From the left: Maria Antoniela Alcalde, Paul de Lay, UNAIDS Deputy Executive Director; Olayide Akanni; Kieran Daly, Elena Grigoryeva at the‘ICASO satellite on Universal Access’, Session Room 7 at AIDS 2010, Vienna, Austria on 19 July 2010
Credit: UNAIDS/Anna Rauchenberger

At a satellite session on universal access to HIV prevention, treatment, care and support, panelists discussed target setting and review process to date, drawing on community analysis from countries over the last few years. The session aimed to start a debate on how, in many countries, genuine targets for universal access (UA) are not being set, especially for populations at higher risk of HIV infection.

The session, titled 'Fool me Once, Shame on you... Fool me twice, Shame on me: Key population leadership for Universal Access', was organised by the International Council of AIDS Service Organizations (ICASO).

Panelists included UNAIDS Deputy Executive Director, Programme, Dr Paul De Lay, who discussed UNAIDS' analysis of the current situation, particularly at the country level, including target setting for key populations.

“Significant strides have been made since 2006 in achieving universal access, such as a 12-fold increase in access to services for prevention of mother-to-child HIV transmission, but by the end of 2010, only one-third of countries will have reached the UA targets they set,” said Dr De Lay.

“National targets need to be set that get at the heart of the issues facing vulnerable and key populations,” he added.

Talking about UNAIDS' commitment to providing universal access, Dr De Lay said, "It may be tempting to blame someone for not reaching universal access. But we need to keep ourselves focused on what we need to do, rather than what we did not yet do."

In 2006 governments committed, in the form of a Political Declaration on HIV/AIDS, to providing universal access to HIV prevention, treatment, care and support services to all those in need by 2010. During its recent Programme Coordinating Board meeting, UNAIDS proposed to call on the General Assembly to extend the commitment to universal access to 2015, and to report back on its progress in June 2016. This was not without reason.

Over the past years many countries have brought in new legislation protecting the rights of key populations, particularly those of men who have sex with men and transgender communities. While on the other hand, there still remain several others that have new legislation, or are planning new legislation, that will drive key populations further away from services.

"As you see a polarization of conservative and liberal values in individual countries, we see this playing out on the world stage," Dr De Lay explained.

In such a scenario, there is a need to revitalize monitoring to assist countries and set targets that will reduce sexual transmission, empower men who have sex with men, sex workers and transgender people to protect themselves, protect drug users from becoming infected and remove punitive laws, policies and practices, stigma and discrimination.

Ahead of the official opening of the XVIII International AIDS Conference, a town hall event saw the coming together of influential leaders in the AIDS response to share their insights of what the future of HIV prevention and treatment must look like if the goal of zero new infections and zero AIDS deaths is to be reached by 2015.

Organized by UNAIDS and the International AIDS Society (IAS), the town hall event “Towards a paradigm shift in HIV treatment and prevention” engaged dynamic leaders Kgalema Motlanthe, Deputy President of South Africa, Michel Sidibé, Executive Director of UNAIDS, and Julio Montaner, President of the International AIDS Society, in a discussion on HIV prevention, treatment, investments and human rights.

The Deputy President of South Africa underscored his country’s commitment to the HIV response despite the financial crisis that threaten gains made, such as increased access to treatment and for the first time declining rates of new HIV infections among young people.

“Even as the world experiences an economic downturn, investments in the fight against HIV must not be the soft target for austerity measures,” said Mr. Motlanthe. “South Africa has prioritized the AIDS response as an investment in life, hope, health systems, and human development with the view to improve the quality of life.”

By taking AIDS further out of isolation, the Deputy President underscored that his country could see significant reductions in maternal and infant deaths. He called on all countries to renew the commitment to universal access by bringing it in line with the MDG timeframe of 2015.

Following Mr. Motlanthe’s speech, Mr. Sidibé spoke on Treatment 2.0, a radically simplified treatment platform that UNAIDS believes could have secondary benefits for prevention. “Let’s be realistic: Costs for treatment are rising. People are starting to lose hope and we need to bring the hope back,” said Mr. Sidibé. “We need drugs that are cheaper, easier to administer, and diagnostics that are simpler to use. Treatment for prevention is not just a dream. It is possible if we share the responsibility.”

