United States of America

Dr Piot noted the leadership role that
has been played by the United States
in addressing the global AIDS
epidemic. Photo credit: H. Fancher

UNAIDS Executive Director Peter Piot participated in a forum at the Woodrow Wilson International Center for Scholars in Washington, D.C., discussing the United States’ important role in the global AIDS response and the upcoming reauthorization of the U.S. President’s Emergency Plan for AIDS Relief. U.S. Representative Nita M. Lowey and Kent R. Hill of the U.S. Agency for International Development also spoke at the forum.

During his speech, Dr Piot noted the leadership role that has been played by the United States in addressing the global AIDS epidemic, and called on the country to maintain and strengthen this commitment. “We must accelerate our efforts, and broaden them—by bolstering our long-term, sustainable efforts to fight this disease,” he said. “For the United States in particular, that means sustaining the leadership role you have played in recent years. Your investments have had powerful results for many people around the world. We need your leadership to continue – and intensify – on all fronts.”

The UNAIDS Executive Director is in the United States to speak with leaders from government and civil society about the state of the global AIDS epidemic and role U.S. organizations can play in the response. On Tuesday 18 September he addressed students and faculty at Washington D.C.’s Howard University. Next week he will give the keynote speech at a symposium on children and AIDS at Harvard University Medical School.

Howard University’s hospital was the first in the
United States to routinely offer HIV testing to all
patients.

The important role of academic organizations in the global AIDS response was underlined on Tuesday 18 September in a special lecture given at Washington D.C.’s Howard University by UNAIDS Executive Director Dr Peter Piot.

Addressing students, faculty, community members and journalists, Dr Piot praised Howard University for its commitment to confronting HIV in Washington, D.C. – one of the areas most affected by AIDS in the United States, with approximately one in twenty of the city’s residents living with HIV.

“This university has done so much to raise awareness to unmet needs at every level of society – and you have been a great partner in the global fight against AIDS. Faculty and students at Howard are addressing HIV on multiple fronts as scholars, scientists and activists,” said Dr Piot. “The world must follow your example. That is the only way we will ever get ahead of this epidemic,” he added.

Howard University’s hospital was the first in the United States to routinely offer HIV testing to all patients; its law students run a legal clinic for people living with HIV; and the university recently convened a conference on the global AIDS response.

In his speech, sponsored by the National Minority AIDS Council, D.C.-based AIDS service organization the Women’s Collective, and Howard’s Student Health Center and Women’s Health Institute, the UNAIDS Executive Director also highlighted the important role of the United States in funding the global AIDS response.

“PEPFAR [the United States’ President’s Emergency Plan for AIDS Relief] enabled us to make a quantum leap forward against AIDS,” Dr Piot said. “With PEPFAR, the global discussion about responding to AIDS stopped being about ‘millions’ and started being about ‘billions.’ PEPFAR runs out next year, giving the United States a unique opportunity to continue its support of a truly global effort.

”Later this week, Dr. Piot will speak at the Woodrow Wilson Center for International Scholars in Washington. He will also travel to Boston to give the keynote speech at a symposium at Harvard University Medical School on children and AIDS.

UNAIDS Executive Director Dr Peter Piot giving the
2007 Payne Lecture at Stanford University on May 9.

“AIDS is forcing us to adopt new approaches, look at things differently, and transform the way we do things,” said UNAIDS Executive Director Peter Piot as he gave the 2007 Payne Lecture at Stanford University on May 9.

In remarks punctuated with statistics, Piot reflected on how the epidemic and its response have evolved and how AIDS is changing the world. He also outlined some of the key challenges ahead for sustaining the AIDS response in the long-term.

“We are still in the middle of a crisis. Eight thousand people are dying every single day from AIDS,” he said.

The UNAIDS Executive Director stressed that AIDS has turned into one of the most serious challenges our planet has ever faced, ranking with climate change, international terrorism, and the threat of nuclear war as “one of the defining issues of our time.”

He outlined how major progress has been made on many fronts, including decreasing rates of infection and increasing levels of antiretroviral medicine. And, he underlined, AIDS has become an agent for social change—for example, contributing to the gay rights movement by increasing awareness and leading to a healthy and more open consideration of sexuality and gender roles.

Dr Piot outlined how major progress has been made
on many fronts, including decreasing rates of
infection and increasing levels of antiretroviral
medicine.

Nevertheless, he stressed, much remains to be done.

“The truth is that after 25, 26 years since AIDS was discovered, the end of this epidemic is nowhere in sight. AIDS is both a global problem and a multi-generational problem ,” he said.

“We need young people in the fight against AIDS because it is not going to be over tomorrow,” he added.

Roughly 65 million people have been infected with HIV since 1981. What started as a disease associated with middle-class gay men is now a universal problem.

“There are countries in southern Africa where 30-40% percent of the adults are HIV-positive,” Piot said. “Just imagine what that would be in California — 10, 20 million people living with HIV.”

Numbers like these are especially devastating countries with failing health systems, he said. He also noted that the epidemic is spreading alarmingly quickly in the former Soviet Union and India.

