During her first visit to the Russian Federation, the reigning Miss World, Mireia Lalaguna of Spain, and runner-up, Miss Russia 2015, Sofia Nikitchuk, showed their support for the 90–90–90 HIV treatment target by getting tested for HIV in Moscow. They encouraged everyone to do the same and know their HIV status.

The treatment target aims to ensure that, by 2020, 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads.

"I know how important it is for the world to end the AIDS epidemic by 2030,” said Ms Lalaguna. “This goal may seem ambitious, but if each of us does what we can—starting with learning our HIV status—then we will succeed.”

Ms Nikitchuk said, “I am proud to join the efforts of organizations and people in the Russian Federation and around the world who are working together to end the AIDS epidemic.”

On behalf of the Miss World Organization, Steve Douglas said, “Miss World is a contest that promotes beauty with a purpose and we support the important message of getting tested for HIV as the first step towards 90–90–90.”

The UNAIDS Regional Director for Eastern Europe and Central Asia, Vinay Saldanha, underscored that the world is witnessing a transformation in public attitudes to HIV infection, people who are living with HIV and HIV testing. “Everyone who is diagnosed with HIV should be provided with immediate access to HIV treatment and achieve viral suppression, so that HIV is no longer transmitted,” Mr Saldanha said.

“Our task is to ensure that everyone knows how to protect themselves from HIV. And if HIV infection has occurred, we need to provide treatment for people living with HIV to ensure that they live long and fruitful lives,” said Vadim Pokrovsky, Head at the Russian Center for AIDS Prevention and Treatment.

HIV activists in Sri Lanka are celebrating a landmark decision by the country’s Supreme Court that which prohibits HIV discrimination in education settings. 

Princey Mangalika, Executive Director of the Positive Women’s Network in Sri Lanka, said, “I would like to express my appreciation to the Supreme Court. This marks a momentously progressive step forward for the people living with HIV community in Sri Lanka.”

The Supreme Court issued the directive in response to a fundamental rights violation petition filed by Chandani De Soysa in February 2016. Ms De Soysa is from the rural community of Illukhena, Kuliyapitiya, in western Sri Lanka. She was left in difficult circumstances when she lost her husband last September. Ms De Soysa believed strongly that her five-year-old son was entitled to an education and tried to enrol him in the local school. However, the school system denied the boy entry because a rumour was circulating that his father had died of AIDS-related causes and that the boy was HIV-positive.

“I felt dead inside, when my child was not accepted into school, when my own neighbours discriminated against me without any human consideration, I felt lost,” said Ms De Soysa.

Even though it was a violation of her son’s human rights, Ms De Soysa agreed to him taking an HIV test. Although his status was confirmed as negative, the boy was still denied enrolment. Ms De Soysa visited a number of other schools in the area, but they all refused admission.

“It was not an easy decision to make, but I decided that for my child I would fight. I did not want any other parent or child to face such an unbearable situation,” said Ms De Soysa. With support from UNAIDS and the Positive Women’s Network, she filed her petition with the Supreme Court.

The court’s directive, which was released on 28 April, stated that the right to an education of children living with or affected by HIV must be upheld, based on the country’s constitutional directive of universal access to education for children between the ages of 5 and 14 years old.

The Supreme Court also went a step further, reminding the state of its obligation to take necessary measures to protect, promote and respect the human rights of people living with HIV. This is the first court decision in South Asia to make a general pronouncement recognizing the human rights of all people living with HIV and sets a precedent for future cases in Sri Lanka challenging HIV discrimination experienced in settings other than education.

“I would like to give a special note of thanks to all the people out there who offered their support in various forms, from money, food, scholarships, to a simple word of encouragement. I cannot express in words my gratitude for this kindness,” said Ms De Soysa. “My son has a dream to be a doctor one day and I hope he will be an HIV specialist.”

While Ms De Soysa has won the right for her son to attend his local school, she has decided to send her son to a private school, Trinity College in Kandy, which prior to the court’s decision had offered a full scholarship. The school is the alma mater of cricket champion Kumar Sangakkara, who has championed people living with HIV and visited the school to raise awareness of HIV as part of the Think Wise campaign, a joint initiative by UNAIDS, the United Nations Children’s Fund and the International Cricket Council.

“This is a great day for social justice,” said Steve Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific. “Sri Lanka’s highest court has stood up in support of people who are being left behind. From now on, no child can be denied access to education based on HIV.”

There have been other cases of children being denied school admission because of their association with HIV, which have been settled through mediation.

