United States of America

UNAIDS Executive Director Michel Sidibé with the young delegates participating at the youth pre-conference event. Washington, DC. 18 July 2012.

Every day 2 400 young people aged 15 to 24 are infected with HIV around the globe, which represents 40% of all new infections among adults. With this age group bearing a significant burden of the epidemic, they must be central to the AIDS response. An event on the eve of AIDS 2012 is bringing together around 200 young people to ensure that youth participation in the major international AIDS gathering of the year is meaningful and effective.

Taking place 18-20 July, the ‘pre-conference’ is an opportunity for young delegates to connect with their peers, plan strategy and maximize their ability to navigate AIDS 2012 successfully. The event offers the possibility to share high quality information on the latest trends in the epidemic along with an examination of youth-specific issues, challenges and needs. Skills-based training on HIV is also provided to the young participants. Organized by YouthForce--a coalition of youth organizations from around the world—the pre-conference youth event has provided an essential platform for young people since the Barcelona International AIDS Conference in 2000.

“Young people bring a fresh perspective to the HIV response, fueled by passion and creativity,” said Mimi Melles, pre-conference co-chair and Officer at Advocates for Youth. “We are innovators and change-makers, and without our meaningful involvement, we will never be able to achieve our targets of zero new infections, zero discrimination and zero AIDS-related deaths,” she added.

In the last few years, there has been a particular emphasis on addressing the needs of young people living with HIV and those from key affected populations such as men who have sex with men, injecting drug users and sex workers. In January of this year, the United Nations Secretary-General presented his five-year action agenda where he outlined working for women and young people as one of his five priorities. Similarly, in October 2011, UNAIDS launched CrowdOutAIDS — a youth-led policy project that used social media tools and crowdsourcing technology to enable young people from around the world to develop a set of recommendations for the UNAIDS Secretariat to work more effectively with young people in the AIDS response. The recommendations feed into the Secretariat’s New Generation Leadership Strategy aimed at increasing youth leadership, ownership and mobilization by 2015.

“We need a youth movement that takes ownership of the response and that holds governments accountable to scale up equitable access to HIV services,” said UNAIDS Executive Director Michel Sidibé speaking at the opening ceremony. “Through CrowdOutAIDS we enabled young people shape UNAIDS’ strategy for youth engagement, and I remain committed to implement it,” he added.

At the pre-conference event, UNAIDS together with the YouthForce will launch the collaboration project A Declaration for Change: How young people will achieve an AIDS-free generation - which will run for the duration of the pre-conference. It will allow all young people taking part in the event, as well as young people around the world, to outline a list of priorities that will lay the foundation for how youth organizations, networks and activists will collaborate and mobilize to reach the 2015 goals of the 2011 Political Declaration on AIDS.

Ways of effecting broad social mobilization among youth, especially young people in key populations, will be explored in detail during the youth event. High-risk populations often face significant challenges in accessing HIV treatment and other health care services because of stigma and discrimination.

The meeting will also provide an opportunity to identify ways to remove existing social and legal barriers that block young people’s access to HIV services. For example, in nearly 70 countries there are laws or regulations that present obstacles to accessing HIV prevention services for young people. Only a fraction of nations in the most affected regions allow minors to access HIV testing without parental consent.

Not only is it seen as critically important for young people to act as leaders in the response, but concrete ways for youth to get involved in the design, implementation and monitoring and evaluation of HIV programmes will be debated. According to Aram Barra, YouthForce chairperson, his peers are more than ready for the challenge. “Organizations, networks and governments must build a long term strategy together, beyond AIDS2012, inclusive of newcomer activists and young people living with HIV,” said Mr Barra. “Only by doing this will we strengthen the global AIDS response,” he added.

During the three-day conference there will be a broad range of lively sessions including; HIV criminalization: Are you at risk?; Gay, lesbian, bisexual, transgender (GLBT) rights in the HIV movement; What is a successful youth-adult partnership?; Building youth AIDS competency for community action; Empowerment of young people in the sex trade; and How to tell a powerful story through photography.

