An estimated 122,000 teachers in sub-Saharan Africa living with HIV have been given voice in a collaborative project by UNAIDS Cosponsor the World Bank and African Ministries of Education networks of HIV/AIDS focal points.

An estimated 122,000 teachers in sub-Saharan Africa living with HIV have been given voice in a collaborative project by UNAIDS Cosponsor the World Bank and African Ministries of Education networks of HIV/AIDS focal points. The result is a book and a documentary film produced by Partnership for Child Development with support by the World Bank.

On the opening day of ICASA the African premiere screening and launch of the documentary “Courage and Hope” took place in Dakar. Don Bundy, World Bank Lead Specialist on School Health HIV/AIDS & Education introduced the film and its background.

After hearing at an education summit in 2006 how teachers living with HIV in Gabon were returning to their classrooms thanks to HIV treatment and playing new leadership roles in fighting the disease, Bundy encouraged the World Bank and the Partnership for Child Health to finance Courage and Hope.

“This kind of support for teachers helps both maintain the trained workforce and provides young people with credible adult role models,” says Bundy.

Elizabeth Lule, Manager of ActAfrica described how children have a chance to live a life free from HIV if they can acquire knowledge, skills, and values that will help protect them as they grow up. “Providing young people, especially girls, with the ‘social vaccine’ of education offers them a real chance at a productive life, free of HIV,” she said.

(from left): Debrework Zewdie and Elizabeth Lule from the World Bank and Barbara de Zalduono of UNAIDS speak to participants at the launch of Courage and Hope. Credit: UNAIDS/Mamadou Gomis

In the book twelve teachers from Burkina Faso, Cameroon, Ghana, Kenya, Mozambique, Rwanda, Senegal, Tanzania mainland, Zanzibar and Zambia vividly recount their experiences that testify to ordinary yet courageous life with HIV and the impact their HIV status has on their loves, families, schools and communities.

The vast majority of teachers living with HIV in sub-Saharan Africa are unaware of their positive status, and many are reluctant to undergo HIV testing for fear of consequences of a positive test outcome.

In the film four of the teachers—Beldina Atieno, Martin Mkug Ptoch, Jemimah Nindo, and Margaret Wambete—detail the challenges they faced once their positive status became public. These range from stigmatization to shunning and discrimination against them and their families.

“HIV does not kill. What kills is the stigma and discrimination associated with the virus,” says Beldina Atieno, a 38 year-old teacher from Kenya who learned the hard way how to cope with discrimination after being thrown out of the house by her husband and losing her children as well as her job.

Despite the personal hurdles the teachers faced, they are confident that accessing effective care, support and anti retroviral medicines, they are able to live, and to enjoy full and healthy lives. The personal reflections of these teachers offer courage and hope to the other estimated 121,996 teachers living with HIV in sub-Saharan Africa.

The film “Courage and Hope: African Teachers Living Positively with HIV” was first shown at the International AIDS Conference 2008 in Mexico and broadcast from the UNAIDS booth, where free copies of the DVD were also distributed.

At the Dakar launch, Martin Ptoch, who is a teacher living with HIV featured in the film described the positive reactions to the film and book to date. Barbara de Zalduondo, Chief, Programmatic Priorities and Support UNAIDS and Debrework Zewdie, World Bank, Global HIV/AIDS Program also spoke at the launch.

A satellite symposium to highlight the impact that TB has on people living with HIV was held on 3 December 2008 during ICASA. Credit: UNAIDS/Mamadou Gomis

TB is among the leading causes of death in people living with HIV and accounts for an estimated 13% of AIDS deaths worldwide. HIV and TB are so closely connected that they are often referred to as co-epidemics or dual epidemics. Each worsens the impact of the other, yet despite evidence of positive impact of joint interventions, TB and HIV programmes have largely been implemented independently.

Sub-Saharan Africa carries the highest burden of HIV infections and AIDS related mortality in the world, accounting for more than 60% of people living with HIV worldwide. On average, 22% of TB patients in the Region are co-infected with HIV, and approximately 40% of TB deaths are due to HIV.

