UNAIDS Executive Director Michel Sidibé in panel discussion with Dr Deborah Birx, Director of the Global AIDS Program, CDC, Dr Georges Tiendrebeogo, Royal Tropical Institute, Cordaid and Dr Miguel H. Diaz, U.S. ambassador to the Holy See. Rome, 14 October 2009.
Credit: US embassy to the Holy see

The Executive Director of UNAIDS, Michel Sidibé took part in a meeting on prevention and early treatment of HIV and TB in young children. The conference is being held at the Pontificia Universita’ della Santa Croce in Rome, and is organized by Caritas Internationalis and the Embassy of the United States of America to the Holy See.

The newly appointed president of the Vatican’s Pontifical Council for Health Care Workers, Archbishop Zygmunt Zimowski, opened the meeting.

Addressing the conference, Mr Sidibé stressed the importance of the faith community in delivering health care services and spreading hope, acknowledging that 30-70 percent of all health care in African countries is provided by faith based organizations (FBOs).

In partnership with faith based organizations the virtual elimination of mother to child transmission of HIV could be possible, said Mr Sidibé: “We have the technology. We have the will. And we have one of the most powerful networks on earth as key partners: the wide-reaching, dedicated communities of faith, driven by deep devotion to social justice and human rights.”

Mr Sidibé also highlighted the unique position of religious leaders as gatekeepers of large communities, to mobilize and sustain a vibrant grassroots movement in the AIDS response – a movement which urgently needs reinvigorating to call for prevention of mother-to-child transmission and integrated TB and HIV services at a national level.

With an estimated 370,000 children being born with HIV in sub-Saharan Africa every year and only 45 percent of HIV positive pregnant women receiving ARV prophylaxis on the continent, the meeting offers an opportunity to promote dialogue among Roman Catholic Church leaders on the urgent need to expand access to testing and treatment for children living with HIV and TB and to promote greater coverage of measures to prevent mother to child transmission of HIV.

During his visit to Rome, Mr Sidibé also had the opportunity to meet with representatives from Sant’ Egidio, the largest Catholic Lay volunteer organization in the world which provides 70,000 people with ART and nutrition in 10 sub-Saharan countries.

The conference will run from 14 to 16 of October and brings together medical doctors, member of religious orders, heads of Catholic run AIDS projects, professors of Theology, as well as representatives for the pharmaceutical industry.

It was co-sponsored by the Pontifical Council for Health Care Workers, UNAIDS, World Health Organization Stop TB Department, Stop TB Partnership, Health Commission of the Unions of Superiors General, and the ‘Bambino Gesù Children’s Hospital.

Preventing mothers from dying and babies from becoming infected with HIV is one of the key priority areas in the UNAIDS outcome framework 2009-2011

Michel Sidibé met with clinic staff including the counsellors, doctors and nurses as well as the Administration and Dean of the Medical school.
Credit: UNAIDS

Concluding his official visit to India yesterday, UNAIDS Executive Director Michel Sidibé visited the HIV treatment centre at Bowring & Lady Curzon Hospitals in Bangalore. The government run centre is the largest and oldest in Karnataka and has the highest rate of integrated HIV and TB services in India. The treatment centre is also one of the few sites able to both evaluate, with a viral load test, when first line treatment is failing, and provide access and establish people on second line treatment.

Mr Sidibé praised the work of Karnataka in leading the integration of HIV/TB services at the same facility and also for making access to second line treatment available to patients in need.

According to Mr Sidibé, "This clinic is a model, showing that access to 1st and 2nd line ART drugs made in India are being scaled-up for Indians in need of treatment." He said it represented an example of what could be possible in the future for Africa.

The HIV treatment centre at Bowring & Lady Curzon Hospitals in Bangalore able to establish people on second line treatment as needed.
Credit: UNAIDS

The UNAIDS Head had an opportunity to meet with patients and their families who shared personal testimonies of how treatment has given them back their lives and health, even enabling them to return to work. He also met with clinic staff including the counsellors, doctors and nurses as well as the Administration and Dean of the Medical school.

