PCB Programme Coordinating Board

UNAIDS Executive Director, Michel Sidibé addressing the Board. 25 June 2013, Geneva, Switzerland. Credit: UNAIDS

UNAIDS governing body, the Programme Coordinating Board (PCB) is holding its 32nd Board meeting from 25-27 June in Geneva.

In the opening session, UNAIDS Executive Director Michel Sidibé will address the Board giving an overview of the progress made in the AIDS response as well as the challenges ahead, including the position of UNAIDS in the post-2015 development agenda.  

At the invitation from Mr Sidibé, Amina J. Mohammed, the United Nations Secretary-General’s Special Adviser on post-2015 Development Planning, will share her views on the AIDS response in the post-2015 Framework and its contribution to global health and development.

The Board will also receive a report on the progress made to date and the stakeholders’ roles in moving forward to ensure that AIDS features prominently in in the post-2015 development agenda.

(From L to R) Keynote Speaker Reverend MacDonald Sembereka from Malawi and UNAIDS Executive Director Michel Sidibé interacting during the Thematic Segment on Non-Discrimination at the 31st PCB. 
Credit:UNAIDS/V.Martin

UNAIDS Programme Coordinating Board (PCB) met in Geneva this week.  In his report to the board the Executive Director of UNAIDS Michel Sidibé called on members to maintain commitment for the 1000 days leading to the 2015 target deadline and opportunities post 2015.

“Clearly, we are doing the right things, and are doing them faster smarter and better,” said Mr Sidibé. “But make no mistake––the epidemic is not over. We have an agenda to complete and must embrace the opportunity––not only to achieve an AIDS-free generation, but also to rewrite the future of global health and development.”

A stronger response for women and girls

UN Women participated in the board meeting for the first time after becoming a Cosponsor of UNAIDS last June. Emphasising the urgent need to empower women the Executive Director of UN Women Michelle Bachelet said, “Women must be equal citizens; have a life free from violence; have equal access to and control over productive resources; have greater access to education, information and prevention; and their work in the care economy must be counted, valued and supported.”

The board members also recognised the need to strengthen the response for women and requested that UNAIDS works to ensure that women and networks of women living with HIV are meaningfully engaged in all stages of planning, implementation and monitoring of the AIDS response.  

Non-discrimination

The third day a special thematic discussion on non-discrimination took place, moderated by BBC journalist Nisha Pillai. Speakers underlined that HIV-related discrimination is all too often experienced by people who are already marginalized and vulnerable, and can be devastating. Acting as a major obstacle to HIV testing, prevention and treatment, the goal of zero discrimination is essential to advancing the response to HIV.

Mr Sidibé highlighted the importance of achieving zero discrimination: “We cannot continue to address discrimination in the same way we have until now. The people we are not reaching today are the most difficult to reach because they feel they can’t come forward for fear of discrimination.”

Mr Sidibé welcomed Reverend MacDonald Sembereka from Malawi as the keynote speaker for the segment. A civil and human rights activist living with HIV, Reverend Macdonald has experienced HIV-related discrimination first hand, “Discrimination is alive and kicking in our societies – a painful and silent killer. If we don’t address the vice of discrimination the three zeros will remain a pipe dream,” he said.

He gave a moving speech on his personal struggles with dealing with discrimination, and how society should support, rather than ostracize, people affected by HIV. “The blame for continued discrimination lies with all of us––when we fail to challenge cultural practices that exclude people, ignorance that drives people from families villages and communities, old and archaic rules that lead to men who have sex with men being denied basic health care services, religious beliefs that hold people hostage to rigid interpretations sacred texts and that deny women access to education and encourage child marriage and ingrained prejudice that allows sexual violence to flourish.”

Following Reverend Macdonald’s speech, the moderator invited participants to engage in an open discussion on the response to HIV-related stigma and discrimination in different sectors, including health care, employment, education, justice and the community.

