Participants at the Qatar Symposium. Doha, Qatar. 02 November 2011

Families need to be empowered to provide the first line of protection against stigma, raise HIV awareness and decrease new HIV infections in the Middle East and North Africa (MENA) countries according to the participants of the recently concluded Qatar Symposium.

The event, which took place 1 – 2 November 2011 in Doha, was organized by the Doha International Institute for Family Studies and development (DIIFSD), UNAIDS and UNICEF to examine the linkages between family, Millennium Development Goals and AIDS in the Middle East.

“We need to address the AIDS epidemic with responsibility and courage,” said Dr Sima Bahous, Assisstant Secretary General of the League of Arab States. “HIV hinders the social, economical and developmental progress of the region and has a negative impact on the health of the family.” 

The Qatar Symposium focused on how investments in children, young people and women can have a real impact in reducing the HIV prevalence in the region. MENA is one of the few regions in the world where the AIDS epidemic is still on the rise with an HIV prevalence that has doubled in the last 10 years and where AIDS related deaths have tripled.

Topics discussed at the conference included the goal to eliminate new HIV infections among children, the need for HIV prevention programs that focus on children and young people most at risk of infection as well as how family affects their involvement in potentially risky behaviour.

According to Shahida Azfar, UNICEF Regional Director in MENA, a significant number of women, young people and children are affected by HIV in the region despite the gains made during the past decade. In 2009, more than 6 400 children aged 0-14 years old in MENA countries became infected with HIV. The number of children living with HIV (aged 0-14 years old) rose to 21 000 and in the same year, young people (aged 15-24) living with HIV were around 94 000.

UNAIDS Regional Director for MENA Hind Khatib accepting an award from Lt. General Dahi Khalfan Tamim, Commander in Chief, Dubai Police on behalf of UNAIDS Executive Director Michel Sidibé.

Participants agreed that families can be highly protective as they offer a dependable means of HIV prevention education and the clout to keep children in school, on track and out of risk. Family support can improve adherence to HIV treatment, provide sustaining care and offer the first line of protection against stigma and isolation.

“Countries in MENA need to help families mobilize against AIDS through education, outreach and helping to rise up against the stigma associated with AIDS,” said Dr Faleh Mohammed Hussain Ali, Assistant Secretary General for Policy Affairs at the Supreme Council of Health in Qatar.

In addition to placing the family at the heart of the AIDS response, participants also called for enhanced political commitment and better engagement of civil society including the media.

UNAIDS Regional Director for MENA Hind Khatib stressed that achieving UNAIDS vision of zero discrimination, zero new HIV infections, and zero AIDS related deaths will require more than simply accepting the validity of current political, social and scientific approaches. “It will require a deliberate creative act of promoting family ties and cultural values, confronting social norms and re-examining laws that detract people of their dignity and respect.”

UNAIDS Executive Director Michel Sidibé poses for a team photo with young people taking part in one of the Grassroots Soccer skills building sessions. Capetown, 4 May 2011.
Credit: UNAIDS/AFP Photo G. Guercia

Grassroot Soccer announced on Wednesday the appointment of the UNAIDS Executive Director Michel Sidibé as a member of its Global Board of Directors. Grassroot Soccer is an international nonprofit organization that uses the power of soccer to prevent new HIV infections among youth in Africa.

“Learning through sport is one of the most effective ways of building confidence and raising HIV awareness,” said Mr. Sidibé. “Grassroot Soccer is making a positive difference in the lives of young people across Africa and I am very proud to be a part of this important movement.”

The non-profit organization also appointed the former CEO of Product (RED) Susan Smith Ellis as a member of its Board.

“In our first ten years, we’ve provided more than 450,000 young people in Africa with vital information on HIV prevention and life skills,” said Thomas Clark, MD, Grassroot Soccer Founder and CEO.  “With the expertise and passion of these new board members to compliment our team, we’re confident we will reach our goal of graduating one million youth through our program by the World Cup 2014, and empowering whole communities to live more healthy productive lives, with soccer as the hook.”

Grassroot Soccer has programs in 10 African countries with flagship sites in South Africa, Zambia, and Zimbabwe. Founded in 2002 by four professional soccer players, Grassroot Soccer engages professional African football players, coaches, teachers and peer educators in several countries to deliver an interactive HIV prevention and life skills curriculum to youth. Topics include making healthy decisions, avoiding risk, building support networks, reducing stigma and discrimination, increasing knowledge about testing and treatment, addressing gender issues and assessing values.