Greater and better focused involvement of youth in the AIDS response will reap positive dividends as a significant portion of the general decline in new HIV infections is attributed to behavior change in the young. Between 2001 and 2010, HIV prevalence declined among people aged 15 to 24 in at least 21 of 24 countries with national prevalence of 1% or higher. The young delegates at AIDS 2012 are intent on using the conference to get their voices heard and help consolidate these gains when they return to their home countries.

The new 2012 UNAIDS report Together we will end AIDS will be launched ahead of the XIX International AIDS Conference in Washington, DC, which is taking place from 22-27 July.

The report contains the latest data on numbers of new HIV infections, numbers of people receiving antiretroviral treatment, AIDS-related deaths and HIV among children. It also highlights new scientific opportunities and social progress, and gives an overview of international and domestic HIV investments.

The report will be launched during a high-level interactive panel discussion held at the Newseum in Washington DC. The event will bring together some of today’s influential thought-leaders on HIV, global health and development to share insights into the future of the AIDS response.

Watch the live webcast of the launch of Together we will end AIDS here

L to R: United States Congresswoman and member of the Global Commission on HIV and the Law, Barbare Lee; UNAIDS Executive Director Michel Sidibé; Deputy Secretary-General of the United Nations Jan Eliason; UNDP Administrator Helen Clark; and His Excellency Festus Mogae, former President of Botswana and member of the Global Commission on HIV and the Law.
Credit: D.Lowthian

The Global Commission on HIV and the Law launched its landmark report on 9 July 2012 at UN Headquarters in New York. The new report denounces the detrimental impact that punitive laws have on human rights and the HIV response and makes bold recommendations for addressing them.

“Never before has there been such an examination of the role of law in HIV,” said Festus Mogae, Former President of Botswana and member of the Commission. “What we have found is an epidemic of bad laws that is costing lives. We must end the epidemic of bad laws and enact laws based on evidence, common sense and human rights,” added Mr Mogae.

Stigma, discrimination and punitive legal approaches have long been recognized as barriers to the HIV response. They heighten vulnerability to HIV especially among key populations at higher risk of infection and make it difficult for individuals and communities to access HIV prevention, treatment, care and support services. UNAIDS has long called for the removal of punitive laws and their replacement with protective ones. Yet, countries across the world still maintain laws, policies and practices that infringe upon human rights, fuel discrimination and prevent global and national efforts to address HIV.

Speaking at the launch of the report, UNAIDS Executive Director Michel Sidibé noted that “the strength of this report is that it goes beyond a superficial description of stigma and discrimination to question the legal and structural fabrics that sustains inequality, injustice and human rights violations in the context of HIV”.

The report titled “HIV and the Law: Risks, Rights and Health” is a result of a two-year consultative process during which the Commission received more than 1 000 submissions from people affected by laws, law enforcement and access to justice issues in the context of HIV. The report took into account recommendations from 7 regional dialogues involving governments and civil society, and the input from a Technical Advisory Group of experts on HIV and the law.

Punitive laws increase risk of HIV infection

The Commission—an independent group of political and social leaders from around the world—pointed out that women in many parts of the world are governed by plural legal systems where traditional and customary law perpetuates their social and economic inequality. This situation makes women vulnerable to relationships and/or sexual violence which put them at risk of HIV infection. The Commission described the realities of many pregnant women living with HIV who face discrimination in health care including forced sterilization, even though simple and inexpensive medicine can prevent mother-to-child HIV transmission and keep mothers alive.

In the report, Commissioners called on governments to use the law to protect women from inequality and violence. They also urged governments to end legal barriers that prevent young people from accessing HIV information and services, as well as sexuality education—all necessary to avoid HIV infection.

