PEPFAR

L to R: ONE Senior Advisor and Washington Post Columnist Michael Gerson, South Africa’s Minister of Finance, Honourable Pravin Jamnadas Gordhan, EGPAF Family Ambassadors Fortunata Kasege and her daughter Florida Mwesiga, UNAIDS Executive Director Michel Sidibé, CTAOP Founder and UN Messenger of Peace Charlize Theron, BD CEO, President and Chairman of the Board, Vincent Forlenza, US Global AIDS Coordinator, Ambassador Eric Goosby.
Credit: UNAIDS/C.Kleponis

Shared responsibility of the AIDS response must become part of a new global compact. This was the central message of a high-powered breakfast meeting that took place in Washington, DC on 18 April.

The event brought together leaders in the response to AIDS with members of United States Congress, the Administration, the private sector and AIDS advocates to emphasize how the adoption of the ‘shared responsibility’ approach is translating joint efforts into real results.

The Executive Director of UNAIDS, Michel Sidibé thanked the United States for its longstanding leadership in the AIDS response through such ground-breaking initiatives as the multi-billion dollar President’s Emergency Plan for AIDS Relief (PEPFAR) and its support to the Global Fund to Fight AIDS, TB and Malaria. “The continued leadership and investment from the United States is not only helping to leverage additional resources from donor governments but also from the domestic budgets of low-and middle-income countries,” said Mr Sidibé.” 

South Africa’s experience, for example, shows how the shared responsibility is being translated into real results on the ground. The government now accounts for some three-quarters of the AIDS spending in the country and, under a Partnership Framework signed with the US, it will finance almost 90% of its response by 2017.

According to South Africa’s Minister of Finance, the Honourable Pravin Jamnadas Gordhan, “South Africans have turned the tide against AIDS. Our achievement is a tribute to the close collaboration between South Africans—government, business, researchers, and community workers—and the steadfast and generous support of our partners in the international community.”

South African film star, United Nations Messenger of Peace and founder of the Africa Outreach Project, Charlize Theron said, “The tipping point is upon us and we have an incredible opportunity to turn the tide on HIV and end the AIDS epidemic for good.  I ask that you please take this opportunity to heart and from wherever you sit—Congress, corporate America, the community—that you continue to use your power and influence to keep creating hope and help moving the AIDS response forward.  We can, we must, and we will overcome this epidemic together.”

Florida Mwesiga, Family Ambassador for the Elizabeth Glaser Pediatric AIDS Foundation, played a special role in highlighting the impact of HIV on young people. “I’m thankful that my mum was able to receive treatment that protected me from HIV while she was pregnant,” said Ms Mwesiga. “My mum continues her fight to ensure all mothers everywhere can experience the gift of an HIV-negative child,” she shared. “My mother’s courage to stand up and demand change inspires me every day. And it’s because of her that I feel so empowered to also make a difference,” added Ms Mwesiga reminding all participants that everyone has an important role to play in the response to AIDS.

It was clear by the end of the meeting that important contributions by the US to the AIDS response are crucial to achieving the ambitious but attainable goal of an AIDS-free generation. Ambassador Goosby concluded that, “Collectively, we've taken great strides in the global AIDS response. PEPFAR is proud of its close collaboration with host countries and other partners in supporting this transformational change. While much work remains to be done, through country ownership, smart investments, and shared responsibility, I am confident that we will create an AIDS-free generation.”

The event was co-hosted by the Charlize Theron Africa Outreach Project, the Elizabeth Glaser Pediatric AIDS Foundation, ONE, the United States Global Leadership Coalition, and UNAIDS. 

L to R: Director of the National Institute of Allergy and Infectious Disease, Anthony Fauci, the United States Global AIDS Coordinator, Ambassador Eric Goosby, the Director of ICAP and the Global Health Initiative at the Mailman School of Public Health, Wafaa El-Sadr and the UNAIDS Executive Director, Michel Sidibé.
Credit: UNAIDS/B. Hamilton

The World Leaders Forum and the International Center for AIDS Care and Treatment Programs (ICAP) co-hosted a special event at Columbia University entitled “A Future without HIV/AIDS: Dream or Reality?” on 28 September.

