This article first appeared in the official programme of the 23rd Teddy Award

23rd TEDDY Award, 59th Berlinale International Film Festival

Film offers invaluable insights into the lives of different cultures, groups, and people. It is a medium that has a long history in addressing controversial topics and issues. For men who have sex with men, cinema has been a powerful platform to highlight the challenges they face in society.

From the 1969 release of Midnight Cowboy through to the works of Rosa von Praunheim, social acceptance of the acknowledgement and openness about men who have sex with men has grown. Most recently, major Hollywood films such as Brokeback Mountain (2006) have brought further mainstream attention and acceptance. Undoubtedly, AIDS – and its impact on this community – has been one of the most powerful storylines used in the past two decades, especially as the men who have sex with men community continues to be one of the groups hardest hit by the epidemic. The landmark film Philadelphia (1993) has been widely used to change attitudes towards AIDS and men who have sex with men, as well as to evoke an upsurge of compassion.

Nearly three decades since AIDS was first recognized, much progress has been made globally to prevent new HIV infections and provide antiretroviral therapy to those who need it. But men who have sex with men continue to bear a substantial burden of HIV infection, with increasing numbers of new infections occurring in a number of countries worldwide.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) works closely with communities and organizations of men who have sex with men and promotes their leadership and participation in the global AIDS response. UNAIDS acts as a bridge builder, linking men who have sex with men and their organizations with governments, other civil society and international partners. UNAIDS’ role is to ensure commitment to the protection of the human rights of men who have sex with men, and support countries to put in place strategies and programmes to achieve universal access to HIV prevention, treatment, care and support.

Obstacles in responding to the sexual health needs of men who have sex with men

A significant hurdle in reaching out to men who have sex with men in a number of countries is the criminalization: few men who have sex with men come forward for fear of stigma, discrimination, and/or legal repercussions and this, in turn, impedes efforts to reach men who have sex with men, and their partners with HIV services, such as prevention, treatment, care and support. Within the diverse communities related to men who have sex with men are groups which are even more stigmatized, such as sex workers, men who are living with HIV, or transgender people, and their specific needs all require attention.

A recent report addressing HIV and men who have sex with men in a number of countries in Eastern Europe, the Caucasian Republics and Central Asia found that although most of the early cases of HIV in the region were diagnosed among men who have sex with men, this remains the least understood of the most-at-risk groups. Reasons include the reluctance of these men to be identified as such (even in a medical context), homosexual sex resulting in criminal prosecution in some countries, and, even the absence of criminal sanctions, stigmatization and physical violence.

In a survey conducted among men who have sex with men in Georgia in 2005, one quarter of those interviewed (25.7%) reported having faced social exclusion, discrimination and even violence by strangers, neighbours, family members and friends because of their sexual orientation. The survey revealed that 10% of all respondents had faced physical violence, with reports of beatings and two cases of rape, while other respondents reported social rejection and unfair dismissal from work.

The impact of violence against men who have sex with men has galvanized action in Latin America where Brazil and Mexico top the table of reported incidents. But this may be because rights groups there monitor the situation more closely than elsewhere in the continent.

UNAIDS encourages governments to “know their epidemic” and know how it affects men who have sex with men. Using this information, governments need to not only invest resources in supporting HIV prevention, treatment, care and support for men who have sex with men – tailored programmes that respond to their health needs – but also address the discrimination, violence and other barriers that stand in the way of accessing services.

Epidemic among men who have sex with men

Spanning a period of just 28 years since five gay men in the United States were the first identified with an unusual pattern of diseases later labeled AIDS, the epidemic has claimed the lives of more than 25 million people so far across the globe.

Sex between men occurs in every culture and society – though its extent and public acknowledgement vary from place to place – and is thought to account for between 5% and 10% of global HIV infections. It is the predominant mode of HIV transmission in many high-income countries and continues to be the population group most-at-risk of acquiring HIV within Western Europe. However, in countries reporting on access to HIV services by key population group, only around 40% of men who have sex with men have access to the HIV prevention and care services they need.

Regional trends

Sex between men is the most prominent mode of HIV transmission in nearly all Latin American countries, the United States, Canada and some Western European countries.

