Professor Kallings a Swedish national, was appointed Special Envoy for AIDS in Eastern Europe and Central Asia by the UN Secretary-General in May 2003.

Professor Kallings a Swedish national, was appointed Special Envoy for AIDS in Eastern Europe and Central Asia by the UN Secretary-General in May 2003. He was the founding President of the International AIDS Society in 1988. As its Secretary-General from 1994 to 2002, he played a key role in shaping the IAS as the world’s first global society for scientists and health care workers committed to the prevention and treatment of HIV. He has also been an adviser to the World Health Organization, Chairman of the Global Commission on AIDS and Senior Adviser to the Global Programme on AIDS on Scientific and Policy Affairs.

In the second of a series of interviews with the UN Special Envoys for HIV/AIDS, Professor Kallings shares his views on his role and the challenges facing the AIDS response in Eastern Europe and Central Asia.

Professor, what motivates or inspires you to work on AIDS?

As a boy during the 1930s I was struck by the ravages of tuberculosis on the Swedish countryside, in particular, witnessing a bonfire made of all the belongings of a whole family annihilated by tuberculosis made a deep impression on the mind of me as eight years of age. On a clay field in the ice-cold March wind, still with snow in the furrows, I watched everything burning, the grandfather's clock, furniture, clothes, even a beautiful shotgun on the top. The local health authority did not know better than to order everything burnt to eradicate the bacilli - that big was the fear of the disease.

As a doctor I specialized in clinical microbiology and infectious diseases, especially interested in opportunistic infections among immune-compromised patients, such as children with leukemia.

When I became Director of the Swedish Institute for Infectious Disease Control public health was in focus for my responsibilities. In addition, I was all the time engaged in international projects, not the least with World Health Organization.

The second strong motivation, and also my inspiration, is meeting with people affected by HIV in poor countries, be it in African villages and hospitals or in brothels in Mumbai, India or Chiang Mai, Thailand, or among injecting drug users in Belarus or Ukraine. The courage, warmth and concern of the people I have met for fellow human beings in spite of their own misfortune have touched and inspired me deeply.

How do you see your role as Special Envoy of the UN Secretary-General for HIV and AIDS?

My role as a UN Special Envoy as I see it, is to reach the highest political leadership of countries to address the central and sensitive issues directly circumventing bureaucracy and conventional avenues. I am not paying courtesy visits, but heading for results. There are no special rules for a Special Envoy—that is what makes them special!

For instance, my meetings with President Viktor Yushchenko of Ukraine have resulted in directives of key importance to the National AIDS Programme, including allowing the importation of methadone for substitution treatment for injecting drug users.

What unique qualities do you bring?

My white hair serves me well. Knowledge, experience, and always having justified and verifiable views. My words can have the impact of a volley hitting a ship at the waterline.

How can you make a difference?

I can make a difference by being well prepared, basing recommendations on impartial facts, while being empathic and intensely engaged.

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

As Special Envoy, the proudest achievement has not happened yet! Before that, my proudest achievement was to bring the International AIDS Conference to Durban, South Africa in 2000. That was a landmark event and opened the eyes of the world to the enormous catastrophe of HIV. The "Durban effect" cannot be overestimated. Without that global awareness I do not think that the 2001 UN General Assembly Special Session on HIV/AIDS would have happened, nor the creation of the Global Fund to Fight AIDS, TB and Malaria.

What are the main challenges facing the Special Envoy in Eastern Europe and Central Asia?

The main challenge in Eastern Europe is to overcome the traditional, deeply-rooted contemptuous view of drug users, sex workers and homosexuals.

Also much of my efforts focus on getting civil society recognized by Governments in Eastern Europe. During the Soviet Union, non-governmental organizations (NGOs) did not exist as by definition the State was supposed to take care of everything the people needed and civil society activities were considered as subversive actions.

Still today, in some countries, NGOs are looked upon with suspicion as potential Trojan horses supported by Western countries. Therefore, I am attempting to bring people living with HIV and NGO representatives to sit alongside me at the table of the Presidents, which has made a difference and been welcomed for instance in Ukraine.