Mr Sidibé’s visit to Bangalore also included his participation in a civil society event in Bangalore, where he met with representatives of civil society and spoke with women living openly with HIV.

UNAIDS Executive Director first official visit to India also included events and meetings in New Delhi and Mumbai.

UNAIDS Executive Director Michel Sidibé joined the Chief Minister of Karnataka, B.S. Yediyurappa at the official launch of the Ashodaya Academy, Bangalore 12 October 2009.
Credit: UNAIDS

In Bangalore earlier today, UNAIDS Executive Director Michel Sidibé joined the Chief Minister of Karnataka, B.S. Yediyurappa at the official launch of the Ashodaya Academy – the first learning site on HIV in the Asia-Pacific region run entirely by sex workers. The Chief Minister welcomed the opening of the centre in Mysore, which begins its first HIV training course with over 200 sex workers from Ashodaya, as well as participants from as far away as Bangladesh, Cambodia, India, Myanmar and Nepal.

Michel Sidibé praised the commitment of the Chief Minister for taking time out from the ongoing relief and rehabilitation efforts of flood-hit Karnataka. "In the midst of the humanitarian crisis you are facing, your support for HIV is a special sign of your leadership and commitment to poor and vulnerable people without a voice," said Mr Sidibé.

“It’s a proud moment for us and we have come together to fight the spread of HIV,” said Prathima, a sex worker from in Mysore.

The Ashodaya centre will build the capacity of organizations to improve and develop community-led approaches for educating sex workers about HIV.
Credit: UNAIDS

Ashodaya Samithi, an association of sex workers in Mysore also expressed their appreciation that Chief Minister B.S. Yediyurappa had taken the time to attend the opening and offered his public support to them. The association of sex workers made a donation to the Government of Karnataka of 50,000 rupees, which their organization had collected in support of flood relief efforts.

The Chief Minister expressed how deeply he was touched by the charitable donation, saying that a donation of this size from them meant more to him than a donation 10,000 times larger from wealthy sources.

UNAIDS Country Coordinator Charles Gilks said that the donation symbolized even more than its monetary value, representing “an outstanding example of one community supporting their brothers and sisters in another community in time of emergency and need.”

Karnataka has a relatively advanced HIV epidemic. The state is the second highest prevalence state in southern India with the adult HIV prevalence in several districts exceeding 1% for the past 9 years. Sex work is a key factor in HIV transmission in Karnataka. Mapping exercises have estimated there are more than 64,000 female sex workers in urban areas, and 61,000 in rural areas.

Outreach to these sex work communities is a vital part of the AIDS response in this region. The Ashodaya Academy will build the capacity of organizations to improve and develop community-led approaches for educating sex workers about HIV and it is supported by the Bill and Melinda Gates Foundation, the University of Manitoba and the Asian Development Bank in partnership with UNAIDS.

Leading gay activist Ashok Row Kavi (left) with UNAIDS Executive Director Michel Sidibé
Credit: UNAIDS

During his visit to The Humsafar Trust site in Mumbai, Executive Director of UNAIDS Michel Sidibé shared with its founder, gay activist Mr Ashok Row Kavi, his vision of achieving universal access to HIV prevention, care and treatment in India by 2010.

Mr Sidibé was visiting Mumbai during his first visit to India as Executive Director of UNAIDS, he also congratulated The Trust on its contribution towards making the annulment of Section 377 of the Indian Penal Code a reality. The organization was part of the petition filed in a Delhi court against Section 377 which criminalized homosexual sex.

The Humsafar Trust is one of the first organizations in India to advocate for the rights of men who have sex with men. In 1990 Mr Row Kavi, along with a few other self-identified homosexual men, started a magazine called Bombay Dost (Bombay Friend) in an effort to create a “gay community”. They were deluged with letters from other men around the country, and even further, from Nepal, Pakistan, Afghanistan and Central Asia who were also in search of this community. Five years later, Mr Row Kavi moved into a government-provided abandoned building amid slums in Mumbai to offer health education and related services to men who have sex with men.