In both Canada and the United States, unprotected sex between men accounted for 40% of new HIV diagnoses in Canada in 2006 and 53% in the United States in 2005. The number of new HIV diagnoses attributed to unprotected sex between men has also increased sharply in recent years in Western Europe. In Germany, for example, the number of new HIV diagnoses among men who have sex with men rose by 96% between 2002 and 2006.

The urgency in Latin America is underlined by official reports on the state of the HIV epidemic in Colombia, Ecuador, Bolivia and Peru where sex between men is acknowledged as being the main source of new HIV infections.

In Asia, unprotected sex between men poses a significant but under-studied factor in the region’s HIV epidemics. In Bangkok, HIV prevalence among men who have sex with men went from 17% in 2003 to 28% in 2005. Male sex workers also face a particularly high risk of infection.

In Africa, several recent studies suggest that more attention is needed to better understand the role of HIV transmission among this population and that the proportion of the epidemic attributable to sex between men may be larger than hitherto thought, but there is still a great lack of information.

Looking ahead

Experience has shown that effective responses to HIV are those based on respect for human rights, and unimpeded access to HIV prevention, treatment, care and support. UNAIDS supports efforts to amend laws prohibiting sexual acts between consenting adults in private, enforce anti-discrimination legislation, provide legal aid services, and promote campaigns that address homophobia. These protections, alongside universal access to HIV prevention, treatment, care and support for men who have sex with men, will go a long way to turning the tide of the epidemic in many parts of the world.

Law, law enforcement practices, stigma and discrimination must be tackled as part of national AIDS responses as vulnerability to HIV infection is increased where men are either excluded from, or exclude themselves from, sexual health programmes and services out of fear. Gay, lesbian, bisexual and transgender communities must be – and have the right to be – empowered to participate equally in the social and political life of their communities and countries. These communities, who were the frontrunners in the early days of the AIDS response, are key partners today in the movement for universal access to HIV prevention, treatment, care and support.

UNAIDS Executive Director Mr Michel Sidibé addressed the audience of the 23rd edition of the TEDDY Award in Berlin on 13 February.
Credit: UNAIDS

UNAIDS Executive Director Mr Michel Sidibé addressed the audience of the 23rd edition of the TEDDY Award in Berlin on 13 February with a strong message: universal access to HIV prevention, treatment, care and support must be accessible to all people who are in need—including men who have sex with men and other populations most-at-risk of HIV infection.

UNAIDS partnered with the organizers of the TEDDY Award to focus this year’s Teddy Topic on homophobia, human rights and AIDS.

The TEDDY Award is one of the longest running (since 1987) and most-respected international film awards for the lesbian, gay, bisexual and transgender (LGBT) community. The award is part of the annual Berlin International Film Festival commonly know as the Berlinale, which ended on 15 February.

At the start of the evening ceremony, Mr Sidibé engaged in a lively conversation with Dirk Ludigs, a well-known German journalist and author, outlining the work of UNAIDS and its partners in addressing the global AIDS epidemic.

Mr Sidibé stressed that countries can and should actively promote tolerance and inclusion, as well as confront homophobia and gender violence.

On the issue of human rights violations against sexual minorities, Mr Sidibé stressed that laws criminalizing sex between men drive the HIV epidemic underground, increasing the isolation of gays, bisexuals and transgender people and making them more reluctant to come forward to access HIV services.

Currently, 84 countries in the world have legislation that prohibits same sex behaviour. In the 2006 Political Declaration on HIV/AIDS, governments committed to removing these legal barriers and passing laws to protect vulnerable populations. Countries that have non-discrimination laws against men who have sex with men, injecting drug users and sex workers have achieved higher rates of coverage of HIV prevention efforts.

Mr Sidibé’s messages were fitting as many of the LGBT-themed films at this year’s Berlinale concentrated on stigma and discrimination, the impact of AIDS as well as other challenges LGBT face in society.

Mr Sidibé said UNAIDS will continue to place human rights at the centre of its agenda and protect and support the rights of the LGBT community.

Other special guests at this year’s TEDDY Award included the mayor of Berlin, Mr Klaus Wowereit, the Ambassador of Mali in Germany, Ms Fatoumata Sire Diakite, British actress Tilda Swinton, American actor Joe Dallesandro, Dr Gottfried Langenstein, the president of ARTE (the French-German public broadcaster), and several German politicians. The host of the ceremony was Annette Gerlach, head of culture at ARTE.