Another Special Envoy activity is to bring focus to neglected areas such as prisons which are breeding grounds for intravenous drug use, HIV, hepatitis C and tuberculosis (TB). For instance, I visited a prison with prisoners living with HIV and multi drug resistant TB outside Tbilisi, Georgia together with the First Lady who has a key role in the national HIV programme. Despite some progress in the region, I still see no harm reduction and substitution treatment allowed in prisons in Ukraine, while those programmes are widely available outside prison settings.

What in your view are the particular challenges facing this region?

Improving living conditions, including expanded employment possibilities for young people as well as improving the self esteem of both girls and boys and including education on sex and personal relations in schools are all important social challenges, as well as improving gender equity.

The widely different socio-economic conditions between nations and within parts of countries make the HIV epidemics in Eastern Europe and Central Asia very heterogeneous.

Another problem is that the region faces a future health care crisis unless many more people currently living with HIV get antiretroviral treatment to prevent them developing AIDS and becoming ill.

What do you think are possible solutions?

The only possible solution is to scale-up access to HIV prevention and treatment services. That has not happened yet, but the region has that capability should the political will be there. Good attempts on a small scale are fine but only a full response will help. In these efforts, the leadership of the governments is a key. I also look forward to developing activism around HIV prevention as activism in HIV treatment alone won’t get us too far with combating the HIV epidemic.

Which successes in the AIDS response make you optimistic about the future?

There seem to be some inborn difficulties to coordinate efficient responses in some countries and several countries continue to overly rely on foreign aid instead of increasing spending from their own national budgets. However, the greatly increased awareness about the AIDS epidemic among the political leaders compared to only a few years ago makes me optimistic.

UNAIDS Goodwill Ambassador and international football star
Michael Ballack
Credit: UNAIDS/Oliver Beckmann

UNAIDS Goodwill Ambassador and international football star Michael Ballack and UNAIDS are proud to team up for an online competition.

To win one of many great prizes courtesy of “Michael Ballack Clothing” and UNAIDS —including caps, t-shirts, and sweatshirts just answer the following questions:
Questions

1. UNAIDS is a Joint United Nations Programme composed of a Secretariat and Cosponsoring organizations. Name any two of UNAIDS Cosponsors.

2. In his video message, what is UNAIDS Goodwill Ambassador Michael Ballack’s personal video message about HIV prevention? Watch the video on YouTube !

Send your answers along with your full name and address by email to: competition@unaids.org  

Closing date is 20 November 2008 and competition winners will be announced on World AIDS Day, 1 December 2008.

Michael Ballack has been a UNAIDS Goodwill Ambassador since 2006. Through a series of campaigns he raises awareness about HIV prevention among young people and will continue to support UNAIDS in the run-up to the FIFA World Cup in South Africa in 2010.

UNAIDS Deputy Executive Director Michel Sidibe addressed the vital role of civil society at “Rendez-vous de la coopération québécoise et canadienne dans la Francophonie” hosted by the Canadian International Development Agency (CIDA).

Ahead of the XIIe Sommet de la Francophonie, the role of civil society in development and international cooperation is being discussed at an important pre-conference event taking place in Quebec City 15-17 October.

“Sustainable partnerships” is the central theme of the “Rendez-vous de la coopération québécoise et canadienne dans la Francophonie” hosted by the Canadian International Development Agency (CIDA), a meeting to explore Quebec and Canada’s role in international cooperation in French-speaking countries.

On 15 October UNAIDS Deputy Executive Director Michel Sidibe took part in a keynote event. Mr Sidibe reflected on the crucial role that civil society plays in an effective AIDS response in Francophone Africa and elsewhere, citing examples of successes in specific countries.

“In this global mobilization for AIDS, civil society has undoubtedly been the determining catalytic agent that has often initiated, consolidated and always brought forward new ideas and concern around human rights, addressing the virus and inspiring international organizations and traditional bilateral cooperation,” said Mr Sidibe. “Civil society has always been present in all major decisions in the AIDS response,” he continued.