The board agreed that the theme of the next PCB would be HIV and young people. India was elected as the next Chair of the PCB with Australia as Vice-Chair and Congo as Rapporteur.

Credit: UNAIDS

The 31^st UNAIDS Programme Coordinating Board (PCB) meeting is taking place in Geneva from 11-13 December.

During the opening session, UNAIDS Executive Director Michel Sidibé will present his report outlining the progress made since the last Board meeting in June 2012, as well as the challenges ahead. At the invitation from Mr Sidibé, Dr Richard Horton, Editor in Chief of the Lancet, will share his views on the AIDS response in the Post-2015 Framework and its contribution to global health and development.

The Executive Director of UN Women, Michelle Bachelet will participate in the meeting for the first time since the UNAIDS Board approved the appointment of UN Women as the 11th Cosponsor to the Joint Programme in June 2012. The UNAIDS Board will also receive a mid-term review on the implementation of the Agenda for Accelerated Action for Women, Girls, Gender Equality and HIV.

The thematic segment of the meeting will take place on Thursday and will focus on Non-Discrimination. Participants will examine policy and programmatic actions that reduce HIV-related discrimination in various sectors, including health care, employment, education, justice and the community. The segment will also be an opportunity to discuss strategies for expanding these policies and programmes in the context of national HIV responses.

The 31^st meeting of the UNAIDS Board is being chaired by Poland.

Igor Radziewicz-Winnicki, Under Secretary of State, Ministry of Health of Poland and Chair of the upcoming UNAIDS Board meeting and UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle. 03 December 2012, Warsaw, Poland.

Government officials, civil society representatives—including people living with HIV—and other experts in the AIDS response gathered in Warsaw, Poland to discuss the challenges faced by the region with the fastest growing HIV epidemic in the world.

At the 19th annual conference on HIV, which took place from 3-4 December hosted by the Ministry of Health of Poland, participants shared best practices and explored opportunities to strengthen the AIDS response in Eastern and Central Europe.

“For obvious reasons, we are trying to focus on the situation of Eastern Europe, as this is the region where the epidemic dynamic is the highest in the world,” said Igor Radziewicz-Winnicki, Under Secretary of State, Ministry of Health. “It is one of the major epidemiological challenges at the moment,” he added.

According to UNAIDS, between 2001 and 2011, the estimated number of people living with HIV in Eastern Europe and Central Asia increased by more than 50% from 970,000 to 1.4 million. Furthermore, despite the scale up of antiretroviral coverage in the last years only an estimated 25% of people eligible for HIV treatment are receiving it.

The epidemics in the region continue to be fuelled by injecting drug use where countries have had limited progress in slowing the spread of HIV among people who inject drugs. Evidence from recently published studies suggests that accessibility to needle and syringe programmes is low in most countries in the region. Access to other HIV prevention methods such as condoms, HIV testing or treatment is also very limited for people who use drugs.

In her keynote address, UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle highlighted the need to scale up evidence-based and country-specific HIV prevention programmes focusing on the needs of key populations at higher risk. She also emphasized the need to increase access to antiretroviral treatment for all eligible persons in the region.

Although funding for HIV prevention programmes for people who inject drugs has increased in some countries, most of this increase results from the efforts of international donors. Domestic public sector sources in the region provide only 15% of spending on HIV prevention programmes for people who inject drugs. Ms Beagle called on political leaders to commit to scale up domestic investment and to increase national ownership of such programmes.

“Leaders in the region need to demonstrate strong political will to focus on the right programmes for the right people, to increase domestic investment, and to be role models in reducing HIV–related stigma and discrimination.” stated Ms Beagle.

Poland: Chairing the UNAIDS Board

The host country of this year’s conference will be the next Chair of the UNAIDS Programme Coordinating board that will take place from 11-13 December in Geneva, Switzerland. Poland is the first country of the region to be elected as Vice-chair and subsequently Chair of the UNAIDS board which is a clear recognition of their leadership in the region. Poland has played a critical role in making the issues affecting the region more visible to the Board.