TB is the most common cause of illness and death among people living with HIV in Africa, despite being preventable and curable. Rising rates of drug resistant TB, especially extensively drug resistant tuberculosis (XDR-TB), further threaten the response to AIDS in the region.

Alasdair Reid, UNAIDS HIV/TB Adviser
Credit: UNAIDS/Mamadou Gomis

For these reasons, on Wednesday 3 December UNAIDS, WHO and WFP in collaboration with the TB/HIV working group of the Stop TB Partnership organized a satellite symposium to highlight the impact that TB has on people living with HIV and what needs to be done to reduce this unnecessary burden of illness and death.

The symposium underlined what needs to be done by HIV programmes and civil society to improve the prevention, diagnosis and treatment of TB in people living with HIV. It introduced the ‘Three I’s for HIV/TB’, a package of interventions - including Intensified TB case finding (TB screening), Isoniazid preventive therapy and Infection control - that aim to reduce the burden of TB among people living with HIV. Furthermore, the need to jointly address nutrition as an essential element in the response to TB and HIV was promoted. TB and HIV both compromise the nutritional status of affected persons, leading to malnutrition, which in turn aggravates the severity of HIV and TB.

Credit: UNAIDS/Mamadou Gomis

Few countries have comprehensive plans to reduce the burden of TB among people living with HIV in the region. The consequence is that the coverage with key TB and HIV interventions is still very low. Collaborative TB/HIV activities are essential to ensure that TB patients living with HIV are able to access HIV testing and treated appropriately, and to effectively prevent, diagnose and treat TB in people living with HIV.

In 2006, only 22% of TB patients were tested for HIV in sub-Saharan Africa, and less than 1% of people living with HIV were screened for TB disease.

The symposium demonstrated the need for rapid scale up to ensure universal access to TB prevention, diagnosis and treatment services for people living with HIV in Africa.

“The ICASA symposium has helped to enhance the engagement of HIV service providers and affected communities in the implementation of these crucial interventions and strengthen collaboration between TB programmes, HIV programmes and civil society,” said Alasdair Reid, UNAIDS HIV/TB Adviser.

UNHCR marked World AIDS Day by reflecting on successes in the agency’s AIDS response while recognizing that there is still a long way to go. UNHCR is a cosponsor of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Afghan refugee returnees from Pakistan attend an awareness session on HIV at a UNHCR transit centre. Credit: UNHCR/M.Maguire

A senior UNHCR official said on Monday that while the UN refugee agency had made progress in responding to the challenges of HIV among displaced populations in recent years, there is still a long way to go.

“UNHCR’s HIV and AIDS programmes have come a long way,” said Arnauld Akodjenou, head of UNHCR’s Division of Operational Services, in a special World AIDS Day message for staff. “HIV remains one of the policy priorities of the High Commissioner [for Refugees António Guterres] and protection remains the cornerstone of UNHCR’s HIV and AIDS strategy.”

Akodjenou noted that “Today, we have reached nearly 100 percent coverage in universal precautions in health clinics in refugee camps and safe blood supply to refugees; [while] access to programmes for prevention of mother-to-child transmission increased to more than 60 percent.”

Universal precautions refers to the medical practice, of avoiding contact with patients' bodily fluids such as wearing gloves when collecting or handling blood and body fluids.

He also revealed that anti-retroviral therapy is now available to UNHCR beneficiaries in many refugee camps, and that its coverage for refugees increased to 75 percent in 2008.

But serious challenges remain. “We need to scale up efforts in HIV prevention, care and treatment for our staff, refugees and other persons of concern. We need to work closer with communities to develop community-based HIV prevention and care initiatives while continuing to tackle stigma and discrimination towards people living with HIV. We also need to ensure medical confidentiality in all circumstances,” said Akodjenou.

“Each of us should contribute in our own way to fighting HIV and AIDS. This may include advocating for the inclusion of refugees and other displaced persons in national HIV policies and programmes, tackling the social and economic inequalities and injustices, and protecting and promoting human rights.”

