Exactly ten years ago, President George W. Bush announced the creation of The Presidents Emergency Plan for AIDS Relief (PEPFAR) in his State of the Union Address.  When it was created, back in 2003, PEPFAR’s initial aim was to provide antiretroviral treatment to 2 million people living with HIV in resource-limited settings, to prevent 7 million new HIV infections, and to provide care and support to 10 million people by 2010.

Since those early days PEPFAR has come a long way, far exceeding its initial goals. By 2012 PEPFAR was directly supporting life-saving antiretroviral treatment for more than 5 million men, women and children worldwide. In 2012 alone PEPFAR supported HIV testing and counselling for more than 11 million pregnant women and provided medicines to prevent new HIV infections in children to around 750 000 women who tested positive for HIV. According to PEPFAR, this allowed 230 000 children to be born free from HIV.

“The leadership of the United States of America in the AIDS response has been instrumental in achieving results for people living with and affected by HIV,” said UNAIDS Executive Director Michel Sidibé. “Over the last 10 years new HIV infections worldwide have fallen by more than 20%, and as more people have been able to access antiretroviral therapy, AIDS-related deaths have fallen by a staggering 25% since the peak of the epidemic. These gains would not have been possible without the financial and political commitment of the United States and particularly PEPFAR,” he added.

The United States’ continuing leadership in the AIDS response was further confirmed this week when President Barack Obama gave his annual State of the Union Address.  In the hour-long address, President Obama directly talked about the United States’ commitment to achieving an AIDS-free generation. 

“In many places, people live on little more than a dollar a day. So the United States will join with our allies to eradicate such extreme poverty in the next two decades: by connecting more people to the global economy and empowering women; by giving our young and brightest minds new opportunities to serve and helping communities to feed, power, and educate themselves; by saving the world’s children from preventable deaths; and by realizing the promise of an AIDS-free generation.”

In July 2012, Secretary Hilary Rodham Clinton called on PEPFAR to produce a blueprint outlining how the United States will contribute to reaching an AIDS-free Generation which was subsequently launched in December of that year.

The Blueprint: Creating an AIDS-free Generation, reflects on lessons learned from PEPFAR’s  experience in supporting countries to rapidly scale-up HIV prevention, treatment and care services. It also highlights the unprecedented opportunity the world has to help move more countries towards and beyond the tipping point in their epidemics and put them on a path to achieving an AIDS-free generation.

The blueprint makes clear that the United States’ commitment to this goal will remain strong, comprehensive and driven by science and will serve as a roadmap for the United States’ response to HIV in the coming years.

Under the revised penal code young people between the age of 14 and 18 years old will be able to exercise their sexual and reproductive rights.
Credit: UNAIDS

The Constitutional Tribunal of Peru is amending an article in its penal code which for many years had criminalized consensual sexual activity among young people. Sentencing was particularly severe with adolescents facing up to 30 years in prison. Article 173 of the penal code was also preventing young people from accessing essential health and reproductive services for fear of prosecution.

Under the revised penal code young people between the age of 14 and 18 years old will be able to exercise their sexual and reproductive rights providing the two parties are consenting. Non-consensual sexual relations will still constitute a crime in Peru with lengthy sentencing for people found guilty.

"The Constitutional Tribunal ruling generates a protective effect in relation to adolescents, because it provides them with greater access to sexual and reproductive health services as well as guidance and information to avoid sexually transmitted infections, including HIV," said Mima Barnechea from the United Nations Population Fund (UNFPA).

In 2012, UNFPA and UNAIDS presented a formal request before the Constitutional Tribunal advocating for the declaration of unconstitutionality of Article 173.  This process was part of a wider effort particularly from the Office of Peru’s Ombudsman, Eduardo Vega Luna as well as legal demands presented before the Tribunal by more than 10 000 Peruvian citizens.

"UNAIDS welcomes the Constitutional Tribunal’s decision and congratulates the magistrates for their determination to protect adolescents’ human rights,” said UNAIDS Coordinator for Peru and Bolivia, Regina Castillo. “The Tribunal’s decision reinforces young people’s right to make decisions regarding their health and sexuality and the need to construct policies and programmes that recognize young people as active actors of change.”

According to a National Demography and Health Survey of 2011 a large percentage of Peruvians initiate sexual relations before the age of 18.  More than 12% of female adolescents (ages between 15 and 19) have been pregnant at least once.

