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GENEVA, 25 November 2020—Today, on the International Day for the Elimination of Violence against Women, UNAIDS is calling for the world to urgently scale up efforts to eliminate the neglected pandemic of violence against women and girls in all their diversity, a widespread human rights violation that affects one in three women at least once in their life.

Prior to the COVID-19 pandemic, it was estimated that globally 243 million women and girls aged 15–49 years had been subjected to sexual and/or physical violence perpetrated by an intimate partner in the past 12 months. Evidence shows that the COVID-19 pandemic has resulted in significant increases in gender-based violence in nearly all countries.

“The growing evidence confirms that the impacts of the COVID-19 pandemic are not gender-neutral,” said Winnie Byanyima, UNAIDS Executive Director. “The impacts of lockdowns and travel restrictions imposed in many countries to curb the spread of the COVID-19 pandemic,  the failure to designate sexual and reproductive health services and services for survivors of violence as essential services, and the undermining of women’s economic security have  compounded the barriers for women and girls experiencing abuse, especially those who are trapped at home with their abusers.”

Adolescent girls and young women are also increasingly being subjected to early marriage and trafficking, missing out on education because of school closures and lacking access to comprehensive sexuality education and sexual and reproductive health services, including contraception and abortion, as a result of the COVID-19 pandemic.

COVID-19 is increasing violence against women and amplifying existing gender inequalities, further exacerbating HIV risks and vulnerabilities for women, at the same time that access to gender-based violence services, as well as HIV and other sexual and reproductive health services, are being reduced or are unavailable during the pandemic. Violence against women is a major factor driving risks for HIV—in areas with a high HIV burden, such as sub-Saharan Africa, women subjected to intimate partner violence are 50% more likely to be living with HIV. And men who are perpetrators of violence against women tend to be at higher risk of HIV themselves and to use condoms less frequently, thus increasing the risk of HIV transmission.

Violence, or the potential for it, discourages many women and adolescent girls living with HIV from disclosing their HIV status to their partners, families and health-care providers, making it more difficult for women and girls to stay on HIV treatment.

Gender-based violence restricts women’s and girls’ decision-making and erodes their sexual and reproductive health and rights, including deciding if, how, when and with whom they have sex, their ability to protect their health and their ability to access HIV prevention services and stay on treatment.

“The COVID-19 pandemic has reflected once again just how unacceptable it is to continue with half measures and unmet commitments to ending violence against women,” added Ms Byanyima. “If we are serious about achieving gender equality, and ending AIDS, preventing gender-based violence must finally become a global, national and local priority.”

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 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 23 November 2020—The latest progress report of the Global HIV Prevention Coalition shows that despite observed declines in new HIV infections among adults in several countries, overall progress in HIV prevention efforts remains variable and is too slow to reach the 2020 targets committed to at the 2016 United Nations High-Level Meeting on Ending AIDS.

“We can’t end AIDS if year after year people continue to become newly infected with HIV,” said Winnie Byanyima, Executive Director of UNAIDS. “This year is a milestone for taking stock of a decade of progress towards ending AIDS by 2030. Sadly, the world has come up short against the commitments made to drastically reduce new HIV infections.”

In 2016, United Nations Member States committed to reach a worldwide HIV prevention target of fewer than 500 000 new HIV infections among adults by 2020, a 75% reduction from 2010. By the end of 2019, the reduction was just 23%, with 1.7 million people becoming infected with HIV last year.

Launched in 2017, the Global HIV Prevention Coalition aims to bring fresh momentum and clarity to HIV prevention programmes in 28 focus countries—the 28 countries worldwide with the greatest burden of new HIV infections. The 28 coalition countries have identified and promoted priority programme approaches and interventions, rekindled political commitment for HIV prevention and guided and supported programme implementation.

Progress in reducing new HIV infections in coalition countries is varied. In Eswatini, for example, new HIV infections declined by 64% between 2010 and 2019. In Pakistan, on the other hand, there was a 74% increase. But in 26 coalition countries new HIV infections declined.

