On 1 December 2006, UNAIDS joined with a broad range of UN and Thai partners to organize a World AIDS Day event with a difference.

As well as hosting a packed celebration event, Thailand captured international attention with an attempt to create the world’s longest chain of condoms.

And at the end of March, confirmation arrived—at 2,715 metres long, the condom chain sets a new Guinness World Record™.

The tying of the world’s longest chain of condoms was one of the events of the “Condom Chain of Life Festival”, a unique celebration of World AIDS Day, held at Lumpini Park in Bangkok. The festival was organized by the United Nations Educational, Scientific and Cultural Organization (UNESCO) Bangkok in collaboration with the Thai Red Cross, PLAN Thailand, UNAIDS and local NGOs as part of efforts to promote the acceptance of condoms, emphasize the need for safe sex, and encourage strengthening of national policies for comprehensive treatment, care and support for people living with and affected by HIV.

UNAIDS Special Representative Senator Mechai Viravaidya, well known for his groundbreaking HIV prevention efforts in Thailand, led the tying of the chain.

Here, UNAIDS Country Coordinator for Thailand, Patrick Brenny, tells (click on link below to listen to the interview) www.unaids.org about how the World Record attempt came about and its importance to the Thai AIDS response.

Mr. Jorge Sampaio, UN Special Envoy to
Stop TB helping to give out TB treatment
at the Martin Preuss Centre in Malawi.
Photo credit:S.Muguro

Tuberculosis was declared a national public health emergency in Malawi this week. More than 77% of TB patients in Malawi are also HIV positive and TB is the leading cause of death among people living with HIV.

The UN Special Envoy to Stop TB, Mr. Jorge Sampaio and WHO Regional Director for Africa, Dr. Luís Gomes Sambo, attended a ceremony hosted by the Honourable Mrs. Marjorie Ngaunje, Minister of Health, to launch the new five-year plan to

L to R: Dr. Gomes Sambo, WHO
Regional Director for Africa;Hon.
Marjorie Ngaunje, M.P.,Malawi
Minister of Health; Mr.Sampaio,
UN Special Envoy to Stop TB;
Dr. Moeti, WHO Representive,
Malawi

tackle the tuberculosis emergency. The plan seeks to increase access to TB diagnostic and treatment services, improve collaboration between the TB and HIV services and strengthen community involvement.

In Ghana UNAIDS, UNICEF and WHO joined civil society representatives, traditional leaders and politicians to launch a National Stop TB Partnership on World TB Day.

Civil society partners march through the streets to
raise awareness of TB and HIV on World TB Day in
Ghana. Photo credit: T.Erkkola

Collaboration between the TB and HIV programmes has already been fruitful in Ghana but needs to be increased to reduce the high death toll from HIV/TB co-infection.

UNAIDS HIV/TB Adviser, Dr Alasdair Reid, said: “Increasingly we are realising that we cannot address AIDS without addressing TB and vice versa. The best way to do this is through HIV and TB programme collaboration”

Supporting the active engagement of people living with HIV in the AIDS response is one of UNAIDS’ most important goals. Building on its work in this area, UNAIDS has developed a policy brief with recommendations for governments, civil society and international donors on how to increase and improve the involvement of people living with HIV in global, regional and country AIDS responses.

Nkensani Mavasa from South Africa addressing the United Nations
General Assembly on HIV and AIDS in New York. Credit: UNAIDS/J.Rae

GIPA or the ‘Greater Involvement of People Living with HIV/AIDS’ is a principle that aims to realize the rights and responsibilities of people living with HIV, including their right to participation in decision-making processes that affect their lives. GIPA aims to enhance the quality and effectiveness of the AIDS response and is critical to progress and sustainability.

The idea that personal experiences should shape the AIDS response was first voiced by people living with HIV in Denver in 1983. The GIPA Principle was formalized at the 1994 Paris AIDS Summit when 42 countries agreed to “support a greater involvement of people living with HIV/AIDS at all levels and to stimulate the creation of supportive political, legal and social environments”.