Moderated by PBS Senior Correspondent Ray Suarez, the debate brought together global health leaders, including the Director of the National Institute of Allergy and Infectious Disease, Anthony Fauci, the United States Global AIDS Coordinator, Ambassador Eric Goosby, the UNAIDS Executive Director, Michel Sidibé, and the Director of ICAP and the Global Health Initiative at the Mailman School of Public Health, Wafaa El-Sadr.

The participants engaged in a meaningful exchange of experiences around local and global responses to AIDS. The leaders were optimistic but reminded the audience of the work that still needs to be done, including improved HIV treatment and increased funding.

“The speed with which we have been able to increase the number of people on HIV treatment in just a few years has never been seen before in the history of public health,” said Mr Sidibé. “Today, 56 countries in the world have been able to stabilize the epidemic or significantly decrease the number of new HIV infections. We have broken the trajectory of new HIV infections and created a momentum which allows us to say that we are turning the tide on AIDS. But we must continue to invest in AIDS if we want to see further returns on our investments,” he added.

Speakers reflected on future obstacles and opportunities in the global AIDS response, and the need to find the balance between realistic expectations and global aspirations. The panel looked at scientific and programmatic advances in confronting the epidemic and considered the impact of the global financial crisis, as well as other health and development priorities, on the AIDS response.

Dr El-Sadr highlighted how people are taking control of the response to AIDS at the local level: “In multiple countries in sub-Saharan Africa, alongside the scale-up of treatment we are also seeing a decrease in risky behaviour at the population level and a decrease in new HIV infections. In addition to scientific discoveries and developments in health systems, people are much more engaged in trying to control the epidemic in their own communities.”

Ambassador Goosby underscored the progress made in scaling up HIV treatment: “We are approaching a moment where the number of people who are going on to treatment will exceed the number of new infections that are occurring on the planet, but it is important to look for every possible opportunity to expand capacity.” Ambassador Goosby also noted that while some funding was reduced for the President's Emergency Program for AIDS Research (PEPFAR), enhancing the efficiencies in the delivery of HIV programmes has enabled the US government to support an unprecedented number of people on HIV prevention, treatment and care in low-income countries for fewer resources.

The recently proven efficacy of using HIV treatment as prevention was highlighted as an important breakthroughs in the AIDS response. Participants agreed on the need to use it in combination with the other prevention methods available. “The combination of HIV prevention tools we have today have the capability to turn-around the trajectory of the pandemic,” said Dr Fauci. “If you also superimpose the powerful tool of treatment as prevention, we see the light at the end of the tunnel.”

While not too long ago talking about the end of AIDS would have seemed premature, participants agreed that significant progress has been made in virtually all aspects of the global AIDS response. “Now we know we can put an end to AIDS”, said Dr Fauci. “The question is – will we?”

Participants noted that the world is on track to achieve many of the ambitious goals that were set for 2015, including 15 million people accessing HIV treatment and the elimination of new HIV infections among children and keeping their mothers alive. According to the panel, the advances in science, political support and community responses have transformed the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths into a realistic objective to end the AIDS epidemic.

“If we come together, bring the knowledge together, bring the resources together, bring the partnerships together and work together we can turn the tide and transform this epidemic. This is a transformative moment,” concluded Dr El-Sadr.

Ambassador Eric Goosby speaks at the Satellite Session on the Global Plan towards the elimination of new HIV infections among children during International AIDS conference in Washington, on July 24, 2012. Credit: UNAIDS/Y. Gripas

WASHINGTON DC, 24 July 2012— Speaking at a satellite session today at the XIX International AIDS Conference, Ambassador Eric Goosby, the U.S. Global AIDS Coordinator, and Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), commended countries and their international partners for recent progress in preventing new HIV infections among children and saving mothers’ lives.

