A report on HIV among men who have sex with men and transgender people in the Asia-Pacific region has called for urgent scale-up of strategies to prevent the transmission of HIV, and to ensure greater access to treatment, care and support for those already in need.

Titled “Priority HIV and sexual health interventions in the health  sector for men who have sex with men and transgender people in the Asia-Pacific Region”, the report was developed after a meeting held in Hong Kong in February 2009, organized by WHO Regional Office for the Western Pacific, UNDP, UNAIDS and the Department of Health of Hong Kong.

The context of the report is important as it comes at the back of two similar reports—by the Commission on AIDS in Asia and by the Commission on AIDS in the Pacific—recommending that the control of the HIV epidemic in the region would imply focusing on the most-at-risk populations, including men who have sex with men (MSM) and transgender persons (TG).

The HIV epidemic among MSM and TG is escalating globally and in Asia, MSM are disproportionately affected by it, with the odds of MSM having HIV infection being 18.7 times higher than that in the general population, the report states. The Asian Epidemic Model projects that unless effective prevention measures are intensified, by 2020, around 46% of new infections in Asia will be among MSM, up from 13% in 2008.

The report lays great emphasis on repealing laws by parliament or decisions by courts that violate the constitutional rights of MSM. Male-to-male sexual behaviour remains a criminal offence in 18 Asia-Pacific countries, contributing directly to the stigma associated with male-to-male sex and driving MSM underground, making it more difficult for prevention programmes to reach them.

To counter difficulties in motivating health workers and reducing stigma and discrimination, the report recommends sensitizing health workers to work with people living with HIV, including MSM and TG; and recruiting MSM and TG into healthcare positions.

The report recommends for the involvement of MSM in community responses to HIV through self-organization. MSM should be given supportive access to the full range of services in which staff are sensitized to their issues and needs. Peer support and counselling should be actively encouraged, it states.

National health sector strategies and plans should call for the engagement of civil society and MSM and TG community based organisations in strategic planning, programme development, implementation, monitoring and evaluation.

Finally, the report recommends involving WHO, United Nations Development Programme (UNDP), UNAIDS, United Nations Educational, Scientific and Cultural Organization (UNESCO) and the Asia Pacific Coalition on Male Sexual Health (APCOM) in all aspects of planning, implementing, monitoring and evaluating health sector responses to HIV at the global, regional, national and local levels.

Mother and baby in Lesotho Credit: UNAIDS/M. Hamman

In sub-Saharan Africa an estimated 60% of people living with HIV are women, mostly in the reproductive age group. In the absence of appropriate interventions, HIV infection in women translates directly to infant and child infections.

Each year approximately 1.4 million women living with HIV become pregnant. Among antenatal clients in sub-Saharan Africa, the proportion of women living with HIV ranges from 5% to as high as 30%—and HIV among childbearing women is the main cause of infection among children.

More than 90% of infant and young child infections occur through mother-to-child transmission, either during pregnancy, labour and delivery, or breastfeeding. Without intervention, about one in three children born to mothers living with HIV will become infected.

In 2008, 430,000 children were newly infected with HIV, 90% of whom lived in sub-Saharan Africa. Most of these children, in the absence of access to antiretroviral treatment will die within one year of birth. Those who survive often lose their parents, if they too do not have access to antiretroviral therapy.

However the lives - of mothers and their babies—can be saved, through a combination of HIV testing and counselling, access to effective antiretroviral prophylaxis and treatment, safer delivery practices, family planning, and safe use of breast-milk substitute.

UNAIDS Executive Director Mr Michel Sidibé has called for the elimination of mother-to-child transmission of HIV by 2015. Africa is responding to this call. This week more than 200 participants from 20 countries with the highest burden of infections among pregnant women are meeting in Nairobi to chart out a a course of action to the needed HIV services.

At the heart of the plan is to mobilize resources. UNAIDS, UNFPA, WHO, UNICEF and the Global Fund to Fight AIDS, TB and Malaria (Global Fund) are co-convenors of this meeting will be providing technical support to these countries in building their capacities to develop sound business plans that can be funded.

“Africa‘s leaders are becoming serious about protecting their future generations,” said Michel Sidibé. “Investments made to protect mothers from HIV and babies from becoming infected is a moral responsibility of all governments.”

