UNAIDS Director, Regional Support Team for Asia and Pacific Steve Kraus and First Lady of Cambodia, Lok Chumteav Bun Rany Hun Sen during the official ceremony to appoint her as a National Champion for the UN Secretary-General’s Action Plan for Women’s and Children’s Health. Phnom Penh, 21 February 2011.

The First Lady of Cambodia, Lok Chumteav Bun Rany Hun Sen, has been appointed the National Champion for the UN Secretary-General’s Action Plan for Women’s and Children’s Health at a ceremony in Phnom Penh on 21 February.

In her role as National Champion, Bun Rany will regularly visit health centres across Cambodia to advocate for healthy motherhood with midwives and other health professionals, women and their families, as well as local communities.

The UN Secretary-General launched the Action Plan in April 2010. It is a roadmap that identifies the finance and policy changes needed to improve health and save women’s and children’s lives.

Cambodia has one of the highest levels of maternal mortality in Asia, with 461 deaths per 100,000 live births. With a strong tradition of delivering babies at home, less than half of all babies are delivered in a health facility in Cambodia, and just 60% of births are assisted by trained birth attendants.

Integrated approach to the health MDGs

Although the country has a long way to go to meet its Millennium Development Goal 5 (improve maternal health) target by 2015, it has seen progress in recent years by addressing the health related MDGs through a joint and comprehensive approach. In 2007 Cambodia adopted the “Linked Response Initiative,” a national strategy to expand access to HIV, reproductive and sexual health, family planning, tuberculosis and maternal health services using the prevention of mother-to-child HIV transmission as an entry point.

Additionally, resources for the AIDS response are supporting integrated laboratory services at referral hospitals allowing tests for TB, malaria, HIV and sexually transmitted infections to be carried out in a single laboratory enabling cost and labour efficiencies and rapid return of results to patients.

“These national innovations to health delivery are leading the way to breaking down barriers to broader health care which an isolated approach to AIDS cannot achieve,” said UNAIDS Country Coordinator Tony Lisle. “It translates to a far more effective use of scarce resources and brings many more women and their children closer to meaningful and comprehensive care.”

It is hoped that Bun Rany’s role as National Champion for the UN Secretary-General’s Action Plan for Women’s and Children’s Health as well as her role as National Champion of the Asian Pacific Leadership Forum on HIV and Development will strengthen the country’s integrated approach to tackle MDGs 4, 5 and 6 and will complement the leadership of the Royal Government of Cambodia on addressing maternal and child health and HIV. Cambodia received a Millennium Development Goal Award in September 2010, an acknowledgement of the country’s efforts to halt and reverse the AIDS epidemic.

Ms Helen Evans Interim Chief Executive Officer, Global Alliance for Vaccines and Immunisation (GAVI); Dr Michel Kazatchkine Executive Director, Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM); Ms Tamar Manuelyan Atinc Vice President, Human Development Network, World Bank; Dr Tachi Yamada President, Global Health Program, Bill & Melinda Gates Foundation; Dr Margaret Chan Director-General, World Health Organization (WHO); UNAIDS Executive Director Michel Sidibé; Mr Anthony Lake Executive Director, United Nations Children’s Fund (UNICEF); Mr Babatunde Osotimehin Executive Director, United Nations Population Fund (UNFPA).

The Health 8 group gathered at the UNAIDS Headquarters in Geneva on Wednesday 23 February to reflect and strategize on one of most pressing issues affecting the health of the world’s population—maximizing health outcomes with available resources.

The Geneva meeting, convened in this occasion by UNAIDS Executive Director Michel Sidibé, focused on how to get “more health for the money.” Participants held discussions under three main topics: the UN Secretary-General’s Global Strategy for women’s and children’s health, the role of multilateralism in the new economic order, and the provision of technical support for capacity building.