“The latest data is encouraging and a testament to the dedication and tireless work under way to virtually eliminate new paediatric infections,” said Ambassador Eric Goosby, who leads the President’s Emergency Plan for AIDS Relief (PEPFAR).  “The United States is committed to working with countries to succeed in this mission and achieve the goal of an AIDS-free generation.”

A steep decline in new HIV infections among children

According to a new report from UNAIDS, there were an estimated 330 000 new HIV infections among children globally in 2011—a 24% reduction since 2009, when about 430 000 children were newly infected with HIV. Among 21 Global Plan priority countries in sub-Saharan Africa, the estimated number of children newly infected with HIV fell by 25%, from 360 000 in 2009 to 270 000 in 2011.

Progress has been made possible through rapid improvement in access to services that prevent mother-to-child transmission of HIV (PMTCT). There was a dramatic increase in coverage of PMTCT services in the 21 priority countries between 2009 and 2011: from 34% to 61%. HIV transmission rates from mother-to child have also declined since 2010 with the introduction of more effective prophylaxis regimens.

“We know how to get to zero—science has shown the way,” said the UNAIDS Executive Director. “The only thing that can stop us now is indecision or a lack of courage. Through strengthened political will and financial resources, we can reach our twin goals of zero new HIV infections among children and zero AIDS-related maternal deaths.”

AIDS-related maternal deaths also on the decline

The estimated number of pregnancy-related deaths among women living with HIV fell from 46 000 in 2005 to 37 000 in 2010—a 20% reduction. Among 21 high-priority countries, pregnancy-related deaths among women living with HIV fell from 41 500 in 2005 to 33 000 in 2010.

Despite significant progress, challenges remain. In sub-Saharan Africa, AIDS continues to be the leading cause of maternal death. And among children born to HIV-positive women, one in five was infected with HIV through pregnancy or breastfeeding in 2011.

The Global Plan

Spearheaded by UNAIDS and the U.S. Office of the Global AIDS Coordinator, the Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive was unveiled in June 2011 at the UN General Assembly High Level Meeting on AIDS. It has two main targets for 2015: a 90% reduction in the number of children newly infected with HIV and a 50% reduction in the number of AIDS-related maternal deaths.

Reaching these targets will require accelerated action across a number of key areas including: preventing HIV infections among women of reproductive age; avoiding unintended pregnancies; reducing HIV transmission from mother to child; and providing treatment, care and support to mothers living with HIV and their families.

UNAIDS and PEPFAR bring together Health Ministers and partners from countries with the highest numbers of new HIV infections in children to scale up progress.
Credit: UNAIDS/A.Obeid

Ministers of Health and representatives from the 22* countries with the most new HIV infections in children have come together to report on progress towards achieving zero new HIV infections in children by 2015 and find ways of stepping up action.

In 2010, an estimated 390 000 children were born with HIV. However, with access to comprehensive HIV services the risk of transmission can be reduced to below 5%. In response to this, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) convened partners to develop a global plan to stop new HIV infections among children by 2015 and keep their mothers alive. The plan focuses on the 22 countries in which 90% of new HIV infections in children occur, 21 of which are in sub-Saharan Africa.

“By uniting our forces across boundaries, institutions and communities, we will leverage this historic opportunity to welcome the first generation born free of HIV by 2015,” said UNAIDS Executive Director, Michel Sidibé. “By building bridges between the movements of AIDS, maternal and child health and women’s movements, we will quicken the pace of this race towards zero.”

Since the launch of the Global Plan at the 2011 High Level Meeting on AIDS, great strides have been made in reducing HIV infections among women of reproductive age and expanding access to antiretroviral therapy for pregnant women living with HIV. However, progress is not being scaled up as quickly on meeting the family planning needs of women living with HIV, preventing maternal mortality and ensuring that all children living with HIV have access to antiretroviral therapy. All of which are key elements in the global plan to achieve zero new HIV infections in children.

“We have the knowledge and the tools to ensure that all children are born HIV-free and that their mothers are healthy,” said United States Global AIDS Coordinator Ambassador Eric Goosby. “Countries are at the forefront of efforts to achieve this vision, and as partners, we are firmly committed to their success.”