As part of a larger campaign to ensure that policymakers keep their promises on AIDS, this year’s World AIDS Day theme is "Lead – Empower – Deliver." UNHCR offices around the world marked the occasion with a range of events, and many offices reflected on the success of current programmes – such as the launch of a major awareness and prevention campaign in south-east Democratic Republic of the Congo (DRC).

The landmark campaign in Katanga province kicked off in October, when a travelling roadshow visited the town of Moba, on Lake Tanganyika, and the surrounding areas. Staff from UNHCR and partner organizations distributed information about HIV, provided training and offered locals free HIV testing and counselling.

Since 2006, when UNHCR set up field offices in Katanga, tens of thousands of people have returned to their homes from overseas or other parts of the province. But they remain at risk to disease, including HIV, said Philippe Creppy, head of UNHCR’s Moba office.

The campaign in Katanga, which will enlist the help of traditional chiefs and local health workers, will spread awareness about the vital importance of prevention and will also encourage people to take part in free HIV testing and counseling services. The young will be a particular focus. UNHCR will also work with civil society to design and implement HIV programmes.

Creppy said UNHCR and its partners hoped that free counselling and testing, together with the training of medical staff and the development of health facilities and comprehensive policies, would help “put the brakes on the rapid development of this scourge in the territory.” Those who test positive for HIV and who need treatment will receive anti-retroviral drugs.

The campaign, involving more than a dozen non-governmental organizations, will gradually be extended to the rest of the DRC and is scheduled to last five years.

(from right) Mr Geoff Manthey (Regional Programme Advisor); Mr Robert Sutherland (UN+ representative); Ms Heyzer (Executive Secretary, ESCAP) and Mr Prasada Rao (UNAIDS Regional Support Team Director) at the World AIDS Day launch. United Nations Convention Center, Bangkok, Thailand. 1 December 2008Credit: UNAIDS

Marking World AIDS Day, UN staff from the Asia Pacific region launched a “UN Cares” regional programme yesterday in Bangkok.

Robert Sutherland, representative of UN Plus in Asia and the Pacific, delivered a speech at the launch in which he acknowledged his appreciation of the leadership of UN agencies in delivering on AIDS, and appealed for even more support for creating an environment free of stigma and discrimination within UN.

After the lighting of two red candles – which according to Asian tradition marks a beginning – the UN Under Secretary-General and Executive Secretary ESCAP, Ms. Noeleen Heyzer delivered her address. She stressed the role of a coordinated “one UN” to ensure that the UN Secretary-General’s commitment to UN Cares is realized in the region. She said, “This year’s World AIDS Day theme ‘Lead, Empower, Deliver’ allows us to reflect on our roles as UN leaders. With this theme, let us pledge to contribute to our own staff welfare when it comes to HIV and AIDS by ensuring time and support needed to meet a specific set of ten minimum standards of UN Cares by the end of 2011.”

On the occasion, the UN Cares Asia-Pacific Regional Coordinator, Dr Lazeena Muna-McQuay was introduced. Dr Muna-McQuay is jointly hosted by UNFPA, ESCAP and UNAIDS RST.

Two UN Cares videos were screened during the programme including the speech of Secretary-General during the official launch of global UN Cares programme and the “voices of support from the field”.

The launch closed with a commitment, as iterated by the Secretary-General, to make UN Cares ten Minimum Standards achieved by all UN agencies by the year 2011.

UN Cares

The UN Cares programme has been developed through interagency consultation between UNAIDS Cosponsors and other. It is a single harmonized programme available to UN system personnel and their families in all entities and all duty stations, designed to help them to access their rights defined in the 1991 United Nations HIV/AIDS Personnel Policy and in the ILO Code of Practice on HIV/AIDS and the World of Work and recognize their individual responsibilities related to HIV. The UN Cares global programme was launched by the Secretary-General in May this year in New York.

