UNAIDS Executive Director Michel Sidibé (second from left) met with His Excellency the Governor General of PNG, Grand Chief, Sir Paulius Matane (middle) during his official visit to Papua New Guinea. 25-26 August 2010. Credit: Noreen Chambers

Approximately 0.92% of the adult population in Papua New Guinea was living with HIV in 2009, according to new estimates from the National Department of Health and the National AIDS Council Secretariat.

This latest round of estimates of HIV prevalence—carried out by a panel of national and international experts—is based on extensive data from antenatal clinics in Papua New Guinea’s Highlands, Southern, Momase, and New Guinea Islands regions.

In recent years, there has been a substantial increase in the number of health facilities in Papua New Guinea conducting HIV tests among pregnant women—from 17 in 2005 to 178 in 2009. New data collected at these facilities have provided a clearer picture of the country’s HIV prevalence than ever before.

“These new estimates have greatly enhanced our understanding of the scale and scope of Papua New Guinea’s AIDS epidemic,” said UNAIDS Executive Director Michel Sidibé, in an official visit to Papua New Guinea. “They provide an opportunity to redouble our efforts to achieve universal access to HIV prevention, treatment, care and support.”

An estimated 34 100 people in Papua New Guinea were living with HIV in 2009. HIV prevalence was found to be the highest in the country’s Highlands and Southern regions, at 1.02% and 1.17%, with lower but increasing prevalence in Momase and New Guinea Islands, at 0.63% and 0.61%. Approximately 3200 people in Papua New Guinea were newly infected with HIV in 2009 and, that same year, some 1300 people died of AIDS.

Papua New Guinea had previously projected a higher national HIV prevalence for the year 2009, based on data from a relatively small number of rural and urban sites. The downward revision in estimates reflects—to a large extent—improvements in national disease surveillance systems. The new findings also indicate that the spread of Papua New Guinea’s HIV epidemic may be levelling off.

“The risk factors that contribute to HIV infection in Papua New Guinea have not changed,” said Mr Sidibé. “We cannot afford to be complacent or reduce investments in the country’s AIDS response.”

The Youth Olympic Games provide an opportunity to highlight the role of young people in promoting HIV prevention. Credit: UNAIDS

AIDS-inspired dance workshops, sports games with an HIV awareness-raising twist and make-your-own plasticine prevention messages were highlight activities coordinated by UNAIDS at the first-ever Youth Olympic Games, as part of the culture and education programme designed to encourage young Olympic athletes to learn more about issues of well-being, healthy lifestyle and social responsibility.

Throughout the proceedings of the Youth Games, held in Singapore from 14 to 26 August, a UNAIDS booth and a series of workshops addressed sexuality and HIV transmission, including myths and misconceptions, through interactive games, peer-to-peer discussion and innovative dance and drama methods.

Hosted in the Olympic village, the activities were accessible to the 3600 participating young athletes aged 14-18 and 1400 team officials. Every day, hundreds of young athletes visited the UNAIDS booth and workshops, with all activities coordinated and delivered by volunteers from UNAIDS event partners Y-PEER from the Philippines, Singapore-based organization BEADS as well as Youth Olympic Games volunteers.

“Despite language barriers, we were able to unite and channel energies of athletes coming from different cultures and backgrounds to talk about HIV and reiterate the need for protection and awareness,” said Y-PEER volunteer Mario Balibago.

While visiting the UNAIDS booth, athletes were encouraged to post updates to the UNAIDS Facebook page. “HIV is a good thing to talk about with the youth and to share… all over the world. Protect yourself and show love for people with HIV,” posted Kernesha Spann, a young 400m runner from Trinidad and Tobago.

The UNAIDS booth also received a number of high-profile visitors including Mr Jacques Rogge, President of the International Olympic Committee, and Mr Wilfried Lemke, the UN Secretary-General’s Special Advisor on Sport and Development, who both commended the use of innovative formats to reach young people with HIV messages through sport.

