The Clinton Global Initiative (CGI) is a
non-partisan catalyst for action that brings
together a community of global leaders
from various backgrounds to devise and
implement innovative solutions to some
of the world’s most pressing challenges.

The annual meeting of the Clinton Global Initiative (CGI) concludes today in New York. The three-day event brought together a diverse group of world leaders from government, business, international agencies and civil society to examine global challenges and transform that awareness into action.

UNAIDS Executive Director Dr Peter Piot and former President of the Portuguese Republic, Jorge Sampaio participated in a working group breakfast on global health which addressed AIDS, tuberculosis, and malaria.

Increased effort and investment in the AIDS response in recent years have yielded examples of successful approaches that can be replicated or scaled up globally. The participants identified and explored opportunities to improve the way we respond to these diseases with existing tools and knowledge and highlighted current challenges.

Since its inception in 2005, CGI has convened a community that includes more than 80 current and former heads of state, hundreds of business, international and non-profit leaders, major philanthropists, and Nobel Peace Laureates. Their aim is to devise and implement innovative solutions to some of the world’s most pressing challenges.

The 2008 Annual Meeting focussed on challenges and opportunities in the following four focus areas: education, energy and climate change, global health and poverty alleviation.

The Global Campaign for the Health MDGs: First year report 2008.

A group of global leaders met in New York on 26 September 2007 to launch the Global Campaign for the Health Millennium Development Goals (MDGs). The Campaign aims to give renewed impetus to Goals 4, 5 and 6 which focus on the urgent need to improve maternal, newborn and child health and to combat HIV/AIDS, malaria and other diseases.

To mark the first year of the Campaign, a progress report was released on 25 September. It provides an update of major activities during the last year, and highlights concrete actions that are required to accelerate the necessary progress if we are to reach the health related MDGs by 2015.

Read the contribution by Dr Peter Piot, Executive Director, UNAIDS:

Scaling up towards Universal Access: AIDS, Malaria, Tuberculosis and Immunization

AIDS is inextricably linked to the other MDGs: education, gender equality and poverty eradication are all vital for fighting it. And in many countries reducing HIV infections and deaths from AIDS is essential for making progress on other MDGs.

By the end of 2007, the global number of new HIV infections and AIDS-related deaths had begun to decline – largely the result of action on political commitments. At the G8 summits in 2005 and 2008, and at the UN High-Level Meeting on HIV/AIDS in 2006, leaders agreed to scale up to universal access to HIV prevention, treatment, care and support by 2010.

There are now 105 countries with national targets for universal access, and 147 countries submitted progress reports this year. In 2007, investment in HIV programmes reached US$10 billion, up from US$8.3 billion in 2005. Extraordinary efforts resulted in three million people in low- and middle-income countries receiving anti-retroviral treatment in 2007 – a million more than in 2006.

Several heavily affected countries are making progress on HIV prevention. There are falls in the number of people having more than one partner in the last year, increases in condom use among promiscuous young people, and, in sub-Saharan Africa, signs that people are beginning to have sex at a later age.

Access has improved to antiretroviral drugs that prevent mother-to-child transmission (PMTCT) of HIV. In low- and middle-income countries, a third of women who need the drugs can get them – up from 14% in 2005. Some countries, including Argentina, Botswana, Georgia and the Russian Federation, have achieved close to universal access, with PMTCT services at more than 75% coverage. In Botswana, just 4% of children born to HIV-positive mothers are infected.

Other prevention efforts are also improving. Of 39 countries reporting on it, coverage of HIV-prevention services for sex workers is 60%. For people who inject drugs coverage is nearly 50% in 15 countries, and for men who have sex with other men it is 40% in 27 countries.

In many countries AIDS programmes are supporting fragile health systems, improving service delivery, staff, information systems, governance and the procurement and management of drugs. We recommend using a third of HIV/AIDS resources to strengthen health systems.

There is more to do. In low- and middle-income countries, two-thirds of people requiring antiretroviral drugs cannot get them. For every two people starting HIV treatment, five become infected. AIDS remains the biggest killer of African adults (25-49) and is among the top ten killers worldwide. Like climate change, AIDS will require a long-term response. We need to build on progress and strengthen links with other health programmes, notably tuberculosis, sexual and reproductive health, and maternal and child health.

This will require more money: over 50% more by 2010 to maintain the current pace of growth in prevention and treatment. The price is worth paying.

