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And looks forward to further studies to see if findings can be replicated.

GENEVA, 4 March 2013—The Joint United Nations Programme on HIV/AIDS (UNAIDS) and UNICEF welcome a new case study, which found a baby treated with antiretroviral drugs in the first 30 hours of life and who continued on HIV treatment for 18 months appeared to be functionally cured.

The findings were presented today at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Georgia in the United States of America.

According to researchers the mother who was living with HIV at the time of birth had not received antiretroviral (ARV) medication or prenatal care. Researchers say that the child was born prematurely in July 2010 in the state of Mississippi. Due to the high risk of exposure to HIV, the researchers say the baby was started on a triple therapy regimen of antiretroviral drug 30 hours after birth and before proof of infection could be confirmed. The newborn’s HIV-positive status was subsequently confirmed through a highly sensitive polymerase chain reaction testing which was conducted on several occasions.

The case study stated that the baby was discharged from the hospital after one week and continued ARV treatment until 18 months of age, when for reasons that are unclear the treatment was discontinued. However, when the child was seen by medical professionals about a half a year later, blood samples revealed undetectable HIV levels and no HIV-specific antibodies.

If the findings are confirmed this would be the first well-documented case of an HIV-positive child who appears to have no detectable levels of the virus despite stopping HIV treatment.

“This news gives us great hope that a cure for HIV in children is possible and could bring us one step closer to an AIDS free generation,” said UNAIDS Executive Director Michel Sidibé. “This also underscores the need for research and innovation especially in the area of early diagnostics.”

In 2011, UNAIDS and its partners launched a Global plan for the elimination of new HIV infections among children by 2015 and keeping their mothers alive. Significant progress has been made and continued support and research is needed.

“While we wait for these results to be confirmed with further research, it is potentially great news,” said UNICEF Executive Director, Anthony Lake. “This case also demonstrates what we already know—it is vital to test newborn babies at risk as soon as possible.”

According to data from the World Health Organization and UNICEF only 28% of HIV-exposed babies were tested for HIV within six weeks of birth in 2010. Obstacles to early diagnosis and treatment include the high cost of diagnostics and difficulty of getting timely results and limited access to services and medicines. There were 330 000 children newly infected with HIV in 2011. At the end of 2011, 28% of children under the age of 15 living with HIV were on HIV treatment, compared to 54% of eligible adults.

Now two and a half year’s old, the toddler continues to thrive without antiretroviral therapy and has no identifiable levels of HIV. However, UNAIDS cautions that more studies need to be conducted to understand the outcomes and whether the current findings can be replicated.

Credit: UNAIDS/D.Kwande

A mid-term review on the implementation of the Global Plan Towards the Elimination of New HIV infections among Children by 2015 and Keeping their Mothers Alive took place in Nairobi, Kenya from 6-7 December. The two-day workshop discussed the way forward in overcoming three key bottlenecks to achieve the Global Plan targets, including early infant diagnosis, human resources for health and supply chain management.

In June 2011, UNAIDS and the President’s Emergency Plan for AIDS Relief (PEPFAR) unveiled the Global Plan with 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. The Global Plan focuses on 22 priority countries with the highest estimated numbers of pregnant women living with HIV.

Opening the meeting, US Deputy Global AIDS Coordinator Deborah Von Zinkernagel noted the momentum that has been gained in the 18 months since the launch of the Global Plan. “Strong political leadership, progressive policy change, and accelerated programmatic scale up at various levels are helping to significantly reduce new HIV infections among children and AIDS-related deaths among mothers,” said Ms Von Zinkernagel. “While the job is far from done, the intensified efforts of many partners under the Global Plan are advancing our progress towards the goal of achieving an AIDS-Free Generation”, she added.

Speaking about the challenges, participants highlighted that immediate confirmation of HIV infection in children is urgent to ensure timely initiation of antiretroviral therapy, as half of the children infected with the virus die before the age of two years. UNAIDS estimates that in 2010, among 65 reporting countries, only 28% of infants born to mothers living with HIV received an HIV test within the first two months of life. In 2011, 230 000 children died from HIV-related causes worldwide and only 28% of children eligible for treatment were receiving it, compared to 54% of adults.