The report notes that there has been significant progress in implementing 10 strategic actions set out in the Global HIV Prevention 2020 Road Map, but a number of countries still have difficulties in changing underlying factors that hold back effective HIV prevention programmes, including shortfalls in financing, insufficient action on addressing the obstructive legal, policy and structural barriers that hinder programmes for key and vulnerable populations and the slow adoption of guidance on social contracting.

“To drastically reduce new HIV infections, we have to bridge the gaps and dismantle barriers that deny adolescent girls, young women and key populations access to quality, respectful sexual and reproductive health services. It’s time to end, once and for all, all forms of stigma, discrimination and marginalization that stand in their way,” said Natalia Kanem, Executive Director of the United Nations Population Fund.

The COVID-19 pandemic is an additional challenge to maintaining progress in HIV prevention this year. Of particular concern are disruptions in HIV prevention services such as voluntary medical male circumcision, interrupted access to prevention commodities, including safe injection supplies, the effects of lockdowns on educational and social support services and the interplay between economic downturns and heightened HIV risk behaviours and vulnerability. This year’s report therefore begins to document adaptations that countries are taking to mitigate the potential effects of the COVID-19 pandemic.

The progress report was launched at a virtual meeting of ministers of health from Global HIV Prevention Coalition focus countries at which members took stock of the progress to date, with the aim of charting a way forward for the next five years on the road to ending AIDS by 2030.

“HIV prevention will be at the core to the new global AIDS strategy for the next five years,” added Ms Byanyima. “Together with the United Nations Population Fund and the rest of the UNAIDS Joint Programme, we will support the Global HIV Prevention Coalition to reach our ultimate goal of zero new HIV infections.”

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 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

A new television series for young people in the Kyrgyz language, School Elections, was launched online last week. During six 15–20-minute episodes, a girl, Ayana, who is living with HIV, tells her story of bullying, friendship and the fight for human dignity. The producers of the series hope that Ayana’s example will give hope to young people who face similar challenges.

“We have a simple idea to promote: you may differ from others in your health, appearance or level of wealth. But regardless of this, we all deserve respect, friendship, love and happiness. This series is about kindness and acceptance of others as they are,” said Azim Azimov, Head of Production at the Media Kitchen production studio and the main screenwriter of the series.

Starting on 6 November, new episodes will be aired weekly on YouTube and will also be broadcast on television, Instagram and the teens.kg youth project website. Additionally, each series has one to three interactive episodes—the leading actors invite the viewers to look at the problems raised in the series through the viewers’ eyes, experience each situation for themselves and make their own decisions.

According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), more than 30% of students around the world experience various forms of bullying at the hands of their classmates. Students who are perceived as “different” are often subjected to bullying for reasons of appearance, health status, including HIV status, sexual orientation and gender identity, social status or the economic situation of the family.

“This series tells people about the complex issue in simple and understandable language, to show how strong-willed and honest young people can overcome ignorance, indifference, cruelty and injustice, inspire others and change life for the better,” said Tigran Yepoyan, UNESCO Regional Adviser on HIV, Education and Health.

“This series is a powerful new instrument for reducing stigma in our society, it not only shows the difficulties of living with HIV, discrimination and bullying but also motivates our adolescents not to be afraid to fight for dignity and justice and move forward towards their dreams,” said Meerim Sarybaeva, UNAIDS Country Director for Kyrgyzstan.

The official soundtrack of the series, which was supported by the UNESCO Institute for Information Technologies in Education and UNAIDS, was performed by the singer Ayim Ayilchieva.

The World Health Organization (WHO), in coordination with UNAIDS, has updated its HIV Testing Services dashboard with new data for 2020, ahead of this year’s World AIDS Day.

The interactive dashboard gives users a wide range of information on HIV testing from countries worldwide on, for example, HIV prevalence, the number of people testing positive for HIV and the number of people testing for HIV for the first time or repeating a test. Data are given in charts and tables and are differentiated by age, sex and other characteristics.

