UNAIDS Executive Director Michel Sidibé joined the President of South Africa Jacob Zuma (right)for the launch on 25 April 2010. Credit: UNAIDS/A. Vlachakis

UNAIDS Executive Director Michel Sidibé was invited by the South African government to join in the launch of a new testing campaign with President Jacob Zuma, Health Minister Aaron Motsoaledi, Premier Nomvula Mokonyane and civil society representatives Vuyiseka Dubula from the Treatment Action Campaign and Nkululeko Nxesi from the National Association of People living with AIDS.

Some 2000 people were on hand at the Natalspruit hospital in Erkuhuleni, Johannesburg. In his address at the launch, Mr Sidibé applauded President Zuma and Minister Motsoaledi for their leadership and commitment to the HIV response in South Africa, and for the unprecedented mobilization of the nation to know their HIV status.

Mr Sidibé noted: “This campaign is the biggest national mobilization in South Africa around any one single issue since the end of apartheid. Testing 15 million people by the end of 2011 is the largest programme scale-up in the world we have seen so far. It is historic.” He went on to say that South Africa was “writing a new page in the story of Africa by being the architects of the end of the HIV tragedy.”

In his statement, President Zuma disclosed his negative HIV status and encouraged South African citizens to test regularly. He stressed that the disclosure of one’s status was an individual decision and not mandatory.

The President implored the people of South Africa to change their attitudes about the epidemic and the stigma attached to HIV. He mentioned that stigma arose from ignorance, and that the benefit of the voluntary HIV Counselling and Testing campaign is its capacity to educate people about HIV and to promote the rights and dignity of people living with HIV.

The ceremony included the launch of the HIV Counselling and Testing campaign song, which was performed by Choome and Arthur Mopokane, two of South Africa’s popular singers, as well as a performance by the traditional musician Ihashi Elimhlophe.

The launch concluded with Mr Sidibé, Minster Motosaledi, Premier Mokonyane and other South African leaders testing for HIV.

South Africa’s HIV Counselling and Testing campaign is the largest HIV counselling and testing scale-up in the history of the HIV epidemic. The campaign aims to test 15 million people for HIV and to expand access to antiretroviral treatment to 80% of those in need by 2011.

South Africa has the world's largest population of people living with HIV; an estimated 5.7 million people in the country are living with HIV, representing nearly one sixth of the global disease burden. Approximately 18% of adults in South Africa are infected with HIV.

Preventing mother-to-child transmission of HIV (PMTCT) is one of the key pillars in the worldwide response to the AIDS epidemic and one of the priorities of UNAIDS Secretariat and its Cosponsors. The World Health Organization (WHO) has recently published a strategy paper outlining its commitment to support country-level and global efforts to scale up PMTCT services and to integrate such services into maternal, newborn and child health programmes.

Preventing mothers from dying and babies from becoming infected with HIV is one of UNAIDS’ key priority areas as outlined in its . The new PMTCT strategic vision 2010–2015: preventing mother-to child transmission of HIV to reach the UNGASS and Millennium Development Goals, reflects an important part of WHO’s health sector response to HIV and will contribute directly towards achieving the results of the Outcome Framework.

As a UNAIDS cosponsor which co-leads efforts to prevent mother-to-child HIV transmission within the United Nations, along with cosponsor UNICEF, WHO will use the PMTCT strategic vision to accelerate global support for prevention of mother-to-child HIV transmission.

The strategy paper urges the international community to set new, more ambitious targets that promote progress towards the virtual elimination of paediatric HIV by 2015. It also calls for greater collaboration with partners, such as the Global Fund to fight AIDS, Tuberculosis and Malaria, and the US President’s Emergency Plan for AIDS Relief (PEPFAR).

Significant progress in PMTCT has occurred in recent years and in 2008 around 45% of pregnant women living with HIV in low- and middle-income countries received antiretroviral drugs to prevent mother-to-child transmission of HIV. This is in contrast to only 10% in 2004.

Despite these successes, coverage levels of PMTCT services are still low in a number of resource-limited countries and communities. According to the UNAIDS/WHO AIDS Epidemic Update 2009 an estimated 430,000 children were newly infected with the virus in 2008, more than 90% of them through vertical transmission from their mothers. Without treatment, around half of these children will die before their second birthday.

But mother-to-child transmission is almost entirely preventable where services are accessible, and PMTCT interventions can reduce the risk of infection to less than 5%.