Understanding the links between sustainability and equality is critical, says the 2011 Human Development Report

Progress in health and development in the poorest countries is in serious danger if the world does not make a concerted effort to reduce inequities, protect the environment and promote sustainability. This is the stark warning highlighted in the 2011 Human Development Report, launched on Wednesday by the United Nations Development Programme (UNDP).

Sustainability and Equity: A Better Future for All, explores in great detail the relationship between health, education, income, gender disparities, sustainability and social inequalities. Significant progress cannot be achieved in one area without progress in all. If such gains are not attained, the least developed countries could see themselves diverging significantly from global patterns of development by 2050. The ideas expressed in the document are very much intended to provide a key focus of debate in the run up to the 2012 UN Conference on Sustainable Development (Rio+20).

As the UNDP Administrator Helen Clark states in the report’s foreword, understanding the links between sustainability and equality is critical, “if we are to expand human freedoms for current and future generations.” She adds, “The remarkable progress in human development over recent decades cannot continue without bold global steps to reduce both environmental risks and inequality.”

According to the Human Development Report, sustainability does not touch only on the environment but on the very way we choose to live our lives, with full awareness that our actions will have potentially profound consequences for coming generations. 

A Better Future for All notes that although the majority of people across the globe are becoming healthier and living longer, sub-Saharan Africa has not seen the same decline in health inequality. This is especially the case in southern Africa which is still bearing the brunt of the HIV epidemic with adult prevalence exceeding 15 percent in several countries. The report highlights the need to address the social, educational and gender inequities to successfully respond to the AIDS epidemic.

Gender disparity, evidenced by a lack of access to reproductive health products and services for many of the world’s women, is also shown in the report to have a profound effect on health, environmental sustainability and poverty.

An expansion in reproductive health rights, health care and contraceptive access will not only benefit individual women and their families but could have a marked effect on slowing global population growth.  According to the report, some 215 million women in developing countries have unmet family planning needs. However, in every country where such needs are met and women have comprehensive reproductive options, fertility rates are at, or below, replacement level.

The report concludes that it is possible to implement programmes which have an impact on sustainability and equity, with benefits for both people who are most disadvantaged and for the environment itself. Such programmes have sustainability and equality etched into policy and programme design and reserve a critical space for the voices of the most deeply affected.

UNDP has commissioned the editorially-independent Human Development Reports each year since 1990, when its Human Development Index (HDI), a composite measure of health, education and income, first challenged purely economic measures of national achievement and called for consistent global tracking of progress in overall living standards.

Kenyan Prime Minister Raila Odinga (left) shakes hands with UNAIDS Executive Director Michel Sidibé following a meeting at the Prime Minister’s office in Nairobi on 2 November.

In a meeting with Kenyan Prime Minister Raila Odinga on 2 November, UNAIDS Executive Director commended the Government of Kenya on progress in the country’s HIV response, including the significant scale-up in treatment access and expansion of services to prevent new HIV infections among children.

Over the past decade, Kenya has stabilized its rate of new HIV infections. National adult coverage of antiretroviral therapy has expanded from an estimated 4% in 2004 to 72% in 2010. About 78% of pregnant women living with HIV are now receiving antiretroviral treatment to prevent new HIV infections in their children, compared to 21% in 2006.

“Building on the momentum of this year’s High Level Meeting on AIDS, we are seeing unprecedented support for our vision of zero new HIV infections among children and keeping their mothers alive,” said Mr Sidibé, while meeting with the Prime Minister in Nairobi. “I congratulate the Government of Kenya for translating this goal into action on the ground.”

Prime Minister Odinga said that the Government of Kenya will pursue the initiation of a national declaration calling for the elimination of new HIV infections among children by the year 2015. “I will lead all line ministries to support this critical goal,” he said.

The Prime Minister underscored that Kenya’s new constitution, adopted in August 2010, is a model for equity and social inclusion. “This is a great opportunity for us to lead on HIV and human rights for the people of Kenya who need access to services and justice,” he said. Greater financial contributions from national sources will be critical to ensure the long-term sustainability of Kenya’s response to AIDS, he added.

The UNAIDS Executive Director commended the Government of Kenya for establishing the Kenya HIV/AIDS Tribunal under the Kenya HIV Prevention and Control Act—one of the first tribunals in the world aimed at increasing access to justice for people affected by HIV and addressing HIV-related stigma and discrimination.

Mr Sidibé’s meeting with Prime Minister Odinga launched his two-day official UNAIDS mission to Kenya. During the mission, the UNAIDS Executive Director will meet Kenya’s Minister of Special Programmes, the Minister of Public Health and Sanitation and the Minister for Medical Services. He will also deliver opening remarks at a consultation for Global Fund Implementers.

