Western Central Europe

During a recent visit to Germany, the Executive Director of UNAIDS, Michel Sidibé, met with representatives of the federal government, local government, civil society, communities affected by HIV and the private sector.

Under the leadership of Chancellor Angela Merkel and the Minister of Health, Hermann Gröhe, Germany has prioritized global health on the international agenda, culminating in the first ever Group of Twenty (G20) Health Ministers Meeting, which took place in Berlin, Germany, on 19 and 20 May.

Political commitment

“Ending AIDS is a historic goal and I firmly believe we can reach it. UNAIDS has to maintain its leadership role in the global AIDS response. We have to increase our joint efforts and UNAIDS is central to that work,” said Mr Gröhe. "Health is a prerequisite for social development. This is one of the reasons why Germany made global health a priority under our G20 presidency. With this decision taken by our Federal Chancellor, Angela Merkel, a global health policy is going to be a hallmark of our country’s international responsibility. Only if we cooperate and work together, we can prepare the world for future health crises,” he added.

During the meeting, Mr Sidibé thanked the government, and particularly the Minister of Health, for their longstanding support to UNAIDS and commitment to the AIDS response. “Putting health on the agenda of the G20 and particularly holding a meeting of the G20 Health Ministers for the very first time is revolutionary,” said Mr Sidibé. “It highlights the shared understanding that quality health care is essential to social and economic stability.” They agreed on the danger of complacency and the potential reversal of gains it could bring.

Mr Sidibé also met with the Parliamentary State Secretary for the Ministry of Economic Cooperation and Development, Thomas Silberhorn, where he highlighted the critical role of UNAIDS in ending the AIDS epidemic and the impact it would have on the broader Sustainable Development Goals.

During his visit he also spoke to Bärbel Kofler, Germany’s Commissioner for Human Rights Policy and Humanitarian Aid. She said, “Access to health is a human right.” They discussed the need for continued engagement to break down discrimination and stop exclusion and prejudice, particularly for people who are vulnerable and are being left behind. Mr Sidibé emphasized that fragile communities not only exist in developing countries, but can be found the world over—from Baltimore to Bamako.

Working together to Fast-Track the AIDS response in Germany

Taking the engagement to the local level, Mr Sidibé next met with representatives of the city of Berlin, which joined the Fast-Track cities initiative in 2016. He also met the nongovernmental organization Deutsche AIDS-Hilfe, which recently launched a campaign to End AIDS in Germany by 2020, and its local branch, Berliner AIDS Hilfe, as well as the advocacy group Action Against AIDS Germany.

During the meeting, Mr Sidibé highlighted that city health systems that are inclusive and accessible have the best chance of engaging people who might otherwise be left behind. “Having a strong civil society has made a big difference in the response to HIV,” he said.

Private sector engagement

In addressing the international business community on the eve of the B20 Health Conference Mr Sidibé said. “Today’s global health challenges, including emerging pandemics and antimicrobial resistance, threaten not just individual lives, but impact social cohesion and economic development. The private sector can bring unique innovation, technologies and services and needs to be an integral part of a multisectoral response to build resilient, responsible and responsive health systems.”

As guest of honour, Mr Sidibé congratulated the winners of the newly launched German Global Health Award—the German Healthcare Partnership (GHP), Bio Deutschland and the Voice of German Industry. The initiative exemplifies how the private sector and civil society alike are needed to drive innovation in the health-care sector.

Roland Göhde, Chairman of the Board at GHP, said, “With the German Global Health Award launched in this year of Germany’s G20 presidency, we would like to underline our strong private sector commitment towards multi- and inter-sectoral partnerships engaged in health system strengthening and universal health coverage. We are partners and committed to making the world a healthier and safer place.”

Sitting in his Mini Cooper, sporting traditional Bavarian lederhosen and a smart black waistcoat, Maik is a picture of health. It is hard to believe that nine years ago he was fighting for his life.

Maik is a 43-year-old engineer and test driver for a large German car manufacturer. He speaks slowly and softly, “Back then I didn’t think I’d ever drive a car again.”

