Members of the public take part in "Race for life" in Kiev, Ukraine. With an adult HIV prevalence of 1.6% in 2007, Ukraine has the largest HIV prevalence in Europe. Credit: UNAIDS

An estimated 1.5 million adults and children are living with HIV in Eastern Europe and Central Asia. With an adult HIV prevalence of 1.6% in 2007, Ukraine has the largest prevalence in all of Europe. Estonia, Russian Federation and Ukraine all have HIV prevalence that exceeds 1%.

Experts are concerned that the epidemic continues to outpace the response.

“There has been a dramatic increase in the estimated number of people living with HIV in the Eastern Europe and Central Asia region since 2001, an increase of as much as 66%,” said Dr Denis Broun, Director of UNAIDS Regional Support Team for Europe and Central Asia.”Conversely, during the same period, HIV prevalence decreased by 5% in Asia, " he continued.

There have been improvements in the region including a growth in access to HIV treatment services leading to lowering mortality from AIDS. Also there has been an increase in prevention of mother-to-child HIV transmission services which are helping to reduce the number of babies born with HIV. Community participation in the AIDS response has been strengthened with progressively more meaningful involvement of people living with HIV, civil society and religious organizations.

Prevention services for those most-at-risk

Given that injecting drug use is the major mode of HIV transmission across Eastern Europe and Central Asia, HIV prevention among drug users and their sexual partners should be a vital component of AIDS responses in the region. However HIV prevention services, and in particular prevention work among vulnerable groups and young people have not been scaled-up with the rising numbers of infections.

“It’s essential to have much more aggressive prevention in the region. HIV prevention makes sense for human society, both economically and strategically,” said Dr Broun.

Regional leadership in CIS 

(from left) Dr Denis Broun, Director of UNAIDS Regional Support Team for Europe and Central Asia; Georgiy Narushevich, the Adviser to the CIS Executive Committee. Credit: UNAIDS

A major step towards a more strategic AIDS response was achieved at the expanded meeting of the Commonwealth   of Independent States (CIS) Coordination Council on HIV/AIDS which took place recently in Moscow

Representatives of ten member states of the CIS with participation of community of people living with HIV in the region, discussed actions for the implementation of the 2009-2013 CIS Programme of Joint Actions on HIV/AIDS.

This Programme was approved by the Council of the CIS Heads of Government last November. It will facilitate the introduction and practice of fundamental principles in the HIV response in CIS countries. For example, to improve coordination within countries via a single national AIDS programme, with one coordinating body and one agreed country-level monitoring and evaluation system.

Also, to turn the tide of the epidemic, other strategies were identified such as providing access to free, voluntary and confidential HIV counseling and testing and national prevention programmes to reach young people and key populations at higher risk.

A dialogue about and reporting on the implementation of the Programme of Joint Actions will continue with UNAIDS with ongoing support offered online and at regular working groups meeting.

Expanded meeting of the Commonwealth of Independent States Coordination Council on HIV/AIDS. Moscow, 25-26 February, 2010.
Credit: UNAIDS

The discussion took place against the backdrop of reviewing the progress in achievement of Universal Access targets by 2010. Participants also outlined the urgent measures to be taken to accelerate progress. This meeting of the CIS Coordination Council on HIV/AIDS was an opportunity to review progress and challenges in scaling up universal access to HIV prevention, treatment, prevention, care and support.

“We reached a consensus on the priority measures for implementation of the Programme of joint actions at the meeting,” Georgiy Narushkevich, the Adviser to the CIS Executive Committee commented.

“That’s a major achievement in consolidation of the HIV response at the high political level.”

Deputy President Kgalema Motlanthe (left) met with Professor Michel Kazatchkine, Executive Director of the Global Fund (right) and Michel Sidibé, UNAIDS Executive Director (second from right). Luthuli House, Johannesburg 8 March 2010. Credit: Juda Ngwenya/The Global Fund

South Africa is transforming its AIDS response. Today, the Deputy President of South Africa HE Mr Kgalema Motlanthe met with Executive Directors of UNAIDS and Global Fund in Johannesburg. He recommitted his government’s commitment to meet their universal access targets.

“AIDS is one of the top priorities for South Africa and we will work with development partners and civil society,” said Deputy President Mr Motlanthe.