Peter Piot
Executive Director
UNAIDS

(from left) Dr. Peter Piot, Executive Director
of UNAIDS; Julian Lob-Levyt, Executive
Secretary of the Global Alliance for Vaccines
and Immunization (GAVI); Dr. Tedros
Adhanom, Minister of Health, Ethiopia;
Andrew Jack, Financial Times Pharmaceuticals
Correspondent; Michel Kazatchkine,
Executive Director of the Global Fund;
Ann Veneman, Executive Director of
UNICEF participate in MDG HLM side
event on MDG 6 equity challenge.
23 September, UNHQ, New York.
Credit: UNAIDS/Brad Hamilton

In 2000, global leaders embraced a series of Millennium Development Goals (MDGs) that resolved to make the world safer, healthier, and more equitable.

We are half-way to the 2015 target date and progress is mixed and uneven. To assess the gaps and understand what more needs to be done to ensure nations are on course to achieve the commitments they have made, a High-level Event on the MDGs takes place on 25 September 2008 hosted by the United Nations Secretary-General and the President of the General Assembly.

MDG 6 and universal access to HIV prevention, treatment, care and support by 2010

MDG 6 aims that by 2015 the world will have halted and begun to reverse the global HIV epidemic.

UN Member States have also committed, in a Political Declaration at the General Assembly in 2006, to taking extraordinary action to move towards universal access to HIV prevention, treatment, care and support by 2010. At this juncture it is useful to assess the HIV response.

Dr. Peter Piot, Executive Director of UNAIDS
speaks at MDG HLM side event on MDG
6 equity challenge. 23 September, UNHQ,
New York. (right) Julian Lob-Levyt, Executive
Secretary of the Global Alliance for Vaccines
and Immunization (GAVI)
Credit: UNAIDS/Brad Hamilton

Although Goal 6 specifically addresses the HIV epidemic, an effective HIV response will also support achievement of other Millennium Development Goals. Success in the achievement of the MDGs will also make an impact on HIV epidemics around the world. Addressing the obstacles to universal access to HIV prevention, treatment, care and support services will contribute to the achievement of the broader MDGs. These include addressing stigma and discrimination, human rights and gender inequality as well as ensuring sustainable financing, affordable commodities, strengthened health systems and human resources, and accountability.

MDG 1: Eradicate extreme poverty and hunger.

There is a complex relationship between AIDS, poverty and human development, a so-called ‘vicious circle’ within which the impacts of AIDS increase poverty and social deprivation, while socio-economic inequalities increase vulnerability to HIV infection.

With the eradication of extreme poverty and hunger, people may reconsider lifestyle options which put them at higher risk of HIV such as working far away from home or in commercial sex.

Especially in high-prevalence settings, HIV deepens household poverty and slows economic growth. Alleviating the epidemic’s burden helps countries to grow their economies, reduce income inequalities, and prevent acute hunger. In Western Kenya, antiretroviral treatment has led to a large and significant increase in the labour supply. Within six months of starting treatment there is a 20% increase in the likelihood of participating in the labour force, and a 35% increase in weekly hours worked. This brings economic and other benefits to the family including for children’s nutritional status.

MDG 2: Achieve universal primary education.

The HIV response promotes universal education initiatives. Ensuring children’s access to school is an important aspect of HIV prevention, as higher levels of education are associated with safer sexual behaviours and delayed sexual debut and reduce girls’ vulnerability to HIV.

School attendance is a central focus of initiatives to address the needs of children orphaned or made vulnerable by HIV. Better access to treatment helps to minimize the epidemic’s impact on fragile educational systems; it also reduces the likelihood that young people will be withdrawn from school in response to HIV in the household.

MDG 3: Promote gender equality and empower women.

The effects of gender inequality leave women and girls more at risk of exposure to HIV so progress in this Goal is of fundamental importance to the HIV response.

Less access to education and economic opportunity results in women being more dependent on men in their relationships, and some who have no means of support must resort to bartering or selling sex to support themselves and their children. Where women cannot own property and lack legal protections, their dependence within their families is even greater.

The HIV response itself is also helping to drive efforts to reduce inequalities between the sexes. Countries are now monitored on the degree to which gender equity is a component of national HIV responses. Thus, the epidemic has increased the urgency of initiatives to forge new gender norms, and extensive worldwide efforts are under way to develop new HIV prevention methods that women may initiate. HIV has prompted parents, communities, and governments alike to approach the sexual and reproductive health needs of women, girls, and sexual minorities with renewed commitment.

