Ahead of the XVIII International AIDS Conference to be held in Vienna from 18 – 23 July, UNAIDS has launched its OUTLOOK Report 2010 in Geneva.

Key findings:

The new UNAIDS Outlook report outlines a radically simplified HIV treatment platform called Treatment 2.0 that could decrease the number of AIDS-related deaths drastically and could also greatly reduce the number of new HIV infections. Evidence shows that new HIV infections among young people, in the 15 countries most affected by HIV, are dropping significantly as young people embrace safer sexual behaviours.

Also in the report, a sweeping new UNAIDS and Zogby International public opinion poll shows that nearly 30 years into the AIDS epidemic, region by region, countries continue to rank AIDS high on the list of the most important issues facing the world.

And an economic analysis makes the case for making health a necessity, not a luxury, outlining the critical need for donor countries to sustain AIDS investments and calling on richer developing countries to invest more in HIV and health.
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SUPPLEMENTS:

Treatment 2.0 - Is this the future of treatment?

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Young people are leading the HIV prevention revolution

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Making sense of the money + Where does the money for AIDS go?

PDF | 389 Kb

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The Benchmark - What the world thinks about the AIDS response

PDF | 1.54MB | 412 Kb

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OUTLOOK micro site:
Visit the UNAIDS OUTLOOK special site to access additional materials

The research was supported by a telephone helpline service to respond to health and human rights concerns of sex workers during the World Cup.
Credit: UNFPA

As part of the UN South Africa Programme of Support to the FIFA 2010 World Cup, UNFPA and SWEAT (Sex Worker Education & Advocacy Taskforce) partnered with South African researchers to investigate key dimensions of HIV and sex work during the tournament. This rigorous research was supported by a telephone helpline service to respond to health and human rights concerns of sex workers during the World Cup. According to Mr. Eric Harper, Executive Director of SWEAT: “These projects give weight to the rights watch dimension for most-at-risk-populations that is so vital when the largest sporting event in the world occurs.”

Sex work in South Africa became one of the most talked about issues in preparation for the tournament. Newspapers warned of an influx of sex workers to the country to exploit the lucrative potential of the arrival of thousands of soccer fans. As the programme’s lead researcher, Marlise Richter, maintained: “Public health and human rights responses to international sporting events should be based on rigorous, systematic research - not on fear-mongering and sensationalism.” This referred to media reports that over-estimated the number of foreign sex workers headed to the country and the result of confusing issues of trafficking and sex work. The research also addresses the significant data shortages related to sex work and HIV in South Africa in the longer term.

The research assessed sex worker fears, expectations and experiences of the World Cup, gathered information on sex worker mobility, frequency of health care visits and interaction with police. It also tracked the number of clients and potential changes in sex work activity during the World Cup. The tournament presented a strategic opportunity for South Africa to respond to the challenges that the sex industry poses in a rights-based way and provided the momentum for these issues to be taken further in the future. At the same time, conducting research that tracked the changes in the sex work sector during a big, international sporting event is vital to inform future policy and planning for similar events across the world.

Following a right-to-health approach, and in accordance with the UNAIDS Guidance Note on HIV and Sex Work , UNFPA supported SWEAT to provide sexual and reproductive health services, including HIV prevention, to sex workers during the tournament and beyond. Sex workers’ ability to look after their health, more especially their sexual and reproductive health, is inextricably linked to their ability to access human rights in general.

Commenting on the initiative, Dianne Massawe, Project Officer for SWEAT said: “This partnersunhip affords us the opportunity to respond specifically to the sexual and reproductive health aspect through increased outreach and distribution of safer sex tools and information to sex workers. In addition, the telephone helpline provide[d] valuable assistance to sex workers around the human rights abuses they face.”

South Africa is often referred to as the epicentre of the AIDS epidemic, home to the world’s largest number of people living with HIV. Within this epicentre, populations most at risk of HIV infection must be prioritised in prevention strategies. UNFPA supports SWEAT in research that will generate further evidence on the need for comprehensive programmes that promote a human rights-based approach to universal access to HIV prevention, treatment, care and support in the context of adult sex work.

The completed research report is expected by September 2010.

Ahead of the XVIII International AIDS Conference in Vienna, AIDSspace.org has created a group to provide a forum for AIDSspace members to share information and updates on events during the six day conference. Members can start discussions as well as send a promotional e-postcard to spread the word.

