On the occasion of the 68th General Assembly of the United Nations starting in New York on 24 September, WHO, UNFPA, UNAIDS, UNICEF and the UN Secretary General’s Special Envoy for Financing the Health MDGs and for Malaria released a joint statement calling for a final push to achieve the health-related MDGs and lay the foundations for a post-2015 world. 

According to the statement, “Now is the moment to build on our remarkable success and insure that we actually meet the health MDGs in the time left to achieve them.”

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HRH Crown Princess of Norway, Mette-Marit (centre) and Pablo Aguilera, Director of HIV Young Leaders Fund participating in the interactive dialogue with key emerging leaders in the social good space on the topic of Creating a new narrative on AIDS for the post 2015 world – what role can the social good sector play? Credit: UNAIDS

Bloggers, HIV experts and emerging leaders in the social good arena from around the world met in New York to discuss how new technologies can be used to effectively respond to HIV and can help create a new narrative around AIDS for the post 2015 world.

The dialogue took place during a session held at the Mashable Social Good Summit, which is organized on the side-lines of the 68th session of the United Nations General Assembly. The aim of the Summit is to bring together global leaders to discuss an idea: the power of innovative thinking and technology to solve the world’s greatest challenges. This year’s main debates focused around finding innovative solutions for a world post-2015—when the Millennium Development Goals will come to an end.

Speaking at the event, UNAIDS Goodwill Ambassador Her Royal Highness Crown Princess Mette-Marit of Norway stressed the importance of keeping AIDS in the Post-2015 development framework and called on Member States to ensure young people have a seat at the discussion table.

“We need a new narrative on AIDS. One that projects hope and inspires action,” said the Crown Princess. “Young people demand to play a role in shaping and changing their world,” she added.

Participants identified social media as a primary tool to communicate the realities of young people living with HIV. Raising awareness among young people about how their peers live with the virus could help create a new social dialogue; one that challenges taboos and addresses stigma and discrimination.

“As a young person living with HIV, I can tell you it is very different now from what it was 15 or 20 years ago,” said Pablo Aguilera, Director of HIV Young Leaders Fund. “We need to craft a compelling new narrative about AIDS, based on the realities of today, to engage people in reaching the end of the epidemic.”

However, according to participants, any social media initiative addressing HIV must take into consideration the digital divide. They stressed that all initiatives must ensure that online tools are used for offline action. 

One such project is ACT 2015 where Youth organizations and UNAIDS, with support from HRH Crown Princess, will aim to catalyze social action to inspire a new wave of activism in the AIDS response.

ACT 2015 will engage and support youth activists to host online and offline host forums in their local communities to jointly agree and advocate for a new progressive framework that addresses the real HIV and sexual and reproductive health needs of young people. The open forums will take place during the month of November 2013.

World closing in on Millennium Development Goal 6, globally the AIDS epidemic has been halted and reversed—race is on to reach universal access to HIV treatment.

GENEVA, 23 September 2013—As world leaders prepare to meet at the United Nations General Assembly to review progress towards the Millennium Development Goals—a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS) shows dramatic acceleration towards reaching 2015 global targets on HIV.  

New HIV infections among adults and children were estimated at 2.3 million in 2012, a 33% reduction since 2001. New HIV infections among children have been reduced to 260 000 in 2012, a reduction of 52% since 2001. AIDS-related deaths have also dropped by 30% since the peak in 2005 as access to antiretroviral treatment expands.

By the end of 2012, some 9.7 million people in low- and middle-income countries were accessing antiretroviral therapy, an increase of nearly 20% in just one year. In 2011, UN Member States agreed to a 2015 target of reaching 15 million people with HIV treatment. However, as countries scaled up their treatment coverage and as new evidence emerged showing the HIV prevention benefits of antiretroviral therapy, the World Health Organization set new HIV treatment guidelines, expanding the total number of people estimated to be in need of treatment by more than 10 million.