MDG 4: Reduce child mortality.

Deaths due to AIDS among children is declining since 2003 as there is a drop in new infections and more children being put on treatment. However in most-affected countries such as Botswana and Zimbabwe, more than one third of all deaths in children under 5 are due to AIDS.

A key component of a comprehensive HIV response is the scaling up of prevention strategies that can nearly eliminate the risk of mother-to-child HIV transmission.

MDG 5: Improve maternal health.

Women now account for about half of all people living with HIV, and for more than 60% of infections in Africa. Greater access to antiretroviral medicines is improving the health and well-being of women, and pre-natal programmes for preventing mother-to-child transmission help mothers remain in good health to care for their children.

Integration of HIV initiatives with programmes addressing sexual and reproductive health is helping to ensure that women have access to the information and services they need to make informed reproductive decisions.

MDG 6: Combat HIV/AIDS, malaria, and other diseases.

Progress in TB control will greatly benefit the AIDS response as TB, which is mostly curable and preventable, is one of the most important causes of illness and death among people living with HIV.

A strong HIV response yields health benefits that extend well beyond HIV itself. The push to expand access to HIV treatment in resource-limited settings is helping to strengthen fragile health infrastructures and is driving improvements in human capacity in low- and middle-income countries.

MDG 8: Develop a global partnership for development.

Perhaps more than any other issue in our time, HIV has highlighted global and economic inequities, and has galvanized action on international development. HIV has helped place people at the centre of development.

Progress on inclusive, country-owned development strategies will deliver greater success for improved aid effectiveness, strengthened health systems and the AIDS response.

The AIDS response has championed more inclusive partnerships as being key and has pioneered the principle of country ownership through the 'three ones'.

High-level Event on the MDGs: Side events

UNAIDS Secretariat, its cosponsors and partners will host the following side events in relation to MDG 6:

The MDG 6 equity challenge
Organized by the Mission of Ethiopia, UNAIDS, Global Fund to Fight AIDS, TB and Malaria, and the Global Alliance for Vaccines and Immunization (GAVI). The meeting will focus on achieving MDG 6 by increasing access to basic health services, especially the delivery of new health technologies to geographically and socially marginalized communities.

UN system coherence to achieve MDG 6
Organized by the Missions of Ireland and Tanzania, UNAIDS, and UN Development Operations Coordination Office. The meeting will highlight coordination mechanisms to promote and enhance system wide support of national priorities to achieve MDG 6.

A poster exhibition on “Millennium
Development Goals and AIDS” is running
from 22 to 26 September in the Basement
Colonnade of the United Nations in
New York.

Marking the High-level Event on the Millennium Development Goals (MDGs) which takes place on 25 September, a poster exhibition on “Millennium Development Goals and AIDS” is running from 22 to 26 September in the Basement Colonnade of the United Nations in New York.

The exhibition explores the synergies between the AIDS response and the MDGs. Success will be mutual: the achievement of the MDGs will boost the AIDS response and conversely the response to AIDS can significantly contribute to several of the development goals.

Safeguarding women's rights and increasing
their economic independence reduces
their vulnerability to HIV.

Improving maternal health and reducing child mortality require strong health systems and an integrated HIV prevention, treatment, care and support services. Safeguarding women's rights and increasing their economic independence reduce the vulnerability of women to HIV. In addition universal access to HIV prevention, treatment, care and support is an important milestone for the achievement of the Millennium Development Goals.

The exhibition is an initiative of the Inter-Agency Working Group on AIDS, which includes UNAIDS Secretariat and Cosponsors as well as UNIFEM, the UN Dept of Public Info (DPI) and the UN Dept of Peacekeeping Operations (DPKO).

The AIDS response: Relationship to development in Africa

As high-level participants and international experts gather to discuss Africa’s development needs and challenges at UN headquarters in New York on 22 September, we take a look at how HIV and the AIDS response is impacting development on the continent.

In countries in Africa most heavily affected by HIV, the epidemic has reduced life expectancy by more than 20 years, slowed economic growth and deepened household poverty. However effective, sustainable AIDS responses offer an opportunity to overturn the critical development challenges to overcoming poverty, improving education, extending life expectancy and reducing child mortality.