During her welcoming remarks, the Director General of the World Health Organization, Margaret Chan emphasized the full commitment of her organization towards the success of the Global Plan. “This is an ambitious, noble and achievable cause,” said Dr Chan. “It is also a great opportunity to make progress towards the integration of health services in countries.”

The President of the 65^th World Health Assembly emphasized the need to raise awareness among communities to ensure that both men and women have access to HIV services for their own health and to prevent HIV infections in children. “Women still face stigma and discrimination when found HIV positive,” said the Health Minister from Côte d’Ivoire, Thérèse N’Dri-Yoman. “Women will not disclose their status and therefore won’t access HIV services unless communities provide them with the support they need.”

Ministers shared their ideas and experiences on four focus areas related to the implementation of the Global Plan: Financing and political ownership; quality of care; community engagement; and human resources.

Speaking about innovative methods of funding, Zimbabwe’s ‘AIDS Levy’ was praised as an example of a sustainable national initiative to mobilize resources for the AIDS response. “Even though no one likes to pay taxes, people are recognizing the utility of the AIDS Levy given the results achieved in the AIDS response,” said Zimbabwean Minister of Health and Child Welfare, Henry Madzorera.

Namibia’s Minister of Health and Social Services, Richard Kamwi, also explained how his country is rapidly increasing its domestic contribution to the overall resources allocated to the AIDS response.   

The integration of services to provide better quality of care for women was also stressed as a key element by several countries. In Tanzania, for example, the Minister of Health and Social Welfare, Hussein Mwinyi, reported that currently all family planning services integrate HIV services and vice versa. Similarly, the Government of Ghana has issued a policy to provide free family planning to all. Botswana, one of the most advanced countries in preventing mother-to-child transmission of HIV, has integrated HIV services in all health settings providing antenatal care to pregnant women. “We are doing everything possible to bring health to people,” said Botswana’s Minister of Health John Seakgosing.

Countries like Burundi, Chad and the Democratic Republic of Congo reported efforts to increase the capacity of health care providers with initiatives such as nurse-driven antiretroviral treatment programmes, expanding service delivery outlets and promoting decentralization.

The importance of community engagement in implementing the Global Plan in countries was stressed by Lucy Ghati from the National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK). “Communities are critical if prevention of mother-to-child services are to be scaled up,” said Ms Ghati. “Women living with HIV must be represented on local and national committees to determine what their needs are as well as to ensure ownership of the response.” Similarly, France’s AIDS Ambassador Mireille Guigaz said, “Every time we look at the problems of women and children we have to get as close as possible to communities. If we don’t give them the opportunity to express how they feel and take their experiences into account, we won’t be able to provide a successful response to AIDS.”

The Deputy General Manager of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Debrework Zewdie, noted that 15% of the funding for HIV prevention goes to the elimination of new HIV infections among children. However, she highlighted that the Global Fund is demand-driven and that countries must request the funds.

Sweden’s AIDS Ambassador Anders Nordström emphasized his country’s commitment to preventing new HIV infections among children and said that Sweden would be allocating US$ 15 million to support Global Plan efforts.

Business Leadership Council for a Generation Born HIV-Free CEO John Megrue reinforced the commitment of the private sector to eliminate new HIV infections among children and keep their mothers alive. He highlighted that the organization will focus its efforts on mobilizing resources among the private sector, advocating for other companies to join the council and to helping countries to accelerate implementation of the Global Plan.

The meeting was the first annual face-to-face gathering of representatives from the 22 focus countries since the launch of the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping Their Mothers Alive in 2011.

*The 22 priority countries are: Angola, Botswana, Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Swaziland, Uganda, United Republic of Tanzania, Zambia and Zimbabwe.

Front L to R: U.S. Global AIDS Coordinator Ambassador Eric Goosby, UNAIDS Executive Director Michel Sidibé and Nigeria’s First Lady Dame Patience Jonathan.