“It is critical to have differentiated HIV testing data at this stage in the epidemic,” said Cheryl Johnson, WHO Technical Officer. “Having such data will help programmes to implement the World Health Organization’s guidelines so that they may reach the remaining people living with HIV who do not know their status. We look forward to working with countries on how they can use their data to guide efficient and effective HIV testing services.”

Countries need to have a range of testing approaches to reach people living with HIV who do not know their status and others at risk of acquiring HIV. The dashboard will help countries to develop the best mix of testing services—such as self-testing, index testing and various forms of community and facility-based testing services—suitable for their settings. Countries can also monitor the progress of the number of people who newly learn their HIV status.

“We are using data to intensify our efforts to reach the remaining people living with HIV who don’t know their status and to facilitate linkage to care by prioritizing and differentiating testing so we can reach underserved geographies and populations in Uganda. The dashboard is a useful tool to help guide decision-making and our national strategy moving forward,” said Geoffrey Taasi, Programme Officer, HIV Testing Services, Ministry of Health, Uganda.

The information on the dashboard is a mixture of WHO and UNAIDS data, national programme data, modelled estimates and population survey data—it also includes the implementation status of testing services and national policies. The data used were selected in consultation with representatives of ministries of health, research partners, local and international implementing partners and donors.

In addition to the website, the dashboard can be accessed through the WHO HTS Info app using a smartphone or tablet.

“Expansion of relevant HIV testing approaches is critical for Viet Nam to achieve the 90–90–90 targets. With support from the World Health Organization and other partners, we have successfully piloted community-based HIV testing, including lay provider testing and self-testing. We are now working to scale up these approaches nationwide,” said Nguyen Hoang Long, Director-General of the Viet Nam Authority of HIV/AIDS Control, Ministry of Health, Viet Nam.

The 51^st Union World Conference on Lung Health opened today under the theme “Advancing Prevention”. In light of the COVID-19 pandemic, the conference is taking place virtually for the first time in its 100-year history. The event will feature cutting edge science around tuberculosis (TB), air pollution and tobacco control, but also deliver special sessions dedicated to COVID-19 and its intersection with lung health and infectious diseases. Speakers include Her Imperial Highness Crown Princess Akishino of Japan, President Bill Clinton, Shannon Hader, UNAIDS Deputy Executive Director and Divya Sojan—a nurse and TB survivor—among others.

According to the World Health Organization (WHO) Global Tuberculosis Report 2020, there has been an encouraging 63% reduction in tuberculosis deaths among people living with HIV since 2010. This is approaching the 75% global target reduction adopted in the 2016 United Nations Political Declaration on Ending AIDS. However, the report also shows that TB remains the leading cause of death among people living with HIV, resulting in just over 200 000 deaths in 2019—30% of all AIDS-related deaths.

Less than half of the estimated 815 000 people living with HIV who developed tuberculosis disease in 2019 were found, diagnosed and reported to national programmes as receiving treatment for both conditions. The remainder are either missed by programmes, not diagnosed or treated appropriately, or their treatment is incorrectly reported. Once diagnosed however, at least 90% of people with tuberculosis knew their HIV status in over 80 countries and territories and 88% of people living with HIV on TB treatment received lifesaving antiretroviral therapy.

Tuberculosis is curable and preventable. Tuberculosis preventive treatment has been recommended by WHO since 2004 for all people newly diagnosed with HIV. It prevents tuberculosis disease and save lives. Until recently, coverage had been woefully inadequate. However, a combination of advocacy, political commitment, increased availability of shorter, more acceptable treatment options, adequate funding and community engagement has led to an impressive increase in the number of people living with HIV who received TB preventative treatment.

In 2019, WHO reported that 3.5 million people living with HIV started TB preventative treatment – compared with 1.8 million in 2018. The total for 2018 and 2019—5.3 million—already represents 88% of the 6 million target set for 2022 in the 2018 United Nations Political Declaration on Tuberculosis; suggesting that this target could be achieved ahead of schedule.

“It took decades to overcome health worker and community doubts, mobilize specific funding for TB preventative treatment and to invest in research for shorter, more effective and more acceptable treatment regimens,” said Shannon Hader, Deputy Executive Director of UNAIDS, “Now we should raise the target and increase access to and use of the best TB preventative treatment regimens for all in need.”