In its annual budget for 2010-2011, the country has proposed a budget of US$ 1.1 billion for the AIDS response, the biggest domestic investment in a developing country. South Africa has recently taken the responsibility of providing antiretroviral treatment from its own budget and aims to provide access to nearly 2.1 million people living with HIV.

“A successful AIDS response in South Africa can break the trajectory of the global AIDS epidemic,” said Mr Michel Sidibé, UNAIDS Executive Director. “South Africa must lead the region in stopping all new infections and providing treatment for everyone who needs it.”

At the meeting the Deputy President also pledged to support the regional and global AIDS response and advocate for a fully funded Global Fund. The Global Fund also invited the Deputy President to participate in the Third replenishment conference that will be chaired by the UN Secretary-General Ban Ki-moon in October this year. Sustaining investments in health and development are critical if the world has to reach the millennium development goals

“We welcome South Africa’s support in fully funding the Global Fund,” said Dr Michel Kazatchkine, Executive Director. “We cannot afford to let down the millions who are still waiting to receive treatment and prevention services.”

UNAIDS also called on South Africa to leverage the upcoming football 2010 FIFA World Cup to mobilise the global community on preventing HIV transmission to children. “We can eliminate mother to child transmission of HIV by the time the next World Cup is played in Brazil,” said Mr Sidibé. “From Soweto to Rio de Janeiro, we have to show the red card to AIDS for stopping babies from becoming infected with HIV.”

At a separate meeting of civil society representatives working on issues of maternal health, TB, HIV and malaria, participants urged for a synergetic approach to ensure that health rights are realised. 8 March 2010. Credit: Juda Ngwenya/The Global Fund

At a separate meeting of civil society representatives working on issues of maternal health, TB, HIV and malaria, participants urged for a synergetic approach to ensure that health rights are realised. Recent evidence shows that many maternal deaths are now associated with HIV. South Africa has pioneered the integration of HIV and TB services under one roof. Efforts such as these complement each other as well as increase efficiencies. South Africa leadership-political, civil society and people are together bringing about change—for the better.

Virtual elimination of mother to child HIV transmission by 2015 is now within reach if current rates of progress by Global Fund-supported programmes and other efforts are maintained. Malaria may be eliminated as a public health problem within a decade in most countries where it is endemic. Tuberculosis prevalence in many countries is declining and the international target of halving TB prevalence could be met by 2015.

These are projections from the Global Fund’s 2010 Results Report, released today. They are contingent on the current rate of scaling up of health investments for the three diseases being at least maintained and ideally accelerated further.

“A world where no children are born with HIV is truly possible by 2015,” says Professor Michel Kazatchkine, Executive Director of the Global Fund. “It is also possible now to imagine a world with no more malaria deaths, since already an increasing number of countries have been reporting a reduction in malaria deaths of more than 50 percent over the past couple of years. No other area of development has seen such a direct and rapid correlation between donor investments and live-saving impact as these investments in fighting AIDS, TB and malaria.”

According to the report, Global Fund-supported programmes saved at least 3,600 lives per day in 2009 and an estimated total of 4.9 million since the creation of the Global Fund in 2002. These are people who would otherwise be dead, had it not been for interventions supported by the Global Fund.

“The Global Fund is about getting results. This report clearly shows the world’s investments are making a difference,” said Mr Michel Sidibé, Executive Director of UNAIDS. “However AIDS is not over in any part of the world and without a fully funded Global Fund, our shared dream of universal access to HIV prevention, treatment care and support could become our worst nightmare—putting the lives of millions of people currently on treatment in jeopardy and millions of pregnant women in a position not able to protect their babies from becoming infected.”

The Results Report forms part of the documentation for donors in preparation for the Global Fund’s replenishment conference in October 2010 in New York, where the organization will ask donors for financial contributions for 2011-2013. This is the third time since the Global Fund was established in 2002 that donors are being asked to replenish its finances.

At an initial Replenishment review meeting to be held in The Hague on 24 March, the Global Fund is presenting three resource scenarios for consideration to donors, each with an indication of the results that could be expected in terms of achievements on the ground at the end of the replenishment period. The different scenarios range from US$ 13 to 20 billion for the three-year period.

