Western Central Europe

The ambitious HIV treatment target set for 2020 greatly influenced governments and partners in their approach to the AIDS response, said senior officials of Luxembourg and UNAIDS at a briefing for diplomatic missions in Geneva, Switzerland, on 9 November.

Efforts to scale up treatment in the next five years are crucial to ending the AIDS epidemic. The 90–90–90 treatment target for 2020 calls for 90% of people living with HIV to know their HIV status, 90% of people who know their HIV-positive status to access antiretroviral treatment and 90% of people on treatment to have suppressed viral loads.

Unlike earlier treatment targets, which focused solely on the number of people starting HIV treatment, 90–90–90 focuses on the ultimate aim of HIV treatment—viral suppression, which significantly reduces both the risk of HIV-related illness and death and the risk of HIV transmission.

At the briefing, speakers from UNAIDS and Luxembourg outlined priority areas to implement 90–90–90. They reiterated that the political will and the scientific tools exist to end the AIDS epidemic. Success has been achieved in different areas and regions of the world, but more needs to be done to ensure that no one is left behind and to close the treatment gap for children.

Luxembourg, a longstanding supporter of UNAIDS, became a strategic partner this year in the push to end the AIDS epidemic as a public health threat by 2030. The alliance between UNAIDS and Luxembourg aims to leverage the therapeutic and preventive benefits of antiretroviral therapy.

At the briefing, Marc Angel of Luxembourg was appointed as a UNAIDS champion for the 90–90–90 treatment target. He has been an AIDS advocate for more than 25 years.

As a member of the Chamber of Deputies of Luxembourg since 2004, Mr Angel serves as the Chairman of the Committee for Foreign and European Affairs, for Defence, for Cooperation and Development and for Immigration of the Luxembourg Parliament.

Princess Tessy of Luxembourg made a personal visit to UNAIDS headquarters in Geneva, Switzerland, on 14 and 15 September to learn more about the AIDS epidemic as well as the work of UNAIDS.

During the visit, Princess Tessy discussed with UNAIDS Executive Director Michel Sidibé and UNAIDS experts the challenges facing the AIDS response today and explored areas where she could make a difference, particularly in support of women and girls.

Deeply involved with charities and nongovernmental organizations, Princess Tessy is very interested in young people’s access to health and eliminating gender inequality. She is also interested in using her previous experience in humanitarian work to address AIDS in emergency contexts. In 2004, Princess Tessy volunteered to take part in the United Nations mission in Kosovo as part of the BELUKOS 13/15 detachment.

Princess Tessy travelled to UNAIDS with senior staff members from the Luxembourg Institute of Health, who presented the work that the country is doing to end the AIDS epidemic.

As one of UNAIDS’ top donors, Luxemburg is a long-standing champion of the AIDS response in both its domestic approach to the epidemic and through its support to countries most affected by HIV. Luxembourg is one of UNAIDS’ strongest allies in promoting human rights in the context of HIV, addressing the needs and rights of women and girls, stopping new HIV infections among children and supporting national strategic planning to advance HIV programmes in countries.

The AIDSImpact 2015 conference held in Amsterdam from 28 to 31 July has heard appeals for the better integration of behavioural and psychosocial scientific research in the AIDS response. Researchers from around the world presented the latest findings in behavioural and psychosocial science related to HIV prevention, treatment and care, focusing both on the global level and on specific countries and communities hardest hit by the epidemic.

The conference promoted pioneering work on understanding the dynamics of a changing epidemic. There was a particular focus on new opportunities for HIV prevention thanks to the increased availability of biomedical interventions as well as of increased HIV-testing options. The key to their future success, however, lies in understanding the behavioural and psychosocial consequences, advantages and challenges in integrating such programmes within different global contexts.

Fast-Track cities

The Fast-Track cities approach was also covered during a special session on “The Tale of 3 Cities” where health officials from Sao Paulo, Amsterdam and San Francisco shared their experiences of the AIDS response. All three cities are signatories to the Paris Declaration, which commits authorities to putting their cities on the Fast-Track to ending the AIDS epidemic.   

During the conference, the economic returns of the Fast-Track approach were also discussed. Each dollar invested in ending AIDS by 2030 can generate more than US$ 17 in net returns.

Focusing on key population groups

Participants also discussed issues faced by key population groups, with a particular emphasis on the gay community and men who have sex with men. Participants heard that stigma and discrimination continue to be a major obstacle to the Fast-Track approach.

Delegates heard that the Internet and other new technologies are increasingly important in the AIDS response, offering opportunities for innovative HIV prevention programmes. 