Today, the Humsafar Trust continues to offer a drop-in centre, counselling services and a medical clinic that provides treatment for sexually transmitted diseases, facilities for HIV testing and referrals for HIV treatment. The Trust has been a frontrunner in challenging Section 377 and bringing about legal change to the way homosexuality is treated in India.

Explaining how the Humsafar Trust came to being, Mr Row Kavi, who also works as a consultant to UNAIDS, said “Because sex between men doesn’t lead to procreation, it is not taken seriously in India. At Humsafar, we never ask who you are; we’re only interested in whether you’re playing safe or not.”

The Humsafar Trust was joined by the Naz Foundation (India) Trust, a New Delhi-based non-governmental organization working on the AIDS response and sexual health in India since 1994, and the Lawyers Collective in filing a petition in the Delhi High Court against Section 377. Their efforts were rewarded when, on 2 July 2009, the court in a historical judgment declared 377 a violation of the rights to privacy, liberty, health and equality enshrined in the Constitution of India.

During his recent visit to New Delhi, Mr Sidibé congratulated these activists at an event in their honour. The court ruling strengthens the National AIDS Control Organisation’s (NACO) efforts to reach out to people at higher risk of HIV.

The UNAIDS Head said India’s decision on 377 is a huge victory because “removing laws that criminalize and discriminate herald a new framework and new commitment and a new movement to universal access to health and human rights”.

Statistics provided by NACO show that Section 377 encouraged people to remain hidden, making it difficult for them to access essential HIV, health and social services.

In a meeting with positive networks and civil society representatives, Mr Sidibé reassured those living with HIV that they were central to the UNAIDS mission. He said he looked forward to renewed energy in the AIDS response nationally and globally, despite the global financial and economic crisis.

Mr Sidibé’s visit to India will conclude on October 12.

(from right) Oscar Fernandes, Convener – Parliamentarians’ Forum on HIV/AIDS; UNAIDS Executive Director Michel Sidibé (centre); Dr Charles Gilks UCC India. New Delhi, 9 October 2009
Credit: UNAIDS

UNAIDS Executive Director Michel Sidibé attended an event in Delhi today to recognize the activists whose efforts contributed towards the recent annulment of Section 377 of the Indian Penal Code. The law, which criminalized consensual sex between men and transgendered people, was overturned in a historical judgment by the Delhi High Court on 2 July 2009.

Mr Sidibé congratulated India’s lesbian, gay, bisexual and transgendered communities for their solidarity leading up to the court judgment, declaring it “a victory for tolerance, fairness and equality”.

Mr Sidibé also called on the activist communities to mobilize in the response to HIV and act as a voice for the voiceless for those who are most vulnerable to HIV. “If such laws are removed, India’s HIV prevention programme could serve as a model in the future for other countries around the world,” Mr Sidibé said.

In his address to the award reception, Mr Sidibé also strongly advocated for the removal of punitive laws specifically against sex work and drug use which are detrimental to the AIDS response. He said criminalization risks pushing at communities already at higher risk “into the dark shadows and undermines our efforts to ensure universal access to HIV prevention, care and support services”.

Section 377

The High Court ruling came after a long legal battle in which India’s lesbian, gay, bisexual and transgendered communities made a united effort in order to make their voices heard.

In its court affidavit against Section 377, India’s National AIDS Control Organization had contended that the law hampered HIV prevention efforts. It cited that only 6% of all men who have sex with men have access to HIV prevention, treatment, care and support services, as most of them are reluctant to reveal their same sex behaviour due to fear of extortion, harassment, and violence at the hands of law enforcement authorities. It was noted that Section 377 encouraged people to remain hidden, making it difficult for them to access essential HIV, health and social services.

According to Justices Shah and Muralidhar, the Constitution of India recognizes, protects and celebrates diversity, and they declared Section 377 as a violation of the rights to privacy, liberty, health and equality enshrined in this Constitution.

The event was held to recognize the activist communities whose efforts contributed towards the recent annulment of Section 377 of the Indian Penal Code. New Delhi, 9 October 2009
Credit: UNAIDS

Though the decision was largely seen as a victory for men who have sex with men and transgendered people, it has been hailed as a victory for all – regardless of sexual orientation and gender identity. The judgment is noteworthy and progressive in terms of its rejection of a hetero-normative and homogenous conception of sexuality. The judgment held that morality cannot be held as a ground for restriction of fundamental human rights.