In addition to the Teddy Award ceremony, Mr Sidibé met with the German Minister for Health, Ms Ulla Schmidt, the Minister for Economic Cooperation and Development, Ms Heidemarie Wieczorek-Zeul, several delegates from the German Federal Parliament, and representatives of the Berliner AIDS-Hilfe and the Deutsche AIDS-Hilfe, two NGOs engaged in HIV advocacy and policy in Berlin and Germany, respectively.

Click on the image to start video

(front row from left) Professor Miriam Were, Excellency Mr Joaquim Chissano, His Excellency Mr Festus G. Mogae and Ms. Joyce Mhaville. (back row from left) Dr. Innocent Ntaganira (WHO AFRO), Mr Ndolamb Ngokwey (UN Resident Coordinator in Mozambique), Dr. Kereng Masupu (Champions Secretartiat), Dr. Antonica Hembe (SADC), Mr Luke Nkinsi (Melinda and Bill Gates Foundation), Mr Mauricio Cysne (UNAIDS) and Paula Mondlana (Africa Forum)
Credit: UNAIDS/Doug Johnson

The “Champions for an HIV-free Generation” - an organization of African leaders including former African presidents and other influential personalities – visited Mozambique as part of their mandate to mobilize leadership in Africa and to promote effective policies and action on HIV prevention.

The aim of the visit was to advocate for keeping AIDS high on the political agenda in Mozambique as well as to step up efforts to prevent the spread of HIV in the country. As outspoken opinion-leaders, the Champions sought to initiate a dialogue in changing behavioural and societal norms.

“The Champions realize that stronger, more visionary leadership must come from within the continent most affected by this epidemic. We are here to reach our peers, our African brothers and sisters, to find solutions together,” said His Excellency Mr Festus Mogae, former president of Botswana.

Led by Mr. Mogae, the Champions met with Mozambique’s President Armando Guebuza, Prime Minister Luisa Diogo and several cabinet members, as well as with leaders of civil society organizations, development partners and the media. Through their discussions, the Champions shared regional experiences in fighting the disease and urged the scale-up of effective HIV prevention strategies.

Other Champions taking part in the visit included His Excellency, Mr. Joaquim Chissano, former President of the Republic of Mozambique; Professor Miriam Were, chairperson of the Kenya National AIDS Control Council; and Ms. Joyce Mhaville, chairperson of the Steering Committee of the African Broadcast Media Partnership Against HIV/AIDS (ABMP).

(from left) Excellency Mr Joaquim Chissano, Professor Miriam Were, Ms. Joyce Mhaville, (seated) His Excellency Mr Festus G. Mogae
Credits: UNAIDS/Doug Johnson

"The Champions for a HIV Free Generation is an extraordinary initiative. The Champions play a pivotal role in advocating for the scale up of key prevention activities that can have the greatest impact such as multiple concurrent partnerships and male circumcision," said UNAIDS Country Coordinator Mauricio Cysne.

Male circumcision

One of the priority issues that the Champions brought to Mozambique is the subject of male circumcision. The Champions asked the government to consider the rapid scale-up of male circumcision as a priority under the country’s current comprehensive HIV prevention plan. The Champions pointed out the compelling scientific evidence, globally and even locally, that male circumcision can reduce HIV infections greatly.

Furthermore, they also stressed the fact that male circumcision should always be considered as part of a comprehensive HIV prevention package and that the communication strategies around male circumcision are critical to prevent men from developing a false sense of security and engage in high-risk behaviours that could undermine the partial protection provided by male circumcision.

Multiple partnerships and concurrent relationships

Multiple partnerships and concurrent relationships were other issues brought forward by the Champions. In Mozambique, as in other parts of the southern Africa region, many people have more than one sexual partner. Close sexual networks are formed when men and women have multiple sexual partners or concurrent relationships—ongoing relationships with more than one intimate partner overlapping for weeks, months or years. If someone in this network acquires HIV it increases the chance of everyone else who is part of this network becoming infected.

