United States of America

Ahead of World AIDS Day 2008, two sculptures by Keith Haring have come to UNAIDS to join the “Art for AIDS” collection. Credit: UNAIDS

Ahead of World AIDS Day 2008, two sculptures by Keith Haring have come to UNAIDS to join the “Art for AIDS” collection. His iconic and poignant work has been instrumental in raising awareness around AIDS issues worldwide.

The UNAIDS headquarters building in Geneva received on Wednesday two new additions to its “ART for AIDS” collection. The artworks are two sculptures by the celebrated artist and AIDS activist Keith Haring which have been loaned to UNAIDS by the Keith Haring Foundation.

In his all-too-brief lifetime, Keith Haring (1958-1990) produced artwork at a prodigious rate and reached a worldwide audience that transcended differences of race, nationality, gender, age, and sexual orientation. He used his now iconic symbols— the barking dog, radiant baby, dancing person and the heart—to encourage reflection on and dialogue about social and political issues.

The humanist elements of his work allowed him to communicate on virtually universal terms. As a result, Haring used his designs for many public and social awareness campaigns, including AIDS prevention, literacy, UNICEF children's causes, and the fight against South African apartheid.

Haring enlisted his imagery during the last years of his life to generate activism and awareness about AIDS. Credit: UNAIDS

Haring was diagnosed with HIV in 1988. In 1989, he established the Keith Haring Foundation, whose mandate is to provide funding and imagery to AIDS organizations and children’s programmes, and to expand the audience for Haring’s work through exhibitions, publications and the licensing of his images. Haring enlisted his imagery during the last years of his life to speak about his own illness and generate activism and awareness about AIDS.

Although his art had always reflected his social consciousness, in Haring's last years many of his works were devoted to creating cultural awareness about HIV and gay rights issues.

The UNAIDS’ Art for AIDS is an art collection created to recognize the role art has played in the response to AIDS. The pieces in the collection have been chosen to provoke thought and dialogue around some of the most difficult issues around AIDS. With an initial emphasis on contemporary African art, the collection has grown to more than 60 museum quality pieces thanks to the involvement of artists, collectors and donors around the world.

Bishop Mark Hanson, presiding bishop of the Evangelical Lutheran Church in America and president of the Lutheran World Federation, washes the feet of two HIV positive women during the August 1 plenary of the Ecumenical Pre-Conference. On the right is Herlyn Marja Uiras, of Churches United Against HIV and AIDS in Southern and Eastern Africa. Third from right is Sophie Dilmitis, HIV and AIDS coordinator for the World YWCA. Between the two women is Nyaradzai Gumbonzvanda, general secretary of the World YWCA.
Credit: Ecumenical Advocacy Alliance

Engaging in an act of “humility and repentance,” a world church leader began his presentation to an international ecumenical AIDS conference by washing the feet of two women living with HIV.

The Rev. Mark S. Hanson, presiding bishop of the Evangelical Lutheran Church in America (ELCA), Chicago, and president of the Lutheran World Federation, Geneva, washed the feet of Herlyn Marja Uiras of Churches United Against HIV and AIDS in Southern and Eastern Africa and Sophie Dilmitis of World YWCA, Geneva.

Hanson was part of a plenary session addressing stigmatization and discrimination against people living with HIV. He said washing the womens’ feet was the only way he could begin his remarks with integrity.

“I am absolutely convinced that we as religious leaders and we in the religious community that so shunned and shamed people with HIV and struggling with AIDS … must begin first by engaging in public acts of repentance. Because absent public acts of repentance, I fear our words will not be trusted,” he said.

Following the act of repentance, a delegation of religious leaders from the Ecumenical pre-conference went to the Positive Leadership Summit “Living 2008” to share this with the delegates. The religious leaders were warmly received and joined the closing reception of the conference. Delegates from “Living 2008” sent a message to the faith based leaders, conveyed to the closing plenary by members of INERELA+, the International Network of Religious Leaders Living with or Personally Affected by HIV and AIDS:

“What we most want is simply to be accepted rather than tolerated
Accepted as people living with HIV
Accepted as men who have sex with men
Accepted as people who use drugs
Accepted as people who want families and can be responsible parents
Accepted for who we are.”