There are around 80 countries worldwide with laws which criminalise same sex behaviour. Through collaborating with civil society as well as other stakeholders UNAIDS works towards removing punitive laws, polices and practices that hamper the AIDS response. This in one of the nine priority areas in the UNAIDS outcome framework 2006-2011.

Representatives from the sexual minority communities in New Delhi also explored with Mr Sidibé ways of successfully engaging with government and health authorities in the wake of the court ruling.

Today, October 7 2009, we mark World Day for Decent Work. The International Labour Organization, a Cosponsor of UNAIDS, works towards achieving the globally endorsed goal of Decent Work. Rights at work include freedom from discrimination, expansion of employment opportunities, social protection for all and social dialogue.

Supporting the rights of people living with HIV in the workplace: The Honourable Shri Mallikarjun Kharge, Union Minister of Labour and Employment (speaking) and Syed Mohammad Afsar, ILO’s HIV and AIDS Technical Specialist for South Asia and National Project Coordinator for India
Picture courtesy of ILO

An innovative tool in India’s response to HIV in the world of work has just been launched by the International Labour Organization (ILO) and the India Network of People living with HIV/AIDS (INP+). The two organizations have come together to release a unique training video and handbook package aimed at guiding those living with the virus in AIDS advocacy in the workplace.

Unveiled by the Honorable Shri Mallikarjun Kharge, Union Minister of Labour and Employment, the package contains testimonies from people living with HIV (PLHIV) in workplace settings as this has proven to be a very effective training initiative in the past. Practical, and offering step-by-step guidelines, it is designed to encourage HIV-positive people to be open about their status and spread the message of tolerance, anti-discrimination and respect for human and employment rights for those affected by the virus across the country.

The video and handbook have been developed with contributions from more than 100 people living with HIV and are available in both English and Hindi.

One active participant in this process is Hari Singh, a board member of the Delhi Network of People Living with HIV, who has been working with the ILO in advocacy initiatives since 2007. He spoke at the launch of his growing confidence in talking about his HIV status. He now speaks to employers, workers and trade unions about his life experience and provides clear and specific anti-AIDS messages.

As in many other countries and communities, AIDS stigma and discrimination are still rife in Indian society, including the workplace, and a number of individuals have been hounded from their jobs because of their status. According to Naveen Kumar of the Delhi Network of Positive People, this can have devastating consequences: “If you take away our jobs, you will kill us faster than HIV.” Removing punitive laws, policies, practices and stigma and discrimination that block effective responses to AIDS is one of the nine priority areas in the UNAIDS Outcome Framework 2009-2011.

This latest intervention is part of an ongoing umbrella project spearheaded by the ILO in India, the first country in the world to implement an ILO technical cooperation project on HIV following the creation of the agency’s programme on HIV/AIDS and the world of work in 2001. From the very beginning, a person living with HIV has been represented on the ILO Project Management Team.

Hari Singh addresses the launch of the video and handbook package. He has been working with the ILO to make sure that the voices of PLHIV are heard in the workplace.
Picture courtesy of ILO

“The ILO in partnership with INP+ has been actively pursuing the principle of right to employment and other basic employment-related rights of PLHIV in the development and implementation of HIV workplace policies and programmes,” explains K.K. Abraham, INP+ president.

As Syed Mohammad Afsar, ILO’s HIV and AIDS Technical Specialist for South Asia and National Project Coordinator in India maintains, “Work is just as important as treatment for people living with HIV. The ILO Code of Practice on HIV/AIDS and the world of work includes non-discrimination for purposes of employment as one of its key principles. People should be allowed to work and earn a living as long as they are fit to work.”

The ILO India project has been supported by the United States Department of Labour and, more recently, by the US President's Emergency Plan for AIDS Relief (PEPFAR). It is now seen by many as something of a yardstick for other programmes executed by the ILO with ministries of labour and with employers’ and workers’ organizations to address AIDS in the world of work.

