New data analysis released on 10 March by the United States Centers for Disease Control and Prevention (CDC) highlights that HIV and syphilis disproportionately impact men who have sex with men in the United States (U.S.).

New data analysis released on 10 March by the United States Centers for Disease Control and Prevention (CDC) highlights that HIV and syphilis disproportionately impact men who have sex with men in the United States (U.S.).
The data, presented at CDC's 2010 National STD Prevention Conference, found that the rate of new HIV diagnoses among men who have sex with men (MSM) in the U.S. is more than 44 times that of other men and more than 40 times that of women.

"While the heavy toll of HIV and syphilis among gay and bisexual men has been long recognized, this analysis shows just how stark the health disparities are between this and other populations," said Kevin Fenton, M.D., Director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. "It is clear that we will not be able to stop the U.S. HIV epidemic until every affected community, along with health officials nationwide, prioritize the needs of gay and bisexual men with HIV prevention efforts."

According to CDC many aspects contribute to the high rates of HIV and syphilis among gay and bisexual men in this country. Homophobia and stigma can prevent MSM from seeking prevention, HIV testing and counselling, and treatment services. Other causes include limited access to prevention services, unsafe sex practices and complacency about HIV risk due to existence of treatment, particularly among young gay and bisexual men.  Also, the risk of HIV transmission through anal sex is much greater than the risk of transmission via other sexual activities.

''It seems like we have come full circle in the United States,'' said UNAIDS Executive Director Michel Sidibé. ''Efforts must be redoubled to include gay and bisexual men in AIDS programming and reach out to and address the HIV prevention needs of all men who have sex with men.'' 
Prevention programmes

According to UNAIDS, HIV prevention measures for men who have sex with men should include consistent and proper use of condoms, and access to water-based lubricants. High quality HIV-related services, like voluntary counseling and testing in a non-discriminatory environment,, should be made available as well as specific and targeted information on prevention and risk reduction strategies designed to appeal to and meet the needs of men who have sex with men. Further quality treatment for sexually transmitted infections with referral for HIV services must be made available.

The U.S. Department of Health and Human Services notes that in the United States men as a whole, are less likely to use the health care system than women. Men often seek care when they are experiencing critical health problems. Men who have sex with men who do not access health care may not know they are infected with HIV or an STD, thus compromising their own health status. The persistence of stigma and homophobia compounds the situation still further.

CDC officials noted that the new analysis underscores the importance of the HIV and STD prevention efforts to reach gay and bisexual men recently announced as part of the U.S. President's fiscal year 2011 national budget proposal.

The new analysis is the first step in more fully assessing the extent of HIV among MSM and other populations in the United States. The CDC is developing more detailed estimates of infection rates among MSM by race and age, as well as among injection drug users. Ultimately, these data can be used to better inform national and local approaches to HIV and STD prevention to ensure that efforts are reaching the populations in greatest need.

UNAIDS Executive Director, Mr Michel Sidibé and CPLP Executive Secretary, Mr Domingos Simões Pereira signing the cooperation agreement. 17 March 2010, Lisbon, Portugal.

The Community of Portuguese-Speaking Counties (CPLP) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) formalized their cooperation in response to AIDS in CPLP countries with a Memorandum of Understanding. The cooperation agreement was signed today by CPLP Executive Secretary, Mr Domingos Simões Pereira and by UNAIDS Executive Director, Mr Michel Sidibé.

“This agreement strengthens the cooperation that has existed for several years between CPLP and UNAIDS. We are particularly committed to promoting the human rights of people living with HIV and to preventing infection in those countries where Portuguese is the official language,” stated CPLP Executive Secretary, Domingos Simões Pereira.

The Memorandum of Understanding seeks to mobilize technical, political and financial support for civil society networks and organizations, including people living with HIV in the Portuguese-speaking countries. It aims to develop channels for sharing experiences between these countries, by means of horizontal South-South technical cooperation.

“South-South cooperation among Portuguese-speaking nations can help achieve universal access to HIV prevention treatment, care and support and eliminate mother to child transmission of HIV,” said Mr Sidibé.  “We can learn from each other, especially when we share a common vision in changing the course of the AIDS epidemic.”