The Health 8 (H8) is an informal group of eight health-related organizations comprising WHO, UNICEF, UNFPA, UNAIDS, GFATM, GAVI, Bill & Melinda Gates Foundation, and the World Bank. It was created in mid-2007 to stimulate a global sense of urgency for reaching the health-related Millennium Development Goals and has focused on better ways to speed up efforts to bring lifesaving-health improvements to people worldwide.

A version of this story was first published at UNODC.org

The comprehensive HIV prevention package will include access to sterile needles and syringes
Credit: UNAIDS

The Kenyan government is taking an innovative approach to reducing HIV among injecting drug users. In a bold new initiative, the government is set to give drug users free access to HIV prevention and treatment services. Supplies of sterile needles and syringes, substitution treatment, social support and referral to other health services, including antiretroviral therapy, will be available.

In a pilot project, 12 primary health care centres in Mombasa are offering drug dependence treatment and psycho-social support in several communities on an out-patient basis. For the next three months, the Kenya Red Cross will provide support to the Ministry of Health. HIV voluntary counseling and testing are also offered. The Ministry of Medical Services is preparing a rapid capacity building plan and staff will receive additional training in the next few weeks and months.

It is expected that this model will be adopted in other regions.

The action plan to roll out the comprehensive HIV prevention package follows a recent national meeting on people who inject drugs convened by the National AIDS Control Council (NACC). The meeting’s resolutions were also endorsed by Members of Parliament during a subsequent leadership workshop on HIV.

The United Nations is playing a key role in the programme and the UNAIDS family has worked in close partnership with the National AIDS Control Council and many government agencies, to encourage the adoption of this comprehensive HIV prevention package.

The United Nations Office on Drugs and Crime is also joining the government in developing an intensive training programme for 700 health professionals and civil society actors to offer quality services for injecting drug users.

Kenya’s government has recognized the importance of addressing the needs of key populations such as people who inject drugs, sex workers and their clients, men who have sex with men, and people in prisons. This was reinforced by its Modes of Transmission Study published in March 2009 which indicated that such populations accounted for more than a third of all new HIV infections. The adoption of the comprehensive package for HIV prevention among people who inject drugs is seen as a significant step forward.

Credit: The World Bank

Information about the spread of HIV in the Middle East and North Africa region has been extremely limited, with no real picture of the epidemic emerging. As a major contribution to increasing knowledge of AIDS in the region, the World Bank recently convened a discussion to highlight the first ever comprehensive scientific analysis of the epidemic.

A groundbreaking report, a joint effort involving the World Bank, UNAIDS and the World Health Organization, was the focus of the event at the Bank’s Washington Headquarters. The event on 15 February brought together policy makers from the region, politicians, researchers, civil society actors, and partners. They discussed the findings and implications for prioritizing resources amid the fundamental social and political changes currently affecting the region.

HIV in North Africa and the Middle East

HIV infection has already reached all corners of North Africa and the Middle East. There are substantial differences in the way the virus is spread across the region and various risk contexts are present. The epidemic has become generalized in Djibouti and Sudan, though prevalence in the general population in most other countries is low. The nearly one million people  who inject drugs (0.2% of the population), men who have sex with men and their sexual partners, and commercial sex networks are the most impacted by HIV. A significant number of individuals have also contracted the virus while living and working abroad.

Levels of risk behaviour, such as using non-sterile injecting equipment, are high in a number of countries in the region. This confirms the potential for further HIV spread among the key populations.

A number of social challenges, including pervasive stigma, are also facilitating the spread of the virus.

The way forward

Laith J. Abu-Raddad, the report’s main author, who participated in the World Bank discussion, believes that with today’s greater understanding of the epidemic, time is of the essence in building a more meaningful response. “We are no longer groping in the dark on HIV in the region. The data are now available and we have a good understanding of what’s happening with regard to HIV transmission and the populations affected.” He added, “The priorities are clear to address the problem of the rising epidemics in the region and it is time for policy makers and partners to take action.”

