South Africa

World leaders call on South-South cooperation to reverse the AIDS epidemic and lead an integrated approach to accelerate progress towards the Millennium Development Goals

NEW YORK, 22 September 2010—World leaders gathered at the United Nations called for a new model of partnership to strengthen the AIDS response and achieve broader health and development outcomes. Without synergy between AIDS and other health and development initiatives, the leaders agreed sustainable progress towards global goals to end poverty and ensuring healthy societies will not be achieved.

A high-level meeting co-hosted by China, South Africa, Nigeria, Ethiopia and UNAIDS brought together world leaders including the Premier of China, the Prime Minister of Ethiopia and Ministers from South Africa, Nigeria, Burundi, Democratic Republic of Congo, Kenya, and Rwanda. They were joined by heads of international organizations and civil society.

"The era of health and development programmes operating in isolation is over,” said Mr Michel Sidibé, UNAIDS Executive Director, who chaired the meeting. “We have to work together to make this one movement—we cannot afford to have a fragmented approach to health and development. This Africa-China partnership can be the engine that accelerates progress towards the MDGs.”

Developing countries are joining hands to push for a combined approach to health and development and giving communities a strong voice in defining their health needs. The new South-South partnership will promote innovation, local solutions that make a difference, sharing of technology, and building local capacities.

The AIDS epidemic is stabilizing globally and new infections are steadily declining around most of the world. This has been possible as the international community has made significant progress in achieving goals towards universal access to HIV prevention, treatment, care and support.

"We cannot turn a deaf ear to the call of life, and we must not be slow in reaching out,” said H.E. Wen Jiabao, Premier of China. “We should redouble our effort to advance the global campaign against HIV/AIDS and ensure that the related MDGs be met on schedule. China has been actively involved in the international cooperation on HIV/AIDS prevention and treatment."

Endorsing the UNAIDS approach of “AIDS plus MDGs”, the leaders called for the AIDS movement to take the lead in bringing about integration and innovation.

“The ‘AIDS plus MDGs’ approach seeks to bring about change that will create a new dimension of performance. Not just in the response to AIDS, but also in efforts to achieve other MDGs, accelerating progress on those that are trailing behind,” said Dr Asha-Rose Migiro, UN Deputy Secretary-General. “Progress towards reversing the HIV epidemic is therefore central to the broad international development agenda.”

Investments in AIDS have contributed to strengthening health systems and primary health care as well as better access to social welfare programmes in many countries. In Ethiopia, a strong, results-driven alliance between the Ethiopian Government and its key development partners is producing win-win results by channelling more than US$ 300 million of AIDS resources to strengthen the county’s health systems.

“Ethiopia’s strategy to integrate AIDS and health issues has not only decreased the burden on health facilities, but it has also enabled the health system to reach the vulnerable and poor,” said H.E. Meles Zenawi, Prime Minister of Ethiopia. “Community ownership of development has helped us achieve progress that is sustainable over time.”

South Africa has integrated HIV and TB services under one roof, reducing both AIDS and Tuberculosis-related deaths. Under its ambitious programme to test 15 million people for HIV, it is offering comprehensive health checkups for women and girls. In 2009, nearly 90% of all pregnant women were able to access treatment to protect their babies from being born with HIV.

“We have to strengthen primary health care services that integrate HIV, maternal and child health, sexual and reproductive health into development,” said Dr. Aaron Motsoaledi, Health Minister of South Africa. “Communities must own the health agenda which is at the centre of their own development.”

However, HIV continues to hamper progress in reducing maternal and child mortality in many sub-Saharan countries. More than 40% of all maternal mortality in countries such as Botswana (77%), Swaziland (75%), Lesotho (59%) and Zimbabwe (53%), Namibia (50%), South Africa (43%) is attributable to HIV.  Where health services are integrated, the results have been spectacular. In Pampaida, Nigeria, a Millennium Development Village in Kaduna state, there have been very few maternal deaths or children born with HIV in recent years, thanks to an integrated approach to health care delivery.

“We are saving mothers and children by strengthening the health system,” said Professor Onyebuchi Chukwu, Health Minister of Nigeria. “We are investing in health using resources from debt relief because access to good quality health care is a necessity and a basic human right, not a luxury.”

In 2000, world leaders adopted the Millennium Declaration. This milestone in international cooperation inspired development efforts that have improved the lives of hundreds of millions of people globally. Five years remain to move forward to meet the eight Millennium Development Goals by 2015.