Development needs leveraged through AIDS leadership

When committed national leadership on AIDS is combined with long-term coordinated financing, dividends beyond the epidemic are being seen in Africa. Scaling up HIV services means addressing years of under-investment in health human resources in resulting in strengthened health systems which lead to improved maternal and child health. As individuals benefit from antiretroviral treatment, they live longer and their labour productivity rises, lifting households from poverty and improving food security for their families.

“How we fare in fighting AIDS will impact all our efforts to cut poverty and improve nutrition, reduce child mortality and improve maternal health, curb the spread of malaria and tuberculosis.” - United Nations Secretary-General Ban Ki-Moon speaking at the General Assembly High Level Meeting on HIV/AIDS, New York, June 2008

In addition, an AIDS response that addresses deep seated drivers or causes of vulnerability to HIV infection—stigma, discrimination, gender inequality and human rights—will impact wider development.

Successes and progress

Affected countries in Africa are showing strengthening leadership in addressing challenges by increasing the use of their own resources. The per capita domestic public HIV expenditure (from governments’ own sources) in sub-Saharan Africa was six times greater than other parts of the world after adjusting by income level (2008 Report on the global AIDS epidemic).

The substantial increases in AIDS funding and the investment in prevention and treatment of recent years are producing encouraging results in a number of countries in Africa.

In Rwanda and Zimbabwe changes in sexual behaviour—waiting longer before becoming sexually active, having fewer multiple partners, increased condom usage among people with multiple partners—have been followed by declines in the number of new HIV infections. Condom use is increasing among young people with multiple partners in Benin, Burkina Faso, Cameroon, Chad, Ghana, Kenya, Malawi, Namibia, Uganda, Tanzania and Zambia.

HIV epidemics in Malawi, South Africa and Zambia appear to have stabilized and most of the comparatively smaller HIV epidemics in West Africa are stable or are declining, as is the case for Burkina Faso, Cote d’Ivoire, Mali and Nigeria. HIV prevalence in HIV epidemics in East Africa have either stabilized or are receding.

Gains in access to antiretroviral treatment

More people have access to HIV treatment than ever before. Of the 3 million people who received HIV treatment in 2007, more than 2 million of them are in sub-Saharan Africa. In the period 2003 to 2007, Namibia scaled up treatment from 1% to 88%, Rwanda from 3% to 71%. As a result we’ve seen number of AIDS-related deaths decline over the past two years from 2.2 million to 2 million in 2007.

This is paying incalculable dividends for African countries. HIV treatment means that HIV-positive people are living longer, in better health and with a higher quality of life. They can continue to be productive within their workplace and community and there is less risk of their household falling into poverty and food insecurity.

Good progress has also been made in the prevention of mother-to-child transmission of HIV with increases in coverage of services in countries including Botswana, Namibia, Swaziland and South Africa.

This progress suggests a return on the investments made on different fronts, particularly in HIV prevention and treatment, and shows that with continued commitment, countries can overcome the development challenge that the epidemic poses.

Demographic impact of HIV

However, in spite of successes the epidemic continues to outstrip the response. The 2008 report on the global AIDS epidemic released by UNAIDS shows that AIDS continues to be the leading cause of death on the continent of Africa. In southern Africa, the average life expectancy at birth is estimated to have declined to levels last seen in the 1950s—below 50 years for the sub-region as a whole.

The numbers are stark: 67% of all people living with HIV and almost 90% of children living with HIV are in sub-Saharan Africa. In Botswana and Zimbabwe more than one third of all deaths in children under 5 are due to AIDS.

Progress, but gaps remain

As pointed out in the UN Secretary-General’s Report to the June 2008 High-level meeting on AIDS, countries need to sustain the progress that they have already made and continued leadership is required for the implementation of fully funded and sustainable national strategies and programmes on HIV.

HIV: A public health and a development issue

HIV is both a public health and a development issue which requires a sustained, inclusive and multi-sectoral response.

The Commission on HIV/AIDS in Africa (CHGA) issued a report earlier this year which included a call for leadership at all levels to be mobilized and coordinated for a concrete HIV response and broader development plan. The report also calls for addressing gender inequalities in national strategies as 60% of people living with HIV in sub-Saharan Africa are women.

High-level meeting on Africa’s development needs

At the high-level meeting on Africa’s development needs taking place in New York on 22 September, heads of State or Government, ministers as well as civil society organizations, intergovernmental organizations, UN agencies, funds and programmes, as well as the Bretton Woods institutions will gather to discuss “Africa’s development needs: State of implementation of various commitments, challenges and the way forward.” The meeting will conclude with the adoption of a Political Declaration. UNAIDS Secretariat, its cosponsors and partners will host a series of side events.