Participants also stressed that, despite progress made in the provision of services to prevent mother-to-child transmission of HIV, access to appropriate diagnostics and/or treatment for pregnant women still remained inadequately low. According to UNAIDS, the percentage of treatment-eligible pregnant women living with HIV who were receiving antiretroviral therapy for their own health in 2011 was an estimated 30%.

In countries like the Democratic Republic of Congo, Chad, and Nigeria, less than 20% of pregnant women received HIV testing and counselling in 2010. Participants noted that, in some cases, the lack of access to these services is caused by uninformed or misguided government policies that do not prioritise the provision of this life-saving treatment.

Overall supply chain challenges, and in particular, the cost of commodities have overarching implications. Participants agreed that without an effective supply chain, the goals of the Global Plan are impossible to meet. Strategies such as pooling and integrating procurement, strengthening and harmonizing regulatory systems, systems transparency, and improving the accuracy of commodity forecasting to reduce stock wastage are critical to maximize  supply chain efficiency. The meeting also discussed the importance of predictable funding and skilled personnel to enable efficient logistics management while lowering costs.

A shortage of human resources for health, including doctors, nurses and midwives was discussed as a major bottleneck in rapidly expanding HIV prevention, treatment and support services for mothers and children. Many of the participating countries are experimenting with task-shifting and task-sharing, as well as working with community and lay health workers in order to stretch the reach of health care services. Strategies that can accelerate the recruitment, retention and retraining of health care providers were shared, such as formalizing the role of community health workers, the development of a formal professional management cadre to oversee health facilities, and accelerated pre-service training schemes.

Participants agreed that eliminating new HIV infections among children and keeping their mothers alive is not, and should not be, just about pills. It is first and foremost about protecting the health, dignity and security of mothers living with HIV and their children. They heard reports of human rights violations of women living with HIV such as mandatory HIV testing, forced sterilizations, as well as stigma and discrimination especially in the health care setting. Networks of women living with HIV demonstrated how they have been overcoming these challenges including sensitizing communities on their rights, demanding action and accountability from governments and other stakeholders, and playing a central role within their country programs to end vertical transmission. During the workshop, participants agreed on key actions required for progress to be made against the targets of the Global Plan in these areas. Participants also discussed the global financing architecture, and how to maximize towards available resources such as Global Fund and PEPFAR, but beginning with their own domestic funding.   

Closing the meeting, the Director of the Department of Evidence, Innovation and Policy at UNAIDS Dr Bernhard Schwartlander, commended countries for their rapid momentum. “The call for elimination of new HIV infections among children by 2015 and keeping their mothers alive has been widely heard”, he said, “and countries are now making important and sustained investments for their populations. It is now time to notch up our efforts as we enter the second phase of the Global Plan, and be better accountable to our governments and the people we serve.”

The meeting was attended by government representatives from 16 of the 22 priority countries under the Global Plan, as well as representatives from PEPFAR, the UN, and several global implementing agencies.  Others present included Women Fighting AIDS in Kenya (WOFAK), The International Community of Women with HIV/AIDS (ICW), and the Inter-Agency Task Team on the Prevention and Treatment of HIV among Pregnant Women, Mothers and Children.

Young people from Gabon playing the interactive board game “Vie2Jeune”.
Credit: Aiducators4life

According to the Ministry of Health of Gabon, only 1 out of 2 young Gabonese aged 15-24 have a comprehensive knowledge on HIV in a country where the prevalence rate among youth aged 15-24 is about  4.8%, and 15% of youth have sexual relationships before the age of 15.

In an effort to revolutionise HIV prevention in Gabon, Shell Gabon in co-operation with the non-governmental organization Aiducators4life, the government and UNICEF launched an innovative tool aimed at stimulating discussions on HIV among youth (13+) in the country.