GIPA seeks to ensure that people living with HIV are equal partners and breaks down simplistic and false assumptions that those living without HIV are “service providers” and as those living with HIV are “service receivers”.

The new UNAIDS policy brief gives an overview of the context for the policy brief, underlines why this principle is key to the long-term sustainability and development of the AIDS response, highlights some of the challenges to achieving GIPA and outlines a number of actions governments and other bodies need to implement to ensure the principle is put into practice.

“No single agency can provide for the full spectrum of needs of people living with HIV: partnerships between actors are therefore needed,” says Kate Thomson, UNAIDS GIPA focal point. “To enable the active engagement of people living with HIV, UNAIDS urges all actors to ensure that people living with HIV have the space and the practical support for their greater and more meaningful Involvement.”

Governments, international agencies and civil society are urged to implement and monitor minimum targets for the participation of people living with HIV, including women, young people and marginalized populations, in decision-making bodies.

The policy brief also underlines that selection processes should be inclusive, transparent and democratic and that people living with HIV should be involved in developing funding priorities and in the choice, design, implementation, monitoring and evaluation of HIV programmes from their inception. “The engagement of people living with HIV is all the more urgent as countries scale up their national AIDS responses to achieve the goal of universal access to prevention, treatment, care and support services,” states the brief.

Wide ranging benefits

Measuring involvement of people living with HIV in policy is not an easy or exact science; yet, experiences have shown that when communities are proactively involved in ensuring their own well-being, success is more likely. People living with HIV have directly experienced the factors that make individuals and communities vulnerable to HIV infection. As a result, their involvement in programme development and implementation and policy-making will improve the relevance, acceptability and effectiveness of programmes.

An HIV positive woman addressing students at the University of Beijing,
People's Republic of China, during a session organized by a local NGO
to raise AIDS awareness. Credit: UNAIDS/K.Hesse

“Positive people bring the unique perspective of their experience to the range of organizations and agencies working in AIDS, “ says Dr Keven Moody, International Coordinator for the Global Network of People Living with HIV and AIDS, GNP+.

As the policy brief underlines, the benefits of GIPA are wide ranging. At the individual level, involvement can improve self-esteem and boost morale, decrease isolation and depression, and improve health through access to better information about care and prevention. Within organizations, the participation of people living with HIV can change perceptions, as well as provide valuable experiences and knowledge. At the community and social levels, public involvement of people living with HIV can break down fear and prejudice by showing the faces of people living with HIV and demonstrating that they are productive members of, and contributors to, society.

“The participation and contribution of people living with HIV is one of the best examples of global progress in public health. We have come from a place where people openly living with HIV were stoned to death, to a place where we have been invited to stand among the leaders of the world to shape international policies,” said Gracia Violeta Ross, the National Chiar of the Bolivian Network of People Living with HIV/AIDS. “There is still a long way to walk but we have made historical changes and gains of which we can be proud,” she said.

From principle to action: Leading by example

The policy brief draws on examples of policy makers, county and community actions that are transforming GIPA from principle to action. In Tanzania, nearly 80% of Tanzanian parliamentarians are dues-paying members of the Tanzanian Parliamentarians’ AIDS Coalition (TAPAC). Putting the principle into practice, TAPAC engages people living with HIV as advisers and organizes regular roundtable meetings with them to discuss issues. TAPAC members meet people living with HIV in their constituencies and publicly speak up in favour of GIPA. “You cannot plan for [people living with HIV]; you have to plan with them! Political leaders have to stand up for the rights of people living with HIV by enacting laws, budgeting for programmes and also by speaking up in ways that will normalize HIV,” said the Honourable Lediana Mafuru Mng’ong’o, Member of Parliament, Tanzania, Chair of the Coalition of the African Parliamentarians against HIV/AIDS and the Tanzanian Parliamentarians’ AIDS Coalition, who’s ‘voice’ is featured in the UNAIDS policy brief.