By the end of 2009, Global Fund-supported programmes provided antiretroviral treatment to 2.5 million people, treatment to 6 million people who had active TB and had distributed 104 million insecticide-treated nets to prevent malaria. In addition to averting at least 3,600 deaths daily, the programmes prevent thousands of new infections and alleviate untold suffering and economic loss for poor families in 144 countries.

Established as a public-private partnership to mobilize and intensify the international response to the three global epidemics and help achieve the UN Millennium Development Goals (MDGs), the Global Fund has disbursed US $10 billion for HIV, TB and malaria efforts through December 2009.

The coming years will see even more results, as half of the total disbursements by the Global Fund were delivered in 2008 and 2009. In addition, much of the US$ 5.4 billion of financing approved in the last two rounds of proposals (8 and 9) will reach countries in 2010 and 2011, and will continue to significantly boost health outcomes.

The progress in combating AIDS, TB and malaria as a result of these investments has also had a positive impact on child mortality and maternal health. The MDGs call for halting and reversing the major diseases as well as reducing child mortality and improving maternal health by 2015.

Global Fund grants have made significant contributions to reducing the largest causes of mortality among women and children. This is particularly the case in sub-Saharan Africa, where HIV, TB and malaria are responsible for 52 percent of deaths among women of childbearing age and malaria alone accounts for 16 to 18 percent of child deaths.

HIV and TB results up to December 2009

HIV

• 2.5 million people are currently on antiretroviral therapy (ART), a level of coverage deemed unattainable less than a decade ago.
• AIDS mortality has declined in many high-burden countries.
• The Global Fund contributed about one-fifth of all disbursements by bi- and multilaterals for the HIV response in low- and middle-income countries in 2008.
• 1.8 billion condoms distributed.
• 105 million HIV counseling and testing sessions provided.
• 790,000 HIV-positive pregnant women in low- and middle-income countries received antiretroviral prophylaxis to prevent mother-to-child transmission– which represents 45 percent of coverage of women in need.
• 4.5 million basic care and support services provided to orphans and other children made vulnerable by AIDS.

Tuberculosis

• Around 6 million people with active TB were treated by December 2009.
• 1.8 million TB/HIV services provided – a 150 percent increase since the end of 2008, contributing to the decline of TB prevalence and mortality rates in many countries.
• The Global Fund provides 63 percent of the external financing for TB and multidrug-resistant TB (MDR-TB) control efforts in low- and middle-income countries – it is by far the major source of international funding for tuberculosis.
• Today, countries are on track to meet the international target of halving TB prevalence by 2015.

Progress towards meeting Millennium Development Goals

The report points out that continued, substantial increases in long-term financial commitments by donors will be needed to consolidate the gains and to reach the MDGs by 2015.

Within that time-frame, 2010 is decisive.

Funds committed now will benefit programmes which will have effect on the ground from 2012 to 2015. The numbers show that countries are approaching a positive tipping point: if they continue on this path, the returns will be exponential and the world will reverse the AIDS, TB and malaria epidemics.

“In health, 2010 is a pivotal year to finance the final stretch of the effort to reach the Millennium Development Goals”, says Professor Kazatchkine. “We have made unprecedented progress but it is fragile. If we lose momentum now there will be a heavy price to pay. A failure to continue the scale-up of investments in health will betray the trust of millions.”

Examples of South Africa’s successes in the fight against HIV and China’s successes in tuberculosis can be found throughout the report.

South Africa has stepped up a rapid expansion of HIV prevention, care and treatment services. The Global Fund disbursed US$ 97.2 million for HIV grants and US$ 87.2 million for TB/HIV grants by the end of 2009 to support the South African efforts to respond to HIV. Activities focused mainly on behavior change communication, provision of ART and TB/HIV collaborative activities. Initially, the Global Fund financed much of the scale-up of ART, but more recently the government has assumed financial responsibility for provision of ART. Between December 2007 and December 2008, the number of people receiving ART in South Africa increased by 53 percent, from 458,951 to 700,500. As ART coverage has increased, mortality rates, which had been rapidly increasing in previous years, stabilized.

