Kenyan Finance Minister Uhuru Kenyatta presented the national budget for the 2010-2011 financial year to parliament on 10 June. The budget sees a near doubling of past allocations for HIV treatment, earmarking Ksh. 900 million (US$ 11.25 million) for antiretroviral treatment.

Earlier this year UNAIDS Executive Director, Michel Sidibé jointly launched the country’s National AIDS Strategic Plan (2010- 2013) with the Prime Minister, Right Honorable Raila Odinga. Mr Sidibé and the Kenyan Government then signed a Memorandum of Understanding committing the two parties to joint actions in several key areas including sustainable financing to support the national HIV response; and virtual elimination of vertical transmission of HIV from mother-to-child. During his visit Mr Sidibé also met with the President, His Excellency Mwai Kibaki as well as key ministers involved in the HIV response.

Mr Sidibé then called on the government of Kenya to earmark Ksh. 1 Billion per year to ensure the continuity of HIV treatment for people in need and to reduce instances of medicine stock-out threats. He also recommended the government counter donor dependency and develop a Cabinet paper on long-term sustainable financing of the national AIDS response including exploring options for increasing domestic resource mobilization such as airtime tax and airline taxes.

“UNAIDS welcomes the government’s increase in domestic funding towards the national AIDS response,” said Mr Sidibé, UNAIDS’ executive director.

In addition, a high-level steering committee has been established by the government to explore sustainable financing and a concept paper on alternative domestic financing scenarios has been developed detailing critical building blocks required to be put in place. The culmination of these efforts will be the development of a cabinet paper which will substantially reduce the country’s dependence on external financing for HIV programmes. 

“This is a unique experience with the UN I’ve never seen elsewhere,” said Lisa Sherburne, an HIV specialist with Save the Children. Credit: UN

Pham Xuan Tung talks eagerly and takes notes for his group during a biology lesson on HIV transmission and the replication of the virus in blood cells. This new type of highly interactive class is something Tung, a student at Hoang Quoc Viet upper secondary school in Dong Trieu District, Quang Ninh Province, clearly enjoys.

The class is based on a new, integrated reproductive health and HIV prevention curriculum for secondary school students being developed and piloted by the Ministry of Education and Training (MOET), with support from UNICEF, UNFPA, UNESCO and Save the Children in Viet Nam. Many students in Quang Ninh Province, Quang Tri Province and Ho Chi Minh City are following the new pilot curriculum.

A comprehensive national HIV prevention curriculum

Many students in Quang Ninh Province, Quang Tri Province and Ho Chi Minh City are following the new pilot curriculum. Credit: UN

“I have seen a positive change in the participation of students in my class. The new teaching and learning method allows room for every student to speak up, and they are much more responsive,” said Tung’s teacher Truong Thi Hoa.

The new curriculum for secondary schools nationwide draws on UN-supported work in schools, including healthy living and life skills programmes, reproductive health and HIV prevention initiatives, and pre-service training for teachers. Integrating the areas into core lessons and extra-curricular activities, it includes special training for parents so they can better discuss HIV and reproductive health issues with their children – subjects that can be particularly sensitive and difficult to address.

“This is a unique experience with the UN I’ve never seen elsewhere,” said Lisa Sherburne, an HIV specialist with Save the Children. “It allows more resources, more cohesive actions and a more powerful voice for the Viet Nam education sector.”

The changes are all aimed at integrating HIV prevention into the next national curriculum framework and new textbooks to be developed by the ministry and approved by the National Assembly in 2015.

However, many challenges remain. The ministry needs strong political leadership and greater capacity for planning and coordination, sufficient resources, teachers with better capacity, and effective intra-ministry and multisectoral coordination.

“Our biggest challenge is how to facilitate the close collaboration among departments in the ministry and among ministries related to the education sector response to HIV,” says La Quy Don, vice director of MOET’s Department of Student Affairs.

For Eamonn Murphy, UNAIDS Viet Nam Country Director, this is also a top priority.  “We are committed to providing joint support for policy-making, enhanced coordination and implementation of several key aspects of the education sector’s response to HIV.”

Empowering young people to protect themselves against HIV is a key priority area in UNAIDS Outcome Framework 2009-11.

Every 4 years, the world turns its eyes to the football World Cup, the biggest sporting tournament on the planet.  This year, the World Cup is being held in South Africa with many top teams and stars taking part. As in years past, UNAIDS will be hosting a web-competition, under the slogan “Give AIDS the Red Card” in order to celebrate the games.  With the help of UNAIDS Goodwill Ambassadors Michael Ballack and Emmanuel Adebayor, the “Give AIDS the Red Card” campaign leads us in the direction of preventing and ending mother-to-child transmission of HIV by the year 2015.

