Principal actors in the AIDS movement join world leaders at critical crossroads

(Left to Right): Interpreter; Tetyana Afanasiadi, Human Rights and Community Activist; Paul De Lay, UNAIDS Deputy Executive Director, Programmes; Joseph Deiss, President of the UN General Assembly; Jean-Victor Nkolo, Spokesperson, UN General Assembly President at Opening Press Conference on June 7, 2011 at UN Headquarters, NYC. Credit: UNAIDS/B.Hamilton

NEW YORK, 7 June 2011—More than 3000 people will come together at the United Nations in New York tomorrow for the UN General Assembly High Level Meeting on AIDS. The meeting, which runs from 8-10 June, will provide an opportunity to take stock of the progress and challenges of the last 30 years and shape the future AIDS response.

The High Level Meeting on AIDS is taking place 10 years after the historic 2001 United Nations Special Session on HIV/AIDS, and the 2006 signing of the Political Declaration where UN Member States committed to moving towards universal access to HIV prevention, treatment, care and support. More than 30 Heads of State, Government and Vice Presidents are expected to attend the meeting which will include official plenary and five panel sessions along with 40 individual side events. On the final day of the High Level Meeting on AIDS, UN Member States are expected to adopt a declaration which will guide country responses to HIV over the next five years.

The opening and closing plenary sessions will be presided over by Joseph Deiss, President of the United Nations General Assembly. He said, “The momentum around this meeting is unprecedented and promises to make this an historic event. We are looking to UN Member States to make bold commitments which will help us reach our shared goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths.”  

Although some countries are still struggling to reach their universal access targets, many have made significant strides in responding to their epidemics. Twenty-two countries have achieved universal access to services which prevent mother-to-child transmission of HIV.

As well as country-led successes, considerable progress has been made in the global response to HIV since the 2001 UN Special Session on HIV/AIDS. The rate of new HIV infections has decreased by 25% in the last 10 years, deaths have reduced by 20% in the last 5 years and 6.6 million people are now accessing antiretroviral therapy, compared to just a few thousand in 2001. Progress has also been made in breaking down barriers to stigma and discrimination and in removing punitive laws such as travel restrictions for people living with HIV.

“Inequity, discrimination and laws against people living with or at risk of HIV continue to block access to HIV services for people most in need,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “We need a response to HIV that is grounded in human rights and one which promotes equality and equity. Achieving this will open the way to a world free from HIV.”

UNAIDS recently reported that despite successes in HIV  prevention and treatment, more people than ever before were living with the virus, 34 million according to latest estimates. They also reported that international funding for AIDS had declined.

“If resources go down—people most in need will suffer,” said Tetyana Afanasiadi, Human Rights activist from Ukraine. "The lives of millions of people directly depend on the resources allocated. Today I am alive thanks to antiretroviral therapy and opioid substitution therapy which I had access to through prevention and support programmes. Reducing of the resources allocated to those programs is a direct threat for me and for millions of people around the world."

The High Level Meeting on AIDS is taking place from the 8-10 June at the United Nations in New York. It will bring together UN Member States, International Organisations, Civil Society, people living with HIV and public and private sector partners.

For more information and to see the full program and access feature stories, webcasts, videos, media information and related documents please visit the official website at: http://www.un.org/en/ga/aidsmeeting2011/

UNAIDS Goodwill Ambassador Amr Waked addresses guests during the launch of the "Graphic Intervention: 25 years of International AIDS Awareness Posters" at the Art Director's Club in New York, 06 June 2011.
Credit: UNAIDS/J.Szenes

Over the course of the AIDS epidemic, countries have promoted HIV awareness and safe sex through a variety of media, such as public service announcements, glossy magazine spreads, newspaper advertisements, radio programmes and the Internet. A new exhibition, now on display at the Art Directors Club in New York City, offers a glimpse at one of the most commonly-used visual media in the history of HIV campaigns: the poster.

“The poster as a medium is cheap and easy to produce locally, so it has been an effective way to reach specific groups with HIV messages,” said Elizabeth Resnick, curator of the exhibition Graphic Intervention: 25 Years of International AIDS Awareness Posters, at a launch event on 6 June attended by more than 300 members of New York’s art and design community as well as representatives from international organizations and civil society.

Graphic Intervention presents more than 150 posters from around the world covering a diverse array of artistic styles and languages. The posters address a wide range of themes in national HIV responses, including HIV transmission, condom use, access to HIV treatment and care, AIDS-related stigma and gender inequality.