“Shell is truly committed to slow the spread of HIV in this country,” said the Director General of Shell Gabon, Adrian Drewett who officially launched the board game on the 3rd of December at Lycee Paul Indjendjet Gondjout in Libreville.

The new tool consists of an interactive board game called “Vie2Jeune”. Aligned with Gabonese culture and customs, the game provides relevant information for young people on topics like safe sex, sexually transmitted infections, facts about HIV, teenage pregnancies and discrimination against people living with HIV. There are about 60 information cards and 60 question cards that are used while playing the game.

This board game was successfully launched in Zambia in 2009. The new French version was developed by Aiducators4life in cooperation with a French biology teacher and a French language teacher. The game is approved by medical experts and it has been tested extensively in schools in both Libreville and Gamba.

The entertaining format of the game makes it easily acceptable in many cultures and people groups especially where readership is low. “This is a very direct and very ‘fun’ approach to learning about HIV,” said UNAIDS coordinator in Gabon, Ms Inge Tack. “We noticed during the tests that this approach was very effective and also different to the current methods used in schools.”

Shell Gabon will finance 1000 games for secondary schools in Gamba and Libreville. The final objective is to provide all Gabonese secondary schools with the game which has just been approved for educational purpose by the Gabonese Ministry of Education. The distribution of the game will start in January 2013. 

The Network of Positive Youth for Latin America and the Caribbean has launched a regional consultation for young people living with HIV. The aim of the consultation is to obtain information on the realities that young people living with HIV face in their everyday lives in order to develop new and more effective HIV strategies focused on their specific needs.

The consultation tool, developed with support from UNAIDS, UNICEF and UNFPA, consists of an online and confidential survey of roughly 40 questions that focuses on young people aged 18 to 29 years old and living with HIV from 17 Latin American and two Spanish-speaking Caribbean countries. The online platform is designed to run on any computer and has a special program to facilitate access from mobile devices.

The tool will collect information related to the socio-demographic aspects of young people living with HIV, their access to health services, experiences with stigma and discrimination, and their leadership and community participation. Young people living with HIV will be able to participated in the survey until 30 November 2012 at the following website: http://consulta.jovenespositivos.org

“Usually, positive youth remain invisible to research and data collection exercises.  This consultation is an opportunity to make our voices heard,” explained Mariana Iacono, a founding member of the Network of Positive Youth. “To be able to develop HIV strategies and programs that meet our needs we must know our situation, needs and realities in our communities.”

A team of young people from the Network of Positive Youth will analyze the results of the online consultation and will design a short and long term action plans for the region. The results will also serve as advocacy tools to demand the development of national strategies that focus on the needs of young people living with HIV. “We know that sometimes it is difficult to share feelings and memories, but we believe it is from our own experiences that we can bring new ideas and solutions to address HIV in a more inclusive and cost effective way,” said Pablo Aguilera, member of the Network.

In Latin America, an estimated 68 000 adolescents (10-19 years) are living with HIV. Of these, 34 680 are women. In 2011, 34 440 new HIV infections occurred among young people between 15 to 24 years, accounting for 41% of all adult HIV infections. “A generation of young people born with HIV is growing up with its specific needs being largely neglected,” noted Mark Connolly, UNICEF Senior Adviser for Latin America and the Caribbean. In 2011, an estimated 2 000 children were born with HIV in the region.

As young people living with HIV transition from childhood through adolescence to young adulthood, they face a range of specific needs, including accessing treatment, tackling stigma and discrimination, and accessing youth-friendly integrated HIV and sexual and reproductive health services. “Young people living with HIV are a heterogeneous group, with diverse populations that needs urgent attention in many areas, especially those who are more affected by stigma and discrimination, such as transgender, gays and drug users,” said Cesar A. Núñez, UNAIDS Regional Director for Latin America. 

The UNFPA Regional Director for Latin America and the Caribbean, Marcela Suazo emphasized that the epidemic on positive young people is worsened because of social exclusion, as well as gender inequality, stigma and discrimination related to HIV. “It is necessary to ensure a human rights platform that extends strongest non-discriminatory access of young people to education, counseling and adequate sexual and reproductive health," she said.