Describing the vital importance that civil society plays in AIDS response at this turning point in the epidemic, he outlined its ability to speak with many voices, represent many different perspectives, mobilize political leadership, ensure a rights-based approach to HIV responses and bring life-saving prevention messages directly to communities.

The importance of securing input from the full spectrum of civil society, including people living with HIV, cannot be overstated. The wide range of strategic and tactical expertise within civil society organizations makes them ideal partners in the process of preparing National Progress Reports and specifically, civil society organizations are well positioned to provide quantitative and qualitative information to contribute to the data collected by governments.

UNAIDS has a range of specific tools to help civil society make an impact including the Technical Support Facilities to assist and solve problems in strategic planning, communications, resource mobilization and tracking and monitoring and evaluation. This reinforces national capacity and supports countries have a country-owned, country-led and demand-driven AIDS response.

Other speakers at the event were Mrs Djakagbè Kaba, President of the Guinean Network of Economic and Social Solidarity, RéGESS (Guinea); Mrs Danièle Magloire, Coordinator of the Bureau of Rights and Democracy (Haïti) and Mr Bakary Doumbia, Director-General of KILABO (Mali).

XIIe Sommet de la Francophonie

The governments of Canada and Québec, in partnership with the Government of New Brunswick, are hosting this year’s Francophonie Summit which takes place in Québec City from 17 to 19 October and will include delegations from some 69 states and governments. Mr Sidibe will attend the opening of the Summit.

The Summit is a gathering of the heads of state and government of member countries in the Organisation internationale de la Francophonie (OIF), an institution founded on the basis of a shared language (French) and shared values. It has 55 member states and governments and 13 observer states, representing a total population of 803.4 million and close to one-third of all United Nations member states. It supports member states in policy development and spearheads political action for multilateral cooperation.

HIV epidemics

While sub-Saharan Africa’s epidemics vary significantly from country to country in both scale and scope, the region is home to 67% of people living with HIV worldwide and almost 90% of all children living with HIV. On a positive note, most of the comparatively small HIV epidemics in West Africa are stable or are declining—as is the case for Burkina Faso, Côte d’Ivoire, and Mali. In Côte d’Ivoire, HIV prevalence among pregnant women in urban areas fell from 10% in 2001 to 6.9% in 2005.

However in 2007, adult national HIV prevalence was above 5% in seven countries in Central and East Africa including Francophone Cameroon, the Central African Republic and Gabon. More than one third (35%) of female sex workers surveyed in 2006 in Mali were living with HIV, and infection levels exceeding 20% have been documented among sex workers in Senegal and Burkina Faso.

Living with TB in Kolkata, India. Credit: LHIL/Kaushik Sengupta/Drik

Tuberculosis (TB) is the leading cause of illness and death among people living with HIV in many parts of the world, yet TB is mostly curable and preventable.

In 2006 less than 1% of people living with HIV were screened for TB yet an estimated one-third of people living with HIV worldwide are co-infected with TB and at a high risk of developing TB disease.

In spite of the two diseases being so inextricably linked, for many years, efforts to tackle HIV and TB were largely separate. Recognising the importance of a coordination of efforts, the Union World Conference on Lung Health which runs from 16 to 20 October 2008 will hold a series of symposia on TB and HIV.

The 39th Union World Conference on Lung Health of the International Union against Tuberculosis and Lung Disease (The Union) takes place at the Palais des Congrès in Paris, France,. The theme of this year’s conference is “Global threats to lung health: the importance of health system responses”. In addition to some 14 symposia, a Special Session on TB/HIV programme collaboration will be held. The outcomes of this session will be followed up in 2009 Union World Conference on Lung Health.

“The lethal interaction between the HIV and TB epidemics is both a threat to global lung health and to the lives of people living with HIV,” said Alasdair Reid, UNAIDS HIV/TB Adviser.