Nine years ago Maik had left his doctors baffled. He had lost 30 kilos, and had become very ill. At the back of his mind, Maik knew he might have HIV—as a gay man he knew he was at higher risk of infection, but he was careful, and his last HIV test, 10 years ago, was negative. But he was worried. “I had the old pictures of AIDS in my head,” he said. “I was very scared.”

Despite the unmistakable symptoms, his doctor didn’t offer him an HIV test, but sent him home with throat lozenges for his mouth infection. “For me,” said Maik “This was proof enough that I didn’t have HIV.”

It was only when he was referred to a specialist that the possibility of HIV was raised and Maik was offered an HIV test. The results came back positive. Maik had HIV and his immune system was weakening. “I thought, I’m going to die because I didn’t have the courage to take an HIV test.”

At home he gave his partner the choice. “Either leave now or stay and watch me die.”

His partner stayed and Maik was given antiretroviral therapy.

Incredibly, just six weeks later, he was back at work. “I have been improbably lucky,” said Maik. He now works a full 40-hour week and makes time for sport.

Maik has shared his story to inspire and encourage others to test for HIV as part of the campaign by the German nongovernmental organization Deutsche AIDS-Hilfe to end AIDS in Germany by 2020. The campaign, Kein AIDS für Alle, aims to stop new HIV infections and ensure that by 2020 no one in Germany will develop AIDS.

“Ending the AIDS epidemic is within reach for Germany and ensuring that people know their status and can access treatment is critical to reaching that goal,” said Michel Sidibé, Executive Director of UNAIDS.

HIV treatment has been available in Germany for more than 20 years, preventing the onset of AIDS and allowing people living with HIV to live longer, healthier lives. However, it is estimated that every year more than 1000 people in Germany develop AIDS because of late diagnosis or because they are not accessing treatment.

“There are many reasons why people don’t take an HIV test. Some think they’re not at risk, even doctors don’t always recognize the need to test for HIV,” said Silke Klumb of Deutsche AIDS Hilfe. “There’s also still a huge fear of stigma and discrimination in Germany. And, unfortunately, not everyone has access to HIV services; undocumented migrants, for example, are one group that is being left behind.”

The Kein AIDS für Alle campaign will inform people about the risks of HIV infection and show that a positive test for HIV is not a death sentence, but the first step to living a long and healthy life.

“Don’t wait until it's too late,” affirms Maik. “Get tested regularly. A positive HIV diagnosis is a dramatic experience. But you can live well with HIV, providing you get treatment.”

HIV is the virus that causes HIV infection. AIDS is the most advanced stage of HIV infection.

The campaign will aim to eliminate stigma and discrimination around HIV and encourage members of key populations to access HIV prevention, testing, treatment and care services through innovative initiatives. There will also be support for doctors as part of efforts to improve timely diagnosis of HIV.

Deutsche AIDS Hilfe is an independent, non-profit association with 120 autonomous member organizations, including AIDS and drug treatment service organizations, HIV prevention projects, gay and lesbian centres and housing and home care projects. Together, they are committed to HIV prevention, treatment care and support and advocacy around HIV in Germany.

As part of efforts to achieve the commitments in the 2016 United Nations Political Declaration on Ending AIDS, UNAIDS is working to support community-led service delivery and build the capacity of civil society organizations to deliver HIV prevention, treatment and care services based on a non-discriminatory approach that respects, promotes and protects human rights. 

An exhibition at the Red Cross and Red Crescent Museum in Geneva, Switzerland, traces the AIDS response through posters and art from around the world over the past 30 years. The Fight against AIDS in Images explores the evolution of how HIV has been portrayed in campaigns encompassing sexuality, politics, stigma and HIV prevention—from using an image of a skull to the red ribbon, from depicting HIV as a death sentence to showing people living positively with HIV and from spreading fear to using humour.

“The point of our exhibition is not the disease itself, but all the communication materials around it,” said the Red Cross and Red Crescent Museum Director, Roger Mayou. “The many posters are a true mirror of society through the ages.”