The three-day Ecumenical pre-conference was held under the theme of "Faith in Action Now!" and took place in Mexico City on 31 July - 2 August 2008. Approaching 500 participants from all over the world explored the challenges posed by HIV and the AIDS epidemic to people of faith, evaluated action taken, and planned strategies required in the Christian response to HIV and AIDS.

UNAIDS Senior Partnership Adviser Pauline Muchina made a number of presentations and Sally Smith UNAIDS Partnership Adviser led a workshop for faith-based organizations (FBOs) in collaboration with the Ecumenical Advocacy Alliance, on engaging with the recently drafted UNAIDS strategy on Religion and FBOs.

The Ecumenical Pre-conference is just one of several faith-related events in the run up to and during this year’s International AIDS Conference taking place in Mexico City.

On 2 August an evening celebration took place to mark 5 years of advocacy in Africa by ANERELA+, the African Network of Religious Leaders Living with and Personally Affected by HIV and AIDS, and to mark the formal launch of INERELA+. The network is based on the power of religion to promote human rights and positive social change. It seeks to be a global movement to challenge HIV-related silence, stigma and discrimination and to advocate for evidence-based prevention and treatment for all.

The Inaugural Summit of Religious Leaders Living with HIV begins on 3 August. It will provide a space for people living with HIV who are religious leaders to discuss their priorities and future plans for a High Level Meeting of Religious Leaders. The summit will concentrate on three topics: overcoming stigma and discrimination; living positively with HIV and mobilizing and empowering faith communities and other religious leaders. INERELA+ will bring together around 50 faith leaders who live with HIV, from a wide variety of faith traditions and countries.

President George W. Bush is joined by Annette Lantos, right, and invited guests Wednesday, July 30, 2008 in the East Room of the White House, as he signs H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008. White House photo by Joyce N. Boghosian.

On 30 July 2008, US President George W. Bush signed the Tom Lantos and Henry J. Hyde United States Global Leadership against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008. This legislation replaces and extends the existing act by five years and also expands it three-fold to US$ 48 billion.

A number of guests joined President Bush in the White House for this historic event. They included senior members of the US House and the US Senate and Congressional and agency staff as well as family members of the politicians Tom Lantos and Henry J. Hyde in whose memory the act honours.

President Bush expressed his appreciation to Dr Peter Piot, UNAIDS Executive Director for attending and thanked him and Rajat Gupta, the Chairman of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria for their presence.

(left to right) Dr Peter Piot, UNAIDS Executive Director and Michele Moloney-Kitts, Assistant U.S. Global AIDS Coordinator at the White House on the day U.S. President George W. Bush signed the Tom Lantos and Henry J. Hyde United States Global Leadership against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008, 30 July 2008

Dr Peter Piot paid tribute to the leadership of the President and the US Congress: “The generosity of the US government has helped to truly transform the global response to AIDS and the course of the epidemic. It has enabled all of us to make a qualitative and quantum leap forward.”

President Bush acknowledged that AIDS is a long-term crisis that will require serious commitment and resources for decades: “Defeating HIV/AIDS once and for all will require an unprecedented investment over generations. But it is an investment that yields the best possible return: saved lives.”

President Bush first announced the President's Emergency Plan for AIDS Relief (PEPFAR) in a State of the Union address in 2003 and a US$ 15 billion act was passed by US Congress that same year.

Joining the President on the occasion of the signing of the reauthorization, were two people directly benefiting from PEPFAR. Agnes Nyamayarwo, from Uganda, who now travels extensively educating people about HIV and Mohamad Kalyesubula, who works in a clinic caring for HIV positive people.

Latest figures show that after decades of increasing mortality, the annual number of AIDS deaths globally has declined in the past two years, in part as a result of greater access to HIV treatment.

Credit: President's Emergency Plan for
AIDS Relief

The US Senate has voted on legislation authorizing US$ 48 billion for AIDS, TB and malaria over the next five years. The legislation will replace and expand three-fold the current US$ 15 billion act passed by Congress in 2003 which expires at the end of September.

U.S. President George W. Bush announced the President's Emergency Plan for AIDS Relief (PEPFAR/Emergency Plan) in a State of the Union address in 2003. It was the largest commitment ever by a country for an international health initiative dedicated to a single disease.

There are 15 focus countries in sub-Saharan Africa, Asia and the Caribbean being assisted by the PEPFAR.