With an estimated 700,000 people living
with HIV China’s HIV prevalence remains low
– estimated at less than 0.1 per cent of the
total population – but the epidemic
continues to grow in all parts of the country.
Credit: Creative Commons Attribution 2.0
License - Hao Wei

With an estimated 700,000 people living with HIV China’s HIV prevalence remains low – estimated at less than 0.1 per cent of the total population – but the epidemic continues to grow in all parts of the country. Most of the new HIV infections are related to sexual transmission and injecting drug use.

The AIDS epidemic remains a formidable challenge and several factors in China are fuelling it, including shame, fear, stigma and discrimination associated with AIDS, low awareness of HIV, rural poverty, high mobility of workers, availability and affordability of commercial sex, and injecting drug use.

There is no doubt that China has dramatically improved its AIDS response in recent years and its government has demonstrated real political leadership and commitment to effectively tackle the epidemic. This commitment has been translated into new laws, policies, growing HIV prevention efforts and increased access to treatment. The challenge for Chinese society now is to move from the excellent policies developed centrally to reach out to people in the provinces and communities with the services they need.

HIV prevention

HIV prevention remains a top priority for
China’s AIDS response. More than 30 million
people are estimated to be practicing risky
sexual and drug use behaviour.

HIV prevention remains a top priority for China’s AIDS response. More than 30 million people are estimated to be practicing risky sexual and drug use behaviour. These include injecting drug users (IDUs), men who have sex with men, sex workers and their clients. For that reason, there has been an increase in programmes targeting those at higher risk, such as a methadone treatment for drug users, condom promotion among sex workers and clients as well as among men who have sex with men.

There have been improvements in HIV prevention programmes even though a full implementation of combination prevention is yet to be achieved. For example, methadone maintenance treatment, clean needles and syringe exchange for drug users has been introduced with the aim of establishing a total of 1500 methadone maintenance treatment clinics by the end of this year. These clinics represent an important milestone towards the implementation of a much needed comprehensive prevention approach for IDUs including needle exchange programmes and condom provision as well as treatment for sexually transmitted infections (STIs).

Treatment

HIV treatment, care and support has improved significantly over the last five years. Antiretroviral drugs are supplied to more than 34,600 individuals as part of the “Four Frees and One Care Policy”. This is a major improvement considering that in 2003 there were 5,000 people on treatment. The increased access to treatment has also contributed to the implementation of pilot studies for the introduction of second line antiretroviral (ARV) drugs at the national level, with particular attention to availability of these drugs and monitoring of adherence.

Stigma and discrimination

Stigma and discrimination continue to be
areas of concern both within the health care
setting and with the population at large.

Stigma and discrimination continue to be areas of concern both within the health care setting and with the population at large. A recent survey supported by UNAIDS and carried out in six major cities of China revealed that 41% would be unwilling to work in the same place with people living with HIV (PLHIV), 26% would not shake hands and 49% thought that they could get HIV through a mosquito bite.

In an attempt to address the situation, the banning of discrimination of people living with HIV has been outlined in the Law of Communicable Disease Prevention and Control and the 2006 Decree on AIDS.

Civil society

Civil society in China is still finding its feet. UNAIDS is investing significant resources in trying to bring together a diverse set of organizations and networks to get a stronger and more coherent contribution from civil society organizations as working with community groups can greatly increase the impact – and cost effectiveness – of AIDS strategies.

China has demonstrated a commendable leadership and commitment towards an effective AIDS response. The National five year plan to control AIDS (2006-2010) is currently being implemented and the coverage, quality and comprehensiveness of its implementation along with meaningful involvement of all stakeholders, will be the key to achieving the target of keeping HIV infected people below 1.5 million in 2010.

Three awardees of UNAIDS Award for Outstanding Contributions to the AIDS Response were presented by Dr Peter Piot (3rd from left). The three awardees are Prof. Li Xiguang (right), Executive Dean of Tsinghua University School of Journalism and Communication; Mr Serge Dumont (2nd left), UNAIDS Special Representative and Omnicon Group Inc. Senior Vice President and President Asia Pacific, and Yao Ming, Chinese Basketball icon (his manager on his behalf).

Progress in scaling up HIV prevention, treatment, care and support is underway in China thanks in part to the involvement of leaders from many different sectors of Chinese society in the AIDS response.