The Global Fund has made a substantial contribution to China’s TB control efforts, with a total approved amount of US$ 452.3 million, of which US$ 165.6 million was disbursed by the end of 2009, accounting for about 15 percent of the national TB programme budget. In 2007, China had achieved 100 percent DOTS – the basic package that underpins the Stop TB strategy - coverage and an 80 percent case detection rate for new smear-positive cases. Treatment success reached 93 percent, exceeding the international target of at least 85 percent. The TB burden in China has been steadily declining. Between 2000 and 2008 the TB mortality rate declined from 9.8 to 5.4 per 100,000 population. However, Multi-drug resistant TB is increasing in some parts of China and is becoming a major challenge.

Since its creation in 2002, the Global Fund has become the dominant financier of programmes to fight AIDS, tuberculosis and malaria, with approved funding of US$ 19.2 billion for more than 600 programmes in 144 countries. To date, programmes supported by the Global Fund have saved 4.9 million lives through providing AIDS treatment for 2.5 million people, anti-tuberculosis treatment for 6 million people and the distribution of 104 million insecticide-treated bed nets for the prevention of malaria.

(from left) Professor Michel Kazatchkine, Executive Director of the Global Fund; Hon. Dr. Aaron Motsoaledi, Minister of Health, South Africa; Michel Sidibé, UNAIDS Executive Director and Sisonke Msimang, Executive Director, The Open Society Initiative for Southern Africa. 08 March 2010.
Credit: Juda Ngwenya/The Global Fund

A new report by the Global Fund projects that UNAIDS’ call for the virtual elimination of mother–to-child transmission by 2015 is within reach.

UNAIDS’ Executive Director Michel Sidibé and South Africa’s Health Minister Aaron Motsoaledi, joined the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria Michel Kazatchkine for the launch of the Global Fund 2010 Results Report in South Africa which highlights progress made towards these three diseases.

The report also projects that if the current rate of scaling up health investments for the three diseases is maintained then malaria may be eliminated as a public health problem within a decade in most countries where it is endemic and the international target of halving TB prevalence could be met by 2015.

“With these very exciting goals within reach—we need to do everything we can to ensure they become a reality,” said Mr Sidibé. “Without a fully funded Global Fund, our shared dream of universal access to HIV prevention, treatment care and support could become our worst nightmare—putting the lives of millions of people currently on treatment in jeopardy and millions of pregnant women in a position not able to protect their babies from becoming infected.”

The three leaders were in South Africa, a country that has stepped up a rapid expansion of HIV prevention, treatment, care, and support services. In the last year the new AIDS budget has increased by 33% to US$ 1 billion dollars for 2010. Between December 2007 and December 2008, the number of people receiving ART in South Africa increased by 53 percent, from 458,951 to 700,500. As ART coverage has increased, mortality rates, which had been rapidly increasing in previous years, stabilized.

“With the support of the Global Fund and UNAIDS mother-to-child transmission can be eradicated in South Africa. As the health of our mothers and children directly affects the development of our country. South Africa has to achieve this goal by 2015,” said Dr Aaron Motsoaledi, Minister of Health, South Africa.

Global Fund grants results:

• 2.5 million of the 4 million people are currently on antiretroviral therapy (ART).
• Approved HIV proposals total up to US$ 10.8 billion covering 140 countries.
• 1.8 billion male and female condoms distributed.
• 105 million HIV counseling and testing sessions provided.
• 790,000 HIV-positive pregnant women in low- and middle-income countries received ARV prophylaxis to prevent mother-to-child transmission– which represents 45% of coverage of women in need.
• 4.5 million basic care and support services provided to orphans and other children made vulnerable by AIDS.

The Global Fund will hold its replenishment conference in October 2010. Donors are being asked to replenish its finances from a range of US$ 13 to 20 billion for 2011-2013.

“In health, 2010 is a pivotal year to finance the final stretch of the effort to reach the Millennium Development Goals”, says Dr Kazatchkine. “We have made unprecedented progress but it is fragile. If we lose momentum now there will be a heavy price to pay. A failure to continue the scale-up of investments in health will betray the trust of millions.”

Credit: UNAIDS/A. Gutman

As the world marks International Women’s Day, there is growing concern that women and children are bearing the brunt of the AIDS epidemic. To turn the tide, UNAIDS, the International AIDS Society (IAS) and 14 other leading public and private sector organizations have teamed up to release a new scientific research agenda.