The Global Fund is an important source for these resources. It has committed to working with countries and other partners to ensure that at least 80% of Global Fund supported prevention of mother-to-child transmission (PMTCT) programmes meet the requisite levels of efficacy and quality by December 2010. The Global Fund has also committed to accelerate the scale up of PMTCT programmes and extend coverage to at least 60 per cent of women in need globally by the end of 2010.

A first step is to help countries reprogramme their existing grants to improve the effectiveness of the current programme strategies as well re-direct resources from savings and efficiency gains. The second step is preparing countries to make quality submissions to the Global Fund’s round 10 call for applications.

Many countries are already doing so. Ethiopia, having identified low antenatal coverage as a bottleneck to PMTCT utilization, is using its US$ 600 million grant to strengthen its maternal and child health services. South Africa has used the reprogramming opportunity to strengthen the participation of civil society in the PMTCT reprogramming exercise. Nigeria is using its reprogramming opportunity to strengthen broad program coverage and set more ambitious targets, much needed as Nigeria has the largest PMTCT burden globally. Zambia and Ghana also raised US$ 3 million from the Global Fund.

UNAIDS together with its Cosponsors UNICEF and WHO have facilitated such reprogramming in Tanzania which helped the country to mobilize an additional US$ 2.2 million for the country’s PMTCT programme. As a result the country increased its target coverage to 70%.

This story was first published on UNDP.org

More than 90 per cent of men having sex with men (MSM) in the Asia-Pacific region do not have access to HIV prevention and care services due to an adverse legal and social environment. If countries fail to address the legal context of the epidemic, this already critical situation is likely to become worse. The implementation of effective, human rights-based national HIV responses requires governments to consider the effect of laws and law enforcement practices on the health of men who have sex with men (MSM) and transgender persons.

A high-level forum on punitive laws, human rights and HIV prevention among MSM in the Asia-Pacific region was convened by the UN Development Programme (UNDP), the Asia Pacific Coalition on Male Sexual Health (APCOM) and the Centre for Comparative and Public Law (CCPL) at the University of Hong Kong. They were reviewing the findings of an upcoming report.

The study, “Laws affecting HIV responses among men who have sex with men and transgender persons in Asia and the Pacific: an agenda for action,” notes 19 of 48 countries in the region criminalize sex between men, with laws often taking on the force of vigilantism leading to abuse and human rights violations. Of the 192 member states of the United Nations, 85 have laws that still criminalize homosexual behaviour and, in some of these countries, conviction can even result in the death penalty.

On the occasion of International Day Against Homophobia, UNAIDS Executive Director Michel Sidibé said, “I salute the dedication and efforts of lesbian, gay, bisexual and transgender communities to demand their rights. Change is happening from exclusion to inclusion, from stigma to dignity but not everywhere ... I call on all governments to create to create social and legal environments that ensure respect for human rights.”

At the gathering in Hong Kong, Mandeep Dhaliwal, UNDP Cluster Leader on Human Rights, Gender and Sexual Diversity, said, “The development and strengthening of an enabling legal and social environment is critical for comprehensive interventions for men who have sex with men and transgender people to have the greatest impact.”

At least 5–10% of all HIV infections worldwide are due to sexual transmission between men, though this figure varies within countries and between regions considerably. In Asia, men who have sex with men are disproportionately affected by HIV. It is estimated that HIV prevalence is as high as 14% in Phnom Penh, Cambodia; 16% in Andrha Pradesh, India; and 28% in Bangkok, Thailand.

Men who have unprotected sex with men may also have unprotected sex with women and thus serve as an epidemiological bridge for the virus to the broader population. For example, a survey of over 800 men in China who have sex with men found that 59% reported having had unprotected sex with women in the previous year.

HIV transmission prevention programmes addressing men who have sex with men are therefore vitally important. However, this population is often seriously neglected because of official denial by governments, the relative invisibility of men who have sex with men, stigmatization, ignorance or lack of adequate information.

In some cases, men who have sex with men are neglected due to reluctance by individuals and organizations to work with them. In many countries, prevention efforts are hindered by laws that criminalize male-male sex, making work with men who have sex with men difficult and hindering their contribution to the response to the epidemic.