Speaking at the launch on Monday, Egyptian actor and activist Amr Waked, a UNAIDS Goodwill Ambassador for the Middle East and North Africa, called for a revolution in his region’s response to HIV—similar to the Arab Spring movement that has swept across Egypt and neighbouring countries in recent months.

“I saw firsthand how youth unified their efforts and succeeded in the revolution as one!” said Mr Waked, who joined the demonstrations earlier this year in Egypt’s Tahrir Square. “It is time to harness the same energy and leadership among youth to bring a better world for people affected by HIV and AIDS, a world that respects human rights for all,” he added.

Graphic Intervention draws on the extensive international AIDS poster archive of James Lapides, a Boston-based collector, along with posters donated to the Massachusetts College of Art and Design. “The posters are a way of remembering those who have died due to AIDS—a graphic quilt of a different kind,” says Lapides, in an essay published on the exhibition web site. “The poster should be celebrated for its central role in promoting awareness, saving lives, raising donations, influencing the public debate and speaking out in the face of this terrifying global disease,” he adds.

A selection of posters from the Graphic Intervention exhibit have been reproduced in OUTLOOK 30, a new publication from UNAIDS commemorating 30 years of the AIDS epidemic.

Graphic Intervention will be on display during the UN General Assembly High Level Meeting on AIDS, a gathering of global leaders from 8-10 June 2011 that is expected shape the future course of the global response to AIDS.

UN General Assembly High Level Meeting on AIDS

Thirty years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS, the world has come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8–10 June 2011 in New York. Member States are expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response.

UNAIDS Executive Director Michel Sidibé and Ms Alicia Keys, Artist and Global Ambassador of Keep a Child Alive at the launch of the report report titled “In Women’s Words: HIV priorities for positive change”. New York, 7 June 2011.
Credit: UNAIDS/J.Szenes

To bring to the forefront priority actions for the AIDS response put forward by women around the world ahead of the General Assembly High Level Meeting on AIDS, a special event was held on 7 June.

The event launched a report In Women’s Words: HIV priorities for positive change . The publication summarizes the key messages and findings from a global virtual consultation which engaged with nearly 800 women from over 95 countries and in nine languages. The consultation was a platform to give a voice to women living with and affected by HIV to express their priorities and vision for the future of the AIDS response. The publication enables the participants of the consultation to share their viewpoints and call to action to a wider audience.

The launch was followed by a panel discussion moderated by journalist and author Stephanie Nolen.

The President of Rwanda Paul Kagame described the efforts in his country to end gender inequality. “In Rwanda, we strive every day to empower every women and girl to claim their true value, not as a favour, not because it is politically expedient, but because it is their right and we embrace that.”

UNAIDS Executive Director echoed the importance of criticality of women’s empowerment. “We will never succeed in achieving zero new infections, zero AIDS-related deaths and even zero stigma and discrimination, when women living with HIV are coerced into sterilization or abortion; or in a world where women cannot negotiate safe sex; a world where rape is not treated as a crime.”

Frika Chiya who is a young woman living with HIV, highlighted women’s calls to be fully engaged in scaling up the AIDS response saying, “I am a living proof that a lot has been achieved in the last 10 years; let’s not lose the momentum. Talk to us, not about us.”

International artist and Global Ambassador of Keep a Child Alive Alicia Keys also participated in the event. “If we show the next generation of women and girls that we care by providing the resources to achieve universal access, this will empower them,” she said. “If we do that, we will stop the epidemic in its tracks.”

The event was co-organized by UNAIDS, UN Women, the Global Coalition on Women and AIDS and the ATHENA Network. Watch a video below:

UN General Assembly High Level Meeting on AIDS

Thirty years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS, the world has come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8–10 June 2011 in New York. Member States are expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response.

(Left to Right): Michel Sidibé, Executive Director of UNAIDS; Anders Johnsson, Secretary General of the IPU; at Parliamentarians Meeting on June 7, 2011, at UN Headquarters, NYC.
Credit: UNAIDS/B. Hamilton

The world’s parliamentarians have a crucial role to play in an effective response to the AIDS epidemic. They provide leadership, help set the national agenda, formulate laws and authorize AIDS spending. How this influence can be harnessed in the challenge to HIV was the central theme of an important meeting for parliamentarians held on the eve of the UN High Level Meeting on AIDS in New York.