UNAIDS Executive Director Dr Peter Piot is acknowledging the contributions of nine such individuals during his official visit to China this week, 16-19 September, by presenting them with the UNAIDS’ “Award for Outstanding Contributions to the AIDS Response”.

Medals are awarded to Yao Ming, international Chinese basketball player, Serge Dumont, UNAIDS Special Representative and businessman, Li Xiguang, Executive Dean of Tsinghua University’s School of Journalism and Communication, Li Junru, Vice President of Central Party School, Doctor Xu Lianzhi from You’an Hospital, Doctors Ren Minghui, Hao Yang and Wu Zunyou with the Chinese Ministry of Health and Meng Lin, who is living with HIV and the head of the organization “Arc of Love”, which works for people living with HIV.

The awardees were chosen for their efforts to help stop the spread of HIV and to spur greater awareness of the epidemic in China, where an estimated 700,000 people are living with HIV in the country.

Dr Peter Piot, UNAIDS Executive Director, delivered an inauguration speech on Global and China’s AIDS epidemic and response at Global Health Forum in Tsinghua University, China.

Dr Piot is presenting the awards at several occasions throughout Beijing. The first ceremony was on 17 September at Tsinghua University, where he delivered the inaugural lecture for the university’s new Global Health Forum. Later the same day, Dr Piot presented the medal to Central Party School Vice President Li Junru following a lecture at the School on the role of leadership in China’s AIDS response.

Combating stigma in China, engaging more partners in the response

Yao Ming was recognized for his role in combating the stigma and discrimination faced by people living with HIV in China. A star player with the US National Basketball Association (NBA), Yao Ming has been a very important advocate for people living with HIV. In 2006, Yao featured in a PSA with HIV positive basketball icon Magic Johnson with key messages on stigma and discrimination. The PSA has been widely used in China and was used in the UNAIDS-International Olympic Committee (IOC) Olympic AIDS Campaign. Yao Ming also featured in the UNAIDS-IOC AIDS leaflet that accompanied all condoms distributed at the Beijing Olympics as part of that campaign.

“I am very honoured to receive this esteemed award for AIDS work,” said Yao Ming, who received his award by video. “Contributing to the fight against AIDS is something that I happily do as I believe that AIDS is one of the most important global problems. We can and we should all do something to stop the spread of AIDS and the discrimination of people living with HIV”.

Commenting on the athlete’s engagement, Dr Piot said, “I am really pleased that the AIDS response has the critical support of sports stars, the business community, media and academia alike. AIDS is so much more than a health issue and without the help of champions like the ones we honour today, we cannot be successful in stopping the spread of AIDS.”

HIV prevention remains a priority for China’s AIDS response. Reaching out with correct information on prevention is crucial and requires greater collaboration; from government and community organizations to private business and media.

Highlighting the role of the private sector, UNAIDS Special Representative Serge Dumont said, "There are many ways the business sector can contribute to a successful AIDS response. In particular, savvy approaches are required in a number of places around the world to help overcome the prevalent prejudices, which continue to affect people living with HIV".

A recent survey supported by UNAIDS found that 65% of the surveyed adult population were unwilling to live in the same household as a person living with HIV and nearly 50% thought mistakenly that HIV can be transmitted through a mosquito bite.

Commenting on his award, Professor Li Xiguang underscored media’s role in AIDS education. “Journalists can make an important difference on how people think about AIDS through good reporting,” he said. “False perceptions need to be overcome by communicating correct information in interesting and innovative ways.”

Throughout his engagements in China, Dr Piot commended the Chinese on their efforts and progress made in responding to AIDS, in particular around HIV prevention and antiretroviral treatment. But he emphasized AIDS is not yet over in any part of the world – including China – and called on leaders to scale up their efforts for a heightened response.

UN Special Envoy for AIDS
in Africa Elizabeth Mataka

The United Nations Special Envoys for HIV/AIDS are individuals specially selected by the UN Secretary-General to help advance the AIDS agenda in the regions they cover. In a series of interviews, we explore their motivation and commitment to ensuring that AIDS is kept high as a political priority within their respective regions of responsibility and operation.

Elizabeth Mataka is a social worker by training and has been working in the field of HIV for the past 18 years. She was appointed Special Envoy for AIDS in Africa in May 2007.

Elizabeth Mataka, you have worked for many years in the AIDS response. What motivates you to work on AIDS?

