The African Union international conference on maternal, newborn and child health is being held in Johannesburg, South Africa from 1 to 3 August. Credit: UNAIDS

In 2012, more than 200 000 children were newly infected with HIV among the 21 countries in sub-Saharan Africa where almost 90% of the world’s HIV transmissions to children occur.  While this was a 38% decline from 2009, it still means that nearly 600 children were newly infected each day.

As part of on-going efforts to improve the health of women and children across Africa, the African Union recently convened an international conference on maternal, newborn and child health in Johannesburg, South Africa. The conference, which runs from 1 to 3 August, addresses a number of important issues including service delivery and quality of service, access to medicines, family planning and task shifting. It also looks specifically at the impact of HIV on women and children and how to ensure increased access to essential HIV services.  

“As leaders we have the power to ensure that no woman dies giving life. We also have the power to ensure that no child dies from an avoidable cause,” said the President of South Africa, Jacob Zuma during the opening ceremony of the conference.

Stopping new HIV infections among children and ensuring their mothers have access to HIV services including treatment for their own health is a top priority for UNAIDS. In 2011, UNAIDS and PEPFAR spearheaded a new initiative which has been embraced by the global community. The Global Plan to eliminate new HIV infections among children and keeping their mothers alive (Global Plan) has set the ambitious goal for 2015 of reducing new HIV infections among children by 90% and reducing AIDS-related maternal and paediatric mortality by 50%.

To highlight the urgent need to scale up progress, UNAIDS held a special session at the conference to build on momentum around the Global Plan and address bottlenecks in the African countries where most new HIV infections among children occur. During the session UNAIDS reported that while seven countries have shown a rapid decline in new HIV infections (50% or more decline between 2009 and 2012), six others are showing signs of stagnation (less than 30% decline), and the remaining seven show moderate performance (30-49% decline).

“We need to reflect on how we shift the paradigm of how we are working today. The paradigm is a disease approach, but we need a holistic approach. We cannot afford to have women coming in to the facility and being addressed for TB on one day; HIV on another day... We need to consider her as a woman – a whole human being – who needs holistic support,” said UNAIDS Executive Director, Mr Michel Sidibé.

The African Union is a strong supporter of the Global Plan and has actively advocated for increased efforts to expand access to HIV services for women and children.

“The focus on maternal, newborn and child health is not expenditure, it is an investment. It is an investment in our common humanity and our common survival… We can do it, we must do it. We have no choice,” said African Union Chairperson, Dr Nkosazana Dlamini Zuma.

The South American Football Confederation (CONMEBOL) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) today signed a Memorandum of Understanding (MoU) in order to combine efforts to promote UNAIDS' Protect the Goal campaign and raise awareness about HIV/AIDS, particularly among the youth. The signing ceremony took place on the occasion of the special session of South America's soccer governing body in the presence of CONMEBOL President Eugenio Figueredo and Dr Djibril Diallo, on behalf of UNAIDS Executive Director Michel Sidibé.

The main objectives of the MoU are to carry out joint advocacy and communication activities in competitions organized by CONMEBOL —one of the Fédération Internationale de Football Association's (FIFA) six continental confederations— in support of the "Protect the Goal" campaign, a brand new initiative within the framework of UNAIDS' sport for global advocacy that was launched at the 2013 Orange Africa Cup of Nations in South Africa.

Globally, an estimated 4.6 million young people (15-24 years of age) are living with HIV. About 2300 young people are infected with HIV each day.

Quotes

The Executive Director of UNAIDS, Michel Sidibé, has appointed the First Lady of Mozambique as a Patron of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

A long-standing champion of the response to HIV, Maria Dia Luz Guebuza has advocated for zero new HIV infections among children for a number of years. In 2012, at the 32nd Summit of Heads of State and Government of the Southern Africa Development Community (SADC) she was instrumental in convening a powerful meeting of First Ladies. During the meeting the 15 First Ladies developed the ‘Maputo Declaration on the Elimination of Mother-to-Child Transmission of HIV’ which Dr Guebuza presented to heads of State who officially adopted the declaration at the Summit.