Contestants can win a variety of prizes, including signed memorabilia from players, if they can answer these 3 questions correctly:

1.HIV infection is widely stigmatized and people living with HIV often face discrimination. What is an effective way of tackling stigma and discrimination?

2.What is the purpose of UNAIDS’ new campaign featuring Ballack and Adebayor “Giving AIDS the Red Card”?

3.As of 2008, how many people were living with HIV in Sub Saharan Africa?

Send your answer to competition@unaids.org by July 11th 2010 

Good Luck!

UNAIDS welcomes the efforts of UNITAID towards the establishment of the Patent Pool Foundation, scheduled for July this year. On 8 June 2010 the UNITAID Board made the final decision to move forward with the new Medicines Patent Pool Foundation and to provide US$ 4.4 million for its first year of operations.

"What this means in practical terms," said Mr Philippe Douste-Blazy, Chair of the UNITAID Executive Board, "is that formal negotiations with the patent holders can now begin. We expect the Patent Pool Foundation to have its first licenses within a year."

Access to HIV treatment is a key issue of universal access, and if a patent pool is successful in obtaining licenses for AIDS drugs it will contribute towards lowering the price of drugs and promote the production of fixed drug combinations as well as encourage generic manufacturers to produce WHO prequalified antiretroviral (ARV) drugs including pediatric ARVs.

“A successful patent pool will help in accelerating the scaling up access to care and treatment and will decrease the risk of stock out of medicines in the developing world,” said Mr Michel Sidibé, UNAIDS executive director.

Why a patent pool?

A patent pool brings together the patent rights held by different owners such as universities, pharmaceutical companies or government institutions, and makes them available on a non-exclusive basis. Through this mechanism, developers of pharmaceutical products could access a “one-stop-shop” for patents. In return producers pay a royalty to the patent holder.

Such a pool could make it easier to produce new medicines that combine several pharmaceutical compounds patented by different companies into a single pill. These medicines, known as “fixed-dose combinations” are easier for children and adults to take than multiple tablets with different schedules, promoting HIV treatment compliance and boosting treatment outcomes.

The patent pool could also make newer medicines more affordable in developing countries, through opening up manufacture to different producers. While some older medicines for the treatment of AIDS have become increasingly affordable, newer products are still very expensive. The need for affordable HIV treatment will become more urgent as increasing numbers of people living with HIV fail their first-line therapy and need second-line treatments.

Couple in Ecuador Credit: P. Virot

Indigenous peoples need to be identified as a priority group in the HIV response, the Report of the 5th International Policy Dialogue in Canada has clearly indicated. The report also called for a better integration of indigenous peoples into the international response to AIDS.

Health Canada, in collaboration with UNAIDS and Public Health Agency of Canada, hosted an International Policy Dialogue on HIV/AIDS and Indigenous Peoples in Ottawa, Canada, in October 2009. The dialogue provided a platform to discuss the impact of HIV on indigenous peoples, and to explore a way forward in terms of research, policy and programme development.

The final report that emerged out of that dialogue states that the relationship between HIV and indigenous peoples has not received due international attention, despite the fact that indigenous peoples have particular vulnerabilities to acquiring HIV.

The report identifies patterns of transmission for indigenous men and women, including a higher proportion of new HIV diagnoses among indigenous peoples; high rates of HIV transmission among indigenous women, particularly in developing countries; and, a younger age of HIV infection of indigenous peoples compared with the non-indigenous population in some countries.

Given these vulnerabilities, the report calls for the identification of indigenous peoples as a priority group. It also calls for countries to develop national strategies for HIV and indigenous peoples and to advocate for AIDS service organizations to develop culturally-appropriate services for indigenous peoples in partnership with indigenous communities’ representatives.

Identifying limitations of current systems for surveillance and data collection, the report notes how indigenous people are often invisible in reported statistics. It also discusses how best to leverage international policy instruments, such as the UN Declaration on the Rights of Indigenous Peoples (UNDRIP) and ILO Convention 169 (Indigenous and Tribal Peoples Convention).

The report welcomes the creation of the International Indigenous Peoples Working Group on HIV/AIDS (IIHAWG), with participants during the dialogue expressing belief that it could provide a unified voice for indigenous peoples. It recommends the IIHAWG meet annually, beginning with preparations for indigenous participation before and during the XVIII International AIDS Conference in Vienna in 2010.

UNAIDS observes that the several key risk factors that render individuals and communities acutely vulnerable to HIV are present in large numbers of indigenous populations worldwide. These factors include lack of political and social power, socio-economic disadvantage including poverty, lower education standards and subsequent lower health literacy and stigma and discrimination relating to race, sexuality and HIV status.

Approximately 50 stakeholders participated in the three-day dialogue, including from New Zealand, Australia, North, Central and South America, from indigenous peoples’ communities and networks, and from both government and non-governmental organizations.