The partnership with the Youth Olympic Games is geared towards emphasizing UNAIDS’ priority area of empowering young people to protect themselves against HIV and as part of activities in support of the International Year of Youth, which commenced on 12 August. Following the successful interventions in Singapore, UNAIDS will continue to work with the International Olympic Committee to strengthen the partnership, including exploring the development of a cadre of Youth Athlete Champions for HIV.

“Sport is an incredible channel for getting HIV messages out to young people. As well as the athletes, the volunteers working with us at the booth also became hugely sensitized on HIV issues and wanted to spread the word further,” said Dawn Foderingham, Partnerships Advisor at the UNAIDS Regional Support Team for Asia and the Pacific who coordinated UNAIDS’ participation in the Youth Games. “Young people are champions both on and off the field and their leadership on HIV can have critical impact,” she added.

Asia-Pacific Year of Youth launch roundtable panel. Credit: UNAIDS

HIV and sexual and reproductive health has been identified as a central theme for discussion as part of the International Year of Youth, a United Nations (UN)-led initiative launched this month by the Secretary General Ban Ki-moon.

Under the overarching theme of “dialogue and mutual understanding,” the Year of Youth aims to promote peace, respect for human rights and solidarity across generations through activities that highlight issues of increasing importance for youth—including HIV, the environment, hunger and employment. Young people are encouraged to participate in local and global efforts to achieve internationally-agreed targets, such as the Millennium Development Goals.

With young people aged 15-24 accounting for 40% of all new HIV infections, increased youth engagement in the AIDS response is critical. Empowering young people to protect themselves from HIV is one of ten UNAIDS priority areas, with the overall goal of a 30% reduction in new HIV infections by 2015. UNAIDS has committed to achieving three ‘bold results’ in at least nine of the 17 high-burden countries. These include:

• ensuring at least 80% of young people in and out of school have comprehensive knowledge of HIV;
• doubling young people’s use of condoms;
• doubling young people’s use of HIV testing and counselling services.

Youth in Asia-Pacific call for open dialogue on HIV

UNAIDS National Goodwill Ambassador for China, CCTV presenter and moderator of the Asia-Pacific Year of Youth launch James Chau listens to interventions from young people. Credit: UNAIDS

At the Asia-Pacific launch of the Year of Youth in Bangkok, Thailand, young people from across the region underlined limited access to sex education and HIV-related information as key areas of concern. During the launch event—a roundtable dialogue between youth representatives, heads of UN agencies and government officials, moderated by UNAIDS Goodwill Ambassador for China and television presenter James Chau—young participants highlighted the need for parents and others to “get outside their comfort zones” in order to better reach youth with information on sex and HIV.

“My parents have talked to me openly about sex and HIV for as long as I can remember,” said Benya, a 14-year-old high school student from Bangkok. “I think this helps me make good choices in my life.”

Young participants emphasized that greater access to evidence-based information on HIV and sexual and reproductive health, through both traditional and new media channels, was critical for youth empowerment on HIV-related issues.

Steve Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific, underscored that evidence shows that when young people are given accurate information about sex and HIV, they choose to have sex later, with fewer partners and increased use of condoms.

Steve Kraus, Director of the UNAIDS Regional Support Team, underlines that young people are “leading the prevention revolution.” Credit: UNAIDS

“Young people are leading the prevention revolution. Recent data show that HIV prevalence has dropped by 25% among youth in 15 of the highest-burden countries. We have to continue this momentum,” said Mr Kraus. “The International Year of Youth provides a key opportunity for us to massively increase our emphasis on bringing young people to the table and ensuring their voices are heard in the important debates on HIV.”

For the Asia-Pacific region—and across the world—the Year of Youth launches will be followed by a series of targeted activities to showcase youth contributions to development, encourage dialogue and highlight the benefits and significance of youth participation in all aspects of society.

Opening ceremony of the Youth Olympic Games, Singapore, 14 August 2010. Credit: SPH-SYOGOC/Alphonsus Chern

During the next two weeks, Singapore is making Olympic history by being the host of the first-ever Youth Olympic Games, opening on 14 August 2010.

The Youth Olympic Games, to be held every two years (alternating Summer and Winter), is an international high-level sporting event for young people, which offers a balance of sport, culture and education. The Games were created to educate, engage, and influence young athletes, inspiring them to play an active role in their communities.