The Commission also called for the removal of laws that criminalize people on the basis of their sexual orientation and gender identity, possession of drugs for personal use, and engagement in adult consensual sex work. It cited extensive evidence of how such criminal laws exacerbate risk of HIV infection among men who have sex with men, transgender people, people who use drugs and adults who sell and buy sex. According to the report, such laws drive people underground and into the margins of society away from health and HIV services. Furthermore, if convicted and sent to prison, the risks of contracting HIV, TB and Hepatitis C are very high because, in many countries, laws prohibit the provision of health and HIV prevention services and commodities in prisons.

Nick Rhoades from the Center of HIV Law and Policy spoke against the criminalization of HIV exposure and transmission, having himself been convicted in the United States of America, even though he had used condoms, had an undetectable viral load and did not transmit HIV. Citing the many HIV specific criminal laws, he said: “People have hands and can hit each other with their fists, but you don’t see a law specifically criminalizing a hand as a ‘deadly weapon’ like HIV is.” The Commission has called for the criminal law to be strictly limited to the malicious and intentional acts of actual transmission of HIV.

Participants at the launch highlighted how punitive legal approaches are undermining the investment in HIV prevention and treatment that is finally beginning to show the real possibility of halting and reversing the epidemic. They underlined that the persistence of punitive laws and practices is a serious concern at a time when the world has stabilized new HIV infections, increased its knowledge on effective HIV prevention and is preparing to harness the full potential of expanded HIV treatment. “It is outrageous that in 2012, when we have everything we need to beat this epidemic, we still must fight prejudice, discrimination, exclusion and bad laws,” said Mr Sidibé.

Law as an instrument to protect individuals

Commissioners at the launch underlined that there are many positive examples of countries that have used the law as an instrument to protect individuals, to create an environment that addresses stigma and violence thus encouraging access to HIV services. Other countries have used the law to challenge overly broad and stringent intellectual property regimes to reduce the cost of essential HIV medicines and to ensure their availability including through the production of generics.

“Law reform is complex, but countries can do much more,” said UNDP Administrator Helen Clark. “The task before us is to ensure better laws are adopted and enacted,” she added.

The Commission and its work have started dialogues across the world on issues that are difficult, controversial and complex. They are also issues that are central to human dignity, health and social justice. These dialogues are part of what Governments committed to do in the 2011 Political Declaration on AIDS where they pledged to review laws and policies that “adversely affect the successful, effective and equitable delivery of HIV services and consider their review”.

“We now have a powerful tool for advocacy and engagement to ask governments to uphold human rights for all people vulnerable to HIV,” said Ebony Johnson of the Athena Network. “This report should not be shelved.”

The Global Commission on HIV and the Law is an independent body, convened by the United Nations Development Programme (UNDP) on behalf of the Joint United Nations Programme on HIV/AIDS (UNAIDS). The Commission was supported by a Technical Advisory Group, which reviewed and analyzed existing public health and legal evidence and also commissioned original analysis. Additional information on the Commission, its processes and work is available at www.hivlawcommission.org.

L to R: UNAIDS Executive Director Michel Sidibé, Ambassador Sylvie Lucas of Luxembourg, First Secretary of the Republic of Malawi Janet Zeenat Karim, International Treatment Preparedness Coalition (ITPC) co-founder David Barr. United Nations, NYC, on June 11, 2012.
Credit: UNAIDS/B.Hamilton

Coinciding with the 2012 General Assembly AIDS review, the Permanent Missions of Malawi and Luxembourg to the United Nations and UNAIDS organized a panel discussion to further understand the strategic investments needed for the AIDS response. The discussion brought together representatives of member states, UN organizations and civil society.

Participating in the discussion, UNAIDS Executive Director Michel Sidibé stressed the need to focus investments where they can have greater impact. “Proven, effective and context-specific HIV prevention and treatment interventions must be prioritized and scaled up,” said Mr Sidibé. “Approaches that are not tailored to reach people most in need, are at inappropriate scale and intensity, or whose benefits are undercut by persistent inefficiencies, should be discouraged,” he added.