“If we want to win the battle against HIV, the full participation of people living with HIV in the AIDS response is necessary. At the same time, people living with HIV need to stand united, they need to strengthen their organizations and they need to speak with one voice in order to influence policy makers and to realize GIPA,” he added.

Russian civil society networks, including people living with HIV, during a
workshop on community-based advocacy and networking to scale up HIV
prevention. Credit: UNAIDS/S. Drakborg

Similarly i n Kazakhstan-also featured in the policy brief— there is a growing movement to engage people living with HIV in the response. Today, the country’s national and local level strategic planning and monitoring and evaluation processes actively engage people living with HIV.

But a s Dr Yerasilova Isidora, Director General, the Republican AIDS Centre (National AIDS Programme) outlines in the policy brief, the involvement of people living with HIV is not always straightforward, or welcomed. In Kazakstan the majority of people living with HIV are injecting drug users and sex workers and involving them in the response is often met with mistrust and opposition. Nevertheless, policy makers have taken a stand and pushed forward the agenda.

“We have managed to identify several partners [among groups and networks of people living with HIV] and have supported them by developing their personal and institutional capacities to become proactive and to make their voices heard,” she explains in the brief. Slowly but surely, Kazakstan is seeing results: In Temirtau, the city facing the largest HIV epidemic in Central Asia, more people living with HIV are openly talking about their status, which is improving public understanding and reducing stigma.

“Positive people have a great deal to contribute towards the challenges posed by AIDS, if they are given the opportunity to spell out their needs on an equal platform with government and non-government organizations.”

At the 6 th annual session of Burkina Faso’s National AIDS Commission, President Blaise Compaoré underlined his personal commitment to fighting AIDS as he chaired the one-day session and called for a scaling-up of the AIDS response towards universal access to HIV prevention, treatment, care and support in the country.

The annual session brought together actors involved in the country’s AIDS response to discuss ways forward in coordination of the response, to outline achievements in 2006 and to agree on action to strengthen AIDS action in Burkina Faso.

The President of Burkina Faso, who also serves as President of the National AIDS Commission, welcomed participants and highlighted Burkina Faso’s commitment to tackling AIDS issues and the necessity to make the country’s response an inclusive one, involving partners from all sectors of society. He outlined the significant results that had been achieved, particularly in Burkina Faso’s HIV prevention strategy, and thanked both public and private sectors for their hard work in the area of prevention.

UNAIDS Director of Country and Regional Support, Michel Sidibe, attended the session and heralded the President’s concrete commitment to AIDS. “The participation of President Compaoré is an example of truly exceptional leadership on AIDS—chairing for 10 hours of the meeting, engaging and motivating all sectors of the response and driving action forward,” he said.

“Burkina Faso is on the right road. The challenge now is to coordinate these efforts to make the response as effective as possible and to make the goal of universal access to HIV prevention, treatment care and support a reality. We at UNAIDS will do all we can to support Burkina Faso in doing this,” he added.

The session was well represented with around 200 people from different sectors of the AIDS response in Burkina Faso including ministers, parliamentary representatives, religious groups, youth groups, women’s organisations, associations of people living with HIV, technical and financial partners, private sector representatives and regional governors. In addition, representatives from National AIDS Commissions from the neighbouring countries of Benin, Mali, Niger, Senegal and Togo were present at the session as well as the UNAIDS Regional Support Team for West and Central Africa.

During the meeting participants reported on and analysed data from 2006 and made specific recommendations in the areas of planning, coordination and technical support; transfer of resources and monitoring and evaluation of the epidemic for 2007 and beyond.

In a communiqué finale issued at the close of the meeting, the National AIDS Commission underlined the recommendations for the country to reinforce coordination and partnerships within the response and to give greater focus and develop specific strategies on the issue of gender and AIDS, fighting stigma and discrimination and improving paediatric treatment and care.

