Feature Story

Emerging from conflict: women’s role in rebuilding better, fairer communities

20 October 2010

Women clearing rubble from the streets of Port-au-Prince, Haiti. Credit: UN Photo/Sophia Paris

Too often women suffer the worst consequences of war. In certain parts of the world gender-based and sexual violence are increasingly used as a weapon of conflict and are a prevalent characteristic of numerous humanitarian crises. The latest flagship report from the United Nations Population Fund (UNFPA), State of world population 2010, explores the dangerous consequences for women caught in conflict and crisis who are left vulnerable to HIV infection, disabilities, social stigma and psychological trauma. 

The publication of the report, which also highlights many positive actions by individuals, civil society and governments to confront this issue, coincides with the tenth anniversary of Resolution 1325 on Women, Peace and Security. The resolution is the United Nation’s Security Council’s challenge to the abuse of women in conflict and their marginalisation in the peace building process.

Subtitled From conflict and crisis to renewal: generations of change, the report examines developments in the 10 years since this key resolution. The report is based on stories from the field in a range of countries that have experienced turmoil and are now on the sometimes rocky road to recovery: Bosnia and Herzegovina, Liberia, Timor-Leste and Uganda.

HIV in crisis situations

The impact of HIV in crisis situations is also explored. Sexual violence makes women vulnerable to HIV infection. The social instability, poverty and powerlessness that often accompany social upheaval and displacement also facilitates HIV transmission with weakening of norms regulating sexual behaviour. 

Countries should not just be rebuilt, but built back better and renewed, with women and men on equal footing, with rights and opportunities for all.

Thoraya Ahmed Obaid, UNFPA’s Executive Director

The report shows how women and young people have overcome difficulties and started to rebuild their lives and their communities. In post-conflict northern Uganda, where a rebel war raged for more than 20 years, young people are working with the local branch of Straight Talk Foundation, a national NGO, which has set up the Gulu Youth Centre. It is now a major provider of sexual and reproductive health care for youth in the area, including HIV counselling and testing. This is a much-needed service for the region's young women as older teenage girls are much more likely to be living with HIV.

Women and men together for peace

There is also recognition that men play a vital role in bringing about positive change. Male traditional leaders in Africa and the Asia-Pacific region are now taking women’s rights and needs into account in decision-making.

Increasingly, women are also elected as local leaders on their own steam and take active part in re-building society in post-conflict situations. For example in Burundi and Nepal, two conflict affected countries, women in civil society have been heralded for their efforts and impact throughout the peace process.

According to the State of world population, concerned people at all levels are searching for ways to build new and healthy societies where women and girls—and men and boys—can flourish.

As Thoraya Ahmed Obaid, UNFPA’s Executive Director, said about the report, “Countries should not just be rebuilt, but built back better and renewed, with women and men on equal footing, with rights and opportunities for all.”

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Asia-Pacific drive for increased focus on HIV and sex work

20 October 2010

Sex workers, government officials and UN representatives joined the first-ever Asia-Pacific regional consultation on HIV and sex work. Credit: APNSW

HIV transmission via sex work accounts for many new HIV infections  in the Asia-Pacific region. Yet in many countries HIV prevention, treatment and care services for sex workers are lacking. At the first consultation of its kind in the region, sex workers, government officials and United Nations participants emphasized the urgent need for action to increase focus on sex work within national HIV responses.

“I was arrested when the police saw I had condoms.” “Sex workers’ rights are being violated.” “Sex workers are going underground now. We don’t know where they are.”

These are just some of the experiences shared at the first-ever Asia-Pacific consultation on HIV and sex work, held in Pattaya, Thailand, from 12-15 October. Some 150 participants from eight countries* in the region—including sex workers, government officials, representatives from civil society and the United Nations—came together to call for a greater emphasis on ensuring universal access to HIV prevention, treatment, care and support services for sex workers.

Sex workers experience firsthand the effects of laws and harmful enforcement practices that violate their human rights and hamper progress in the HIV response.