Panellists agreed that incremental yet bold steps must be taken to close the financing gap by 2015, including greater allocations from domestic and international resources. Ambassador Sylvie Lucas of Luxemburg highlighted that in order to achieve the targets, “international donors, emerging economies, affected countries and additional stakeholders must all actively contribute, in accordance with their respective capacities.”

Mrs Janet Karim, speaking on behalf of the Permanent Representative of Malawi, stressed that despite efforts and political will, some countries cannot meet the financial needs required from their domestic sources and called for innovative partnerships to be sought to support governments’ efforts.

“It is indeed necessary to actively explore new sources of sustainable financing at all levels, including enhanced support from the private sector, the use of regional development banks, and the introduction of a tax on financial transactions,” said Mrs Karim. “At the same time, let us follow up on the commitment that we made to strengthen existing financial mechanisms, including the Global Fund and relevant United Nations organizations, through the provision of funds in a sustained and predictable manner,” she added.

The UNAIDS Investment Framework was presented as an opportunity for development partners and national governments toward developing a ‘shared responsibility’ agenda and maximizing value for money.

Stressing the need for affected communities to continue to be at the centre of the response, David Barr from the International Treatment Preparedness Coalition (ITPC) emphasized that human rights, equity, inclusion and participation should be seen as high-yield investments rather than avoidable costs. “It is essential that HIV care be centered around the protection of human rights, gender equity and the reduction of stigma,” said Mr Barr. “Without creating a safe environment for those of us at risk, we cannot engage in care and, therefore, all our public health efforts will be wasted.”

Participants agreed that, of the targets set in the 2011 Political Declaration on HIV/AIDS, among the most challenging and crucial was the one focused on “Close the global AIDS resource gap by 2015 and reach annual global investment of US$22-24 billion in low- and middle-income countries”. The AIDS financing target was considered not just a target in itself, but a critical enabler for the achievement of all of the Declaration’s targets.

L to R: United States Global AIDS Coordinator Ambassador Eric Goosby, Anglo American's chief medical officer Brian Brink, UNAIDS Executive Director Michel Sidibé and President of GBCHealth John Tedstrom.
Credit: GBCHealth

Taking stock of the successes, challenges and future of the global AIDS response after three decades was at the core of the Global Business Coalition annual conference on Health (GBCHealth) held from 14-15 May in New York.

Under the theme of “Defining forward: Business, health and the road ahead” the conference brought together corporate executives, government leaders, policy makers, multilateral organizations, civil society and the media to discuss the most serious global health issues of today.

Headline speakers included Michelle Bachelet of UN Women, Barbara Bush of Global Health Corps, Deepak Chopra, Muhtar Kent of The Coca-Cola Company, Madam Bongi Ngema-Zuma, South Africa’s First Lady and UNAIDS Executive Director Michel Sidibé. 

Considerable progress made

AIDS@30 was the first, tone-setting session in the GBCHealth conference, where the UNAIDS Executive Director Michel Sidibé shared a platform with Anglo American's chief medical officer Brian Brink, the United States Global AIDS Coordinator Ambassador Eric Goosby and President of GBCHealth John Tedstrom. Mr Sidibé highlighted the considerable progress that has been made in the international AIDS response. He emphasized the fact that almost 60 countries—34 in sub-Saharan Africa—have stabilized or reduced the number of new HIV infections. This was attributed in part to extensive collaboration between a range of partners.

“Local governments are taking greater responsibility for their epidemics. But HIV is a shared responsibility that involves governments, donors, civil society and the private sector."

Mr Brink agreed that the private sector has a key role to play in ensuring the success in the response to AIDS and described Anglo American’s efforts to implement workplace policies to keep its workforce and their families healthy.

“Anglo American has demonstrated that investing in HIV prevention, treatment and care has measurable and positive impact on the bottom line,” said Mr Brink. “By investing in your employees, you reduce absenteeism, increase productivity and contribute to the wellbeing of the company."

The debate was wide-ranging and touched on a number of issues, including how the epidemic has evolved; the necessary and sufficient conditions for a truly sustainable response and the prospects for AIDS funding in an uncertain economic climate.