“Burkina Faso has made great progress in the response to AIDS over recent years and the results are encouraging, we have seen a levelling off––and in some urban sites a decline––in HIV prevalence,” said UNAIDS Country Coordinator for Burkina Faso, Mamadou Sakho Lamine. “However, Burkina Faso still has a serious generalised epidemic, increasingly women are becoming infected and there is evidence that new infections are also on the rise among young people. There is still much to be done,” he added.

At the close of the session, President Compaoré called on participants to ‘double their efforts in the fight against AIDS’ and congratulated them on constructive suggestions and recommendations which will help strengthen the AIDS response in Burkina Faso.

UNAIDS Executive Director Dr Peter Piot with the Director General of the World Health Organisation Dr Margaret Chan at the launch of the Global Tuberculosis Control Report in Geneva.

WHO Director General Dr Margaret Chan welcomed the new findings in the report and emphasised that TB needed to be tackled as part of the larger challenge of increasing access to primary health care services.

UNAIDS Executive Director Dr Peter Piot stressed the importance of scaling-up collaboration between the TB and HIV communities if the goal of universal access to quality TB and HIV prevention, diagnostic, treatment and care services is to be achieved.

Director of the WHO Stop TB Department Dr Mario Raviglione warned of the serious threat XDR-TB posed to the global response to AIDS and highlighted the need for greater funding to support research into new diagnostics, treatments and vaccines.

Dr Kevin de Cock, Director of WHO's HIV/AIDS programme welcomed the report's findings and underlined Dr Piot's message of strenghtening cohesion between groups working on TB and groups working on HIV.. 

All photo credit: D.Bregnard

TB ANYWHERE IS TB EVERYWHERE is the theme of this year’s World TB Day. UNAIDS, WHO and the Stop TB Partnership have come together this World TB Day to highlight their commitment to working together in scaling-up TB and HIV programmes and call for increased action on the two diseases.

Statements on World TB Day

HIV/TB features in World TB Day events

Events linked to World TB Day in Ghana and Malawi highlight the importance of greater collaboration between the HIV and TB communities in order to reduce the burden of these leading causes of death.

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Global tuberculosis control
report

Launch of the 2007 Global Tuberculosis Control Report

At the launch of the WHO Global Tuberculosis Control Report, UNAIDS Executive Director highlighted the need for TB and HIV communities to scale up collaboration if the goal of universal access is to be achieved. The report, released by WHO, indicates that the worldwide TB epidemic has levelled off for the first time since it was declared a public health emergency in 1993. But despite these signs that the epidemic may be slowing, there are still major impediments to rapid progress against TB - prominent among them being the lack of investment, uneven access to diagnosis and treatment within countries, the emergence of XDR-TB, the inextricable links between HIV and TB and the ageing population.

Global Tuberculosis Control Report
Photo Gallery - Press launch of report 

Photo credit:StopTB/T.Falise

TB ANYWHERE IS TB EVERYWHERE

Tuberculosis is both preventable and curable, so why today is TB still a global emergency? On World TB Day this year experts around the world will be debating this issue and looking into the reasons behind the chronic lack of investment in TB programmes and research.Also on the agenda this year will be the discovery of a strain of TB that is resistant to almost all drugs (extensively drug resistant TB – XDR TB); the deadly synergy between HIV and TB; and the ageing global population––all of which are jeopardizing the ability of TB control programmes around the world to cope.

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Photo credit: WHO

Joining forces to tackle TB and HIV 

TB is one of the biggest killers of people living with HIV and at least one third of the 39.5 million people estimated to be living with HIV around the world are likely to be infected with the TB bacteria. As a result of chronically poor investment in global TB control a new strain of TB is emerging that has become resistant to most of the available anti-tuberculosis drugs. Known as extensively drug resistant TB (XDR TB) this strain has serious implications for people living with HIV as it is almost untreatable in many of the countries where it is occurring leading to very high death rates. WHO and UNAIDS, together with other actors working on TB and HIV issues are stepping up action to stop the spread of TB and this deadly new strain. 