Call for further trials needed to make promising antiretroviral gel available to women at risk of HIV as quickly as possible

GENEVA, 3 September 2010—Two further clinical trials are planned to confirm a vaginal gel which has shown potential in reducing the risk of HIV. The results of the first trial of the gel, which were announced in July at the XVIII International AIDS Conference in Vienna, must be confirmed before the product can be made available for general use.

The tenofovir-based gel was found to be 39% effective to reduce a woman's risk of becoming infected with HIV during sex in a study completed by the Centre for the AIDS Programme of Research in South Africa (CAPRISA), a UNAIDS Collaborating Centre on HIV prevention research.

The CAPRISA study was conducted in South Africa with women aged 18 to 40 years who used the gel once during the 12 hours before sex and once during the 12 hours after sex.

Experts at a meeting convened last week by UNAIDS and WHO in Johannesburg, South Africa, proposed that further trials should determine whether different populations of women will have the same level of protection as seen in the CAPRISA trial.

One study, which will take place primarily in South Africa, will establish if the CAPRISA results can be repeated in a variety of settings with a population that includes younger women. It will also evaluate whether the gel can be used safely by sexually active 16 and 17 year olds in settings where HIV incidence is high.

The other study, which will be conducted in other African countries, will examine if a different dosing schedule is safe and effective. It will test if a single application of the gel before sex, or failing that immediately after, is equally effective and safe as the original two dose regimen. The single dose schedule would be less expensive and easier for women to use.

In addition, an ongoing trial being conducted by the Microbicides Trial Network, studying the same gel but used daily, will generate additional data on safety and product use.

Research in the communities where the CAPRISA trial was carried out will also examine how to best promote, distribute, and monitor gel use through existing family planning facilities. This would allow former trial participants and others in their communities to have early access to the new gel, but within the context of programmatic research.

While participants agreed on research priorities, concerns were expressed over the limited funding committed thus far to carry forward the next phase of research, which is estimated to cost US$ 100 million. Only US$ 58 million is available.

Nearly 20 years of research have gone into microbicides. If confirmed, the tenofovir gel would empower women by adding significantly to the options they have to protect themselves from HIV without requiring the cooperation of their male partner. About half the people living with HIV in the world are women. In sub-Saharan Africa more women are infected than men. HIV is a major cause of maternal mortality.

“This promising tenofovir gel is a woman-initiated and controlled HIV prevention tool that could now be within reach,” said Dr. Catherine Hankins, Chief Scientific Adviser to UNAIDS. “Funders, advocates, and scientists can work together to close the funding gap rapidly, gather the evidence, and ensure that no time is lost in getting a safe and effective microbicide to women.”

Convened at the invitation of the South African government, the meeting brought together members of government agencies from South Africa and other countries, microbicide research teams and product developers, women’s health and HIV prevention advocates, people living with HIV, clinical and social science researchers, statisticians, civil society representatives, public health experts, ethicists, and representatives from national drug regulatory authorities.

New global initiative at the FIFA World Cup shines spotlight on the elimination of mother-to-child transmission of HIV

   (From left) Mr Michel Sidibé, UNAIDS Executive Director, and Mr Kirsten Namatandani, President of South African Football Association (SAFA) 
Credit: Juda Ngwenya

JOHANNESBURG, 12 June 2010—A new campaign is using the power and outreach of football to unite the world around a common cause—preventing the transmission of HIV from mother to child. Launched today in South Africa by the UNAIDS Executive Director, Michel Sidibé, international musician Akon, UNAIDS Goodwill Ambassador and producer of the World Cup opening ceremony, Lebo M, UNAIDS National Goodwill Ambassador, Jimmie Earl Perry, and Kirsten Nematandani, President of the South African Football Association. The campaign aims to ensure an HIV-free generation by the 2014 FIFA World Cup to be held in Rio de Janeiro, Brazil.

Each year, an estimated 430 000 babies are born with HIV globally, the large majority in Africa. Over the course of a 90-minute football match, nearly 80 babies will become newly infected with HIV. In many parts of Africa, AIDS-related illness is the leading cause of death among infants and young children.

Through the campaign—backed by international football stars and UNAIDS Goodwill Ambassadors Michael Ballack of Germany and Emmanuel Adebayor of Togo—captains of 32 World Cup qualifying teams have been invited to sign the appeal: “From Soweto to Rio de Janeiro, give AIDS the red card and prevent babies from becoming infected with HIV.” Nineteen captains have already signed on, including host country South Africa and defending champion Italy.

“By the next football World Cup we can virtually eliminate HIV transmission to babies,” said UNAIDS Executive Director Michel Sidibé who attended the campaign launch in South Africa. “Let us give AIDS the red card permanently.”