“Not only can we meet the 2015 target of 15 million people on HIV treatment—we must also go beyond and have the vision and commitment to ensure no one is left behind,” said Michel Sidibé, Executive Director of UNAIDS.

Significant results have also been achieved towards meeting the needs of tuberculosis (TB) patients living with HIV, as TB-related deaths among people living with HIV have declined by 36% since 2004.

Despite a flattening in donor funding for HIV, which has remained around the same as 2008 levels, domestic spending on HIV has increased, accounting for 53% of global HIV resources in 2012. The total global resources available for HIV in 2012 was estimated at US$ 18.9 billion, US$ 3-5 billion short of the US$ 22-24 billion estimated to be needed annually by 2015. 

As well as outlining new global HIV estimates, the 2013 UNAIDS Report on the global AIDS epidemic reviews progress on ten specific targets which were set by United Nations Member States in the 2011 UN Political Declaration on HIV and AIDS.

The report finds that progress has been slow in ensuring the respect of human rights, securing access to HIV services for people most at risk of HIV infection, particularly people who use drugs, and in preventing violence against women and girls––a key factor in vulnerability to HIV. Gender inequality, punitive laws and discriminatory actions are continuing to hamper national responses to HIV and concerted efforts are needed to address these persistent obstacles to the scale up of HIV services for people most in need.

The 2013 UNAIDS Report on the global AIDS epidemic is available on line at unaids.org

Donor disbursements in 2012 totalled US$ 7.86 billion

GENEVA/Washington D.C., 23 September 2013––As world leaders prepare to meet to review progress towards the Millennium Development Goals, a report from the Kaiser Family Foundation and the Joint United Nations Programme on HIV/AIDS (UNAIDS) evaluates international efforts to finance the response to the AIDS epidemic. The annual funding analysis finds donor governments disbursed US$ 7.86 billion toward the AIDS response in low-and middle-income countries in 2012, essentially unchanged from the US$ 7.63 billion level in 2011 after adjusting for inflation.

Overall, donor government funding for HIV has stayed at about the same level since 2008 - a plateau that followed a period of dramatic growth that saw donor nation support increase more than six-fold between 2002 and 2008. This flattening mirrors a similar trend in development assistance more generally, reflecting the economic and fiscal constraints of the post-financial-crisis period.

The United States government remains the largest donor to HIV efforts, contributing US$5 billion in 2012 towards the AIDS response in low-and middle-income countries and to the Global Fund, up slightly from the US$ 4.5 billion in 2011. The U.S. increase results from a quickened disbursement rate of previously approved funding.

"After years of sharp increases in donor government support which led to significant progress in the fight against the HIV epidemic, funding flattened after the worldwide recession and is likely to remain flat for the immediate future," said Kaiser Family Foundation President and CEO Drew Altman.

"We are at a critical moment in the AIDS response," said Luiz Loures, Deputy Executive Director, Programme, UNAIDS, "Scientific advances and new guidelines are providing opportunities to accelerate action and expand access to lifesaving HIV services. To take full advantage of these opportunities all efforts must be made to ensure the response to HIV is fully funded."

Five donor governments - Australia, Canada, Japan, Sweden, and the U.S. - reported increased total assistance for HIV in 2012, with U.S. assistance increasing by just more than US$ 500 million. Six decreased funding in 2012: Denmark, France, Ireland, the Netherlands, the U.K., and the European Commission. Three donor governments - Germany, Italy, and Norway - stayed constant in their support in 2012. The report found that the great majority, US$ 6 billion, of international HIV assistance is provided bilaterally.

The United States accounted for nearly two-thirds (63.9%) of disbursements from donor governments bilaterally and multilaterally. The United Kingdom was the second largest donor (10.2%), followed by France (4.8%), Germany (3.7%), and Japan (2.7%). When viewed as a share of national economies, Denmark provided the highest amount of resources for HIV in 2012, followed by the U.K, Sweden, the U.S., and Ireland.