(from left) His Excellency Mr Joaquim Chissano, Professor Miriam Were, Ms. Joyce Mhaville and His Excellency Mr Festus G. Mogae
Credits: UNAIDS/Doug Johnson

The Champions emphasized the importance of developing a nation-wide campaign to reduce multiple concurrent partners and to demonstrate strong leadership and engagement of prominent persons seen as role models. These recommendations come shortly after a new national HIV prevention strategy has been approved by the Mozambican government, and the Champions advocated for keeping the momentum for addressing issues of sexual behaviours that can increase the risk of HIV infection.

Social transformation

A social transformation of gender roles and relations is already under way in Mozambique, which can be seen from the recent legal changes. The Legislation on the Protection of People Living with HIV Against Stigma and Discrimination was promulgated in January 2009 and a new Domestic Violence Bill is underway which will improve women’s ability to negotiate sex and to prevent HIV infection. The Champions stressed that the government should fully support the development and implementation of these new legal mechanisms.

Finally the Champions pointed out the necessity for sustainable funding of the AIDS response and offered to share successful experiences from other countries in the region on effective allocation of resources and private/public partnerships.

More than 1.6 million people are estimated to be living with HIV in Mozambique. The disease, which disproportionately affects women and children, is estimated to claim more than 92,000 lives each year. Among the main drivers of the epidemic in Mozambique are large numbers of multiple and concurrent partnerships, low levels of circumcision and gender inequality.

Background on the Champions

The Champions for an HIV-Free Generation are highly visibly leaders and outspoken advocates for those affected and infected by HIV. Led by H. E. Mr. Mogae as chairperson, the founding members include four former African presidents, a Nobel Laureate, and other high-level African leaders from different walks of life. The Champions focus their efforts in sub-Saharan Africa, home to more than two-thirds of all people living with HIV. With a focus on proven HIV prevention practices, the Champions embrace and promote key policy, legal, cultural and behavioral practices and messages that help accelerate the social outcomes needed to achieve an HIV-free generation.

The collaborating partners of this initiative are the World Bank, UNAIDS, the World Health Organization, the Bill and Melinda Gates Foundation, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and PEPFAR.

UNAIDS Executive Director Michel Sidibé addressed a public meeting attended by members of local AIDS organizations, community organizations, civil society, as well as diplomatic and government officials. The South African Minister of Health Ms Barbara Hogan also addressed the meeting.
Credit: UNAIDS/G. Williams 

This morning the Executive Director of UNAIDS, Mr Michel Sidibé gave his first major global statement at a public meeting in Khayelitsha, a township on the outskirts of Cape Town in South Africa which has a population of approximately half a million people.

Building on the commitment countries have made to reach universal access by 2010, Mr Sidibé set out his strategy for the future direction of UNAIDS and highlighted the need to invigorate global momentum, action and commitment towards achieving universal access to HIV prevention, treatment, care and support.

Like other regions of the world southern Africa is feeling the effects of the global economic crisis. Mr Sidibé stressed the need for follow through on domestic and international investments and commitments to meet 2010 country targets.

Khayelitsha is home to around half a million people.
Credit: UNAIDS/G. Williams

"We cannot let the economic crisis paralyze us,” said Mr Sidibé. “Stimulus packages and economic adjustments should be made with a human face in mind. A mother should not have to choose between continuing AIDS treatment and feeding her children. We cannot let down the 4 million people on treatment and millions more in need today.”

Members of local AIDS organizations, community organizations, civil society, as well as diplomatic and government officials were among the guests and the South African Minister of Health Ms Barbara Hogan also addressed the public meeting.

A new report released by UNAIDS today, “What countries need: Investments needed for 2010 targets”, calls for investment to ensure countries reach the ambitious universal access targets that they have set for 2010. To reach these, an estimated investment of US$ 25 billion will be required in 2010 which is US$ 11.3 billion more than is available today.

“It will not be easy to close this gap but it is achievable and absolutely necessary if we are to accelerate the pace of the response to the AIDS epidemic,” said Michel Sidibé. “Together we will help save lives—by putting more people on treatment, protecting babies and young people from getting infected, and ensuring that a whole generation of children will graduate from school.”