“In the ILO project, we have been building the capacity of people living with HIV and engaging them from the beginning. So far, 165 PLHIV from 20 networks in India have been trained in workplace advocacy programmes,” Mr Afsar added.

According to Charles Gilks, the UNAIDS Country Coordinator for India, the initiative is highly welcome. “We cannot stress enough the importance of the rights of people living with HIV – to respect, dignity, access to care and treatment, and here in this project the right to work. Building the capacity of people to advocate this is critical and we salute the achievements of ILO and INP+ in this regard.”

A HIV outreach peer worker chats with a transgendered person in Pattaya, Thailand. Credit: UNAIDS/Vinai Dithajoh

Across the world sex workers, men who have sex with men, transgender people, and other sexual minority groups are disproportionally affected by HIV yet often face considerable challenges in accessing healthcare and other services.

To address the technical and political challenges of securing resources for these key populations while also supporting strong country ownership, the Global Fund to fight AIDS, TB and Malaria (Global Fund), UNAIDS and the Coalition of Asia Pacific Regional Networks on HIV/AIDS is hosting a global expert consultation in Bangkok, 5-7 October 2009.

Mr Prasada Rao, UNAIDS Director for Regional Support Team Asia and the Pacific, earlier opened the Global expert consultation on gender and sexual diversity, emphasising the importance of effective programming for key groups at higher risk of HIV drawing on examples from UNAIDS work in the Asia Pacific region.

“Both UNAIDS and Global Fund, by sharpening their policies and priorities with regard to most at risk populations can influence countries to prioritise high impact prevention in their national plans.

UNAIDS has identified sexual transmission and removal of punitive laws as priorities in its Outcome Framework 2009-2011. The Global Fund is increasingly moving to funding National Strategic Applications (NSAs) rather than individual proposals. Both these policy shifts will immensely benefit MSM and transgender populations by resource availability for high impact programs,” said Mr Rao.

Mr Prasada Rao, UNAIDS Director for Regional Support Team Asia and the Pacific, spoke of the importance of effective programming for people at higher risk if HIV when he opened the meeting in Bangkok, 5 October 2009
Credit: UNAIDS

Mr Rao was joined by David Winters, Country Coordinating Mechanism Manager of the Global Fund; and, Vince Crisostomo Regional Coordinator of the Coalition of Asia Pacific Regional Networks on HIV/AIDS as well as representatives of sexual minority groups from around the world. The meeting brings together experts to discuss the implementation of the Global Fund’s Sexual Orientation and Gender Identities Strategy.

The Strategy, agreed by the Global Fund Board in May 2009, recognizes that key populations at higher risk of HIV face considerable challenges in being able to access or benefit from grants and face social and structural barriers in the realization of their health and rights. The consultation aims to continue collaboration between key partners on work towards resource allocation for activities related to sexual orientation and gender identities. It is also a forum to exchange experiences and practices on these activities in order to achieve a more harmonized AIDS response.

Andy Seale, Senior Adviser for Sexual and Gender Diversity at the Global Fund, said: “Progress in securing greater investment in HIV programming for sex workers, men who have sex with men, transgender people, and other sexual minority groups requires a strong partnership approach. We need to ensure that the same diverse partners that helped develop the Global Fund’s sexual orientation and gender identities strategy are now active in demonstrating leadership in addressing the technical and political challenges of its implementation. This meeting brings together a number of key partners in this effort.”

The consultation, is jointly organised by UNAIDS, the Global Fund and the Coalition of Asia Pacific Regional Networks on HIV/AIDS. The Global Fund finances nearly a quarter of all international spending on AIDS and two-thirds of global spending on malaria and TB. UNAIDS plays a unique link role in this effort by strengthening partnerships across sectors, including within civil society and communities.   

The Coalition of Asia Pacific Regional Networks on HIV/AIDS is a broad-based alliance that brings together seven regional networks that have experience and expertise in initiating and implementing programmes dealing with affected communities and vulnerable populations. The Network builds upon partnerships to ensure effective responses at grassroots level.