Around 370,000 spectators will gather to watch young athletes, aged 14 to 18 from around the world, participate in Singapore 2010. The inaugural games include high-level competition in 26 sports categories and a Cultural and Education Programme focused on a variety of themes including the Olympic values. It will also consist of skills-building sessions for participants, including on HIV.

As young people account for 40% of all new HIV infections globally, placing young people in the driving seat to halt and to begin to reverse the HIV epidemic is crucial.

“Young athletes are role models in their communities. We need to call on these young people to lead the prevention revolution if we are to reach UNAIDS vision of Zero new infections,” said Mr Michel Sidibé, UNAIDS Executive Director, “Sports can be a powerful vehicle to come about change in societies around the world.”

UNAIDS has partnered with the Singapore Youth Olympic Games Organising Committee (SYOGOC) in the context of its overall partnership with the International Olympic Committee (IOC) in order to provide HIV prevention information and raise awareness about HIV among young people during the two weeks of the Games.

Credit: IOC

“HIV awareness and prevention campaigns are most effective when addressed to the youth” said Mr Jacques Rogge, President of the International Olympic Committee. He added: “Sport is a powerful tool for reaching out to today’s youth on all continents and for educating them early on about healthy and responsible behaviours.”

UNAIDS, together with civil society organizations, will conduct a series of workshops focusing on adolescent sexual and reproductive health as well as stigma surrounding HIV under the educational theme “Well-Being and Healthy Lifestyle.” Workshops will be open to the estimated 3,600 young, athletes and 1,400 officials in the Olympic Village.

The workshops will be run in collaboration with Y-PEER, a youth-to-youth initiative, and BEADS, a Singapore organization. The sessions will use dance and competitive games to address topic such as sexuality and HIV transmission, and addressing myths and misconceptions about HIV.

The content of these interactive sessions has been developed specifically for the Youth Olympic Games to engage athletes. In addition, condoms have been made available for free at the medical clinics.

Sport is recognized as a powerful communication tool and is unique in its ability to unify and galvanize people all over the world. In recognizing the importance of sports for development, the partnership with the Youth Olympic Games is geared towards one of UNAIDS’ ten priority areas namely to empower young people to protect themselves against HIV.

Chinese Vice President Xi Jinping (R) meets with Michel Sidibé (L), executive director of UNAIDS in Beijing, 11 August 2010. Credit: Xinhua/Pang Xinglei

UNAIDS Executive Director Michel Sidibé met with top Chinese government leaders yesterday in Beijing to discuss China’s AIDS response. In meetings with Vice President Xi Jinping and Vice Minister of Health, Yin Li, Mr Sidibé commended China for its strong political commitment to the AIDS response, and outlined workable recommendations to strengthen China’s AIDS response.

In discussions with Vice President Xi Jinping, Mr Sidibé noted that China’s achievements in recent decades with regard to poverty reduction, expanding access to education, and reducing mortality and extending life expectancy have been truly astonishing. “China’s progress has strongly demonstrated the commitment of the Chinese government to delivering on human development and its MDG commitments,” said Mr Sidibé. “However, there is still work to be done, and significant scaling-up of quality HIV treatment and prevention efforts will be necessary if MDG 6 (halting and reversing the HIV epidemic) is to be achieved in China.”

Mr Sidibé urged the Chinese government to set targets to halve HIV infections and deaths from AIDS by 2015, in order to meet and exceed MDG 6, and halt and reverse China’s HIV epidemic.

During their meeting at the Great Hall of the People on Wednesday, Vice President Xi said, “the Chinese government attached great importance to the prevention of HIV, which has become the country's leading infectious disease killer. With increased funding for anti-AIDS programs, China has implemented prevention, treatment and care policies to secure the rights and interests of people living with HIV.”

During the meeting Mr Xi also vowed to support appeals from the United Nations and the international community to bolster south-south cooperation with Africa and push for the realization of Millennium Development Goals worldwide.