Preventing new HIV infections among children and saving mothers’ lives were high on the agenda in a two-day mission to Nigeria by Michel Sidibé, UNAIDS Executive Director, and Ambassador Eric Goosby, the U.S. Global AIDS Coordinator. The visit occurred nearly one year after world leaders—including Nigerian President Goodluck Jonathan, Mr Sidibé and Ambassador Goosby—launched The Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive.

Each year, nearly 400 000 children are born with HIV globally. Nigeria carries about one third of the global burden of new HIV infections among children. It is one of 22 priority countries of The Global Plan which, combined, account for nearly 90% of all new HIV infections among children annually.

During the mission, Ambassador Goosby and Mr Sidibé met with Nigeria’s First Lady Dame Patience Jonathan, who leads the country’s prevention of mother-to-child transmission (PMTCT) acceleration strategy, to identify bottlenecks to PMTCT scale up at both the national level and in priority states. Discussions with the First Lady centered on how to optimize and increase all available resources for PMTCT in the country. 

“I will remain steady in my resolve to continue to provide the necessary leadership and support to achieve our national target of eliminating mother to child transmission of HIV in Nigeria,” said the First Lady.

The First Lady also thanked the participants of the mission for their commitment to assisting Nigeria in the critical area of health development, which is a key element of President Jonathan’s “Transformation Agenda.”

“There are no longer technical or scientific barriers preventing us from eliminating the transmission of HIV from mother to child,” said Ambassador Goosby, who heads the President’s Emergency Plan for AIDS Relief (PEPFAR). “Working together, we will address head-on the challenges to achieving elimination in Nigeria and identify the most effective way forward.  Preventing new HIV infections in children is a smart investment that saves lives and gives them a healthy start in life.”

In meetings with leaders from private sector and civil society, including the interfaith community, Ambassador Goosby and Mr Sidibé stressed the importance of working in partnership to accelerate progress in the AIDS response. The delegation also met with members of the Nigerian National Steering Group of The Global Plan, which was launched earlier this month to accelerate and coordinate action on PMTCT by all partners in the country.

While calling for greater global solidarity in the AIDS response, Mr Sidibé also emphasized that country ownership would be essential to accelerate national action around PMTCT. “Our twin goals of zero new HIV infections among children and eliminating AIDS-related maternal deaths can only succeed if countries mobilize the required resources and political will,” he said.

According to government figures, an estimated 16% of pregnant women living with HIV in Nigeria received antiretroviral medicines to prevent mother-to-child transmission of HIV in 2011. There are approximately 3.5 million people living with HIV in Nigeria.

In May 2012, an annual Global Plan progress review will be held on the sidelines of the World Health Assembly in Geneva. Ministers of Health from the 22 priority countries identified in The Global Plan will convene to assess gains made in the first year of the plan’s implementation and to chart a course for continued progress.

UNAIDS Executive Director Michel Sidibé and U.S. Global AIDS Coordinator Ambassador Eric Goosby met with State governors during their visit to Nigeria. 24 April 2012.
Credit: UNAIDS/P.Ekpei

In a round-table discussion on Tuesday, high-level representatives from six Nigerian states committed to working with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to eliminate new HIV infections in children. The meeting came at the start of a joint two-day mission to Abuja by UNAIDS Executive Director Mr Sidibé and Ambassador Goosby, the U.S. Global AIDS Coordinator.

The six Nigerian states represented at the discussion were among the priority states identified for urgent implementation of a national scale-up plan to eliminate new HIV infections among children.

“Even though policies are formed at the national level, only if you assume leadership can new HIV infections among infants be eliminated in your states,” said Mr Sidibé, addressing the Governors of Kano, Benue and Nasarawa States as well as the Deputy Governors of Cross River, Akwa-ibom and River States.

Nigeria carries about one third of the global burden of mother-to-child transmission of HIV. It is one of 22 priority countries of The Global Plan towards the elimination of new HIV infections among children and keeping their mothers alive—a roadmap to ending new HIV infections among children worldwide by 2015.