As a Patron of the Global Plan, Dr Guebuza will highlight the need to expand both HIV prevention and treatment services to women and children not only in Mozambique but across the region, which has been most affected by the AIDS epidemic.

The Global Plan is focusing particular efforts on these 22 countries to achieve two main targets for 2015: a 90% reduction in the number of children newly infected with HIV and a 50% reduction in the number of AIDS-related maternal deaths.

Mozambique is one of the Global Plan’s 22 priority countries and according to the latest progress report Mozambique has made major strides in providing HIV prevention and treatment services for women and children. The number of women receiving antiretroviral therapy to prevent transmission to their children increased from just 38% in 2009 to 86% in 2012 (under 2010 guidelines). Subsequently the number of new infections among children fell in the same time period from 26 000 to 14 000.

The Global Plan towards elimination of new HIV infections among children by 2015 and keeping their mothers alive is an initiative which was launched in 2011 by UNAIDS and the United States Presidents Emergency Plan for AIDS Relief (PEPFAR) at the UN General Assembly High Level Meeting on AIDS.

Quotes

The 2013 Confederation of North, Central American and Caribbean Association Football (CONCACAF) Gold Cup soccer tournament is promoting the HIV prevention campaign “Protect the Goal” of UNAIDS. On 28 July during the final game of the tournament in Chicago, IL, USA the captains of the national football teams from the United States and Panama pledged to raise awareness of HIV in the football community.

The “Protect the Goal” banner was displayed prominently on the pitch prior to the game, in front of about 58 000 fans. Damarcus Beasley, the captain of the U.S. team and Roman Torres, the captain of the Panamanian team, read a statement calling on players, football fans and young people to support the campaign.

CONCACAF has also promoted the “Protect the Goal” campaign during games taking place earlier this month in Los Angeles, CA, Harrison, NJ and Portland, OR.  In April 2013, UNAIDS and CONCACAF signed an agreement in which both organizations agreed to team up to raise awareness about HIV, particularly among the youth.

Globally, an estimated 4.6 million young people (15-24 years of age) are living with HIV. About 2300 young people are infected with HIV each day.

Quotes

(From left to right) UN Messenger of Peace Charlize Theron, South African President Jacob Zuma, and UNAIDS Executive Director Michel Sidibé. Credit: UNAIDS

The challenges facing young people in South Africa were the focus of a dynamic meeting between South African President Jacob Zuma, UN Messenger of Peace Charlize Theron and the Executive Director of UNAIDS Michel Sidibé. Prominent issues in the discussions included the vulnerability of young women and girls to HIV in South Africa, the need for Africa to become more self-sufficient in producing antiretroviral medicines  and the remarkable progress South Africa has made in responding to HIV recent years. 

President Zuma said, “We came from a difficult time. We had all the plans but the manner in which we interfaced with the world was very difficult. I want to thanks UNAIDS, specifically Michel Sidibe, who has been a pillar of strength in supporting our country on HIV. During this very short time we have changed the life expectancy of our people due to his support and guidance."

The importance of reaching young people with HIV services was also stressed together with the need to integrate health care into education and youth programmes. The example of South Africa’s Integrated School Health Programme, which aims to reach school children with primary health care services and life orientation skills, was highlighted as a positive way forward in improving the health of young South Africans.

“It’s time to end AIDS,” said Mr Sidibé. “It’s time for zero preventable deaths due to AIDS, zero tolerance for violence and new infections among young women.”

A recent study revealed that young women between the ages of 15 and 24 are three times more likely to become infected with HIV than young men in the same age group. HIV prevalence is also much higher among women (23%) in South Africa than in men (13%).

Ms Theron spoke passionately about some of the issues facing young people in South Africa that she has seen and heard through the work of her non-profit organization the Charlize Theron Africa Outreach Project.