Even in the absence of criminalization, other provisions of law often violate the rights of those concerned, thereby obstructing HIV interventions, advocacy and outreach, and service delivery. Moreover, legislation and law enforcement often lag behind national HIV policies, undermining the reach and effectiveness of programmes for men who have sex with men.

This indicates the need for greater coordination between health and justice sectors within government, the report stresses. It highlighted some recent examples of protective laws, judicial and policy actions to improve the legal environment for the men concerned, including important court judgments in Fiji, India, Hong Kong, Nepal, Pakistan, Philippines and the Republic of Korea.

But these are exceptional developments and action is required to improve the legal environment in all countries, it warned.

The final report of the study’s findings will be delivered at the XVIII International AIDS Conference, Vienna, at the session on Criminalizing Homosexual Behaviour: Human Rights Violation and Obstacles to Effective HIV/AIDS Prevention, 20 July 2010.

Helen Clark meets with beneficiaries of an HIV project in Timbuktu. 04 May 2010. Credit: UNDP

The Administrator of the United Nations Development Programme (UNDP) Helen Clark recently ended a four-country tour of Africa to highlight progress towards the Millennium Development Goals (MDGs) in the run-up to the MDGs Summit in September 2010. Ms Clark travelled to Mali, Burkina Faso, Tanzania, and South Africa.

“Achieving the MDGs means quite simply a better life for billions of people,” Helen Clark said. “...Reaching the Millennium Development Goals is possible, and there is a range of tried and tested policies which ensure progress, particularly when backed by strong partnerships.”

UNAIDS participated in one leg of the tour as part of a joint mission with UNDP. UNAIDS Executive Director Michel Sidibé accompanied Ms Clark to Mali on a four-day mission where he reiterated his call for preventing HIV transmission from mothers to children. "I am honoured to join Helen Clark on her first visit to Mali, which is a clear sign of the UN's commitment to reach zero new HIV infections," Mr Sidibé said.

Ms Clark met with Heads of State and Ministers, touched base with women leaders and members of civil society, and visited development projects.

Mali has been making important headway in tackling the AIDS epidemic, having reduced national prevalence from 1.7% in 2001 to 1.3% in 2006 and dramatically expanding universal access to HIV services.

Ms Clark also reiterated the importance of empowering women to achieving the Millennium Development Goals, describing “economic empowerment, access to legal rights, including inheritance rights, and participation in decision-making” as key steps toward achieving women’s empowerment.

In Burkina Faso, she toured a project which facilitates access to energy for rural women, and visited one of 176 UNDP-supported AIDS community associations where she spoke with sex workers about their concerns for the future.

The prevalence rate of HIV in Burkina Faso has dropped from 7% in 2002 to 1.6% in 2008, one of the lowest in West Africa. Despite this progress, the country still faces an epidemic mostly affecting women between 15 and 24 years old.

In Tanzania, Ms Clark met with the Minister for Finance and Economic Affairs, Mustafa Mkulo, to discuss the country’s progress towards the MDGs, particularly on the AIDS response, empowering women, and enrolling children in primary school. She also travelled to Zanzibar and visited the Jozani-Chwaka Bay Conservation Area, the single most important site for the conservation of the island’s biodiversity.

Ms Clark toured the National Electoral Commission’s voter registration facilities where she spoke to first-time voters planning to take part in the national elections this October. UNDP’s support to Tanzania’s election process includes voter education, training for media and political parties, and training domestic observers.

In the last leg of her Africa tour Ms Clark visited South Africa, where she launched an MDGs campaign song in Johannesburg for the 2010 FIFA World Cup, "8 Goals for Africa". The song encourages commitment to the achievement of the MDGs.

“There can be no spectators in the fight against poverty,” she said at the launch. “Everyone has a role to play in scoring the 8 Millennium Development Goals, which if reached would improve the quality of life for hundreds of millions of people across developing countries.”

Ms Clark ended her four-country tour of Africa by launching the second annual Picture This photo contest in Johannesburg in partnership with Olympus Corporation and the Agence France-Presse (AFP) Foundation. The contest, titled Picture This: We Can End Poverty, seeks to show the inspirational work that is being done in many countries to achieve the MDGs.