“Getting to Zero” is the theme selected by the World AIDS Campaign (WAC) to commemorate this year’s World AIDS Day on 1st December. The new theme, that will be used until 2015, echoes the UNAIDS vision of achieving “Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths.”

The decision to choose "Getting to Zero" as the theme came after extensive consultations among people living with HIV, health activists and civil society organizations.

"The potential for creative, connected and meaningful campaigning is really exciting,” said World AIDS Campaign Africa Director, Linda Mafu. "Our organization will focus on Zero AIDS Related Deaths, but the choice is there for others to pick a different zero or all three. It's time to use our imaginations and let everyone know that Getting to Zero is a must,” she added.

Giving regions, countries and constituencies the latitude to focus on one or all of the Zeros that is most relevant to their context was central to the WAC’s decision, an approach fully supported by UNAIDS. “Getting to Zero is the overall agenda for responding to HIV in the next five years, but the priority may be zero discrimination in some parts of the world and zero AIDS related deaths in some other parts—it’s important to keep this connection with the local realities” said Djibril Diallo, Director of Global Outreach at UNAIDS.

This year’s World AIDS Day is anticipated to see renewed activism from the civil society as 1st December 2011 falls only 6 months before the International AIDS Conference taking place in Washington DC. This year also marks the 30th year since AIDS was first report. World AIDS Day will be a platform to pay tribute to early advocates of the response.

Observed worldwide on 1 December since 1998, World AIDS Day is the moment of the year where millions of people  come together across the globe to commemorate people who lost their lives to HIV, applaud progress made in responding to the epidemic and recommit to ending the epidemic.

Minister for Special Programmes Esther Murugi (left) greeting Ms. Asunta Wagura, representative of women living with HIV and advocate for the elimination of vertical transmission of HIV.

More than 200 women living with HIV in Kenya committed to championing the response to AIDS in the country. The call for more involved action came at the end of a two-day National Leadership Conference for Women Living with HIV.

The purpose of the meeting was to reenergize women living with HIV towards strengthening their leadership roles in the HIV response. The conference was facilitated by the National AIDS Control Council and the Network of People Living with HIV in Kenya with support from the UN Joint Team on AIDS.

In her opening remarks, Minister for Special Programmes Esther Murugi reiterated “the urgent need to develop strong leadership of women living with HIV to take the reins to end the AIDS epidemic”.

With its theme of “Championing Women Leadership to AIDS”, the forum centred around three key thrusts: women’s leadership to create a social movement and community action for HIV prevention; women’s political leadership to develop opportunities offered by the new constitution; and women’s leadership to improve uptake and delivery of HIV services.

Kenyan government statistics indicate that national HIV prevalence is 6.3 %, compared to 8 % for women. HIV prevalence among women is nearly double the rate for men, which is 4.3 percent. HIV prevalence among young women aged 15 – 24 years is more than four times higher than men in the same age group at 4.5 and 1.1 percent, respectively.

Women have been pioneers in the AIDS response, as care providers but also as community leaders. The conference provided a forum for women to re-position the leadership of women living with HIV by building on the achievements of the earlier women movements. It also provided a platform to discuss advocacy efforts to influence policies, planning and budgeting processes in national AIDS programmes to respond to the needs of women and girls living with HIV.

“Women and girls living with HIV must be meaningfully engaged at every stage of national HIV responses to ensure that their needs are well addressed,” said UNAIDS Country Coordinator, Maya Harper.

Participants agreed to strengthen strategies to include women living with HIV in national AIDS response as well as to explore opportunities to mentor, empower and build capacity of young women and mentor young women living with HIV into leadership. Participants also resolved to develop advocacy groups at national level to drive the agenda for women living with HIV and increase domestic funding for HIV response.

One highlight of the event was an award ceremony to honour women living with HIV who have championed for and contributed towards Kenya’s HIV response. The awardees were drawn from all regions of the country and included people living with disabilities.

The Minister of Gender, Children and Social Development, Dr Naomi Shabaan, urged the awardees to “continue to mentor others and together we will end AIDS”.

UNAIDS Executive Director Michel Sidibé with Housing Works client Matilda
Credit: Housing Works

In 2009 there were an estimated 1.2 million people living with HIV across the United States of America. In many cities across the United States large numbers of people living with HIV are also homeless. In New York one organization is working hard to address the twin crisis of HIV and homelessness.