Jan Beagle, UNAIDS Deputy-Executive Director, Management and External Relations

Hosted by the Royal Government of Thailand and co-organized by UNAIDS and UNFPA, in collaboration with the Asia-Pacific Network of Sex Workers (APNSW), meeting participants shared strategies and developed national action plans to be carried forward.

Sex work accounts for a significant number of new HIV infections in the Asia–Pacific region. An estimated 10 million Asian women sell sex to 75 million men who, in turn, have intimate relations with an additional 50 million people. In some countries in the region, HIV prevalence among sex workers is nearly 20%. Meet participants stressed that spending on HIV services is falling, despite evidence of their cost-effective impact and that only about one third of sex workers in the region are able to access HIV prevention programmes.

Khartini Slamah of APNSW moderates a discussion on legal and policy barriers. Credit: APNSW

Meeting participants also pointed to numerous punitive laws and policies that can prevent sex workers from accessing HIV services. “Sex workers experience firsthand the effects of laws and harmful enforcement practices that violate their human rights and hamper progress in the HIV response,” said Jan Beagle, UNAIDS Deputy-Executive Director, Management and External Relations, who attended the consultation. “Listening to sex workers is crucial.”

Participants in the consultation heard how sex workers are frequently subjected to violence and harassment, and often face criminal charges and detention. Participants said enforcement of elements within new anti-trafficking and other related laws in some countries including Cambodia, Fiji and Thailand had exacerbated this situation, citing recent cases where carrying condoms had led to arrests.

“Every day we confront brutal realities—arrest, violence, discrimination,” said Kay Thi Win, Chair of APNSW and programme manager of a successful and long-running outreach programme in Myanmar that is largely run by sex workers or former sex workers. “We want to turn the tide by demanding that initiatives designed ‘for’ us be designed ‘with’ us,” she said.

*Cambodia, China, Fiji, Indonesia, Myanmar, Pakistan, Papua New Guinea and Thailand

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Expanding HIV services in post-conflict Liberia

20 October 2010

Photo: UNAIDS Executive Director Michel Sidibe, HRH Princess Mathilde of Belgium and mother of triplets at JFK hospital in Monrovia, Liberia. Credit: UNAIDS

UNAIDS Executive Director Michel Sidibé and UNAIDS and UNICEF Goodwill Ambassador HRH Princess Mathilde of Belgium, wrapped up a joint three-day mission to Liberia, which as a post-conflict country is working to expand its HIV services.

“It is a critical moment for Liberia. If we join together we can put the brakes on new HIV infections,” said Mr Sidibé. “But if we miss this opportunity the AIDS epidemic could regain momentum and more lives will be lost.”

During their trip, Mr Sidibé and HRH Princess Mathilde visited several health and educational facilities which are leading the way in the country’s re-energized AIDS response.

It is a critical moment for Liberia. If we join together we can put the brakes on new HIV infections

Michel Sidibé, UNIADS Executive Director

One site they visited was the JFK Hospital which is located in the capital city of Monrovia and offers a range of integrated HIV and maternal health services. It provides antenatal care to approximately 50 pregnant women each month, including voluntary HIV testing and counselling and services to prevent mother-to-child transmission (PMTCT) of HIV. On average, about 200 people visit the hospital’s antiretroviral therapy clinic every week for treatment and care.

Challenges of delivering HIV services in rural settings

As well as visiting hospitals in the capital, the group also paid a visit to the Phebe Hospital, a rural health facility located in the central Liberian county of Bong that provides a range of health services to around 329 000 people in four different counties. It is considered a leading provider of HIV services including antiretroviral treatment, voluntary HIV testing and counselling, PMTCT services and treatment for tuberculosis. A total of 67 people living with HIV are receiving services and 35 are on treatment.

Education is a key issue; boys and girls should be educated to show respect for one another.

HRH Princess Mathilde

However rural health facilities often face particular problems in delivering health services. For example two weeks ago the machine measuring CD4 counts, which helps monitor the progress of the virus, broke down and the hospital is unsure of when it can be fixed.