Participants at meeting agreed that the current political climate presents a window of opportunity for sustained change. They called on policy makers to focus investment on evidence-informed prevention efforts for key populations to yield long term health and social benefits.

Stigma and discrimination must also be challenged and access to testing, care, and treatment services expanded substantially.

A partnership with civil society, concerned populations and people living with HIV will be the cornerstone of effective implementation. Strengthening grassroots organizations is considered essential for cementing progress made and reaching the most stigmatized and vulnerable.

The report includes data on Afghanistan, Algeria, Bahrain, Djibouti, the Arab Republic of Egypt, the Islamic Republic of Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, the Syrian Arab Republic, Tunisia, the United Arab Emirates, West Bank and Gaza (Occupied Palestinian Territories), and the Republic of Yemen.

On Thursday, UNAIDS Executive Director Michel Sidibé (left) urged the Prime Minister of Thailand, Abhisit Vejjajiva, to lead an HIV prevention revolution in the Asia region, with the goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths. Credit: UNAIDS/V. Dithajohn

On the final day of an official country visit to Thailand, UNAIDS Executive Director Michel Sidibé praised Thailand’s Prime Minister, Abhisit Vejjajiva, for his leadership and commitment on AIDS in the country and urged Thailand to redouble efforts—and resources—on HIV prevention.

Underlining the country’s current successes, including significant advances in the provision of antiretroviral treatment and increased access to services for the prevention of mother-to-child transmission of HIV, Mr Sidibé urged Thailand to lead an HIV prevention revolution in the Asia region.

“Thailand has an outstanding record in the AIDS response which now needs to be taken to the next level,” said Mr Sidibé, encouraging Thailand to take the lead and be the first country in the region to make a concrete impact on the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. 

Thailand is known for its effective, rapid and targeted HIV response. Currently 80% of people in need have access to antiretroviral treatment and nearly 97% of pregnant women living with HIV have access to services to prevent mother-to-child transmission of HIV. The Government of Thailand funds 83% of its national HIV response, but only 14% of the national HIV budget is allocated for HIV prevention.

Prime Minister Abhisit acknowledged that HIV prevention efforts in Thailand need to be rapidly intensified and that they should be clearly focused on key affected populations, such as sex workers, men who have sex with men, and people who inject drugs. He complimented UNAIDS’ bold goal of zero new HIV infections.   Stigma and discrimination was highlighted in the meeting as one of the critical barriers in the HIV response, particularly with regard to its impact on people living with HIV and the affected communities. Prime Minister Abhisit also called attention to Thailand’s newly developed harm reduction policy and said that he was taking action to ensure the policy’s implementation across the country, starting in ten provinces.
Underlining his continued commitment to lead on the issue of AIDS, the Prime Minister expressed his interest in playing an active role in the June 2011 UN General Assembly High-Level Meeting on AIDS.

 

In his 2011 Letter to Partners, Mr Sidibé outlines a set of six new frontiers to move the global AIDS response forward: The democratization of the response; making the law work for not against AIDS; reducing the upward trajectory of programme costs; making funding for AIDS a shared responsibility; making the AIDS movement a bridge to development; and fostering scientific innovation for HIV prevention and treatment.

According to Mr Sidibé, each of the new frontiers supports the other, and he cautions that a singular advancement in any one sector alone will not be sufficient to move the entire global AIDS response forward.

This Letter to Partners coincides with the 30 years of the AIDS epidemic, the 10th anniversary of the 2001 Declaration of Commitment on HIV/AIDS and five years since the world committed to achieve universal access to HIV prevention, treatment, care and support.

“This year we have an historic opportunity to build on and improve the performance of the last three decades,” said Sidibé. “Together, we can make this the defining decade, the decade that signals the beginning of the end of AIDS,” he added in anticipation of the June 2011 General Assembly High Level Meeting on AIDS that will bring together world leaders to renew hope and re-energize the AIDS movement.