The PMTCT strategic vision can help address this by promoting a comprehensive approach that includes the following four components: primary prevention of HIV infection among women of childbearing age; preventing unintended pregnancies among women living with HIV; preventing transmission from an HIV-positive woman to her infant; and providing appropriate treatment, care and support to mothers living with HIV and their children and families.

The new document highlights a series of needed strategic directions:

• Strengthen commitment and leadership to achieve full coverage of PMTCT services
• Provide technical guidance to optimize HIV services for women and children
• Promote and support integration of HIV interventions within maternal, newborn and child health and reproductive health programmes
• Ensure equitable access for all women, including the most vulnerable
• Support health systems interventions to improve service delivery
• Track programme performance and impact
• Strengthen global, regional and country partnerships and advocate for increased resources.

The publication provides a number of country and regional examples. In Asia, several nations have begun linking HIV services with reproductive, adolescent, maternal, newborn and child health services.

Along the same lines, the elimination of mother-to-child transmission of HIV and congenital syphilis in Latin America and the Caribbean (affecting some 6,000 children and 450, 000 pregnancies each year respectively) has been defined as a top priority by the WHO Regional Office for the Americas and UNICEF. Together with partners, they have recently launched a campaign with the objective to eliminate mother-to-child transmission of HIV by 2015.

The PMTCT strategic vision also shows that interventions needed vary depending on country or regional circumstances. In Eastern Europe, for instance, emphasis is not on general population interventions but on improving PMTCT services for key populations at higher risk such as injecting drug users and their partners.

It is clear that whatever the context, the need to eliminate mother-to-child transmission of HIV is of paramount necessity. The PMTCT strategic vision is designed to be a key tool to strengthen WHO's support to this global effort to save lives and protect the health of the world’s women and children.

During an official visit to Senegal, the UNAIDS Executive Director Michel Sidibé (left) was received by the President, Mr Abdoulaye Wade on 19 April.

During an official visit to Senegal, the UNAIDS Executive Director was received by the President, Mr Abdoulaye Wade on 19 April. Mr Sidibé thanked President Wade for taking the initiative to include an important item on the agenda of the African Union Summit in July 2010 in Kampala, Uganda, titled “Accelerating measures on HIV and MDGs: Partnership to Eliminate Mother-to-Child Transmission of HIV in Africa.” The Executive Director noted that HIV has been the major cause of child and infant mortality in major parts of Africa, with about 390,000 children under 15 newly infected with HIV in 2008 alone.

Mr Sidibé also thanked President Wade for the successes recorded by his country in the fight against HIV in general and in the eradication of vertical transmission from mother to child in particular.

In response, President Wade assured Mr Sidibé that “Senegal will work with UNAIDS towards the goal of zero new infections in Senegalese children by 2015.”

Mr Michel Sidibé was in Dakar, Senegal, to take part in the UNAIDS Sub-Saharan Africa Regional Management Meeting, with the aim of leveraging HIV for broader health and development outcomes in Africa and to discuss Senegal’s progress on universal access with its authorities.

UNAIDS Executive Director Michel Sidibé (right) also met the Prime Minister of Senegal, Mr Souleymane Ndéné Ndiaye, who reaffirmed Senegal’s commitment to total eradication of mother-to-child transmission.

Mr Sidibé also met the Prime Minister of Senegal, Mr Souleymane Ndéné Ndiaye, who reaffirmed Senegal’s commitment to total eradication of mother-to-child transmission. He said that “the prevention of new infections should be a priority for all African countries.”

During his visit, Mr Sidibé noted that a lot of progress had been made in the AIDS response in Africa. “In 2008, about 45% of pregnant women living with HIV in this region were receiving antiretroviral drugs to prevent transmission to their children, up from 35% the previous year. Tens of thousands of new HIV infections have been prevented as a result of prevention programmes and the efforts of African governments, civil society and youth,” said Mr Sidibé. Yet despite progress, many challenges remain that prevent people from accessing the HIV prevention and treatment services they need, he added.

To help successfully implement the project and build the capacity of NGO staff and government officials, five days of training in HIV took place in Kabul.
Credit: UNODC

Providing comprehensive HIV services for injecting drug users is critical to an effective HIV response. In recognition of this, the United Nations Office on Drugs and Crime (UNODC) has begun to support the implementation of an initiative to make services accessible to Afghan refugees who inject drugs in Iran and Pakistan, and also to Afghan injecting drug users who have returned home.