“We face many challenges. We have problems with follow up and we lose about a fifth of people who test HIV positive,” said Dr Garfee Williams, the Medical Director of Phebe Hospital. “This is due to many reasons—there are of course problems of discrimination – but also a lack of resources. We just don’t have the staff to go out into communities and provide the necessary care.”

Liberia has a generalised AIDS epidemic and latest data shows that there were around 35 000 people living with HIV at the end of 2007 and 2 300 people died of an AIDS-related illness in the same year.  

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Benin, EU and UNAIDS cooperate on technical support for HIV response

19 October 2010

MoU on the implementation of the technical support plan to the AIDS response in Benin

Ms Françoise Collet Ambassador, for the European Union in Benin, Dr Antoinette Obey Megnigbeto for the Government of Benin, and on behalf of UNAIDS Mr Baruani Kilundu Yuma signing the MoU in Benin, 14 October, 2010. Credit: UNAIDS.

On 14 October, the European Union (EU), the Government of Benin and the Joint United Nations Programme on HIV/AIDS (UNAIDS), signed a Memorandum of Understanding (MoU) on a Technical Support Plan to enhance coordination of the AIDS response in Benin and improve the implementation of the Global Fund grants.

A technical support plan maps the gaps in National AIDS responses and identifies where technical support is needed. This is essential to better coordinate and focus joint efforts for strategic and effective national responses to the HIV epidemic.

The aim of the new plan is to assist the national AIDS coordinating authority to more effectively manage, coordinate and supervise the technical support provided by national and international partner organizations.

Benin is one of the first countries in West and Central Africa with a technical support plan in operation. The plan was developed through an inclusive process, with the assistance of the Technical Support Facility for West and Central Africa and UNAIDS Regional Team in Dakar. The national government, bilateral and multilateral partners and civil society identified operational bottlenecks in the national AIDS response together. Key challenges include effective allocation of existing financial resources, weak coordination, and lack of coverage of prevention of mother-to-child transmission services. Via this process the actions needed to overcome challenges were also mapped out.

This plan will help to strengthen the coordination capacity of the national AIDS response in Benin, and improve implementation of Global Fund grants

Mr Baruani Yuma Kilundu UNAIDS Country Coordinator Benin

It is hoped that the plan’s implementation will build on this inclusive approach and further strengthen consensus among partners on how to plan and put into action HIV programmes in Benin.

The MoU was signed by Ms Françoise Collet Ambassador, Head of the Delegation of the European Union in Benin, Dr Antoinette Obey Megnigbeto Permanent Secretary of the National AIDS Committee for the Government of Benin, and on behalf of UNAIDS by Mr Baruani Kilundu Yuma, UNAIDS Country Coordinator of Benin.

“This plan will help to strengthen the coordination capacity of the national AIDS response in Benin, and improve implementation of Global Fund grants,” said Mr Baruani Yuma Kilundu at the signing of the agreement.

So far Benin has received US$ 70 million for HIV programming from the Global Fund to Fight AIDS, TB and Malaria, with another US$ 60 million to be signed for in round 9.  

UNAIDS will facilitate the coordination, as well as resource mobilization to ensure the implementation of the technical support plan and the EU has approved US$ 500 000 to support its implementation over three years, 70 % of the total need.    

There are an estimated 64 000 people living with HIV in the country with a prevalence of 1.2% in the general population. Significant differences are found between the urban and the rural population, and women carry the largest burden of HIV infection at 1.5% compared to 0.8% among men.

Feature Story

Liberia launches national agenda to improve the health of women and girls

18 October 2010

Liberian President Ellen Johnson Sirleaf, HRH Princess Mathilde of Belgium, and UNAIDS Executive Director Michel Sidibé in Monrovia 18 October, 2010. Credit: UNAIDS

Following a 14-year civil war, Liberia has faced a host of post-conflict challenges that have increased the vulnerability of women and girls to HIV infection, including gender-related violence, poverty, population displacement and limited access to education and health services.

Women and girls represent 58% of the estimated 36 000 people living with HIV in Liberia. HIV prevalence among young women aged 15-24 is about three times higher than that of young men.