Co-organized by the Inter-Parliamentary Union (IPU), the United Nations Development Programme (UNDP) and UNAIDS, the forum was attended by a number of members of parliament and several ministers taking part in the High Level Meeting.

It explored a range of issues, including the impact of law on HIV interventions and how legislation can be used to reinforce, rather than hinder, public health and development responses. These were seen through the prism of three key themes: universal access to HIV prevention, treatment, care and support; protection and promotion of rights of people living with HIV, and those most vulnerable to HIV, and discriminatory and punitive laws which are compromising AIDS investments.

The gathering also examined the underlying politics of the new global consensus on HIV and looked at the main outcomes likely to emerge from the High Level Meeting. The emphasis throughout was firmly on concrete and practical action and translating AIDS commitments into reality, using the full range of parliamentarians’ authority in the spheres of leadership, budget allocation and law making and reform.

In opening remarks Anders B. Johnsson, IPU Secretary General, said the role of members of parliament in the global response to HIV could not be underestimated: “We have entered a new era in the AIDS response where parliamentarians need to work in strategic partnership with UNAIDS and to pay greater attention to shared responsibility and mutual accountability.”

UNAIDS Executive Director, Michel Sidibé made a powerful call for leadership from the parliamentarians: “Violence is a cancer, a gangrene growing inside of us. We may not see it but it is there. It undermines our foundation. It undermines what our ancestors wanted for us. Nonviolence is the only way to create social change. And you are the ones who have been chosen to lead that change.”

Other participants at the meeting included Representative Jim McDermott, US Congress; Petra Bayr, member of the Austrian Parliament; Christoph Benn, the Global Fund’s Director of External Relations and Partnerships; and the Hon Michael Kirby, Judge of the High Court of Australia (retired) and Commissioner of the Global Commission on HIV and the Law.

The need for parliamentarians to effectively deploy legislation as a tool for ensuring and sustaining universal access to HIV services was reinforced by Petra Bayr and Hon. Michael Kirby who said: “In the HIV response, the law is not serving those most vulnerable – sex workers, men who have sex with men, transgender people, injecting drug users. When parliamentarians make no mention of those most vulnerable to HIV – this means that these very populations are out of the reach of essential services and condemned to death. We are suffering from a new virus, ‘Legislative Silence Virus’. We must work together to prevent the spread of this new virus—that is what the Global Commission on HIV and the Law hopes to do.”

The meeting provided a valuable opportunity for the IPU to consolidate its plan of action in the coming years; HIV is a central strand in its new draft strategy, 2012-17. The organization’s commitment to challenging AIDS is long-standing and since 2006 there has been an IPU Advisory Group on HIV/AIDS.

This group focuses on providing members of parliament with access to relevant policy expertise and skills to properly exercise their duties of lawmaking, oversight, leadership and advocacy. It pays special attention to the objective of achieving universal access to HIV prevention, treatment, care and support services, and the protection and promotion of rights as a prerequisite for meeting the Millennium Development Goal 6 targets. 



Credit: WHO

On the eve of the 2011 General Assembly High Level Meeting on AIDS, a side event on HIV treatment was organized by MÉdecins Sans Frontières (MSF) in collaboration with the African Union Permanent Observer Mission to the United Nations.

The opening remarks were given by H.E. Mr Téte António, Permanent Observer, African Union and the moderated discussion was chaired by Morolake Odetoyinbo of Positive Action for Treatment Access, Nigeria.

Bernhard Schwartländer, UNAIDS Director, Evidence, Strategy and Results Department was an invited speaker and the other panellists included the Director General of the National Department of Health, South Africa, Malebona Precious Matsoso; Nelson Otwoma from Network of People Living with HIV/AIDS in Kenya (NEPHAK); Dr Direu Greco, Director of the National HIV/AIDS Department, Ministry of Health, Brazil; and Sharonann Lynch, MSF.

On 3 June a new investment model developed by Dr Schwartländer and colleagues was published in The Lancet. The new framework proposes a paradigm shift in the way AIDS funding is approached, with a greater emphasis on priority setting and optimization of AIDS responses, a shift to community mobilization to deliver programmes and greater synergies between programme elements. Implementing the model would require 30% more funding than currently available when expenditure would be projected to peak, in 2015.