The cooperation agreement forms part of the activities of the III CPLP Congress on HIV/AIDS and Sexually Transmitted Diseases, which is being held in Lisbon, Portugal from March 17-19.

Although the Caribbean as a region has the second highest HIV prevalence after sub-Saharan Africa, most countries have concentrated epidemics which disproportionately affect certain groups including gay men and other men who have sex with men (MSM). In many countries men who have sex with men experience considerable social stigma and are not reached with vital HIV prevention, treatment, care and support services. Not only are men afraid of disclosing their sexual activity, they are also deterred from finding out what they need to know to reduce their risk or to buy condoms.

An environment of homophobia is often reinforced by anti-sodomy legislation which exists in 11 of 16 Caribbean countries*. This can contribute to an intolerant cultural and social environment which risks keeping men who have sex with men away from accessing HIV testing and counselling and education services that would reduce the vulnerability to HIV infection.

In Jamaica—a country with anti-sodomy laws—there is 32% HIV prevalence among MSM, versus 1.6% in the general population. In Trinidad & Tobago and Guyana, countries which also criminalize sex between men, the HIV prevalence ranges from 20% to 32%. While in Cuba, Suriname, the Bahamas, Dominican Republic, countries without such legislation, the HIV prevalence in MSM ranges from 1% to 8%.

According to 2007 UNGASS Country Progress reports less than 40% of MSM in the Caribbean are reached by prevention programmes. Local groups in many countries in the Caribbean have been urging civil society and government programmes to include MSM issues and organizations within the AIDS response. These efforts have been supported by regional networks including PANCAP.

UNAIDS Executive Director Michel Sidibé has called for an end to punitive laws which hamper the AIDS response in this region.

“In most of the countries in the Caribbean that don't have repressive laws, HIV prevalence is between 1% and 8% among men who have sex with men,” said UNAIDS Executive Director Michel Sidibé. “This contrasts sharply with a range of between 20% and 32% in countries which outlaw sex between men.”

“Reducing homophobia and removing punitive laws that criminalize sex between men creates the right conditions for achieving universal access,” Mr Sidibé continued.

A collaborative effort is underway between UNAIDS, UNDP and PAHO/WHO to develop strategies for Latin America and the Caribbean on human rights and improvement of access to health services for MSM and other sexual minorities.

UNAIDS will lead a regional effort in the Caribbean to strengthen HIV prevention programmes among these groups, to bring together the human rights and service provision components for their improved health, human rights and well-being.


* Countries in the Caribbean with laws that criminalize men who have sex with men: Antigua and Barbuda, Barbados, Belize, Dominica, Grenada, Guyana, Jamaica, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Trinidad and Tobago. Countries in the Caribbean with no laws criminalizing men who have sex with men: Bahamas, Cuba, Dominican Republic, Haiti, Suriname. According to ILGA web site accessed 16 March 2010

UNAIDS Executive Director, Michel Sidibé and John Tedstrom, President & CEO of GBC. 15 March 2010, New York . Credit: UNAIDS

On 15 March 2010, UNAIDS Executive Director, Michel Sidibé met with more than 15 private sector companies affiliated with the Global Business Coalition on AIDS, Tuberculosis and Malaria (GBC). Mr Sidibé highlighted UNAIDS’ priorities for 2010-11 and reiterated his call for the virtual elimination of mother-to-child transmission by 2015.

Across the world, each year more than a million pregnant women risk passing along HIV to their child. In 2008, approximately 45% of pregnant women known to be living with HIV received antiretroviral drugs to prevent HIV transmission to their children.

“Ending mother-to-child transmission is everyone’s business and I urge the private sector to leverage their core competencies, resources and advocacy muscle to prevent all babies from becoming infected with HIV” said Mr Sidibé.

The impact of AIDS on the labour force impacts both the public and private sectors. The epidemic is eroding productivity at a time developing countries need to become more competitive to cope with rapid globalization. In the private sector, this raises the costs of doing business and deters investment.