The use of non-sterile injecting drug equipment is one of the most efficient modes of HIV transmission and remains one of the critical activities fuelling HIV epidemics among drug users. HIV can also spread from people who inject drugs to their sexual partners and other populations at higher risk of HIV exposure such as sex workers.

The project aims to create an environment that supports a cross-border regional network of HIV services so that Afghan refugees will be able to access HIV services when they go back to their country. UNODC awarded two grants to non-governmental organizations to provide services to Afghan drug users in Herat province, bordering Iran and Nangarhar, which borders Pakistan.

Khatiz Organization for Rehabilitation in Herat and the Health and Social Development Organisation in Nangarhar are using mobile outreach units to offer a wide-ranging set of servcies. These include facilitating specific information and education materials for drug users; distributing clean needles and syringes; promoting and distributing condoms; treating and helping prevent sexually transmitted infections; primary healthcare such as HIV voluntary counseling and testing services and antiretroviral treatment.

Training in HIV and drug use 

To help successfully implement the project and build the capacity of NGO staff and government officials, five days of training in HIV took place in Kabul. Doctors, nurses, social workers, project managers and employees from the women’s prison participated.

During the meeting, also attended by high-level delegations from the government, UN agencies and NGOs, the seriousness of the situation in Afghanistan was discussed. Dr.Mohammad Zafar, Deputy Minister of Counternarcotics, told the gathering that according to a 2005 UNODC survey, the country has one million drug users, including 19 000 – 25 000 who inject drugs, making up 3.8% of the total population.

According to Dr.Ajmal Sabaoon, National AIDS Control Programme Manager, Afghanistan is moving from a low-level HIV epidemic towards a concentrated epidemic. He briefed participants on results of an Integrated Biological and Behavioral Survey conducted by John Hopkins University in 2009, which indicates that HIV prevalence among injecting drug users in three major cities of the country (Kabul, Herat and Mazar) has increased from 3% to 7% from 2007 to 2010.

Knowledge of HIV among IDUs is also very low. According to the study, only 29 % of the IDUs could correctly identify ways of preventing the sexual transmission of HIV and reject major misconceptions about HIV transmission. About 22 % of the IDUs have ever tested and know their HIV status.

The surveyed injecting drug users are known to be mobile, as almost 80% reported that they had changed residence at least once. Much of the mobility appears to be related to various phases of the conflict in the country, with the majority of IDUs relocating to Pakistan or Iran. The UNODC and its partners hope that by providing HIV services to injecting drug users in such bordering locations will help reverse the growing HIV prevalence among IDU in the country as well as within the sub regional area.

Protecting drug users against HIV is one of the nine priority areas in the UNAIDS Outcome Framework 2009-11. This can be aided by making comprehensive, evidence-informed and human-rights-based interventions, such as harm reduction and demand reduction, accessible to all who need them.

A new report published in the medical journal The Lancet found that, for the first time in decades, the number of women dying each year from pregnancy and childbirth has significantly drop. Credit:UNAIDS/P.Virot

A new report published in the medical journal The Lancet found that, for the first time in decades, the number of women dying each year from pregnancy and childbirth has significantly dropped. Researchers estimate that maternal deaths fell from 526 300 in 1980 to 343 900 in 2008.

UNAIDS Executive Director Michel Sidibé has welcomed the findings of the new report while attending the Launch Meeting of the Secretary-General’s Joint Effort on Women’s and Children’s Health. The two-day meeting brings global health leaders together to generate consensus as well as to plan measures to achieve the Millennium Development Goals 4 and 5.

The report, carried out by the University of Washington and the University of Queensland and funded by the Bill & Melinda Gates Foundation, highlights that progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. Nearly one out of every five maternal deaths— a total of 61,400 in 2008—can be linked to HIV, and many countries with large populations affected by HIV have had the most difficulty reducing their maternal mortality ratio. In South Africa, more than 50% of all maternal deaths are linked to HIV.

“This study serves as a powerful reminder that progress in maternal health efforts is hugely dependent on progress in the AIDS response in countries with the most severe HIV epidemics,” said Mr Sidibé.

Mr Sidibe emphasized the UNAIDS pledge to continued support for the virtual elimination of mother-to-child transmission as outlined in its Outcome Framework 2009 - 2011. He also highlighted UNAIDS' commitment to ensure women living with HIV have access to treatment before and after birth to guarantee that newborn babies are not infected with HIV and mothers stay healthy.