Dr Schwartländer presented the framework which show that the implementation of the new investment framework would avert 12.2 million new HIV infections and 7.4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches, and result in 29.4 million life-years gained. The framework is cost effective at $1 060 per life-year gained, and the additional investment proposed would be largely offset from savings in treatment costs alone

UN General Assembly High Level Meeting on AIDS

Thirty years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS, the world has come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8–10 June 2011 in New York. Member States are expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response.

(Left to Right): Seth Berkley, Michelle Bachelet Jeria, Paul De Lay, Robert C. Orr at Council on Foreign Relations for panel titled: AIDS 2001 - 2011: Then and Now.
Credit: UNAIDS/B. Hamilton

Ahead of the UN General Assembly High Level Meeting on AIDS which will begin on 8 June, the Council on Foreign Relations (CFR) hosted a side event on 6 June at The Harold Pratt House in New York.

The evening, co-organized by the Global Health Program of the CFR and the Joint United Nations Programme on HIV/AIDS (UNAIDS) reviewed the last decade of progress and lessons learned since the landmark 2001 UN General Assembly Special Session on HIV/AIDS and the Declaration of Commitment.

The discussion focused on women and children's health and the prevention of new HIV infections among children. There was considered reflection on the need to engage donors and have good accountability frameworks. Best practices in specific countries were explored, including Botswana. South Africa and Nigeria were both cited as examples of countries with very strong responses.

The guest speakers were Michelle Bachelet, Under-Secretary-General and Executive Director of UN Women; Robert C. Orr, Assistant Secretary-General for Strategic Planning and Policy Coordination, United Nations; and Paul De Lay, Deputy Executive Director, UNAIDS. The discussion was moderated by Seth Berkeley of IAVI.

Dr De Lay described how much has been achieved in the AIDS response in the recent past: “Ten years ago, no one thought we could overcome stigma and discrimination, and we’ve proved them wrong.” Looking ahead to the High Level Meeting on AIDS Dr De Lay described its significance saying “We are charting the way forward for the next 10 years of the response.”

Council on Foreign Relations

The Council on Foreign Relations (CFR) is an independent, nonpartisan membership organization, think tank, and publisher.

UN General Assembly High Level Meeting on AIDS

Thirty years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS, the world has come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8–10 June 2011 in New York. Member States are expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response.

(Left to Right): Dr Jorge Sampaio, UN Secretary-General Special Envoy to Stop TB; Lucica Ditiu, Executive Secretary, The Stop TB Partnership; Michel Sidibé, UNAIDS Executive Director; Osas Ighodaro, Miss Black USA; Ray Chambers, UN Secretary-General Special Envoy for Malaria. UN Headquarters, NYC, on June 6, 2011. Credit: UNAIDS/B.Hamilton

A new epidemiological model produced by the Stop TB Partnership, World Health Organization (WHO) and UNAIDS shows that it is possible to sharply reduce AIDS deaths worldwide by preventing and treating tuberculosis (TB). At present one in four people living with HIV die of TB; the vast majority of these deaths could be averted, since TB is curable.

“Halving TB deaths in people living with HIV by 2015 is possible and is within our reach. We could save up to a million lives by 2015 and bring us one step closer to the UNAIDS vision of zero AIDS-related deaths,” said UNAIDS Executive Director Michel Sidibé.

Building on well-established methods for preventing and treating HIV-associated TB that are recommended by WHO and UNAIDS, the model shows that by scaling up these approaches worldwide a million lives could be saved by the end of 2015.

“There has been a surge in awareness about the deadly TB epidemic among people living with HIV, but insufficient action. Now new scientific work has shown that we can prevent a million deaths among people living with HIV by end 2015 by providing integrated HIV and TB care,” said Dr Jorge Sampaio, the UN Secretary-General's Special Envoy to Stop TB and former President of Portugal. “I call on the world's leaders to take up this challenge. It is time to take bold action. Not to do so would be an outrage.”

A publication that outlines the new model, Time to act: Save a million lives by 2015 - Prevent and treat tuberculosis among people living with HIV, was launched on 6 June at United Nations Headquarters. It calls for the following actions:

• Testing for HIV and TB should be provided every three years in places where both diseases are prevalent.
• Prompt TB treatment needs to be provided to every person living with HIV with active TB—or else treatment to prevent TB.
• HIV and TB treatment must be accessible and of good quality so that people living with HIV are cured of TB.
• Antiretroviral therapy (ART) should be started early, which will help prevent TB, since people living with HIV are far less likely to become ill with and die of TB if they begin ART before their immune systems begin serious decline.
• People who are HIV-positive and diagnosed with active TB should start ART regardless of the status of their immune systems.