"This decision is a milestone that sets the basis for plans and programs at national level to prevent teen pregnancy and reduce sexually transmitted infections including HIV and maternal mortality," said Carlos Tacuri Calderon, youth activist in Peru and member of INPPARES.

UNAIDS estimates that around 74 000 people are living with HIV in Peru of which approximately half became infected before the age of 20. This situation stresses the need to raise awareness on HIV and its modes of transmission among teenagers. In December 2012, the Ministry of Health in collaboration with UNAIDS and other partners launched the campaign “take an HIV test––it’s better to know” which aimed to reach young men with key HIV prevention messages and provided free HIV tests.

The Executive Director of UNAIDS Michel Sidibé was in the Malian capital Bamako over the weekend. He was there to take part in a ceremony marking the reinstatement of funding by the Global Fund to Fight AIDS, Tuberculosis and Malaria for a full-scale HIV programme in Mali.

Under the new agreement, the Global Fund has approved funding for US$ 75 million for HIV screening, prevention and treatment in Mali over the next three years. Efforts will be increased to expand HIV prevention services, particularly to reach key populations at higher risk. A high priority will be to stop new HIV infections in children and widen voluntary testing efforts. Improvements will also be made in coordination and in monitoring and evaluation of the response to HIV in Mali.

The Global Fund announced that it would be resuming its funding in November last year after having reduced funding in 2011 when mismanagement of funds was discovered. Since then both the Government of Mali and the Global Fund have taken essential measures to restore confidence in grant management and ensure continuity of HIV services for people most in need.

Some 110 000 people are estimated to be living with HIV in Mali and 30 000 are receiving antiretroviral therapy.

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Dr Olive Shisana, Chief Executive Officer, HSRC and Professor Sheila Tlou, Director, UNAIDS Regional Support Team for Eastern and Southern Africa signing the memorandum of understanding. 30 January 2013.

UNAIDS and the Human Sciences Research Council (HSRC) have signed a memorandum of understanding to strengthen research, policies, and programmes on HIV prevention globally, with a special emphasis on Africa.

“This partnership is a unique opportunity for UNAIDS to consolidate strategic information on the AIDS epidemic and realise our common vision of zero new HIV infections, zero AIDS-related death and zero discrimination,” said Professor Sheila Tlou, Director, UNAIDS Regional Support Team for Eastern and Southern Africa.

Objectives of the collaboration include developing evidence-based HIV prevention strategies and building capacity at the national level to develop more efficient HIV policies and programmes as well as to improve programme monitoring, evaluation and reporting.

“We are pleased that the HSRC’s credibility in HIV research is recognized and that we are able to make a contribution to this global effort,” said Dr Olive Shisana, Chief Executive Officer, HSRC. “It is indeed a great honour and opportunity for the HSRC and we look forward to this collaboration.”

Based in South Africa, HSRC is a statutory research agency focusing on social sciences. It aims to serve as a knowledge hub that bridges the gap between research, policy and action through partnership with several key constituencies including government, universities, NGOs, and donor and development organizations.

Community leaders representing internally displaced people meeting with representatives from the NGO, UN and government.

As the pressure for better living conditions rises in the camps in the Harad district of Yemen—Community leaders representing internally displaced people are meeting more regularly “We are 10 people in my tent; we have been waiting for new supplies to arrive, why the delay?” said one of the leaders.

The Harad camps host more than 130 000 people affected by long civil unrest in Yemen. To survive, many people walk the seven kilometres to the boarder of Saudi Arabia, hoping to cross into a country that is seen as having more economic opportunities. Others rely on daily wages from jobs at construction, agriculture and fishing sites and yet many people depend on the food provided by host local community.

But most people are not aware of their increased vulnerability to HIV infection as they sometimes resort to high-risk behaviors to meet their basic needs.

Local authorities are concerned about the lack of HIV information and have partnered with UNAIDS and the Office for the Coordination of Humanitarian Affairs (OCHA) to start an HIV awareness raising programme for displaced people.

“We know that HIV is escalating and can grow into a major epidemic—as we have seen this happen in other countries,” said Dr Majed Al Gonaid, Deputy Minister of Health. 