The lives of mothers and their babies can be saved through a combination of HIV testing and counselling, access to effective antiretroviral prophylaxis and treatment, safer delivery practices, family planning, and counselling and support for optimal infant feeding practices.

An estimated 33.4 million people are living with HIV worldwide. Since 2001, there has been a 17% reduction in new HIV infections globally. However, for every two people who access antiretroviral treatment, five more become newly infected with HIV.

Contact:

UNAIDS New York | Richard Leonard | +1 646 666 8003 | LeonardR@unaids.org
UNAIDS South Africa | Sheba Okwenje | +127 11 517 1634 | okwenjeb@unaids.org

UNAIDS Executive Director Michel Sidibé joined the President of South Africa Jacob Zuma (right)for the launch on 25 April 2010. Credit: UNAIDS/A. Vlachakis

JOHANNESBURG, 25 April 2010 – President Zuma today launched an ambitious campaign that could alter the face of the AIDS epidemic, in South Africa and globally. The campaign aims to test 15 million people for HIV by the year 2011, up from 2.5 million in 2009 – a six-fold increase in just two years. Through the campaign, 1.5 million people will receive antiretroviral treatment by June 2011, up from about 1 million in 2009.

“South Africa can break the trajectory of the HIV epidemic,” said UNAIDS Executive Director Michel Sidibé, who attended the national launch event in Gauteng with South African leaders. “This campaign promises to be the equivalent of ‘Truth and Reconciliation’ for the country’s AIDS response.”

South Africa has the world's largest population of people living with HIV; an estimated 5.7 million people in the country are living with HIV, representing nearly one sixth of the global disease burden. Some 18% of adults in South Africa are infected with HIV.

HIV testing provides a critical entry point for conversations around a range of difficult issues, including sexuality, violence against women and intergenerational sex. Through the campaign, for example, each individual tested for HIV will also receive 100 condoms, opening a new dialogue about HIV prevention and safer sex across communities.

Prices for most antiretroviral drugs in South Africa are at least 25-30% higher than the average international prices for these medicines – a key challenge in the country’s efforts to expand treatment. UNAIDS welcomes a recent shift in policy by the Government of South Africa that aims to reduce the cost of providing antiretroviral treatment.

“This is the first time any one country plans to scale up HIV prevention and treatment so quickly for so many people,” said UNAIDS Executive Director Michel Sidibé. “I congratulate South Africa on this courageous initiative.”

South Africa funds more than two thirds of its AIDS response. In 2010, South African leaders committed $1 billion US dollars to the AIDS response – a 30% increase over the previous year.

South Africa captain Graeme Smith encourages youngsters to be aware and take responsibility to reduce the spread of HIV

Johannesburg, 17 September 2009 - Some of the world’s best-known cricketers will appear in the latest THINK WISE public service announcements, which have been released today (Thursday 17 September) ahead of the start of the ICC Champions Trophy 2009 in South Africa.

The campaign features messages and information to raise awareness about HIV which the organisers hope will make a positive impact on the lives of young people across the world and help to prevent new HIV infections.

Around 10 million people living with HIV are from Test playing countries. This accounts for more than a quarter of all the people across the world who are HIV-positive. South Africa is the country most affected with some 5.7 million people living with the disease. According to the Human Sciences Research Council of South Africa nearly 9% of young people aged 15-24 are living with HIV in the country.

HIV prevalence in young people does appear to be declining in South Africa, however, concerns remain regarding multiple and concurrent partnerships and intergenerational relationships that contribute to infections among the young.

South Africa captain, Graeme Smith, who is also a THINK WISE champion, believes it is very important to address the issues of HIV in his country. He said:

“HIV is a worrying issue in South Africa but we all have the responsibility to make the right decisions and take the right steps forward. Through my role as a THINK WISE champion I hope to do my bit to raise awareness and reduce the stigma associated with HIV to help the country move forward.”

These sentiments were shared by Kumar Sangakkara, Sri Lanka captain and fellow THINK WISE champion, who said:

“This is a disease - it doesn't make you a social outcast. People who live with HIV should not have to sit on the side and be a victim of ignorance. The stigma around HIV today is very sad and I think we have a long way to go to eradicate it, but we must start somewhere and the THINK WISE initiative is a great stepping stone.”

The two captains are joined by Virender Sehwag of India, Australia’s Nathan Bracken and England women’s cricketer Isa Guha, a member of this year’s ICC Women’s World Cup and ICC World Twenty 20 winning sides, in championing HIV awareness around major cricket events. This leg of the campaign builds on the launch of THINK WISE at the ICC World Twenty 2009 and will aim to confront a lack of education and awareness about HIV and the stigma associated with the virus.