Members who join the group are provided with a specially-designed AIDSspace badge to show support for the conference.

In addition to forums, the group page provides links to key conference resources, such as the official conference programme, webcasting, and the daily bulletin. An interactive calendar offers an overview of the key sessions, satellites and other events happening throughout the week.

During the conference, the group will be updated daily with news from Vienna.

AIDSspace.org was launched in November 2009 as an online network for the 33.4 million people living with HIV and the millions engaged in the AIDS response.

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

UNICEF Goodwill Ambassador Angélique Kidjo dances with children at a 'safe park' in Soweto, on the outskirts of Johannesburg.
Credit: © UNICEF/NYHQ2010-1150/Hearfield

UNICEF has been using the 2010 FIFA World Cup to help harness the power of sport to promote children’s rights. A series of partnerships and programmes around the global football championship are providing children with the opportunity to learn about their world and be better protected. 

A special partnership between UNICEF and the South African government addresses potential problems that may arise due to the increased presence of people. In a country where an estimated 12 million children live in poverty, special attention is being given to unaccompanied minors, some of whom may be induced to travel to the cities where games are played in search of employment opportunities and adventure.

A massive communication campaign was launched that sends out a message that child abuse and exploitation have no place in South Africa. Targeted at children, parents and tourists, the campaign uses digital, print and electronic outreach to warn about child abuse, exploitation, child sex tourism and trafficking. Partners, including hotels, car rental companies and tour operators are also disseminating messages about child rights and safety throughout their networks. 

Child-friendly spaces, supported by UNICEF and partners, have been open at four of the major FIFA Fan Fests in Soweto, Sandton, Nelspruit and Port Elizabeth. The sites have played to host to 15,000 to 45,000 fans as well as social workers, child and youth care workers and trained volunteers charged with identifying children who are in need of protection and emergency care. TV screens showed matches in the spaces and age-appropriate activities were offered as well.

UNICEF also harnessed the influence of international stars visiting the country for the tournament, such as UNICEF Goodwill Ambassador Angelique Kidjo, to highlight the immense needs of South African children made vulnerable by poverty and HIV. 

Outside South Africa, a pilot programme called “World Cup in my village” has given young people in three locations in Rwanda and Zambia the opportunity to view matches on large open-air screens and projectors.  In addition to the football, the screens are broadcasting important information about children’s health and their rights.

According to Anthony Lake, UNICEF Executive Director from New York: “The World Cup gives us a chance to focus positive public attention on the special risks children face in countries like South Africa and around the world and the special efforts we can take to protect them from those threats.”

Renowned Egyptian actor Amr Waked has been named Regional Goodwill Ambassador for the Joint United Nations Programme on HIV/AIDS (UNAIDS) in the Middle East and North Africa (MENA). A popular star, Mr Waked is an influential figure with teenagers as well as adults across the region. Now, he joins UNAIDS' commitment to speaking out against stigma and discrimination of people living with or affected by HIV.

"I will work with all partners, including the media, to raise awareness about the disease, reduce stigma, discrimination and fear, and deliver correct messages to people who don’t know about AIDS and who keep judging others without knowing about their lives and circumstances,” said Mr Waked.

“People living with HIV have to get the support they need. It is not the disease that kills you; it is the people around you who refuse to understand and help you, who kill you,” he added.

In his capacity as Regional Goodwill Ambassador Mr Waked will help raise awareness on issues related to HIV and give greater voice to the needs of people living with HIV in the Middle East and North Africa. He will also address issues of stigma and discrimination faced by people living with HIV and key populations at increased risk of infection and advocate for rights of people living with HIV and young people.

Mr Waked has taken part in the “Unite for Children, Unite Against AIDS” campaign with UNICEF. He also contributed to the production of two docudramas on HIV as well as participating in UNICEF’s SOTNA (“Our voice”) programme with young people, and he also mainstreamed HIV and Hepatitis C prevention messages into the TV series "lahazat harega" (Emergency situations).

Speaking of Mr Waked's appointment, Dr Hind Khatib, Regional Director, UNAIDS MENA Regional Support Team, said, “Amr has chosen to be the voice of the voiceless. He has been interested in this field for a long time and has contributed to the production of a documentary that reflects the stigma and discrimination faced by people living with HIV in the Middle East and North Africa. We count on him to work with us in advancing the AIDS agenda in the region.”