Read UNAIDS statement

The annual Jackson Hole Film festival
(JHFF) begins on 6 June in Wyoming,
United States of America.

This leading independent film festival has always been committed to creating a platform for global inspiration and change. In this, it’s fifth year, it is inviting senior UN officials to discuss ways to engage the world on neglected issues with media figures and members of the film industry.

In addition to the screening of 100 independent films and documentaries, the Festival is hosting the first Global Insight summit in partnership with the United Nations. UN Secretary-General Ban Ki-moon will open the event which takes place Saturday 7 June 2008 which will be open to the public.

The aim of this event is to host a dialogue on critical global issues. The Festival organizers hope that Global Insight summit be a meaningful forum for exchange between senior UN officials and writers, producers and directors from film and television.

Children and HIV

UNAIDS Deputy Executive Director Deborah Landey will moderate a panel on children and HIV.

The numbers are stark. Half of all new HIV infections worldwide are in young people aged 15-24. Large numbers of young people are sexually active at an early age, are not monogamous, and do not use condoms regularly. Young people may not always be able to negotiate safe sex and in addition, may experiment with alcohol and drugs, including injection drugs, which further expose them to HIV.

The mass media has an important role to play in promoting greater awareness and understanding of HIV and communicating about its prevention.

Many others are directly affected by AIDS. Over 15 million children under 18 have lost one or both parents to the disease and countless others become responsible for the care of their siblings and other family members when parents are debilitated by poor health. As a consequence children become more vulnerable to poverty, homelessness and school drop-out.

Globally in 2007, 2.1 million children under the age of 15 were living with HIV, 420,000 had been newly infected and 290,000 died due to the disease. Most of these were infected with the virus while still in the womb, during birth or while breastfeeding. Salman Ahmad, renowned Pakistani singer and UNAIDS Special Representative will also participate, sharing how he addresses—through his music and performances—the challenge of stigma against those living with and affected by HIV. Countering stigma and discrimination towards young people living with HIV is vital to ensure their fullest integration and participation in society.

UNICEF Executive Director, Ms Ann Veneman will moderate a panel on children and armed conflict.

Complementing the Summit will be a selection of films that exhibit the power of media to address global issues. Through a juried selection process, the Global Insight Film Award will be given to the film that best demonstrates the use of film to help highlight an important global issue.

15th Conference on Retroviruses
and Opportunistic Infections took place in
Boston 4-6 February 2008. Credit: CROI

The annual Conference on Retroviruses and Opportunistic Infections (CROI) began in 1994 as a small meeting of scientists studying HIV and clinicians treating people with HIV. It is now one of the most important annual HIV gatherings and provides a forum for basic scientists, clinical investigators, and global health researchers to present, discuss, and critique their investigations into the epidemiology and biology of human retroviruses and the diseases they produce.

The 15th CROI concluded in Boston on 6 February and while announced trial results were not encouraging, many significant topics were discussed. The absence of a scientific breakthrough in HIV vaccine development underscores the need to scale-up existing prevention and treatment strategies.

HSV-2 trial - No observed reduction in risk

Disappointing results were announced from trials to see if ongoing treatment of the virus that causes herpes in humans, herpes simplex virus type 2 (HSV-2), would reduce the risk of HIV transmission. HIV-negative people with HSV-2 were asked to take medication to suppress outbreaks of herpes. However, the trial results showed no difference in rates of HIV infection between individuals who had taken the medication and those who hadn’t.

Scientific data shows a link between HSV-2 infection and susceptibility to acquiring HIV infection and there are other on-going trials exploring different aspects of this link, so researchers remain cautiously hopeful about this avenue of research.

Male circumcision

Previously-released data from the studies of male circumcision in Uganda which were stopped in December 2006 were presented by trial investigator Maria Wawer. One trial explored whether circumcising a HIV-positive man reduced the risk of HIV transmission to his HIV-negative female partner. Results showed a trend towards increased HIV transmission from men to their female partners. This trend was more notable, although still not statistically significant, when the men resumed sex before their wound had healed completely.

While this data is not new, its presentation at CROI gave an opportunity for discussion and analysis of its implications. Advocates stressed the necessity for all male circumcision programmes to directly address women’s increased vulnerability to infection by sex with a recently-circumcised, HIV-positive man.