The virtual elimination of mother-to-child transmission would tackle one of the three ways of transmission of HIV (sexual, blood related and vertical). It also represents a positive difference on the health of women and children contributing to Millennium Development Goals 4, 5 and 6. Above all, it is doable in a business time frame i.e. by 2012 in the 13 highest burden countries and globally by 2015.

UNAIDS is convinced that mother-to-child transmission is an issue that the private sector can effectively tackle. The private sector has core competencies which can be of use: financial and accounting skills, technical know-how, understanding of communications products, marketing and selling of products and services, and valuable knowledge to reach and change opinions and behaviours of large number of people.

More than 15 private sector companies affiliated with the Global Business Coalition on AIDS, Tuberculosis and Malaria (GBC) participated in the meeting to explore effective collaboration with UNAIDS to achieve virtual elimination of mother-to-child transmission. Credit: UNAIDS

The meeting included companies such as Abbott, BD, Boehringer Ingelheim, Bristol-Myers Squibb, Booz & Co., Colgate-Palmolive, Johnson & Johnson, Mylan, the National Basketball Association, OraSure, Pfizer, Premier Medical Corporation, Spike DDB, Standard Bank, Standard Chartered Bank, Unilever and Vestergaard.

“As we move into an era which is shaped by new and unexpected resource challenges and which prioritizes more sustainable responses to HIV and other global health challenges, it is more important than ever that we are all part of a unified team,” said John Tedstrom, President & CEO of GBC. “Our partnership with UNAIDS generally and our joint commitment to combating mother-to-child transmission of HIV expressed in today's meeting is part of the Coalition's effort to ensure alignment on all our global health priorities.”

Several international companies have made public and global commitments in support of virtual elimination of Mother-to-Child Transmission of HIV. Johnson & Johnson in South Africa, Bristol-Myers Squibb, Bayer College of Medicine in Africa, Boeringer’s Viramune donation programme to developing countries, and Chevron in Angola.

The meeting laid an effective platform to develop a follow-up plan for the development of public-private partnerships in order to strengthen the AIDS response. Over the next 24 months, UNAIDS, GBC and their partners will intensify efforts to save mothers and babies as an achievable and inspirational step toward helping countries achieve their universal access goals to HIV prevention, treatment, care and support.

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

UNAIDS Executive Director Michel Sidibé at a press conference held March 10 to discuss AIDS 2010.

The rapidly growing AIDS epidemic in Eastern Europe, fuelled primarily by unsafe injecting drug use, will be a key focus of the XVIII International AIDS Conference (AIDS 2010), to be held in Vienna in July.

"To break the trajectory of the HIV epidemic in Eastern Europe, we must stop new infections among injecting drug users and their partners," said UNAIDS Executive Director Michel Sidibé at a press conference held March 10 to discuss AIDS 2010. "People using drugs have a right to access the best possible options for HIV prevention, care and treatment."

The United Nations, through the Joint United Nations Programme on HIV/AIDS (UNAIDS) and UNODC, is supporting the AIDS 2010 conference, to be held from 18 to 23 July 2010, which is organized by the International AIDS Society, a non-governmental organization.

Around 25,000 people working in the field of HIV, including policymakers, legislators, researchers, people living with HIV and others committed to working on AIDS issues will attend the conference, whose theme, Rights Here, Right Now, emphasizes the central importance of human rights in responding to HIV.

By holding the conference in Vienna, the organizers will highlight the situation in Eastern Europe and Central Asia, regions experiencing a fast growing epidemic largely through unsafe injecting drug use. An estimated 1.5 million people are living with HIV in these regions. Sharing needles and injection equipment is thought to be three times more likely to transmit HIV than sexual intercourse.

"We can and must reverse the HIV epidemic, first of all by preventing the spread of drug use, and then by providing treatment to addicts. In this comprehensive programme, HIV-targeted measures include providing clean injecting equipment, opioid substitution and antiretroviral therapy," said UNODC Executive Director Antonio Maria Costa.