The report called, “Asking the Right Questions: Advancing an HIV Research Agenda for Women and Children” includes 20 specific recommendations to expand and improve responses to the HIV-related challenges facing women and children worldwide.

“With this roadmap, we can work together to remove the roadblocks to universal access to HIV prevention and treatment and move forward to a world where women and children are no longer left behind,” said UNAIDS Executive Director Mr Michel Sidibé.

HIV is the leading cause of death and disease among women of reproductive age. The majority of the estimated 33.4 million people living with HIV in 2008 were women and children.

The Agenda was developed through extensive consultation with investigators, clinicians, civil society and UN agencies and was supported by an expert-led mapping exercise and literature review.

IAS Executive Director Robin Gorna said, “This agenda defines priority research needed to greatly improve our knowledge about and capacity to prevent and treat HIV in women and children. Implementation of this research agenda is key to closing these knowledge and service gaps and to saving women’s and children’s lives.”

The report identifies priority research questions within four broad categories: 1) clinical research on preventing mother-to-child transmission and pediatric treatment, 2) clinical research on women’s treatment issues; 3) operations research for women and 4) operations and implementation research related to stopping mother-to-child transmission.

To address these challenges, the report recommends increased investment in research, greatly expanding data sharing on HIV and women and children, as well as greater efforts to separate clinical data by gender.

The full research agenda on women and children is available online at www.iasociety.org/ilf.aspx.

The Brazilian Lesbian, Gay, Bisexual, Transvestite and Transsexual (LGBT) Association (Associação Brasileira de Gays, Lésbicas, Bissexuais, Travestis e Transexuais or ABGLT) recently launched an “LGBT Communication Manual” aimed at communication professionals, students and teachers to reduce the use of inappropriate language that prejudices, or perpetuates misunderstandings about the millions Brazilian LGBT people and their supporters.

The manual was created with the support of UNAIDS as part of ABGLT’s “Allies” Project. The Brazilian LGBT movement produces a number of tools as part of their goal to educate Brazilians about the human rights of sexual minorities. The tools reinforce the message that every citizen plays an important role in building a fairer, more just society for all regardless of sexual practice.

Highlighting common misconceptions about LGBT practices and identities that continue to be seen in the media is one of the themes of the manual. For example, a man may have sex with men without considering himself homosexual, bisexual or gay. He may have homosexual practices, but continue to identify himself as a heterosexual man.

For this situation, health professionals have coined the phrase “men who have sex with men” or MSM, to identify the sexual behaviour of a person rather than labelling sexual orientation or gender identity.

The manual also reminds professionals that a person should never be identified in media product (including news story, video, or photograph) as being HIV positive unless they formally agree in advance.

Social norms still barrier to diversity

“The initiative of elaborating a manual like this is extremely crucial and we welcome it and congratulate the ABGLT for such community service,” said Mr Pedro Chequer, UNAIDS Country Coordinator in Brazil.

Mr Chequer notes that Brazilian legislation does not punish people for their sexual orientation or gender identity, and on the contrary, it states and reinforces the rights of all citizens.

“In addition,” said Mr Chequer, “the very First National Conference on LGBT people was convened by the President of Brazil in 2008. However, unfortunately social norms still make it difficult for people to deal with diversity and respect to all. We do hope that this manual may mean an additional seed of cultural and behaviour change, for the better”

Lesbian, Gay, Bisexual, Transvestite and Transsexual communities in Brazil

The Brazilian Lesbian, Gay, Bisexual, Transvestite and Transsexual Association was created in 31 January 1995 by 31 founding groups. Currently it is a national network of 220 organizations and is the largest LGBT network in Latin America.

The resolution of the 1st ABGLT Congress in 2005 reads: “Vulnerability to HIV and its consequences are heightened by violations of the right to life, freedom, information, education, health and equality (non-discrimination)... Reducing vulnerability is related to increased active citizenship, whereby in addition to having rights and duties, citizens take an increasing part in public matters.”

An innovative fundraising movement is taking to the skies on Thursday, with the potential to raise millions of dollars for HIV and global health. UNAIDS Executive Director Michel Sidibé joined UN Secretary-General Ban Ki-Moon, former US President Bill Clinton, movie director Spike Lee and international recording artists Will.I.Am and David Guetta in New York to launch MASSIVEGOOD. This new fundraising tool will enable travellers to make a “micro-contribution” towards major global health causes every time they buy a plane ticket, reserve a hotel room or rent a car.

