The number of the world’s refugees, asylum seekers and internally displaced people has risen dramatically, topping 50 million for the first time since the Second World War, says a report released by UNHCR, the United Nations refugee agency.  

According to UNHCR global trends 2013, published to coincide with World Refugee Day, marked annually on 20 June, 51.2 million people have been forcibly displaced, up 6 million from 2012.

The war in the Syrian Arab Republic is given as the main reason for this increase, as a growing number of individuals and families join 2.5 million Syrian refugees and 6.5 million internally displaced people. Conflicts in South Sudan and Central African Republic are also highlighted as the cause of widespread forced movement.

The plight of internally displaced people, a record 33.3 million, is highlighted as a special concern by UNHCR. It is hard to reach the many that remain in conflict zones and they lack the international protection received by refugees. Given this situation, the report describes 2013 as one of the most challenging years in UNHCR’s history.

United Nations High Commissioner for Refugees António Guterres said, “We are seeing here the immense costs of not ending wars, of failing to resolve or prevent conflict. Peace is today dangerously in deficit. Humanitarians can help as a palliative, but political solutions are vitally needed. Without this, the alarming levels of conflict and the mass suffering that is reflected in these figures will continue.” 

People who are forcibly displaced often become more vulnerable socially, economically and in terms of their health. For example, contracting HIV may be more likely if they engage in transactional sex to meet their basic needs. In addition, access to health and education services can be very limited and the use of rape as a weapon of war also heightens vulnerability.

The global trends report contends that UNHCR remains committed to safeguarding the rights and well-being of those forced to flee their homes and continues to work to find long-term solutions, such as voluntary return, local integration or resettlement in a third country. According to Mr Guterres, the countries of the world also have to redouble efforts to both end conflict and support people in need.

“The international community has to overcome its differences and find solutions to the conflicts of today in the Central African Republic, South Sudan, Syrian Arab Republic and elsewhere. Non-traditional donors need to step up alongside traditional donors. As many people are forcibly displaced today as the entire populations of medium-to-large countries, such as Colombia or Spain, South Africa or Republic of Korea,” he added.

UNAIDS Executive Director Michel Sidibé commended Tunisia for its leadership role in the AIDS response in the Middle East and North Africa region during his meeting with President Moncef Marzouki on 20 June in Tunis, Tunisia. Mr Sidibé also congratulated the country for its selection to host the 18th International Conference on HIV/AIDS and STI’s in Africa (ICASA) in 2015.

President Marzouki placed Tunisia among the pioneer countries to ratify the Arab Convention on HIV Prevention and Protection of the Rights of People Living with HIV—adopted in March 2012 by the Arab Parliament—and promised to push for AIDS to remain on the post-2015 development agenda. At the end of the meeting, President Marzouki signed the Protect the Goal ball, pledging his commitment to raise global awareness of HIV.

During his three-day visit to the country, Mr Sidibe also met with representatives of civil society and affected communities, the Vice-President of the National Constituent Assembly, Mehersia Labadi, the Minister of Health, Mohamed Salah Ben Ammar, the Minister of Finance, Hakim Ben Hamouda, and Donald Kaberuka, President of the African Development Bank.

In discussions with community leaders, Mr Sidibé stressed the important role of civil society in advocating for a rights-based approach in the AIDS response and the need for governments to engage them more in the political dialogue. He also emphasized the urgent need for legislative reform and a public health approach towards people who use drugs, to avoid criminalization and ensure access to HIV services.

Mr Sidibé also reiterated the importance of domestic funding to ensure a sustainable response to the epidemic, while stressing the need to establish a concrete investment plan that focuses resources where they are most needed.

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Significant progress has been made in the Asia and the Pacific region towards reaching the targets of the 2011 United Nations Political Declaration on HIV and AIDS, and the region can aspire to ending the AIDS epidemic by 2030. This was one of the main conclusions of the two-day consultation held on 12 and 13 June in Bangkok, Thailand, to discuss the challenges and opportunities for accelerating the scale-up of HIV prevention and treatment programmes in the region post-2015.

With less than 500 days to go to reach the targets of the 2011 Political Declaration, the meeting reinforced the need for concerted action to reach the 2015 targets as well to set ambitious new targets for 2020 and 2030. In a bid to leave no one behind and realize zero new HIV infections, zero discrimination and zero AIDS-related deaths, it was agreed by participants that scaling up HIV testing, focusing on key populations at higher risk, innovation in service delivery and increased funding are key to ending the AIDS epidemic by 2030.

The regional consultation brought together more than 50 participants, including representatives of the Governments of China, Fiji, India, Indonesia, Myanmar, Thailand and Viet Nam, regional communities of people living with HIV, men who have sex with men, sex workers, transgender people and people who use drugs, UNAIDS Cosponsors and development partners.

Following the regional consultation, country dialogs will be organized with key stakeholders to agree on a set of national HIV prevention and treatment targets.

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A new report by the West Africa Commission on Drugs (WACD) says that drug trafficking, consumption and production in West Africa is undermining institutions, threatening public health and damaging development efforts. The report, Not Just in Transit: Drugs, the State and Society in West Africa, particularly highlights the importance of addressing drug use in as a public health issue rather than criminalizing people who use drugs.