Liberian President Ellen Johnson Sirleaf—Africa’s first democratically-elected female head of state—today unveiled a national roadmap for improving the health and well-being of women and girls. Launched in collaboration with HRH Princess Mathilde of Belgium, a Goodwill Ambassador for UNAIDS and UNICEF, Liberia’s new Agenda for accelerating country actions for women, girls, gender equality and HIV aims to:

  • Strengthen data collection and analysis to better understand the impact of the HIV epidemic on women and girls in Liberia
  • Accelerate access to integrated reproductive and HIV services for women and girls
  • Contribute to broader efforts to stop violence against women and girls

Liberia’s national Agenda is based on a global plan developed by UNAIDS and partners to address the gender inequalities and human rights violations that put women and girls at a greater risk of HIV. Speaking at a launch event in Monrovia, President Sirleaf said she was proud that Liberia had been selected as the first country to roll out this national Agenda.

I congratulate President Sirleaf for embracing this Agenda—for recognizing and supporting your most valuable natural resource: women and girls

Michel Sidibé, UNAIDS Executive Director

UNAIDS Executive Director Michel Sidibé, who is on an official visit to Liberia with Princess Mathilde and UNICEF, praised Liberian authorities for placing AIDS and sexual and gender-based violence at the heart of the country’s post-war recovery efforts.

“I congratulate President Sirleaf for embracing this Agenda—for recognizing and supporting your most valuable natural resource: women and girls,” said Mr Sidibé. “Women are the solid centre of human life—of families, communities and care.”

Princess Mathilde focused her remarks on the critical importance of education in solving the nation’s ills. “Education is linked to the well-being of children,” she said. “It gives women the possibility to become economically self sufficient. It gives them the opportunity to decide on matters that concern their own lives. It gives them a voice with which to defend their own interests.”

The three-day joint mission to Liberia, which kicked off today, includes meetings with senior government authorities, associations of people living with HIV, and health and medical providers.

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UNAIDS Executive Director praises Iran’s evidence-informed approach to HIV in prison settings

13 October 2010

Michel Sidibé meets with H.E. Mohammad Reza Rahimi, First Vice President of the Islamic Republic of Iran. Credit: UNAIDS

In nearly all countries, HIV prevalence among prisoners is significantly higher than in general population. A variety of factors contribute to the spread of HIV in prison settings, including unsafe injecting drug use, unprotected sex, tattooing with contaminated equipment and poor prison health services.

In the Islamic Republic of Iran, HIV prevalence among prisoners is about eight times higher than in the general population. Injecting drug use is the main mode of HIV transmission, accounting for more than 70% of reported HIV cases in Iran.

A visit this week to Iran by UNAIDS Executive Director Michel Sidibé highlighted the country’s progressive work in addressing its HIV epidemic in prisons and among people who inject drugs. Iran’s 250 prisons, rehabilitation camps and juvenile correctional centers house approximately 180 000 inmates. Nearly half of all inmates are imprisoned on drug-related charges.

“What I saw in Qezel Hessar Prison is an evidence-based approach marked by tolerance, pragmatism and compassion,” said Mr Sidibé after touring the largest detention center in the region.  “I am impressed with the comprehensive package of HIV prevention, treatment, care and psychosocial support that the prison provides.”

Located near Karaj City, the Qezel Hessar Prison has 19 000 inmates, the majority incarcerated on drug-related offences. The facility offers a wide range of HIV-related services, including opioid substitution therapy, antiretroviral therapy, voluntary testing and counselling, access to condoms and sterile razors, psychotherapy and other behavioral interventions.

Qezel Hessar Prison provides methadone maintenance therapy to more than 2700 inmates on a daily basis, a 30-fold increase since 2003. Like most other prisons in country, married prisoners are allowed conjugal visits with their spouses and are provided with private rooms and condoms.

Executive Director meets senior Iranian officials and people living with HIV

Michel Sidibé meets with a group of HIV-positive people at the "Positive Club" in the Iranian Research Center for HIV and AIDS. Credit: UNAIDS

In meetings with First Vice President Mohammad-Reza Rahimi and other top Iranian officials, Mr Sidibé urged authorities to work towards the goals of “zero new HIV infections among drug users” and “zero newborns with HIV.” Iranian authorities expressed the commitment of the Islamic Republic of Iran to address the HIV epidemic based on the Islamic concept, “If you save one life, you are saving humanity.”