“Through the photo contest this year we want to show that the MDGs can be reached, even in the poorest and most disadvantaged countries,” Ms Clark concluded.

UNAIDS Executive Director Michel Sidibé visited the outpatient clinic and maternity ward at Yaoundé’s central hospital. 19 May 2010.

After almost ten years, 28-year old Angele is a mother again. “My daughter is my joy. She is such a wonder,” said the young woman who wishes to keep her identity a secret as she is living with HIV in Oug-ebe, a shantytown in Yaoundé, Cameroon.

She found out she was HIV-positive in 2001 when she underwent a test at the time of her first pregnancy. Even though she took antiretroviral treatment to prevent HIV transmission to her fetus, her baby was born HIV-positive and died after nine months from an AIDS-related illness. “They told me that I was in a highly infectious stage when I was pregnant so the drugs didn’t work. I was devastated. Only after almost ten years, when I heard the science had improved did I get pregnant again," said Angele.

And her gamble paid off with a gift: Crissile (not real name) a healthy baby girl who is HIV free. While Angele savours each moment with the playful toddler, she confesses that she still lives with a shadow of doubt. “I always worry that maybe the diagnosis was wrong. They say the test isn’t always right”.

An addition to that gnawing concern is her daily struggle with stigma and discrimination. During the interview, she nervously closes the window and shuts her door, to keep her disclosures from curious neighbours. “We rent this place and if the neighbours found out I was HIV-positive, I might get kicked out of my home,” said Angele.

At the moment she is a volunteer in an outpatient clinic in Yaoundé’s central Hospital, but has no job and relies on her family for support.

Over the past ten years the clinic, which provides care management and treatment for HIV patients, has seen a lot of progress. Last year, it treated more than 26-thousand HIV patients and put more than 6000 on antiretroviral therapy. “I think discrimination has gotten better, but we still mask what we do by also saying we treat skin diseases, so our HIV patients have a cover,” said the centre’s director, Dr Charles Kouanfack.

Cameroon has led the way in Africa in decentralizing its AIDS response. Now almost all health districts are equipped to prevent mother-to-child HIV transmission (PMTCT). While coverage of treatment to prevent babies from getting HIV reached almost 34% of pregnant women living with HIV in 2009, a vast improvement from the 18 % of 2008, the country still has a long way to go. Dr Kouanfack says while health districts have reached almost their maximum level of PMTCT coverage the problem is that many women do not go to hospitals and clinics to give birth. Pregnant women in rural and marginalized communities will have their children at home with a mid-wife. So, the next step would be to implement strategies to reach out to vulnerable women.

However, ramping up HIV coverage has had other benefits. “The resources which have gone to HIV treatment have also helped improve the capacity of health systems in general. We see that ameliorating the management of HIV has helped increase the professionalism of our laboratories and medical staff,” said Dr K Kouanfack.

UNAIDS Executive Director Michel Sidibé has championed the prevention of mother to child HIV transmission. He has made the eradication of babies born with HIV a top priority. “It is not acceptable that in countries like France or the US practically no pregnant HIV positive women give birth to babies with HIV, but in places like Cameroon, still far too many babies are born with HIV,” said Mr Sidibé. “This kind of inequality is intolerable. We know we can stop mother to child transmission of HIV, so we must continue to redouble our efforts to overcome this injustice.”

He visited the HIV treatment centre and maternity ward at Yaoundé’s central hospital this week and praised the efforts Cameroon has made to eradicate the transmission of HIV from mother to child. But he called on the leadership to continue to expand prevention measures and become a model of PMTCT in Africa.

UNAIDS Executive Director Michel Sidibé (right) during the plenary session on human security issues in Africa. Yaoundé, 19 May 2010.

The heads of seven African states are in Yaoundé at the invitation of Cameroon’s President Paul Biya to celebrate the 50th anniversary of their countries’ independence on Thursday. The seven leaders, who come mostly from central Africa, also took part in the closing ceremony of the international conference “Africa 21” on Wednesday evening.