During the meeting, Mr Sidibé saluted Nigerian President Goodluck Jonathan for participating in the launch of The Global Plan last June at the United Nations in New York. Together with Ambassador Goosby, he suggested that a few key Nigerian states, in close collaboration with UNAIDS and PEPFAR, could step up efforts to end mother-to-child transmission of HIV.

Ambassador Goosby acknowledged the importance of the gathering. “These governors recognize the importance of addressing paediatric infections in their respective states. Their leadership will not only help Nigeria reduce the number of infants from being infected by HIV, but it will help advance the overall goals of The Global Plan,” he said.

Benue State in north-central Nigeria has an HIV prevalence of 10.6%—the highest of any state in the country. Calling himself a strong advocate for ending HIV, Benue State Governor Gabriel Suswam said that he often takes HIV tests to encourage others to go for testing.

Nasarawa State Governor, Umaru Tanko Al-Makura, said his State has an agency that supervises the care of people living with HIV and is ready to cooperate with efforts to eliminate mother-to-child HIV transmission.

The discussion ended with a call by Kano State Governor, Rabiu Kwankwaso, to create an event that would shine a spotlight on HIV and ensure that the issue came to the forefront once again in Nigeria.

During the joint mission in Nigeria, Mr Sidibé, Ambassador Goosby and other participants in the delegation—including Peter McDermott of the Children’s Investment Fund, Anil Soni of Business Leadership Council and other members of the steering group for The Global Plan—will meet with high-level government officials, business leaders, and representatives from civil society and the inter-faith community. They will also commemorate victims of last year’s bomb attack on UN House in Abuja.

The delegation of United States Congressional staff members visited the ASAZA project, one of the main programmes in the country responding to gender violence and child sexual abuse.

A delegation of nine United States Congressional staff members travelled to Zambia from 18 – 24 February. The aim of the visit was to have a first-hand understanding of the progress made and challenges remaining in scaling up HIV treatment, care and prevention programs in one of the most heavily impacted countries Sub-Saharan Africa.

The trip, organized by UNAIDS in collaboration with the Office of the United States Global AIDS Coordinator and the American Embassy in Lusaka, provided Congressional staff with an overview about how the United States government and the United Nations system are working with the Government of Zambia to support the country’s AIDS response.

“What I have seen this week only reinforces my belief that the United States has a critical role to play in helping local communities address the many profound challenges posed by AIDS,” said Diana Ohlbaum, Democratic Congressional staffer co-leading the visit. “It’s inspiring to see how much of an impact what we do in Washington has here on the ground in Zambia,” she added.

Zambia has an estimated HIV prevalence of 13.5% with more than a million people living with HIV. Each year there are an estimated 82 000 new HIV infections in the country. While there has been important progress in scaling up access to antiretroviral treatment and in reducing new infections among children, the delegation saw a need for greater efforts to address the structural causes of vulnerability to HIV such as gender disparities.

The delegation visited a variety of programs in Lusaka, Monze and Livingstone—including programs focused towards the elimination of new infections among children, male circumcision and access to HIV treatment. The group also learned about the opportunities to integrate HIV programs and other primary health services, including the recently launched Pink Ribbon-Red Ribbon Initiative which seeks to better integrate HIV and cervical cancer programs.

Gender violence and child abuse

The delegation visited one of the main programmes in the country responding to gender violence and child sexual abuse. The programme, hosted at the Mazabuka District Hospital outside Lusaka, has been supported by both United States and United Nations funding and is designed to mitigate the impacts of sexual and gender-based violence.

ASAZA also supports a men’s network which works through traditional leaders in both urban and rural settings to change behavior and set new social norms among men.

Known as the ASAZA program, short for “A Safer Zambia”, the project supports survivors of sexual and gender-based violence through integrated care and long-term assistance and by working with surrounding communities to make it less common. Some of the support provided includes the collection and preservation of forensic evidence, prosecution of perpetrators, provision of medical treatment and facilitation of links to safer houses and survivor support groups.