HIV-related stigma and discrimination continues to prevent people from accessing key education and health services and reduces employment opportunities. Research conducted by people living with HIV in 13 countries in Asia between 2009 and 2014 found that an average of 12% of HIV-positive people surveyed reported exclusion from social gatherings and activities and 23% said they had been verbally insulted, harassed or threatened.

Sri Lanka’s legal milestone is a big step forward for the rights of people affected by HIV in South Asia. Sindh Province in Pakistan has a comprehensive HIV law, but there is no such protection across the country. India’s courts have ruled to recognize the right to non-discrimination in several specific contexts, including schools; however, a national HIV law has yet to be passed by the parliament. 

The challenges of responding to HIV in western and central Africa have been outlined in a new report from Médecins Sans Frontières (MSF). The report, Out of focus: how millions of people in west and central Africa are being left out of the global HIV response, describes how stigma and discrimination, stock-outs of diagnostics and medicines, and unaffordable or poor-quality facilities are presenting major hurdles to access to HIV testing and treatment services.

Around 6.6 million people are estimated to be living with HIV in western and central Africa, more than half residing in Nigeria alone. The region accounts for one in five new HIV infections globally, one in four AIDS-related deaths and close to half of all children newly infected with the virus worldwide. An estimated 5 million people living with HIV in western and central Africa do not have access to life-saving HIV medicines.

UNAIDS is working with countries in the region to identify the locations and populations where HIV services need scaling up. Data from the region show that many people affected by HIV in western and central Africa live in and around city areas and that people at higher risk of HIV infection, include men who have sex with men, sex workers and people who inject drugs.

“The world will only end the AIDS epidemic by 2030 through an intelligent and focused deployment of resources that identifies the people and places most in need,” said UNAIDS Deputy Executive Director Luiz Loures. “We must reach people affected by HIV wherever they live and whoever they are, including in western and central Africa.”

UNAIDS is helping countries in western and central Africa to build the foundations for a better coverage of services to match needs. UNAIDS is also working with countries on a Fast-Track approach over the next five years to end the AIDS epidemic as a public health threat by 2030.

The Fast-Track approach includes achieving the 90–90–90 treatment target for 2020, whereby 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing antiretroviral treatment and 90% of people on treatment have suppressed viral loads. Other Fast-Track Targets include zero infections among children and that 90% of women and men, especially young people and people living in high-prevalence settings, have access to HIV combination prevention and sexual and reproductive health services.

To achieve the targets, a rights-based approach that reaches everyone in need will be essential, particularly to overcome the barriers of stigma and discrimination that continue to prevent people from accessing HIV services. Global solidarity and shared responsibility will also be critical to respond to the particular challenges faced in western and central Africa to ensure that no one is left behind.

“Closing the treatment gap in western and central Africa will happen either now or never,” said Mit Philips, health policy adviser at MSF. “But it is unrealistic to think they can break the deadly status quo alone.”

The fifth Eastern Europe and Central Asia AIDS Conference took place in Moscow, Russian Federation, from 23 to 25 March and concluded by calling on governments, international organizations, the business community and religious and civil society organizations to Fast-Track the AIDS response in the region.

In his closing remarks, UNAIDS Deputy Director Luiz Loures made a strong call for the provision of evidence-informed HIV prevention and treatment services to close the gap in access to coverage for key populations.

The conference outcome statement, which was debated by the participants and the co-chairs of the three conference tracks—medicine and science, international cooperation and civil society—includes specific references to the need for evidence-informed HIV prevention programmes, including harm reduction, increased domestic funding and further support for civil society organizations. It also calls upon the governments of eastern Europe and central Asia to reaffirm their commitment to the target of ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals at the United Nations General Assembly High-Level Meeting on Ending AIDS, which will take place from 8 to 10 June in New York, United States of America.

Three panel discussions were organized during which speakers from Belarus, Brazil, Kazakhstan and the Russian Federation, as well as Ndaba and Kweku Mandela, engaged in a public discussion on key HIV issues, including HIV and sport, HIV and the mass media and the challenges of HIV public information campaigns today.

The conference brought together 2500 participants from 79 countries and featured more than 350 plenary and parallel presentations. The conference outcome statement included the proposal of the Government Russian Federation for the sixth Eastern Europe and Central Asia AIDS Conference to be held in Moscow in 2018.

A version of this story was first published on UNESCO.org.