The high-level conference, themed “Africa, a chance for the world: realities and challenges,” brought together many international leaders including Chairperson of the African Union Commission, Jean Ping, Secretary General of the Commonwealth, Ali Abdussalam Treki, two former French prime ministers, Michel Rocard and Alain Juppe, as well as former United Nations Secretary General Kofi Annan.

“Africa is a sleeping giant about to be awoken,” said Mr Annan, who then outlined how the region is increasingly becoming an active player on the world stage, participating actively in the G20 and in international climate talks in Copenhagen last December.

UNAIDS Executive Director Michel Sidibé also participated in the closing ceremony and was the president of a plenary session on human security issues in Africa.

“In today’s interconnected and interdependent world, countries recognize that domestic action alone can no longer assure the security of their people and economies,” said Mr Sidibé, “AIDS is one of the first examples in the modern era of how a transnational threat to human health has prompted a concerted response to global governance.”

He stressed that if the impact of the epidemic on health and human security is not stopped, many African countries will be unable to adequately address any other development issue. To overcome the inroads HIV is making on the African continent he said AIDS must be taken out of isolation and called on international, national and community leaders to harness their political clout and resources to push for an end to AIDS.

Country visit

UNAIDS Executive Director Michel Sidibé and Cameroon’s First Lady Chantal Biya during his visit to the pan-African non-governmental organization “Synergies Africaines contre le SIDA et les souffrances” (African Synergies against AIDS and suffering). Yaoundé, 19 May 2010.

As part of his official visit to the country, Mr Sidibé was invited by Cameroon’s First Lady Chantal Biya to visit the pan-African non-governmental organization “Synergies Africaines contre le SIDA et les souffrances” (African Synergies against AIDS and suffering) where he also met the First Lady of Burkina Faso, Chantal Compoare. The NGO leverages the celebrity status of its 26 African First Ladies who are members and have as a mission improving the health of the African people. At the NGO, members of civil society expressed their hope for UNAIDS to support Cameroon in its bid to qualify for the Global Fund to Fight AIDS, Tuberculosis and Malaria’s Round 10 after the country’s unsuccessful proposal for previous round.

Mr Sidibé also visited First Lady Biya’s international research centre which is conducting research into an HIV vaccine as well as exploring resistance to antiretroviral therapy.

On Tuesday, Mr. Sidibé and Deputy Secretary-General of the United Nations, Dr. Asha-Rose Migiro discussed the challenges and national priorities on HIV with the United Nations country team in Cameroon. Later, they visited Yaoundé’s Sanitation Project (PADY) which is funded by the African Development Bank and implemented by the government of Cameroon. The project aims to alleviate the recurrent flooding in the city of Yaoundé and also reduce urban poverty. A PADY employee spoke about sensitization on HIV. The project provides voluntary counseling and testing on HIV and 50% of employees have undergone HIV tests.

Global Fund Ambassador, Carla Bruni-Sarkozy. Credit: Global Fund

The Global Fund to fight AIDS, Tuberculosis and Malaria has launched a new campaign BORN HIV FREE to mobilize public support for its work and contribute to the global effort for a world where no child is born with HIV by 2015. At the core of the campaign, originated and supported by Global Fund Ambassador, Carla Bruni-Sarkozy, is a series of creative films intended to inspire people to sign up online in support of The Global Fund’s mission.

Carla Bruni-Sarkozy’s support for the BORN HIV FREE campaign follows a call in 2009 from UNAIDS Executive Director Michel Sidibé to virtually eliminate mother-to-child transmission by 2015.

HIV-positive mothers can pass on HIV to their babies during pregnancy, child labour, delivery or by breast-feeding. The risk of transmission can be significantly reduced if they get access to HIV prevention and treatment services.

“It is heartbreaking that over 400,000 babies are born with HIV every year even though we have the medical means and the expertise to prevent this,” said Carla Bruni-Sarkozy, The Global Fund’s Ambassador for Protecting Women and Children against AIDS. “I hope the BORN HIV FREE campaign will inspire millions of people to support The Global Fund so we can finally put an end to this terrible injustice.”

HIV-positive mothers can pass on HIV to their babies during pregnancy, child labour, delivery or by breast-feeding. The risk of transmission can be significantly reduced if they get access to HIV prevention and treatment services.