ASAZA also supports a men’s network which works through traditional leaders in both urban and rural settings to change behavior and set new social norms among men. 

“We know that gender-based violence and abuse are contributors to the AIDS epidemic in many countries,” said Lisa Carty, Director of the UNAIDS office in Washington, DC. “To see the model developed at ASAZA, particularly the involvement of the men’s network, and to hear the courageous stories of gender-based violence survivors is proof that communities can take action to combat gender violence.  We all need to support this type of innovative approach,” she added.

WASHINGTON D.C./GENEVA, 8 November 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) commends the United States Government on its continued leadership in the AIDS response following the call by the US Secretary of State Hillary Rodham Clinton for global solidarity to “change the course of the epidemic and usher in an AIDS-free generation”.

“Leadership from the United States has been vital to the AIDS response to date and will be key to seizing this historic opportunity,” said Michel Sidibé, Executive Director of UNAIDS. “Secretary Clinton has reaffirmed the United States’ Government’s strong commitment to this effort and has described a vision that should inspire us all. I hope that her call will galvanize leadership from around the globe to accelerate efforts to end the AIDS epidemic.”

In her speech, the US Secretary of State outlined the far-reaching impact of scaling up scientifically proven prevention strategies in combination with new and emerging developments in HIV science and research. These strategies include: elimination of new HIV infections among children, increased voluntary medical male circumcision, and expanded access to treatment.

Earlier this year UNAIDS highlighted the significance of the recent research demonstrating that people who access treatment early can reduce their likelihood of transmitting HIV to a partner by 96%. The potential impact of treatment for prevention will change attitudes, connect communities and motivate millions of people find out their HIV status and to talk openly with their partners about HIV.

To achieve an AIDS-free generation, the US Secretary of State reiterated UNAIDS’ call for greater engagement and investment in the global AIDS response by both donor and recipient countries.

UNAIDS underlines the importance of shared responsibility in the AIDS response. Shared responsibility is one of the central pillars of UNAIDS’ strategy to reach zero new HIV infections, zero discrimination and zero AIDS-related deaths by 2015.

UNAIDS is already working closely with PEPFAR and other partners around the world to achieve the ambitious goals UN member states committed to in the 2011 Political Declaration on HIV/AIDS. Achieving these goals will bring the world one step closer to an AIDS-free generation.

UNAIDS Executive Director Michel Sidibe speaking at the launch of the Congressional HIV/AIDS Caucus on Capitol Hill, Washington, DC. 15 September 2011.

The United States Congress has launched a new bi-partisan caucus to strengthen the US’s response to AIDS both at home and around the world and maintain its position as a global leader on AIDS. The launch of the bipartisan Congressional HIV/AIDS Caucus was announced at an event in Washington DC by the three Caucus co-chairs; Congresswoman Barbara Lee; Congressman Trent Franks and Congressman Jim McDermott.

The co-chairs were joined, among others, by the Executive Director of UNAIDS, Michel Sidibé, who commended the US on its continued commitment to HIV. "The United States' global leadership and the generosity of the American people have made a profound and positive difference in the AIDS epidemic. This sustained commitment, across political administrations for more than a decade, has saved millions of lives. And I am counting on the Congressional HIV/AIDS Caucus to continue to play a critical role in shaping the future of the AIDS response."

The United States has played a leading role in the global responding to HIV and its commitment is the largest by any country for a single disease. In 2003 President George W. Bush launched the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) which now has partnerships in 30 countries worldwide and has committed nearly US$ 39 billion to HIV and TB since its inception.

In 2010, PEPFAR estimates that its funding and programmes directly supported life-saving antiretroviral treatment for more than 3.2 million men, women and children worldwide.

“We cannot fool ourselves into thinking that we have HIV under control, because we don’t,” said Congressman Jim McDermott, Co-Chair of the Congressional HIV/AIDS Caucus. “Despite the enormous progress we have made over 30 years, we still have no vaccine, and treatment remains out of reach for so many. We have to keep our eye on the ball and continue pushing forward: prevention, treatment, and finding a vaccine must remain our focus.” 