Mr Waked will start his work next week in the city of Dubai where representatives from the Region will convene to discuss where MENA is in its efforts to scale up universal access to HIV prevention, treatment, care and support.

Vice Minister Yin Li addressed the Forum on 5 July 2010

For the first time in China, government and civil society have formed a partnership to offer innovative ideas from a rights-based perspective to strengthen the national response to HIV. The China Red Ribbon Beijing Forum was launched on 5 July 2010 at a high-level meeting attended by Vice Minister of Health Yin Li and more than 100 members of civil society, including grassroots organizations.

“The Chinese government places great importance on the AIDS response,” said Vice Minister Yin Li.  “National leaders are setting a strong example in advocating and driving all sectors of society to protect the human rights of people living with HIV and AIDS, reducing stigma and discrimination and leading the way forward.”

Forum speakers respond to questions from the floor.

“What’s happened here today is truly significant, and we shouldn’t underestimate its importance,” observed Steve Kraus, Director, UNAIDS Regional Support Team Asia-Pacific. “Partnership between government and civil society, fostering candid and open debate, is critical to success for all national AIDS programmes.” 

Dr Wang Longde, president of the Chinese Preventive Medicine Association and chair of the Forum’s Interim Steering Committee emphasized that “Only by adopting a people-centred approach, by ensuring the protection of people’s rights, can strategies and measures in our AIDS response be fully implemented, the scope of our response be expanded, and the lives of those living with or affected by HIV be improved.”

The Forum’s 14-member Interim Steering Committee includes representatives from government and civil society. It will be replaced after a year by a Steering Committee whose membership will be chosen through wide consultation with civil society and other stakeholders.

Rights-based approach

Mr Steve Kraus, Director UNAIDS RST Asia Pacific.

Thomas Cai is founder of AIDS Care China whose community-based HIV care work has been honoured both internationally and at home. An appointee to the interim committee, he is convinced that the initiative is an opportunity for a new way of doing things.

“This Forum should and will be more than just rhetoric,” Cai explained. “Yes, there is skepticism about whether it is truly going to make a difference, or if it’s more show than substance. But by using HIV as an ‘experiment’, if you will, the aim is to strengthen the rights-based approach that serves as our context.”

Looking forward

A broad range of issues were discussed including how the law can be crafted to protect the rights of those vulnerable to, or living with, HIV; how to address stigma and discrimination; and how HIV prevention efforts can be strengthened across China through rights-based approaches.

“Converting the discussions into concrete results is the next step,” said Mark Stirling, UNAIDS Country Coordinator for China.

Forum delegates already highlighted a number of areas that need to be prioritized. These include:

• Incorporating a rights-based approach into China’s next HIV/AIDS Five-Year Action Plan (2011-2016);
• Ensuring compliance with existing anti-discrimination clauses, and conducting a legal audit to assess where conflicting laws need to be revised or removed;
• Creating a standardised framework to address compensation for HIV infection through contaminated blood products or the selling of blood;
• Addressing the need for registration and legal recognition of non-governmental and community-based organizations;
• Fostering dialogue between the Ministries of Health, Public Security and Justice to examine how harm reduction work could be strengthened to reduce the risks of infection to injecting drug users, sex workers and men who have sex with men;

Family in Djibouti. Credit: UNAIDS/P. Virot

National ownership is central to sustainable AIDS responses and is beyond doubt a path to improved aid effectiveness. To set the stage for engaged debates on national ownership and actions to realize this, UNAIDS organized a consultation in Geneva on 21 June 2010 that brought together government representatives, civil society, representatives from  regional political bodies, and development partners.

The dialogue resulted in a clear definition of national ownership which is:

“Inclusive multi-sectoral national leadership at all levels in managing the design of effective AIDS policy and strategy, its implementation, monitoring, reporting and sustainable resourcing as part of the national development agenda, and for assuring board result-based mutual accountability mechanisms and national capacities to strengthen the AIDS response”.

Participants also established indicators to measure progress. These indicators cover multi-sectoral AIDS coordination; non-discriminatory laws and regulations; inclusive process in the development of Strategy, work plan, operational plan and review; monitoring and evaluation and mutual accountability system; integration of HIV in national development plans and capacity development plans; sustainable HIV financing; mutual financial accountability mechanisms; alignment and harmonization; and capacity building.
Addressing the forum, Mr Michel Sidibé, executive director of UNAIDS, highlighted the need for countries and donors to move from short-term aid commitments to longer term financing that is both predictable and sustainable. According to Mr Sidibé key to achieving this is “understanding the interaction of ownership and external funding” which can happen by focusing on the ways that significant donors actually enable national ownership and empower country partners.