“ AIDS does to society what HIV does to the human body — it weakens the immune system just as it weakens the resiliency in a society,” he said. “It weakens the ability to cope and to deal with difficult things.”

Dr Piot spoke of a “brilliant alliance” that would
combine the efforts of politicians, big business, trade
unions and religious institutions to combat the
disease.

He added that as an exceptional disease, AIDS requires an exceptional response and outlined a number of challenges ahead including increasing and sustaining political commitment and funding, ensuring the money available reaches the people who need it most, advancing scientific developments and addressing the fundamental drivers of the AIDS epidemic – such as gender inequality and violence against women, stigma and discrimination, and the marginalization of homosexuals, drug users, and migrants.

“There is enormous stigma and discrimination attached to the disease, and that’s what makes it so unique,” Piot said. “It’s about sex and drugs; that’s what makes it so difficult to address.”

Piot spoke of a “brilliant alliance” that would combine the efforts of politicians, big business, trade unions and religious institutions to combat the disease. “ We need the brightest and most creative minds to defeat this epidemic,” he said.

Photo credit : B. Hamilton

UN Secretary General Kofi Annan, UNAIDS Executive Director Peter Piot, AIDS activist Lynn Murchison and Hunger Project President Joan Holmes took part in an event in New York to commemorate World AIDS Day.

Speaking at the event, the UN Secretary-General highlighted the importance of accountability – the theme of this year’s Worlds AIDS Day – by saying, “ Accountability requires every President and Prime Minister, every parliamentarian and politician, to decide and declare that “AIDS stops with me”.

Dr Piot gave a brief overview of the epidemic saying that the latest global AIDS figures give reason for concern and for some hope. He also highlighted the need for more attention to be brought to women and girls.

Ms Holmes took the opportunity to endorse the recent recommendation of the Secretary General’s High-Level Panel on UN System-wide Coherence for the creation of a new, unified and ambitiously funded agency for gender equality and women’s empowerment.

The event was chaired by Rev. Kevin Bean and attended by approximately 400 people. It was organized by The Hunger Project, UNAIDS and St. Bartholomew’s Church and co-sponsored by African Regional Youth Initiative, EngenderHealth, The Interfaith Center of New York, Islamic Cultural Center of New York, MaAfrika Tikkun, Mosque of Islamic Brotherhood, Muslim Women’s Institute for Research and Development, Population Council, World Council of Churches and World Council of Conservative Synagogues. Entertainment was provided by PG and Love Choir and Salah.

UN Secretary-General Kofi Annan was joined by UNAIDS Executive Director Dr Peter Piot and leaders of different faiths to commemorate World AIDS Day at St. Bartholomew’s Episcopal Church in New York. The gathering in New York was one of a host of events taking place around the world to mark World AIDS Day 2006.

All photo credit : B. Hamilton

And warmly congratulates Global AIDS Ambassador Eric Goosby in his new expanded leadership role

GENEVA, 14 December 2012—The United Nations Joint Programme on HIV/AIDS (UNAIDS) welcomes the creation of a new United States Global Health Diplomacy Office and the announcement that US Global AIDS Ambassador Eric Goosby will lead this new effort. 

“I can think of no one better than Eric to bring this new vision to life,” said Michel Sidibé, Executive Director of UNAIDS. “We have seen the amazing impact of PEPFAR in forging a new kind of partnership with countries to save lives. We look forward to working closely with Ambassador Goosby and the new Office to help multiply these results across global health and development.”  

To elevate global health issues the United States will pursue new partnerships with countries to foster better health outcomes. The new office will provide guidance to US Ambassadors to more effectively support countries, to strengthen the sustainability of health programmes and to continue to promote a vision for shared responsibility and global solidarity.

Ambassador Goosby brings more than 30 years of global health experience and will continue to lead the United States President’s Emergency Plan for AIDS Relief (PEPFAR).  PEPFAR recently unveiled a new blueprint for how the US Government will work with countries to help achieve an AIDS-free generation.

FDA gives approval for the use of antiretroviral therapy to prevent HIV in people who do not have the virus in the United States

GENEVA, 16 July 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes today’s announcement by the United States’ Food and Drug Administration (FDA) for the use of an antiretroviral drug combination (emtricitabine/tenofovir disoproxil fumarate)  to prevent the sexual transmission of HIV for people who do not have HIV, but who are at high risk of being exposed to the virus. 

HIV prevention of this kind is called pre-exposure prophylaxis­­—commonly known as PrEP.  Emtricitabine and tenofovir disoproxil fumarate have been used to treat HIV infection since 2004, in combination with other antiretroviral drugs. This is the first time that an antiretroviral pill has been approved for use by people who do not have HIV. 

The FDA has approved the drug combination for use as part of a comprehensive HIV prevention strategy that includes condom use and other safer sex practices, risk reduction counselling and control of other sexually transmitted infections. Regular HIV testing and counselling is an essential part of approved use for prevention, since there is a danger of drug resistance if used by people who have HIV but do not know they are living with the virus.