Together with Treatment 2.0, Mr. Sidibé said a ‘prevention revolution’ is required to break the trajectory of the epidemic. He said this revolution will not happen without “prevention diplomacy” with the leaders like those who were assembled at the town hall.

Julio Montaner, IAS President, shared his optimism for the merging of prevention and treatment efforts and said that by treating more people, new HIV infections can be reduced.

Following the opening segment, the town hall’s host, James Chau, news anchor with China Central Television (CCTV) and a UNAIDS National Goodwill Ambassador for China, engaged the audience in an interactive panel discussion on prevention and treatment with Barbara Lee, US Congresswoman, 9th District of California, Rolake Odetoyinbo, Executive Director of Positive Action for Treatment Access, Mphu Ramatlapeng, Minister of Health and Social Welfare of Lesotho, and Claudia Ahumada of the World AIDS Campaign.

The panellists shared their personal perspectives of the challenges and progress in implementing HIV prevention, treatment, care and support services as well as ensuring human rights.

The town hall featured a special appearance of UNAIDS International Goodwill Ambassador Annie Lennox who spoke passionately on why she is engaged in the response.

“I don’t want to see any mother die of a preventable disease. Why should that be?” she asked the audience. “HIV is the leading killer of women of reproductive age globally. Why doesn’t the world respond to this? I will keep campaigning until we see the kind of changes Michel Sidibé is talking about.”

Ms Lennox closed the event by asking the leaders and activists who shared the stage and those in the audience to “recommit to the response and take it further.”

HRH the Crown Princess of Norway and UNAIDS Executive Director Mr Michel Sidibé, Vienna, 17 July 2010. Credit: UNAIDS/Heimo Aga 

Young leaders from around the world joined HRH the Crown Princess of Norway and UNAIDS Executive Director Mr Michel Sidibé and others to exchange experiences on leadership in the AIDS response during a formal and an informal session on 17 July 2010 at AIDS 2010.

Bringing together current leaders with an emerging generation of young leaders, the afternoon sessions were an opportunity to share experiences and exchange ideas on the concept of “new generation leadership” between established and young leaders and identify the potential opportunities.

New Generation Leadership

Based on recommendations of young leaders during the Young Leaders Summit in Oslo, Norway in June 2009, new generation leadership hopes to increase the participation of young people in policy-making and help foster a new generation of leadership.

UNAIDS Goodwill Ambassador, Her Royal Highness Crown Princess Mette-Marit of Norway is committed to supporting the issue of new generation leadership in the AIDS response. Noting the importance of this approach, HRH Mette-Marit said, “In my role with UNAIDS I consider helping to strengthen young leadership to be my most important task.”

“We are at a crossroads and we need young people to be at the forefront of our efforts. Join me to pave the way for new leaders," HRH Princess Mette-Marit added.

HIV Youth Mentorship Hub

The UNAIDS Executive Director, calling for “young leaders of today, not for tomorrow,” also launched the concept of an HIV Youth Mentorship Hub. The Hub is envisaged as a mechanism to strengthen the visibility and effectiveness of youth leadership in the global AIDS response. Through its online community e-platform, AIDSspace, the Joint Programme hopes to provide a structured opportunity to connect established leaders in the HIV response with emerging young leaders. The young leaders and their respective mentors would be able to interact and discuss issues related to HIV prevention, treatment, care and support.

The HIV Youth Mentorship Hub also aims to make a repository of knowledge and skills in youth leadership available. This will enable young people to shape the implementation of effective HIV programmes and to foster a youth movement to reduce new HIV infection among young people.

Support for youth leadership is a key priority for UNAIDS. According to its Outcome Framework 2010-2011, the Joint Programme strives towards "Empowering young people to protect themselves from HIV" as one of its ten priority areas. The New Generation Leadership programme and HIV Youth Mentorship Hubs are steps in this direction.

As Paddy Masembe, a delegate representing the Uganda Network of Young People Living with HIV, pointed out at today’s event, the youth voice is critical, “People say young people are too young to discuss sex, but we are too young to die!”