In 2010 the Stop TB Partnership and UNAIDS set the joint goal of reducing by half the number of deaths among people living with HIV, compared to 2004 levels, between 2011 and end 2015. With the new model, they have agreed to aim to avert one million deaths.

Civil society is also calling on their governments to fully adopt this TB/HIV plan. “Our message is clear and simple. If people living with HIV don't get tested and treated for TB, many of us will die from this disease, even though we are receiving life-saving antiretroviral treatment. It's a terrible waste, because TB is curable,” said Lucy Chesire, a leading international advocate on behalf of people affected by HIV-associated TB.

It is estimated that the cost of all the elements needed to prevent one million TB deaths among HIV-positive people worldwide would come to about US$ 790 million per year.

UN General Assembly High Level Meeting on AIDS

Thirty years into the AIDS epidemic, and 10 years since the landmark UN General Assembly Special Session on HIV/AIDS, the world has come together to review progress and chart the future course of the global AIDS response at the 2011 UN General Assembly High Level Meeting on AIDS from 8–10 June 2011 in New York. Member States are expected to adopt a new Declaration that will reaffirm current commitments and commit to actions to guide and sustain the global AIDS response.

Credit: Carl Kaufman / Yale

The Global Health Leadership Institute (GHLI) of Yale University held its 2011 GHLI Conference from 5-10 June 2011 under the theme of “moving health systems forward”. The Conference convened senior health practitioners from around the world to facilitate collaborative solutions in strengthening health systems.

Speaking on 5 June, UNAIDS Executive Director Michel Sidibé gave an inaugural address to the conference to commemorate 30 years since the start of the AIDS response and shared UNAIDS’ perspective on future directions.

“We are so pleased to have Michel Sidibe join us to open our conference this year and help further bring attention to the role strategic planning and leadership play in helping solve global health issues,” said Elizabeth Bradley, Ph.D., faculty director, Yale Global Health Leadership Institute.  “The conference is about gathering health officials from around the world to share experiences, develop leadership and identify creative ways to solve problems that affect the everyday lives of people in these countries,” she added.

Mr Sidibé stressed the transformative role that the AIDS response has played in community mobilization and strengthening health systems. “The AIDS response has led to enormous progress towards scaling up access to treatment and reaching out to people at risk of HIV infection, with a strong human rights focus. This has been, and continues to be, a catalyst for change in the health systems of many affected countries.”

This year’s week-long event brought together senior health practitioners from Ghana, Liberia, Rwanda, and South Africa to focus on health system issues including mental health, maternal mortality, human resource management and management capacity building. These countries have achieved improvements in health despite limited resources and have gathered to discuss and apply strategic problem solving to national health priorities.

In his speech, Mr Sidibé also recognized the leadership of these four countries and praised their high level representation at the General Assembly High Level Meeting on AIDS.

Each country delegation, comprised of senior leadership from Ministries of Health, non-governmental organizations and academic institutions, brought a health system challenge to address at the conference with the support of Yale faculty and experts. Delegates participated in interactive lectures, cross-country roundtable discussions, keynotes and facilitated work sessions. Delegates met with prominent leaders in global health and received training in strategic problem-solving and leadership.

Global Health Leadership Institute

The Yale Global Health Leadership Institute (GHLI) develops global health leadership through innovative education and research programmes that strengthen the capacity of countries and communities to ensure health equity and quality of care for all.

As the world marks 30 years of AIDS, UNAIDS estimates 34 million [30.9 million–36.9 million] people are living with HIV and nearly 30 million [25 million–33 million] people have died of AIDS-related causes since the first case of AIDS was reported on 5 June 1981

(From left): Michel Sidibé, UNAIDS Executive Director; Christina Rodriguez, Co-Founder, Smart Youth; Asha-Rose Migiro, Deputy Secretary-General at Press conference on AIDS at 30: Progress of nations, held at UN Headquarters, New York City on June 3, 2011.
Credit: UNAIDS/B. Hamilton

NEW YORK/GENEVA, 3 June 2011—About 6.6 million people were receiving antiretroviral therapy in low- and middle-income countries at the end of 2010, a nearly 22-fold increase since 2001, according to a new report AIDS at 30: Nations at the crossroads, released today by the Joint United Nations Programme on HIV/AIDS (UNAIDS).