"30 years ago, access to HIV treatment in the countries hardest hit by the epidemic was not deemed possible. Today's increased access to treatment is a tangible prove of what can be achieved when all sectors join forces to address the AIDS epidemic," said Ambassador Goosby.

It was also stressed that one of the major achievements of the AIDS response is the fact that it has been an entry point to larger social issues, giving vulnerable people a voice and the power to use it. As Michel Sidibé contended, "HIV should not be seen as a disease but an opportunity and entry point to address critical issues in society including human rights and gender equality."

Participants concluded that businesses, from the largest global corporations to micro enterprises, private sector associations and coalitions need to lend their resources and expertise in order to effectively respond to AIDS. Businesses should move beyond ensuring the well-being of their employees and actively contribute to the response by disseminating vital AIDS information through print, broadcast and billboard advertising space; lobbying for effective AIDS policies and providing financial resources to life-saving programmes.

Donations have double benefit

Donating to UNAIDS in the United States of America has become easier. ‘UNAIDS USA’, a 501c3—a tax-exempt nonprofit organization in the United States of America —has been set up to facilitate the engagement of alternative sources of financing. This will make it easier for individuals, foundations and the private sector to contribute to the work of UNAIDS and its 10 cosponsors.

“I believe we can make real advances in the AIDS response in the next five years, but to do so we need to join forces not just with governments but with private individuals, activists, corporations and foundations,” said UNAIDS Executive Director Michel Sidibé. “Every small contribution helps to reach UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS related deaths.”

AIDS activists fighting for better health, equity and social justice.
Credit: ACT UP

Before there was a name for it, there was a voice. Before there was treatment, there was a movement. AIDS activism has revolutionized the way the world approaches health. In the epidemic’s 30-year history—AIDS activists have sparked the imagination and actions of millions fighting for better health, equity and social justice.

AIDS activism had its start with groups like ACT UP—the AIDS Coalition to Unleash Power. Twenty-five years ago this month, Larry Kramer was speaking from his heart in New York and galvanizing what would become the first group to use political advocacy to change the course of the AIDS epidemic.

“I spread the word that I was going to make a speech at the community centre, and an awful lot of people showed up, I'm happy to say,” said Mr Kramer in an interview in 2005. “It was amazing; it was totally amazing.”

“Larry called us together and asked us to help him take to the streets to sound the alarm that AIDS had become the largest killer of young men and women in cities like New York and the government and society was doing nothing,” said UNAIDS Civil Society Partnership Advisor Eric Sawyer. “We were charting a new path—no one had ever organized a social justice activist movement around a health issue, let alone organizing a civil disobedience on health to mirror the civil rights movement. We were both excited and a bit scared as we had no social or legal protections and were being fired from jobs, evicted from our homes and even physically attacked due to societal fear and discrimination."

One of the things ACT UP was known for was its public and confrontational style. “You do not get more with honey than you do with vinegar; you just do not,” said Mr Kramer in the documentary Age of AIDS. “If it makes them angry enough, maybe they'll say why are they angry.”

Also ground-breaking was the use of strong messages and graphics such as the Silence=Death campaign which helped break the “conspiracy of silence” around the AIDS epidemic.

Now 25 years into AIDS activism Mr Sawyer thinks the advent of effective HIV treatment has made many people complacent. “There is a false belief that the AIDS epidemic is under control,” he said. “While circumstances for people living with HIV are much improved—nearly 2 million people will still die of AIDS this year and AIDS activism is needed now more than ever!”

ACT UP will mark its anniversary with an old-style march through the streets of New York on 25 April 2012. Mr Sawyer explains that ACT UP and Occupy Wall Street will take to the streets again to demand a financial transaction tax as a way of gaining innovative sustainable financing for global health initiatives such as the AIDS response.

Today, out of the 34 million people living with HIV worldwide, about 6.6 million people in low- and –middle income countries have access to HIV treatment with nearly 8 million additional people still in need.