UNAIDS Executive Director, centre, on stage at the closing of the Youth Pre-Conference.
Credit: UNAIDS/Heimo Aga

UNAIDS Executive Director Mr Michel Sidibé has highlighted how young people are leading the prevention revolution.

Mr Sidibé was speaking at the reception of the closing ceremony of the Youth Pre-Conference which took place 16 July 2010.

Referring to the data that shows that HIV prevalence has dropped 25% among youth in 15 of the highest burden countries, Mr Sidibé noted “young people are leading the prevention revolution… my dear young friends, never forget that your generation is different—and you are making the difference!”

He called for better access to comprehensive information on sex and sexuality  and sexual and reproductive health services; more investment in young people within national development goals to ensure an HIV-free generation and better data disaggregated by age and gender so responses can be tailored.

Mr Sidibé also highlighted the importance of human rights and gender equity saying no one should be ashamed or stigmatised by who they are or who they love.

The three day event for young people attending AIDS 2010 consisted of information sessions and skills-building workshops on HIV issues ranging from scientific knowledge to effective political advocacy. The event which began on 14 July and covered a range of workshops for young delegates to get the most out of the forthcoming XVIII International AIDS conference which begins on 18 July. Delegates had a chance to familiarize themselves with logistics, hone their advocacy and networking skills and attend “share your knowledge” sessions with peers.

Young people are high on the agenda at the forthcoming AIDS 2010.

Call for framework of human rights, harm reduction and health resources

Following a worldwide electronic consultation conducted by the Vienna YouthForce Advocacy Sub-committee, young people will run a campaign at AIDS 2010 to promote human rights, harm reduction and health resources as a framework to achieve HIV services for young people—Now make it happen!.

By highlighting these “3 HRs” to policy experts and decision makers in the coming week they hope to highlight young people’s needs in the AIDS response.

Recent analysis shows that when young people are empowered, they are taking responsibility for their behaviour and making a difference in the AIDS response.

Trends in HIV prevention and young people

Young people have shown that they can be change agents in the prevention revolution. According to UNAIDS Outlook Report published 13 July 2010, HIV prevalence has decreased among young people in more than 16 of the 21 countries most severely affected by the epidemic.

Of these, 12 have seen HIV prevalence among young people drop by more than 25%. Countries include Kenya, Ethiopia, Malawi, Namibia, Zimbabwe, Botswana, and Côte d’Ivoire. Young people are leading the revolution by adopting safer behaviours—they are choosing to have sex later, have fewer partners and are using condoms.

UNAIDS has made empowering young people to protect themselves from HIV a priority area. It calls on countries to implement a comprehensive set of programmes that put young people’s leadership at the centre of national responses, and empower young people to prevent sexual and other transmission of HIV infection among their peers.

Youth Pre-Conference

The Youth Pre-Conference was jointly organized by the AIDS 2010 Youth Programme and Vienna YouthForce (VYF), a global platform of international, regional and local youth organizations that focus on HIV as well as on sexual and reproductive health and rights.

The event received support from the UN Population Fund (UNFPA). UNFPA is the UNAIDS Cosponsor which leads on youth and HIV issues. It is committed to promoting meaningful youth participation in international events and has provided considerable support to young people during the previous three international AIDS conferences in Bangkok 2002, Toronto 2006 and Mexico 2008.

The eighteenth International AIDS Conference will begin on Sunday in Vienna. These events, which take place every two years, are the biggest gatherings of scientific, community and government leaders, UN agencies, donors and the general public committed to finding solutions to end the spread of HIV and provide access to services.

UNAIDS Executive Director Michel Sidibé affreses MSMGF, 17 July 2010. Credit: UNAIDS&Heimo Aga

“The human rights of men who have sex with men and other sexual minorities must be fully protected and respected if universal access to HIV services is to be achieved,” said UNAIDS Executive Director Mr Michel Sidibé.

“All people should have equal access HIV prevention, treatment and care services in their countries regardless of sexual orientation,” Mr Sidibé continued.

The Executive Director was speaking during a keynote address to the Global Forum on MSM & HIV (MSMGF), held ahead of the International AIDS Conference in Vienna.