COVID-19 is already disrupting TB and HIV services, adding to the dual stigma that prevents people from accessing services; lockdown measures that are a further barrier to people being tested or collecting their treatment for TB and HIV and diverting human, financial and laboratory resources away from tuberculosis and HIV.

It has been estimated that globally, a three-month lockdown and a protracted 10-month restoration could lead to an additional 6.3 million people falling ill with TB and an additional 1.4 million TB deaths over the next five years. That would result in a setback of at least five to eight years in the fight against TB – bringing 2021 global TB incidence and deaths to levels not seen since 2013 and 2016 respectively – due to the COVID-19 pandemic.

“Now, more than ever, is the time for the HIV and TB communities to team up and call for investment in shorter treatment and prevention regimens and better infection control, supported by the socioeconomic and human rights protections people need,” said Shannon Hader, UNAIDS Deputy Executive Director. “Overcoming COVID-19, TB, HIV and future pandemics requires global solidarity. Together we must develop and equitably distribute combination prevention, including vaccines, and treatment to all—true universal access that prioritizes those who need it most.”

A chatbot named Eli that can answer questions about growing up, love, relationships and sexual health, including HIV prevention and treatment, has been launched on the VKontakte social network, adding to the resources for health available to young people in eastern Europe and central Asia.

Created by the United Nations Educational, Scientific and Cultural Organization (UNESCO) Institute for Information Technologies in Education (IITE), Eli answers questions on six topics—psychology, physiology, sex, relationships, family and health. The knowledge base was created by an editorial team in collaboration with health workers and psychologists using materials on, for example, sexual and reproductive health, psychological well-being and HIV prevention, testing and treatment from UNESCO, UNAIDS and other United Nations agencies.

A large proportion of Eli’s knowledge base is on HIV prevention, testing and treatment. In a dialogue with a user, Eli explains why young people who have sex may need to be tested for HIV, what kind of tests are available, where and how they can be done and why it is crucial to start antiretroviral therapy immediately if the test results show that the person is HIV-positive. Eli helps to overcome fears and concerns and motivates its users to seek medical help.

“The use of modern innovative information technologies is an indispensable element of successful HIV education and prevention among young people, and UNESCO remains the leader in this area,” said Alexander Goliusov, Director, a.i., of the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

Machine learning technologies were used to create the chatbot. Users can ask Eli a question of their own or choose one of the suggested questions. Artificial intelligence powers the response, taking into account possible connections—for example, when talking about sexually transmitted infections, Eli will give information about symptoms and diagnostic methods and will also tell the user what to do if his or her partner does not want to use protection.

Eli’s language combines expertise and respect for the user and its speech is as gender neutral as possible and free from stigma.

“Eli is an irreplaceable assistant for those who are growing up and discovering new feelings and relationships and who often need truthful information without edification and stereotypes. Eli is another step in implementing UNESCO's global strategy to empower girls and boys to increase their health literacy and to build and maintain healthy, respectful and rewarding relationships,” said Tigran Yepoyan, Head of ICT and Health Education at UNESCO IITE.

In the first week after its launch, more than 4000 people subscribed to the Eli VKontakte group and Eli answered more than 150 000 questions from 10 000 users. People also shared their feedback: “Cool and important topic!” “Eli learns and shares it with us! Go for it, Bot!” “This is very cool guys!”  “I would like to thank the creators of this project. You are doing great!”

Eli is available right now and instructions are available for those who have never used such a service.

Eli will serve as a prototype for the creation of similar chatbots in Russian and in the national languages ​​of Kazakhstan and Kyrgyzstan this year and in the languages of other countries in eastern Europe and central Asia in the future.

GENEVA, 9 October 2020—UNAIDS sends its heartfelt congratulations to the World Food Programme (WFP) for being awarded the 2020 Nobel Peace Prize. WFP’s efforts to ensure food security for all, particularly the most vulnerable women, men and children, including people living with HIV, have saved countless lives and prevented hunger and starvation in countries all around the world.