While in Beijing, Mr Sidibé also took the opportunity to present awards to Vice Minister Yin Li and Mr Li Jingwu of the Law Office of China’s State Council, in recognition of their considerable commitment and contribution to China’s AIDS response.

UNAIDS Executive Director, Mr Michel Sidibé, delivers a keynote speech on "HIV in Cities of the 21st Century” at the International Forum on Cities and Health, 9 August 2010, Shanghai, China Credit: UNAIDS 

Approximately half of the world’s population lives in cities. By 2050, seven out of ten global citizens will be living in a “mega-city” of more than 10 million people. In an official visit this week to Shanghai—one of the world’s largest metropolises—UNAIDS Executive Director Michel Sidibé called attention to the central role that cities can play in the AIDS response.

“While it is clear that cities are important to the HIV response, they have not been sufficiently mobilized and supported to act,” said Mr Sidibé, addressing an audience of more than 100 health sector leaders and practitioners from across China. “I believe that it is time for this to change and for cities to take the lead in making HIV history.”

The rapid growth of cities has created conditions where HIV can thrive. Globally, it is estimated that as many as 50% of HIV-positive people live in cities. In some urban areas, the HIV epidemic is so pervasive that it is compares to national epidemics of entire countries.

Noting that city governments have administrative power and well-established systems for delivering social services, Mr Sidibé urged city authorities to mobilize all available resources to ensure universal access to HIV prevention, treatment, care and support. To that end, only a few cities, he said, have shown bold leadership and acted in a timely manner.

UNAIDS Executive Director, Mr Michel Sidibé, delivers a keynote speech on "HIV in Cities of the 21st Century” at the International Forum on Cities and Health, 9 August 2010, Shanghai, China Credit: UNAIDS 

Efforts by the city of Bangkok to reduce HIV prevalence among sex workers provide one such success story. In collaboration with health providers, the police, entertainment industry owners, non-governmental organizations and sex workers, authorities in Bangkok launched a city-wide campaign in the early 1990s promoting 100% condom use. Over the course of 20 years, HIV prevalence among the city’s brothel-based sex workers has fallen significantly.

While in Shanghai, Mr Sidibé commended Chinese leaders on the country’s progress in scaling up methadone maintenance treatment and needle exchange programmes in large cities, which have been critical in reversing the HIV epidemic among injecting drug users. “I encourage China to continue to expand these programmes—particularly at the community level—and to reconsider whether drug detention centres are really effective as part of a national strategy to prevent HIV transmission,” he said.

Other cities facing burgeoning HIV epidemics among injecting drug users, such as Sydney, Toronto and Geneva, have implemented cost-effective harm reduction programmes, including needle exchange and opiate substitution therapy, stemming the tide of new HIV infections.

Mr Sidibé challenged China’s cities to be at the forefront of localized AIDS responses that address, in particular, the needs of populations at higher risk of HIV infection, such as men who have sex with men, migrant workers, sex workers and injecting drug users. He called on Shanghai to build on the momentum of Expo 2010, uniting and mobilizing mega-cities of the world to become HIV-free by 2015.

The World Health Organization (WHO) has launched a web-based consultation to seek input on the development of the WHO Global Health Sector Strategy for HIV/AIDS, 2011-2015.

The Sixty-third Session of the World Health Assembly adopted a resolution requesting that the World Health Organization (WHO) Director-General develop a WHO HIV/AIDS Strategy for 2011-2015, through a broad consultative process.

You are invited to provide your feedback on the consultation materials found on the WHO web site. These materials will be available in Arabic, Chinese, English, French, Russian and Spanish.
Comments should be submitted by 31 August using this online form. Where possible, please submit your comments in English to facilitate the synthesis of all inputs.

The 2011-2015 strategy will:

• Build on the achievements and experiences of the "3 by 5" initiative and the five strategic directions of the WHO HIV/AIDS Universal Access Plan 2006-2010;
• Take into consideration the broad global HIV, health and development architecture, including the UNAIDS Strategy (under development) and UNAIDS Outcome Framework, and existing commitments to achieving Universal Access and the Millennium Development Goals;
• Identify existing and agreed global targets to motivate countries to plan for bold HIV responses through to 2015;
• Provide guidance to countries on how to prioritize their HIV and broader health investments;
• Provide a framework for concerted WHO action at the global, regional and country levels and across all relevant WHO departments.