The Belgian Minister of Development Cooperation, Alexander De Croo, has announced that Belgium will maintain its financial support for UNAIDS from 2016 to 2019. The pledge was made during a meeting between Mr De Croo, Belgian Minister of Social Affairs and Health Maggie De Block and UNAIDS Executive Director Michel Sidibé in Brussels on 3 June.

Separately, the Flemish Government also reconfirmed its financial support to UNAIDS until 2018.

During his visit, Mr Sidibé met with federal and regional government representatives. He stressed the key role played by the country’s civil society in keeping HIV on the agenda of the government. 

Belgium is currently in the process of implementing its first ever national strategic HIV plan, which was launched together with UNAIDS at the end of 2013. The plan prioritizes efforts to reach the most affected populations, such as men who have sex with men and migrant workers. Despite relatively low numbers of people living with HIV in Belgium, the AIDS epidemic remains a concern as the yearly number of new HIV infections has not declined in recent years.  

The aim of achieving the ambitious global 90–90–90 treatment targets received a boost as the Government of Luxembourg and UNAIDS hosted at high-level debate on the issue in the Belgian capital, Brussels.  

Taking place on 3 June, the debate formed part of the 2015 European Development Days, a flagship two-day European Commission event that brought together more than 5000 participants from 140 countries and 1200 organizations to explore key development concerns facing the continent.

During the HIV-related session participants examined how to build broad-based global support for the 90–90–90 agenda and identify best practices to successfully implement the targets. To achieve the 90–90–90 targets would be to ensure that, by 2020, 90% of people living with HIV know their HIV status, 90% of people living with HIV have access to antiretroviral therapy and 90% on treatment have viral suppression.

UNAIDS Executive Director Michel Sidibé told the gathering that significant progress has already been made. He noted, however, that the ultimate goal of ending the epidemic as a public health threat by 2030 cannot be achieved without new resources and investments, especially over the next five years. He stressed the catalytic and transformational role that 90–90–90 can play in the post-2015 era and towards the sustainable development goals.

It was agreed that HIV remains a global challenge, touching all continents, including Europe, where significant HIV transmission persists, and that it was necessary for every country and every region to play a key role in a renewed, multi-layered HIV response.

Michel Sidibé was joined by, among others, Luxembourg’s Minister for Development Cooperation and Humanitarian Affairs Romain Schneider, Bounkong Sihavong, Vice-Minister of Health for the Lao People’s Democratic Republic, Daouda Diouf, Director of the international nongovernmental organization Enda Santé, and Marc Angel, Chairman of the Foreign and European Affairs and Development Cooperation Commission, Luxembourg Parliament.

On 28 May, Deputy Executive Director of UNAIDS Luiz Loures visited Finland to identify avenues for cooperation to end the AIDS epidemic by 2030.

During his visit he met with representatives of the Ministry of Foreign Affairs and Ministry of Social Affairs and Health and with members of parliament to discuss how collective investments in the AIDS response have yielded impressive results and how they can be leveraged to reach people being left behind.

Mr Loures noted that all populations are not being reached equally. AIDS-related illnesses remain the number one cause of death among women of reproductive age and new HIV infections among young women and vulnerable groups remain high. Fifteen countries account for 75% of new HIV infections globally, including four of Finland’s seven long-term partner countries.

He also highlighted the need for innovative approaches to bring the benefits of science closer to communities, using data and mobile technology to better target public health investments, and expanding prevention efforts to social media to reach young people.

During his meetings, Mr Loures outlined the UNAIDS Strategy, currently being reviewed by the UNAIDS Programme Coordinating Board, which aims to break the trajectory of new HIV infections and sets forth a plan to Fast-Track the end of the AIDS epidemic as a public health threat. He also highlighted how UNAIDS’ work extends beyond the health sector to address issues of human rights, gender equality and building inclusive societies, areas that are at the core of Finland’s priorities.  

Mr Loures praised Finland’s model of economic growth and social development and said it was a model that other countries could follow. Pekka Puustinen, Director-General of the Finnish Department of Development Policy, emphasized that Finland remains committed to peace and security and that UNAIDS’ work in addressing human rights, stigma and discrimination contributes to more stable societies. Through its participation in the UNAIDS Programme Coordinating Board, Finland continues to use its experience to influence global policy on health, sexual and reproductive health and rights, and development.  

As part of the visit, Mr Loures also met with faith-based and other community organizations providing services to people living with and at risk of acquiring HIV living in Finland to learn from their experiences.

During a visit to the Netherlands, UNAIDS Executive Director Michel Sidibé underlined the importance of leaving no one behind in the response to AIDS. Mr Sidibé applauded the support the Netherlands provides in the global response to AIDS and said the country’s leadership would remain crucial to ending the AIDS epidemic as a public health threat by 2030.