UNAIDS Executive Director Michel Sidibe with Minister of State for Health and Family Welfare Mr Dinesh Trivedi.
Photo: UNAIDS India

In his first visit to India as Executive Director of UNAIDS, Michel Sidibé has held a series of meetings with the Government in which he emphasized the role of political leadership to ensure that the country’s universal access goals to HIV prevention, care and treatment are achieved in India by 2010.

In Delhi, Mr Sidibé congratulated the Indian government for the progress made in the HIV response. He spoke in a meeting with Ms K. Sujatha Rao, Health Secretary, Ministry of Health and Family Welfare, praising the results achieved by the Ministry and the National AIDS Control Organisation (NACO) in expanding access to HIV treatment beyond the targets set by the country, as well as the implementation of targeted programmes which are having a positive impact on HIV transmission rates.

The UNAIDS Head also expressed his support for the recent decision of a Delhi court to annul Section 377 of the Indian Penal Code that criminalised homosexuality in India. The historic decision is a breakthrough for rights groups in India and strengthens the NACO’s efforts to reach out to the people at higher risk of HIV, like men who have sex with men and transgendered people.

UNAIDS Executive Director Michel Sidibe with Ms. K. Sujatha Rao, Health Secretary, Ministry of Health & Family Welfare
Photo: UNAIDS India

Meeting with Mr Dinesh Trivedi, Minister of State for Health, Mr Sidibé urged him to guard against complacency towards HIV response in the face of other emerging challenges such as H1N1 and climate change-related health issues. He appealed for India to strengthen its role in the UNAIDS programme coordinating body and become a donor to UNAIDS in view of the country’s increased political and economic status in the world community.

Mr Sidibé will hold a series of meetings with other State officials this week as well as with civil society and private sector representatives.

The epidemic in India

There are an estimated 2.4 million people living with HIV in India, the highest in any country in Asia. For every 100 people living with HIV in India, 61 are men and 39 women; prevalence is also high in the 15-49 age group.

The epidemic, like in most of Asia, is concentrated among key populations at higher risk of HIV. Currently, six states are classified with having a high HIV prevalence – Maharashtra in the west, Andhra Pradesh, Karnataka and Tamil Nadu in the south, and Manipur and Nagaland in the northeast. According to recent data, new pockets of concern are now emerging in North India as well.

The independent Commission on AIDS in Asia has noted that India has significantly increased domestic spending on HIV in recent years, accounting for nearly 50% of the country’s total AIDS budget. Mr Sidibé’s visit to India will continue in the coming days and will events in Mumbai and Bangalore.

ITU TELECOM WORLD 2009 welcomes Youth Forum participants.
Credit: ITU / F. Rouzioux

Digital and technological revolutions have dramatically changed the way in which people communicate around the world. Many communities in developing countries don’t yet have access to computers and the internet however according to the International Telecommunications Union (ITU) an estimated 2.2 billion mobile phone users lived in developing countries by end 2008 – 64% of the global market. Estimates show that by 2012, half of all individuals in remote areas of the world, who often do not have access to clean running water, electricity or the Internet, will have mobile phones.

H.E. Mr Ban Ki-Moon, UN Secretary-General and Dr Hamadoun Touré Secretary General of the International Telecommunication Union (ITU) observing the vibrant Opening Ceremony of TELECOM 2009
Credit: ITU / F. Rouzioux

The ITU is gathering the global telecommunications sector together in Geneva this week for Telecom WORLD 2009. The United Nations Secretary-General Ban Ki-moon opened the conference on 5 October. Delegates will explore areas of societal change including the digital divide, climate change, and disaster relief. With its focus on development opportunities, the event brings together corporate social responsibility and displays cases of best practices.

The explosion of mobile technology presents a great opportunity to scale up the AIDS response in poor countries.

UNAIDS Executive Director Michel Sidibé is convinced of the value of this approach. “Communication tools are reaching more and more people even in the most remote villages. They connect us all into a global community,” he said.

“Harnessing technology in creative ways will help us reach people in need. I want universal access to HIV prevention, treatment, care and support services to be as ubiquitous as mobile phone coverage,” Mr Sidibé continued.