The exhibition begins with Nan Goldin photographs from the mid-1980s as part of the first thematic, Other People’s Disease, highlighting how HIV was seen at the time to be concentrated among key populations.

The second theme, Silence is Broken, highlights how civil society and public figures raised their voices to address HIV. The iconic image of the pink triangle with the saying “Silence = Death” dates back to 1987 and was a part of the New York AIDS Coalition to Unleash Power (ACT UP) campaign.

Next comes AIDS and the Media. The death in 1990 of an American boy named Ryan White, who was infected with HIV by contaminated blood, crystallized the fact that the virus can affect anyone. More women and heterosexual couples appeared on posters and many countries crafted messages for national campaigns, as shown by the German posters from 1990 that emphasize “Don’t give AIDS a chance”.

The Virus, the second to last theme, focuses on explaining the science behind AIDS. A rendition of a normal T-cell and an HIV-infected T-cell by the Cancer Institute in 1991 has the slogan “Visualize this”. An Algerian World AIDS Day poster from 1994 likens the virus to mines floating in the ocean with a tagline “Protect the family”.

The last theme, Living Together, introduces the fact that, with the advent of antiretroviral medicines in 1996, HIV need not be fatal. As a result, the Swiss Stop Sida (End AIDS) campaign began to incorporate a “Love life” message on their posters in 2005. A black and white UNAIDS World AIDS Day poster shows a close-up of a man with the tagline “I am accepted”—part of the I am Living My Rights campaign stressing the normality of living life as an HIV-positive person.

“HIV has become invisible, a fatigue has almost set in,” Alexandra Calmy from the HIV unit at the Geneva University Hospitals said. “And yet 2.1 million people are infected with HIV every year, so it is important to talk about AIDS, and this exhibition does just that.”

UNAIDS is working with countries towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.

The National Health Service (NHS) in Scotland, United Kingdom, announced on 10 April that pre-exposure prophylaxis (PrEP) would become available in Scotland.

PrEP is taken as a daily pill to significantly reduce the chances of contracting HIV. UNAIDS recommends PrEP use by people who are HIV-negative but at higher risk of becoming infected. The people who can benefit most from PrEP include gay men and other men who have sex with men, transgender people, sex workers and serodiscordant couples before the partner living with HIV becomes virally suppressed.

Since government estimates show that a large proportion of new HIV infections in Scotland are among gay men and other men who have sex with men, the introduction of PrEP could make a significant impact on the number new HIV infections in Scotland.

PrEP has been made available in a number of countries around the world as choice for HIV prevention. It cannot currently be obtained from the NHS in the rest of the United Kingdom, but can be accessed from some private clinics.

Countries agreed in the 2016 United Nations Political Declaration on Ending AIDS to reach 3 million people with PrEP by 2020.

High-level representatives of Denmark, Finland, Norway and Sweden came together on 28 March to discuss how to accelerate efforts in implementing the UNAIDS Fast-Track approach to ending the AIDS epidemic as a public health threat by 2030. During the Nordic consultation, hosted and chaired by State Secretary Ulrika Modéer, from the Ministry of Foreign Affairs in Sweden, the participants discussed obstacles and opportunities for progress towards achieving the Sustainable Development Goals.

The Executive Director of UNAIDS, Michel Sidibé, shared his vision and perspective on the opportunities towards ending AIDS and spoke about the recent reform of UNAIDS. The link between sexual and reproductive health and HIV was discussed, as was the need for greater efficiencies, reform in the global health architecture in order that health becomes more effective and a reduction of fragmentation. 

The global response to HIV has averted almost 9 million deaths since 2000, when the Millennium Development Goals (MDG) were set. Despite such progress, AIDS is the leading cause of death among women aged 15–49, the sixth leading cause of death among adolescents and a leading cause of death among children worldwide.

Recognizing the impact of HIV on health and development, in 2016 United Nations Member States adopted a Political Declaration on Ending AIDS to advance progress towards ending AIDS by 2030.