Around 80 countries criminalize same sex behaviour and along with social stigma in many other parts of the world this creates obstacles to HIV prevention. Where men may be afraid to or embarrassed about disclosing their sexual activity, they may also be deterred from finding out what they need to know to reduce their risk or to buy condoms. UNAIDS supports efforts to enforce anti-discrimination legislation, provide legal aid services and promote campaigns that address homophobia.

HIV and men who have sex with men

Unprotected sex between men accounts for between 5% and 10% of global HIV infections. It is the predominant mode of HIV transmission in much of the developed world. Currently, access to prevention, treatment, care and support services is limited compared with the share of the burden faced by men who have sex with men who are 19 times more likely to become infected with HIV than the general population.

For example while men who have sex with men account for the largest share of HIV infections in Latin America, only a small fraction of spending in the region supports prevention programmes focused on this population.

By ensuring that they are empowered to access and deliver comprehensive and appropriate packages of HIV services and by ensuring that law enforcement agencies and the judicial system protect their rights, men who have sex with men, can protect themselves from HIV and access treatment.

Global Forum on MSM & HIV: Be Heard

The “Be Heard” event explored the challenges and best practices in achieving universal access to HIV-related prevention, care, treatment, and support services for sexual minority communities worldwide. It brought together around 450 human rights advocates, artists, researchers, public health officials, multi-lateral organizations, and global donors for a day of workshops, skills building, information exchange, and networking sessions.

Sessions at the event addressed a range of issues, from HIV prevention, to funding for MSM projects, to engaging MSM living with HIV in the response to HIV, and empowering MSM in Africa.

First convened at the 2006 International AIDS Conference in Toronto, the MSMGF was established in response to a shared concern that current HIV strategies and responses do not adequately address the needs of men who have sex with men.

UNAIDS Deputy Executive Director, Management and External Relations Ms Jan Beagle. Credit: UNAIDS Anna Rauchenberger

The recent adoption of a ground-breaking human rights instrument on HIV and the world of work has brought the key role of the workplace in the global AIDS response into sharp focus.

On 17 July, the eve of the XVIII International AIDS Conference, the International Labour Organization (ILO) convened a workplace partners’ forum to explore how best to achieve greater coordination and harmonization in taking a rights-based approach to address HIV in the world of work.

Attracting high-level participation, the forum brought together delegates from UNAIDS and its ten cosponsors, HIV workplace implementers, workers, employers, donors and networks of people living with HIV. Speakers included the Honourable Rudolf Hundstorfer, Austrian Federal Minister of Labour, Social Affairs and Consumer Protection; Mr Patrick Obath, Chairperson of the Federation of Kenya Employers; and Ms Jan Eastman, Chairperson of the Global Union AIDS Programme.

UNAIDS Deputy Executive Director, Management and External Relations Brand, Ms Jan Beagle also gave a keynote address along with Dr Sophia Kisting, Director of the ILO Programme on HIV/AIDS and the world of work.

Ms Beagle highlighted the important role of the workplace in providing universal access to prevention, care and support saying “the workplace provides unique entry points to reaching people where they spend the most amount of time in their daily lives.”

“We are all aware that HIV affects the most economically active age range in every population and the majority of the 33.4 million people estimated to be living with HIV worldwide are workers. Many are still subject to stigma and discrimination and the threat, or reality, of losing their jobs due to their status,” Ms Beagle continued.

The forum catalysed action in the development and implementation of country-level interventions and promoted greater engagement of the private sector and business in HIV programming. It was an opportunity to share ideas and experiences with a view towards establishing a global partnership network that will be of special benefit during the implementation phase of the new standard, which is the first international labour standard to concentrate on HIV.

Labour standard on HIV in the world of work

Formulated with the aim of enhancing the contribution of the world of work to attaining universal access to HIV prevention, treatment, care and support services, the recently adopted labour standard also contains provisions for anti-discrimination measures at all levels and stresses the importance of confidentiality and employment and income generation for people living with HIV. It is also intended to protect workers against unfair dismissal due to actual or perceived HIV status and mandatory HIV testing.