From this week, travellers in the United States can go to commercial travel websites like Travelocity and Accor Hotels and find MASSIVEGOOD. With one click they can contribute US$ 2 to fighting HIV, malaria and tuberculosis and to improving maternal and child health care in developing countries. With the global financial crisis tightening conventional funding, this new fundraising mechanism can help achieve universal access to HIV prevention, treatment, care and support.

“Hope for universal access must not turn into a nightmare. Innovative financing mechanisms such as MASSIVEGOOD are critical to keeping the four million on antiretroviral treatment alive,” said Mr Sidibé.

The Millennium Foundation created MASSIVEGOOD with the support of the global travel and tourism industry. Funds will be distributed to UNITAID, an organization which increases the availability of key treatments in poor countries by purchasing life-saving drugs.

At the official launch on 4 March Secretary-General Ban Ki-moon clicked on MASSIVEGOOD and made the very first $2 donation. He was joined by Mr Sidibé, Mr Clinton and other leaders in innovative financing.

Mr Clinton said “With MASSIVEGOOD, the Millennium Foundation has found a way to involve millions in a new way to solve today’s global health crisis. It really is a great honour to be the first to click MASSIVEGOOD and I look forward to watching movement grow.”

Other key figures in global health also praised the initiative. Dr. Margaret Chan, Director-General of the World Health Organization, said “The launch of MASSIVEGOOD is happening at a critical turning point in the international community’s commitment to the Millennium Development Goals. With only five years left to act on the promises of the 2000 Millennium Declaration, we need initiatives that encourage everyday people to get involved in global health causes.”

The launch is part of series of events in New York City promoting innovative fundraising mechanism. Earlier in the week, Grammy Award-winning recording artist Will.I.Am recorded a new song, “MASSIVEGOOD” in collaboration with DJ David Guetta and internationally acclaimed South African singer Yvonne Chaka Chaka.

While celebrities and world leaders are helping MASSIVEGOOD to take off, it will be up to individual travellers to transform their pocket change into a ticket to a better life for millions of people in developing countries.

Marking a significant step towards achieving the country’s universal access goals, Fiji passed a law decriminalizing consensual homosexuality through the Fiji National Crimes Decree on 1 February 2010. With this legislation Fiji becomes the first Pacific Island nation with colonial-era sodomy laws to formally decriminalize sex between men*.

The new Crimes Decree removes all clauses about “sodomy” and “unnatural acts” and uses gender neutral language in the remainder of the sexual offences section.

“We’d like to congratulate the Government of Fiji on taking a bold step by removing the punitive law,” said Stuart Watson, the Pacific Coordinator of UNAIDS.

“This reform is an important milestone towards achieving a rights-respecting legal framework, not only for men who have sex with men but the entire community in Fiji.”

HIV, the law and human rights in the Pacific

In 2007 the UNAIDS Secretariat and UNDP reviewed the legislation of 15 Pacific Island countries relevant to HIV issues, including discrimination, ethics, access to treatment and privacy and confidentiality. The Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Palau, Papua New Guinea, Samoa, Solomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu were included in this project.

Following this review, UNAIDS’ Pacific office along with the UNDP Pacific Center, and the Regional Rights Resource Team (RRRT) convened a meeting in New Zealand with Attorney Generals and Ministers of Health from the countries. Together with leading international and regional experts they discussed HIV, the law and human rights to relation to the specific national laws in the region that impact the response to HIV. The aim was to better support effective and rights-based legal responses to the epidemic.

The participants reaffirmed the importance of implementing “The Pacific Regional Strategy on HIV/AIDS 2007-2008”, endorsed by Pacific Heads of Governments in Samoa in 2004. This regional strategy is an all-encompassing plan that highlights the importance of human rights in any HIV intervention.

Call for review, reform and enactment of appropriate legislation

The Attorney Generals and Ministers of Health then called for the review, reform and enactment of appropriate legislation that reinforces universal human rights to protect and ensure the dignity of all people affected by HIV; that promotes an integrated response to HIV taking into account the interrelation between sexual and reproductive rights and prevention of HIV; and further protects the rights of people in communities regardless of gender, sexuality, sexual or gender identity, or other defining characteristic.