One of my biggest motivations is the unbelievable change that I have witnessed over the years in the health status of people living with HIV thanks to the wonders of ART (antiretroviral treatment). I am also inspired by the commitment, cooperation and support of the international community, civil society and implementing countries.

I believe in universal access to HIV prevention, care, treatment and support and therefore want to be part of this amazing growth from fatality to hope—hope that treatments will get better and be accessible to all, and hope that someday we wake up to a cure or vaccine.

This hope makes me want to be a part of the movement that shared the earlier frustration and fear and which looks forward to tomorrow’s promise. I saw one of my farm helpers rising from a desperate condition to a healthy and happy man thanks to HIV treatment which I facilitated. He is now a peer-educator to other farm workers, positive and happy.

What do you see as your role as a Special Envoy for HIV and AIDS in Africa?

I see my role as an advocate to promote key issues on AIDS and for the implementation of the UNGASS Declaration of Commitment on HIV and AIDS in Africa. I also represent the UN Secretary-General and/or UNAIDS Executive Director at key events or meetings related to HIV. Along with the UN Teams on AIDS and UN Resident Coordinators I seek to promote the most effective ways to support expanded national responses.

Additionally, I have decided to make the following issues the focus of my work during my tenure of office:

1) Empowerment of women and girls
2) Universal access to HIV prevention, care treatment and support
3) Meaningful engagement of civil society in AIDS responses
4) Advocating for more resources for resource-constrained countries.

What unique qualities do you bring to the role of Special envoy?

I am empathetic, I identify with those who have no voice. I am candid but sensitive and do not shy away from confronting what I believe must be confronted to make a difference to the AIDS epidemic. I have spoken loudly about the need to change those aspects of culture that drive the epidemic. I continually challenge all of us to look at our gender relations and the position of women and urge the need to change our mindset with regard to the socialisation of our children.

I am also respectful of other people’s views and work. So, while I may not necessarily agree with someone or some approach, I give space to others aware that I do not know everything.

How can you make a difference in this role?

As a woman coming from the world’s most AIDS-affected region Africa, I can speak with credibility about the epidemic, its impact on families, communities, individuals and on our overall development agenda.

I can identify with the suffering because I have, as everyone has in this region, lost relatives, friends and workmates to AIDS. Having interacted with people affected by AIDS in many ways, I can advocate based on real-life experience. In this regard I continuously speak of the need for government to introduce social safety-nets for poor people and advocate that good nutrition should be regarded as an integral part of treatment.

Coming from a civil society background, I know the strength, capacity, commitment and dedication of civil society. I also have first hand experience in civil society leadership and how it can pioneer the response to AIDS as it is acknowledged to have done in Zambia for instance. I can therefore be an effective advocate for meaningful civil society involvement.

What's your proudest achievement as Special Envoy for HIV and AIDS in Africa?

I am proud to have been able to develop communication skills and an approach that opens doors for me to address issues at the highest levels of government. I am also proud of the trust placed in me by various civil society groups especially womens’ groups. I have met with Presidents Mwanawasa of Zambia and Kagame of Rwanda and other high ranking Ministers in the region with invitations to travel to a number of other African countries.

My greatest moment was in Germany last year during the Global Fund to Fight AIDS, TB and Malaria Replenishment Meeting when I gave a speech that contributed to the new special focus now given to the financial empowerment of women and girls–a long overdue development that I am proud to have contributed towards.

Who or what inspires you?

I am inspired by the numerous community groups and volunteers who do so much work and achieve so much with little resources. I believe that these groups need to be recognised and motivated.

It is an inspiration how, somehow, the AIDS epidemic has helped open up discussions and raise awareness about human rights and other issues that were being swept under the carpet.

I am also inspired by my husband and children who are proud of me and create space for me to do what I am so committed to doing. The understanding and encouragement I get from my family inspires me to go on.

This story first appeared on UNDP.org

Fashion designer Bibi Russell (right)
Credit: Shaju John for UNDP

Internationally-renowned fashion designer Bibi Russell, along with UNDP and the Modern Dress Sewing Factory (MDSF), has launched an international designer label "Bibi for WE".

Under this brand, MDSF - an all-women business subsidiary of the network of people living with HIV in Cambodia - will produce and market a range of bags under the "Bibi for WE" international label. These will be designed by Bibi Russell, who was synonymous with leading international designer-labels and fashion-houses of the 1970s and 1980s.