In commemoration of this year’s World AIDS Day the UNAIDS Office Washington, in partnership with UNAIDS partners, cosponsors and local civil society organizations, is holding a week-long World AIDS Day visit for women living with HIV from India, Swaziland and the US.

The visiting participants are: Beri Hull, from the USA, who is North America representative of the International Community of Women Living with HIV and AIDS; Jahnabi Goswami from India who is general secretary, INP+ the national Network of People Living with HIV; and Thembi Nkambule of Swaziland who is national coordinator of Network of Women Living with HIV, Swaziland. All three lead education and advocacy efforts in their respective countries.

The three women hope through sharing their stories of courage, determination and selfless service to their communities they inspire leaders who will become champions on issues regarding women and AIDS.

The visit began yesterday in Washington, DC. Today a World AIDS Day luncheon commemorating the 20th Anniversary of World AIDS Day is being held at the National Press Club. Michele Moloney-Kitts, assistant coordinator, Office of the U.S. Global AIDS Coordinator and Tim Wirth, former U.S. senator and President, UN Foundation and Better World Campaign will also address this event.

On 3 December, the Global AIDS Alliance, UNAIDS, and participants will travel to Rock Hill, South Carolina for a two-day HIV awareness-raising tour, which is designed to educate and inform audiences about the role UNAIDS and the participants play in the global AIDS response. The visit will emphasize the need for effective leadership and AIDS solutions tailored to work for specific epidemics, including helping women and girls.

The report, titled Children and AIDS: Third stocktaking report, was jointly prepared by UNICEF, the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Population Fund (UNFPA).

Early diagnosis and treatment can significantly improve the prospects for survival of newborn babies exposed to HIV, according to a report released today by four United Nations agencies.

The report, titled Children and AIDS: Third stocktaking report, was jointly prepared by UNICEF, the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Population Fund (UNFPA).

This report is the third review of progress on how AIDS affects children and young people since the Unite for Children, Unite against AIDS campaign was launched in October 2005 by UNICEF, UNAIDS and other partners with a commitment to be accountable for results.

Unite for Children, Unite against AIDS is a call to action around the impact of HIV and AIDS on children. It focuses on the needs of children in four key areas, known as the “Four Ps”: Preventing mother-to-child transmission of HIV; Provision of paediatric treatment; protection and support of children affected by AIDS; and prevention of infection among adolescents and young people.

This 2008 Stocktaking Report examines data on progress, emerging evidence, and current knowledge and practice for children as they relate to the four programme areas. The report also calls for actions in the next one to three years that can significantly improve prospects for children and women affected by AIDS. These initiatives involve changes in thinking, as well as concrete actions.

Prevention of mother-to-child transmission of HIV
Most pregnant women diagnosed with HIV do not have access to essential care and treatment, including antiretroviral therapy for their own health, to further reduce HIV transmission and prevent orphaning, according to the new report. Far too few pregnant women know their HIV status. In 2007, only 18% of pregnant women in low- and middle-income countries where data were available were tested for HIV, and of those who tested positively for HIV, only 12% were further screened to determine the status of the HIV disease and the type of treatment they require. Addressing mothers’ needs for diagnosis and treatment will improve not only their own overall health but their children’s survival.

Providing paediatric treatment and care
The report found that children under the age of one are not getting diagnosed and are missing out on treatment. As a result, large numbers of very young children are dying every year due to AIDS-related illnesses. Recent evidence found mortality levels reduced by up to 75% when infants were tested early and treated within the first 12 weeks of life. In 2007, however, only 10% of children born to HIV-positive women were tested before they were two months old. Therefore, the report advocates for increased testing to enable appropriate treatments to begin as early as possible.

Protection and care for children affected by AIDS
There is growing evidence in support of programming that addresses the wider context of children’s vulnerability as the basis to assist those children, families and communities directly affected by AIDS. The stocktaking report highlights that responses should be AIDS-sensitive and not AIDS-exclusive. While support to strengthen family and community responses to the epidemic remains a high priority, there is recognition of the need to support national protection systems, including government capacity to address child welfare generally.

