The United Nations Secretary-General Ban Ki-moon presented his report on HIV to the sixty-eighth United Nations General Assembly in New York on 6 June 2014.

The report Towards ending the AIDS epidemic: meeting the 2015 targets and planning for the post-2015 era takes stock of progress made in implementing the targets set out in the 2011 United Nations General Assembly Political Declaration on HIV and AIDS. The report provides an update on developments in the AIDS response and recommends key actions to accelerate progress towards achieving the goals and targets to be met by 2015. The report also urges a commitment to ending the AIDS epidemic as a development priority in the post-2015 development agenda.
 
UNAIDS Executive Director Michel Sidibé will also participate in an interactive panel discussion on the side-lines of  the General Assembly plenary meeting to exchange views on what it will take to end the AIDS epidemic.

*Note: On 30 July a decision was adopted by the General Assembly calling for a High-level meeting on HIV/AIDS in 2016. Read the draft decision submitted by the President of the General Assembly.

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The Latin America and Caribbean regions have set new targets for expanding HIV testing and treatment by 2020 to reduce new HIV infections, late diagnosis and AIDS-related deaths, as well as to improve the quality of life of people living with HIV.

Named 90–90–90, the new benchmarks were adopted during the First Latin American and Caribbean Forum on the HIV Continuum of Care, which was held in Mexico City, Mexico, from 26 to 28 May. During the meeting, the participants endorsed a call to action to adopt the UNAIDS and Pan American Health Organization (PAHO) 2020 treatment cascade targets for the two regions. These targets include increasing to 90% the proportion of people living with HIV who know their diagnosis, increasing to 90% the proportion of people living with HIV receiving antiretroviral treatment and increasing to 90% the proportion of people on HIV treatment who have an undetectable viral load.

Representatives of national HIV programmes, civil society, people living with HIV, academia and the scientific community were among the 141 people from 26 countries who participated in the forum. The meeting was organized by a coalition of partners, including UNAIDS, PAHO, the Governments of Mexico and Brazil and other regional partners.

The bold targets are a response to recent scientific evidence that diagnosing HIV and starting treatment earlier can prevent its transmission and dramatically improve health outcomes. Suppressed viral load is critical for reducing both the harmful effects of HIV infection on people’s health and the risk of infecting others.

“The expansion of early diagnosis and treatment combines individual clinical benefits of early treatment with the benefits of preventing transmission in the community,” said César Núñez, UNAIDS Regional Director for Latin America. “Many people living with HIV first learn they are infected late in the course of infection, undermining the effectiveness of HIV treatment and facilitating the continued spread of HIV.”

According to the participants, increasing demand for HIV testing is essential to reducing the number of new HIV infections and requires robust and sustained investment in community-based HIV literacy programmes as well as strengthened community systems. To do this, countries agreed to review their models of care in order to make them more accessible to patients. 

“If we want more people undergoing treatment with an undetectable viral load, it is essential that they know their diagnosis and begin treatment early,” said Massimo Ghidinelli, head of the HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit at PAHO.

During the last three years, HIV responses have been scaled up in several Latin American and Caribbean countries. According to new PAHO/WHO 2013 estimates, about 70% of the population currently knows their HIV status. However, 35% of new HIV diagnoses present late with a CD4 count below 200. At present, 48% of eligible people living with HIV are on HIV treatment, and, of these, 66% are virally suppressed.

UNAIDS Caribbean Director Ernest Massiah emphasized that although reaching the new targets will be challenging, the regions have a good track record of working towards ambitious goals.

“The Caribbean and Latin America treat a higher proportion of people living with HIV than any other low- and middle-income region. In most of the Caribbean we are close to eliminating HIV in children because of the excellent rates of antenatal testing and treatment. With the combined efforts of HIV programmes, civil society and international partners on these new targets, we can accelerate progress towards ending the AIDS epidemic,” said Mr Massiah.

Papua New Guinea has the highest prevalence of HIV in Oceania (0.5% in 2012) and is experiencing an epidemic concentrated in key population groups and in certain geographical locations. During an official visit to the country, UNAIDS Deputy Executive Director Jan Beagle met with a variety of stakeholders—including representatives of the government, parliamentarians, development partners, civil society, the private sector and faith-based organizations—which were opportunities to highlight that one of the strengths of the AIDS movement globally has been its ability to build coalitions of stakeholders across disciplines and sectors. “AIDS is much more than a health issue, it is a development, human rights and gender issue. To get to zero in Papua New Guinea we need the power of a coalition of all sectors to ensure that no one is left behind,” said Ms Beagle during a meeting with members of the parliamentary working groups on HIV and population and sustainable development.

In Hela Province, Ms Beagle saw first hand the work of the Oil Search Health Foundation. The Foundation, in partnership with the government, civil society and communities, is providing HIV-related services and using HIV as an entry point for broader health and development outcomes—an example of a public–private partnership delivering quality services in a cost-effective way in a challenging environment.

Women are vastly underrepresented at all levels of the government (only three women sit in the national parliament), which limits their power to influence public policy at all levels. Violence against women is extremely high, and is experienced by an estimated two thirds of women. UN Women, as part of its Safe Cities Global Initiative, is promoting a safer working environment for women in two pilot marketplaces in the National Capital District of Papua New Guinea—where 80% of market vendors are women—enabling women to keep their earnings safe and to be safer physically. In the markets, infrastructure is being upgraded, market stalls renovated and potable running water made available. New innovative cashless methods for the collection of fees are being implemented to prevent extortion and theft, market vendor associations established and a referral system for survivors of family and sexual violence in the markets piloted. With support from UNAIDS, health mobile clinics will be established in these pilot markets to provide basic health services, including HIV-related services.