"If you join hands with women living with HIV with affection and confidence, they can create magic with their fingers," said Bibi who is also an APLF (Asia Pacific Leadership Forum on HIV/AIDS and Development) Champion and founder of "Fashion for Development," a movement seeking to help women weavers around the world.

The designs will use local materials such as Cambodian silk and showcase local cultural motifs. Bibi has trained HIV-positive women in the selection of materials, design, finishing and quality control.

"We don’t want sympathy, but support to live a life of respect and dignity," said Pham Srim, Business Manager at MDSF. "Severe poverty and stigma make our lives impossible. We have recurrent health problems and have to fend for our treatment, food and shelter; but the most crushing is the discrimination by society" she said. "With HIV, one can lead a normal and productive life - that is the message of WE," she added. 

"WE is a symbol of resilience and resolve by women in the face of ill-health, poverty and discrimination," said Mr. Douglas Broderick, Resident Representative of UNDP in Cambodia. He said the label represents a new hope and empowerment for all the women living with HIV in Cambodia. He urged the private sector and general public to generously support the initiative.

"This project is very innovative and will go a long way to assist women living with HIV in Cambodia to improve their situation," said Jane Batte, UNAIDS Social Mobilization Officer.

UNAIDS and other UN agencies, through the United Nations Country Team (UNCT), will provide advocacy assistance and support in marketing the products on the international market.

Women and Wealth Project

In Asia and the Pacific, the impact of HIV on a household is disproportionately borne by women. In response to the social and economic issues affecting the lives of HIV-positive women, the UNDP Regional HIV and Development Programme for Asia and the Pacific initiated the Women and Wealth Project (WWP) in late 2006, in partnership with a Thai NGO, Population and Community Development Association and UNDP country offices.

Ms. Caitlin Wiesen, Practice Team Leader and Regional Programme Coordinator, Regional HIV and Development Programme, said "Bibi for WE" is a milestone in the evolution of the WWP. "Women and Wealth and the WE brand arose out of the acute necessity of positive women to cope socially and economically with the impact of the epidemic on their lives." Innovation and sustainability are the essential features of the Women and Wealth project, she said.

WWP pursues the empowerment of women living with and affected by HIV through the development of small-scale social enterprises in Cambodia and India. Women participating in the project have expressed increased confidence, dignity, and hope and reduced stigma and discrimination against them. The Modern Dress Sewing Factory (MDSF) started its operations in Cambodia in January 2007. The garment factory employs 17 women living with HIV, including three women who form the management team.

United Nations Development Programme (UNDP) is a Cosponsor of UNAIDS.

Delivering on the Global
Partnership for Achieving the
Millennium Development
Goals - MDG Gap Task
Force Report 2008

Important gaps remain in delivering on the global commitments in the areas of aid, trade, debt relief, and access to new technologies and to affordable essential drugs and treatment for HIV, malaria and tuberculosis. A new report by the United Nations Millennium Development Goals Gap Task Force identifies these gaps in detail and provides recommendations to all major stakeholders on how to address these gaps. In the countdown to 2015, urgent responses are needed to bridge the existing implementation gaps to make good on the promises made to achieve the Millennium Development Goals.

Inadequate access to essential medicines for HIV, malaria and tuberculosis

The findings of the report show that in some developing countries strong partnership between government, pharmaceutical companies and civil society, including consumers can lead to improved access to affordable essential medicines for HIV, malaria and tuberculosis.

However, access to essential medicines in developing countries is far from adequate. Information available in a number of countries suggests the existence of large gaps in the availability of medicines in both the public and private sectors as well as a wide variation in prices which render essential medicines unaffordable to poor people.

Millennium Development Goals Gap Task Force

The report was launched by the UN Secretary General Ban Ki-moon on 4 September. The Task Force was created by the Secretary-General following discussion of the Policy Committee on 1 May 2007 to improve monitoring of the global commitments contained in the Millennium Development Goals.

The main purpose of the Millennium Development Goals Gap Task Force is to systematically track existing international commitments and their fulfillment at the international and country level in the areas of official development assistance, market access, debt relief, access to essential medicines and technology.

The Task Force integrates more than 20 UN agencies, including participation from UNAIDS, the World Bank and the IMF, as well as the OECD and WTO. The United Nations Development Programme and the Department of Economic and Social Affairs of the United Nations Secretariat (UN/DESA) are lead agencies in coordinating the work of the Task Force.