Through mobile technology, the millions of people in developing countries who had been left behind by the digital divide are now able to access health information and healthcare services at their fingertips. Mobile phones are being used as low-cost tools for HIV testing, data collection, epidemic tracking, and training of health workers, HIV prevention and treatment support.

Some innovative examples include the HIV awareness and testing campaign via SMS (“Text to Change”, Uganda); HIV testing and treatment support with mobile phones (“Project Masiluleke”, South Africa); strengthening health systems via mobile phones (“Phones for Health”, Rwanda); and smart cards to monitor HIV patients (India and Zambia). These are a small part of the growing field of mHealth, whereby mobile communications, such as mobile phones and portable digital assistants (PDAs), are used for health services and information. mHealth programmes are gaining prominence in regions worldwide.

SMS messages can help change behaviour

Short message service (SMS) messages now offer a cost-effective, and efficient method of disseminating health messages in developing countries. According to the UN Foundation report mHealth for Development: The Opportunity of Mobile Technology for Healthcare in the Developing World, formal studies and anecdotal evidence demonstrate that SMS alerts have a greater impact in influencing behaviour than radio and television campaigns.

SMS alerts are also relatively unobtrusive, offering the user confidentiality in environments where HIV is often taboo. In developing countries, SMS alerts have proven highly effective in targeting hard-to-reach populations in rural areas, where the absence of clinics, lack of healthcare workers and limited access to health information often prevent people from making informed decisions about their health.

SMS campaigns on HIV testing and treatment support

A growing number of countries, largely in Africa, are partnering with local mobile phone carriers to launch HIV awareness and testing campaigns via SMS. These campaigns have been particularly effective in providing young people with the facts about HIV and encouraging them to get tested. Mobile phones have also been used to encourage people living with HIV to take their medication and go to their medical appointments. Taking HIV medication regularly is crucial to avoiding drug resistance. 

Project Masiluleke uses mobile technology to encourage South Africans to get tested for HIV. It sends one million “Please call me” text messages each day throughout South Africa, encouraging people to get tested and treated for HIV. The SMS messages are written in local languages, and are used to direct users to the National AIDS Helpline. Once patients call, the hotline representatives provide information on HIV testing services and locations. Knowing one’s HIV status is critical in a country where almost 20% of the population is living with HIV, but less than 3% know their status.

Using mobile technology for diagnosis and data collection

Health workers in remote areas with no health facilities are now able to diagnose and provide treatment support to people living with HIV through wireless access to medical information databases or medical staff. As a result, patients are able to receive treatment in their villages and homes.

Furthermore, data collection from remote areas is much faster, reliable and more efficient through mobile technology. Innovative initiatives such as “Phones for Health” are helping to close the information gap that exists for patient data in developing countries, allowing decision-makers to make smarter investments by allocating resources where they are needed most. Data collection is a crucial component of HIV programmes in developing countries as policymakers and health providers at the national, district and community level need accurate data to determine the effectiveness of existing programmes and shape new policies. 

GIS mapping to strengthen HIV programmes

WHO in collaboration with its partners is strengthening HIV surveillance, prevention and treatment programmes in countries by using a global information and mapping system compiled through remote field data collection tools, wireless applications and satellite systems. This allows WHO to monitor and analyze the epidemiological trends in HIV infection worldwide as well as the effectiveness of HIV prevention and treatment programmes. For example, the data collected through the mapping system can help health experts determine which health centres have sufficient stock of antiretrovirals (ARVs).

Web-based technology to fight HIV

In addition to mobile technology, web-based technology is also revolutionizing the way health information is disseminated across the globe. A large proportion of people worldwide are now able to access information about HIV transmission, prevention, care and treatment with the click of a mouse.

When it comes to educating young people about HIV, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its Cosponsors, particularly UNICEF, UNFPA and The World Bank, are using the web in innovative ways to disseminate messages about HIV prevention.