The US Global AIDS Coordinator Ambassador Eric Goosby stressed the importance of “mutual accountability.” He pointed out the imperative that donors “carry out their development work in such a way that engagements with country partners and priorities are mutually beneficial.”

The participants discussed strategic incentives to foster greater country partner ownership of national AIDS policies and programmes and to encourage production and use of evidence. In addition, how national ownership can be enhanced by mobilizing greater domestic resources and investments, and the roles and action that country partners and development partners can employ together to strengthen ownership.

Renewed approach to technical assistance and capacity building

Better and more sustainable articulation of countries’ needs, mentoring countries with counterparts from the North, coupled with the aggressive development of TA in the South and South-South cooperation would result in a renewed approach to technical assistance (TA). This could ensure that it is driven by demand rather than by supply. To strengthen national ownership, the inclusion of capacity building support as an integral part of joint operational planning would strengthen country’s responses. Zambia’s Minister of Health, H.E. Kapembwa Simbao, pointed out that “national ownership refers to the availability of in-country expertise to monitor their programmes.” 

UNAIDS Secretariat, in collaboration with all stakeholders, will continue to foster national ownership so that countries can make evidence-informed decisions and invest funds where they are most needed in order to achieve better outcomes for the AIDS response as well as the countries’ wider health and development goals. UNAIDS also plans to continue to support country and regional consultations that include all constituents.

The AIDS epidemic has raised new and complex legal and human rights challenges leading to judicial rulings on matters related to HIV that have become part of the jurisprudence of many countries. Through interpretation of national constitutions, legislation and international human rights treaties, the judiciary has sometimes had a transformative and beneficial impact on the national response to HIV and on the public perception of HIV.

Enabling jurisprudence has emerged in countries as diverse as Australia, Botswana, Brazil, India, Iran, Kenya, Namibia, South Africa, United Kingdom, United States of America and Venezuela. This includes judgments on employment law, access to education, medical insurance, treatment in prisons, segregation, confidentiality, access to medicines, and the rights of prisoners. Through a well-informed, evidence-based and protective application of the law, the judiciary can create the type of legal and social environment necessary to halt and roll back the AIDS epidemic; to provide access to justice to those affected; and to achieve national commitments to attain universal access to HIV prevention, treatment, care and support.

Beyond the court, members of the judiciary are leaders in their communities and societies who should be engaged in the response to HIV. Their stance, attitudes and behaviour towards HIV-related issues, people living with HIV and members of most at risk populations can help shape social attitude towards these populations. Members of the judiciary can challenge stigma and discriminatory practices against people living with HIV and members of key populations both inside the court and within the community at large.

However, in the quickly evolving area of scientific, medical and legal issues related to HIV epidemic, there has been little opportunity for judges to take stock of epidemiological and scientific developments. Nor has role of members of the judiciary as agents of justice and protectors of human rights been fully explored or used to address vulnerability to HIV and ensure human rights protection for all in the context of the epidemic.

Recognising the potential and actual role of the judiciary in the AIDS response, UNAIDS is committed to supporting the judiciary, including in the following areas:

• Providing opportunities for continuing education and discussion among the judiciary on recent developments in the HIV response and their legal implications
• Supporting judges to make the courts more accessible to all people affected by HIV
• Stimulating rights-based and evidence-informed standard-setting on pertinent HIV-related legal and human rights issues by and for members of the judiciary
• Creating opportunities for members of the judiciary to exchange with key stakeholders of the HIV response, including people living with HIV, women affected by HIV, and members of key populations at higher risks.

UNAIDS’ support to judiciary leadership is guided by its commitment to working with key national and international actors towards the removal of “punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS”, as affirmed in the UNAIDS Outcome Framework 2009-2011

UNAIDS sees members of the judiciary as key stakeholders in supporting and enforcing a protective legal environment to the HIV response.

According to Susan Timberlake, Senior Human Rights and Law Advisor at UNAIDS, “Through the courts, judges can  uphold non-discrimination based on HIV status, protect women and  key populations  from violence and denial of services, and overturn  punitive laws that violate human rights in the context of the epidemic.”

As part of the efforts to engage the judiciary in the HIV response a groundbreaking meeting of eminent African jurists was held in Johannesburg, South Africa in December 2009 to discuss HIV and the law in the 21st century.