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Jorge Sampaio, UN Secretary General's
Special Envoy to Stop TB

UNAIDS interviews UN Special Envoy to Stop TB

UNAIDS asks the UN Secretary General’s Special Envoy to Stop TB and former President of Portugal, Dr Jorge Sampaio about his involvement in the fight against TB, its links with HIV and what he sees are the top priorities for HIV/TB collaboration in the future.  

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It’s an unfortunate reality that all too often, the people most at risk and most in need of HIV prevention, treatment and care programmes are those least likely to have access to these services. According to latest estimates, only one in ten people ‘most at risk’ has access to prevention services. In many cases, for injecting drug users, sex workers and men who have sex with men, AIDS poses a double burden—on the one hand, there are a very limited number of programmes specifically designed to reach them, and on the other hand, they are often faced with discrimination, stigma and in some cases even criminal prosecution by the societies they live in.

But evidence and experience shows that focusing AIDS programmes and services specifically on people who are most at risk leads to encouraging progress within the response and can help reduce stigma and discrimination.

This month’s review of the UNAIDS Best Practice collection looks at the issue of men who have sex with men (MSM) in the Asia and the Pacific region and the focused programmes implemented in six countries that are showing progress.

In Asia, men who have sex with men are disproportionately affected by HIV. It is estimated that HIV prevalence is as high as 14% in Phnom Penh, Cambodia; 16% in Andrha Pradesh, India; and 28% in Bangkok, Thailand.

Men who have unprotected sex with men may also have unprotected sex with women and thus serve as an epidemiological bridge for the virus to the broader population. For example, a survey of over 800 men in China who have sex with men found that 59% reported having had unprotected vaginal sex with women in the previous year.

“It is a commonly held misperception that male-male sex happens only among men who self identify as ‘gay’. Most men who have sex with men living outside the West are not identifiable as such, they live and work in their communities unremarked and are often heads of families with children,” the Best Practice outlines

“HIV transmission prevention programmes addressing men who have sex with men are therefore vitally important. However, this population is often seriously neglected because of official denial by governments, the relative invisibility of men who have sex with men, stigmatization of male-to-male sex, ignorance or lack of adequate information,” it says.

The MSM programmes, implemented in Bangladesh, India, Indonesia, the Philippines, China and New Zealand, were chosen to be part of the UNAIDS Best Practice collection due to their success in providing comprehensive interventions that engage all actors involved in the AIDS response.

Although different in their make-up, the programmes have common elements and activities that have proved to be effective in reaching and supporting men who have sex with men on AIDS issues in Asia.

Advocacy activities with governments, health services and mainstream communities are common to all programmes. In Bangladesh, successful advocacy from the Banhu Social Welfare Society, including networking and participation in governmental meetings, has ensured the inclusion of issues relating to men who have sex with men in the five-year National AIDS Strategic Plan. In Indonesia, the Aksi Stop AIDS and Family Health International programme have worked hard to engage the authorities in the AIDS response. The Indonesian Ministry of Health is now recognising the seriousness of the situation and communities of men who have sex with men have been invited to participate in consultations on AIDS-related issues.

The Best Practice publication highlights a number of interesting outreach activities that some of the programmes are implementing. For example, in Hong Kong, the ‘AIDS concern’ organization set up a programme focusing on customers of saunas. Materials promoting safer sex such as leaflets, comic books and information brochures were produced and distributed across 13 saunas and outreach workers met with owners and staff to foster relationships and assess the situation. Increasingly, condoms, and lubricant were also distributed. “Good relations between the outreach workers and the sauna owners continue and there have been increased opportunities for contact with clients as a result of testing services. As a result clients are less apprehensive,” the publication states.

The programmes highlighted in the publication underline that activities implemented by people living with HIV have been proven to be more effective and help to further break down AIDS-related stigma and discrimination.