Housing Works has been providing high quality services for homeless men, women and children living with HIV in and around New York City since 1990. The organization offers homeless people living with HIV essential services such as housing, medical, dental and mental health care, meals, job training, drug treatment and HIV prevention and treatment services. It is currently providing support to more than 20 000 homeless and low-income New Yorkers living with HIV.

The Executive Director of UNAIDS Michel Sidibé visited one of the centres run by Housing Works which provides HIV testing, counselling and treatment services in the heart of New York.

“HIV can affect people who are the most difficult to reach with HIV services,” said Mr Sidibé. “This project is an example of how an integrated approach to social welfare improves the lives of vulnerable people by providing them with hope and restoring their dignity.” 

The centre, called Cylar House, pairs a medical clinic and adult day centre with a residential tower comprising of 36 apartments. In the same building Housing Works also run a food services business and a job training centre to help people living with HIV who are unemployed learn skills to return to work.

“Before I came to Cylar House I was homeless, using drugs, not taking HIV medication or taking care of my health,” said Matilda Echevarria, a 60-year-old resident. “Housing Works saved my life. Having my own place allows me to keep up with my medical and mental health appointments, to take my HIV medicines every day, and to feel good about myself.”

Housing Works’ pioneering job training programme at Cylar House teaches basic employment skills and guarantees graduates paid employment at Housing Works once students finish their studies. Nearly one third of Housing Works employees are graduates of the job-training program.

Anthony E.S. Jones, a former homeless person who was addicted to drugs is now clean and sober. He graduated from the job training program and is now employed as a Community Outreach Worker/Intake Coordinator for Housing Works. He explained how important a safe roof over his head was to his road to recovery, “Housing is a gateway to maintaining one’s overall health,” he said.  Yvette Torres, Executive Director of Keith D. Cylar House added, “Having stable housing allows people to be able to focus on their health and well-being, not having to be pre-occupied with where they will sleep at night and whether they will be safe.”

The Cylar House HIV housing and treatment project has been replicated in several cities across the United States.

At the end of the visit a memorial ceremony was held to pay tribute to leading AIDS and Tuberculosis activist Winstone Zulu, who passed away earlier this month. Mr Zulu had stayed at the centre for several months after he became ill during a meeting he was attending at the United Nations. 

“UNAIDS owes a debt of gratitude to Housing Works for opening its arms, it’s heart, it’s services and it’s healing community to Winstone in his time of need,” said Mr Sidibé. “The world also owes thanks to Winstone for bringing a face to the twin crises of HIV and TB. We need more heroes like Winstone Zulu and more organizations like Housing Works.”

More than 1 200 leading figures from the worlds of science, politics, economics and civil society are at the World Health Summit taking place from 23 – 26 October in Berlin to discuss some of the major challenges in global health today.

Under theme Today’s Science - Tomorrow’s Agenda five main issues are being addressed at the conference: the impact of climate change on health; the rapid increase in chronic diseases in developing and industrialized countries; the worldwide burden caused by mental diseases; vaccine strategies; and international health policy.

HIV featured high on the agenda as one of the greatest health crises of modern times. The urgent need to integrate HIV with other health services was stressed along with the importance of comprehensive and sustained access to health for the billions of people in need.

UNAIDS Deputy Executive Director, Programme, Paul De Lay gave the key note speech on the third day of the conference and outlined the need to successfully integrate non-communicable diseases with HIV.

“It is critical to scale up the response to infectious diseases to save millions of people,” said Dr De Lay. “This is where the AIDS response can help. Thirty years of innovation, expertise and highly developed service platforms can successfully inform and be integrated with responses for non-communicable diseases.”

Dr De Lay also chaired a working session on the role of new technologies in HIV prevention which looked at how the scientific breakthroughs of the past year have added to the set of tools available to stop HIV transmission. The session focused on how, by using the most effective set of actions within an enabling environment, numbers of new HIV infections could be significantly reduced.

“We are at a very unique time in the HIV epidemic,” said Dr De Lay. “The recent scientific advances are initiating some essential changes in HIV prevention and treatment. The main question now is one of implementation and scale up.” 

At the close of the summit a set of recommendations will be put forward to decision-makers from the relevant fields. Such recommendations will aim to address some of the urgent challenges in medical research, global health and health care delivery discussed at the conference.

The State of World Population report highlights the importance of investing in young people and addressing their needs.

Within a matter of days, the world’s population is projected to reach 7 billion. This represents both a great challenge and a great opportunity. We can achieve a healthy and sustainable future for all if we act decisively now, according to the State of World Population Report 2011, published today by the United Nations Population Fund (UNFPA).