As part of the 14th session of the UN Human Rights Council taking place in Geneva from 31 May-18 June 2010, the Council held on 4 June 2010 an interactive debate with the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standards of physical and mental health, the Independent Expert on the question of human rights and extreme poverty, and the Special Rapporteur on violence against women, its causes and consequences.

In his report, Anand Grover, the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, focused on the impact of criminal law on the realization of the right to health and related rights. He specifically reported on the impact of criminalization of same-sex conduct and sexual orientation, sex work, and HIV transmission – three examples of the criminalization of private consensual sexual conduct between adults.

“We hope the report of the Special Rapportueur will help to generate constructive debate, and catalyze change toward a more rights-based and effective AIDS response,” said UNAIDS Human Rights and Law Officer Jason Sigurdson who delivered a joint statement for the UNAIDS Secretariat and UNDP.

The 14th session of the UN Human Rights Council continues in Geneva until 18 June 2010.

A version of this story has been published at unfpa.org

UNFPA Executive Director Thoraya Obaid (centre) with midwives whose key role in maternal health has been highlighted throughout the Women Deliver conference. Credit: Moises Saman

UNFPA, the United Nations Population Fund, and CARE International, one of the world’s largest humanitarian aid agencies, have announced an agreement to enhance collaboration on maternal health programmes in more than 25 countries. This move, launched at the Women Deliver conference in Washington DC, will bring together UNFPA’s effective work with national governments and CARE’s expertise in engaging local communities.

"No woman should die giving life. Through collaboration we can make a bigger impact to improve the health of women and girls. UNFPA partners with governments, other UN agencies and civil society to advance the health and rights of women and girls, and we welcome this new partnership with CARE," said Thoraya Ahmed Obaid, Executive Director of UNFPA, when signing the agreement at the conference in Washington, DC.

A key element of promoting maternal health is mounting an effective challenge to HIV as, according to a recent World Health Organization report, AIDS-related illness is the leading cause of death and disease among women of reproductive age in low- and middle-income countries.

Through the Mothers Matter Programme, CARE aims to reduce maternal death by improving access to safe pregnancy and delivery services for 30 million women by 2015. Similar to the work of UNFPA, this signature programme will focus on family planning, skilled attendance at birth and emergency obstetric care within the context of a functioning health system. The Mothers Matter strategy aims to empower communities and civil society organizations to advocate for, and participate in, improved maternal health care; to mobilise local governments and civil society to ensure access to responsive health systems; and to promote supportive policy action while advocating internationally for greater global commitment and investment of resources.

At the 64th session of the General Assembly held on 9 June in New York, Deputy Secretary-General of the United Nations Dr. Asha-Rose Migiro on behalf of United Nations Secretary-General Ban Ki-Moon introduced the 2010 report on the progress made in the implementation of the Declaration of Commitment on HIV.

As part of the 2010 General Assembly AIDS Review, Mr Ban stated that the report puts forward "a set of recommendations that are ambitious, but achievable." He said the report, "presents a strong case for strengthening the links between the AIDS response and the other Millennium Development Goals".

In 2001 the Declaration of Commitment on HIV/AIDS mandated the UN General Assembly to review and debate an annual report by the Secretary-General on progress made in implementing the declaration. Its purpose is to identify problems and constraints, and present recommendations to make further progress in the AIDS response.

Expressing concern over governments cutting back on their response to AIDS to give more to other development efforts, the Secretary-General said, "The cost [of replenishment] may be great. But the cost of inaction will be even greater."

The report noted that the epidemic continues to outpace the HIV response: for every two people starting antiretroviral therapy, five are newly infected.

Recognizing the long-term benefits that will accrue from investing in HIV programmes, national governments and international donors should sustain and increase financial contributions to HIV programmes, it suggested.

The Secretary-General put special emphasis on the fifth MDG which focuses on maternal health, adding, "What is less well-known is that HIV is one of the leading causes of death among women of reproductive age worldwide.”

The report indicated that in 2007, one in five low- and middle-income countries achieved more than 50 per cent coverage of services to prevent mother-to-child HIV transmission, as well as antiretroviral therapy.

"A few years ago, tools to eliminate mother-to-child HIV transmission were just ideas. Now they are being put into practice all over the world," Mr Ban added.

Endorsing the strategic approach taken by UNAIDS to focus on ten priority areas under its Outcome Framework, Mr Ban said, "The Millennium Development Goals are indivisible and should never be pitted against each other."

Millennium Development Goal 6 calls to halt and begin to reverse the HIV epidemic by 2015. But unless the international community dramatically accelerates its efforts, we will not meet that target, the report noted.