As a result of this initial UN-sponsored consultation, the Republic of the Fiji Islands requested technical assistance from UNAIDS and WHO to help draft comprehensive rights-based HIV legislation for the country. Parallel to the drafting and community consultation process for the national HIV Decree, and based on the High court’s ruling, the colonial era law criminalizing sex between men was removed. This became law on 1 February 2010 through the Fiji National Crimes Decree.

HIV in the Pacific

The 2009 AIDS Epidemic Update notes that there is generally a very low HIV prevalence in the Pacific compared with other regions. In these small island nations adult HIV prevalence tends to be well below 0.1%. National epidemics are overwhelmingly driven by sexual HIV transmission, although the specific populations most affected vary substantially within the region.

According to the Report of the Commission on AIDS in the Pacific the extent to which HIV is transmitted by sex between men in the Pacific is not known. Since most sex between men in the Pacific is hidden, illegal and denied, it is not addressed appropriately in most national HIV plans.

Behavioural surveillance identifies male-to-male sex among youth in Solomon Islands, Vanuatu and Samoa, as well as police and military in Fiji Islands, STI clinic patients in Fiji Islands and Samoa, and seafarers in Kiribati. Despite a possible link between unprotected sex between men and relatively high rates of HIV infection in Papua New Guinea, Fiji, New Caledonia, French Polynesia and Guam, none of these countries has conducted recent behavioural surveillance surveys or qualitative studies about the characteristics of these men, or initiated targeted campaigns to encourage them to use safer sexual practices.

Major obstacles to making such campaigns effective remain, both with the social stigma and the illegal status of homosexual activity. Not only are men ashamed of or embarrassed about disclosing their sexual activity, they are also deterred from finding out what they need to know to reduce their risk or to buy condoms.

Stuart Watson, believes that legal reform will enable better outreach to these communities.

“The change in law is a huge step towards being able to approach all communities with education programmes and prevention resources. This would enable better access to HIV prevention services for all, reducing HIV and sexually transmitted infection risk,” said Mr Watson.

* Male to male relationships are not legal and are punishable by imprisonment in the following 9 Pacific island nations: Cook Islands, Kiribati, Nauru, Palau, Papua New Guinea, Samoa, Solomon Islands, Tonga, Tuvalu.
A further 13 countries and territories in the Pacific do not criminalize men who have sex with men.

UN to support civil society and governments to address gender inequalities and human rights violations that continue to put women and girls at risk of HIV infection

Credit: UNAIDS

New York/Geneva, 2 March 2010 – UNAIDS, together with celebrated artist and activist for women and HIV, Annie Lennox, has launched an Agenda for Accelerated Country Action for Women, Girls, Gender Equality and HIV (2010–2014), which has been developed to address gender inequalities and human rights violations that continue to put women and girls at risk of HIV infection.

The five-year action plan was launched at a high-level panel during the 54th meeting on the Commission on the Status of Women, being held in New York until 12 March. It calls on the UN system to support governments, civil society and development partners in reinforcing country actions to put women and girls at the centre of the AIDS response, ensuring that their rights are protected.

“Violence against women is unacceptable and must not be tolerated,” said Michel Sidibé, UNAIDS Executive Director. “By robbing them of their dignity, we are losing the opportunity to tap half the potential of mankind to achieve the Millennium Development Goals. Women and girls are not victims, they are the driving force that brings about social transformation.”

UNAIDS and partners will support the country roll-out of the Agenda for Action in pathfinder countries, including Liberia.

Annie Lennox underlined her unshakable commitment to the cause of women and girls affected by HIV.

“I believe we need a broad movement for change,” she said. “The bottom-line for me is that, in essence, we are all the same. All human beings, wherever we are, have the basic right to be happy and healthy. I see this Agenda for Action as a great opportunity to bring the realities faced by many women and girls to the forefront and to call attention to the injustices faced by many women and girls, placing them at a bigger risk of HIV.”

As of December 2008, 33.4 million people were living with HIV worldwide, of which 15.7 million ─ almost half ─ were women. The proportion of women infected with HIV has risen in many regions over of the world over the past 10 years. In sub-Saharan Africa, 60% of people living with HIV are women. Nearly 30 years into the HIV epidemic, HIV services do not sufficiently address the specific realities and needs of women and girls.