Evidence shows that timely administration of antiretroviral drugs to HIV-positive pregnant women significantly reduces the risk of HIV transmission to their babies; it is a proven, inexpensive, and effective intervention. However, at the end of 2008, only 45% of HIV-positive pregnant women received the necessary treatment in low- and middle-income countries. Progress in this area can only be achieved by improving the quality of data and by integrating programmes which prevent the transmission of HIV from mothers to their children into the broader reproductive health agenda.

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

Ann M. Veneman visits clients at a children's clinical centre built by Baylor College of Medicine and Bristol-Myers Squibb in Maseru, Lesotho, where paediatric and family HIV care and treatment services are provided to young children and their caregivers.

During a recent visit to Lesotho, UNICEF Executive Director Ann M. Veneman launched Facts for Life, a publication that delivers life-saving information to families and communities on how to prevent child and maternal deaths, diseases, injuries and violence.

“Education is key”, said Ms Veneman. “Through simple messages, Facts for Life aims to bring vital knowledge to parents and caregivers, who are the first line of defence in protecting children from illness and harm.”

Circulated worldwide

Some 15 million copies Facts for Life have reached billions of people since its first publication in 1989. It is a co-publication by UNICEF, WHO, WFP, UNESCO, UNFPA, UNDP, UNAIDS and the World Bank, and provides practical advice on pregnancy, childbirth, major childhood illnesses, child development, early learning, parenting, protection, care and support for children.

New chapter on child protection

The publication includes a chapter on managing HIV. It promotes early diagnosis in children, effective treatment and anti retroviral therapy when prescribed. Currently most HIV-positive children are given such treatment after the age of five, when it might be too late. Without treatment, half of all babies born with HIV will die before their second birthday.

“One in ten children in Lesotho does not survive to see his/her fifth birthday, most as a result of AIDS and preventable causes like pneumonia and diarrhea, exacerbated by malnutrition” said Ms. Veneman, “Facts for Life can help bridge the information gap that contributes to the needless death of millions of young children.”

The publication also contains a new chapter on child protection, which provides information on keeping children safe from violent and harmful behaviours and practices.

“Girls and boys must be protected from violence and abuse,” said the Executive Director. “Protecting children so that they can grow up in safe environments and reach their full potential can help break the cycle of poverty.”

Functioning ARV dispensing site in Port-au-Prince after the devastating 12 of January earthquake. Credit: UNAIDS

Haitian civil society representatives visited Washington, D.C. on 6 April to mobilize political support for reconstructing the AIDS response in Haiti.

The civil society delegation, with support from UNAIDS, gave a testimony of their experiences with the earthquake and highlighted the importance of reconstructing the AIDS response with direct involvement of affected communities, especially people living with HIV. The briefing was held at Capitol Hill during a US Congressional briefing sponsored by US Senator Kirsten Gillibrand (D-NY) and attended by congressional staff, AIDS advocates and US civil society representatives.

Later that same day, the delegation from Haiti visited US Global AIDS Coordinator Ambassador Eric Goosby and his colleagues from USAID. The US government team pledged its support to encourage the Haitian government to include the involvement of people living with HIV in planning the reconstruction of the AIDS response in Haiti.

On 24 March, US President Obama asked the US Congress to approve $2.8 billion as an emergency requirement for relief and reconstruction support for Haiti following the devastating earthquake of 12 January 2010. The request is now pending before US lawmakers who will very soon vote on the proposal.

There were an estimated 120 000 people living with HIV in Haiti before the earthquake. Most of the structural damage happened in the three departments (Ouest, Sud-Est and les Nippes) that accounted for nearly 60% of the population of people living with HIV.

Following an initial rapid assessment of the situation with the Ministry of Public Health and Population, UNAIDS released a concept note Helping Haiti rebuild its AIDS response. The report explains the current situation in Haiti and what may be required to meet the immediate and intermediate AIDS response needs.

Civil society networks of people living with HIV as well as many of the organizations providing HIV services have been affected by the earthquake and are in need to be strengthened.

Austria’s Minister of Health Alois Stöger, (right) met UNAIDS Executive Director Michel Sidibé in Vienna, 7 April 2010. Credit: UNAIDS

During an official visit to Vienna, UNAIDS Executive Director Michel Sidibé met with high-ranking government representatives of Austria, including the Minister of Health Alois Stöger, Executive City Councillor for Public Health and Social Affairs of Vienna Sonja Wehsely, as well as Her Excellencies Ambassadors Irene Freudenschuss-Reichl, Director General of the Department of Development Cooperation at the Ministry of Foreign Affairs of Austria and Brigitte Öppinger-Walchshofer, Director General of the Austrian Development Agency.