Dr Sophia Kisting, Director of the ILO Programme on HIV/AIDS and the world of work. Credit: UNAIDS/Anna Rauchenberger 

Commenting on the event, Dr Kisting said, “This forum should allow us to generate creative ideas on how we can optimise the implementation of the Recommendation. Our success will be determined by our collective resolve to deliver."

Responding effectively to HIV in the workplace is seen as essential to the development of national HIV strategies and forms part of a wider spectrum including health, education and social protection. According to the ILO, workers should be central in the design, implementation and evaluation of workplace programmes which are to be developed through widespread consultations with governments, employers and people living with HIV. 

The XVIII International AIDS Conference (AIDS 2010) will begin in Vienna on 18 July. A pivotal year in the AIDS response, it will coincide with a major push for expanded access to HIV prevention, treatment, care and support as 2010 is the target year set by countries to achieve universal access to HIV services and comes ten years after nations committed to the historic Millennium Development Goals.

With the international financial downturn and bleak global economic outlook threatening to undermine public investments, the event hopes to help keep HIV on the front burner, and is a chance to demonstrate the importance of continued HIV investments to broader health and development goals.

“Rights Here, Right Now”

The overarching theme of AIDS 2010 is "Rights Here, Right Now". It highlights that the protection of human rights is a fundamental prerequisite to an effective response to HIV—whether directly involving people living with HIV or particular groups, such as women and girls, men who have sex with men, people who use drugs, sex workers or young people.

AIDS 2010 will provide a multidisciplinary forum for networking and the sharing of information related to new research and evidence-based programmes and policies. It is a chance for the many stakeholders involved in HIV to take stock of where the epidemic is, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward.

HIV epidemics in Eastern Europe and Central Asia

Taking place in Vienna, AIDS 2010 will turn attention towards the growing epidemics in Eastern Europe and Central Asia where an estimated 1.5 million people were living with HIV in 2008, a rise of 66% from 2001. HIV prevalence in the region is also on the rise, with severe and growing epidemics in the Ukraine and the Russian Federation.

One of the highlights of the AIDS response in the region is the high coverage of services to prevent mother-to-child HIV transmission. In December 2008, coverage of services to prevent mother-to-child transmission exceeded 90% in Eastern Europe and Central Asia.

However reaching many of people at higher risk of HIV remains a challenge. Injecting drug use is the main mode of HIV transmission in this region. An estimated 3.7 million people inject drugs, and roughly one in four are thought to be HIV-positive. Evidence suggests that injecting drug users in the region, are often the least likely to receive antiretroviral therapy.

Preventing sexual transmission of HIV prevention will also be high on the conferences agenda. With increasing transmission among the sexual partners of drug users, many countries in the region are also experiencing a transition from an epidemic concentrated among injecting drug users to one that is increasingly characterized by significant sexual transmission.

UNAIDS at Vienna

UNAIDS will be publishing live updates from the conference. UNAIDS @ Vienna blog, on twitter and facebook. During the upcoming week interviews with activists and conference goers on their perspectives of the conference and the AIDS response will also be posted on YouTube.

Vienna partners

The conference takes place every two years and is the largest gathering for those who work in the AIDS response including policymakers, people living with HIV and civil society.

Local and regional partners include the host the City of Vienna, the Government of Austria, Austrian AIDS Society, Aids Hilfe Wien, East Europe & Central Asia Union of PLHIV, European AIDS Clinical Society and the European Commission.

International partners include UNAIDS and its Cosponsors, WHO and the United Nations Office on Drugs and Crime; the International Council of AIDS Service Organizations; the Global Network of People Living with HIV/AIDS; the International Community of Women Living with HIV/AIDS; the World Young Women’s Christian Association; and the Caribbean Vulnerable Communities Coalition.

Towards a paradigm shift in HIV treatment and prevention

At this defining moment—reshaping the AIDS response is a necessity. Join UNAIDS and the International AIDS Society to set the tone for the AIDS 2010 Conference: challenging and encouraging delegates to call for and join a movement to reshape the AIDS response to reach universal access to HIV prevention, treatment, care and support.

Guest speakers include Kgalema Motlanthe, Deputy President of South Africa; Julio Montaner, President of the International AIDS Society, and Michel Sidibé, Executive Director of UNAIDS.