One of the calls to action in People and possibilities in a world of 7 billion, launched in more than 100 cities worldwide, is making sure that the needs of young people are addressed more effectively and that investing in their future is given a higher priority.

At the report’s launch in London, UNFPA Executive Director Dr Babatunde Osotimehin highlighted that reaching the world’s 1.8 billion people aged 10 to 24 is critical. “Young people hold the key to the future, with the potential to transform the global political landscape and to propel economies through their creativity and capacities for innovation,” said Dr Osotimehin. “But the opportunity to realize youth’s great potential must be seized now. We should be investing in the health and education of our youth. This would yield enormous returns in economic growth and development for generations to come,” he added.

Dr Osotimehin also noted that millions of adolescents in the developing world have little or no access to sexuality education and do not have sufficient knowledge to prevent pregnancies and protect themselves against HIV.

The report, which concentrates on individuals, organisations and communities working to improve conditions for themselves and those around them, shows a number of young people who are making a real difference.

In a chapter which describes youth as a “new global power reshaping the world”, Ethel Phiri is introduced as a 22-year old peer educator involved in youth outreach programmes in Mozambique. She runs bancadas femininas, discussion groups at schools, markets and other community areas around Maputo supporting young people with issues relating to sexual and reproductive health and HIV prevention.

People and possibilities in a world of 7 billion focuses on a wide range of population trends and their implications. It examines ageing populations, high rates of urbanization, poverty and inequality, environmental sustainability and rising international migration in a variety of countries with different contexts.

Although different countries are dealing with different challenges, the report maintains that the world must pull together to effect real and lasting change. “We all have a stake in the future of humanity,” stressed Dr Osotimehin. “Every individual, every government, every business, is more interconnected and interdependent than ever, so what each of us does now will matter to all of us long into the future. Together we can change and improve the world.”

UNAIDS Executive Director Michel Sidibé participating at the “Megabits and MDGs" session of the Broadband Leadership Summit.
Credit: ITU

There is broad agreement that information and communication technologies (ICTs) can accelerate progress towards achieving the Millennium Development Goals (MDGs). But questions remain on how to scale up both access and content. This was the topic at hand for a plenary session at the Broadband Leadership Summit held in Geneva on 24-25 October 2011.

At the "Megabits and MDGs" session, President Pierre Nkurunziza of Burundi raised the issue of fostering partnerships to reach the country’s citizens with broadband access. According to President Nkurunziza, this would help accelerate e-government, e-learning, e-health and e-commerce.

His thoughts were echoed by Commodore Josaia Voreqe Bainimarama, Prime Minister of the Republic of Fiji faced with the task of reaching  890 000 people spread across 110 islands where “Broadband becomes a solution to overcome the challenge of distance.” 

For Klaus Leisinger, President and CEO of the Novartis Foundation, broadband allows for more democratic access to knowledge. 

Osman Sultan, CEO of Du, an integrated telecommunications company based in United Arab Emirates said that ICTs have become a basic human need and a basic human right. Mr Sultan stressed that old business plans would not work in this new ecosystem. “No one owns the customer,” he said while talking about how one can build a platform but the customers will decide how to use it. 

The summit was organized by the International Telecommunication Union (ITU) and the Broadband Commission for Digital Development under the theme "Broadband for the Global Good". It explored how broadband infrastructure and services can be made to work to the benefit of developing countries.

The Broadband Commission on Digital Development

The Broadband Leadership Summit brought together a number of leading industry heads, various heads of state and governments, the heads of a number of international organizations and members of the ITU/UNESCO Broadband Commission for Digital Development. 

UNAIDS Executive Director Michel Sidibé launching a new initiative run by young people, for young people, called “Crowd Out AIDS”
Credit: ITU

At the Summit, UNAIDS Executive Director Michel Sidibé launched a new initiative run by young people, for young people, called “Crowd Out AIDS”. Engaging through the most popular social media sites around the world and a Wiki platform, the UNAIDS Secretariat will ask young leaders to draft its new youth HIV strategy, debate, and then work with UNAIDS to implement it. It aims to reach more than 100 000 young people with the opportunity to input their ideas.

"It is absolutely critical that we engage youth at this level, not as recipients of our messages but the actors and creators of change," Mr Sidibé said. "In this global movement we need more global citizens.”

The Broadband Commission was established by ITU and UNESCO in May 2010 based on the increased belief that expanding broadband access in every country is key to accelerating progress towards the MGDs.