Ms Beagle pointed out Poland’s exemplary collaboration with civil society organizations in designing and implementing its own national AIDS strategy. “This is a model of political engagement at multiple levels—international, regional, national and local,” stated Ms Beagle.

UNAIDS PCB delegation visiting a drop-in centre for people who use drugs and other key populations being implemented by the NGO Convictus in Kiev. 5 October 2012.
Credit: UNAIDS

Representatives from the UNAIDS Programme Coordinating Board (PCB) visited Ukraine from 4-5 October to learn about its National AIDS Programme and to experience first-hand the progress made and the challenges remaining in the country’s AIDS response. This was the first visit of the UNAIDS governing body to the Eastern Europe and Central Asia region.

The PCB delegation met with the Vice-Prime Minister and Minister of Health of Ukraine, Dr Raisa Bogatyryova, as well as with other government officials, development partners, civil society and community representatives—including members of national and regional networks of people living with HIV—and with the UN Country Team and the Joint Team on AIDS.

The meeting with Dr Bogatyryova offered an opportunity to discuss the concept of shared responsibility and to explore ways in which domestic financing could be strengthened.

The Ukrainian Government has increased the domestic investments for HIV by 10-fold (between 2005 and 2010), and has succeeded in increasing external financing especially for HIV prevention, care and support programmes for key populations. Yet, 50% of the country’s AIDS response remains dependent on donor financing.

“The current situation in Ukraine is confirming the importance of the country’s decision for the state leadership and accountability in our joint fight against HIV,” said the Vice-Prime Minister Bogatyryova. “We are committed to further scale up HIV treatment and prevention in Ukraine with a new national AIDS strategy for the next five years,” she added.

The Delegation and the Vice-Prime Minister talked about the need to scale up HIV prevention and treatment services as the current HIV treatment programme in the country is meeting the needs of only 25% of people eligible. They also highlighted the importance of creating an enabling environment to facilitate access to HIV services to key populations at higher risk of infection such as sex workers, people who use drugs and men who have sex with men.

Ukraine is experiencing the most severe HIV epidemic in Eastern Europe with an estimated 230 000 people living with HIV. Injecting drug use remains the leading cause of HIV infection in the country, with an HIV prevalence of 21.5 % among people who inject drugs.

The members of the Delegation had the opportunity to visit several health facilities to see the work being done on the ground. In the Kiev city AIDS clinic, for example, the government and civil society partners are providing services for people living with HIV and people who use drugs—including HIV and TB treatment, substitution maintenance therapy (SMT) and psychological support. Also in Kiev, the Lavra Clinic, is a specialised medical facility that provides clinical care to HIV-positive patients, and has a drop-in community centre which offers HIV testing, prevention and care for people who use drugs, sex workers and transgender people.

The delegation also interacted with women at the maternity clinic of the Kiev City Center of Reproductive Health and Perinatology, which provides services to stop new HIV infections among children as well as substitution maintenance therapy to pregnant women who also use drugs. They also talked to the service providers (medical professionals, psychologists, outreach and social workers, and volunteers) to learn more about their activities and challenges they face.

Efforts to stop new HIV infections among children and keeping their mothers alive have yielded positive results in Ukraine where 96% of pregnant women living with HIV received antiretroviral prophylaxis in 2011. Mother-to-child transmission of HIV was reduced from 28% in 2001 to 4.7% in 2009.

Throughout the visit, the delegation highlighted the key role played by civil society organizations in advocating for, and providing HIV services for key populations, care and support to people living with HIV, and in reducing stigma and discrimination towards affected communities.

PCB delegates with the UN Country Team and Joint Team on AIDS in Ukraine at the UN House in Kiev. 5 October 2012.
Credit: UNAIDS

“I have seen civil society in action in this region and I must say that it is particularly strong in Ukraine. The partnership between civil society organizations and national and local governments is essential in order to further scale up and sustain HIV services for the most vulnerable populations in Ukraine,” said Matt Southwell, the PCB NGO representative for Europe.