“We are so proud of WFP’s achievement and are honoured to have WFP as one of our Cosponsors, working with us to end AIDS,” said Winnie Byanyima, Executive Director of UNAIDS. “We will continue to work closely together to achieve our shared goals of zero hunger, zero new HIV infections, zero AIDS-related deaths and zero discrimination for all.”

For people living with HIV, food and nutrition are critical components of care and support. WFP’s work on HIV includes nutritional recovery for malnourished people living with HIV, support at the individual and household levels, supplying food, cash and vouchers, and linking food and health systems. As part of its HIV and tuberculosis programmes in 29 countries, WFP also links clients with social protection programmes and livelihood strengthening activities in order to ensure that health gains can be sustained in the long term, as people living with HIV need to stay on treatment for life.

WFP’s efforts have improved the lives of people living with and affected by HIV and have advanced access and adherence to HIV treatment. UNAIDS thanks WFP for its work and collaboration and congratulates WFP on its well-merited achievement of being awarded the Nobel Peace Prize.

Additional information on WFP’s work on HIV is available here.

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 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

NEW YORK, 23 September 2020—The World Health Organization (WHO) together with the UN, specialised agencies and partners today called on countries to develop and implement action plans to promote the timely dissemination of science-based information and prevent the spread of false information while respecting freedom of expression. 

WHO, the UN, UNICEF, UNAIDS, the UN Development Programme (UNDP), UNESCO, the International Telecommunication Union (ITU), the UN Global Pulse initiative and the International Federation of the Red Cross and Red Crescent Societies  (IFRC), together with the governments of Indonesia, Thailand and Uruguay held a webinar on the margins of the 75th UN General Assembly to draw attention to the harm being done by the spread of misinformation and disinformation, the latter being deliberate misinformation to advance an agenda.

“As soon as the virus spread across the globe, inaccurate and even dangerous messages proliferated wildly over social media, leaving people confused, misled and ill-advised”, said UN Secretary-General António Guterres. ”Our initiative, called “Verified”, is fighting misinformation with truth. We work with media partners, individuals, influencers and social media platforms to spread content that promotes science, offers solutions and inspires solidarity. This will be especially critical as we work to build public confidence in the safety and efficacy of future COVID-19 vaccines. We need a ‘people’s vaccine’ that is affordable and available to all.”

“Misinformation and disinformation put health and lives at risk, and undermine trust in science, in institutions and in health systems,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “To fight the pandemic we need trust and solidarity and when there is mistrust, there is much less solidarity. False information is hindering the response to the pandemic so we must join forces to fight it and to promote science-based public health advice. The same principles that apply to responding to COVID-19 apply to managing the infodemic. We need to prevent, detect and respond to it, together and in solidarity.” 

“On top of the immediate impact on pandemic responses, disinformation is undermining public trust in democratic processes and institutions and exacerbating social divides”, said UNDP Administrator Achim Steiner. “It’s one of the most concerning governance challenges of our time. UNDP is actively collaborating with Member States, fellow UN agencies, and other partners to find holistic responses which respect human rights.”

“Misinformation is one of the fastest growing challenges facing children today,” said Henrietta Fore, UNICEF Executive Director. “It takes advantage of the cracks in trust in societies and institutions and deepens them further, undermines confidence in science and medicine, and divides communities. In its most pernicious forms, such as when it convinces parents not to vaccinate their children, it can even be fatal. Because misinformation is more a symptom than a sickness, countering it requires more than just providing truth. It also requires trust between leaders, communities and individuals.” 

“We can beat COVID-19 only with facts, science and community solidarity,” said Executive Director, Winnie Byanyima. “Misinformation is perpetuating stigma and discrimination and must not come in the way of ensuring that human rights are protected and people at risk and those marginalized have access to health and social protection services.”

“Since the start of the pandemic, UNESCO has mobilised its international networks of media partners, journalists, fact-checkers, community radio stations, and experts, to give citizens the means to fight against false information and rumours — phenomena that have been exacerbated by the pandemic,” said Audrey Azoulay, the UNESCO Director-General. ”Collective mobilisation to promote quality and reliable information, while strictly ensuring respect for freedom of expression, is essential. A free, independent and pluralistic press is more necessary than ever.”

