Leaders from across Africa and beyond are gathering for a special African Union (AU) summit which marks the 50^th anniversary of unity on the continent.

Meeting in the Ethiopian capital, Addis Ababa, from 25-27 May, Heads of State and Government will celebrate achievements spearheaded by the AU and its predecessor the Organisation of African Unity established in 1963.

On Saturday, a Special Commemorative Summit will debate Pan Africanism and the African renaissance and stage an event involving more than 70 world leaders, 15 000 invited guests, a gala dinner hosted by Ethiopian Prime Minister Hailemariam Desalegn and performances from international stars like Salif Keita and Papa Wemba. The following two days are given over to the 21^st Assembly of Heads of State and Government where leaders will help chart Africa’s way forward.

Since it was set up some thirteen years ago, the African Union has worked to ensure the further development of the continent and it is committed to meeting future social, health and economic challenges. This is especially relevant now when there is so much emphasis on the post 2015 development agenda and what this will mean for people, countries and regions.

Highlights

There are several meetings and side-events occurring during the Summit. Today, for example, the African Regional Civil Society Health Platform, the Consortium of Christian Relief and Development Association and the Global Network of People Living with HIV are hosting a roundtable discussion. 

They are joined by UNAIDS Executive Director Michel Sidibé and Mark Dybul, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. High on the agenda will be the collective responsibility of ‘Getting to Zero’ (zero new HIV infections, zero discrimination and zero AIDS-related deaths) and keeping health issues central to the post 2015 development agenda. 

There will also be a focus on the implications of the Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa adopted by African leaders last year. The Roadmap is a plan aimed at improving health outcomes and access to affordable high quality medicines, as well as diversifying financing mechanisms. Advancements in the AIDS response in Africa have been considerable in recent years, with ever greater numbers of people on HIV treatment and dramatic reductions in the rate of new HIV infections. The roundtable will look at how these successes can be built upon.   

With the theme of accountability a motif of the summit the African Union Commission, alongside UNAIDS and the New Partnership for Africa’s Development (NEPAD), will launch Delivering results towards ending AIDS, Tuberculosis and Malaria in Africa, the first thematic accountability report on the AU-G8 partnership.  It recommends that both bodies exercise greater leadership, especially in the spheres of sustainable financing, access to medicines and human and gender rights.   

The summit also provides an opportunity for AIDS Watch Africa (AWA) to measure partners’ progress in the three key diseases affecting the continent—AIDS, tuberculosis and malaria. AWA was founded by African Heads of State in 2001 as a platform for advocacy and accountability.  The outcome of its recent Action Committee meeting will be presented to the 21^st session of the AU Assembly for endorsement and follow up action.  AWA is expected to request that member states develop a sustainable investment plan for health with year on year increases in domestic funding.

According to the Chairperson of the African Union Commission Dr. Nkosazana Dlamini Zuma, the continent has made great strides in the last 50 years and needs now to look to the future. She said, “As we celebrate the 50th anniversary of the OAU and AU, we are inspired by their example, and pledge to work together in solidarity for an integrated, people-centred and prosperous Africa, at peace with itself.” 

Participants at the Youth and UNAIDS event held in Hammamet, Tunisia from the 20-22 of May. Credit: UNAIDS

AIDS activism has radically changed since the beginning of the epidemic. New modes of communication are amplifying people’s voices, creating cross-national webs of solidarity opening up new opportunities for progressive social change.

Young activists in countries around the world are increasingly demanding HIV services to be tailored to their needs and claiming their seat at the decision-making table.

While the HIV prevalence has fallen by nearly 27% among young people aged 15-24 globally between 2001 and 2011, young people still account for 40% of all new HIV infections among adults. In 2011, there were some 4.6 million young people living with HIV.

Against this backdrop, UNAIDS brought together 12 global and regional youth organizations working on HIV, sexual and reproductive health and rights, and lesbian, gay and transgender rights  with the 16 community, country and regional youth activists that constitute the recently established UNAIDS Youth Advisory Forum. The aim was to strategize on a clear direction to move the AIDS response forward for young people.   

“Many small organizations lack the time, resources, and strategic space to reflect on their work and forge new alliances,” said Pablo Aguilera, director of the HIV Young Leaders Fund and member of the UNAIDS Youth Advisory Forum. “We called for this meeting to ensure the movement is responsive to the needs of young people most affected by HIV.”