In Latin America, a new wave of youth-led community mobilization is emerging, advocating for human rights and demanding access to HIV services. The Regional Network of Positive Youth is organizing youth to participate in decision-making and consultation spaces beyond national spheres. In December 2012, the Network is organizing the first regional meeting of young people to define coordinated actions across the region, enhance leadership and mobilization towards meeting the global targets for 2015.

Cricketing stars from the South Africa team, including JP Duminy (third from right), join ‘Think Wise’ campaign volunteers at an a HIV-awareness raising event in Colombo, Sri Lanka.
Credit: UNICEF Sri Lanka

World cricket players have united in a call to young fans to ‘get the facts’ about HIV prevention and to help eliminate AIDS-related stigma and discrimination. The call is part of a United Nations and International Cricket Council (ICC) HIV awareness-raising campaign taking place alongside the ICC World Twenty20 (WT20) tournament in Sri Lanka, which runs until 7 October.

Rallying support for the campaign known as ‘Think Wise’—an initiative of the ICC, UNAIDS and UNICEF— players from the South African Cricket team interacted with young people living with and affected by HIV in Colombo on 26 September.

“It is very important to create awareness on HIV—not only for our generation but also for the generation to come,” said South African player JP Duminy. “HIV is an issue for South Africa and the whole world and sport is one of the things that can bring nations together on important issues,” he added.

JP Duminy and his team-mates gave the youth attending the event tips on how to improve their batting, bowling and fielding skills during a specialized coaching session. At the same time, they spoke openly about HIV with the youth participants, stressing the importance of young people being informed, staying protected and eliminating harmful stigma and discrimination against people living with and affected by HIV.

A similar interaction session was held earlier in the WT20 tournament between players of the West Indies cricket team and children living with HIV. “This is definitely a great initiative and it’s important that young people are educated on the methods of protecting themselves from HIV,” said Trinidadian leg spin bowler Samuel Badree.

Commending the players’ commitment to raising awareness on HIV, Steven Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific said: “We are all striving for the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. Cricket and cricketing stars have the power to unite and reach beyond national boundaries, driving efforts towards ‘getting to zero’ and ending AIDS.”

Outrunning AIDS: towards an AIDS-free generation

Young people taking part in the ‘Think Wise’ activities emphasized the benefit of such events. “It was great to have the opportunity to play cricket with the teams and it was very important because of the reach that the campaign is having with the public—great opportunities for many important conversations,” a young participant said.

Players from the West Indies Cricket Team interacting with ‘Think Wise’ volunteers, children living with HIV and their families as part of the ‘Think Wise’ campaign.
Credit: UNICEF Sri Lanka

More than 40% of the new HIV infections globally are being reported among 15-24 year olds, which means that 3000 young people are being newly infected with the virus every day. Stigma against people living with HIV and people from communities at higher risk is still widespread across many cricket playing countries.

“Stigma and discrimination undermine our vision of an AIDS-free generation. This can be realized only if we all respect the rights of those living with or affected by HIV," said Rachel Odede, HIV Advisor in the UNICEF Regional Office for South Asia, underlining the importance of this Think Wise theme.

For almost a decade, and with the help of ‘Think Wise’ Champions including Virender Sehwag (India), Kumar Sangakkara (Sri Lanka), Ramnaresh Sarwan (West Indies) among others, the ICC/UNAIDS/UNICEF ‘Think Wise’ campaign has used the power of cricket to help address key issues around AIDS, particularly for young people across the major cricket-playing countries.

“Through cricket we can reach millions of people and the message is clear: Let’s talk more about HIV, let’s get informed. We know that stigma kills. Let’s ‘Think Wise’, don’t stigmatize,” said Indian batsman and ‘Think Wise’ Champion Virender Sehwag during the WT20 tournament.

ICC CEO David Richardson added: “The profile and reach of the ICC World T20 gives us an opportunity to raise awareness and reduce stigma about HIV and, along with the players, we are delighted to help this cause.”