“Increasing collaboration between TB and HIV programmes as highlighted at this conference strengthens our joint response and helps to overcome health system constraints to delivering universal access and saving lives,” Reid added.

The aim is to facilitate dialogue and exchange experiences between TB and HIV experts as it is universally recognised that improved collaboration between TB and HIV programmes will lead to more effective prevention and treatment of TB among people living with HIV and to significant public health gains.

Kaisernetwork.org is the official web caster of the 39th Union World Conference on Lung Health, providing access to daily conference developments.

Dr Murilo Moreira, President CEN AIDS Brazil addresses the First regional Workshop of Business Coalitions from Latin America and the Caribbean Credit: UNAIDS

São Paulo - Business Coalitions on AIDS have emerged as an effective platform for the private sector response to the epidemic. AIDS has already claimed the lives of 25 million in the global workforce and remains a serious threat to business. Although some companies are already effectively addressing AIDS in the workplace, others simply do not know how or where to start mitigating risks. Business Coalitions have emerged to fill this gap and provide the private sector with the tools and processes it needs to effectively address AIDS in the workplace and in their surrounding communities.  

Emergence of Business Coalitions on AIDS

Business Coalitions also act as a voice for the private sector, often through representation on national AIDS committees and by interacting with other key stakeholders. Coalitions have formed partnerships with international donors, civil society groups, governments, other regional and national Business Coalitions. These relationships are critical in delivering a coordinated response to the epidemic.

UNAIDS has supported the development of a number of national business coalitions on HIV in regions heavily impacted by the epidemic. UNAIDS is currently working with over 30 national business coalitions, helping to support the private sector response to AIDS.

First regional Workshop of Business Coalitions from Latin America and the Caribbean

Brazilian Business Council on HIV-AIDS Prevention (CEN)

On October 6 and 7 2008, UNAIDS and the Brazilian Business Council on HIV-AIDS Prevention (CEN) convened a regional workshop of business coalitions and initiatives from Latin America and the Caribbean in Sao Paulo to recognize the critical role that the private sector play in the response to HIV, exchange experiences and discuss challenges and opportunities.

The workshop was attended by coalitions from Barbados, Belize, Brazil, Guatemala, Guyana, Jamaica, Mexico, and Suriname as well as the Trade Union Confederation of the Americas, the Barbados Workers Union, the Brazilian national AIDS Program, several companies members of the CEN, a state company from Paraguay, the national council of private companies from Panama and Venezuela, Futures Group, Impulso - a network of Mexican NGOs working on AIDS, the Pan-Caribbean Partnership Against HIV/AIDS (PANCAP), and the ILO.

Participants discussed best practices, issues of funding, brainstormed on how to improve the coordination with labour unions and on how to optimize the integration of the private sector and workplace into national AIDS plans as well as the development of national HIV anti-discrimination workplace regulations.

“Too often we see companies developing lovely policies but falling down on the implementation side. You need to work on behaviour change education to leave something significant and sustainable behind,” noted Madhuri Supersad, HIV/AIDS technical adviser for ILO in the Caribbean region.

The workshop provided a forum for stakeholders working with business coalitions such as the ILO to reiterate the importance of the tripartite mechanism involving workers, employers and governments as well as to present the current process undertaken by the ILO leading towards a global standard on HIV/AIDS in the workplace in 2010.

Civil society was represented by a Mexican NGO and participants felt that much more needed to happen in many countries to build partnerships between the private sector and civil society to mutually benefit one another.

Participants at First regional Workshop of Business Coalitions from Latin America and the Caribbean Credit: UNAIDS

It was decided to revitalize some Latin American coalitions especially in the Mercosur region, or improve the visibility and impact of the existing ones - having in mind that there can not be a “one size fits all” approach in the region. These efforts could lead to the establishment of a Pan Latin America business coalition in the near future. The upcoming regional AIDS conference in Peru next April 2009 could be a great platform to launch such an initiative.

Participants committed to continue the dialogue started during this workshop by exchanging materials and activities and seeking advice from each other on specific topics.