Read the 2011 Letter to Partners 

This SWING Foundation volunteer was one of many to promote messages of HIV prevention and safe sex on Valentine’s night in Bangkok. Credit: UNAIDS

High heels, sequined outfits and pumping music fill Bangkok’s ‘Soi Cowboy’ street. For many, it’s a typical evening in one of the city’s well-known red-light zones. But a closer look at the fashion parade tells that this isn’t just any other night—the elaborately designed outfits, made entirely from condoms, are part of a Valentine’s night HIV prevention drive led by SWING (Service Workers In Group) Foundation, a Thai-based non-governmental organization.

With HIV prevention-slogan banners raised high in the air—“Safe sex, safe life!”, “Heart of love, heart of condom!”— volunteers from SWING walk the temporary runway, handing out condoms and information leaflets. Such targeted HIV prevention drives are just one aspect of SWING’s work with men, women and transgendered “service workers,” SWING’s preferred terminology for sex worker.

Based in the Thai red light districts of Bangkok, Pattaya and Ko Samui, the SWING Foundation provides educational opportunities for workers, including English language classes and vocational training. The Foundation also serves as a drop-in centre where workers can stop by, eat, use the internet, prepare for the evening, and take part in HIV-related information games and sessions.

“Our activities help workers increase their self confidence and possibilities to develop their individual potential,” said Surang Janyam, who co-founded SWING in 2004. “For many, it is so hard to feel they can get support, and they fear discrimination. SWING provides a safe space and options,” she added.

An established success story in Thailand, SWING’s reputation is spreading across borders as a model for programmes that provide HIV services where they are most needed. Its success is ascribed in part to the fact that Foundation is managed and run almost entirely by current or former sex workers.

Across the Asia-Pacific region, an increase in the size and scale of programmes focused on populations at higher risk of HIV exposure—planned and implemented by the communities themselves—is urgently needed.

According to the latest available data, most epidemics in the region are still concentrated among people who inject drugs, sex workers and men who have sex with men. In a number of countries, there are signs of increased HIV infection rates among these key affected populations. Data, where available, on HIV prevention coverage from a number of countries across the region suggest that less than half—and in some cases only one third—of people from key affected populations have been reached by prevention services.

“In the Asia-Pacific region, we know that HIV responses must focus solidly on key affected populations if we are to sustain and advance progress,” said UNAIDS Executive Director Michel Sidibé, who was a special guest at the Valentine’s event hosted by SWING. “We need to drive commitment and action to ensure programmes like SWING are emulated and multiplied across the region,” he added.

In Soi Cowboy on Valentine’s night, the message is loud and clear: Nothing about us without us. “We care about you!” shouted SWING co-founder Khun Tee through a megaphone, as his colleagues paraded by in their colourful condom combinations. “HIV is real—please use a condom every time you have sex with anyone!”

UNAIDS Executive Director Michel Sidibé (left) met with M.R. Sukhumbhand Paribatra, Governor of Bangkok, on 16 February at the Bangkok Metropolitan Administration City Hall. Credit: UNAIDS/V. Dithajohn

In an official mission this week to Thailand, UNAIDS Executive Director Michel Sidibé held discussions with M.R. Sukhumbhand Paribatra, Governor of Bangkok, on progress, challenges and opportunities for the AIDS response in the Thai capital. During the meeting, Mr Sidibé asked for increased support to help make Bangkok the first city to reach the goal of "zero new HIV infections."

Acknowledging the specific challenges faced by mega-cities in Asia—where new HIV infection rates among some key populations, including men who have sex with men, remain high and where migration is a complex daily reality—Mr Sidibé urged the Governor to play an active role in the June 2011 UN General Assembly High-Level Meeting on AIDS with other high-level city officials from mega-cities around the world. "This would be a perfect opportunity to tell the world that Bangkok is committed to getting to zero," said Mr Sidibé.