A record 1.4 million people started lifesaving treatment in 2010—more than any year before. According to the report, at least 420 000 children were receiving antiretroviral therapy at the end of 2010, a more than 50% increase since 2008, when 275 000 children were on treatment.

“Access to treatment will transform the AIDS response in the next decade. We must invest in accelerating access and finding new treatment options,” said Michel Sidibé, UNAIDS Executive Director. “Antiretroviral therapy is a bigger game-changer than ever before—it not only stops people from dying, but also prevents transmission of HIV to women, men and children.”

His statement follows the recent HPTN052 trial results which found that if a person living with HIV adheres to an effective antiretroviral regimen, the risk of transmitting the virus to his or her uninfected sexual partner can be reduced by 96%.

“Countries must use the best of what science can offer to stop new HIV infections and AIDS-related deaths,” said UN Deputy Secretary-General Asha-Rose Migiro. “We are at a turning point in the AIDS response. The goal towards achieving universal access to HIV prevention, treatment, care and support must become a reality by 2015.”

HIV prevention efforts showing results

According to the report, the global rate of new HIV infections declined by nearly 25% between 2001 and 2009. In India, the rate of new HIV infections fell by more than 50% and in South Africa by more than 35%; both countries have the largest number of people living with HIV on their continents.

The report found that in the third decade of the epidemic, people were starting to adopt safer sexual behaviors, reflecting the impact of HIV prevention and awareness efforts. However, there are still important gaps. Young men are more likely to be informed about HIV prevention than young women. Recent Demographic Health Surveys found that an estimated 74% of young men know that condoms are effective in preventing HIV infection, compared to just 49% of young women.

In recent years, there has been significant progress in preventing new HIV infections among children as increasing numbers of pregnant women living with HIV have gained access to antiretroviral prophylaxis during pregnancy, delivery and breastfeeding. The number of children newly infected with HIV in 2009 was 26% lower than in 2001.

About 115 low- and middle-income countries are providing optimal treatment regimens for pregnant women living with HIV as recommended by the World Health Organization (WHO). There are 31 countries that still use sub-optimal regimens in many of their HIV prevention programmes. UNAIDS urges all countries using sub-optimal regimens to revise their treatment guidelines and make the transition to optimal WHO recommended regimens.

AIDS is not over—significant challenges remain

According to the latest estimates from UNAIDS, 34 million [30.9 million–36.9 million] people were living with HIV at the end of 2010 and nearly 30 million [25 million–33 million] have died from AIDS-related causes since AIDS was first reported 30 years ago.

Despite expanded access to antiretroviral therapy, a major treatment gap remains. At the end of 2010, 9 million people who were eligible for treatment did not have access. Treatment access for children is lower than for adults—only 28% of eligible children were receiving antiretroviral therapy in 2009, compared to 36% coverage for people of all ages.

While the rate of new HIV infections has declined globally, the total number of HIV infections remains high, at about 7000 per day. The global reduction in the rate of new HIV infections hides regional variations. According to the report, above-average declines in new HIV infections were recorded in sub-Saharan Africa and in South-East Asia, while Latin America and the Caribbean experienced more modest reductions of less than 25%. There has been an increase in the rate of new HIV infections in Eastern Europe and in the Middle East and North Africa.

In virtually all countries, HIV prevalence among populations at increased risk of HIV infection—men who have sex with men, people who inject drugs, sex workers and their clients, and transgender people—is higher than among other populations. Access to HIV prevention and treatment for populations at higher risk of infection is generally lower due to punitive and discriminatory laws, and stigma and discrimination. As of April 2011, 79 countries, territories and areas criminalize consensual same-sex relations; 116 countries, territories and areas criminalize some aspect of sex work; and 32 countries have laws that allow for the death penalty for drug-related offences.

According to the report, gender inequalities remain a major barrier to effective HIV responses. HIV is the leading cause of death among women of reproductive age, and more than a quarter (26%) of all new global HIV infections are among young women aged 15-24.

AIDS resources declining

According to the report, investments in the HIV response in low- and middle-income countries rose nearly 10-fold between 2001 and 2009, from US$ 1.6 billion to US$ 15.9 billion. However, in 2010, international resources for HIV declined. Many low-income countries remain heavily dependant on external financing. In 56 countries, international donors account for at least 70% of HIV resources.