The workshop was followed by the 10th anniversary celebrations of the CEN an anniversary which is a landmark for the private sector response not only in Brazil but for whole Latin America.

For further information, please contact UNAIDS focal points:

Marie Engel
Partnerships Adviser Private Sector Partnerships UNAIDS
Tel: +41 22 791 554
Email : engelm@unaids.org

In the Caribbean region: Dawn Foderingham, Tel. +1 868 623 7056 x 278,
email foderinghamd@unaids.org

In the Latin American region: Rosemeire Munhoz, Tel. +507 302 4509,
email munhozr@unaids.org

In Brazil: Naiara Garcia da Costa Chaves, Tel. +55 61 3038 9222,
email costan@unaids.org  

United Nations Secretary-General together with senior officials from the United Nations system met with seventeen of the world’s research-based and generic pharmaceutical and diagnostic companies

On 9 October 2008, the United Nations Secretary-General together with senior officials from the United Nations system met with seventeen of the world’s research-based and generic pharmaceutical and diagnostic companies to review progress on strengthening efforts to expand access to HIV services in low- and middle-income countries.

This meeting was a follow-up to the last high-level dialogue between the UN and pharmaceutical and diagnostic companies in July 2006.

UNAIDS Executive Director Dr Peter Piot also participated in the event. During his wider remarks, he highlighted the achievements of the United Nations and the international community in their efforts to scale up access to HIV prevention, treatment, care and support.

The meeting took place immediately after the high level gathering on the Millennium Development Goals where Member States agreed to increase funding for research and development of essential drugs to treat AIDS and other diseases.

Although there has been an increase in the number of people receiving antiretroviral treatment in low-and-middle incomes (3 million people were on treatment by the end of 2007, up from 1.3 million in 2006), only one-third of those who need antiretroviral treatment in low-and middle-income countries are receiving it.

In recent years, there have been a number of achievements in relation to HIV treatment such as the development of fixed-dose combinations for first-line treatment, including pediatric formulations, price reductions for first-line and pediatric antiretrovirals as well as further investment and development of technologies for prevention and diagnosis of HIV and monitoring the efficacy of antiretroviral therapy in both adults and children.

The Secretary-General highlighted the need for greater collaboration between the private sector and the UN to expand existing efforts in the spirit of Goal 8 of the MDGs on building a global partnership for development. He noted that progress on all fronts is essential in order to reverse the AIDS epidemic.

Participants agreed to continue to hold periodic high-level meetings, under the leadership of UNAIDS, to take stock of progress and to identify new collaborative measures.

200 delegates from 42 countries met in Dublin, Ireland on the 6th and 7th October 2008 for the 4th Global Partners Forum on Children affected by HIV and AIDS.
Credit: UNAIDS

In order to review progress, set global priorities, and make commitments for children affected by HIV, 200 delegates from 42 countries including leaders in government, civil society and UN agencies met in Dublin, Ireland on the 6th and 7th October 2008 for the 4th Global Partners Forum on Children affected by HIV and AIDS.

The Global Partners Forum was established in 2003 to build momentum in fulfilling global commitments for children affected by HIV as was stated in the United Nations General Assembly 2001 Declaration of Commitment on HIV/AIDS and the Millennium Development Goals.

The current definition of children affected by HIV (UNICEF and UNAIDS) are those under 18 years of age who are living with HIV or have lost one or both parents due to AIDS or whose survival, well-being or development is threatened or altered by HIV. However, in hyperendemic countries where HIV prevalence exceeds 15% most children are directly or indirectly affected by AIDS.

According to the latest UNAIDS report on the global AIDS epidemic, the number of children living with HIV has increased from 1.6 million in 2001 to 2 million in 2007, 90% of which live in sub-Saharan Africa where nearly 12 million children under 18 have lost one or both parents to AIDS.

The 4th Global Partners Forum, co-hosted by the Government of Ireland, UNICEF and UNAIDS, aimed to renew the commitment of international partners to accelerate support for the protection and care of children affected by HIV, report progress and highlight good practices identified since the 3rd Global Partners Forum in 2006, as well as to produce a participant-endorsed communiqué defining priorities for the next two years.