The Ubuntu Clinic in Khayelitsha treats tuberculosis and HIV
Credit: UNAIDS/G. Williams

The public meeting took place at the Ubuntu Clinic which treats tuberculosis (TB) and HIV. With a TB/HIV co-infection rate of around 70 % in Khayelitsha, this clinic allows patients to register for both TB and antiretroviral treatments. Given that TB accounts for an estimated 13% of AIDS deaths worldwide, it’s vital to ensure that people living with HIV have access to TB prevention, diagnosis and treatment. The Ubuntu Clinic’s model of "service integration" has since spread to other clinics across the township. The Ubuntu Clinic ran the first programme on the prevention of mother-to-child transmission in South Africa and has provided antiretroviral treatment to approximately 20,000 people.

This afternoon Mr Sidibé flies to Johannesburg where he will hold a series of meetings with civil society and Foundation representatives as well as meet United Nations staff. This is the first official country visit Mr Sidibe has undertaken in his new role as Executive Director of UNAIDS.

“What countries need: Investments needed for 2010 targets”

A new report released by UNAIDS, "What countries need: Investments needed for 2010 targets," estimates that an investment of US$ 25 billion will be required for the global AIDS response in 2010 for low- and middle-income countries—US$ 11.3 billion more than is available today.

“It will not be easy to close this gap but it is achievable and absolutely necessary if we are to accelerate the pace of the response to the AIDS epidemic,” said UNAIDS Executive Director Michel Sidibé.

The investment needs is based on the country-defined targets to reach universal access to HIV prevention, treatment care and support by 2010. The new report anticipates that nearly one third of this investment will come from domestic sources, with investments from multilateral and bilateral sources needed for the remaining US$ 17 billion.

The report highlights that, of the total investments required, approximately one third is for activities addressing behavioural change, social drivers of the epidemic, social mitigation and other services that are managed outside of the health sector through multisectoral programmes.

Another one third is aimed at strengthening health systems. The weakness of health systems is a major obstacle to scaling up to universal access to prevention, treatment, care and support.

The remaining one third will go towards HIV specific health services, such as programmes to reduce mother-to-child HIV transmission, blood safety, and provision of antiretroviral therapy for those in need.

HIV prevention, treatment and care

It is estimated that nearly US$ 11.6 billion will be required for HIV prevention and US$ 7 billion for treatment.

The priority HIV prevention services chosen by countries are based on UNAIDS prevention guidelines, which call on countries to prioritize programmes according to the type of national epidemic. For example, countries with generalized epidemics have an urgent need to scale up prevention services for young people. Whereas countries with concentrated epidemics are advised to focus first on providing services and programmes to the most-at-risk populations, including sex workers, their clients, injecting drug users, and men who have sex with men.

The investments needs for treatment and care cover more than the provision of antiretroviral treatment. Besides including costs for antiretroviral treatment, they also include provider initiated testing and counseling, treatment and prophylaxis for opportunistic infections, nutritional support, laboratory testing, palliative care and the cost of drug-supply logistics. The costs for CD4 testing to monitor the response to antiretroviral therapy and disease progression are also included.

What can be achieved with the $25 billion?

With the achievement of country-defined targets of HIV-related services, in 2010 approximately 6.7 million individuals would be receiving antiretroviral treatment. More than 70 million pregnant women will be screened and receive prevention of mother-to-child transmission services; 20 million men who have sex with men, 7 million sex workers and 10 million people who inject drugs will receive HIV prevention services. Seven million orphans will be supported and nearly 8.1 billion condoms (male and female) distributed. This will result in averting 2.6 million new HIV infections, cutting HIV incidence by nearly 50% and averting 1.3 million deaths.

Achieving country-defined targets by 2010 presents an opportunity to change the pace of the response to the AIDS epidemic. It will help save lives—by putting more people on treatment, protecting babies and young people from getting infected, and ensuring that a whole generation of orphans will graduate from school. It will also build the foundation for sustaining the AIDS response for years to come, as well as contributing to the strengthening of health systems and increasing human resources. It will help reduce homophobia, stigma and discrimination, especially of the voiceless and marginalized. It will contribute to reducing violence against women and girls and empowering millions to protect themselves from HIV and sexual abuse.

It is clear that in today’s financial climate, investments must be made wisely. But the human face must be kept in mind; behind each reduction or cutback is an individual, a family.

“We cannot let the economic crisis paralyze us,” said Mr Sidibé. “Stimulus packages and economic adjustments should be made with a human face in mind. A mother should not have to choose between continuing AIDS treatment and feeding her children. We cannot let down the 4 million people on treatment and millions more in need today.”