The new report, produced as a partnership between the Kaiser Family Foundation and UNAIDS, provides the latest data available on donor funding based on data provided by governments.

This report is based on analysis of data of 24 donor government members of the Organization for Economic Co-operation and Development's Assistance Committee. It includes their combined bilateral assistance to low- and middle-income countries, and contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as to UNITAID. 

HIV scientists, doctors, and health economists have gathered in London on 22-24 September to present the clinical and financial case for HIV treatment and other HIV prevention activities to achieve the 2015 global AIDS targets. Under the title Controlling the HIV Epidemic with Antiretrovirals: From Consensus to Implementation, more than 400 delegates considered data about how the latest HIV prevention programmes work.

The Summit was hosted by the International Association of Providers of AIDS Care (IAPAC) in partnership with the British HIV Association (BHIVA), Public Health England (PHE), and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Speaking at the opening, UNAIDS Executive Director, Michel Sidibé highlighted the importance of accelerating access to HIV treatment saying that HIV treatment should be available to everyone who needs it. Following the key note speech, high-level panel members discussed HIV treatment expansion; the importance of using data to expand programmes; the need to maximize impact with the resources available; and the need to empower communities to deliver HIV services.

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UNAIDS Executive Director Michel Sidibé met with President Yoweri Kaguta Museveni of Uganda at the State House in Entebbe. Photo courtesy of State House, Uganda.

The President of Uganda Yoweri Kaguta Museveni reaffirmed his country’s commitment to end the AIDS epidemic in a meeting with UNAIDS Executive Director, Michel Sidibé and UN Secretary General’s Special Envoy for HIV/AIDS in Africa, Dr Specioza Wandira Kazibwe. The meeting, held on 17 September at the State House in Entebbe, was an opportunity to review recent progress made in Uganda’s AIDS response.

“Under the leadership of President Museveni, Uganda is uniquely positioned to reassert its role and reputation as a success story of the AIDS response in Africa,” said Mr Sidibé.

In the late 1990’s, Uganda was internationally recognized as a success story in Africa, having reduced high HIV infection rates and extended access to life-saving treatment for people living with HIV. Between 2006 and 2011, however, there were signs that its earlier success had fallen by the way-side with new HIV infections on the rise.

New HIV infections in Uganda increased from 120 000 in 2005 to 160 000 in 2011 with a slight decrease in 2012—an estimated 140 000 new HIV infections were recorded last year.

In 2012-2013, Uganda made breakthrough progress by scaling-up its national, evidence-based response to HIV. In 2012 alone 193 000 people living with HIV were newly enrolled in the national treatment programme. The Ugandan Ministry of Health is also expanding its HIV prevention strategy to reduce the number of new HIV infections in Uganda.

Demonstrating his commitment to the AIDS response, President Museveni committed to address the upcoming high-level event on Millennium Development Goal 6 and HIV treatment organized by UNAIDS on the side-lines of the United Nations General Assembly, which will be held on 23 September 2013.

As part of the official visit, Mr Sidibé and Dr Kazibwe joined the Ugandan Minister of Local Government, Hon Adolf Mwesige during a meeting with local leaders from 112 Districts in the country. They urged the district authorities to accelerate their efforts to ensure that integrated health care services are available for people living with HIV in their communities.

“Uganda’s constitution says sovereignty is with the people and elected leaders are servants of the people,” said Dr Kazibwe, “The people who elected you are crying out to you to make sure that resources are mobilized to improve delivery of services for HIV and health at the district level,” she added.  

In his two-day official visit to Uganda, Mr Sidibé also met with the Speaker of the Ugandan Parliament, Members of Parliament from the Committee on HIV/AIDS, and representatives from civil society and private sector organizations. Issues discussed included the need to ensure social equity and the respect for human rights of key population at higher risk of HIV infection; the regional production of HIV medicines; and the importance of increasing domestic resources to sustain the national AIDS response.