“Trust is a cornerstone of our digital world,” said Houlin Zhao, Secretary-General of the International Telecommunication Union. “Building on the long-standing WHO-ITU BeHe@lthy BeMobile initiative, ITU has been working with national ministries of telecommunications and health and mobile network operators since the beginning of this crisis to text people who may not have access to the internet, providing them with science- and evidence-based COVID-19 health advice directly on their mobile phones.”

WHO and partners urged countries to engage and listen to their communities as they develop their national action plans, and to empower communities to build trust and resilience against false information. 

“Engaging communities on how they perceive the disease and response is critical to building trust and ending outbreaks,” said Jagan Chapagain, IFRC Secretary General. “If our response does not reflect the communities’ concerns and perceptions, we will not be seen as relevant or trusted by affected populations, and the epidemic response risks failure.  More than ever, local responders are at the forefront of this crisis. We need to recognize the incredible role they play in understanding and acting on local knowledge and community feedback.”

The co-hosts also called on the media, social media platforms, civil society leaders and influencers to strengthen their actions to disseminate accurate information and prevent the spread of misinformation and disinformation. Access to accurate information and the free exchange of ideas online and offline are key to enabling effective and credible public health responses.

"UN Global Pulse was set up a decade ago inside the UN System to pioneer the use of real-time and predictive insights to protect vulnerable communities in times of crisis”, said Robert Kirkpatrick, Director of UN Global Pulse, the United Nations Secretary-General’s initiative on big data and artificial intelligence (AI). “During this pandemic we have seen a tremendous increase in requests for advanced analytics from across the UN System and Member States. We will continue to work with WHO and other partners to help identify and combat mis- and disinformation.” 

Note to Editors

WHO defines an infodemic as an overabundance of information, both online and offline. It includes accurate information as well as mis- and disinformation. 

In May 2020, WHO Member States passed Resolution WHA73.1 on the COVID-19 response at the World Health Assembly. The Resolution recognises that managing the infodemic is a critical part of controlling the COVID-19 pandemic: it calls on Member States to provide reliable COVID-19 content, take measures to counter mis- and disinformation and leverage digital technologies across the response. The Resolution also called on international organisations to address mis- and disinformation in the digital sphere, work to prevent harmful cyber activities undermining the health response and support the provision of science-based data to the public. 

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 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

This story was first published by WHO

In the first year of the Stronger Collaboration, Better Health: The Global Action Plan for Healthy Lives and Well-being for All (GAP), 12 signatory agencies have engaged with several countries to help them achieve their major health priorities. The initial focus has been on strengthening primary health care and sustainable financing for health.  Somalia is one of the countries where progress under the GAP is most advanced and where its added value has been most clearly demonstrated.

The Somalia country Director and Representative of the World Food Programme, Dr Cesar Arroyo underlined the vital importance of the GAP – through cementing collaboration among the 12 agencies: “The GAP initiative marks a crucial step towards solving health-related challenges in Somalia and offers us an opportunity to strengthen our partnerships across the humanitarian community thereby enhancing operational efficiency, particularly within the COVID-19 context and beyond”.

Three decades of civil war and instability have weakened Somalia’s health system and contributed to it having some of the lowest health indicators in the world. The situation varies from region to region but between 26-70% of Somalia’s 15 million people live in poverty and an estimated 2.6 million people have been internally displaced.

But the Government is committed to using current opportunities to strengthen health and social development. These include implementation of Somali National Development Plan for 2019–2024 and the Somali Universal Health Coverage (UHC) Roadmap, launched in September 2019.

Both plans identify primary health care as the main approach to improving health outcomes in the country.  Primary health care provides whole-person care for most health needs throughout the lifespan, ensuring that everyone can receive comprehensive care ─ ranging from health promotion and prevention to treatment, rehabilitation and palliative care ─ as close as possible to where they live.