In his discussions with Mr Sidibé, Governor Paribatra said that a focus on marginalized populations, particularly migrants, is critical to effective AIDS responses in Bangkok. While underscoring the complexity of city-based approaches to the HIV epidemic, he stressed his intention to rise to the challenge of "zero new HIV infections" in the Thai capital. Governor Paribatra expressed interest in attending the High-Level Meeting in June and in addition hosting a "getting to zero" gathering of officials from other mega-cities in the region during his term.

UNAIDS International Goodwill Ambassador Toumani Diabaté Credit: Malik Sidibé

UNAIDS International Goodwill Ambassador Toumani Diabaté received a GRAMMY award for best traditional world music album for his joint album with Ali Farka Toure's entitled “Ali and Toumani”.

The album is a recording of duets from two of Africa’s most distinguished musicians, the late guitarist Ali Farka Touré and kora player Toumani Diabaté. The duo’s first album together, also won a GRAMMY following its 2005 release.

At the 53^rd GRAMMY Award ceremony, which took place in Los Angeles on 13 February, Vieux Farka Toure accepted the Award on behalf of his late father, Ali Farka Toure, and Toumani Diabaté.

Toumani was appointed UNAIDS International Goodwill Ambassador on 12 December 2008. He uses music as a tool to reach out to people with important messages on HIV prevention and educating his audiences about stigma and discrimination. Today, his music encourages the empowerment of people and spreads AIDS awareness messages in Mali and overseas.

Toumani descends from a long line of oral historians and singers. He has blended ancient West African music tradition with other modern and traditional music from across the world and been instrumental in introducing the kora, a 21-string harp lute, to audiences around the world and in developing it into a solo concert instrument.

Sabu Yerkoy (Radio Edit)

In an official visit to the Suan Kalub Palace in Bangkok, UNAIDS Executive Director Michel Sidibé met with HRH Princess Soamsawali of Thailand.

In an official visit to the Suan Kalub Palace in Bangkok on Monday, UNAIDS Executive Director Michel Sidibé commended HRH Princess Soamsawali of Thailand for her “tireless dedication, commitment and leadership” in the country’s HIV response.

“Through deeds, words and provision of resources where they are most needed, Your Royal Highness has shown true vision and commitment on HIV,” said Mr Sidibé, who is currently in Thailand on a three-day country mission. “I look forward to our ongoing collaboration to save and improve lives,” he added.

Presenting the Princess with a commemorative plaque for her ongoing efforts to prevent mother-to-child transmission of HIV (PMTCT) and HIV-related stigma and discrimination, Mr Sidibé noted Princess Soamsawali’s longstanding involvement in the HIV response, which dates back some 25 years.

Through her patronage of the Thai Red Cross, HRH Princess Soamsawali helped bring PMTCT services to Thailand in 1996, several years before a PMTCT programme was introduced as part of Thailand’s national response to the HIV epidemic. Within the programme, triple antiretroviral therapy is made available for all pregnant women living with HIV, independent of their CD4 count.

During their meeting, UNAIDS Executive Director and HRH Princess Soamsawali emphasized the importance of ensuring access to HIV programmes for marginalized populations and those at higher risk of  HIV exposure—particularly men who have sex with men and illegal migrants.

While noting progress in Thailand’s HIV response, the Executive Director highlighted that more needs to be done. An estimated 530 000 people in Thailand are living with HIV and prevalence of the virus among people aged 15-49 is 1.3%.

“I would like to see Bangkok free of HIV,” said Mr Sidibé. “This means greater action is needed to break down barriers to ensure support is given to those who need it most,” he said. HIV programmes supported by HRH Princess Soamsawali provide antiretroviral treatment to marginalized populations, and the Princess underlined that her support in this area would continue.

Mr Sidibé’s official visit to Thailand, which ends on 17 February, includes a number of meetings with high-level government officials and representatives from civil society organizations.