Funded by OCHA, the programme is being carried out by the local NGOs Women Association for Sustainable Development (WSAD) and the For All Foundation for Development in partnership with the UNAIDS country coordinator.

The programme consists of awareness-raising sessions on HIV, sexually transmitted infections and life skills to enable young people living in the camps to protect themselves from HIV. Also, as part of the programme, 20 male and female youth peer educators from the camps as well as the host communities will be trained on HIV prevention. Sensitization sessions with religious and community leaders and local council members will also be conducted to eliminate the stigma and discrimination as well as the gender based violence faced by people in the camps. Finally, HIV voluntary counselling and testing services will be provided jointly with the awareness raising activities.

“Such initiatives should be taking place in all humanitarian programmes,” emphasized Renu Chahil-Graf, Director of the UNAIDS Regional Support Team for the Middle-East and North Africa. “We hope that it will be seen as a best practice so that we don’t need to wait—for peace to arrive to provide HIV services.”

Integrating HIV in the humanitarian response

The United Nations Resident Coordinator for Yemen Ismail OuldCheikh Ahmed has been advocating for attention to be paid to HIV. “We must promote the integration of HIV and gender-based violence activities in the overall humanitarian programme,” he said.

L to R: Ms Sabah Badri, Chair of NGO For All Foundation, Dr Renu Chahil-Graf, UNAIDS Middle East and North Africa Regional Director and Mr Khaled Marh, Assistant Director of the camp.

 A report on AIDS, Security and Humanitarian Response presented at the 30^th UNAIDS Programme Coordinating Board (June 2012) highlights that a major objective of the work of UNAIDS, its Cosponsors and partners in supporting the HIV response in humanitarian emergencies has been mainstreaming AIDS into the overall humanitarian intervention, integrating it as a cross-cutting issue. The report raises a number of concerns that governments and organizations need to take into account, such as providing refugees and internally displaced people with continued access to antiretroviral therapy and HIV prevention services, as well as strategies which deal with broader issues like gender-based violence.

UNAIDS Executive Director Michel Sidibé met with the Executive Secretary of the Economic Commission for Africa, Dr Carlos Lopes, on the side-lines of the African Union Summit in Addis Ababa, Ethiopia. They discussed how to support Africa’s HIV response through innovative funding mechanisms and the importance of gathering reliable data, documenting Africa’s potential to produce quality-assured medicines, including antiretroviral drugs.

Dr Lopes said he was committed to strengthening the Commission’s partnership with UNAIDS in order to provide a rigorous and consistent evidence base that can influence the policy debate on AIDS and broader health and development.

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Dr. Ibrahim Mayaki re-elected as NEPAD’s CEO

GENEVA, 1 February 2013—The United Nations Joint Programme on HIV/AIDS (UNAIDS) applauds Senegalese President Macky Sall on his election as chairperson of the New Partnership for Africa’s Development’s (NEPAD) Heads of State and Government Orientation Committee. The election took place on the fringes of the African Union Summit in Addis Ababa, Ethiopia. The high level body of 20 African leaders provides leadership and policy guidance to NEPAD.

“I congratulate President Sall on his election to this position which is key to the future of health and development in Africa,” said Michel Sidibé, UNAIDS Executive Director. “NEPAD is a critical partner of UNAIDS and is helping to drive the AIDS response forward on the continent.”

NEPAD in close cooperation with the African Union Commission, and with technical support of UNAIDS is developing the first ever accountability report on AIDS, tuberculosis and malaria in Africa, under the G8-Africa framework for 2013.

The report will assess progress, achievements and shortcomings in delivering commitments made by Africa and the G8 on the three diseases since African Union Heads of State and Government adopted the Abuja Declaration on HIV/AIDS, Tuberculosis (TB) and Other Infectious Diseases in 2001.

President Sall has been an important supporter of the AIDS response. Under his leadership, Senegal’s HIV response has continued to make progress. HIV prevalence is low and the country has made major efforts in the past five years to scale-up access to HIV prevention, treatment, care and support.

NEPAD members also re-elected Dr. Ibrahim Mayaki as Chief Executive Officer. The former Prime Minister of Niger has had a pivotal role in developing the African Union Roadmap on Shared Responsibility and Global Solidarity which calls for innovative solutions to accelerate the response to AIDS, TB and malaria.