Know your epidemic

As the Best Practice outlines, in many countries, prevention efforts are hindered by laws that criminalize male-male sex, making work with men who have sex with men difficult and hindering their contribution to the response to the epidemic. Where social, cultural and religious attitudes make the issue politically sensitive, politicians are generally reluctant to support policies and programmes that might result in public criticism from community leaders and groups .

HIV prevention programmes for men who have sex with men like those featured in the Best Practice are vitally important to stop HIV transmission. However, lack of research about men who have sex with men including their behaviours and attitudes, and criminalization and stigmatization of and legal discrimination against these men, are also significant barriers to implementing effective programmes. Research was an integral part to the success of the AIDS Concern sauna outreach activities in Hong Kong – as part of the activity a research project was undertaken to determine the prevalence of high risk behaviours among sauna clients, levels of access to free condoms and lubricant, and the nature of information materials that would be best suited to sauna clients.

Through the examples of the six MSM programmes, the publication underlines that HIV programming for men who have sex with men needs to be carefully tailored to local cultures and conditions. Rather than relying on approaches based on patterns of male-male sexual behaviour observed in Western Europe and North America, local sexual minorities should be identified and engaged in developing programmes. In New Zealand, the New Zealand AIDS Foundation promotes the use of a community’s cultural resources to make AIDS information materials relevant and attractive. Designs, images, colours, language and models are used which are instantly recognizable as belonging to either the Maori or Pacific Islander communities.

As the Best Practice underlines, UNAIDS supports a range of responses aimed at reducing the vulnerability of men who have sex with men to HIV and its impacts including the promotion of high-quality condoms and water-based lubricants, ensuring their continuing availability; safer-sex campaigns and skills training; peer education among men who have sex with men and female partners; and strengthening organizations of self-identified gay men, enabling them to promote and rapidly increase HIV prevention and care programmes for men who have sex with men.

“Twenty five years into this epidemic, the reality is that only one in ten men who have sex with men have access to HIV prevention services. This is a massive failure, and setting it right has to be among the highest priorities for the increasingly strong global AIDS response as we aim to achieve universal access to HIV prevention, treatment, care and support for all groups, including men who have sex with men and transgender people,” said Purnima Mane, UNAIDS Director of Policy, Evidence and Partnerships.

Jorge Sampaio, UN Secretary General's
Special Envoy to Stop TB

Ahead of World TB Day, UNAIDS asks the UN Secretary General’s Special Envoy to Stop TB and former President of Portugal, Dr Jorge Sampaio about his involvement in the fight against TB, its links with HIV and what he sees are the top priorities for HIV/TB collaboration in the future.

1. During the last decade, you have made important contributions to many of the challenges currently facing the international community. What made you passionate about becoming more involved in TB?

For me, health for all is a matter of human rights. Three out of the eight Millennium Development Goals are health-related and include fighting against the three global pandemics, AIDS, tuberculosis and malaria. I’ve been aware of TB all my life because my father was a doctor––but I realized that TB was a major new public health emergency when the MDGs started being discussed around the turn of this century.

2. How do you think your role in politics is helping you to fulfil your new role as Special Envoy to Stop TB?

I am a lawyer by profession and obviously that helps with advocacy, I have also had a long political career (now I am retired!), so I am used to political negotiations and have had a lot of experience in diplomatic and international affairs. In my personal view, political experience is critical because my role as a Special Envoy is not to settle technical questions, but rather to increase political and social support for the TB control policies recommended by WHO and the Stop TB Partnership. My main focus is to persuade world leaders, policy makers, main international, regional and national stakeholders, the media, the private sector, patients, communities and others to secure greater political support for fully funding and implementing the Global Plan to Stop TB.