Working together, the Government of Somalia, GAP agencies and multilateral and bilateral partners have identified 5 priorities for enhanced collaboration to accelerate progress towards UHC.

Says Monique Vledder, Head of Secretariat for the Global Financing Facility for Women, Children and Adolescents: “The launch of the Global Action Plan has helped accelerate momentum across global health agencies to align their support to country partners. In Somalia, the GFF has brought the spirit of the GAP from the global to the country level, convening partners across the federal and local governments, Somaliland, UN agencies, donors and civil society to establish the Health Sector Coordination Committee. Country stakeholders and GAP agencies are now building consensus around a priority package of essential services and critical health system reforms”.

Establishment of a health coordination mechanism
Efforts are underway to set up a coordination mechanism for all health partners to strengthen primary health care and fill gaps in services at the district level, building consensus around a priority package of essential services and critical health system reforms and mapping the availability of services and health workers.

Improving access to a package of high-quality essential health services
The country’s health services package is being updated with support from GAP agencies and other partners, with a focus on prevention and community-based components, communicable and noncommunicable diseases, and mental health.

Strengthening emergency preparedness and response through UHC
Somalia is prone to emergencies from natural disasters and disease outbreaks and is now responding to COVID-19. GAP agencies are exploring opportunities to support the finalization and implementation of components of a National Action Plan for Health Security, which includes strengthening of laboratory and early warning systems and ensuring that a package of essential health services and key commodities are effectively delivered in humanitarian settings.

Strengthening the role and capacity of the Ministry of Health
This is essential to address fragmented health service delivery and funding arrangements; improve institutional capacity for policy-making, regulation, coordination, planning, management and contracting; and use of data in decision-making.

Harnessing the private sector for UHC
Private health services and the pharmaceutical sector are largely unregulated in Somalia but could contribute to improving access and achieving UHC. GAP agencies are exploring opportunities to support the development and operationalization of a strategy for the private health sector, to assess its current role in service delivery and implementation of regulatory frameworks and contracting mechanisms.

“GAP provides us an opportunity to accelerate progress in achieving universal health coverage in Somalia through coordinated action and alignment with development partners and UN agencies. More than ever, we now need to push this agenda as we support the health systems of Somalia recover stronger and better from the COVID-19 pandemic“, said WHO Country Representative in Somalia, Dr Mamunur Malik.

“Our collective engagement in improving access to care for women, children, and other vulnerable groups will be decisive in improving health and well being in the country. Through an integrated, coordinated and collaborative approach such as the GAP, we can also build the required capacity of national and local health authorities to  deliver not only cost-effective health interventions using a primary healthcare approach, but also monitor and track porgress of the health-related indicators of sustainable development goal in the country", he added.

Although there are many health and social challenges in Somalia, the GAP is leveraging emerging opportunities to strengthen primary health care to support the country in achieving UHC and other health-related SDGs.  

To move these efforts forward, GAP agencies are collaborating with the Government to develop an operational plan. They aim to align this with the new funding that a number of agencies are providing for the response to COVID-19, to support the scale-up of primary health care, including implementation of the package of essential health services.

Within the UNAIDS Joint Programme, the United Nations Population Fund (UNFPA) is a co-convenor, together with other United Nations funds and programmes, on HIV prevention among adolescents, young people and key populations, as well as on decentralizing and integrating sexual and reproductive health and rights and HIV services. UNFPA also plays a technical role in prevention and condom programming within the Global HIV Prevention Coalition.

The UNFPA Evaluation Office undertook an evaluation to assess the performance of UNFPA in integrating its approach to supporting the response to HIV within the broader context of sexual and reproductive health and rights, population dynamics, gender equality and human rights for the period 2016–2019, the results of which have recently been published.

“The lessons and recommendations from this evaluation will strengthen the organization’s HIV response, to deliver stronger results during the United Nations Secretary-General’s Decade of Action to achieve the Sustainable Development Goals. The evaluation results are also particularly relevant as UNFPA channels its efforts to align its programming to respond to and recover from the COVID-19 pandemic,” said Marco Segone, Director of the UNFPA Evaluation Office.