For the duration of the WT20, a public service announcement featuring Kumar Sangakkara and Virender Sehwag will be screened at all tournament matches. Players from the teams taking part in the men’s and women’s semi-finals will wear red ribbons as a sign of solidarity for people living with HIV and umpires and referees will also sport the ‘Think Wise’ logo on their shirt sleeves.

The “Let’s Talk” Think Wise roadshow, supported by UNAIDS, ready to leave Colombo with its youth volunteers.
Credit: P. Deshapriya

A bus embossed with HIV messages, red ribbons and the faces of world cricketing stars is making a whistle stop tour through more than a hundred sites in Sri Lanka. Carrying young volunteers, the bus is part of the HIV awareness-raising campaign “Let’s talk” taking place around the world Twenty20 cricket tournament that runs from 18 September to 7 October in Sri Lanka.

An integral part of the joint UNAIDS, UNICEF and the International Cricket Council (ICC) partnership known as ‘Think Wise’, the bus has been on the road since late August. Using the power of cricket it aims to reach out to thousands of young people in Sri Lanka providing them with HIV information as well as inviting them to talk about AIDS.

Serving as the face of the roadshow, Sri Lankan cricketing hero and ‘Think Wise’ Champion Kumar Sangakkara’s message is featured on the side of the bus: “When you know the facts, you know what to do. Get the facts. Protect yourself against HIV”.

As the bus pulls up at one of the designated stops, the vibrant young volunteers greet locals with music, dance and organize activities including street cricket and an HIV quiz. With tickets to the Twenty20 final as the prize, the quiz along with the other activities is intended to help promote key HIV prevention and anti-discrimination messages.

“Education programmes through entertainment are really needed as they reach out to young people, especially those most at risk,” says ‘Think Wise’ roadshow volunteer Paba Deshapriya as she invites young people attending to sign on a giant wicket in support for the Sri Lankan team at the Twenty20 tournament. At the same time, she presents them with red ribbons and information about HIV services they can access in their area.

“The roadshow interactions are clearly showing that public knowledge of HIV is still extremely low—which means the bus and the AIDS response in Sri Lanka still have a long journey,” said roadshow team leader Mr Hans Billimoria.

Under the broader umbrella of the ‘Think Wise’ campaign, the bus roadshow is the result of a diverse national partnership in Sri Lanka that includes UNAIDS, UNICEF, Family Planning Association of Sri Lanka, the National STI/AIDS Control Programme, the National Youth Council, the community organization Grassrooted and local youth organizations. The initiative aims to not only give clear and up to date information on HIV, dispel AIDS-related myths and challenge social stigma against people living with HIV but also to link people with local HIV services including HIV testing and counseling, treatment and support.

Despite a relatively low HIV prevalence in the country (less than 0.1%), stigma and discrimination against people living with HIV and key affected communities is high and presents a major barrier to the HIV response. National surveys suggest that many people at higher risk of infection delay testing themselves for HIV and coming forward for treatment because they are concerned by the implications of testing HIV-positive and the confidentiality of their HIV status.

At the Think Wise roadshow, participants ‘sign the wickets’ in support of the Sri Lankan cricketing team’s performance in the World Twenty20 tournament and to show their solidarity for people living with HIV.
Credit: P. Deshapriya

Dr Nimal Edirisinghe Director of the Sri Lankan national STI and AIDS Control Programme said, “This is an ideal opportunity as the campaign actively links young people to HIV prevention and treatment services.”

According to the UNAIDS Country Coordinator for Sri Lanka Mr David Bridger an AIDS-free generation is within our reach. “That’s why through the ‘Think Wise’ campaign we say: ‘Let’s talk – Get the Facts – Protect yourself’ encouraging open dialogue on sex, sexual diversity, risks and HIV prevention methods,” he said.

As the bus continues its journey through Sri Lanka, additional HIV activities related to the ‘Think Wise’ campaign will take place during the Twenty20 tournament. These include screenings of a public service announcement at every match, the wearing of red ribbons by players in the semifinals and interaction events between cricket players from the West Indies and South Africa teams and young people.