Life on the edge

Yet, as the results published last week in The Lancet show, injecting drug users often have little or no access to evidence-informed comprehensive HIV services. Globally, only two needles and syringes are distributed to injecting drug users per month and only 8 per cent of injecting drug users receive opioid substitution therapy (Mathers et al, 2010).

UNODC Executive Director Antonio Maria Costa speaking at a press conference held March 10 to discuss AIDS 2010.

Many of today’s drug users live a life on the margins of society: they can be arrested, even for possessing a clean needle, and sent to prison, where the perfect environment is created for HIV and TB to spread. Or they can be confined to compulsory drug detention centres, often with no due legal process, where they are shackled and beaten in the name of drug “treatment” but with no access to any medically supervised remedies for drug dependency.

“We must focus our efforts to create evidence-based harm reduction measures that work, helping drug users protect their health and the health of the broader community—including preventing HIV infection,” said Mr Sidibé during his intervention at the 53rd session of the Commission on Narcotic Drugs. “Harm reduction is an effective and important form of HIV prevention and a key component of our pledge for universal access to HIV prevention, treatment, care and support”.

Effective harm reduction approaches include access to clean needles, opioid substitution therapy for opiate users, access to antiretroviral therapy and reducing sexual transmission of HIV from drug users to their sexual partners through condom promotion.

UN Secretary-General Ban Ki-moon has called on Member States to ensure that people who are struggling with drug addiction be given equal access to health and social services, and asserted, “No one should be stigmatized or discriminated against because of their dependence on drugs.”

UNODC is the lead agency within UNAIDS for HIV prevention, treatment, care and support for injecting drug users and in prison settings. It works in 55 priority countries in Africa, Eastern Europe and Central Asia, South and South-East Asia, Latin America and the Caribbean, helping countries to provide drug users, prisoners and people vulnerable to human trafficking with comprehensive evidence-informed HIV services.

UNAIDS Executive Director Michel Sidibé met with UN Human Rights Council President Ambassador Martin Uhomoibhi on 11 March 2009 at UNAIDS Secretariat, Geneva.
Credit: UNAIDS

UNAIDS Executive Director Michel Sidibé met with UN Human Rights Council President Ambassador Martin Uhomoibhi on 11 March. The Tenth Session of the Human Rights Council is currently taking place in Geneva.

A progress report from the United Nations Secretary-General on HIV and human rights has been submitted to the Tenth Session of the Human Rights Council which is taking place in Geneva from 2-27 March 2009.

The report notes some advances in recent years, but it also underlines that “a number of human rights challenges remain, which pose barriers to achieving universal access to HIV prevention, treatment, care and support.” These include stigma and discrimination; legal and policy barriers to accessing HIV-related services, including harm reduction services; and human rights violations against women and girls, men who have sex with men, sex workers, people who use drugs, and prisoners.

UNAIDS Executive Director meets UN Human Rights Council President

UNAIDS Executive Director Michel Sidibé hosted a meeting with UN Human Rights Council President Ambassador Martin Uhomoibhi on 11 March. They discussed the importance of raising the profile of HIV in the work of the Council, and mobilising leadership to address difficult human rights issues that stand in the way of universal access to prevention, treatment, care and support.

The UNAIDS Executive Director spoke of the vital importance of paying attention to human rights to protect the most vulnerable in the AIDS epidemic.

Mr Sidibé added that communities and individuals most affected by AIDS have to remain at the centre of all efforts – locally, nationally and globally and that civil society must be supported to stand by those most affected and amplify their voice.

UNAIDS Statement to the Human Rights Council

On 4 March the UNAIDS Secretariat addressed the Human Rights Council during its High Level Segment, underlining that the commitment that governments made to universal access by 2010 is a critical human rights imperative. The statement, delivered by Senior Human Rights and Law Adviser Susan Timberlake, noted that gains in recent years mean that nearly 4 million people are on antiretroviral treatment today, and numbers of new infections are falling. “If we build on momentum, universal access is a goal within reach.”

UNDP took the floor of the Council during the presentation of the report on HIV and human rights. It called on governments to promote an enabling legal environment in order to achieve universal access by 2010, including by repealing laws that discriminate against and criminalise men who have sex with men, sex workers and people who use drugs. It also stressed concern over the inappropriate criminalisation of HIV transmission and exposure in a number of countries, and the risk that such actions will undermine public health efforts to increase uptake of HIV testing and access to HIV prevention, treatment and care services.