The meeting was opened by the Minister of State for Overseas Development, Peter Power, T.D. and a keynote address was given by An Taoiseach Brian Cowen, the Prime Minister. Other keynote speakers included the First Lady of Honduras Xiomara Castro de Xelaya, and HIV activist and singer/songwriter Annie Lennox. The meeting differed from many others by the presence and active contribution of children from western and eastern Europe, Asia, Africa, and Latin America, including some infected and affected by HIV.

Despite efforts to care and protect vulnerable children, exclusion, stigma, and discrimination of children affected by HIV continue to be common challenges in most countries.
Credits: UNAIDS

Children’s vulnerability to the epidemic was captured in the evidence-based synthesis paper presented at the forum by UNICEF to promote awareness and to inform the discussions. Priority issues were further elaborated during panel discussions addressing topics such as family-centered care, strengthening national responses for the most vulnerable children, and quality programming at the community level. Although it was acknowledged that there has been progress in global efforts for children affected by HIV, it was also recognized the severe remaining constraints which make it impossible for some children to realize their human rights.

Evidence from the synthesis paper and discussions at the forum, including contributions from the children, highlighted that despite efforts to care and protect vulnerable children, exclusion, stigma, and discrimination of children affected by HIV continue to be common challenges in most countries. Stigma has been cited as a reason for children not being enrolled in school, receiving care, or being adequately served by programmatic responses.

Attending school is essential to the development of skills and acquisition of knowledge to enable young people to reach economic and social fulfillment. Schools also have the protective effect of educating children about HIV and how to avoid infection. However, HIV poses several constraints that prevent children from going to school or forces them to an early drop out. For instances, many children become responsible for the care of their siblings and other family members when parents are debilitated by poor health. The need to provide food or generate income prevents these children from attending school while at the same time increasing their vulnerability to HIV. This vulnerability represents part of a vicious cycle: their circumstances put them at high risk for exploitation and abuse, and therefore exposure to HIV.

Schools also have the protective effect of educating children about HIV and how to avoid infection. Credit: UNAIDS

Evidence presented at the 4th Global Partners Forum showed that families are bearing the bulk of the costs for infected children. Therefore, families under stress through chronic poverty, labor constrains and facing the impact of illness and death, need external assistance. In response to these challenges, a number of countries are beginning to scale up cash transfers, as part of a social protection package, to alleviate poverty and to increase access to essential services. Such social protection has been shown to be feasible even in resource-constrained countries with high HIV burdens.

Even though the main mode of HIV transmission, and the extent of HIV-related vulnerability among children may differ from region to region, the response challenges were seen to be the same, such as fear of HIV testing by parents, lack of access to treatment for children, and lack of social and psychological support.

The messages of the meeting and the action points were summarized by a communiqué which was presented, debated and adopted during the plenary. It recognized that more information and data were now available and the reality on the ground is better understood to inform action. Based on the evidence presented, the communiqué highlighted four priority action points: the well-being of children and parents infected by HIV; strengthening families and communities as units of prevention, treatment, care and support; increasing effectiveness of programs, services and resources; and human rights for vulnerable children.

Participants committed themselves to implementing the action points of the communiqué, to monitor their progress, and to hold themselves accountable to children affected by HIV. UNAIDS committed to work with governments, the UN family and civil society to put children and families at the heart of the response to HIV through efforts at global, regional and country level.

Fifth International Conference on HIV/AIDS Prevention in Armed Forces was held in September 2008, St. Petersburg, Russia

Studies show that rates of sexually transmitted infections among armed forces are generally higher than in civilian populations. Among male population groups, military and police report the highest risk behaviour, such as engaging in sex without using a condom, and highest number of partners.