As part of his official mission, Mr Sidibé also visited a “Positive Club” located in the Iranian Research Center on HIV and AIDS. Addressing a group of people living with HIV, he said: “When I hear the words “hope,” “happiness” and “job,” I feel that our efforts have not been wasted.”

During the visit, Mr Sidibé emphasized the work of Iranian health authorities in helping restore the lives and dignity of people living with HIV through the establishment of such Positive Clubs and the provision of information, antiretroviral medicines and other HIV-related services.

Speaking on behalf of people living with HIV, the head of the Positive Club’s council told Mr Sidibé that AIDS is a very difficult area to address. “It requires courage and patience, and you are one of those people who have the courage and patience to work in this area,” he said. “We are happy to have your support, and we are ready to work with you together.”

Feature Story

Plan launched to halve TB prevalence and death rates by 2015

13 October 2010

The Stop TB partnership has launched a Global Plan to Stop TB (2011-2015) aimed at halving tuberculosis (TB) prevalence and death rates by 2015 to reach the Millennium Development Goal of halting and beginning to reverse the epidemic by 2015.

The Plan, launched in South Africa, identifies research gaps that need to be filled to bring rapid TB tests, faster treatment regimens and a fully effective vaccine to the market. It also shows how public health programmes can modernise diagnostic laboratories and adopt the new TB tests which have become available, replacing the century old diagnostic methods still used in many countries.

The Stop TB partnership are calling for US$ 37 billion to finance the plan from 2011-2015 which they estimate will allow them to diagnose and treat 32 million people over the next five years.

Without dramatic increases in funding and political commitment between 2010 and 2015 the Stop TB Partnership estimates that over 50 million people will develop active TB and that over 10 million lives will be lost to the disease which is both preventable and curable.

Every year around half a million people die from HIV-associated TB. If the plan's targets are met, by the end of 2015, all TB patients will be tested for HIV and, if the test is positive, receive anti-retroviral drugs and other appropriate HIV care. In HIV treatment settings, all patients will be screened for TB and receive appropriate preventive therapy or treatment as needed.

“Over a million people living with HIV fall ill with TB every year,” said Dr Paul De Lay, Deputy Executive Director, Programme, UNAIDS. “We need to make sure that all people living with HIV who need it, receive antiretroviral therapy, and that all people living with HIV are screened for TB every time they see a health care worker. This will help us to prevent diagnose and treat TB early and effectively in people living with HIV and avoid unnecessary deaths.”

In July this year the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the Stop TB Partnership signed a memorandum of understanding to combine efforts to halve the number of people living with HIV who die from TB by 2015, compared to 2004 levels. The memorandum also outlines the importance of providing life-saving antiretroviral treatment for all TB patients living with HIV.

The Global Plan to Stop TB was launched by the South African Minister of Health, Dr Aaron Motsoaledi at a press conference held in the Pholosho Primary School in Alexandra which teaches more than 2000 children from the region.

Following the launch speakers from the press conference, together with children from the school, participated in a football tournament as part of the Kick TB Campaign. This is a campaign which seeks to combat TB as well as the stigma associated with it, by fusing sport and social mobilization to create a platform through which TB messages can be effectively conveyed.

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Charity event in Ukraine boosts youth awareness of HIV prevention

12 October 2010

Participants in "Race for Life" charity event receive award. Credit: UNAIDS

“A healthy future starts with you” was the slogan of Race for Life, a charity event held on 9 October in Kiev, Ukraine. Over 3000 people gathered in Kiev’s city center to support people living with HIV, raise money for children born with HIV, and express their readiness to join hands to halt the epidemic.   

Ukraine is one of the countries most heavily affected by HIV in the region. According to UNAIDS estimates, around 440 000 people are living with HIV in Ukraine, representing over 1% of the adult population. Every day, some 50 new cases of HIV are registered in the country.