“We can win this battle against AIDS if we get the funding we require,” said Professor Michel Kazatchkine, Executive Director of The Global Fund. “This campaign is intended to encourage people to sign up in support of The Global Fund and to show their leaders that there is strong public support to continue and increase funding for its mission.”

The campaign will operate in several languages with short animation films aiming to expand public awareness that an HIV-free generation is possible within five years if governments continue funding the AIDS response. More information can also be found on the campaign’s web site (www.bornhivfree.org).

Since its establishment in 2002, The Global Fund has approved proposals totaling US$ 19.4 billion making it the main contributor to the health–related Millennium Development Goals. If current progress rates are maintained, it is possible to ensure that virtually no children anywhere in the world are born with HIV by 2015.

A majority of The Global Fund’s resources come from donor governments. This year countries will pledge funding for the next three years (2011-2013) to fight AIDS, Tuberculosis and Malaria. On 5 October 2010, UN Secretary-General Ban Ki-moon will chair a meeting of donor countries in New York. The BORN HIV FREE campaign will run until the key meeting in New York in order to mobilize public support for its work.

(L to R) Chen Zhu, Minister of Health of China, Aaron Motsoaledi, Minister of Health of South Africa and UNAIDS Executive Director Michel Sidibé. Credit: UNAIDS

In key bilateral meetings held on the eve of the 63rd World Health Assembly in Geneva, Michel Sidibé, Executive Director of UNAIDS engaged ministers of health from leading countries on how investments in AIDS can be used to leverage progress towards the other Millennium Develop Goals (MDGs).

During a meeting with Chen Zhu, Minister of Health of China, and Aaron Motsoaledi, Minister of Health of South Africa, Michel Sidibé cited these two countries as leading examples of the AIDS plus MDG agenda. “China and South Africa are leading examples of how national leadership on AIDS can accelerate broader goals for health and development.”

Michel Sidibé congratulated Minister Zhu for China’s recent decision to lift HIV-related travel restrictions prior to the opening of Expo 2010 in Shanghai. “Every individual should have equal access to freedom of movement,” said Michel Sidibé, UNAIDS Executive Director. “This is a powerful signal that foreigners who wish to visit, work and live in China are welcome—regardless of their HIV status.”

Michel Sidibé also praised Minister Motsoaledi for South Africa’s leadership in response to HIV. “With the launch of the National HIV Counselling and Testing Campaign, South Africa has launched the world’s largest AIDS initiative that integrates HIV with larger public health goals.” said Sidibé. On 25 April, South Africa’s President Zuma launched South Africa’s National HIV Counselling and Testing Campaign, which aims to voluntarily test 15 million South Africans for HIV in coming months. According to Minister Motsoaledi, “the HIV Counselling & Testing campaign also offers people taking HIV tests the incentive of free screening for hypertension, blood sugar levels, haemoglobin, TB and cervical cancer.”

UNAIDS is collaborating with China and South Africa on the development of the ‘AIDS plus MDG agenda,’ which aims to position the AIDS movement as a force for accelerating progress towards the MDGs. UNAIDS is developing plans for a high-level side event on AIDS plus MDGs during the UN Summit on the Millennium Development Goals in September 2010 that will be co-hosted by the Governments of China and South Africa.

In another meeting, Michel Sidibé met with Dr Jose Gomes Temporao, Minister of Health of Brazil. Brazil is recognized by UNAIDS for having been one of the first countries to achieve universal access to treatment. “Brazil is a model to other countries in its national response to AIDS,” said Michel Sidibé. “Brazil has also demonstrated how AIDS has strengthen the national health system, and the fight for equality and human rights.” Mr Sidibé and Dr Temporao also discussed how Brazil has used HIV to advance the use of trade-related aspects of intellectual property rights (TRIPS) to increase access to essential health commodities. They also agreed feature the results of a 10-year assessment of the Doha Declaration on TRIPS and Public Health and HIV in Brazil later this year.

May 17 is the International Day Against Homophobia. Homophobia is considered one of the main obstacles in implementing HIV prevention strategies. Of the 192 member states of the United Nations, 85 have laws that still criminalize homosexual behaviour and, in some of these countries, conviction can even result in the death penalty.