A new progress report released by UNICEF titled "Committing to Child Survival: A Promise Renewed" is showing a sharp drop in the estimated number of deaths among children under the age of five worldwide. This number fell from nearly 12 million in 1990 to an estimated 6.9 million in 2011.

Releasing the report, UNICEF Executive Director Anthony Lake said, “The global decline in under-five mortality is a significant success that is a testament to the work and dedication of many, including governments, donors, agencies and families.”

The report combines mortality estimates with insights into the top killers of children under five and the high-impact strategies that are needed to accelerate progress.

An estimated 3.4 million children under 15 years old were living with HIV in 2011, 91% of them in sub-Saharan Africa. In the same year, about 230,000 died of AIDS-related causes. According to the report, access to antiretroviral therapy (ART) was still low in most countries, with only about 28% of children who needed treatment receiving it in 2011, in contrast to the 57% coverage among adults. However, the report was optimistic about progress being made especially in extending antiretroviral medicines to prevent mother-to-child transmission (PMTCT) of HIV.

In high-income countries, access to PMTCT services has cut rates of trans­mission to about 2%. In low- and middle-income countries however, 57% of an estimated 1.5 million pregnant women living with HIV in 2011 received antiretroviral therapy to prevent HIV transmission to their babies. Nonetheless the report notes that progress is being made in nearly every country.

There is growing momentum behind a concerted scale-up of coverage of PMTCT and paediatric HIV care and treatment services. This success follows the launch in June 2011 of the “Global Plan towards the elimination of new HIV infections in children by 2015 and keeping their mothers alive”.

There are also new and emerging technologies which improve diagnosis and treatment of infants and young children. However, the report recommends a simplification of treatment regimens and medicines, as well as programmatic innovations for identifying children living with HIV and retaining them on antiretroviral therapy.

During the launch, Mr Lake also talked about "unfinished business", saying, "Millions of children under five are still dying each year from largely preventable causes for which there are proven, affordable interventions.”

Greater efforts are particularly required in populous countries with high mortality, the report says. In addition to medical and nutritional factors, improvements in other areas including education, access to clean water and sanitation, adequate food, child protection and women’s empowerment will also improve prospects for child survival and development.

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

Young audiences in six African countries will be able to share the experiences of a vivid cast of characters in a dramatic new radio show: Shuga: Love, Sex, Money. The programme hit the airwaves on 27 June in Cameroon, Democratic Republic of Congo, Kenya, Lesotho, South Africa and Tanzania across 65 stations. 

During 12 eight-minute episodes, the show provides a view in the lives of a group of four fictional characters aged 15 to 24.  The series tells the story of their dreams, friendships, challenges and triumphs in a world with HIV.

Shuga Radio has been developed from the award-winning original TV version and is supported by UNICEF, MTV Staying Alive Foundation and the PEPFAR Partnership for an HIV Free Generation. They are working in collaboration with young people and representatives from government and partners in participating countries to reach an estimated listenership of 45 million in the region. 

The radio show’s storyline examines a similar range of themes to those in the TV drama including; HIV counselling and testing, condom use in stable relationships, positive prevention, gender inequality and sexual violence, transactional sex, alcohol abuse and the role of multiple concurrent partnerships in the HIV epidemic.

Exploring such issues is crucial, given the vulnerability of young people to HIV in sub-Saharan Africa, which has one of the highest rates of infection in the world. In addition, most youths living with the virus do not know their status. 

“Every day there are more than 2 500 new HIV infections in young people across the world, four out of 10 are in sub-Saharan Africa and the vast majority of these are young women and adolescent girls,” said Geeta Rao Gupta, UNICEF Deputy Executive Director.  “Shuga, an initiative that combines media with a partnership for service delivery, is an example of how to work with partners and young people to reach key audiences and maximize the return on investments for HIV prevention.”