To deliver results for young people on the ground, a decentralized, connected global youth movement—that thinks globally but acts locally is needed to initiate a new wave of activism in the AIDS response.

The meeting, called the Youth and UNAIDS: A pact for social transformation took place in Hammamet, Tunisia from the 20-22 of May. The main outcome of the consultation was a pact outlining five key themes that cut across individual organizational agendas where youth organizations can make tangible impact towards the goals set in the 2011 United Nations General Assembly Political Declaration on HIV and AIDS.

The five themes include: Integrating HIV services into sexual and reproductive health services, with a focus on government accountability and sexuality education; enabling legal environments and removing punitive laws that impede access to services for young key populations at higher risk; scaling up treatment and disaggregating data for evidence informed advocacy; using resources effectively; and ensuring that HIV remains a priority in the Post-2015 development framework through strategic lobbying of national delegations.

“This new commitment to collaborate around specific priorities is a radical departure from business as usual in the youth AIDS response. Through strengthening collective action that goes beyond organizational agendas, we hope the movement can achieve concrete change for young people affected by HIV,” said Caitlin Chandler, community representative who co-facilitated the meeting together with Beth Goodey from the youth-led development agency Restless Development.

Supporting increased collaboration and strategic direction of the youth movement in the AIDS response is a key priority for the new UNAIDS youth programme, which aims to increase youth leadership, ownership, and mobilization in the AIDS response at the country, regional, and global level by 2015 and beyond.

“We want to work closer with organizations of young people living with HIV and young key populations at higher risk to create broad alliances,” said Mariangela Simao, UNAIDS Director of Gender, Human Rights and Community Mobilization Department. “It’s an effective strategy to ensure national ownership for progressive social change—because the demand for change will come from within,” she added.

During a meeting on May 23 in Geneva, the Minister of Health of the Kingdom of Bahrain, Dr Sadiq AbdulKarim Al Shehabi and UNAIDS Executive Director Michel Sidibé pledged to strengthen cooperation between UNAIDS and the Ministry of Health.

Mr Sidibé commended the leadership of the Minister Al Shehabi in Bahrain in responding to the AIDS epidemic. He also asked Dr Al Shehabi to champion national and regional initiatives to prevent new HIV infections among children by 2015 and to accelerate scale up of HIV treatment in the Arab Region.

Dr Al Shehabi welcomed the partnership with UNAIDS and committed to putting HIV on the agenda of the Gulf Cooperation Council, currently chaired by the Kingdom of Bahrain.

The Arab Region has one of the fastest growing HIV epidemics in the world. Between 2001 and 2011, the estimated number of people living with HIV in Arab countries increased from 170 000 to 230 000. The numbers of AIDS-related deaths and new HIV infections have also increased significantly. Between 2001 and 2011, there was a 32% increase in AIDS-related deaths and since 2001, the number of people newly infected with HIV in Arab countries has increased by more than 47%—from 19 000 to 28 000. Recent studies suggest that concentrated epidemics are emerging among key populations at higher risk of HIV infection in many countries of the region.

Quotes

Message from UNAIDS Executive Director Michel Sidibé

GENEVA, 17 May 2013—More than 30 years ago, gay men lit the first spark that kindled the world’s response to the AIDS epidemic. Thanks to the audacity and courage of lesbians, gays, bisexuals, and transgender people, we have now seen extraordinary progress against AIDS around the world.

However, stigma and discrimination based on sexual orientation or gender identity still drive new HIV infections and are an obstacle to treatment efforts in every part of the world.

We call on political and community leaders to cast aside discriminatory laws and social practices.

The right to health belongs to everyone. Everyone should have access to HIV prevention, care, treatment and support.

Today and every day, UNAIDS stands with our fellow LGBT brothers and sisters for a world without homophobia and transphobia.

Let us work together to realize our vision: a world with zero new HIV infections, zero discrimination, and zero AIDS-related deaths.