In recent years, various sectors of Ukrainian society have united their efforts to respond to the country’s rapidly-growing HIV epidemic. The Ministry of Education, Kiev city administrations, media organizations, the private sector, non-governmental organizations and community organizations were among the organizers of this year’s race.

Race for Life is a tool for social mobilization in the overall response to the epidemic, especially in public awareness,” said Svetlana Cherenko, Chairman of the Committee on Combating HIV in Ukraine’s Ministry of Health. HIV prevention among youth is one of the country's main priorities.

Initiated by the UN Office in Ukraine in 2001, Race for Life was held annually until 2005. The event was organized again this year to convey healthy lifestyle and HIV prevention messages to youth.

“We must continue talking to young people about HIV transmission, about prevention, about personal responsibility. Everything is in their hands today—their health, their life and their future,” said Denis Broun, UNAIDS Regional Director for Europe and Central Asia, who also ran 3 kilometers in the race.

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African law students argue against criminalisation of HIV transmission

12 October 2010

Dr Meskerem Grunitzky Bekele, Director of the UNAIDS Regional Support Team for West and Central Africa and Maître Robert Dossou, President of the Constitutional Court of Benin (centre), with students from the winning team of the 19th African Human Rights Moot Court Competition. Credit: UNAIDS

More than 120 young law students from 60 universities representing 24 African countries gathered in Cotonou (Benin) from 4-9 October 2010 to compete in the 19th African Human Rights Moot Court Competition.

Law students argued on a hypothetical human rights case as if they were before the African Court on Human and Peoples’ Rights. Law lecturers served as judges in the preliminary rounds and internationally recognised human rights law experts adjudicated the final round of the competition.

Held in a different country each year, this annual competition was organised by the Centre for Human Rights at the University of Pretoria (South Africa) in collaboration with the UNESCO Chair in Human Rights and Democratisation at the Université d’Abomey-Calavi in Benin.  

“The competition provided an amazing opportunity for us, law students, to put our legal training into practice,” said Ms Evy Carole Bouo, from the Université de Cocody (Cote d’Ivoire) who participated in proceedings. “It gave us the chance to meet and interact with prominent African and international legal and human rights experts,” she added.

This year’s hypothetical case raised several human rights issues, including the criminalisation of HIV transmission. Human rights and health experts, civil society organisations and people living with HIV have raised concerns in relation to laws criminalising HIV transmission on the grounds that the overly-broad application of these legal provisions may reinforce HIV-related stigma. Such laws may also deter people from seeking HIV prevention, treatment and care services for fear of prosecution, and may lead to human rights violations.

In their written submissions, students argued, among others, that the overly-broad criminalization of HIV transmission is contrary to the principles of justifiable limitations of human rights provided under the African Charter on Human and People’s Rights and international law.

The removal of “punitive laws, policies, practices, stigma and discrimination that block effective responses to HIV” is one of UNAIDS priority areas as outlined in its Outcome Framework 2009-2011.

During this year’s Moot Court Competition, UNAIDS, UNFPA and UNESCO launched a project, in collaboration with the Centre for Human Rights at the University of Pretoria to compile information on the legal and policy issues relating to HIV and young people in Africa. The project will map laws and policies related to access to HIV-related education for young people, the minimum age of consent to HIV testing, and access to HIV prevention and treatment for young people.

Professor Frans Viljoen, Director of the Centre for Human Rights, noted that this joint initiative with UNAIDS, UNFPA and UNESCO “shows the relevance of the Moot Court Competition for human rights education in Africa and also for getting students involved in a critical research project that can positively influence legal and policy debates in their countries and beyond.”

Speaking at the closing ceremony of the competition, Dr Meskerem Grunitzky Bekele, Director of the UNAIDS Regional Support Team for West and Central Africa emphasised the importance for young law students to get involved in the discussions on complex issues related to HIV and the law.

“An enabling and protective response to HIV that challenges discrimination and empowers all individuals, including young people, to access HIV prevention, treatment and care services is needed today more than ever”, Dr Bekele said.