“The PCB field visit to Ukraine was an excellent opportunity to expose the delegation to the particular challenges of one of UNAIDS high impact countries and the most severe epidemic in Europe,” said Jan Beagle, UNAIDS Deputy Executive Director, Management and Governance. “The members of the delegation were also able to witness the critical role of UNAIDS in leading the Joint UN Team with the support of the Resident Coordinator and UN Country Team.”

The PCB delegation was composed of the Deputy Minister of Health of Poland and PCB Chair, the PCB Vice Chair from India, delegates from the United States of America, United Kingdom, Togo, the Islamic Republic of Iran and El Salvador, the European NGO constituency, three UNAIDS cosponsoring agencies (WHO, UNODC, UNFPA), and the UNAIDS Deputy Executive Director, Management and Governance.

Vice-Prime-Minister and Minister of Health of Ukraine, Raisa Bogatyrova and UNAIDS Executive Director Michel Sidibé. UNAIDS Headquarters, Geneva. 12 September 2012.
Credit: UNAIDS

A senior delegation from Ukraine led by the Vice-Prime-Minister and Minister of Health, Raisa Bogatyrova met with UNAIDS Executive Director Michel Sidibé at the UNAIDS Headquarters in Geneva on 12 September 2012. During the meeting, they discussed the existing challenges and opportunities for an effective HIV response in the country.

With an HIV prevalence among people who inject drugs of 21.5 %, Ukraine is experiencing the most severe HIV epidemic in Eastern Europe. Mr Sidibé commended Ukraine’s efforts to address the situation and highlighted the positive outcomes resulting from the availability of harm reduction services, including needle-exchange and opioid substitution therapy for people who inject drugs.

“I am very impressed by the impact achieved by harm reduction programmes in Ukraine,” said Mr Sidibé. “This is clear evidence that a combination of leadership, good policies and resources, can halt even the most severe HIV epidemic,” he added. Mr Sidibé also welcomed the Government’s commitment to provide adequate financing for the sustainability of such prevention programmes. Currently, harm reduction programmes are externally funded and implemented by civil society organizations.

“Ukraine can only overcome this epidemic in partnership with international organizations and civil society,” said Ms Bogatyrova. The national AIDS response in Ukraine—one of the most comprehensive in Eastern Europe according to UNAIDS—is characterized by a strong inclusion and collaboration between national and international partners.

The Vice-Prime-Minister also highlighted the link between HIV and national security. “HIV has a disproportionate impact on young people. From the point of view of the national security – HIV is Ukraine’s top priority.” 

The Government of Ukraine has increased the domestic investments for HIV by 10-fold in the last five years. During the meeting, ideas were exchanged on how to enhance the impact of HIV investments, scale-up HIV treatment, which currently only covers 25% of the people eligible and how to make procurement of HIV drugs more efficient.

Members of the Ukrainian delegation visiting UNAIDS. UNAIDS Headquarters, Geneva. 12 September 2012.
Credit: UNAIDS

Mr Sidibé expressed the hope that Ukraine as a large, middle-income country in the heart of Europe could serve as a model to other countries in the region for the delivery of HIV prevention, treatment, care and support services.

The preparations for the upcoming visit to Ukraine of a delegation of the UNAIDS Programme Coordinating Board (PCB) on 4-5 October 2012 were also discussed. The first visit of the PCB to Ukraine will be led by the UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle. The aim of the visit will be to learn about the country’s National AIDS Programme, which is currently being revised, as well as to experience first-hand the progress made in the AIDS response.