It called upon stakeholders in the AIDS response to make a solid commitment towards eliminating mother-to-child transmission and optimizing the health of HIV positive mothers and their families.

It also advised national partners to begin planning now for long-term sustainability of antiretroviral therapy, including addressing the inevitable increase in demand for second- and third-line drug regimens.

As the 2010 World Cup kicks off this Friday, thousands of football fans will arrive in South Africa to cheer on their favourite teams.

HIV awareness and prevention is also a high priority during this time. HIV can spread particularly among young people, through the dangerous combination of alcohol and unsafe sex.

As HIV can be spread through unprotected sex, condoms are vital to protecting people from HIV infection. Male and female condoms are the most efficient, available technologies to reduce the sexual transmission of HIV and other sexually transmitted infections.

And to reduce the risk of HIV transmission, advocates count on making condoms readily available. Previously successful campaigns have included free condoms in match venues, hotels, stadiums, bars, and clubs. As one fan said, “condoms are more useful with me than in a warehouse.”

Condoms are a key component of the combination prevention package to reduce the sexual transmission of HIV. Other components include delay of sexual initiation, abstinence, being mutually faithful to each other when both partners are uninfected, and reducing the number of sexual partners.

UNAIDS commends the South African government’s commitment to distribute condoms during the World Cup. We support the efforts carried out by the South African National AIDS Council (SANAC) and civil society groups, including the Treatment Action Campaign and AIDS Consortium, to ensure that condoms and HIV information are made widely available during the tournament.

Each day, 7 400 people are infected with HIV worldwide. In South Africa, the host of this year’s World Cup, 5.7 million people are living with HIV ─ the largest number worldwide.

L to R: United Nations Secretary-General Ban Ki-moon, UNAIDS Goodwill Ambassador, Annie Lennox and UNAIDS Executive Director, Michel Sidibé. 07 June 2010. Credit: UNAIDS/S.Johnson

With maternal and reproductive health as a global priority, a three-day conference, Women Deliver 2010, has kicked off in Washington DC under the theme "Invest in women. It pays." The event’s main focus is to highlight that the Millennium Development Goals (MDG) will not be achieved without investing in women and that there is just enough time, if the world commits funding now, to achieve the MDG’s fifth goal of improving maternal health.

UNAIDS Executive Director Michel Sidibé and newly appointed UNAIDS Goodwill Ambassador Annie Lennox gave the welcome address and opening plenary on the first day of the conference.

“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. Let’s join together,” said Mr Sidibé.

Ms Lennox, who spoke on the topic Women Need a World that Delivers added, "I believe that the AIDS response is an excellent entry-point to better invest in women and girls at all levels, and to advance women's sexual and reproductive rights. We need to empower women and girls so that they can better protect themselves and take control of their own sexual and reproductive health."

About 16 million women over the age of 15 are living with HIV worldwide and in sub-Saharan Africa, women make up almost two-thirds of people living with HIV. In many parts of the world, women have a higher risk of HIV than men.

In cultures where gender inequality persists, women are likely to face barriers in accessing HIV, maternal and reproductive health services due to limited decision-making power, lack of control over financial resources, restricted mobility and child-care responsibilities.

A recent study published in the medical journal The Lancet projects that globally HIV has increased maternal mortality by 20%. While maternal mortality has been on the decline globally, it has been on the rise in many sub-Saharan Africa countries, because of HIV. In South Africa, it is estimated that more than 50% of all maternal deaths can be attributed to HIV.

Considerable progress, however, has been made on the treatment front. Over the years, more women have been able to access HIV treatment services. This is primarily due to the fact that more women are accessing antenatal services to prevent HIV transmission to their infants, and more women are coming forward for HIV counselling and testing.

Former President of Chile Michelle Bachelet (left) meets with UNAIDS Executive Director Michel Sidibé during Women Deliver 2010 conference in Washington D.C. Credit: Sylvia Johnson

With over 2,000 participants from 115 countries, including 100 government officials from more than 30 countries, the conference was also the platform to announce the initiation of the first trial among women in Africa testing a vaginal ring containing an antiretroviral drug that could one day be used to prevent HIV transmission during sex.

The technology, if successfully tested, would give women around the world a tool to protect themselves from HIV infection. The trial has been initiated by non-profit International Partnership for Microbicides (IPM).

Speaking on the trial, Mr Sidibe said, "Preventing HIV transmission is essential if we are to win the battle in the long-term and protect the health and safety of future generations. If successful, innovations, like microbicides, could have an extraordinary impact.”

The conference, which ends on 9 June 2010, includes over 300 speakers in 118 separate sessions over three days. Topics included “Modern Contraception Comes of Age”, “Strategies to Address Sexually Transmitted Infections” and “Girls Speak: Exploring the Girl Effect”.