Essential to these efforts will be achieving the 90–90–90 targets, whereby, by 2020, 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads.

In October 2016, Sweden announced that it was the first country to reach the 90–90–90 targets, having reached them in 2015. Today, Sweden estimates that 90% of people living with HIV in Sweden know their HIV status, 97% of people who know their HIV-positive status are accessing treatment and 95% of people living with HIV who are accessing treatment have viral suppression.

Sweden remains a political champion and supporter of HIV efforts globally. Sweden is also a key donor to UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria. From 26 to 28 March, UNAIDS Executive Director Michel Sidibé visited Sweden, at the invitation of State Secretary Ulrika Modéer, to discuss how the response to HIV can be a catalyst for accelerating progress towards achieving the Sustainable Development Goals.

In meetings with a series of key political and technical stakeholders, as well as civil society organizations working on HIV, the participants stressed that HIV prevention must be expanded to end AIDS. They also stressed that HIV programmes must be integrated, brought to scale and implemented to maximum effect, ensuring they reach the people most affected by HIV.

There was consensus that a single disease approach to HIV is inadequate to reach the Sustainable Development Goals and that there is a need for an approach that looks on health not as an outcome but as a prerequisite for development and sustainability.

UNAIDS welcomed a group of prominent British parliamentarians from the cross-party International Development Committee to discuss the role of lawmakers in ending AIDS and contributing to global health. The parliamentarians were Labour Member of Parliament and Shadow Secretary of State for International Development Kate Osamor, Stephen Twigg, Labour Member of Parliament and Chair of the International Development Committee, Conservative Members of Parliament David Mackintosh and Paul Scully, and Baroness Sheehan, member of the House of Lords and the Liberal Democrat spokesperson for international development.

Deputy Executive Director Luiz Loures chaired an informal discussion that began with the Members of Parliament sharing their own experiences of visiting AIDS programmes in Africa and Asia. They spoke of their acute awareness of the complicated nature of the AIDS response, and Mr Twigg highlighted the role that discriminatory laws played in creating barriers to services. Mr Loures noted that one of the biggest challenges to the AIDS response was the risk of complacency. Baroness Sheehan expressed her concern about the increased vulnerability of girls and young women. The discussion explored the role of civil society and the shrinking space for civil society and Mr Scully noted the increasing need to mobilize domestic resources. 

Mr Loures highlighted the critical role of parliamentarians in ensuring that health and development international assistance is maintained and scaled up. Mr Mackintosh highlighted the need for increased efficiency and analysis on returns on investment to enable parliamentarians to advocate for sustained and increased funding.

Ms Osamor thanked Senior Adviser David Chipanta for sharing his personal story of living with HIV and the life-changing impact that access to treatment has had on his life.

The visit was organized by STOPAIDS, STOP AIDS Alliance, Results UK and Malaria No More. The United Kingdom is the fourth largest donor to UNAIDS.

The hotel InterContinental Geneva and UNAIDS have agreed to continue their partnership to highlight the urgent need to increase efforts to keep children free from HIV. At a signing ceremony held at UNAIDS headquarters in Geneva, Switzerland, attended by the Executive Director of UNAIDS, Michel Sidibé, and the General Manager of the InterContinental Geneva, Jurgen Baumhoff, UNAIDS and the InterContinental Geneva committed to continue their Where History is Made alliance.

Where History is Made is a public–private partnership that focuses on ensuring that all children are born free from HIV, that their mothers have access to life-saving medicines and that all children living with HIV lead healthy lives. The collaboration has helped to raise visibility and new funds for UNAIDS’ work since 2013.

The need to increase linkages between gender inequalities and HIV has been stressed as critical to advancing progress in health and across the Sustainable Development Goals (SDGs) at the launch of a new Centre for Gender and Global Health at University College London in the United Kingdom on 16 February.

Studies show that women living with HIV are particularly vulnerable to sexual, physical and psychological violence, and that gender inequalities, including lack of education and economic empowerment, also make women more vulnerable to HIV infection. Building on this growing body of evidence, experts at the launch emphasized that addressing gender inequalities must be mainstreamed across strategies, programmes and institutions in order to achieve the SDGs and to end the AIDS epidemic as a public health threat by 2030.