UNAIDS Executive Director and First Lady of Uganda met with mothers at a health centre in Nadunget, Uganda, 16 September 2013. Credit: UNAIDS

The First Lady of Uganda, Janet K Museveni, showed her commitment to stopping new HIV infections in children by bringing a national campaign to Karamoja, one of the most disadvantaged regions of her country. She launched the Elimination of Mother-to-Child- Transmission of HIV (eMTCT) Campaign in Moroto, a city in the north eastern region on 16 September.

The campaign is part of the government’s push to prevent new HIV infections among children by promoting an antiretroviral therapy (ART) regimen where all pregnant women living with HIV are provided ART for life. This is consistent with the 2013 World Health Organization guidelines which recommend that ART be initiated in certain populations including pregnant and breast-feeding women in resource limited settings. 

Speaking at the launch, the First Lady who is also the Cabinet Minister for Karamoja Affairs said “Sadly, 65 babies are born with HIV every day in Uganda. We must give appropriate, life-saving messages if we are going to reverse this trend.”

The Minister of Health of Uganda, the UNAIDS Executive Director and other high-level dignitaries attended the launch. Uganda was recognized as a leader in Africa’s HIV response and was one of the first four developing countries in the world to provide people living with HIV with access to life-saving treatment. But in recent years, the country’s HIV response has lost some momentum. According to government figures, an estimated 140 000 new HIV infections occurred in 2012, compared to 120 000 in 2005.

There are signs Uganda is revitalizing its AIDS response. New infections among children declined from 27 000 in 2009 to 15 000 in 2012—a 49% drop. The number of women accessing prevention of mother-to-child-transmission of HIV (PMTCT) services in the country also increased rapidly from 45% in 2011 to 73% 2012.

UNAIDS Executive Director Michel Sidibé applauded the First Lady for her personal commitment to bringing HIV treatment and care services to women in poor and marginalized communities.

“Uganda brought hope to millions of people. It showed the word that AIDS can be overcome and Africans can have access to treatment.  This hope was built on courage, strong leadership and partnership,” said Mr Sidibé. “Uganda needs to bring back the courage and commitment of its early days to finish the job and have a generation born free from HIV.”

The First Lady and Mr Sidibé met with two couples, who shared their experience as parents living with HIV. “Thanks to the treatment and advice I got from the health centre I gave birth to a baby born HIV free. That baby is now two years old.” said Angella Nate, who has been living with HIV for the past last six years. “I tell everyone my story because I want all mothers to see their children grow up healthy and get the same chance in life as everybody else.”

The UNAIDS Executive Director will continue with his official visit to Uganda on 17 September, meeting with civil society groups, district level government leaders and the country’s president.

A new study focusing on men’s use of violence against women found that more than half of the 10 000 men interviewed reported using physical or sexual violence against a female partner. Nearly a quarter of the men interviewed reported perpetrating rape against a woman or girl.

The UN multi-country study entitled Why do some men use violence against women and how can we prevent it? was launched in Bangkok, Thailand on 10 September 2013. 

Conducted in six countries in Asia and the Pacific—Bangladesh, Cambodia, China, Indonesia, Sri Lanka and Papua New Guinea—the study explores the prevalence of men’s use of violence against women in surveyed sites, and shows what factors make men more or less likely to use violence. The report also makes important recommendations to prevent violence against women.

“Prevention is crucial because of the high prevalence of men’s use of violence found across the study sites,” said James Lang, Programme Coordinator, Partners for Prevention. “It is also achievable because the findings indicate that the majority of factors associated with men’s use of violence can be changed,” he added.   

The report highlights that, among respondents who admitted using violence against women, many began such violence perpetration at early ages. “We need to start working with younger boys and girls than we have in the past,” said Emma Fulu, Research Specialist for Partners for Prevention. “We also need laws and policies that clearly express that violence against women is never acceptable,” added Ms Fulu.