Five public service announcements (PSAs) featuring the THINK WISE champions will be shown during the tournament on big screens at grounds, on the official event website (iccevents.yahoo.com) as well as by broadcasters across the globe. The PSAs show some of the champions meeting young people in South Africa and teaching them about how they can ‘THINK WISE’.

The THINK WISE initiative builds on a long-term partnership between the ICC, the Joint United Nations Programme on HIV/AIDS (UNAIDS), UNICEF and the Global Media AIDS Initiative (GMAI) that for more than five years has reached out to the cricketing community to work together to respond to global AIDS crisis.

By working with some of the game’s top players, the THINK WISE partnership aims to:

1. Raise awareness about the AIDS epidemic within the cricket community
2. Address stigma and discrimination surrounding the disease and experienced by people living with and affected by HIV
3. Encourage informed decision making and safe behaviours to continue to prevent new infections through targeted information and outreach.

The THINK WISE partnership seeks to educate cricket players, coaches, commentators, broadcasters, volunteers and spectators about the AIDS epidemic, particularly around prevention, and deliver these messages at major ICC events and through broadcast which reaches an audience in 184 territories.

In support of people living with HIV, players and match officials will wear red ribbons, the universal symbol of support for people affected by the disease, in the finals of the ICC Champions Trophy 2009.

The THINK WISE partnership will also be arranging a visit during the tournament for some of the champions to visit a local project which helps to educate youngsters about the virus.

To find out more details about the THINK WISE partnership and to view the public service announcements go to website.

Notes to editors

Broadcasters interested in downloading the THINK WISE Public Service Announcements can access these at www.nuview.tv. (Broadcasters can contact Ben Cummings, ben.cummings@icc-cricket.com, +971 50 640 8759 for further guidance on the downloads).

The THINK WISE champions are

1. Nathan Bracken, Australia
2. Isa Guha, England
3. Kumar Sangakkara, Sri Lanka
4. Virender Sehwag, India
5. Graeme Smith, South Africa

The ICC has been working with UNAIDS since 2003 to respond to HIV in cricket-playing countries. In 2006, we both joined with UNICEF in the prominent partnership which supports the “Unite for Children, Unite Against AIDS” campaign.

In 2007, the ICC also began working with the Global Media AIDS Initiative (GMAI) to deliver messages to a regional and global broadcast audience, working alongside the Caribbean Broadcast Media Partnership (CBMP) on HIV/AIDS and the African Broadcast Media Partnership Against HIV/AIDS (ABMP).

A series of activities have been delivered at major events including the ICC Cricket World Cup 2007, the ICC World Twenty20 2007 and the ICC World Twenty20 2009. This has included leading cricketers visiting local community projects and players wearing red ribbons to show their support for people living with HIV.

UNAIDS

UNAIDS is an innovative joint venture of the United Nations, bringing together the efforts and resources of the UNAIDS Secretariat and 10 UN system organisations in the AIDS response. The secretariat headquarters is in Geneva, Switzerland with staff on the ground in more than 80 countries. The co-sponsors include UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, ILO, UNESCO, WHO and the World Bank. Contributing to achieving global commitments to universal access to comprehensive interventions for HIV prevention, treatment, care and support is the number one priority for UNAIDS. Visit the UNAIDS website at www.unaids.org.

United Nations Children’s Fund (UNICEF)

UNICEF is on the ground in more than 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. Visit the UNICEF website at www.unicef.org.

Global Media AIDS Initiative (GMAI)

Launched in 2004 by former UN Secretary General Kofi Annan in coordination with the Kaiser Family Foundation and UNAIDS, the Global Media AIDS Initiative (GMAI) mobilizes leading media companies around the world to leverage their vast resources to address AIDS. Through large-scale regional coalitions of media in Africa, Asia-Pacific, the Caribbean, Latin America, and Eastern Europe – a network that includes more than 300 media companies – the GMAI leverages the communication power of mass media to get out information about HIV and challenge stigma related to the disease. Visit the GMAI website at www.thegmai.org.

Calls for $25 billion investment to ensure countries reach 2010 targets

CAPE TOWN, South Africa, 10 February 2009—On his first country visit, the new executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Mr Michel Sidibé outlined his vision and priorities for UNAIDS in the township of Khayelitsha.

Speaking to community and political leaders, Mr Sidibé praised the resilience and perseverance of the community working together to achieve goals in the face of incredible challenges. “I wanted to begin my public journey here, where the community response together with government, civil society and key stakeholders lead the way towards universal access in South Africa. Together they are meeting the demand for HIV prevention, treatment, care and support,” said Mr Sidibé.