During his visit, Mr Sidibé met the Minister for Foreign Trade and Development Cooperation, Lilianne Ploumen, and joined civil society and parliamentarians for a panel discussion, which was co-moderated by Princess Mabel of Orange-Nassau.

Luxembourg and UNAIDS have officially launched their partnership to accelerate progress towards the implementation of the 90–90–90 target.

The collaboration between Luxembourg and UNAIDS on the target was announced at the UNAIDS Programme Coordinating Board meeting held in December 2014. The partnership will entail the organization of high-level thematic consultations to generate political, technical and strategic recommendations to help countries achieve the treatment target. 

The first such consultation will be a technical meeting jointly organized by UNAIDS, the Centers for Disease Control and Prevention and Luxembourg, to be held on 10 and 11 February in Geneva, Switzerland. The event aims to generate a clear action agenda to close the HIV testing and treatment gap for key populations at higher risk of HIV infection, such as men who have sex with men, people who inject drugs, prisoners, sex workers and transgender people.

Under the 90–90–90 treatment target, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression by 2020. Modelling suggests that achieving this ambitious target will enable the world to end the AIDS epidemic by 2030, which in turn will generate profound health and economic benefits.

The recommendations of the series of thematic consultations will be used to help to achieve the 90–90–90 targets and to address the remaining challenges in the global AIDS response, such as inadequate diagnostic services, inefficient deployment of health professionals and the availability of HIV services for key populations and children.

Luxembourg is highly committed to its development cooperation efforts, being one of the few countries to still allocate 1% of its gross national income to official development assistance (ODA). The country focuses on a number of priority sectors in its development work; with over 12% of total ODA, health is the most important. 

In the lead up to the post-2015 development agenda, young people have been consistently calling on the international community to recognize their sexual and reproductive health and rights (SRHR) through global, regional and national consultations.

To rally a global movement to influence national positions and political will and to inspire action towards achieving the SRHR goal, UNAIDS, in collaboration with Restless Development, the International Women’s Health Coalition, the PACT for social transformation and the Norwegian Agency for Development Cooperation (Norad), convened a meeting in Oslo, Norway, from 27 to 29 January.

Participants

The event brought together some 40 organizations working on women’s rights, SRHR, lesbian, gay, bisexual, transgender, and intersex issues, and youth and HIV. UNAIDS Goodwill Ambassador, Her Royal Highness Crown Princess Mette-Marit of Norway, and the Director of Norad, Villa Kulild, also participated in the event.

Key messages

• The participants discussed the current situation regarding the post-2015 development agenda and the efforts needed to mobilize and reach youth constituencies in the final phase of intergovernmental negotiations.
• The participants shared lessons learned on high-level coalition building and opportunities to advance the youth SRHR and HIV agendas for the year ahead.
• The participants agreed to form a coalition to advance the social, economic and political determinants of health, strengthen language on SRHR, and address the lack of comprehensive sexuality education and access to health services for young people.
• The coalition will lobby for the inclusion of indicators on these topics in the accountability framework of the post-2015 development agenda.
• The coalition will advance this agenda both through advocacy in New York as well as through connecting and supporting a pool of young advocates calling for change at the country level.
• The coalition also defined the means of collaboration between the different organizations as well as their contributions to the global campaign.
• The global campaign will run from February to September 2015, with several days of action taking place at strategic moments in the lead up to the 70th session of the United Nations General Assembly.

Luxembourg has announced that it will champion the 90–90–90 treatment target and has pledged an additional €500 000 for its implementation in addition to its current multi-year funding agreement.

A collaboration between Luxembourg and UNAIDS will entail the organization of high-level thematic consultations in 2015 to generate political, technical and strategic recommendations to help countries achieve the new treatment target. Luxembourg will further use its championship to promote the 90–90–90 target at the highest political level, including within the European Union.

The announcement was made at the 35th meeting of the UNAIDS Programme Coordinating Board, taking place in Geneva, Switzerland, from 9 to 11 December 2014. The collaboration will officially be launched at the beginning of 2015.

Under the 90–90–90 treatment target, 90% of all people living with HIV will know their HIV status, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy and 90% of all people receiving antiretroviral therapy will have viral suppression by 2020. Modelling suggests that achieving this ambitious target will enable the world to end the AIDS epidemic by 2030, which in turn will generate profound health and economic benefits.

Being one of the few donor countries in the world to maintain its official development assistance at 1% of its gross national income, Luxembourg serves as an example in international development cooperation. The country is also one of UNAIDS’ top donors and has always provided strong support in addressing the needs and rights of vulnerable groups and the promotion and protection of human rights.