Findings of the study provide important evidence and guidance for efforts to eliminate gender inequalities and gender-based violence and increase the capacity of women and girls to protect themselves from HIV.

The World Health Organization reports that forced sex, violence and/or fear of violence can limit the possibility of women to negotiate safe sex and to protect themselves from HIV transmission. Research from the Asia Pacific region suggests that violence is a risk factor for HIV where women living with HIV are more likely to report a history of intimate partner violence than women who are not.

“These findings provide significant insights to help better adapt programmes and initiatives in Asia and the Pacific to reduce gender-based violence and help increase the protection of women and girls from HIV infection,” said Steven Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific.

The study was conducted by Partners for Prevention, a UN Development Programme (UNDP), UN Population Fund (UNFPA), UN Women and UN Volunteers regional joint programme. The study asked men about their use and experiences of violence, attitudes and practices, childhood, sexuality, family life and health.

High-level military representatives from 19 countries in West and Central Africa have called on governments to scale up HIV prevention programmes specific for military and security forces to reduce new HIV infections and sexual gender-based violence in conflict and post conflict areas in the region.

The call was made during a meeting of the West and Central Africa Military Network for AIDS Control (REMAFOC) held in Dakar, Senegal from 2-4 September 2013. Established in December 2008 with support from UNAIDS, REMAFOC aims to coordinate the response to HIV among military forces in the region—by promoting collaboration and knowledge exchange between the armed forces of 22 West and Central Africa Members States.

During the meeting, members of the REMAFOC and representatives from UNAIDS, DPKO, UNFPA and the US Department of Defence discussed progress made in the implementation of the United Nation Security Council Resolution 1983 on HIV and security in conflict and post conflict situations. Resolution 1983 identifies sexual and gender-based violence as a specific risk of HIV infection for women and girls.

Participants at the meeting shared best practice activities from countries in conflict or post conflict situations including Côte d’Ivoire, Liberia and the Democratic Republic of Congo. Activities range from training women’s organizations on how to refer victims of sexual violence to health care services to training trainers from the armed and security forces as well as prison and immigration services on HIV prevention.

REMAFOC Member States agreed to develop, in collaboration with the US Department of Defence, a common position paper on HIV and security to scale-up the implementation of Resolution 1983 in the region.

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The national launch of the Technical Assistance Programme for Countries of Eastern Europe and Central Asia in Combating Infectious Diseases took place in the Tajikistani city of Kurgan-Tube, in the Khatlon Region on 10 September 2013.

The Technical Assistance Programme, supported by a three-year grant of US$ 16.5 million from the Russian Government, aims to strengthen health systems, ensure better epidemiological surveillance of HIV, and promote the scale up of HIV prevention programmes among key populations at higher risk in Armenia, Kyrgyzstan, Tajikistan, and Uzbekistan. 

The Programme is supported by the contribution of the Russian Government as a leading partner for health and development in countries of the Commonwealth of Independent States, and is being implemented by UNAIDS, in partnership with the non-governmental organization 'AIDS Infoshare'.

The launch was attended by representatives of the Russian Presidential Administration, the Russian Ministry of Foreign Affairs,  the Ministry of Health of Tajikistan, the Government of the Khatlon Region, the City of Kurgan-Tube, the Ministry of Health of Armenia, as well as representatives from UNAIDS, 'AIDS Infoshare' and civil society organizations from Russia and Tajikistan.

The HIV epidemic in Tajikistan, affects mainly people who use drugs and now the number of new HIV infections is growing among people migrating abroad for work. Knowledge about HIV prevention remains limited among migrant workers and access to HIV services are not widely available upon their return as most live in rural and hard to reach regions of the country.

At the launch, a Russian-made mobile clinic and diagnostic centre was presented to the Government of the Khatlon Region. Equipped with the latest in medical equipment and diagnostic systems, the clinic will provide populations at higher risk of HIV infection in the Khatlon Region with access to integrated HIV testing, counselling and other forms of medical diagnostics and treatment.

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