“I can promise that we will continue to support you to keep yourselves and your peers safe from HIV,” said Ms Theron.

Ms Theron and Mr Sidibé also met with Friends for Life, a non-profit organization located in Alexandra township in Johannesburg. Friends for Life is a community-based HIV prevention, care and support organization which works closely with young people.

“The visit was such a great opportunity for us to share our ideas and concerns as young people,” said Thulani Tshefuta, a representative of the South African National AIDS Council’s youth sector. “We hope that through speaking about the situation of youth in South Africa and continuing to serve as advocates, we see a change in our communities and in the lives of young people living with HIV.”

Kazan, Russian Federation was the host of the 27th Summer Universiade — World University Games. The event attracted 11 000 young athletes from more than 160 nations competing in 27 sports from artistic gymnastics to wrestling.

With this backdrop an HIV prevention project called Games for Health. Games for Life was launched. Around the world about 2300 people aged 15-24 become infected with HIV every day and many of the young people living with HIV are unaware of their HIV status. In the region where the Games took place (Eastern Europe and Central Asia) the number of people living with HIV has almost tripled since 2000.

As part of the launch of Games for Health. Games for Life,  35 000 HIV prevention hand-outs were distributed to participants and volunteers. And some 8000 volunteers participated in information sessions about HIV where they discussed issues such reducing stigma and discrimination and promoting the rights of people living with HIV.

The results of this HIV prevention initiative were presented to the next Universiade organizing committee and will be shared with the organizers of major upcoming sporting events including the Sochi 2014 Winter Olympics and the 2018 FIFA World Cup.

Quotes

The particular impact that HIV has on women and girls was discussed during a panel discussion organised in conjunction with the 55th Session of Committee on the Elimination of Discrimination against Women (CEDAW). Broad ranging discussion took place during the event on how gender inequality, poverty, harmful cultural practices, and unequal power relations exacerbates their vulnerability to HIV infection.

Also underscored was the important, if not central, role of human rights and creating an enabling environment for women and girls. Participants agreed that countries must do more to ensure women and girls have access to comprehensive sexual and reproductive health and HIV services.

The keynote speech was given by Jan Beagle, Deputy Executive Director, Management and Governance, UNAIDS who said the Committee could help to ensure that governments make HIV services available and accessible to all women and girls including sex workers, women who inject drugs and transwomen. Looking to the post-2015 agenda, she stressed the importance of leveraging synergies across movements to advance sexual and reproductive health (SRH) and rights, gender equality and the empowerment of women and girls.

The panellists agreed that all barriers hampering women’s access to sexual and reproductive health services must be removed, and they called on State Parties to CEDAW to make the necessary investments to facilitate access to SRH services. They also encouraged State Parties to enhance their reporting on human rights issues as it relates to women and HIV and to better use CEDAW to advance the rights of women and women living with HIV in particular.

Quotes

ABUJA, Nigeria, 15 July 2013—A report launched today at the Special Summit of the African Union on HIV/AIDS, Tuberculosis and Malaria highlights increased, targeted health spending as an essential foundation to greater economic growth and development in Africa. The report, Abuja +12: Shaping the future of health in Africa, published by the African Union (AU) and the Joint United Nations Programme on HIV/AIDS (UNAIDS), reviews progress made since the AU’s 2001 Abuja Declaration—in which leaders pledged to mobilize domestic and international resources for health and remove barriers to the AIDS response—highlights remaining gaps, and prioritizes next steps.

“Africa’s health and our prosperity are inextricably linked.  2001 was a turning point for Africa as African countries committed to take greater responsibility for the health and wellbeing of their citizens,” said Dr Mustapha Sidiki Kaloko, AU Commissioner for Social Affairs. “Since then, we have invested greater resources and efforts to address AIDS, TB and malaria which has produced exceptional results. We urge all AU member states to commemorate Abuja+12 with a renewed commitment to prioritize health and achieve their commitments and targets by 2015.”