The PCB thematic session on combination HIV prevention engaged participants in a series of interactive activities to identify prevention priorities, including the ‘Paper Doll’ female condom campaign, pictured here.
Credit:UNAIDS/C.Rousset

If the vision of zero new HIV infections is to be achieved, a reinvigoration of HIV prevention is urgently needed. This will be most effective if a combination prevention approach is adopted, where multi-faceted and tailored programmes are implemented. An in-depth exploration of how such an approach can be implemented took place during the thematic session of the 30th UNAIDS Programme Coordinating Board (PCB) meeting in Geneva on 6 June.

The PCB heard that, despite its importance, HIV prevention is still not getting enough attention. In 2008, for example, only 20% of AIDS spending was allocated to HIV prevention.

Dr Paul De Lay, UNAIDS Deputy Executive Director, Programmes, told the assembled representatives of governments, UNAIDS Cosponsors, and NGOs, “We have proven strategies for preventing all modes of HIV transmission, but even after 30 years of effort, these effective programmatic and policy strategies still are not being provided to and used by the right populations, in the right ways and on the scale needed to curtail the epidemic.”

“Today’s subject is timelier than when it was proposed a year ago during the 28th PCB due to the recent surge in biomedical research findings,” said Dr De Lay. “But just as the range of new HIV prevention technologies is expanding, so is the need to also focus on the behavioural and structural aspects of the epidemic.”

Encompassing biomedical, behavioural and structural interventions, combination prevention strategies need to be multi-layered, context-dependent, adaptable and harmonized to have maximum impact.

Dr Marie Laga from the Institute of Tropical Medicine (ITM) in Antwerp, Belgium noted that addressing the behavioral and structural components of an epidemic is not simple and that there has been a tendency to focus on the more straightforward biomedical interventions. However, she cautioned that “…the behavioral components of HIV prevention are essential to make biomedical tools work.” She stressed the efficacy of condoms in reducing new HIV infections, an older technology but still important.

The traditional commodity approach, which considered programme elements in isolation, was also said to be too limited. A successful AIDS response must tackle both short and long term impacts, as well as immediate risks and underlying causes of risk. This will entail engaging affected communities and promoting human rights and gender equality while investing in decentralized and community responses.

Meena Seshu from SANGRAM stressed the structural barriers that sex workers face in India to access HIV prevention services as well as the high stigma and discrimination associated with the disease. Highlighting the key role played by affected communities in preventing HIV infections, Ms Seshu stressed that “sex workers are agents of change, capable of averting the epidemic with the right support. Stop moral criminalization. We are part of the solution.”

All participants emphasized that combination prevention strategies must respond to the local epidemiological and demographic requirements of different groups in a general population. The need to ‘Know your epidemic, know your response’ and know where the next 1000 infections might occur is the fundamental starting point.

“Effective HIV prevention programmes must be based on where and why HIV infections are occurring, what the current response is, and what the additional needs to prevent them are,” said Michael Bartos, Chief, a.i., of UNAIDS’ Science for Action Division. “Prevention responses will fail unless they consider the social and cultural context in which they are intending to make change.”

After the opening, four breakout sessions were organized which concentrated on specific aspects of a coherent combined prevention approach. Topics covered included young people and HIV prevention; the role of civil society and the private sector in HIV prevention; HIV and co-infection among people who inject drugs; and political commitment to HIV prevention.

The session on young people was led and organized by young people themselves and focused on HIV prevention among young people at higher risk. Issues discussed included the existing barriers to access HIV services, the need for enabling legal environments and how to increase youth participation in leading the AIDS response.

Another session paid special attention to the relationship between HIV and the viral hepatitis B and C co-infections, particularly in relation to injecting drug use. This was seen as a major public health concern in several countries in Eastern Europe and Central Asia, recognizing that co-infections cause further complications that accelerate hepatitis progression and make HIV treatment more difficult.

UNAIDS Executive Director Michel Sidibé addressing the UNAIDS Board at its 29th meeting.
Credit:UNAIDS/F. Chironi

UNAIDS governing body, the Programme Coordinating Board (PCB) is holding its 29^th Board meeting from 13-15 December in Geneva.