The 12 episodes will be followed by two 25-minute pre-recorded magazine shows which further examine the topics covered with young people, experts from the focused countries and global and national cooperating partners.

Content and storyline for Shuga Radio were written and created by 30 young people from the six countries in a special workshop hosted by Question Media Group with support from MTV and UNICEF.

Among the characters whose moving stories will be told in the show are Sofia,19; her sweetheart Fally, 20; her cousin Amina,17; smooth-talking risk-taker Karis, 20, and a successful business woman and ‘sugar mummy’ Riziki.

“We are delighted to expand the scope and impact of the Shuga TV series by moving the concept into the radio medium where it will reach millions of listeners on youth, student and community stations who may not have had access to the TV series,” said Georgia Arnold, Executive Director, MTV Staying Alive Foundation.

Available in English, French and Swahili, Shuga Radio will air three times a week for 12 weeks.

The partners behind the project hope that it will emulate the success of the first two series of Shuga broadcast on television in 2009 and 2012. The first reached viewers in more than 48 sub-Saharan African countries and in over 70 nations worldwide.

Research conducted by Johns Hopkins University/Centre for Communications Programmes in Kenya following the airing of Shuga (series I) reported a number of positive outcomes. These included increased intention to go for HIV testing and decreased intention to have multiple sex partners, improved attitudes towards people living with HIV and increased usage of accessible health and social services among youth who had watched the series. 

The UN delegation visited Cama Hospital and the Sir J.J. Hospital—two leading health facilities in the Indian state of Maharashtra that provide health services for pregnant women and children.

On 28 April, United Nations Secretary-General Ban Ki-moon led a high-level mission to Mumbai, India in support of the Every Woman Every Child initiative. During the visit, the Secretary-General commended Indian officials for the progress made in the AIDS response. Mr Ban also encouraged the Government of India to continue efforts to eliminate new paediatric HIV infections by 2015—one of the objectives of the Secretary-General’s five-year action plan.

The Every Woman Every Child initiative is a global effort that was launched in 2010 by Secretary-General Ban Ki-moon to mobilize and intensify global action to save the lives of 16 million women and children and improve the lives of millions more.

Mr Ban was joined by senior UN health officials including the Director-General of the World Health Organization Margaret Chan, the Executive Director of the UN Population Fund Babatunde Osotimehin, the Executive Director of the Joint United Nations Programme on HIV/AIDS, Michel Sidibé, the Deputy Executive Director from the UN Children's Fund, Geeta Rao Gupta and the United Nations Secretary-General’s Special Envoy for Malaria Ray Chambers.

During the visit the Secretary-General, Mrs Ban and his delegation visited Cama Hospital and the Sir J.J. Hospital—two leading health facilities in the Indian state of Maharashtra that provide health services for pregnant women and children.

Mr Ban’s mission concluded with a high level reception hosted by Millennium Development Goals advocates Mukesh Ambani and Ray Chambers, which featured interaction with some of India’s leading AIDS activists, people living with HIV, business and government officials as well as film stars and sports legends. During the reception the Mr Ban announced the appointment of Mr Prasada Rao as his new Special Envoy for HIV/AIDS in the Asia-Pacific region.

L to R: Millennium Development Goals advocate Mukesh Ambani, Kausalya from Positive women network (PWN+), UNAIDS Executive Director Michel Sidibé, Daksha Patel from Gujarat Network of People Living with HIV (GNP+) and United Nations Secretary-General Ban Ki-moon.

The UNAIDS Executive Director Michel Sidibé travelled to India’s capital New Delhi where he met with the Minister of Health and Family Welfare Shri Ghulam Nabi Azad. During their meeting, Mr Sidibé commended India for its new National AIDS Control Programme (NACP-IV) which was developed by national experts and will be funded primarily from domestic sources.

Mr Sidibé paid special attention to India’s role and contribution as a priority country in the implementation of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. It is expected that the national recommendations on the elimination of new HIV infections among children in India will phase-out of single dose nevirapine in the coming months. Mr Sidibé had the opportunity to see first-hand  how services to prevent mother-to-child HIV transmission are being scaled-up at the Ambedkar Hospital, one of Delhi’s largest hospitals.