In 1998, UNAIDS and UNICEF partnered with MTV to launch the award-winning Staying Alive campaign. Ten years later, it has become the world’s largest, youth-focused, HIV prevention campaign. UNICEF’s Voices of Youth website offers young people a safe and supportive space where they can explore, discuss and partner on health, development and human rights issues, including ways to stop the spread of HIV. 

Tapping into viral communication trends

Social media networks such as Facebook, MySpace, and Twitter are gaining popularity worldwide. These examples of viral communication encourage greater interactivity whereby information is disseminated more broadly and quickly. This trend is accelerating the pace at which information is communicated, and its potential to reach new audiences with precise and tailored messages is impressive.

Like many organizations, UNAIDS is increasing its use of social media networks to get its messages out to new and existing audiences. UNAIDS has a presence on both Facebook and Twitter and engages with the sites’ users by posting regular updates and encouraging user comments and feedback. Content-sharing sites like Flickr and YouTube also enable UNAIDS to share its audiovisual content to people worldwide.

The aim of using social media networks is simple: to disseminate messages about HIV and encourage young people to take action to stop the spread of HIV.

Looking ahead

As new technologies continue to evolve, so will the way in which countries respond to HIV. By staying on top of emerging technology trends, countries will be able to use innovative tools to provide people, even in the most remote villages, with access to HIV prevention and treatment services.

By Michel Sidibé, Executive Director, Joint United Nations Programme on HIV/AIDS (UNAIDS) Geneva, Switzerland

The promise of a vaccine against HIV has got one step closer. Results from the largest vaccine trial ever conducted show a modest but encouraging 31% efficacy in preventing new HIV infections in Thailand. This has vindicated thousands of scientists and volunteers who have been hoping that a safe and highly effective HIV vaccine is possible.
 

This news comes at a time when the movement to achieve universal access to HIV prevention and treatment is gaining momentum. Today more than 4 million people living with HIV are receiving antiretroviral treatment and fewer babies are being born with HIV.  With less than half the people who need treatment having access and with each day more people becoming infected with HIV than are started on treatment, we are mortgaging our future. But we are also exposing a fundamental social injustice—between the privileged and the forsaken—a divide we can bridge. 

An acceptable vaccine is not yet ready, but let us prepare today for tomorrow. Let us learn from the lessons of the AIDS response thus far.  

The first challenge is access and affordability. Antiretroviral treatment has been around since 1996, but real access to treatment began only when public pressure was put on world leaders and the prices of medicines came down. Today, AIDS activists are repeating these efforts to reduce prices, this time for second line antiretroviral medicines. It is unacceptable that 98% of pregnant women in developed countries are able to access HIV prophylaxis to stop transmission to their babies when little more than 33% in developing countries can do so.

The news coincides with this week’s United Nations General Assembly. During which the Secretary-General reminded us of “our commitment to equity” and where I appealed to many Heads of State who are committed to promoting equity to place equity in the AIDS response high on their list. We must not allow cost to deter people from access to a vaccine.

The second challenge is creating the conditions for massive uptake of an effective vaccine. Time and again, women and girls are unable to make independent decisions about their health and education. Many men and women do not come forward to take an HIV test for fear of stigma and discrimination. People without a voice—sex workers and their clients, injecting drug users and men who have sex with men—are often excluded from health and social welfare programmes. We look to civil society to continue to break down the barriers to vaccine uptake.

The third challenge is in creating health systems capable of delivering the vaccine. Currently clinics are geared towards immunizing infants and young children. The largest benefits of an HIV vaccine will likely accrue from vaccinating the present cohort of young people and those at higher risk of HIV exposure. A failure to reach adolescents will represent another failure to break the back of the epidemic.

There is no time for complacency in our efforts to stop new HIV infections. The world needs a strong HIV prevention campaign that is evidence-informed and grounded in human rights. It is high time to end discrimination, bad laws, and harmful social norms that fuel HIV transmission.

As scientists and world leaders absorb the implications of the Thai study results in the coming weeks they must be mindful of these challenges. A “ready to use” vaccine is years—perhaps decades away, but when it does become available, it ought to be financed as a public good that is accessible for all. How else can we reasonably expect to put an end to this epidemic?