UNAIDS Chief Scientific Adviser Dr Catherine Hankins said, “This underlines the importance of considering male circumcision as part of a comprehensive prevention package which includes couple counselling and post-surgery advice involving both partners. Couples should consider a mutual commitment to abstinence until the wound is healed completely.”

UNAIDS guidelines recommend that all men undergoing male circumcision should be clearly instructed and supported to abstain from sexual intercourse until certified wound healing, which normally can take up to six weeks, to avoid increasing the risk of both acquiring and transmitting HIV.

Most importantly, individuals must understand that male circumcision does not afford complete protection against HIV infection and that it must not replace other prevention strategies such as correct and consistent use of male and female condoms, reduction in the number of sexual partners, avoidance of penetration, and treatment of sexually transmitted infections.

Vaccines

Last September there was a disappointing failure in Merck’s adenovirus- based HIV vaccine candidate. The consensus from experts at CROI was that it was important for scientists to go back to the drawing board of basic science to get a better understanding of the workings of the virus and the responses of the human immune system. There was a call for increased investment into basic scientific research and less emphasis on expensive clinical trials, although clearly both are needed.

There is a growing acceptance that the search for the elusive HIV vaccine is set to continue for some time. This underscores the need to scale-up existing prevention and treatment strategies and highlights the importance of improving people’s access to sexual health information, access to HIV testing and counselling services and to male and female condoms.

Other interesting topics under discussion at CROI included improved screening for TB, ensuring adequate representation of women in HIV trials, aging and AIDS, and paediatric and adolescent HIV care.

L to R: Timothy E. Wirth, President, United
Nations Foundation and Better World Fund,
Jim Yong Kim, Harvard Medical School,
David Baltimore (moderator), AAAS
President, California Institute of
Technology and UNAIDS Executive
Director Dr Peter Piot.

The 2008 Meeting of the American Association for the Advancement of Science took place in Boston, USA from 14-18 February and brought together science and technology professionals from 56 countries to discuss the latest scientific breakthroughs and challenges.

President of the AAAS, Nobel Prize winner Mr. David Baltimore, said that the event was the ‘largest and most important interdisciplinary scientific gathering of the year’. The main focus of the conference was on the power of science, technology and education, to assist less developed segments of world society while improving cooperation among developed countries and spurring knowledge-driven transformation across scientific disciplines.

Some 10,000 people attended the conference including leading scientists, engineers, educators, and policy-makers as well as members of the national and international media.

The meeting ran under the umbrella theme of "Science and Technology from a Global Perspective" and the program highlighted areas of research, new developments, and cross-cutting activities in support of science, technology and education around the world.

UNAIDS Executive Director Dr Peter Piot
spoke on a plenary panel session on
Global Health Challenges on Monday 18
February.

Among the 150 symposiums and presentations was a round table discussion on the state of public health which focused particularly on AIDS and tuberculosis; presentations on the search for a global AIDS vaccine and the challenge of comprehensive HIV control in sub-Saharan Africa.

UNAIDS Executive Director Dr Peter Piot spoke on a plenary panel session on Global Health Challenges on the closing day of the conference together with Jim Yong Kim from the Harvard School of Public Health and Timothy Worth, President of the UN Foundation and Better World Fund. The session was moderated by AAAS President David Baltimore.

UNAIDS Executive Director Dr Peter Piot address US Senate Committee

At a special hearing - "Meeting the Global Challenge of AIDS, TB and Malaria" - UNAIDS Executive Director Dr Peter Piot addressed the US Senate Committee on Health, Education, Labor and Pensions (HELP) about AIDS, the work of UNAIDS to address the epidemic and the critical difference that the US President's Emergency Plan for AIDS Relief (PEPFAR) has made in the AIDS response.

Also addressing the Committee in Panel I were U.S. Global AIDS Coordinator, Ambassador Mark Dybul and Director of the US Centers for Disease Control and Prevention. Joining Dr Piot in Panel II were World Vision HIV educator Princess Zulu, Professor of the University of California, Dr Norman Hearst and Vice Chair of the IOM Evaluation Committee, Dr Helen Smits.

UNAIDS Executive Director Dr Piot, called on
religious leaders to scale up efforts to promote
tolerance: to denounce discrimination and violence
based on gender, sexual orientation or social status,
and to eradicate the stigma around AIDS.