The good news is that prevention programmes to reduce transmission of sexually transmitted diseases including HIV can be implemented within structured institutions like the military. Existing facilities can be used for testing and counselling, prevention, care and support services. Provision of education and condoms can slow the spread of HIV and as young recruits have strong influence among their peers, within and outside the service, they can transmit clear messages to the surrounding community, thus, changing perceptions and behaviours that can positively impact the larger population.

The UN Security Council made history in January 2000 when for the first time it debated a health issue—AIDS. By subsequently adopting Resolution 1308 (2000), it highlighted the possible growing impact of AIDS on social instability and emergency situations and potential damaging impact of HIV on the health of international peacekeeping personnel. The UN Declaration of Commitment on HIV/AIDS adopted by Member States in the General Assembly Special Session (June 2001) also includes national uniformed services as a key area to be addressed in the global action against the spread of the HIV epidemic.

In addition to the growing engagement of Member States, leading regional bodies are increasingly acknowledging the need to integrate AIDS education into the operations of uniformed services.

Fifth International Conference on HIV/AIDS Prevention in Armed Forces

It is against this context that the “Fifth International Conference on HIV/AIDS Prevention in Armed Forces” was held in September 2008 in St. Petersburg, Russia. The event brought together a broad coalition of participants including politicians, military health service providers, scientists from the Russian healthcare system, epidemiologists and communicable disease specialists engaged in HIV prevention as well as diagnostic and treatment issues. Representatives from governmental bodies, NGOs, and international organisations also took part.

Dr Sergei Furgal, Director, a.i., RST/Eastern Europe and Central Asia, noted the significance of the gathering which distinguished it from previous military conferences in the region: “National delegations represented the armed forces of all nine CIS countries and participants discussed a wide range of programmatic issues.”

“Within the framework of the CIS Regional Network on Military and AIDS it was decided to shape a coordination mechanism for information and experiences exchange with a clear indication of UNAIDS’ role in this process,” he continued.

More than 500 participants gathered to discuss issues related to lowering the prevalence of HIV infection amongst servicemen and servicewomen in the region. Participants attended from the Commonwealth of Independent States (CIS) countries (Armenia, Belarus, Kazakhstan, Kyrgyzstan, Moldova, Russian Federation, Tajikistan, Turkmenistan and Ukraine).

There were several specific and significant outcomes from the meeting. Participants agreed on the need to improve coordination between military medical service departments in order to lower HIV prevalence amongst military personnel. They also plan to expand cooperation with international, governmental and non-governmental organizations to work together to promote HIV prevention in the armed forces. They will consider establishing a coordination method to exchange information and experiences amongst organizations working to curb HIV prevalence in the armed forces of conference participant countries. UNAIDS and the Centre for Social Development and Information have offered to provide support to establish this coordination method.

Other initiatives under consideration include expanding programmes of educational activities for different ranks of servicemen and servicewomen, creating a web site to share HIV information among participant countries’ armed forces, and inviting representatives from other country’s uniformed services agencies to take part in conferences.

The Sixth International Conference on HIV/AIDS Prevention in Armed Forces will take place in 2009 in the Russian Military Medical Academy, St. Petersburg, Russia.

“Portraits of Commitment” is a stunning and
thought-provoking book of photographic
portraits which was launched in 2007 by
the Asia Pacific leadership Forum on
HIV/AIDS and Development (APLF).
Credits: UNAIDS

“Portraits of Commitment” is a stunning and thought-provoking book of photographic portraits which was launched in 2007 by the Asia Pacific leadership Forum on HIV/AIDS and Development (APLF). The book features people from all walks of life in South Asia who, for a range of different reasons, are working to raise awareness among their communities about HIV.

For some, their commitment to the AIDS response stems from personal motivation such as Dr Michael Abeyaratne whose wife became infected with HIV through a blood transfusion, Laxmi Narayan Tripathi whose best friend died in her arms, or Yusif Hamid, a scientist developing affordable medication. Others were already in the public eye and decided to use their popularity or political clout to campaign for acceptance and treatment.