A delegation from Viet Nam visited the drug quality control division of a Thai factory that manufactures antiretroviral medicines. L to R: Dr Chu Quoc An, Head of Delegation, Mr Bang from Viet Nam Social Security, Mr Tien from Drug Administration of Viet Nam, Dr Nhan from Viet Nam Administration for AIDS Control Credit: UNAIDS/Bich.N

Mr Dong, a 37-year-old man from Hanoi, has been living with HIV for a number of years. He is in good health thanks to the antiretroviral treatment that is provided free of charge in Viet Nam and is a leading member of the Viet Nam Network of People Living with HIV (VNP+).

But Mr Dong, as well as many other colleagues in the Network, is worried. He knows that the donors who pay for nearly all of Viet Nam’s HIV treatment programme will soon leave. Who will pay for his antiretroviral (ARV) medicines in the future?

“The first-line of antiretrorival treatment I am currently on costs about US$ 98 per person per year. That is with imported generic medicines,” explains Mr Dong. “I can afford it for now if treatment is no longer free. But I don’t know until when I can stay this healthy and keep my job, while antiretrorival treatment is life-long. That is not to mention that treatment cost could be much higher if I have to shift to second-line treatment or buy non-generic drugs,” he noted.

At the end of 2012, Viet Nam was providing antiretroviral treatment for nearly 60% of all people in need, according to the Viet Nam Administration for HIV/AIDS Control (VAAC). However, 97% of the funds for antiretroviral medicines come from external funding, which is expected to significantly decrease after 2015.

This is the result of Viet Nam’s recent achievement of middle-income country status and the prolonged economic downturn in donor countries. The Government of Viet Nam is increasing its national budget allocations to the HIV response, but much more slowly than the expected decrease in donor support. Current projections of the amount of funding required to purchase antiretroviral medicines for all in need indicate there will be a significant gap by 2016.

Deputy Prime Minister Nguyen Xuan Phuc has called on VAAC to address this potential funding crisis, and VAAC has initiated the development of a “National Plan to Ensure the Sustainable Supply of ARVs Beyond 2015”, in collaboration with development partners, including UNAIDS.

South-south learning and political leadership is key

Collecting evidence and good practice from countries in the region was identified by VAAC as essential to inform the development of the plan. In April 2013, UNAIDS supported a study visit by a multi-sectoral Government delegation to Thailand.

The delegation learned how Thailand, as a middle-income country, is providing universal access to antiretrovirals and all HIV-related tests free-of-charge, financed by the state budget and provided to all in need through national health insurance schemes. They also learned how Thailand has issued compulsory licenses for two kinds of ARVs and centralized procurement and supply chain management of ARVs to keep costs down while also ensuring the Thais have access to high-quality first-line and second-line drugs.

“We learned a lot about how Thailand went through a long process to achieve universal coverage of healthcare for all Thai people and antiretroviral treatment for those in need, and about their challenges,” said Dr Chu Quoc An, head of the Viet Nam delegation. “Yet, the most important lesson learned is that strong political leadership at the highest levels has been Thailand’s key to success.”

Positive outlook

Delegates agreed that leadership, determination and a strong multi-sectoral coordination will be critical for Viet Nam to adapt and adopt lessons learned from Thailand. As the study tour emphasized, adequate time is also needed to enable plans to come to fruition.

“I believe Viet Nam can do it,” said Steve Kraus, UNAIDS Regional Director for Asia and the Pacific. “We can see how the country is accelerating progress towards national targets and international commitments on HIV treatment. We can see the determination is there. UNAIDS is committed to continue supporting this South-South cooperation, and to assist Viet Nam in its quest to ensure life-long treatment for all in need.”

For Mr Dong, the progress towards a sustainable plan for treatment is encouraging, but concerted action is critical. “I am excited to hear about VAAC’s development of the ARVs sustainability plan and the engagement of many sectors,” he said. “I hope National Assembly and Government leaders will pay more attention to this issue so the plan can soon become a reality, for the benefits of people living with HIV and the wider community.”

L to R: UNAIDS Country Coordinator Tatiana Shoumilina, Chief Chiveso, traditional leader, Ms Beagle, and Provincial Governor Martin Dinha, in the area of Bindura, Zimbabwe. Credit: UNAIDS

Zimbabwe is an example of political commitment and progress in the AIDS response. Although it is one of the countries most affected by the HIV epidemic in sub-Saharan Africa, with an adult HIV prevalence of 15%, the country has achieved and sustains universal coverage of treatment to prevent mother-to-child-transmission of HIV (93%) and adult antiretroviral therapy (ART) with 95% of adult Zimbabweans eligible for HIV treatment receiving it.