Preventing infection among adolescent and young people
Significant numbers of young people continue to be infected with HIV each year, and girls in sub-Saharan Africa, in particular, remain vulnerable – 45% of all new infections occur in the 15–24 year-old age group. The new report argues that urgent attention is needed to address the greater HIV risks to girls of multiple concurrent partnerships, intergenerational sex, transactional sex and gender-based violence.

In countries with low-prevalence and concentrated epidemics, HIV prevention responses focused on adolescent risk behaviours – including injecting drug use, unprotected sex between males, and sex in exchange for gifts and money – are a priority. There is strong consensus that combination prevention programmes – integrating behavioural, structural and biomedical approaches – work.

This year’s report is accompanied by ‘Children and AIDS: Country Fact Sheets’, which present key statistical data on the “Four Ps” for 157 countries.

Deputy President of South Africa, Baleka Mbete and UNAIDS Executive Director Dr Peter Piot Credit: UNAIDS/D. Penney

Dr Peter Piot, Executive Director of UNAIDS, is marking the 20th World AIDS Day at a ceremony in Durban, together with South Africa’s Deputy President, Ms Baleka Mbete and South African Health Minister Barbara Hogan.

The World AIDS Day programme is taking place at the SAHARA Kingsmead stadium, where national and global leaders came together to commemorate the event under the theme of “Stop HIV & AIDS: Leadership and Unity”. As one of his last official engagements as Executive Director of UNAIDS, Dr Piot joined high level representatives from national government, civil society and other partner organizations to demonstrate support and commitment to the national AIDS response.

UNAIDS Executive Director Peter Piot with members of South African government and civil society at the World AIDS Day event in Durban South Africa. Credit: UNAIDS/D. Penney

“It is only through working together to tackle the challenges of this epidemic that we can make progress,” said Dr Piot. “Success depends on strong leadership united under a shared vision. The theme of Leadership and Unity chosen by South Africa is a powerful tool that helps bring together the many sectors and resources needed to make progress against HIV and AIDS.”

Earlier in the day, Dr Piot participated in a live television discussion hosted by the South African Broadcasting Corporation alongside the Deputy President, the Minister of Health and a civil society representative living with HIV.

The HIV epidemic in South Africa

South Africa has the largest number of HIV positive people in the world with some 5.7 million people live with HIV in the country. With nearly half a million people receiving antiretroviral treatment, South Africa also has the largest antiretroviral treatment programme in the world.

The severity of the epidemic in southern Africa underscores the need for intensified and accelerated action towards universal access to HIV prevention, treatment, care and support, as nine countries in the region account for 35 per cent of all HIV infections in 2007. UNAIDS has identified HIV prevention as a particular priority and is highlighting the need for countries in the region to accelerate their focus on the need to reduce HIV incidence through combination prevention. By “knowing your epidemic and knowing your response” countries can better design and implement tailored prevention programmes that are evidence informed. Combination strategies include education and raising awareness in relation to delaying early sexual debut and increasing condom use.

South Africa will come to a standstill at noon for 15 minutes on World AIDS Day in a workplace stoppage initiative by the South African National Aids Council. The aim is to strengthen and sustain unity, partnership and leadership in response to HIV. South Africans will pause to pause to consider their personal role in the AIDS response: “Have I tested for HIV? If not, why not? Have I talked to my family and children about preventing HIV? If not, why not? Do I understand about HIV medicines and how they work? How can I stop discrimination?”

Former President Nelson Mandela, President Kgalema Motlanthe, his Deputy Baleka Mbete, Health Minister Barbara Hogan, COSATU President Zwelinzima Vavi, Archbishop Desmond Tutu and Dr Piot, are among those supporting the workplace stoppage HIV awareness campaign.

(from left) Associate Director of UNICEF’s Programme Partnerships, Pascal Villeneuve, Executive Director of the Global Fund, Michel Kazatchkine, Mrs Bruni-Sarkozy, UNAIDS Deputy Executive Director Michel Sidibé. Credit: élysée Palace

Mrs Carla Bruni-Sarkozy today took up her appointment as Ambassador for the Protection of Mothers and Children against HIV/AIDS of the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) at an event in Paris.