3. What role do you think the HIV community and UNAIDS can play in implementing the Global Plan to Stop TB?

Jorge Sampaio Met with UNAIDS
Executive Director, Dr Peter Piot
in Geneva earlier this year to
move the agenda forward on TB
control including the HIV/TB co-
epidemic and XDR-TB

One of the main points I always emphasize is the need to stimulate a co ordinated approach to HIV and TB. Together HIV and TB generate a noxious synergy that accelerates each other’s progression and has led to an explosion of TB cases in regions with high HIV prevalence. In order to control TB in high HIV prevalence settings far more effective collaboration between TB and HIV programmes and communities must be implemented.

I do think that the Global Plan to Stop TB and TB programs based on the WHO Stop TB strategy, as well as UNAIDS’ plans for universal access to HIV prevention, treatment, care and support represent an appropriate framework to scale up TB/HIV collaborative efforts. But some gaps remain––particularly in the areas of political and resource commitment to collaborative TB/HIV activities and new tools for prevention, early diagnosis and rapid treatment of TB in people living with HIV.

4. How can we encourage the TB and HIV communities to work more closely together?

Education for health is dramatically needed to counteract stigma and social discrimination surrounding HIV and TB. Communities have to know the basic facts; TB causes at least 11% of total deaths in people living with HIV (this can rise to as much as 60% in some African settings); 750,000 people living with HIV develop TB each year; most TB can be successfully treated even in people living with HIV; untreated, TB will cause death within weeks for people living with HIV; t reatment of TB can prolong and improve the quality of life for HIV-positive people.

5. How do you think we can keep the world interested in TB and HIV, despite competing issues such as global warming, avian flu, terrorism? 

Health is a key dimension of human safety and development, and is a matter of human rights. To realize these very basic rights worldwide, we need to double efforts and avoid working at cross-purposes which delays us unnecessarily.

6. If we are to have a real chance of getting ahead of these epidemics what, in your opinion, are the areas that the world should be focusing on?

UN Secretary-General Ban Ki-moon with
Jorge Sampaio at UN Headquarters in
New York

In my own personal view, four overarching but long overdue issues deserve immediate attention and call for strong extra action by the international community.

First, keeping the fight against TB high on the global agenda, particularly in light of the emerging of multidrug-resistant and extensively drug-resistant TB, which poses a new major public health threat and requires urgent action.

Secondly, improving coordination in the fight against AIDS and TB.

Third, Africa . Africa must be top priority and put at the highest spot on the international agenda––it is not acceptable that it should remain a continent at risk. Sub-Saharan Africa faces the greatest health challenges, with 11% of the world’s population and 24% of the global burden of TB disease, yet only 3% of the world’s health workers.

Fourth, s trengthening health systems––promoting a global plan to strengthen health systems is a key issue in achieving most of the health related MDGs.

Photo credit:StopTB/T.Falise

Tuberculosis (TB) remains a global emergency despite the fact that it is a preventable and curable disease. Chronic lack of investment in TB programmes and research into new ways to diagnose, treat and prevent TB have left us extremely vulnerable to the new, emerging threats to TB control. The discovery of TB that is resistant to almost all drugs (extensively drug resistant TB – XDR TB); the deadly synergy between HIV and TB; and the ageing global population jeopardize the ability of TB control programmes around the world to cope.

World TB Day on 24 th March aims to focus the world’s attention on these and other major challenges that face global TB control. Achieving the TB-focused targets of the United Nations' Millennium Development Goals by 2015 will depend on increased global commitment to TB control, and greater investment in research and the health services that deliver TB services.

Photo credit:StopTB/P.Virot

TB is one of the biggest killers of people living with HIV. At least one third of the 40 million people estimated to be living with HIV around the world are likely to be infected with the TB bacteria and at greatly increased risk of developing TB disease. Up to 80% of TB patients are co-infected with HIV in sub-Saharan Africa. Improved collaboration between TB and HIV programmes will lead to more effective control of TB among people living with HIV and can ensure that HIV positive TB patients get the HIV treatment and care they need.