Quarraisha Abdool Karim has been presented with a l’Oréal–UNESCO For Women in Science award for her contribution to the understanding of HIV and for her efforts to empower women to help prevent HIV infection in Africa.

Ms Abdool Karim has worked on HIV research for the past 25 years and her work has provided new insights into how the HIV epidemic spreads and affects adolescent girls and young women in Africa. Her knowledge of the science and the people affected by HIV in her native South Africa, which has the highest number of HIV infections in the world, has reinforced her determination to put HIV prevention in the hands of women, particularly adolescent girls and young women.

In 2002, at the height of AIDS denialism in South Africa, she and her husband cofounded CAPRISA, the Centre for the AIDS Programme of Research in South Africa.

Ms Abdool Karim has undertaken research on an anti-HIV gel for use by women before, during and after sex. In 2010, the CAPRISA 004 study, led by Ms Abdool Karim, showed that a gel containing the antiretroviral medicine tenofovir reduced the risk of HIV infection among women by 39%. Today, she continues to study HIV prevention options that will give women in higher-risk populations sustained protection against HIV.

“Until we have eradicated AIDS by finding a vaccine or a cure, then I think my job is not done,” said Ms Abdool Karim.

The L’Oréal-UNESCO For Women in Science programme was founded in 1998 with a simple aim: to ensure that women are fairly represented at all levels in science. Each year, the programme’s award is presented to five outstanding women researchers in recognition of scientific excellence and their potential for leading the global community in positive, productive directions.

“I would encourage young women who feel passionate about changing the world and making a difference to pursue a career in science,” said Ms Abdool Karim at the French Academy of Sciences, where she was presented with the award.

Since the start of the AIDS epidemic civil society has been at the forefront of the response to HIV—demanding access to treatment and HIV services, calling for the respect of human rights and supporting community-led HIV services.

Today the role of civil society remains more relevant than ever as the success of community efforts in providing HIV services, particularly to key populations, is becoming more widely recognized as essential to ending the AIDS epidemic.

Community efforts have proven critical in overcoming many of the major challenges in the AIDS response, including reaching people most affected by HIV with life-changing HIV services, providing support for adherence to treatment and other essential health services. Civil society engagement has also been critical in advocating for new resources, improving HIV programming, and moving progress forwards on human rights issues.

Despite the wide recognition of the important role communities play in responding effectively to HIV, community organizations are facing severe financial challenges and many are closing their doors.

A total of 40% of organizations responding to a recent UNAIDS survey reported that their funding had decreased since 2013. Two thirds expected flat or reduced funding in the future. The decline in funding is resulting in a decline in community services—89% of those who reported a decrease in funding also reported they had to scale down their services as a result.

Greater investment in civil society and community-based service delivery is critical to the Fast-Track approach. Outreach to key populations in low- and middle-income countries should grow to about 7.2% of total investments by 2020, and the estimated resource needs for community-based delivery of antiretroviral therapy should grow to about 3.8% of total investment.

By 2020, investment in community mobilization should increase three-fold to 3% of total resources in low- and middle-income countries to help civil society represent the interests of communities affected by HIV, and to drive ambition, financing and equity in the AIDS response. Social enablers—including advocacy, political mobilization, law and policy reform, human rights, public communications and stigma reduction—should reach 6% of total expenditure by 2020.

UNAIDS has issued two new reports highlighting the importance of investing in community action. Invest in Advocacy details important contributions by community based advocates and points to the need to increase investment to drive an accelerated and more equitable response to HIV. It also notes that a report from the UNAIDS-Lancet Commission on Ending the AIDS Epidemic described advocacy as a “global public good” deserving of support commensurate with its importance.

Stronger Together provides details of the evidence base for community-provided services achieving scale, delivering quality services, and producing results. The report notes guidance from the World Health Organization and others calling for increased engagement of communities to provide a range of HIV and other health-related services.*

In order for community-led services to continue it is essential that international organizations, development partners, governments, private funders and other partners increase investment in community advocacy and services in order to continue and scale up HIV services.

The crucial role of community responses will be among the issues highlighted at the Civil Society Hearing taking place on 6 April in New York. The Hearing is part of the lead up to the United Nations High Level Meeting on Ending AIDS which will take place from 8 to 10 June at the UN headquarters in New York. At the hearing, civil society representatives from around the world will speak to UN Member States about major issues in the AIDS response, including the need for increased financing, leaving no one behind, integration, innovation, and partnering between governments, the private sector and communities.

* The new reports build on other recent publications, Communities deliver and Community-based ART delivery which include more details on the success of community responses.