As the report concludes, universal access has to become a reality for the hundreds of millions of people who are vulnerable to HIV infection and the millions of people living with HIV and their loved ones. Investments already made in responses to AIDS are showing results. This is a time for scaling up, not scaling down.

UNAIDS Executive Director Michel Sidibé (left) met with the Deputy Speaker of Parliament Mrs Nozizwe Madlala-Routledge on 9 February 2009 in Capetown.
Credit: UNAIDS/G. Williams

The Executive Director of UNAIDS, Mr Michel Sidibé, is visiting South Africa where he will announce plans for the future direction of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

This morning in Cape Town he met with the Deputy Speaker of Parliament Mrs Nozizwe Madlala-Routledge.

Tomorrow he will outline his strategy for the future direction of UNAIDS during a speech in the South African township of Khayelitsha where he will be joined by the Minister of Health Hon. Ms Barbara Hogan.

Building on the commitment countries have made to reach universal access by 2010, Mr Sidibé will set out his strategy and highlight the need to invigorate global momentum, action and commitment towards achieving universal access to HIV prevention, treatment, care and support.

He will also outline the investments needed for countries to reach their targets for 2010.

This is the first official country visit Mr Sidibe has undertaken in his new role as Executive Director of UNAIDS.

South Africa currently has the largest number of people living with HIV in the world—approximately 5.7 million and HIV prevalence in adults aged 15 to 49 is 18%.

By Leonard Okello
International head of HIV/Aids, ActionAid

I have received the very sad news of the sudden death of Ramesh Venkataraman, the former ActionAid Asia HIV and AIDS regional coordinator. Ramesh joined ActionAid in April 2007 till he resigned his post at the close of 2008. He passed away on 31 January due to an internal haemorrhage. He had been suffering from multiple illnesses.

Over the last two years that I have worked with Ramesh, he touched my heart and became literally like my younger brother. He had—and will continue to have—a special place in my heart. We shared in depth both official and personal challenges and opportunities.

Ramesh had a deep passion for his work and a special love for ActionAid. He always stood up for Human Rights and fought injustice straight on, but his health frustrated him more and more as the days passed by. He always told me how much he knew of his abilities, but was getting increasingly frustrated by his physical strength failing him. He feared to fail the team that he loved so much and had a sense of responsibility that often drove him to tears of pain and hope depending on the context.

Ramesh was immensely intelligent, and had super advocacy skills with a range of media, cameras, drama, information technology, and a rich humorous language, something that fate never allowed him to fully utilize.

When we last met together in Delhi, Ramesh informed me that he feared his body was giving up. He resigned about two weeks thereafter. We kept in touch on and off although the phone lines were often not really friendly. Last time Ramesh and I talked on phone briefly he was very hopeful following a knee surgery.

But like my mother often told me, when a patient gives you a lot of hope, then you know it is about time to prepare for the worst. Human life, she always told me, lives on hope and it is hope that must keep you going till you rest at the end.

There is something else I learnt from the comrades of the African National Congress (ANC) and at college in Uganda, during the anti-apartheid struggles. "Do not mourn, Comrades, Mobilize!" was the slogan that kept them moving during tough times.

I am seeking of each and every one of the global AIDS movements across the world, to use this time of reflection to mobilize even more to deal with HIV and improve our health.

Please keep the fire that Ramesh kept burning so that we can deliver on whatever he left behind not yet done. Let us complete the struggle for human rights as passionately as he would have loved too.

May his soul rest in eternal peace. Aluta Continua! Solidarity!!

Credit: OneLove campaign

“Talk, respect, protect”

OneLove is a regional campaign running in Southern Africa that aims to get people talking about the trend of having more than one sexual partner at a time. The overall goal is change this behaviour which is a factor in the transmission of HIV in the region.

Using mass media and social mobilisation to communicate its message, OneLove encourages people to discuss multiple partnerships and come to greater understanding of the risks involved in their lifestyle choice.

Multiple partnerships and concurrent relationships

Close sexual networks are formed when men and women have multiple sexual partners or concurrent relationships—ongoing relationships with more than one intimate partner overlapping for weeks, months or years. If someone in this network acquires HIV it increases the chance of everyone else who is part of this network becoming infected.