"The TB and HIV communities can do much more together to address these leading causes of illness and death than they can apart. Much greater collaboration is essential if we are going to reach our common goals of achieving universal access to TB and HIV prevention, diagnostic and treatment services," said Dr Alasdair Reid, HIV/TB Adviser, UNAIDS.

The Global Plan to Stop TB lays out a budgeted plan for what the world needs to do to achieve the TB-focused Millennium Development Goals, including collaborative TB/HIV activities. If fully funded and implemented it will lead to 50 million cases of TB being treated and 14 million lives saved by 2015. However, in its first year the Global Plan is already under-funded.

Photo credit:StopTB/J.Davenport

The plan emphasizes the need for governments of high TB burden countries and donors to increase investment in TB control; greater involvement of affected communities in the response to TB; the need to protect communities from the threat of drug-resistant TB and HIV-related TB; and the need for funding for research into new and effective TB drugs, diagnostics and vaccines.

Ahead of World TB Day, the World Health Organization will release ‘Global TB Control Report’ which outlines the progress on achieving the 2005 global TB control targets. The report will be available on March 22nd at www.who.int/tb.

"Leadership" has been chosen by the World AIDS Campaign as the theme for World AIDS Day 2007 and 2008. This theme will continue to be promoted with the slogan "Stop AIDS. Keep the Promise."—the World AIDS Campaign (WAC) emphasis from 2005-2010.

On December 1 every year, the world comes together to commemorate World AIDS Day. The theme for World AIDS Day has been determined by the World AIDS Campaign since 1997.

“We know that significant advances in the response to HIV have been achieved when there is strong and committed leadership. Leaders are distinguished by their action, innovation and vision; their personal example and engagement of others; and their perseverance in the face of obstacles and challenges,” said the World AIDS Campaign. “Leadership must be demonstrated at every level to get ahead of the epidemic- in families, in communities, in countries and internationally.”

“Much of the best leadership on AIDS has been demonstrated within civil society organisations challenging the status quo. Making leadership the theme of the next two World AIDS Days will help encourage leadership on AIDS within all levels and sectors of society,” the Campaign added.

The 2007/8 theme of “Leadership” will build on the 2006 World AIDS Day focus on accountability, and was selected by the Global Steering Committee of the World AIDS Campaign during their meeting held in Geneva in February.

“We are still dying! Leadership requires that we face this reality. While scaling up of HIV care is now prioritized, it is under funded and poorly implemented,” said WAC Steering Committee Member and Chairperson, Global Network of People Living with HIV/AIDS Deloris Dockrey.

“Leadership can imply the power and authority to make a difference, to lead by action and example,” added fellow Steering Committee member and Coordinator for the Ecumenical Advocacy Alliance, Linda Hartke. “By taking on the global theme of leadership for World AIDS Day, faith leaders and the communities they are a part of can help articulate a vision, build relationships and take concrete action in solidarity with all people committed to reaching universal access for HIV prevention, treatment and care.”

The overall purpose of the World AIDS Campaign from 2005 to 2010 is to ensure that leaders and decision makers deliver on their promises on AIDS, including the provision of Universal Access to Treatment, Care, Support and Prevention services by 2010. Within that five-year mission, annual campaigning themes are selected which are timely, relevant and adaptable to a number of different regions and issues.

The issue of continued and increased leadership on AIDS and it’s importance to a long-term sustainable AIDS response was underlined by UNAIDS Executive Director Peter Piot at the European AIDS Conference held in Bremen, Germany on 12-13 March. “ Leadership makes or breaks the response against AIDS,” he said.

The Global Steering Committee of World AIDS Campaign is comprised of the Global Network of People Living with HIV/AIDS, the International Community of Women Living with HIV/AIDS, the Youth Coalition, the Global Unions Programme on HIV/AIDS, the International Council of AIDS Service Organisations, the Ecumenical Advocacy Alliance, and the International Women’s AIDS Caucus. UNAIDS and the Global Fund to Fight AIDS, TB and Malaria are non-voting members.