The new report highlights five main recommendations for a healthier Africa: unifying leadership, generating innovative financing, making smarter investments in health, strengthening human resources and ensuring no one is left behind. Together, these recommendations aim to leverage health as a force for economic growth and social progress across Africa.

The report also highlights recent successes in the HIV, TB and malaria responses in Africa, including substantial reductions in the number of new HIV and TB infections and deaths from malaria. There is now much broader access to antiretroviral and TB medications and use of malaria control strategies such as insecticide-treated bed nets and indoor residual spraying are becoming more widespread.

“Twelve years ago, African leaders pledged to unite in addressing the health crises which were devastating the continent—and succeeded in making historic progress,” said Michel Sidibé, Executive Director of UNAIDS. “A renewed and bold commitment here in Abuja is essential as drawing from experiences in the AIDS response, we know that smart investments will save lives, create jobs, reinvigorate communities and further boost economic growth in Africa.”

The report cites a number of approaches pioneered as part of the AIDS response that can help improve returns on health investments. These include using investment frameworks to prioritize spending on the most cost-effective interventions; focusing efforts on people most in need; and reducing front-line health care costs by shifting tasks, where appropriate, from physicians to nurses, community health workers or other health practitioners. On strengthening health governance in Africa, the report notes that the principles that have been fundamental to the success of the AIDS response can be leveraged for the post-2015 agenda to advance coordination, innovation and commitment.

A central element of the 2001 Abuja Declaration was the commitment to allocate at least 15% of public expenditures to health by 2015. Over the last five years, health spending in Africa has risen by about 10% annually. However, spending is still nowhere near where it needs to be—just six AU member states (Liberia, Madagascar, Malawi, Rwanda, Togo, and Zambia) have achieved the 15% Abuja target, and an additional US$ 31 billion is required to close the funding gap.

The President of Côte d’Ivoire Alassane Ouattara said his country is committed to stopping new HIV infections among children in a meeting with UNAIDS Executive Director Michel Sidibé, on the side-lines of the 39th conference of Francophone parliamentarians, which took place in Abidjan from 9 to 12 of July. Mr Sidibé also asked the President to lead the region and the continent on innovative financing in the HIV response,

During his one-day official visit to Côte d’Ivoire, Mr Sidibé also met with the country’s President of the National Assembly, Guillaume Kigbafori Soro, and pushed for a more inclusive society in Côte d’Ivoire. There is draft legislation pending in Parliament which aims to improve living conditions for people living with HIV.

Quotes

UNAIDS Executive Director Michel Sidibé addressing the 39th meeting of the Francophone Parliamentary Assembly, Abidjan, Côte d’Ivoire, 11 July 2013. Credit: UNAIDS

During the 39th meeting of the Francophone Parliamentary Assembly (APF), parliamentarians from across the Francophone world met from 9 to 12 July in Abidjan, Côte d’Ivoire to discuss the meeting’s theme of “Parliaments at the heart of nation building”.

High on the agenda for parliamentarians, were issues on inclusion and equal protection as fundamental building blocks to stable societies and sustainable development.

Bringing lessons learned from the AIDS response, UNAIDS Executive Director Michel Sidibé stressed the importance of ensuring social inclusion, “We must address the human dimension of the HIV epidemic, end discrimination and ensure access to services for women and girls, prisoners, migrants, sex workers, people who inject drugs and men who have sex with men.”

His thoughts were echoed by the Secretary General of the APF, Jacques Legendre, “Unequal access to medicines for people living with HIV around the globe is intolerable.”

Adding to the inclusion message the Francophone Youth Parliament, noted the need to strengthen education on HIV prevention and place human rights at the centre of efforts to end the epidemic.

In spite of recent progress, the HIV response in low- and middle-income countries that are members of International Organisation of La Francophonie (IOF) has not shown the same results as that of other countries. In 2011, HIV treatment coverage in IOF countries in sub-Saharan Africa was 43% compared to 59% in non-IOF countries in the region.