The decision of the US FDA is based on their review of results from  recent clinical trials which have found that a daily oral dose of tenofovir, or of the combination emtricitabine/tenofovir disoproxil fumarate, when taken as prescribed by people who do not have the virus, provided significant prevention benefit.

The iPrEx study among men who have sex with men found that PrEP using the emtricitabine/tenofovir disoproxil fumarate combination decreased HIV transmission by 42% on average, and up to 73% among men who took the pill regularly.  The Partners PrEP study found 75% protection among serodiscordant couples in studies in Kenya and Uganda, and the TDF2 trial in Botswana found PrEP to be roughly 63% effective among serodiscordant couples. In all three studies, oral PrEP was provided as part of a comprehensive prevention package of services, and in all three studies showed that adherence to the prescribed regimen was critical to its effectiveness.

The results from the studies showed the potential effects of combination prevention approaches—combining consistent condom use, frequent HIV testing, counselling, and treatment of sexually transmitted infections with pre-exposure prophylaxis for maximum prevention gains.

UNAIDS underlines that no single intervention is completely protective in preventing HIV transmission, which is why UNAIDS advocates strongly for combination prevention, including condom use for individuals at high risk of HIV infection.

GENEVA, 9 March 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) is deeply saddened by the death of United States Representative Donald M. Payne.

Congressman Payne served for more than 20 years in the United States House of Representatives, dedicating his life to improving the lives of people in his home country and around the world.

Congressman Payne was instrumental in co-authoring the original United States President’s Emergency Plan for AIDS Relief (PEPFAR) legislation in 2003, legislation that continues to save the lives of millions of people. He was known for his holistic approach to health, focusing on the whole person living with or at risk of HIV—ensuring that issues such as nutrition, disease prevention, and human rights were integrated.

As both Chairman and Ranking Member of the United States Subcommittee on Africa, Global Health, and Human Rights of the House Foreign Affairs Committee, Congressman Payne worked tirelessly to advocate for equity and access. His vision and dedication will be greatly missed.

GENEVA, 1 December 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) congratulates President Barack Obama on his bold commitment to provide AIDS treatment to 6 million people by 2013 and reach 1.5 million pregnant women living with HIV to protect their children from becoming infected with HIV. This reinforces the collaboration between UNAIDS and the United States on the global plan towards elimination of new HIV infections among children by 2015—the foundation for an AIDS free generation.

“The commitments made by President Obama today will save lives and help move us towards an AIDS free generation,” said Michel Sidibé, Executive Director of UNAIDS. “Getting to zero and ending AIDS is a shared responsibility.”

UNAIDS also welcomes the United States’ strong bipartisan commitment to the global AIDS response. This unprecedented solidarity has made the United States the largest global AIDS donor, providing more than half (54.2%) of all international AIDS assistance available to low- and middle-income countries in 2010. The PEPFAR programme, initiated under the leadership of President George W. Bush and expanded by President Obama, currently provides lifesaving HIV prevention, treatment, care and support services to millions of people, especially in sub-Saharan Africa, the region most affected by the epidemic.

World leaders have pledged to invest between US$ 22-24 billion by 2015 for the AIDS response. In recent years, international assistance has begun to decline, jeopardizing the ability of countries to sustain and scale up access to prevention and treatment services. UNAIDS urges members of the G8 and G20 to expand their investments in AIDS—domestic and international. It also calls on all developing countries to increase their funding for their national AIDS programmes.

President Obama’s call to step up HIV prevention efforts using high-impact combination tools, such as treatment as prevention, male circumcision, antiretrovirals to stop new HIV infections among children and consistent condom use, has the potential to avert millions of new HIV infections. This approach, endorsed by UNAIDS, uses the best of new science and will save both money and lives.

GENEVA, 14 December 2010—UNAIDS is deeply saddened by the death of AIDS advocate Ambassador Richard Holbrooke. During his lifetime, Ambassador Holbrooke was a staunch supporter of the AIDS response and a valued partner of UNAIDS.

Whilst serving as United States Ambassador to the United Nations, Ambassador Holbrooke was instrumental in organising the very first special session of the Security Council on HIV/AIDS in January 2000.

This was the first time United Nations member states had addressed a health and development issue at the Security Council. In July 2000, the Security Council passed Resolution 1308, emphasizing the need to stop the spread of the virus during peacekeeping operations.

“Ambassador Holbrooke managed to redefine the AIDS response by identifying AIDS, not only as a public health issue, but as matter of global security,” said Michel Sidibé, Executive Director of UNAIDS. “Through his unique actions he has mobilised world leaders and business partners in committing to the AIDS response. The AIDS movement has lost a good friend.”

In 2001, Ambassador Holbrooke led the Global Business Coalition on HIV/AIDS in engaging the private sector to join the response to HIV. As President and CEO from 2001 until 2009, he fostered unprecedented commitment from the corporate sector to the global health agenda. Through his unique passion and drive, he was instrumental in successfully mobilising world business leaders in the response to HIV.

Ambassador Holbrooke will be deeply missed and UNAIDS extends its sincere sympathy to his family and friends at this difficult time.