The caucus currently has around 60 members and will focus its work on some key thematic areas; sustaining U.S. leadership and funding for HIV; promoting scientific advances; strengthening U.S. domestic programs and expanding the role of faith-based organizations. It will also provide opportunities to galvanize new leadership in preparation for the International AIDS Conference to be held in Washington, D.C. in July 2012.

U.S. Global AIDS Ambassador Eric Goosby, Jeff Crowley of the White House Office of National AIDS Policy, Michael Gerson from the Washington Post, and a number of advocates from the faith community and the U.S. domestic AIDS advocacy community also participated in the launch.

A version of this story was first published at www.unicef.org  

Actress Lupita Nyong'o in a scene from the Kenyan TV drama ‘Shuga’.
Credit: UNICEF

At its New York headquarters, UNICEF highlighted a recent collaboration with MTV through a screening of ‘Shuga’, a three-part TV drama about a group of young friends living in Nairobi, Kenya. As they explore the complexities of love, the characters confront the risk of HIV infection – and learn that a positive test result is not a death sentence.

MTV produced the programme in collaboration with UNICEF and other partners, including the US President’s Emergency Plan for AIDS Relief, or PEPFAR.

MTV has a long standing commitment to the AIDS response and has been partner of UNAIDS and its co-sponsors since 1996.

Partnerships like this one play a vital role in UN’s efforts to halt and reverse the AIDS pandemic. When it comes to delivering messages about HIV prevention, working with media and entertainment partners such as MTV provides a valuable – and credible – connection to young audiences.

‘Meaningful engagement’

“It’s fast, it’s furious, it’s cool – and that’s exactly how we filmed it,” said actress Lupita Nyong’o, who plays a lead role in ‘Shuga’ as Ayira, a college student who finds herself torn between a boyfriend her own age and an older man. Ms. Nyong’o attended the screening and a panel discussion that followed, along with representatives of key partners in the project.

UNICEF collaborated with MTV to create ‘Shuga’, a TV drama set in Nairobi, Kenya. It includes messages about HIV prevention for young people.
Credit: UNICEF

The series shows how behaviours – including sexual involvement with multiple partners, sexual exploitation and alcohol abuse – can make young people more vulnerable to HIV.

During the panel discussion, PEPFAR Senior HIV/AIDS Prevention Advisor Tijuana A. James-Traore noted the programme’s power to speak effectively to young viewers.

“This is really what we mean when we talk about the meaningful engagement of young people in issues that impact their own lives,” she said. “No other person or persons, I think, could have communicated the messages in the way these young people have done.”

A regional priority

Messages about AIDS prevention are especially crucial in eastern and southern Africa, the heart of the global epidemic.

Lupita Nyong'o, a star of the Kenyan TV drama ‘Shuga’, attended a screening of the programme at UNICEF headquarters and took part in a panel discussion that followed.
Credit: UNICEF

“Young women in eastern and southern Africa are particularly severely affected by HIV,” said the Senior Specialist in HIV Prevention with UNICEF’s Unite for Children, Unite against AIDS campaign, Susan Kasedde. “In some countries, as many as three young women to each young man are infected,” she added.

Starting a dialogue

While popular dramas like ‘Shuga’ will not end the epidemic on their own, they can lead to dialogue about the risks of HIV infection. They can also help to combat the stigma that people living with HIV sometimes face.

“We’re not the silver bullet,” said MTV International’s Vice President for Social Responsibility, John Jackson. “We’re not going to solve this problem. But we’re a critical player in getting a certain section of our community to think, to have a conversation they might not have otherwise.”

The Bill and Melinda Gates Foundation is assessing the effectiveness of ‘Shuga’ in changing behaviour within its target audience. For some members of the cast, that change has already begun.

“Especially where we were doing the scenes where we were doing the HIV testing,” said Lupita Nyong’o, “there was a hush on the set. It was a heavy time for us, and a lot of the actors said, ‘This is real. Yeah, this is real – and I need to make a change in my life.”