In December 2009, UNAIDS Executive Director Michel Sidibé called for a “prevention revolution” and announced the formation of a UNAIDS High Level Commission on HIV Prevention. The Commission, composed of political, business, activist and philanthropic leaders, will lead a political action campaign over the coming year to galvanize commitment at the highest level in support of effective HIV prevention programmes.

The Commission will be launched at the International AIDS Conference in Vienna, Austria on 21 July 2010. Ahead of the launch, the Commission’s Co-chairs, Professor Françoise Barré-Sinoussi, Nobel Prize Laureate in Medicine for her role in the discovery of HIV, and Archbishop Emeritus Desmond Tutu, have endorsed a statement, prepared by the Commission’s Scientific Advisory Panel, calling for renewed leadership and intensified action to prevent new HIV infections.

This statement is open for signature by scientists, activists, and others supporting effective HIV prevention programmes. The statement and list of supporters will be presented at the Commission’s launch.

To sign-on to the statement, visit http://aidsspace.org/commission.php. (The web site is hosted by AIDSspace.org and is available in English, French, Spanish, Russian, Chinese and Arabic). The deadline for signatures is 9 July 2010.

(from left) Mr Michel Sidibé, Executive Director of UNAIDS; Ms Yoka Brandt, Director-General, International Cooperation, Ministry of Foreign Affairs, The Netherlands
Credit: UNAIDS/F. Chironi

UNAIDS governing body, the Programme Coordinating Board (PCB) is holding its 26th Board meeting from 22-24 June 2010 in Geneva.

UNAIDS Executive Director Michel Sidibé addressed the Board on 23 June giving an overview of progress in last six months by the Secretariat, partners and Cosponsors. The UNAIDS Annual Report 2009 was also shared with the Board members.

In his speech, “Delivering results in transformative times”, Mr Sidibé laid out a “reinvigorated mission” for the Joint Programme. Mr Sidibé also identified five challenges for UNAIDS and described approaches for a more focussed UNAIDS, acting more strategically, increased flexibility and responsiveness, a more efficient Secretariat and more accountability.

On 22 June a thematic session took place on “Linking Sexual and Reproductive Health (SRH) services with HIV/AIDS interventions in practice”. Issues related to gender and youth education were also discussed under this theme.

Stakeholders involved in the AIDS response have always been of the opinion that the Millennium Development Goals will not be achieved without ensuring universal access to sexual and reproductive health and HIV prevention, treatment, care and support.

The majority of HIV infections are sexually transmitted or are associated with pregnancy, childbirth and breastfeeding; and the risk of HIV transmission and acquisition can be further increased due to the presence of certain sexually transmitted infections (STI). HIV is the leading cause of death in women of reproductive age, particularly in Sub-Saharan Africa, and contributes significantly to maternal mortality.

UNAIDS Executive Director Michel Sidibé has maintained that, “If we integrate HIV into maternal health programmes, we can make huge progress on almost every global development goal. We can stop mothers from dying of HIV and dramatically reduce maternal mortality.” Most of UNAIDS cosponsors are also involved in improving this field, enhancing human rights and promoting HIV prevention services.

The thematic session of the Board meeting provided a platform for stakeholders and participants to review the challenges of integrating sexual and reproductive health services with HIV interventions and vice-versa, and share lessons and best practices.

Special attention was paid to young people and gender issues, where progress in involving men and boys in SRH services and programmes that address harmful gender norms were included. Young people tend to be more motivated to use condoms to prevent unintended pregnancy than HIV. Programmes that focus on both can broaden their appeal and have an important impact on preventing pregnancy and STIs.

Sexual violence, sexual diversity and sexuality education with due respect to human rights, gender issues and greater involvement of people living with HIV was also addressed.

Participants were invited to discuss opportunities for women to control or influence their own sexuality and reproduction and to become familiar with the female condom. For pregnant women living with HIV, the single most significant intervention that could reduce maternal mortality, and virtually eliminate vertical transmission -- namely the timely initiation of antiretroviral therapy for life -- remains largely underutilized.

Established in 1994 by a resolution of the UN Economic and Social Council and launched in January 1996, UNAIDS is guided by a Programme Coordinating Board (PCB) with representatives of 22 governments from all geographic regions, the UNAIDS Cosponsors, and five representatives of nongovernmental organizations, including associations of people living with HIV.