WHO works in partnership with a broad range of constituencies, including Member States, civil society, donor and development agencies, non-governmental organizations, multilateral agencies (including the UN family), scientific and technical institutions and networks, and the private sector. WHO is committed to a consultation process that involves all key stakeholders and constituencies in the development of the Global Health Sector Strategy for HIV/AIDS, 2011-2015.

Field staff training for the size estimation study in Sri Lanka.
Credit: Dr. Ajith Karawita

HIV prevalence in the general population of Sri Lanka is very low at 0.1%. However data indicates that people who buy and sell sex and men who have sex with men are at risk of HIV infection yet little is known regarding the size of these groups making it difficult to guide the country’s HIV prevention efforts.

To build a baseline of strategic information, the Joint UN Team on AIDS at the request of the National STI/AIDS Control Programme in Sri Lanka, supported the development of a mapping and size estimation methodology for key populations. The World Bank provided technical assistance and UNFPA and UNAIDS gave top-up funding to ensure that communities in four districts could use the methodology.

The study’s findings, published in May 2010 estimate between 35 000 to 47 000 sex workers and between 24 000 to 37 000 men have sex with men in Sri Lanka.

Partnership key for effective HIV prevention

A constructive new partnership has emerged from the process. Representatives of men who have sex with men and sex workers met regularly with senior government officials from the Police and the Ministry of Health to implement the public health programme.

“For the first time in Sri Lanka a public health issue is being addressed by non-traditional stakeholders who have come together for a common cause—the prevention of HIV among key populations at higher risk,” said Dr Palitha Mahipala, Additional Secretary – Ministry of Healthcare and Nutrition and chair of the steering committee created to guide implementation.

Community groups were briefed by a team who worked on similar exercises in Pakistan and India who ensured that the methodology was adapted for easy use in Sri Lanka.

“Community members received excellent training on planning of field work, data collection, data entry, analysis and basic knowledge on micro planning for prevention services for sex workers from the University of Manitoba,” said Chandra Kanthi Abeykoon, Project Coordinator Community Strength and Development Foundation.

Filling the evidence gaps

The mapping was first undertaken in Colombo and Anuradhapura where initial results suggested that the numbers of sexually active men who have sex with men and sex workers were much higher than previously thought. According to the study team, participants from the community organizations appreciated the value of understanding exactly where hotspots for sex work are to ensure that HIV prevention programmes reach people in need of services.

Guarding the confidentiality of participants was a key concern in the project. In order to safeguard identities it was agreed that only community groups had access to the data with street names and locations which is relevant for prevention outreach activities.
The mapping was extended to Batticaloa and Nuwara Eliya. The National STD/AIDS Control Programme has used the broader averaged data from three of the districts to feed into the national estimates process where the country has been able to produce an evidence-based national estimate for key populations at higher risk for the first time.

During the project, the study team faced some challenges where local authorities intervened and questioned the exercise as it concerned behaviors that are regulated by punitive laws: both homosexuality and sex work are illegal in Sri Lanka.  Members of the study team from the Ministry of Health and community organizations travelled to the research sites to meet with district officials to discuss and agree on the goals of the exercise.

Building momentum

Building on the prevention partnership established, the Government and civil society successfully applied for a grant from round 9 of the Global Fund to Fight AIDS, TB and Malaria. The grant, approved in early 2010, will enable the mapping exercise to be extended across the country and be complemented with prevention outreach to these key populations as well as to people who inject drugs, in prison settings.

“This process has been a critical first step in building effective prevention for key populations at higher risk here in Sri Lanka,” said David Bridger, UNAIDS Country Coordinator.

“A comprehensive package of prevention for key populations at higher risk in of HIV infection in Sri Lanka is a solid way of ensuring that HIV will remain at low levels in this country,” he added.