Bring your ideas to this interactive Town Hall event and engage with leaders in the AIDS response. Panelists include: Rolake Odetoyinbo, Executive Director, Positive Action for Treatment Access, Mphu Ramatlapeng, Minister of Health and Social Welfare of Lesotho and Barbara Lee, US Congresswoman, 9th District of California.

Annie Lennox, long-time AIDS activist and UNAIDS International Goodwill Ambassador, will lend her unique voice to setting the tone for the Conference.

Hosted by James Chau, News Anchor, China Central Television; UNAIDS National Goodwill Ambassador for China.

To attend and promote the event on facebook, go to:
www.facebook.com/?ref=home#!/event.php?eid=110421382341713&ref=mf

Note to broadcasters: The Town Hall event will be offered to broadcasters rights-free. Please contact Saya Oka, okas@unaids.org

With the ending of the 2010 FIFA World Cup in South Africa, the UNAIDS web contest has come to a close as well. Contestants joined the UNAIDS Goodwill Ambassadors footballers Michael Ballack and Emmanuel Adebayor in the ‘Give AIDS the Red Card’ web competition to learn about HIV and win prizes. The contest engaged hundreds of participants from all corners of the world. Respondents’ thoughtful ideas for a solution to stopping stigma and discrimination were particularly enlightening and promising.

The UNAIDS advocacy campaign, 'From Soweto to Rio de Janeiro, give AIDS the red card to prevent babies from becoming infected with HIV' is one of the initiatives towards ensuring a healthy and HIV-free generation of children.

Lucky winners will soon receive prizes and memorabilia, courtesy of Ballack, Adebayor and UNAIDS. UNAIDS would like to thank participants from all over the globe for their entries – we hope that you will continue to join us in working towards zero new HIV infections, zero discrimination and zero AIDS-related deaths!

Catherine Ashton, Vice-President of the Commission/High Representative of the Union for Foreign Affairs and Security Policy.

In the lead up to the 2010 International AIDS Conference in Vienna, the European Parliament has voted on a Motion for a Resolution on a rights-based approach to the EU's response to HIV. Referring to the UNAIDS Outcome Framework 2009-2011, the Resolution strongly supports the Joint Programme's position on human rights issues such as decriminalization of sexual transmission, injecting drug users and on men who have sex with men.

Passed by an overwhelming majority of members on 8 July 2010, the Resolution also asks EU member states to meet their commitments as well as to step up efforts in addressing HIV as a global public health priority with human rights as central to its prevention, treatment, care and support, including in EU development cooperation. The XVIII International AIDS Conference which starts in Vienna on 18 July 2010 will run under the theme of human rights: ‘Rights Here, Right Now.’

Vice-President and High Representative of the European Union, Ms Catherine Ashton, made a strong statement to the Members of the Parliament in support of the Resolution: “I am confident that the Vienna Conference will help us to move forward in enforcing the rights of people to be protected against avoidable HIV infections and in gaining access to the evidence-based prevention and highly efficient treatment that so many honourable Members have referred to this evening.”

She also gave a personal commitment to ensure its effective implementation by the European Commission, saying, “I want to assure you as well that we will maintain and increase our dedication to defending these rights inside Europe, but also as part of our relations with third countries whether they are close to our borders or on other continents.

The Resolution calls on the European Commission and the Council to promote efforts to decriminalise HIV transmission and exposure and to support harm reduction programmes for prisoners and injecting drug users.

Recognizing that addressing women’s needs was an essential measure for curbing the epidemic, the Resolution also calls for expanding access to sexual and reproductive health care programmes.

It also called for member states to promote best policies and practices in the political dialogue at global and country-level regarding rights-based responses to HIV and calls on the Commission and the Council to work with UNAIDS and other partners to improve indicators for measuring progress at global, national and at programmatic level to reduce HIV-related stigma and discrimination, including indicators specific to key populations.

UNAIDS urges the removal of all punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS including in the areas of sex work, travel restrictions, homophobia and criminalization of HIV transmission.
With an estimated 33.4 million people living with HIV globally and 2.7 million newly infected in 2008, countries continue to rank AIDS high on the list of the most important issues facing the world.