The next session of the Human Rights Council will take place in June 2009

Credit: © UNICEF/UKRA01115/Pirozzi
UNICEF wants to help Ukraine’s many young injecting drug users protect themselves against HIV

Oksana is a teenage mother with a very young baby. She is also living on the streets of Kyiv, Ukraine’s capital. Having lost touch with her mother, who was sent to prison, she ran away from home to escape her abusive stepfather. She spends most of her day at the central railway station or the underground tunnels nearby but dreams of one day having a settled home for her son. These dreams are unlikely to be realised any time soon.

She is one of the many young people eking out a living on Ukraine’s streets who get no care and support. An unsafe social environment and high risk behaviour such as sex work and injecting drugs make young people living in the streets of Ukraine vulnerable to HIV. They are at the heart of an epidemic in the country worst affected by HIV in Europe and yet rarely have access to HIV prevention and treatment services.

One of the central aims of UNICEF in Ukraine is to try to help these most-at-risk young people, especially those who are homeless, to better protect themselves against HIV. Key activities include supporting outreach teams working with street children and adolescents, training social and health care workers and providing access to basic health services, education, training and housing.

According to the latest statistics, in 2006 more than 60% of injection drug users in Kyiv were living with HIV. In 2009, UNICEF conducted a study among street-based adolescents in several regions of Ukraine, which found high rates of drug use by injection, with two thirds of those having reported sharing needles. The study also revealed that one in ten male street adolescents had had sex with another male, often in exchange for money, clothes, or drugs.

Olena Sakovych is a UNICEF youth and adolescent development officer, who works closely with street children, as well as other most-at-risk adolescents. She is fully aware of the extent of the problem, with some young people initiating drug use by injection as early as age 13, and both boys and girls living on the streets often engaging in sex work at a similar age.

“These young people are the missing face of the HIV epidemic in Ukraine,” says Olena. “They need better care and more services. The situation here is critical. One of our main objectives at UNICEF is to make them visible to Ukraine’s political agenda and its AIDS response.”

The findings of the research informed the development of interventions and provision of health and social services to better address the needs of and help adolescents injecting drugs and engaging in sex work. In the city of Mykolyav, for example, outreach workers now recruit young female sex workers to a drop-in centre that offers a safe space, HIV counseling, and referrals to governmental health and social services centres, and non-governmental organizations that provide HIV prevention services, care and support.

Social workers accompany the women to those services, when necessary, which include gynaecological and infectious disease specialists, HIV treatment centres, and legal aid. Demand has far exceeded expectations. It was hoped that 50 under-aged sex workers would be recruited in the first six months. To date, well over a hundred adolescent girls have received services. A client satisfaction survey showed an increase in knowledge about HIV, as well as in motivation to seek help.

"UNICEF will continue to advocate for, and to support, country efforts to increase understanding of the epidemic and HIV prevention, protection, care and support services for most-at-risk adolescents,” says Susan Kasedde, UNICEF Senior Specialist on HIV Prevention among Adolescents. “In countries like Ukraine, until such services are made available, national epidemics cannot be stopped."

To this end, UNICEF promotes mobilization of governmental leadership; national and local political and community support; legislative and policy changes to enable wider access to HIV prevention and care services for most-at-risk adolescents, and strong partnership between the United Nations, government, civil society, young people themselves and people living with HIV.

“Ensuring that those most vulnerable to HIV infection like, young people on the streets, injecting drug users, those engaging in sex work, and men who have sex with men, have access to HIV prevention, treatment, care and support services is both a human right and a way to finally reverse the spread of the HIV epidemic,” says UNAIDS Country Coordinator Ani Shakarishvili. “Ukraine is continuing to make progress towards universal access but far more needs to be done. Strong political leadership and commitment will guarantee success. “

(L to R) Hon Sasa Zibe, PNG Minister of Health and HIV/AIDS, Governor General Sir Paulius Matane and Hon Misa Telefoni, Chairperson of the Pacific AIDS Commission and Deputy Prime Minister of Samoa during the simultaneous launch of the Pacific AIDS Commission Report and the National HIV Prevention Strategy 2010-2015. PNG, 11 March 2010.

