mother-to-child transmission of HIV. It outlines that breastfeeding is critical to ensuring child survival and strongly emphasizes the urgent need to provide antiretroviral therapy during the breastfeeding period.

More than half of the children eligible for treatment in South Africa and Swaziland now have access. Chad, Ethiopia, Ghana, Kenya, Malawi, Nigeria, South Africa, United Republic of Tanzania and Zimbabwe have doubled the numbers of children accessing treatment from 2009 to 2012. While the report outlines that the number of children requiring HIV treatment will reduce as new HIV infections decline, urgent steps need to be taken to improve early diagnosis of HIV in children and ensure timely access to antiretroviral treatment.

The number of pregnant women living with HIV receiving antiretroviral therapy for their own health has increased since 2009. In Botswana, Ghana, Malawi, Namibia, South Africa, Swaziland and Zambia, more than 75% of the pregnant women eligible receive antiretroviral therapy and more than 50% in Kenya, Lesotho, the United Republic of Tanzania and Zimbabwe. Increasing access to antiretroviral therapy for pregnant women living with HIV for their own health is critical.

The Global Plan towards elimination of new HIV infections among children by 2015 and keeping their mothers alive is an initiative spearheaded by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United States Presidents Emergency Plan for AIDS Relief (PEPFAR)  which was unveiled in June 2011 at the UN General Assembly High Level Meeting on AIDS. It has two main targets for 2015: a 90% reduction in the number of children newly infected with HIV and a 50% reduction in the number of AIDS-related maternal deaths. The Plan focuses on the 22* countries which account for 90% of new HIV infections among children.

This second progress report presents the progress made by the 21 countries in sub-Saharan Africa and some of the challenges they face in meeting the agreed targets for 2015.

* Angola, Botswana, Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Uganda, United Republic of Tanzania, Swaziland, Zambia and Zimbabwe.

PEPFAR

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is the U.S. Government initiative to help save the lives of those suffering from HIV/AIDS around the world. This historic commitment is the largest by any nation to combat a single disease internationally, and PEPFAR investments also help alleviate suffering from other diseases across the global health spectrum. PEPFAR is driven by a shared responsibility among donor and partner nations and others to make smart investments to save lives. Learn more at www.pepfar.gov.

UNICEF

UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit www.unicef.org  Follow us onTwitter and Facebook

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners to maximize results for the AIDS response. Learn more at unaids.org and connect with us on Facebook and Twitter.