Speaking on the occasion, UNAIDS Executive Director Michel Sidibé said, “I urge all governments to take steps to eliminate stigma and discrimination faced by men who have sex with men, lesbians and transgender populations. They must also create social and legal environments that ensure respect for human rights and enable universal access to HIV prevention, treatment, care and support.”


Video message from UNAIDS Executive Director

At least 5-10% of HIV infections worldwide are estimated to occur through sex between men, though this figure varies considerably between countries and regions. Yet men who have sex with men continue to face discrimination from healthcare workers, other service providers, employers and the police. Discrimination prevents men who have sex with men from disclosing their sexual orientation, or reporting for HIV services. Consequently their vulnerability to infection is increased, and national data do not reflect the size of the HIV epidemic that is linked to same-sex behaviour involving men.

Removing punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS is one of UNAIDS’ 10 priority areas in the Joint Outcome Framework for 2009-2011. Another key priority of the Framework is also to empower men who have sex with men, sex workers and transgender people to protect themselves from HIV infection and to fully access antiretroviral therapy.

The 2001 UN General Assembly Special Session (UNGASS) Declaration of Commitment on HIV/ AIDS adopted by all UN Member States emphasized the importance of “addressing the needs of those at the greatest risk of, and most vulnerable to, new infection as indicated by such factors as […] sexual practices.” In the 2006 United Nations Political Declaration on HIV/AIDS, governments committed to removing legal barriers and passing laws to protect vulnerable populations.

Many governments have not acknowledged that sex between men happens and that unprotected anal sex contributes to the transmission of HIV. Often if recognized, there is insufficient political will, funding and programming to address it.

“Homophobia and transphobia drive significant parts of HIV epidemics underground in all regions of the world. Only around one in 10 MSM and transgender people have access to HIV prevention services", said Michel Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. “The Global Fund is fully committed to addressing these inequities for the benefit of MSM and transgender communities and broader populations”.

UNAIDS hosted an event at its headquarters in Geneva that included the screening of a short video on homophobia in Jamaica and how it impacts people, titled A Deadly Cycle and a film Translatina, a full-length documentary that offers a realistic look at the challenges faced by transgender people in accessing education, work, justice, health care, and other services in Latin America.

Also on the agenda were discussions by Frank Mugisha, Executive Director, Sexual Minorities of Uganda; LGBT rights activist Ashok Row Kavi, who is also Technical Officer, Sexual Minorities, UNAIDS country office for India; and Dr Gottfried Hirnschall, WHO HIV director.

In 1990, the World Health Assembly approved the 10th Edition of the International Classification of Diseases (World Health Organization) on May 17, which established that sexual orientation (heterosexual, bisexual or homosexual), on its own, would no longer “be considered as a disorder”. For this reason May 17 is used to mark the International Day against Homophobia.

Credit: WHO/Jesse Hoffmann

The 63rd World Health Assembly, the gathering of the decision-making body of World Health Organization (WHO), opened in Geneva today. Health Ministers and officials from across the world will meet until 21 May 2010 to discuss the implementation of the International Health Regulations (IHR).

There are 194 countries across the globe, including all the member states of the World Health Organization (WHO) who are State Parties to the IHR, a binding, international legal instrument. The aim of these global rules is to help the international community prevent and respond to acute public health risks that have the potential to cross borders and threaten people worldwide.

The IHR, for example, require countries to report certain disease outbreaks and public health events to WHO and also to strengthen their existing capacities for public health surveillance and response.

This year’s World Health Assembly will also focus on monitoring the achievements of the health-related Millennium Development Goals. In the year 2000, 189 countries committed their nations to a new global partnership to reduce extreme poverty. They set out a series of targets to be reached by 2015. These have become known as the Millennium Development Goals (MDGs) and include halving extreme poverty, halting the spread of HIV and providing universal primary education.

The World Health Assembly is attended by delegations from all WHO member states yearly to focus on specific health agenda. Last year’s Assembly focused considerable attention on the widespread outbreak of influenza A (H1N1) and the most effective responses to the potential pandemic, including preparedness, access to vaccines and sharing of influenza viruses.