Mayor Robert Bowser (left), President of the National Conference of Black Mayors, and Dr. Djibril Diallo, UNAIDS Senior Advisor, at the World Summit of Mayors.
Credit: Logan Coles

More than 250 mayors from sub-Saharan Africa and of African descent from the United States, the Caribbean and Latin America focused on strengthening the AIDS response in urban areas during an historic conference held in Dakar, Senegal from 15-19 December.

The 2011 World Summit of Mayors Leadership Conference was hosted by Senegalese President Abdoulaye Wade and co-organized by the US-based National Conference of Black Mayors (NCBM), the National Association of Senegalese Mayors, and UNAIDS.

At a plenary session chaired by the mayors of Dakar and Abidjan, Côte d’Ivoire, delegates engaged in a discussion on HIV risks, prevention strategies and the need to end stigma and discrimination.

“Today we can say with confidence that HIV prevention programmes are producing results. We can report today that 22 countries in Africa have lowered the rate of new HIV infections by 25% since 2001”, said Djibril Diallo, UNAIDS Senior Advisor, in a statement on behalf of UNAIDS Executive Director Michel Sidibé.

Citing the challenges posed by the global financial crisis, Dr. Diallo urged municipal leaders to reinforce their efforts to find ways to take greater ownership of the AIDS response and promote shared responsibility. “This will bring the world closer to the UNAIDS vision of zero new HIV infections, zero discrimination, and zero AIDS-related deaths,” he added.

The plenary session concluded with a proposal for pilot partnerships for HIV prevention between 10 cities and towns in sub-Saharan Africa and the Americas. The proposal was incorporated in the Summit’s action plan. The municipalities will share information on their five most effective activities to reduce HIV infections and ways to increase budget allocations for HIV prevention as well as to improve prevention services. The organizers plan to enlist several large U.S. cities, such as Atlanta, Las Vegas and Washington, DC in the pilot initiative.

“The foundational belief of the Summit is that cooperation between municipalities on the development challenges facing cities on the global landscape, including the HIV epidemic, is essential to the improvement of the well-being of all citizens in urban areas,” said Mayor Robert L. Bowser of East Orange, New Jersey, President of the NCBM, whose membership includes 682 mayors with a constituency of 55 million people across the U.S.

The World Summit of Mayors was convened within the framework of the UN International Year for People of African Descent 2011. Outside of sub-Saharan Africa, an estimated 200 million people in the Americas identify themselves as being of African descent, as do millions more in other parts of the world.

The United Nations Resident Coordinator in Senegal, Bintou Djibo, saluted the Summit’s efforts to forge international partnerships for development between mayors of the Diaspora and in sub-Saharan Africa. “Cooperation between mayors can promote decentralized governance that takes local conditions into account, and advance progress towards the achievement of the MDGs by 2015,” said Ms Djibo.

U.S. Secretary of Health and Human Services Kathleen Sebelius speaks at UNAIDS' World AIDS Day event in Washington, DC. Panels from the AIDS Memorial Quilt, including one from TASO Uganda, are displayed behind the Secretary.
Credit: UNAIDS.

On a day when President Barack Obama announced new United States’ commitments to the AIDS response, the U.S. Secretary of Health and Human Services, Kathleen Sebelius, spoke at a Joint United Nations Programme on HIV/AIDS (UNAIDS) hosted World AIDS Day commemoration event entitled "From Local to Global: Finding Common Cause in the AIDS Response."

The event was organized in collaboration with the District of Colombia (DC) Community Coalition for AIDS 2012 to help foster collaboration and shared learning between the United States domestic and the international HIV communities ahead of the International AIDS Conference to be held in Washington, DC in July 2012.

Secretary Sebelius called upon the audience of 300 activists, implementers and policy makers to redouble their efforts to reach an AIDS-free generation and to push towards the “Getting to Zero” vision both in the United States and globally. She reiterated an announcement by President Obama earlier in the day that the United States would support 6 million people on treatment in low- and middle income countries by 2013 and also allocate a further US$50 million to U.S. domestic programs.