OneLove national campaign South Africa

The South Africa OneLove campaign was launched on 14 January. With outreach to 16 million South Africans, the prime-time TV drama series “Soul City” and the “Soul City” radio drama are key vehicles to get the message out to people across the country. UNAIDS is a partner of the Soul City Institute which aims to promote healthy lifestyle choices through mass media advocacy.

The OneLove theme is also being featured on radio talk shows, through TV and radio advertisements and a number of outreach events. Over a million information booklets will also be distributed in multiple languages.

The overall goal of the campaign is to reduce the number of new HIV infections in South Africa by 10% by 2011. This will contribute to the goal set by the South African National AIDS Council (SANAC), which aims to reduce the number of new HIV infections in South Africa by half in a couple of years.

“South Africa currently has the largest number of HIV positive people in the world with some 5.7 million people living with HIV in the country and HIV prevalence in adults—age 15 to 49—is 18%. Campaigns that inform people of the potential risks of their lifestyle empowers people to make informed decisions about their sexual behaviour,” said UNAIDS Country Coordinator Catherine Sozi.

Social networking to discuss sexual networks

As well as mobilizing traditional media, OneLove is also employing social networks to highlight the issue of sexual networks. The campaign features on a range of social networking and new media fora including video sharing site YouTube, the Flickr shared photo gallery, a Facebook page and Twitter feed.

Participation and sharing of ideas is at the core of the campaign. The OneLove official website (http://www.onelovesouthernafrica.org) hosts, in addition to lots of information resources and fact sheets, a weekly competition and blog. Everyone is invited to comment on articles, add their views on a discussion board and take the online polls.

The HIV epidemic in Southern Africa

The severity of the epidemic in southern Africa—nine countries in the region account for 35 per cent of all HIV infections in 2007—underscores the need for intensified and accelerated action towards universal access to HIV prevention, treatment, care and support.

OneLove signature tune performed at the community launch of the OneLove South Africa campaign in Ubuntu Kraal in Orlando West, Soweto on the 24 January 2009.
Credit: OneLove campaign

UNAIDS has identified HIV prevention as a particular priority and it highlights the importance of reducing HIV incidence through a combination of prevention approaches. Combination strategies include education and raising awareness in relation to delayed sexual debut, increased condom use, male circumcision and reduction in numbers of concurrent relationships. The OneLove campaign is an important vehicle for this.

Monitoring and Evaluation systems and activities are key to tracking what is being done in HIV prevention, treatment and care and whether these activities are making a difference.
Credit: globalhivmeinfo.org

Monitoring and Evaluation (M&E) systems and activities are key to tracking what is being done in the field of HIV prevention, treatment and care and whether these activities are making a difference. A new platform (www.globalhivmeinfo.org) now allows M&E professionals worldwide to access and share information about the AIDS epidemic and the response in a ‘one-stop-shop’.

The webportal includes an extensive and continuously growing number of documents and resources for download in a digital library, interactive calendars of events and training activities and news flashes. The users are able to quickly find information and tools by searching the portal or the digital library, or can tap the wealth of information available on M&E-related sites throughout the internet by using the portal’s external search engine.

Additional features of the portal are social bookmarking functions and automatic alerts and RSS feeds. It also provides mechanisms for communicating with other M&E professionals and its collaborative features enable users to create virtual teams and workspaces. “The webportal is a powerful ‘one-stop-shop’ for information and resources on the M&E of the AIDS epidemic and response. It is a way for M&E professionals to gain exposure to exciting new M&E information, as well as share their own work with the global M&E community,” said Deborah Rugg, UNAIDS Chief, Monitoring and Evaluation Division.

A collaborative effort

The M&E webportal is the product of collaboration among various international agencies that focus on M&E for HIV-related programs, and its purpose is to serve M&E professionals working in local, national, and global capacities. These include field officers placed in-country by international partner agencies; their country counterparts working in national, regional, and local government agencies and non-governmental organizations; staff located at headquarters of international partner agencies; and other practitioners interested in M&E of AIDS programs.

Towards strengthening the “Third One”

As a platform for information exchange within the M&E community working on AIDS with its many partners and actors, the webportal also contributes to strengthening the “Third One” - One agreed country-level Monitoring and Evaluation System - and to ensuring that monitoring and evaluation approaches are coordinated and are generating reliable and timely information on the epidemic and the response.