A high level round table organized by the Federation of Indian Chambers of Commerce and Industry (FICCI) and UNAIDS brought together more than 50 participants including leading representatives from the Indian pharmaceutical industry and the government under the theme “India’s partnership with Africa in pharmaceuticals”. Mr Sidibé encouraged the Indian pharmaceutical industry to seize the opportunities to scale up access to HIV treatment in Africa and engage as strategic partner for the development of pharmaceutical production in Africa.

A new report provides an extensive synthesis and analysis of recent data, gaps and challenges in AIDS prevention, treatment, care and support for young people in Zambia.

For Zambia’s young people the AIDS response has seen a number of important successes, with a significant 25% decline in HIV incidence over the last decade. However, according to a groundbreaking new report, the AIDS epidemic continues to have a huge effect on the country’s youth, especially young women, and much more needs to be done to achieve an HIV-free generation.

Situation Assessment of the HIV Response among Young People in Zambia provides an extensive synthesis and analysis of recent data, gaps and challenges in AIDS prevention, treatment, care and support for this key age group. It was launched at a high level meeting held from 17-18 April in Lusaka.

The event was supported by Zambia’s United Nations Joint Team in collaboration with the National HIV/AIDS/STI/TB Council (NAC), and the ministries of Health; Education; Youth and Sport; and Community Development, Mother and Child Health.

“We must reduce the number of new HIV infections among young people if we are to meet the targets set in the 2011 Political Declaration on AIDS,” said Deputy Minister of Youth and Sport Nathaniel Mubukwanu. “We are committed to continue developing high impact interventions using a combination of HIV prevention strategies to effectively respond to the epidemic,” he added.

Good progress but gaps remain

The assessment, focusing on 10 to 24 year olds, shows that HIV incidence decreased between 2001 and 2009 among young people and the proportion of young people having sex before the age of 15 has halved, from about 17% in 2000 to some 8% in 2009. There has also been a rise in the number of young people who were tested and received their HIV test results, from 7% in 2005 to 34% in 2009.

Despite these achievements, HIV prevalence among young people remains high. In 2007 prevalence among those aged 15-19, for example, was 6% for women and 4% for men.

This is attributed to a number of factors. Dr Clement Chela, NAC Director General, citing the report said these factors included, “Poor comprehensive knowledge of HIV; gender inequality, poverty and the combination of transactional and intergenerational sex, early marriage, alcohol use, peer pressure and the negative gatekeeper attitudes towards condom promotion among young people.”  Data shows that only 53% of adults expressed support for condom education for HIV prevention among young people.

The report also highlights that there is no comprehensive sexuality education package for pupils in school and a high level of stigma towards young people on treatment from their peers.

Way forward

One of the key recommendations in the report for increasing protection of young people is the promotion of their meaningful involvement in HIV policy and programme design and implementation. This can be facilitated by building their capacity as change agents and service providers and encouraging them to generate demand for HIV-related services.

As Youth Representative Chipasha Mwansa contended, while hoping that her peers’ recommendations would be taken with the seriousness they deserve: “Nothing for young people without meaningful involvement of young people.”

According to the report, bottlenecks that need to be addressed in order to meet young people’s needs are those that affect access to condoms, HIV counseling and testing, male circumcision and behavior change communication among young people in and out of school. Furthermore, youth friendly services should be expanded at the health facility and community level, including those integrating HIV care and treatment and legal protection for adolescents living with the virus.

Helen Frary, UNAIDS Country Coordinator, noted that a multipronged approach was necessary. “Providing young people with access to HIV testing, condoms, male circumcision and other reproductive health services, including sexuality education,  will significantly contribute to Zambia achieving the UNAIDS’ vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.”

To ensure that measurable progress is made in Zambia, the UN has pledged to work with relevant ministries and stakeholders to translate these main recommendations –and others— into a clear, costed and time-bound action plan which puts young people centre-stage.