Last year, UNAIDS and NEPAD signed a memorandum of understanding calling for strategic collaboration to advance sustainable responses to HIV, health and development across Africa.

UNAIDS Deputy Executive Director, Programme, Dr Luiz Loures and President of Niger H.E. Mahamadou Issoufou.

The annual congress of the African Society of Gynaecologists and Obstetricians (Société Africaine des Gynécologues et Obstétriciens – SAGO) took place in Niger from 21-23 January 2013 under the theme “Mortality Costs and Maternal and Neonatal Morbidity in Africa”. The meeting was attended by the Prime Minister of Niger, and first ladies of Niger, Burkina Faso and Mali. The UNAIDS Deputy Executive Director, Programme, Dr Luiz Loures also participated in the congress as part of his official visit to the country.

Launched in 1988 by African ob-gyns to strengthen scientific discourse and eliminate barriers between African scientists, SAGO members comprise countries mostly from west and central Africa. Focussing on the Millennium Development Goals (MDG) 4 and 5 to reduce child and maternal mortality rates by 2015, SAGO aims to define standards of practice for gynaecologists and obstetricians.

First Lady of Niger Malika Issoufou Mahamadou with UNAIDS Deputy Executive Director, Programme, Dr Luiz Loures.

The Prime Minister of Niger, His Excellency Brigi Rafin said that the Congress was held at a time where surveys show weak progress in reducing maternal and neonatal morbidity and mortality in Sub-Saharan countries. "Every day 24 women die giving birth and 72 newborn children die in my country," he said.

Niger has made considerable progress in maternal and child health because of its policies, resources and strategies, outstripping other countries in the region. Government scale up of high-impact child health services, including eliminating user fees for pregnant women and children and strengthening child nutrition, has brought down annual mortality rate by 5.1%.

Dr Loures pegged these achievements to the country’s transformative and visionary political commitment, backed by judicious budgetary decisions and a focus on high impact strategies for maternal and child health.

A joint agreement of cooperation was signed UNAIDS and SAGO to accelerate the implementation of the Global Plan to eliminate new HIV infections among children and keeping their mothers alive. “The promotion of maternal and child health is the basis for the achievement of the Global Plan,” said Dr Loures.

Annual congress of the African Society of Gynaecologists and Obstetricians, Niger, 21-23 January 2013.

According to Dr Loures, professional organisations such as SAGO are uniquely placed to advocate for the rights of their patients and clients, particularly women living with HIV. These organizations can ensure that women are not stigmatized, their confidentiality is not violated, or that they are not forced and coerced into accepting services. They can serve as a collective workforce towards achieving the health MDGs and also provide a forum to expand knowledge, exchange information and legitimise and amplify the contribution of the members.

The Organization of African First Ladies against HIV/AIDS (OAFLA) came together on 28 January to mark its 10-year anniversary and held its annual Extra Ordinary General Assembly on the side-lines of the African Union Summit in Addis Ababa, Ethiopia. UNAIDS Executive Director Michel Sidibé attended the anniversary luncheon and congratulated the organization for its contribution to the AIDS response.

OAFLA was established in 2002 by 37 First Ladies from Africa committed to take action against AIDS and improve the lives of women, young people and children. Women account for 58% of people living with HIV in sub-Saharan Africa.

The First Ladies of Africa, together with national partners have launched many high impact campaigns, including ‘FLAME’ which kicked off in 2011 in nine countries to promote the virtual elimination of new HIV infections among children and keeping their mothers alive.

Led by the First Lady of Namibia, Penehupifo Pohamba, OAFLA currently has 40 First Ladies from the continent as signatories to the organization.

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Make your voice heard.

The United Nations has launched a broad consultation process for the next global development goals.

The original Millennium Development Goals that Member States agreed to in 2000 include a goal focused on the AIDS response. 

As part of the outreach effort the UN announced an online crowdsourcing platform called My World where people can prioritize issues and share ideas.

MY World gives people the option to vote on 16 different issues to prioritize and there is an option to ‘SUGGEST a priority’. Ending AIDS is not part of the 16 voting options.

A “get out the vote” campaign has been launched to help make Ending AIDS a priority. Everyone who feels that AIDS should be one of the top issues can write-in “End AIDS”.

MY World will show how votes are trending and use the data to help inform wider consultations on the road to the new global goals. 

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