"The information on sexual and reproductive health for HIV-positive women and girls is still limited,” said Suksma Ratri, a member of Indonesia’s Positive Women’s Network, who participated in today’s launch. “Being sexually active and HIV-positive at the same time is very difficult. Women and girls living with HIV often have restricted options when it comes to their sexuality. They need an adequate and friendly support system that enables them to make free decisions about their sexuality without being discriminated and stigmatised. I think the Agenda for Action will be a good platform for countries to strengthen services for women and girls."

The Agenda for Action provides clear action points on how the UN can work together with governments, civil society and development partners to:

• produce better information on the specific needs of women and girls in the context of HIV;
• turn political commitments into increased resources and actions so HIV programmes can better respond to the needs of women and girls; and
• support leaders to build safer environments in which women’s and girl’s human rights are protected.

The actions include:

• Improving data collection and analysis to better understand how the epidemic affects women and girls.
• Reinforcing the UN Secretary-General’s UNiTE to End Violence against Women campaign through the AIDS response.
• Ensuring that violence against women is integrated into HIV prevention, treatment, care and support programmes.
• Analyzing the impact of socio-cultural and economic factors that prevent women and girls from protecting themselves against HIV.
• Supporting women’s groups and networks of women living with HIV to map commitments made by governments on women and HIV.
• Scaling up engagement of men’s and boys’ organizations to support the rights of women and girls.

The launch of the Agenda for Action involved many prominent leaders from the United Nations system, governments and civil society. Speakers included Asha Rose Migiro, United Nations Deputy Secretary-General; Melanne Verveer, US Ambassador at Large for Women’s Global Issues; Helen Clark, UNDP Administrator; and Vabah Gayflor, Liberia’s Minister of Gender and Development.

A version of this story is published at www.unfpa.org

During a high-level panel on the opening day of the 54th Commission on the Status of Women, UNFPA Executive Director Thoraya A. Obaid, speaking on behalf of the United Nations, called attention to the links between the right to sexual and reproductive health and women's empowerment, gender equality and the achievement of the Millennium Development Goals.

Throughout the first two weeks of March, the 54th Commission on the Status of Women will conduct a 15-year review of the Beijing Declaration and Platform for Action. This Platform, which emerged from the Fourth World Conference on Women in 1995, reinforced the importance of women's rights and empowerment as established a year earlier in Cairo. It called for action on 12 key issues: poverty, education and training, health, violence against women (one of UNAIDS nine priority areas), armed conflict, economy, power and decision-making, institutional mechanisms, human rights, media, environment and girls.

The commission will emphasise the sharing of best practices as well as discussion of obstacles and gaps, especially those related to achieving the Millennium Development Goals, whose tenth year review will take place in September. The synergy among the three development platforms has been articulated by UNFPA Executive Director in a statement she has issued to mark International Women’s Day 2010 (8 March).

“In 1994, at the International Conference on Population and Development (ICPD), leaders declared for the first time that reproductive health and rights are fundamental to women’s empowerment, gender equality and sustainable development. And fifteen years ago, at the Fourth World Conference on Women, world leaders agreed on a platform for action for equality, development and peace.

“Today many of these agreements are reflected in the Millennium Development Goals to which world leaders have agreed, to reduce poverty and put our world on a more sustainable path…With ideas spreading faster than ever, here is an idea whose time has come: We stand a better chance of solving the world’s problems if men and women join together as equal partners in finding innovative solutions.”

At the commission, UNFPA is participating in several side events on sexual and reproductive health rights, HIV, violence against women, peace and security, the role of men and boys as partners for gender equality, and female migration. The Fund is also releasing a review of its contributions to the Beijing commitments, Beijing at Fifteen: UNFPA and Partners Charting the Way Forward (2010).

Another initiative to promote the idea of gender equality and empowerment of women during 2010 is a special radio/audio series on gender equality and the empowerment of women with a focus on young woman and adolescent girls. The programmes, being produced by UN Radio with support from UNFPA, will explore the challenges facing young adolescent girls, as well as their dreams for the future. Additional activities throughout the year will call attention to the Beijing Platform and its links to the International Conference on Population and Development and the Millennium Development Goals