In the opening session, UNAIDS Executive Director Michel Sidibé addressed the Board giving an overview of progress made in the last six months by UNAIDS. In his report, Mr Sidibé also outlined the organizational changes that the Joint Programme will undertake in order to increase efficiency in helping countries achieve the goals set for 2015.

This year’s thematic segment will take place on the last day of the meeting and will focus on HIV and enabling legal environments as it was agreed at the 26th meeting of the Board. This session will allow for more in-depth understanding, consideration and discussion of the legal environment relevant to HIV, its three components (law, law enforcement and access to justice) and their impact on national HIV responses.

The board will also be informed about the progress made in the implementation of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.  

L to R: UNAIDS Deputy Executive Director, Programme Dr Paul De Lay, UNAIDS Executive Director Michel Sidibé, Health Minister of El Salvador and Chair of the 28th PCB, H. E. Dr Maria Rodriguez
Credit: UNAIDS/F.Chironi

The 28th Meeting of the UNAIDS Programme Coordinating Board (PCB) will meet in Geneva from 21-23 June.

UNAIDS Executive Director Michel Sidibé will present his progress report on 21 June followed by a presentation of the Committee of Cosponsoring Organizations (CCO) report highlighting the joint and specific Cosponsors’ activities during the previous twelve months. The report will be presented by Mr Yury Fedotov, Executive Director of UNODC, on behalf of the current CCO Chair Tony Lake, Executive Director of UNICEF.

The main item at this meeting is the Unified Budget, Results and Accountability Framework (UBRAF) 2012-2015, which the Board will consider for endorsement. As a follow up from the previous PCB meeting that took place in December 2010, the Board will receive a report on the outcomes of the thematic segment on “Food and nutrition security and HIV: how to ensure food and nutrition security are integral parts of HIV programming”, and their integration into the work of the Joint Programme. The Board will also receive a progress report on the implementation of the Agenda for Accelerated Action on Women and Girls by country.

Mr Michel Sidibé, UNAIDS Executive Director with Dr Paul De Lay, UNAIDS Deputy Executive Director
Credit: UNAIDS/Bregnard

The 25th meeting of the Programme Coordinating Board (PCB) of UNAIDS opened today in Geneva. The PCB, currently chaired by Ethiopia, is the governing body of UNAIDS and convenes two times per year.

One of the key items on the agenda is the recently concluded Second Independent Evaluation of UNAIDS 2002-2008 (SIE) , which earlier in the year was deemed both a credible and independent evaluation by the Report Oversight Committee. UNIADS has also, through a participatory process by all levels of the organization, drafted a response to the SIE to be will be presented and discussed at the meeting.

Another key agenda item is the presentation of a report on the anticipated impact that the financial crises will have on countries’ abilities to meet their universal access targets. The presentation will also outline recommendations and mitigation strategies of the impact of the global economic crisis on the AIDS response.

In the opening session, UNAIDS Executive Director Mr Michel Sidibé presented his report to the PCB, where members were provided with an update on UNAIDS’ activities since the last meeting.

Members and delegates at the 25th Programme Coordinating Board of UNAIDS
Credit: UNAIDS/Bregnard

Not just outlining recent undertakings, Mr Sidibé in his address also envisioned two key goals for a successful AIDS response. “Firstly”, Mr Sidibé said, “the AIDS movement must be leveraged as a force for transformation in global health, development and environmental sustainability.”

Secondly, Mr Sidibé called for the mobilization of a prevention revolution. The UNAIDS head stressed that by adequate investments today the number of new infections by 2015 could be halved; “2.3 million new infections can be averted and $US 12.5 billion in treatment costs saved,” said Mr Sidibé.

The PCB consists of representatives of 22 governments from all geographic regions, the UNAIDS Cosponsors, and five representatives of nongovernmental organizations, including associations of people living with HIV. The meeting runs to the 10th of December and the next time the board will sit is June of 2010.