“I am worried that international investments are falling at a time when the AIDS response is delivering results for people,” said Mr Sidibé. “If we do not invest now, we will have to pay several times more in the future.”

A 2011 investment framework proposed by UNAIDS and partners found that an investment of at least US$ 22 billion is needed by the year 2015, US$ 6 billion more than is available today. When these investments are directed towards a set of priority programmes that are based on a country’s epidemic type, the impact is greatest. It is estimated that the return on such an investment would be 12 million new HIV infections averted and 7.4 million AIDS-related deaths averted by the year 2020. The number of new infections would decline from about 2.6 million in 2009 to about 1 million in 2015.

Perspectives on AIDS from leaders around the world

The report features commentaries from 15 leaders in the global AIDS response, including South Africa’s President Jacob Zuma, former United States President Bill Clinton, former President of Brasil Luiz Inácio Lula da Silva, the President of Mali, Amadou Toumani Touré, and Jean Ping, Chairperson of the African Union Commission. The commentaries cover a range of areas, such as AIDS funding, South-South cooperation, youth leadership, the empowerment of women, key affected populations, injecting drug use, human rights, stigma and discrimination and systems integration.

Young people leading the HIV prevention revolution

AIDS at 30: Nations at the crossroads also includes an article on a recent event held on Robben Island, South Africa, where Archbishop Desmond Tutu, Co-chair of the UNAIDS High Level Commission on HIV Prevention, passed the baton of leadership in the AIDS response to a new generation of young leaders.

According to the report, some of the most important HIV prevention successes have been led by young people. Data indicate that young people in many heavily affected countries are increasingly adopting safer sexual behaviours.

Dr Paul De Lay at the MDGs Follow-up Meeting
Credit: UNAIDS

The Government of Japan, along with the United Nations Development Programme (UNDP), the United Nations Children's Fund (UNICEF), the World Bank and the Japan International Cooperation Agency (JICA), convened a follow-up meeting on 2-3 June 2011 in Tokyo to discuss the outcomes of the UN Millennium Development Goals (MDGs) Summit that took place in September 2010.

With less than five years remaining before 2015, the target year for achieving the MDGs, the meeting brought together high level delegations from more than 100 countries and international organizations, and provided a unique opportunity to exchange knowledge, as well as to discuss more effective measures to strengthen coordination among a broad range of stakeholders.

The meeting was opened by H.E. Prime Minister Kan, who expressed deep appreciation for the solidarity shown by the international community in the wake of the unprecedented earthquakes and tsunami on 11 March 2011. Mr Kan also assured the audience that Japan remains committed to the achievement of MDGs.

Mr Takeaki Matsumoto, Japan’s Minister of Foreign Affairs, underlined this commitment saying, “Japan remains fully dedicated to carrying out faithfully the international commitments it has expressed in the past to achieving the MDGs.”

UNAIDS Deputy Executive Director, Programme, Paul De Lay took part in the meeting and also participated in one of the several side events, titled Preparing the health systems for the challenges beyond MDGs.

“UNAIDS has called for taking HIV out of isolation. At the High Level Meeting on AIDS next week, one of the major themes will be “integration”, including exploring synergies between HIV programmes and preventing and caring for non-communicable diseases,” said Dr De Lay.

The event, moderated by Dr Suwit Wibulpolprasert, Senior Advisor on Disease Control, Ministry of Public Health, Thailand, included presentations from Michel D. Kazatchkine, Executive Director, The Global Fund to Fight AIDS, Tuberculosis and Malaria; Dr Mickey Chopra, Chief, Health Section, Program Division, UNICEF; and Dr Kenji Shibuya, Professor and Chair, Department of Global Health Policy Graduate School of Medicine, The University of Tokyo.

Coming just days before the UN High Level Meeting on AIDS in New York, the meeting enabled participants to exchange their good practices and also learn from others about projects and programmes focused on hard-to-reach regions and groups. Participants also discussed the “way forward” beyond 2015, using lessons learned in the decade under the current MDGs.

During his visit to Japan Dr De Lay also met with Dr Masato Mugitani, Assistant Minister for Global Health, the Ministry of Health, Labour and Welfare and Mr Masaya Fujiwara, Deputy Director-General for Global Issues of the International Cooperation Bureau, the Ministry of Foreign Affairs to discuss Japan’s active participation in the UN High Level Meeting, especially regarding prevention of mother-to-child transmission of HIV. Dr DeLay also met with civil society representatives who will attend the General Assembly event.