Not Just in Transit: Drugs, the State and Society in West Africa states that the criminalization of  drug use and possession has a range of negative consequences, such as over-burdening already stretched justice systems, exacerbating social problems, increasing human rights violations and encouraging corruption. It also worsens major epidemics such as HIV and Hepatitis C, as people who use drugs often fear accessing the health and harm reduction services they need in case of legal reprisals. This is especially important for people who inject drugs who can be highly vulnerable to HIV through the use of non-sterile equipment.

The report cites data to highlight the extent of the problem in a region where drug consumption is said to be increasing. For example, in Senegal an estimated 9.1% of people who inject drugs are living with HIV, compared to less that 1% of the general population.

As well as treating drug use as a public health issue with socio-economic causes and consequences, the report also advocates for the reform of relevant laws; decriminalization of drug use and low-level, non-violent drug offences; adopting harm reduction approaches and encouraging research, including the gathering of baseline data on trafficking and consumption.

The West Africa Commission on Drugs is convened by former UN Secretary-General Kofi Annan, and chaired by former Nigerian President Olusegun Obasanjo.

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UNAIDS ‘Protect the Goal’ campaign is a global social movement, mobilizing the power of sport to empower young people to access HIV services

UNAIDS Protect the Goal campaign has been launched in Brazil on the eve of the 2014 FIFA World Cup. The campaign kick-off was announced at a special event on 9 June at the emblematic Castro Alves Theatre in Salvador, Brazil. UNAIDS Executive Director Michel Sidibe was joined by global and local partners, including the Government of the State Bahia, the Salvador City Hall, the Brazilian Health Ministry, the United Nations Population Fund (UNFPA) and the Protect the Goal spokespersons, Ndaba and Kweku Mandela.

As part of the Protect the Goal campaign during the World Cup in Brazil, 2 million condoms and Protect the Goal leaflets are being distributed across the 12 World Cup host cities and free rapid HIV tests will be offered at local Fan Fests. Other cities such as Aracajú, Porto Seguro, Ribeirão Preto, Santos and many more are joining the campaign and schools in the state of Bahia are participating with contests and HIV training programmes.

Protect the Goal was first launched at the 2010 FIFA World Cup in South Africa. To symbolize the strong links between Latin America and Africa, the ‘Protect the Goal World tour’ was launched during the friendly match between South Africa and Brazil in March 2014. The tour saw the passing of the ‘Protect the Goal’ football through the countries participating in the 2014 FIFA World Cup. In recent weeks, the Protect the Goal ball was signed by the Heads of State of Algeria, Argentina, Cameroon, Chile, Colombia, Costa Rica, Ivory Coast, Ghana, Honduras, and Nigeria, and Uruguay. The United Nations Secretary-General, Ban Ki-moon, has signed the Protect the Goal football as have many heads of UN agencies and the former UN Secretary-General Kofi Annan.

The Protect the Goal campaign aims to raise global awareness of HIV, encourage young people to commit to HIV prevention; and to emphasize the need to ensure universal access for all eligible for HIV treatment by 2015, the deadline for the UN Millennium Development Goals.

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The lives of millions of women and their newborn babies are being needlessly lost due to chronic lack of investment in midwife services, a new landmark report claims.

In the State of the World's Midwifery 2014: A universal pathway, a woman’s right to health, 73 countries in Africa, Asia and Latin America are shown to account for 96% of the global burden of maternal deaths, 91% of stillbirths and 93% of newborn deaths. Yet they have only 42% of the world’s midwives, nurses and doctors. The report urges these countries to invest in enhancing midwifery services, including education and training, to close this life-threatening gap. 

"Midwives make enormous contributions to the health of mothers and newborns and the well-being of entire communities. Access to quality health care is a basic human right. Greater investment in midwifery is key to making this right a reality for women everywhere," said UNFPA Executive Director, Babatunde Osotimehin.

According to the report, the range of midwifery services needed to care for women and newborn babies includes maternal and reproductive health activities such as obstetric services, family planning and services to preventing mother-to-child transmission of HIV.

The State of the World's Midwifery 2014 highlights progress made since the first 2011 report and examines four critical areas of provision: availability, accessibility, acceptability and quality of midwifery services. Since 2011 a number of countries have made considerable improvements. For example, nearly a third of the 73 nations have increased recruitment and deployment of midwives. However, there still remains a critical shortage of trained personnel which is taking an unacceptable death toll among women and children, says the report. In 2013 alone an estimated 289 000 women and 2.9 million newborn babies died.

There are a series of recommendations set out under the Midwifery2030 vision expounded in the publication which call for all women of reproductive age to have universal access to midwife services. Key planning and policy measures include professional, supportive and preventative midwifery and at least four care visits where birth preparedness and emergency planning are discussed; access to emergency care when needed;  maintaining a women’s health while pregnant; ensuring the availability of HIV-related services; comprehensive sex education and delaying marriage.

United Nations Secretary-General Ban Ki-moon, in the report’s foreword, fully commends Midwifery2030. “This vision is within reach of all countries…..Its implementation will help governments to deliver on women’s right to health, ensure that women and newborn infants obtain the care they need, and contribute to our shared, global ambition to end preventable maternal and newborn deaths.”   

The report was released by UNFPA, the United Nations Population Fund together with the International Confederation of Midwives (ICM), the World Health Organization (WHO) and partners and was launched on 3 June during the 30th ICM Triennial Congress in Prague, Czech Republic.