This scale up of comprehensive HIV prevention, treatment, care and support services in the country has resulted in the decline in the rate of new HIV infections from a peak of 5.21% in 1994 to 0.86% in 2012.

Zimbabwe’s progress in the AIDS response is largely credited to the country’s capacity to mobilize and sustain domestic resources for the response through its innovative AIDS levy—a 3% tax on all taxable individual and institutional income. In 2012 alone, the levy generated US$ 32 million. Zimbabwe also successfully mobilized US$ 311 million from the Global Fund to Fight AIDS, TB and Malaria under its new funding model. A further US$ 244 million, from Zimbabwe’s quality request, is pending the outcome of the upcoming Global Fund replenishment.

In early May 2013, UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle, undertook a country visit to Zimbabwe to witness the progress made. She also looked at challenges ahead in achieving the targets of the 2011 General Assembly Political Declaration on HIV and AIDS and discussed the role of Zimbabwe, as a new member to the UNAIDS Programme Coordinating Board this year, in the governance of UNAIDS and the AIDS response. 

During a meeting with the Vice President Hon Joice Mujuru, Ms Beagle commended the Government of Zimbabwe for its leadership in the AIDS response and encouraged the country to scale-up paediatric ART coverage, which by end of 2012 remained at 42%, and to accelerate efforts to reduce maternal mortality.

Communities leading the way

Ms Beagle travelled to Bindura, a rural area located about 90 km north-east of the country’s capital Harare, where she talked to community representatives, traditional leaders, local service providers, and district and provincial administrators. With support from the non-governmental organization PADARE, a movement of men advocating for gender justice, the community champions male involvement in preventing new HIV infections among children and increasing uptake of HIV prevention and treatment services. It also focuses on strengthening sexual and reproductive health services for young people, especially girls, and addressing gender-based violence.

PADARE concentrates on men in all settings and uses communication and networking tools, workshops and training, lobbying and advocacy to achieve social and behaviour change. The organization works through 65 chapters and has a membership of more than 3 000 in the country’s ten provinces.

“The communities are doing exemplary work, addressing issues related to gender equality and the empowerment of women, using community dialogue and facilitating community actions and solutions,” said Ms Beagle. She urged the communities to ensure that the needs of populations at higher risk of HIV infection—such as women, young people, people with disabilities, sex workers and men who have sex with men—are recognized and appropriately met.

NOTE: As part of her official programme in Zimbabwe, Ms Beagle also met Hon Dr H. Madzorera, Minister of Health and Child Welfare; Hon Dr O. Muchena, Minister of Women Affairs, Gender and Community Development; Hon Dr D. Parirenyatwa, Chair, Parliamentary Portfolio Committee on Health; leadership of the National AIDS Council; members of the Country Coordinating Mechanism; members of the Executive Committee of the Zimbabwe Parliamentarians against HIV network; and the Steering Committee of Zimbabwe GlobalPOWER Chapter. She also interacted with civil society representatives and young people, and engaged with the UN Resident Coordinator and the UN Country Team. She visited the Beatrice Road Infectious Disease Hospital, a public health care organization providing adult and paediatric Opportunistic Infections and ART services.

The Federal Councillor for Foreign Affairs of Switzerland, Didier Burkhalter announced the government’s intention to increase its annual contributions to UNAIDS for 2013, 2014 and 2015 during the official visit of UNAIDS Executive Director Michel Sidibé to the Swiss capital of Bern. Such contribution reaffirms Switzerland’s position among UNAIDS' top 10 donors.

Since the beginning of the epidemic, Switzerland has been committed to the AIDS response and has shown strong leadership both domestically and at the global level. The country has been actively engaged in developing harm reduction policies, the protection of vulnerable groups and the promotion of treatment as prevention.

Mr Sidibé commended Switzerland’s contribution to the global AIDS response and celebrated the country’s critical role as a member of the UNAIDS Programme Coordinating Board (PCB) in shaping the future of AIDS within the post-2015 development agenda.