The first Pacific launch of the report “Turning the Tide: An OPEN strategy for a response to AIDS in the Pacific” took place in Papua New Guinea on Thursday 11 March 2010. The report is the first document to synthesize regional and country information on epidemiology, risks and vulnerabilities, and financing and coordination of the AIDS response. Issues of rights and civil society as well as the impact of AIDS on health are also highlighted.

The report was officially launched by the UN Secretary-General in New York on 2 December 2009. It was produced by the Commission on AIDS in the Pacific, an independent body established to provide an objective and independent analysis of the status and impact of the HIV epidemic in the Pacific region.

“UNAIDS fully supports this report and finds that many of the recommendations in the report align very closely with the priorities identified in the Outcome Framework for Action agreed by all the 10 cosponsors and the secretariat of UNAIDS” said Mr Sidibé.

According to the report, a number of factors have hindered the region’s response to the epidemic. Limited awareness and understanding of the potential impact of the epidemic, weak health care systems and an unsupportive legal environment have all contributed to varying degrees of success by Governments across the region. The report has clearly highlighted the factors inhibiting a strong and determined response to the epidemic. While some of these are known, it is for the first time that all the issues were addressed by the Commission.

His Excellency Sir Paulias Matane, Governor General of Papua New Guinea officiated the national launch of the report together with Honourable Deputy Prime Minister of Samoa and the Chair of the Commission on AIDS in Pacific. J.V.R. Prasada Rao, Special Advisor to the UNAIDS Executive Director delivered a speech on behalf of UNAIDS Executive Director Michel Sidibé.

Uneven response in the region

Pacific countries are often included in broad Asia-Pacific regional groupings where the magnitude of the problem in Asian countries overshadows the challenges and needs of smaller Pacific countries.

These realities about the regions led to the constitution of an independent Commission on AIDS in the Pacific in October 2007 to examine the current scale of the HIV epidemic in the region.

There have been 29,629 reported cases of people living with HIV in the Pacific, with 5,162 new HIV diagnoses reported in 2008.

Papua New Guinea makes up the largest share of cases, growing exponentially from 21% in 1984–1989 to over 99% in 2008. Reported cases in Papua New Guinea total 28,294 but UNAIDS estimates there are 54,000 people living with HIV. It is estimated that by 2012, Papua New Guinea will have a national prevalence rate of 5.07% and a total of 208,714 people will have been infected with HIV.

The predominant means of HIV transmission in the region is unprotected sex. The number of HIV-positive young people is steadily increasing and young women are infected earlier than young men. New Caledonia, French Polynesia and Guam have identified unprotected male-to-male sex and injecting drug use as key issues to address to effectively respond to the epidemic.

The report states that a “one size fits all” response does not suit the diversity of Pacific nations and outdated legislation criminalizing homosexuality and sex work is a major impediment in the region.

A review carried out by the 2009 Reference Group to the UN on HIV and Injecting Drug Use concludes that coverage of HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide is very low and unlikely to be sufficient to prevent, halt, or turn around HIV epidemics. Credit: UNAIDS/P.Virot

A review carried out by the 2009 Reference Group to the UN on HIV and Injecting Drug Use for the first time quantifies the scale of coverage of HIV prevention, treatment, and care services for injecting drug users (IDUs) worldwide. The study concludes that with, specific exceptions, worldwide coverage of these services in IDU populations is very low and unlikely to be sufficient to prevent, halt, or turn around HIV epidemics.

The paper, published by The Lancet in its online edition of 1 March 2010, also highlights the need for improved data collection on injecting drug users in each region in order to get a clearer picture of the extent of their needs. “We still do not know enough about the nature and size of the populations we need to target.”

Already the gaps in services are apparent. In prevention, the study estimates that two needles per month were distributed per person who injects drugs. In the countries that estimate the number of condoms distributed to IDUs, an average of 12 condoms were distributed to each IDU per year.