The highlight of the event was a performance by the Hope for Africa’s Children Choir from Mukono, Uganda. The choir, which is includes children living with or orphaned by HIV, is visiting the United States at the invitation of the United Methodist Church and with the support of UNAIDS. Their compelling music and story-telling reinforced the tremendous progress made in the AIDS response, but also the substantial work that remains to be done.

Highlighting the HIV epidemic in the United States, Mr. George Kerr, a resident of Washington living with HIV, spoke for an urgent need for improved access to HIV prevention, treatment, care and support for citizens of Washington, DC.

Helene Gayle, President and CEO of CARE USA moderated the programme which also included remarks from Deborah von Zinkernagel, Principal Deputy Coordinator for the President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Congressman Donald Payne, and Mr Kerr of the DC Community Coalition for AIDS2012.

Three quilt panels from the AIDS Memorial Quilt Project, which documents the life stories of more than 40,000 lives lost to AIDS, were also exhibited during the event.

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

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

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

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

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

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

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

UNAIDS Executive Director Michel Sidibé with Housing Works client Matilda
Credit: Housing Works

In 2009 there were an estimated 1.2 million people living with HIV across the United States of America. In many cities across the United States large numbers of people living with HIV are also homeless. In New York one organization is working hard to address the twin crisis of HIV and homelessness.

Housing Works has been providing high quality services for homeless men, women and children living with HIV in and around New York City since 1990. The organization offers homeless people living with HIV essential services such as housing, medical, dental and mental health care, meals, job training, drug treatment and HIV prevention and treatment services. It is currently providing support to more than 20 000 homeless and low-income New Yorkers living with HIV.

The Executive Director of UNAIDS Michel Sidibé visited one of the centres run by Housing Works which provides HIV testing, counselling and treatment services in the heart of New York.

“HIV can affect people who are the most difficult to reach with HIV services,” said Mr Sidibé. “This project is an example of how an integrated approach to social welfare improves the lives of vulnerable people by providing them with hope and restoring their dignity.” 

The centre, called Cylar House, pairs a medical clinic and adult day centre with a residential tower comprising of 36 apartments. In the same building Housing Works also run a food services business and a job training centre to help people living with HIV who are unemployed learn skills to return to work.

“Before I came to Cylar House I was homeless, using drugs, not taking HIV medication or taking care of my health,” said Matilda Echevarria, a 60-year-old resident. “Housing Works saved my life. Having my own place allows me to keep up with my medical and mental health appointments, to take my HIV medicines every day, and to feel good about myself.”

Housing Works’ pioneering job training programme at Cylar House teaches basic employment skills and guarantees graduates paid employment at Housing Works once students finish their studies. Nearly one third of Housing Works employees are graduates of the job-training program.

Anthony E.S. Jones, a former homeless person who was addicted to drugs is now clean and sober. He graduated from the job training program and is now employed as a Community Outreach Worker/Intake Coordinator for Housing Works. He explained how important a safe roof over his head was to his road to recovery, “Housing is a gateway to maintaining one’s overall health,” he said.  Yvette Torres, Executive Director of Keith D. Cylar House added, “Having stable housing allows people to be able to focus on their health and well-being, not having to be pre-occupied with where they will sleep at night and whether they will be safe.”

The Cylar House HIV housing and treatment project has been replicated in several cities across the United States.

At the end of the visit a memorial ceremony was held to pay tribute to leading AIDS and Tuberculosis activist Winstone Zulu, who passed away earlier this month. Mr Zulu had stayed at the centre for several months after he became ill during a meeting he was attending at the United Nations. 

“UNAIDS owes a debt of gratitude to Housing Works for opening its arms, it’s heart, it’s services and it’s healing community to Winstone in his time of need,” said Mr Sidibé. “The world also owes thanks to Winstone for bringing a face to the twin crises of HIV and TB. We need more heroes like Winstone Zulu and more organizations like Housing Works.”