The visit acknowledged the strengthening of the relationship between UNAIDS and Austria in recent years, and was very timely as Austria is hosting the XVIII International AIDS Conference in Vienna from 18-23 July 2010.

In his meeting with Minister of Health Alois Stöger, Mr Sidibé commended Austria for its support for the upcoming International AIDS Conference, emphasizing that UNAIDS wanted this event to become a turning point in addressing the epidemic, especially with regard to the debate around AIDS and its strong linkages with human rights, as well as with the issues of migrant populations and violence against women. He encouraged Austria as host of the Conference to play a leadership role on HIV prevention in the Eastern European/Central Asian region, especially given the rise of the co-infections with TB. AIDS was an opportunity to make progress on larger health and development goals through the integration of HIV services with wider health services including treatment of tuberculosis as well as sexual and reproductive health.

Executive City Councillor for Public Health and Social Affairs of Vienna Ms Sonja Wehsely (right) and UNAIDS Executive Director Michel Sidibé discussed together the forthcoming International AIDS Conference in Vienna. The meeting took place 7 April 2010. Credit: UNAIDS

Mr Sidibé commended the City of Vienna for its leading work on HIV prevention in a meeting with the Executive City Councillor for Public Health and Social Affairs of Vienna Ms Sonja Wehsely, and mentioned with regard to the upcoming AIDS Conference that Vienna “should not only be the bridge between the east and the west but also the bridge between people who have and who have not,” and be an opportunity to bring together minorities. The City Councillor affirmed the importance of making the conference visible in order to show that “the City of Vienna was on the side of solidarity.” Mr Sidibé outlined his priorities, being the virtual elimination of mother-to child-transmission and a strong focus on prevention and “zero new infections”. Another topic of discussion was the planned first participation of UNAIDS at the Vienna Life Ball on 17 July 2010. This is the biggest charity event in Europe supporting people living with HIV and has been running annually since 1993.

In discussions with high-ranking representatives of the Ministry of Foreign Affairs and the Austrian Development Agency, Mr Sidibé highlighted the good cooperation between UNAIDS and Austria in the past and expressed his wish to further consolidate the relationship, encouraging Austria to become a regular donor to UNAIDS.

During his visit, Mr Sidibé also met with the Austrian Action Alliance against HIV and AIDS, an association of over 40 Austrian non-governmental organizations who advocate for a greater involvement of Austria in the AIDS response. Mr Sidibé emphasized the importance to strategically reposition the AIDS agenda, given the need for a prevention revolution and the support of civil society activism. He hoped the Vienna AIDS conference could be a bridge to the upcoming MDG summit in September 2010.

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

Malekena George heads home from the Pilot Health Clinic in Lesotho’s Berea district after her first antenatal check-up
Credit: © UNICEF Lesotho/2010

Malekena George, from Lesotho’s Berea district, is eight months pregnant, living with HIV, and exhausted from the five-hour trek she endured to get to the Pilot Health Clinic, for her first antenatal check-up. But because her journey to the clinic was so difficult, this visit may also be her last.

Ms. George's first child died at 13 months, and the Lesotho Ministry of Health is working to ensure that her second baby is not born with HIV.

In 2007, the Government, with help from UNICEF and other partners, initiated a massive effort to improve the country's Prevention of Mother-to-Child HIV Transmission (PMTCT) services. To succeed, they needed to ensure that every clinic in the country could provide HIV testing and treatment.

Lesotho leads the way

Lesotho became one of the first countries in the region to allow nurses to administer antiretroviral (ARV) treatments, which greatly expanded access to these critical interventions in the remote areas of the country where fewer doctors are available.

Malekena George is given her new ‘Mother to Baby Pack’ at the Pilot Health Clinic. The pack includes ARV drugs and antibiotics
Credit: © UNICEF Lesotho/2010

But despite such efforts, major challenges remain, including the fact that many women, like Ms. George, are likely to make only one clinic visit.

This is a typical problem for many health systems in Africa. Though ARV drugs substantially increase the chances that a baby is born free of the virus, providing HIV-positive mothers with the treatment is not easy, especially in remote areas. The combination of distance, lack of transport and poverty prevents many women from making regular antenatal care visits. Such factors also lead many women to drop out of the PMTCT programmes, and to deliver their babies at home without the presence of trained medical professionals.