Dr Renu Chahil-Graf, Director, UNAIDS Regional Support Team for the Middle East and North Africa
Credit: UNAIDS

Across North Africa and the Middle East, UNAIDS estimates that 35,000 people acquired HIV in 2007, bringing to 380,000 the number of people living with HIV. An estimated 25,000 died of AIDS-related illness in the same year. Effectively coordinated HIV prevention, treatment, care and support strategies are vital to the reduction of these figures.

In order to get a clearer picture of the challenges to leading and coordinating an AIDS response in the Middle East and North Africa (MENA) regions, an assessment of the National AIDS Coordinating Authorities (NACA) in 16 countries was recently carried out by the UNAIDS Regional Support Team.

“Having insights into the strengths of their national responses helps country partners identify opportunities for improved coordination,” said Dr Renu Chahil-Graf, Director, UNAIDS Regional Support Team for the Middle East and North Africa.

“Equipped with this information, countries are better informed to make decisions leading to the shared goal of universal access to HIV treatment, prevention, care and support services for those in need,” she continued.

National AIDS Coordinating Authorities assessment

Ministers and High Level Government Officials from MENA countries
Credit: UNAIDS

The assessment looked at institutional structures, governance, relationships between coordinating bodies, capacity strengthening, harmonization and alignment and operational challenges and made a series of recommendations.

Based on the review, UNAIDS convened the first regional meeting on national AIDS coordination in collaboration with the Sultanate of Oman last month in Muscat.

More than 80 participants representing directors of national AIDS programmes, senior health and other government officials from the Sultanate of Oman, Algeria, Egypt, Iran, Jordan, Lebanon, Morocco, Palestine, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates and Yemen took part in the three day meeting. Representatives of WHO, UNDP, UNFPA, World Bank and the Global Fund to Fight AIDS, Tuberculosis and Malaria for HIV (Global Fund) also attended.

Bringing together Ministers of Health, Ministers for Youth and Sports as well as Ministers of Social Services, the interactions facilitated cross-sectoral approaches to moving the AIDS responses forward.

“Three Ones” principles

Across the globe everyone is agreed on the need to use valued resources more effectively. Coordinated and harmonized partnerships are key to making this happen. This has resulted in an agreed set of principles introduced by UNAIDS. These “Three Ones” are shaping international and national initiatives on AIDS.

Implementing the Three Ones nationally requires National AIDS Coordinating structures to be involved in the following areas:

1. Leading the development of prioritized National Strategic Plans;
2. Strengthening monitoring and evaluation systems that facilitate oversight and problem solving for the national programme;
3. Leading participatory reviews of the performance of stakeholders in harmonizing and aligning their support to the national programme.

"Sharing Experiences on the Three Ones Principle in Action in the Middle East and North Africa" was the theme of the three day meeting. In addition to reviewing the results of the assessment, country specific roadmaps for the coming year were developed.

H.E Hasna Barkat Daoud, Minister of Youth, Sports and Tourism, Djibouti (left) chairing a session with Mr Elie Aaraj, President of the Regional Network of AIDS NGOs in the Middle East and North Africa
Credit: UNAIDS

Countries in MENA received approximately US$ 431 million from the Global Fund over the last four years. Recommendations for the revitalization of the national AIDS response in MENA were discussed in several different sessions and working groups and were recapitulated in the closing ceremony.

The universal access goal

“We are all aware that we are far from having achieved the universal access goal to make HIV prevention, treatment and care accessible for all those in need by 2010,” said Jihane Tawilah, WHO Representative and Chairperson of the UNAIDS Theme Group in Oman.

“In 2007, an estimated total of 150,000 people living with HIV were in need of antiretroviral therapy in the region. Those who received the therapy were only six per cent of this number, which is considered the lowest coverage rate among the WHO regions globally,” she added.

The priority in the region is to apply effective preventive intervention strategies and to increase the antiretroviral therapy coverage, she said, adding: “This will require re-examining our policies and practice and redirecting accordingly our efforts and resources to where we can achieve our universal access targets.”

Dr Chahil-Graf also highlighted the need to raise awareness about AIDS among the sections of society not yet reached by HIV prevention information.