Rising above discrimination

The portraits, taken by the celebrated Bangladeshi photographer Shahidul Alam are accompanied by poignant interviews. Most recount experience of stigma in communities where even local politicians often don’t know how HIV is transmitted. Several of those featured have emerged as leaders. Those who would never in their past have seen themselves in such a role, now recognize that they are in a unique position to share and respond to the needs of their communities.

It is striking, among the all-too-common stories of women facing discrimination, to hear one of those profiled Jahnabi Goswami say that her family and neighbours surrounded her with love and support and encouraged her to use her positive status to inform other wives about HIV.

Social responsibility

India Cricket Captain Rahul Dravid has
recorded TV and radio messages that raise
AIDS awareness in remote villages across
India. Credits: UNAIDS/ Shahidul Alam

Religious and spiritual leaders are also celebrated, united by common concern about illness, ignorance, discrimination and the future of their countries.

“If an individual is sick, we can leave it to his or her family to take care of it. But when there’s an epidemic, the government and society must act,” says one of the most celebrated modern mystics, Sadhguru Jaggi Vasudev.

Shalina Bharat is the dean of the School of Health Studies in Mumbai, India. She has pioneered social research in the field of impact of HIV on society. “I know what it means when rights are discriminated or violated; I have seen how it affects people.”

Power of love

The power of love between individuals is another theme running through this book as with the husband and wife Rubina and Asim. Rubina is an HIV-negative wife married to an HIV-positive husband. “I wanted to prove to the world that marrying an HIV positive person is normal,” she says. View photo gallery “South Asia: Portraits of Commitment.”

In order to further improve the coordination
of technical support provided to countries,
UNAIDS and its partners have developed a
new tool in the form of a shared database.
Photo credit: UNAIDS/P.Virot

Many countries require quality and timely technical support to plan, budget, implement and monitor their AIDS programmes effectively and efficiently. While the demand for technical support has increased, the number of providers has also grown dramatically resulting at times in competition, duplication and increased transaction costs for countries using these services.

In order to further improve the coordination of technical support provided to countries, UNAIDS and its partners have developed a new tool in the form of a shared database. This database includes up-to-date information on technical support. So technical support providers and users will be able to know what kind of expertise has been provided to a specific country, by whom and with what results, thus optimizing resources and achieving greater coordination in providing technical support to national AIDS efforts.

The CoATS – Coordinating AIDS Technical Support database – a practical tool for countries to monitor technical support aims to:

1. Facilitate access by country partners to timely and quality assured technical support.
2. Encourage coordination of technical support between providers and users with increased accountability for results.
3. Facilitate collaboration and exchange of information on technical support activities at global, regional and country level

CoATS has been established as a web-portal with data on technical support provided by a range of partners including UNAIDS and its Cosponsors UNDP, UNFPA, UNICEF, World Bank and WHO as well as, USAID/PEPFAR, the Global Fund, GTZ, CSAT, ICTC and the International AIDS Alliance. CoATS is currently being piloted at the country level and UNAIDS will support ten countries in using the CoATS system to monitor their technical support plans. Following a consolidation phase, CoATS will be rolled out more widely.

The data stored in the database can be
searched by country, provider, activity
type, recipient, funder, status and start
and end dates.

The data stored in the database can be searched by country, provider, activity type, recipient, funder, status and start and end dates. The resulting information can then be generated as reports based on searches and exported as PDF documents or as Excel spreadsheets. CoATS will also have a database of different tools and reports from technical support missions that will enable better sharing of information and reduce duplication of efforts.

CoATS has at its heart the Principles of Technical Support developed by the Global Implementation Support Team (GIST) whose mandate is to coordinate technical support to address implementation bottlenecks, disseminate lessons learnt and identify good practices.

“This is an important area of work for UNAIDS. CoATS facilitates greater accountability and country ownership of technical support by providing a clear picture of activities. The database will indicate who is asking for the support, who is paying for it, who is supplying it and who is the consultant carrying it out and when”, said Tim Martineau, UNAIDS Director for Technical and Operational Support Department. “UNAIDS is pleased to be an active member of the GIST and to improving the coordination of technical support”, he added.