However barriers to effective prevention still remain and will continue to affect the implementation of the Government’s HIV prevention programme for key populations at higher risk over the next 5 years. Laws that criminalize certain behaviour push populations at higher HIV risk underground and away from HIV prevention services will need to be raised and more openly discussed. 

(from left) H.E Azeb Mesfin, First Lady of Ethiopia, Chair of OAFLA and Mr Michel Sidibé, UNAIDS Executive Director. 27 July 2010, African Union summit.

In its 8th General Assembly, members of the Organization of African First Ladies against HIV and AIDS (OAFLA) gathered in Kampala, Uganda, to deliberate on the theme of “Maternal and Child Health.” The First Ladies renewed their commitment to champion the well-being of African women and children in a Declaration presented at the end of the meeting.

In her welcome remarks, Mrs Janet Museveni—host of the General Assembly and First Lady of Uganda—expressed her gratitude to all partners who have supported the efforts of OAFLA across Africa since 2001. Sharing Ugandan success stories from the 1990s, she encouraged her fellow First Ladies to use their positions to accelerate the HIV response in their respective countries. “We, the First Ladies of Africa, are supremely positioned to contribute, and even spearhead, HIV prevention campaigns—this is how we will drastically reduce the escalating numbers of new HIV infections among our populations,” she said.

Mrs Azeb Mesfin, First Lady of Ethiopia and Chair of OAFLA, urged her fellow members of OAFLA to continue to use their roles to address HIV in collaboration with partners around the world.

“As African women and First Ladies, we have a tendency to downplay our strengths and achievements,” she said. “HIV in Africa is an African problem and we, as Africans, will work together to find the solution. This does not mean that we do not appreciate the generous support of our friends across the globe. It means that we will provide the leadership necessary to fight this epidemic.”

Speaking at the OAFLA General Assembly, UNAIDS Executive Director Mr Michel Sidibé congratulated African First Ladies for playing a leading role in saving mothers and preventing new HIV infections in children—a major concern for UNAIDS. “As First Ladies of Africa, you can be at the forefront of preventing mothers from dying and preventing babies from becoming needlessly infected with HIV.” He also lauded OAFLA’s “Save the Unborn Child” campaign, which has invigorated countries to push harder to reduce child mortality in Africa.

Mr Sidibé called on the First Ladies to encourage governments, communities, women’s groups, and the AIDS movement to support their efforts to save the lives of mothers and children in Africa. He announced that UNAIDS and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) will grant US$ 300,000 to OAFLA to support the development of regional and national activities to prevent mother-to-child transmission of HIV and address barriers affecting the scale-up of essential services to eliminate pediatric AIDS.

UN Cares

On 29 July 2010 UN Secretary-General Ban Ki-moon awarded a "special commendation" to UN Cares during the UN 21 Awards at UN Headquarters in New York.

UN Cares is an inter-agency programme designed to reduce the negative impact of HIV on the UN workplace by educating UN staff and families on HIV and provide support for staff living with HIV.

The programme is designed to help staff and families to access their rights defined in the 1991 United Nations HIV/AIDS Personnel Policy and in the ILO Code of Practice on HIV/AIDS and the World of Work and recognize their individual responsibilities related to HIV. The global programme was launched in May 2008.

Developed through interagency consultation between UNAIDS Cosponsors and other UN bodies, UN Cares is available to UN system personnel and their families in all entities and all duty stations.

“This commendation by the Secretary-General acknowledges the outstanding global effort from UN colleagues worldwide and those who volunteer their time to disseminate UN Cares messages in the UN workplace,” said Ms Jan Beagle, UNAIDS Deputy Executive Director, Management and External Relations.

“UNAIDS plays a vital role in supporting UN Cares and the award highlights the great work of UNAIDS staff around the world in support of this groundbreaking programme that benefits thousands of UN employees and family members worldwide,” Ms Beagle added.

UN 21 Awards

The UN 21 Awards annual awards were established as part of the reform effort by the former Secretary-General Kofi Annan in 1996 to provide recognition to staff members for innovation, efficiency and excellence in the delivery of the Organization's programmes and services. Commendations are given for excellence and/or outstanding inter-agency coordination.