Mrs Carla Bruni-Sarkozy began her new mission on this the 20th anniversary of World AIDS Day, signing a letter of agreement with Executive Director of the Global Fund, Michel Kazatchkine. UNAIDS Deputy Executive Director Michel Sidibé and the Associate Director of UNICEF’s Programme Partnerships, Pascal Villeneuve were also present and signed a statement offering their full support for this new partnership.

Mr Sidibé spoke of the significance of Mrs Carla Bruni-Sarkozy’s appointment, “I know that Madam Ambassador will help raise the voices of mothers and their families around the world who are affected by AIDS.”

Mr Sidibé spoke of the significance of Mrs Carla Bruni-Sarkozy’s appointment, “I know that Madam Ambassador will help raise the voices of mothers and their families around the world who are affected by AIDS.” Credit: élysée Palace

“Madame Ambassador, thank you for your commitment. Your leadership will help build bridges across communities in France and abroad,” said Sidibé.

This evening Mr Sidibé will attend a World AIDS Day event at Musée de l'Homme hosted by the President of France Nicolas Sarkozy which includes a book launch and multimedia exhibition organized by Magnum Photos and the Global Fund. Tribute will be paid to Nobel Prize winner Françoise Barré-Sinoussi.

Earlier today the United Nations Secretary-General Ban Ki-moon announced the appointment of Mr Sidibé as the next Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).

Press conference held on World AIDS Day 2008, Doha, Qatar 

Government, international, civil society and private sector leaders have gathered in Qatar's capital, Doha, to take stock of the implementation of the 2002 Monterey Consensus on financing for development. The “Follow-up International Conference on financing for Development to Review the Implementation of the Monterrey Consensus” is taking place against a backdrop of global financial uncertainty. Officially inaugurated on Saturday, the conference runs until 2 December.

To mark the occasion of today’s 20th World AIDS Day, at the plenary meeting in Doha, UN Secretary-General Ban Ki-moon delivered a World AIDS Day statement in which he announced the appointment of Mr. Michel Sidibe as the new UNAIDS Executive Director.

The Secretary-General’s statement was followed by a press conference moderated by Mariangela Bavicchi-Lerner, UNAIDS Chief of Donor Relations.

The panel was composed of:

1. Ms. Luisa Morgantini, Vice President of the European Parliament
2. H.E. Trevor Manuel, Minister of Finance, Republic of South Africa and Special Envoy of the Secretary-General for Doha Review Conference
3. H.E. Majozi V. Sithole, MP and Minister of Finance, Kingdom of Swaziland
4. Dr. Laila Isharair, Health and Social Planning Advisor, Qatar General Secretariat for Development Planning, and member of the Qatar National AIDS Committee
5. Dr. Christoph Benn, Director of External Relations and Partnerships, The Global Fund to fight AIDS, TB and malaria
6. Dr. Renu Chahil-Graf UNAIDS Regional Director for the Middle East and North Africa

The Minister of Finance, Republic of South Africa and Special Envoy of the Secretary-General for Doha Review Conference Trevor Manuel emphasized the need on this day to remember the AIDS response.

“This is a financing conference for development and it is important to remind people of the challenges of HIV on 1 December,” he said.

Dr. Renu Chahil-Graf UNAIDS Regional Director for the Middle East and North Africa highlighted the status of the epidemic in the Region and noted the positive efforts made to-date which need to be replicated in other countries.

The Vice-Chair of the European Parliament emphasized the support and commitment of Europe and its institutions to the AIDS response and the Global Fund to fight AIDS, Tuberculosis and Malaria reminded the audience about the challenges ahead in view of reaching Universal Access.

Panelists also expressed their appreciation for the work of outgoing UNAIDS Executive Director Dr Piot and congratulated Mr Michel Sidibé on his appointment.