Sub-Saharan Africa remains the region most heavily affected by HIV worldwide, accounting for two thirds (67%) of all people living with HIV and for three quarters of AIDS deaths in 2007. The nine countries in southern Africa continue to bear a disproportionate share of the global burden—35% of HIV infections and 38% of deaths due to AIDS.

Like other regions of the world, southern Africa is feeling the effects of the global economic crisis. Mr Sidibé stressed the need for follow through on domestic and international investment commitments to meet 2010 country targets.

“We cannot let the economic crisis paralyze us,” said Mr Sidibé. “Stimulus packages and economic adjustments should be made with a human face in mind. A mother should not have to choose between continuing AIDS treatment and feeding her children. We cannot let down the 4 million people on treatment and millions more in need today.”

Most countries have set universal access targets for 2010 that are ambitious and reach real people. For countries to reach the specific targets they have set, an estimated investment of US$ 25 billion will be required in 2010, which is US$ 11.3 billion more than is available today.

A new report today released by UNAIDS, What countries need: Investments needed for 2010 targets anticipates that nearly one third of the US$ 25 billion investment will come from domestic sources. Investments from multilateral and bilateral sources are needed for the remaining US$ 17 billion.

More than US$ 9 billion will be used for strengthening health systems and an additional US$ 9 billion will be used for providing HIV-specific health services. The investments needed would also ensure a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria, an innovative financing mechanism that countries depend on to help fund national AIDS plans.

Countries reaching their 2010 AIDS targets would show dramatic results:

1. An estimated 2.6 million new HIV infections will be averted, cutting HIV incidence by nearly 50%.
2. 1.3 million deaths in the next two years can be avoided.
3. Approximately 6.7 million individuals will be receiving antiretroviral treatment.
4. More than 70 million pregnant women will be screened and receive prevention of mother-to-child transmission services.
5. HIV prevention programmes will reach 20 million men who have sex with men, 7 million sex workers, 10 million people who inject drugs, and nearly 8.1 billion male and female condoms would be distributed.
6. Seven million orphans and vulnerable children would have been supported by social support programmes.

“It will not be easy to close this gap but it is achievable and absolutely necessary if we are to accelerate the pace of the response to the AIDS epidemic,” said Mr Sidibé. “Together we will help save lives—by putting more people on treatment, ensuring that pregnant women receive comprehensive antenatal care including HIV services, and that a whole generation of children will graduate from school.”

The Executive Director also called for greater accountability to make the money work better for people in need. He highlighted the need for programmes to be cost effective, strive to eliminate inefficiencies in service delivery and reduce unit costs. Better aligned and coordinated donor support will also increase the impact of investments.

In a letter to partners also to be released today, Mr Sidibé wrote that UNAIDS would re-double its efforts in helping countries realize their universal access goals including indicator mapping and targeted country support for countries that might be lagging. The letter also outlines ten areas needed to achieve universal access goals.

1. Deliver results country by country - by setting ambitious targets.

2. Promote the human rights of people living with and affected by HIV - by ending laws that impede delivery and use of AIDS related services.

3. Support political demand for universal access - by strengthening links with civil society and community groups.

4. Invest in research and apply the evidence - by continued investment in pre-exposure prophylaxis, microbicides and vaccines.

5. Prioritize prevention efforts - by making pediatric AIDS history and giving young people skills to protect themselves from HIV and violence.

6. Mobilize the resources countries need - including fully funding the Global Fund.

7. Optimize and expand partnerships - by expanding the partnership platform to bring new partners together.

8. Leverage AIDS responses to deliver broader results for people - revitalize health systems to ensure that people living with HIV do not die of TB and have access to primary health care.

9. Monitor progress - country by country and donor by donor - by ensuring transparency and accountability at all levels.

10. Plan to sustain the gains - by empowering and restoring dignity to communities and families affected by HIV and ensuring sustainable and predictable financing.

Since 2001, there has been substantial progress in delivering HIV services to millions of people, especially in low- and middle-income countries. Today, nearly 4 million people are on antiretroviral treatment. By the end of 2007, the annual number of new HIV infections had fallen to 2.7 million from 3 million in 2005. New infections among children have dropped, thanks to rapid scale up of services to prevent mother-to-child transmission of HIV. Young people in many parts of the world are waiting longer to become sexually active; having fewer sexual partners; or are using condoms. And millions of children orphaned by AIDS now have access to social support and protection. These gains have to be sustained in these tough economic times.