The fifth Eastern Europe and Central Asia AIDS Conference (EECAAC 2016) opened on 23 March in Moscow, Russian Federation, with discussions focusing on the urgent measures that countries and partners must take to get on the Fast-Track to end the AIDS epidemic by 2030.

The three-day conference, the largest forum on HIV in the region, unites over 2000 activists, scientists, experts, health-care professionals and community workers from over 70 countries. They will share best practices and strategies in the AIDS response.

EECAAC 2016 will also build on the commitments made in 2015 by the BRICS countries (Brazil, Russian Federation, India, China and South Africa) to contribute to enhanced international cooperation to support the efforts of countries to achieve their health goals. Among them is reaching the 90–90–90 treatment target by 2020, critical to ending the AIDS epidemic as a public health threat by 2030. 

Dmitry Medvedev, Prime Minister of the Russian Federation, conveyed in his official address to conference participants that “the issue of HIV infection goes far beyond the medical sphere, uniting multiple partners, from health professionals and scientists to civil society, governments and experts.”

Representing the Russian Government, Deputy Prime Minister Olga Golodets confirmed that the Russian Federation is contributing to the global effort to end the AIDS epidemic. She thanked UNAIDS for its constructive dialogue. “I am confident that together we can stop the AIDS epidemic,” she said. 

In his opening address to the conference, UNAIDS Executive Director Michel Sidibé expressed his support for the renewed urgent focus on the AIDS epidemic in the Russian Federation and across the region. “In line with the Sustainable Development Goals and leaving no one behind, we should have the courage to explore all progressive policy options in eastern Europe and central Asia. An urgent response is needed to break the trajectory of new HIV infections in the region and to get on the Fast-Track to end the AIDS epidemic by 2030,” he said.

Veronika Skvortsova, Minister of Health of the Russian Federation, emphasized that Russia has managed to achieve a fivefold reduction in the number of HIV-infected children born from mothers living with HIV in the past few years. "In 2006 the risk of vertical transmission of HIV was 10.5% ... According to 2015 data it is just 2%. Thus, 98% of children are born healthy," said Skvortsova.

Anna Popova, Conference Co-Chair and Head of the Russian Public Health Agency Rospotrebnadzor, expressed her hope that EECAAC 2016 continues the tradition of joining efforts for practical results to urgently increase the coverage of HIV prevention and treatment services.

Yana Panfilova spoke on behalf of adolescents living with HIV, “We are ready to be the leaders of tomorrow who will create a world where HIV will be only one small part of our full and productive lives!”

A number of countries in eastern Europe and central Asia are making progress towards the elimination of mother-to-child transmission of HIV. However, the same cannot be said about preventing new HIV infections. Estimates indicate that between 2000 and 2014, new HIV infections in the region rose from 100 000 to 140 000 per year. The low coverage of HIV treatment for people living with HIV also represents a major challenge for most countries.At the end of 2014, an estimated 1.5 million people were living with HIV in eastern Europe and central Asia, of which more than 70% live in the Russian Federation.

On 16 March, the Botswana Court of Appeal ruled that the refusal by the government to register LEGABIBO, an organization of lesbian, gay, bisexual, transgender and intersex (LGBTI) people, was unconstitutional. The Court of Appeal thus upheld the November 2014 decision of the Botswana High Court on this matter. In its ruling on the case, the Court of Appeal highlighted the potential role of LGBTI organizations in public health and HIV efforts and ordered the Registrar of Societies to register it.

The ground-breaking decision concludes a four-year legal proceeding initiated in February 2012, when several individuals filed an application for the registration of LEGABIBO as an organization under the laws of Botswana. The government denied their application, arguing, among other things, that LGBTI rights were not recognized by the constitution. Activists challenged the decision in court.

In November 2014, the High Court ruled that the government’s refusal to register LEGABIBO violated the rights to freedom of expression, assembly and association protected by the country’s constitution. This was the first time a high jurisdiction in Africa had upheld freedom of assembly and association for LGBTI people. The government appealed against the ruling.

In the lead-up to the United Nations General Assembly High-Level Meeting on Ending AIDS, to be held in June, the decision by the Botswana Court of Appeal highlights the importance of advancing zero discrimination and of creating a legal and political space for the protection and involvement of LGBTI people and other key populations in the AIDS response. 

LEGABIBO’s mission is to promote the recognition, acceptance and protection of all human rights of the LGBTI community in Botswana. One of if its main objectives is to promote sexual health among LGBTI people.