These global averages hide even greater regional and national variations in services.

While nearly all countries in western and eastern Europe, central Asia, Australasia, and North America had needle and syringe programmes (NSPs), these services aren’t present in nine of 25 countries in east, southeast, and south Asia where injecting drug use occurs. NSPs were also absent or unreported in 14 of the 16 countries in sub-Saharan Africa where injecting drug use occurs.

Opioid substitution therapy (OST) coverage also varied from 1% or less of IDUs in central Asia, Latin America, and sub-Saharan Africa, to very high levels of 61% in western Europe.

Access to services for all drug users

UNAIDS believes that drug users can be protected from becoming infected with HIV if comprehensive, evidence-informed and human-rights-based interventions are made accessible to all drug users.

“Effective harm reduction approaches include access to clean needles, opioid substitution therapy for opiate users, access to antiretroviral therapy and reducing sexual transmission of HIV from drug users to their sexual partners through condom promotion,” said UNAIDS Executive Director Michel Sidibé. “But current coverage of these services is appallingly low.”

The study was funded by the UN Office on Drugs and Crime (UNODC), Australian National Drug and Alcohol Research Centre, University of New South Wales; and Australian National Health and Medical Research Council.

(L to R): Minister of State for International Development Gareth Thomas, artist, political and social activist Annie Lennox, UNAIDS Executive Director Michel Sidibé and Executive Director of the Global Fund Professor Michel Kazatchkine
Credit: UNAIDS

AIDS is not over in any part of the world and as such country driven goals towards universal access to HIV prevention, treatment, care and support need to remain a priority. This was a recurrent message told by more than 40 champions and leaders of the AIDS response who gathered for a meeting at the House of Lords organized by United Kingdom’s Department for International Development (DFID).

In 2006, world leaders adopted a declaration at the United Nations General Assembly committing to achieving universal access to HIV prevention, treatment, care and support by 2010. DFID was central in helping to build momentum at the G8 and other international fora. Civil society’s role was crucial in shaping this commitment and holding leaders accountable.

Since then, many countries have met some of the goals. More than four million people living with HIV are accessing treatment. There has been a significant drop in new HIV infections since 2001. In sub-Saharan Africa, there were 400,000 less new infections in 2008. Millions of pregnant women tested and counselled for HIV. Thousands of HIV positive pregnant mothers being provided the necessary treatment and support to stop passing HIV to their babies. More than 5 million orphans are receiving social support. Funding for HIV programmes have increased—from development partners and domestic sources reaching US$ 16 billion in 2008.

“We can be proud of what we have achieved,” said Mr Michel Sidibé, Executive Director of UNAIDS. “We have given hope and restored dignity to the millions of people living with HIV across the world.”

Ambassador Eric Goosby, the United States Global AIDS Coordinator, added that the achievements made by countries put them in a better position to say that the resources available are not enough.

From the civil society perspective, Professor Narciso Matos the Director of the Foundation for Community Development in Mozambique said that much of the success has been the number of stakeholders involved “especially the role of religious groups”.

However many countries have yet to reach all their targets. His Royal Highness Chief Mumena of Zambia gave the example of voluntary counselling and testing. He talked about the fact that most people in his country live many miles away from health centres and that the cost of bus fare made visits prohibitively expensive.

Many talked about the resources that the world will need to continue to tackle AIDS. Public opinion about bailout packages given to the private sector has brought new perspectives on funding for development and health issues including ideas around a transactional tax. The AIDS response has been at the forefront of innovation in health financing including UNITAID and MASSIVEGOOD. Initiatives like PEPFAR have changed the way the world works on AIDS.

In summarizing the main points of the meeting, MP Gareth Thomas, Minister of State for International Development, pointed out the importance of the Global Fund Replenishment and the World Bank Replenishment as well as country ownership to continue towards universal access goals.

Ms Vuyiseka Dubula, the General Secretary of the Treatment Action Campaign from South Africa reminded participants the importance of taking care of their own citizens but also to “treat other people beyond their borders”.