The new Centre for Gender and Global Health will work with policy-makers and policy-influencers to address the complex relationships between gender norms and health.

During the launch, speakers shared evidence on the inextricable links between gender and health. UNAIDS Deputy Executive Director Jan Beagle reflected upon institutional responses, calling on organizations to act on the evidence for the development of strategies, programmes and policies, both for an organizational focus and for the internal workings of institutions, for example with regard to staffing.

She recalled that at UNAIDS, the UNAIDS 2016–2020 Strategy and the Secretariat Gender Action Plan have prioritized gender equality, parity and the empowerment of women as fundamental to its progress on HIV and the impact across broader health, development and rights outcomes.

Noting the numerical targets and strategic focus areas of the Secretariat Gender Action Plan, Ms Beagle gave details of significant progress that has been achieved since its inception in 2013. Since the launch of the plan, the number of female Country Directors has risen from 15 (27%) to 26 (41%), and the Secretariat has nearly reached its target of 50% of women in middle management (48%). She emphasized that the progress within UNAIDS is part of a broader change agenda, through which the organizational culture is being transformed to strengthen a work environment that upholds diversity and opportunities for all.

As 2016 draws to a close, UNAIDS welcomes new funding commitments from our partners in the Nordic region for 2017. The renewed political and financial support from the Nordic countries demonstrates their confidence in our performance and UNAIDS 2016-2021 Strategy – on the Fast-Track to end AIDS.

"These investments demonstrate the importance of our shared vision to end AIDS as a public health threat by 2030 as part of the Sustainable Development Goals,” said Michel Sidibé, UNAIDS Executive Director. “We welcome these new commitments, which come at a critical point in controlling the AIDS epidemic and will enable UNAIDS to focus on improving performance, delivering results and ensuring that no one is left behind by the global AIDS response."

The Swedish government will increase its annual core contribution to UNAIDS to SEK 230 million for 2017, to provide support to low- and middle-income countries to meet the goals of the 2016 United Nations Political Declaration on Ending AIDS.

“UNAIDS leadership is critical for our collective ambition of ending AIDS and to ensure zero discrimination of people living with HIV. Sweden’s political and financial support to UNAIDS was clearly demonstrated with the additional core support of SEK 50 million during 2016 to address the financial shortfall,” said Ulrika Modéer, State Secretary, Ministry of Foreign Affairs, Sweden. “We look forward to discussions on a sustainable and strengthened business model for UNAIDS in June 2017.”

Norway will increase its core contribution by NOK 10 million for 2017, resulting in a total of NOK 130 million for 2017.

“Norway has always been a strong and active supporter of the United Nations. The unique UNAIDS model has shown that the United Nations can deliver as one, under one budget and results framework,” said Laila Bokhari, State Secretary, Ministry of Foreign Affairs, Norway. “As a donor and a UNAIDS board member, Norway will continue to support the important mission of UNAIDS."

Denmark has strengthened its commitment to the AIDS response by announcing increased support to UNAIDS to DKK 30 million for 2017.

"UNAIDS is a longstanding and key strategic partner for Denmark in our efforts to end the AIDS epidemic by 2030. UNAIDS is a front-runner in promoting human rights and addressing stigma and discrimination in the area of HIV/AIDS, particularly relating to women and young girls,” said Ulla Tørnæs, Minister for Development Cooperation, Denmark. “I am very pleased that Denmark was able to provide an additional DKK 11 million to UNAIDS in 2016."

Denmark, Norway and Sweden also provided additional financial support to UNAIDS in 2016 as an emergency measure to address the budget deficit.

UNAIDS remains hopeful that more partners will follow the Nordic countries’ leadership in increasing their political and financial support for UNAIDS to reduce the currently projected funding gap for 2017 and ensure that the world is on the Fast-Track to ending AIDS as a public health threat by 2030.

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 towards ending the AIDS epidemic by 2030. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.