To mark the launch of his new book of speeches, We the Peoples: A UN for the 21st Century, former United Nations Secretary-General and Nobel Peace Prize Laureate Kofi Annan invited the Executive Director of UNAIDS Michel Sidibé to hold a public discussion with him on the future of the United Nations and global health. The event was held on 3 June at the Palais des Nations in Geneva before an audience of 700.   

Mr Annan and Mr Sidibé were welcomed to the stage by the Acting Head of the United Nations office in Geneva Michael Møller who emphasized the significance of his efforts in re-imagining the public agenda and role of the UN. During his tenure as UN Secretary-General Mr Annan led many important reforms and opened the UN to a modern and changing world.

Mr Annan began the frank discussion talking about how the UN has to continue to adapt to a changing world.  Referring to the post-2015 development agenda Mr Annan stressed that, "The new sustainable development goals should be workable and understandable by people so they can ask governments to act."

Under his leadership, the Millennium Development Goals were adopted by Member States in 2000, of which the sixth goal is to halt and reverse the spread of HIV. As attested through many of his speeches in We the Peoples: A UN for the 21st Century, the AIDS epidemic weighed heavily throughout Mr Annan’s mandate as a challenge but also a path for development and human rights and freedoms for all. 

Mr Sidibé said he had been inspired by Mr Annan’s sincere compassion for people and his commitment to human rights which reflected his own values and vision. "We won't have a sustainable development framework if there are people left behind," he said. Talking about the future of global health Mr Sidibé added. "To deal with health of people we need to move from a disease approach to a people centred approach."  Mr Sidibé also praised Mr Annan’s call to bring women to the centre.

A strong supporter of UNAIDS since its inception, Mr Annan announced that the proceeds of his book of speeches will be dedicated to UNAIDS. In recognition of his work and commitment to the future of the AIDS response Mr Sidibé said, “It is an honour for UNAIDS and the AIDS response to receive this donation—from a leader and mentor who continues to speak out for the millions of people living with HIV.”

Mr Annan concluded the discussions with reflections on ongoing conflicts around the world. “No country can prosper without rule of law and respect for human rights,” he said.

In 2001, Mr Annan was co-awarded the Nobel Peace Prize for revitalizing the UN and for having given priority to human rights. The Nobel Committee also recognized his commitment to the struggle to contain the spread of the HIV in Africa. At the first ever Special Session on HIV/AIDS, he led the creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Since leaving the United Nations, Mr Annan has been active in pressing for policies that will meet the needs of the poorest and most vulnerable, particularly in Africa. And in 2007, he set up the Kofi Annan Foundation to promote better governance and strengthen the capacity of people and countries.

From peace and security to development and the global community, We the Peoples: A UN for the 21st Century explores some of the most challenging issues the world has faced in the new century. We the Peoples: A UN for the 21st Century is Mr Annan’s second book, following the acclaimed memoir, Interventions: A Life in War and Peace, published in 2012.

They called it Ward 10C. Never “the AIDS ward.” But it was understood that this was the place where patients went if they had HIV. Stigma and despair overshadowed the limited medical interventions that could be provided. Opened in 1997, the ward saw an average of one AIDS-related death every day during its darkest days.  

But today, in a historic symbolic move, St. Paul’s Hospital in Vancouver announced that Ward 10C has outlived its role as the place where life ended.

British Columbia Premier Christy Clark and other officials led an official ceremony on Tuesday lauding the ward’s metamorphosis as a sign that AIDS is no longer a death sentence, and that HIV is virtually under control in the province.

The ward’s new purpose will be to provide cutting-edge care and treatment for people living with HIV, as well as treatment related to bacterial and viral infections like chronic hepatitis B and C among people at risk for HIV.

According to the government, AIDS deaths have fallen by more than 80% in the past decade and new HIV infections have been cut by two-thirds in the province.

Julio Montaner, a leader in the movement for early treatment and his team at the BC Centre for Excellence in HIV/AIDS, showed that by receiving early antiretroviral treatment, people living with HIV can not only survive and thrive—but also reduce their risk of transmitting the virus to partners.

At Tuesday’s ceremony on Ward 10C, Dr Montaner said that when he proposed HIV treatment could prevent new infections, “I was not a popular kid, they told me I was crazy, not only in my backyard but all around the world—now we are seeing AIDS begin to disappear. We did it and everybody else can do it.”

“Thanks to the expansion of access to treatment, people are living longer, healthier lives and we’re starting to see HIV clinics close, it’s a significant step towards ending the epidemic.” said Michel Sidibé, Executive Director of UNAIDS. At the ceremony, he also announced Dr Montaner’s appointment as UNAIDS’ Global Advisor for Treatment.

Mr Sidibé praised Premier Clark for what she and her government have done for the AIDS response in British Columbia and internationally. And he reminded the audience that some 18 million people, in low- and middle-income countries, still do not have access to antiretroviral treatment, “Only with global solidarity, can we ensure that no-one is left behind.”