The inclusion of HIV in this year’s case afforded participants the chance to apply their understanding and knowledge of human rights theory to contemporary issues of concern in Africa such as HIV.

The winner of this year’s competition was the team composed by the Université de Cocody, Côte d’Ivoire (Ms Evy Carole Bouo and Mr Jean-Camille Kouadio), the University of Namibia (Ms Stephanie de Klerk and Mr Albert Titus), and Rhodes University, South Africa (Ms Ingrid Cloete and Mr Fausto Di Palma).

Established in 1992, the African Human Rights Moot Court Competition is the largest annual gathering of law faculties in Africa. It was awarded the UNESCO Prize for Human Rights Education, recognising it as the most far-reaching human rights educational initiative on the continent. Over the past 19 years, it has brought together thousands of students from 131 universities in 48 African countries.

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High-level mission urges Vietnam to optimize use of resources to achieve universal access

08 October 2010

Leaders in Vietnam’s AIDS response urged to optimize resources and focus HIV interventions for key populations at higher risk to help achieve targets for universal access. 

The delegation met with Deputy Prime Minister Truong Vinh Trong. Credit: UNAIDS

A UN high-level delegation headed by the UN Secretary General’s Special Envoy for HIV/AIDS in Asia and the Pacific, Dr Nafis Sadik and Special Advisor to the UNAIDS Executive Director, Mr JVR Prasada Rao visited Vietnam this week to discuss its AIDS response with key stakeholders—including Deputy Prime Minister Truong Vinh Trong, Chairman of the National Committee for AIDS, Drugs and Sex Work Prevention and Control. 

The UN high-level mission to Vietnam is part of a regional assessment across countries in Asia and the Pacific taking place over 2009-2010 to improve the effectiveness of AIDS responses in the region. 

The HIV epidemic in Vietnam is concentrated among key populations at higher risk. While HIV prevalence among adults aged 15-49 is estimated at 0.44%, prevalence is significantly higher among men who have sex with men, intravenous drug users and sex workers in the country. 

Development and provision of a standard package of HIV prevention, treatment, care and support services for key populations of higher risk are among the priority actions recommended by the UN delegation for the country. 

The delegation met with People Living with HIV in Hai Phong City. Credit: UNAIDS

Vietnam has seen recent progress in its response to HIV. The country has scaled up needle and syringe programmes over the past two years. In 2009 drug use was decriminalized which has helped create a more supportive environment for harm reduction interventions. The total increase in the number of clean needles and syringes distributed went from two million in 2006 to 24 million in 2009. 

A recent study found that 94.6% of male intravenous drug users reported using sterile injecting equipment the last time they injected and HIV prevalence among the drug using population has declined from a high level of 29.4% in 2002 to 18.5% in 2009. 

“I am impressed with the strong commitment and leadership showed by Deputy Prime Minister Truong Vinh Trong and leaders of the relevant ministries in addressing HIV,” said Dr Sadik. “This is essential to make policy change happen to scale up access to HIV services.” 

“Vietnam should calculate the financial resources needed to support a comprehensive response to HIV up to 2015 and aim to provide at least one third of the total amount from government budgets to ensure the sustainability of the national response,” Mr Prasada said, underlining the delegation’s recommendations. 

The UN delegation discussed the national response to HIV with a wide range of stakeholders including National Committee members, donors, local and international civil society organizations, provincial HIV authorities, people living with HIV, people at higher risk of HIV infection and the Joint UN team on HIV in Vietnam. 

Civil society representatives underlined the need for increased and sustained resources. “There are two districts in our Hai Phong City still not covered by HIV interventions and people living with HIV there are suffering from stigma, discrimination and lack of access to services,” said Ms. Doan Thi Khuyen, member of a self-help group in their meeting with the delegation. 

“I would like you to advise HIV authorities to provide more resources so that services are available in all districts,” she proposed. 

The delegation will make recommendations for Vietnam to achieve its universal access targets and the AIDS-related MDG, identify the main gaps and barriers and actions to achieve them, and the financial resources and technical assistance needed.

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