During his visit, Mr Sidibé also met with Pascal Strupler, Director of the Federal Office for Public Health, Maya Tissafi, Deputy Director of the Directorate for Development Cooperation of Switzerland, and other key partners from civil society and the private sector.

Quotes

In a meeting on 8 May 2013 with the Vice President of Zimbabwe, Hon Joice Mujuru, UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle commended the Government of Zimbabwe for its leadership in the AIDS response. She congratulated the country on the successful mobilization of US$ 311 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) under the new funding model. A further US$ 244 million, from Zimbabwe’s quality request, is pending the outcome of the upcoming Global Fund replenishment.

Zimbabwe is one of the most affected countries by the AIDS epidemic in sub-Saharan Africa. The scale up of comprehensive HIV prevention, treatment, care and support has resulted in the decline of the HIV incidence rate from a peak of 5.21% in 1994 to 0.86% in 2012. The country is also committed to stopping new HIV infections among children.

Quotes

Burundi’s President Pierre Nkurunziza said his country is trying to increase access to education and health services as key elements to effectively respond to AIDS in the country. He met with UNAIDS Executive Director Michel Sidibé on 9 May in Bujumbura, Burundi.

After 13 years of socio-political crisis marked by civil war and political instability the government of Burundi has committed to the reconstruction of the country by focusing its efforts on the rehabilitation of health services and schools destroyed during the armed conflict. The President has also made the response to AIDS a priority and recently adopted a decree which aimed to significantly scale-up services to prevent new HIV infections among children.

Burundi depends on external assistance to finance 95% of its AIDS response. During his meeting with President Nkurunziza Mr Sidibé encouraged him to invest more domestic resources to ensure an effective, efficient and sustainable response.

As part of his official two-day visit to Burundi, Mr Sidibé visited the health centre of the National Association of Support for People Living with HIV and AIDS Patients (ANSS), and he also met with a large group of representatives from civil society.

Quotes

L to R: Minister of Health of Burundi, Dr Sabine Ntakarutimana, UNAIDS Executive Director Michel Sidibé and United States Ambassador to Burundi, Dawn Liberi.

Burundi marked its National AIDS Day on 8 May and committed to stopping new HIV infections among children and keeping their mothers alive. The Minister of Health of Burundi, Dr Sabine Ntakarutimana who opened the event at the Kamenge health centre in Bujumbura said, “I am committed to bringing Burundi to zero new HIV infections, zero discrimination and zero AIDS-related deaths.”

Burundi’s health authorities report HIV prevalence in the country was 1.4% in 2010 with more than 98,000 people living with HIV in 2011. The country is struggling with a low HIV treatment coverage with only 49% of people eligible for antiretroviral therapy accessing it. Almost 2000 babies were born with HIV in 2011. The government has promised to improve treatment coverage especially for pregnant women living with HIV and recently Burundi’s President Pierre Nkurunziza adopted a decree which aims to significantly scale-up services to prevent new HIV infections among children.

“AIDS is a strategic entry point for advancing Burundi’s social agenda at several levels: protecting women, children and human rights,” said UNAIDS Executive Director Michel Sidibé at the event.

The country will be receiving support for scaling-up services from the United States of America according to its Ambassador to the country, Dawn Liberi. “We will double our financial contribution to cover eight of the 17 provinces in Burundi with services to prevent new HIV infections among children,” she said.

Burundi’s Second Vice-President, Gervais Rufyikiri (left) and UNAIDS Executive Director Michel Sidibé.

In 2011, UNAIDS and partners launched the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive. Burundi is one of the 22 countries that the Global Plan focuses on, where 90% of new HIV infections among children occur.

Mr Sidibé also visited the centre of health and family welfare (ABUBEF). The centre provides medical and care and support services to people living with HIV, as well as conducting HIV prevention programmes.  

As part of his official visit to Burundi, Mr Sidibé met with the Second Vice-President, Gervais Rufyikiri, who has championed the country’s drive to stop new HIV infections in children. In 2005, Burundi emerged from a long civil war and the Vice-President asked UNAIDS to support the country’s efforts towards greater development. He said, “I am asking the international community to pay more attention to Burundi. We are in the process of rebuilding our country and we need your support.”

The UNAIDS Executive Director continues his official mission on 9 May with a meeting with the country’s president.