UNAIDS Executive Director Dr. Peter Piot spoke at the Saddleback Church Global AIDS Summit in Lake Forest, California.  Dr Piot noted the unique and important role in the global AIDS response of religious groups of all kinds, which provide HIV treatment, care and support in some of the remotest parts of the world.

He called on religious leaders to scale up efforts to promote tolerance: to denounce discrimination and violence based on gender, sexual orientation or social status, and to eradicate the stigma around AIDS. He encouraged them to reach out to groups who are marginalized by society and as a result at greater risk of HIV infection. 

"A quarter century into the AIDS response, it is time to take stock of the progress we've made, and consolidate and scale up what's working," said Dr Piot. "It is also time to recognize that all of us can, and must, do more, if we are to get ahead of the epidemic."

Leadership was an important theme of the summit, and was the focus of speeches from Dr Piot and United States Global AIDS Coordinator Ambassador Mark Dybul who spoke in a session called ‘Excellence in Global Leadership’. Also speaking on the topic were leaders from the Organization of African First Ladies Against AIDS – Her Excellency, Mrs. Jeannette Kagame, First Lady of Rwanda and Her Excellency, Mrs. Maureen Mwanawasa, First Lady of Zambia.

The Saddleback Summit was organized by Saddleback Church founder Rick Warren and his wife Kay Warren, Executive Director of the church’s AIDS initiative, as an avenue for attendees to learn more about AIDS and coordinate their efforts to address the disease. The summit is taking place from November 28-30.  A youth summit is scheduled to follow on December 1.

Over the last year, UNITAID has
committed a total of US$ 45 million
for second-line antiretroviral drugs
to fund the treatment of 65 000
patients by 2008.

One year on since its establishment, the international drug purchase facility – UNITAID – is celebrating a number of key achievements.

“In the year since it was established, UNITAID has managed to reduce the price of HIV treatments for children by almost 40%, and those for second-line antiretroviral (ARV) drugs by between 25% and 50%,” UNITAID reported.

“In collaboration with the Clinton Foundation, UNITAID has also delivered more than 33 000 paediatric treatments against AIDS and is on course to meet the needs of 100 000 children by the end of 2007.

”UNITAID was launched in September 2006 during the United Nations General Assembly. The mandate of UNITAID is to contribute to the scaling up of access to treatments for AIDS, malaria and tuberculosis in developing countries by leveraging quality drugs and diagnostics price reductions and accelerating the pace at which these are made available. UNITAID offers beneficiary countries long-term support through sustainable and predictable funding, mobilized by innovative financing mechanisms, such as a solidarity contribution on air tickets, together with multi-year predictable budgetary contributions.

Over the last year, UNITAID has committed a total of US$ 45 million for second-line antiretroviral drugs to fund the treatment of 65 000 patients by 2008. “Four countries (Botswana, Cameroon, Uganda and Zambia) have already received a first supply of second-line ARV drugs through UNITAID and a further 13 countries are currently awaiting delivery,” said UNITAID.

UNITAID is also contributing to the fight against tuberculosis together with the Global Drug Facility and the Stop TB Partnership. By the end of the year, UNITAID will have provided TB treatments to 150 000 children in 19 countries and will be supporting the provision of drugs for Multidrug - resistant TB in 17 low-income countries.

For each programme, UNITAID sets up an ad hoc partnership with existing organizations: World Health Organization, UNICEF, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Clinton Foundation, Global Drug Facility/Green Light Committee and the Stop TB Partnership.

”UNITAID is a prime example of the rapid, flexible and innovative action needed to develop a sustainable long-term response to AIDS and reach universal access to HIV prevention, treatment, care and support,” said UNAIDS Deputy Executive Director, Michel Sidibe. “In less than a year, UNITAID has shown that harmonization, simplification and coordination lead to less duplication and much more effective use of resources. It is a real model of ‘making the money work’ and scaling up of existing programmes for the benefit of the people who need it most.

Based in Geneva, the UNITAID Trust Fund and Secretariat are hosted by WHO. At present, 27 countries— of which 19 are in Africa— are members and contribute to UNITAID. At least 85% of UNITAID funds are spent in low income countries. The budget of UNITAID for 2007 is over US$ 300 million and 90% has already been committed to programmes in more than 80 countries.