In a country such as Lesotho, where one in four people is living with HIV, that one antenatal visit has become all the more critical.

Keeping mother and child healthy

Innovative prevention methods are making a huge difference. The Lesotho Government has designed a minimum package for expectant mothers like Ms. George that includes the most effective ARV drugs and antibiotics needed to keep them, and their children, healthy. When they leave the clinic, women are also provided with clear instructions on what medicines they need to take – and when – and what medicines they need to give to their babies after birth.

In an effort to expand this public health innovation ever further, UNICEF and WHO have created a colour-coded take-home box that will be rolled out to five countries in eastern and southern Africa, Lesotho included, by July. Instead of the nurses having to pack all the medicines in small pill bags, this new 'Mother to Baby Pack' clearly separates the ARV drugs and the antibiotics according to when they need to be taken.

"We had to take advantage of the first antenatal visit," said UNICEF HIV and Maternal Health Expert Blandinah Motaung. "In case a woman delivers at home, she will have that package with her."

A dramatic drop in infections

With the new regimen of ARV treatments, and the efforts to facilitate women taking these medicines at home, health experts expect the number of babies born with HIV in Lesotho to drop dramatically.

"The expectation is that with better adherence to treatment and more focus on helping mothers to exclusively breastfeed for six months, we can further reduce the transmission rate to less than five per cent," said Ms. Motaung.

Take home medicine

After her check-up, Ms. George listened carefully to Marethabile Lelia, the clinic nurse, give instructions on the medicines that she would be carrying home. The mother-to-mother counsellor reiterated the importance of sticking to the treatment.

Although Ms. George has another appointment scheduled at the clinic, Ms. Lelia doesn't expect to see her until she returns with a six-week-old for the baby's first round of immunizations and first HIV test - children are again tested at 12, and then 18 months

As she prepared for her five-hour walk home, Ms. George clung to her medicines, understanding clearly that they represented her best hope of ensuring that her baby would escape HIV infection and grow up healthy

Lesotho has the third highest adult HIV prevalence in the world at 23.2%. There are an estimated 270,273 people living with HIV in Lesotho as of end 2007 of which 258,472 are adults and 11.801 children. At the end of 2007, an estimated 3,966 pregnant women with HIV received anti-retroviral treatment to prevent mother to child transmission (PMTCT) of HIV. The coverage of PMTCT programmes has increased from an estimated 5% in 2005 to 42% in the first quarter 2009

Mr Sidibé delivered an address during the closing ceremony of the conference. 31 March 2010.

While a wide range of AIDS epidemics occur across the Francophone world, this week in Casablanca, countries came together to speak with a common voice and with one common goal – stopping AIDS from making further inroads in French-speaking countries. Representatives from around 50 French-speaking countries wrapped up the 5th Francophone conference on HIV/AIDS today.

“I am impressed by the leadership Francophone countries have shown,” said UNAIDS Executive Director Michel Sidibé, “here in Casablanca we have heard about how French-speaking countries are making important contributions to the AIDS response.”

Mr Sidibé delivered an address during the closing ceremony of the conference. In his speech he said, “In partnership with Francophone countries my dream can become a reality: we can stop all new HIV infections.”

During the conference, speaker after speaker highlighted the financial difficulties the AIDS response faced since the global economic crisis. Mr Philippe Douste-Blazy, President of UNITAID, called for a new approach to address funding needs. "We need innovative financing mechanisms to complement classic institutional financing."

It was the first time that the event, which began on 28 March, was held on the African continent. It brought together scientists, policy-makers and health and development experts from more than 40 countries.

"Over the past few days we have had a lot of fruitful exchanges. We have reached some important conclusions, now we must put them into action," said Patrice Debré, French Ambassador in charge of the fight against HIV/AIDS and infectious diseases.

It was also the first Francophone HIV conference in which UNAIDS participated significantly. The Joint United Nations Programme plans to continue this strengthening of cooperation with Francophone countries.

"I see UNAIDS presence here as the start of a new era of deeper collaboration with French-speaking countries," said Mr Sidibé, "We want to give value to their expertise and reinforce experience sharing between nations."

UNAIDS estimates that there were 4.1 million people living with HIV in Francophone countries and 340,000 new infections in 2008. Prevalence rates vary widely: for example Algeria has a rate of 0.1 percent while the Central African Republic has a rate of 6.3 percent.

The next Francophone Conference on HIV/AIDS will take place in Geneva, Switzerland in 2012.