GENEVA, 30 November 2011—Global progress in both preventing and treating HIV emphasizes the benefits of sustaining investment in HIV/AIDS over the longer term. The latest report by the World Health Organization (WHO), UNICEF and UNAIDS Report on the Global HIV/AIDS Response indicates that increased access to HIV services  resulted in a 15% reduction of new infections over the past decade and a 22% decline in AIDS-related deaths in the last five years.

"It has taken the world ten years to achieve this level of momentum," says Gottfried Hirnschall, Director of WHO's HIV Department. "There is now a very real possibility of getting ahead of the epidemic. But this can only be achieved by both sustaining and accelerating this momentum over the next decade and beyond."

Advances in HIV science and programme innovations over the past year add hope for future progress. In times of economic austerity it will be essential to rapidly apply new science, technologies and approaches to improve the efficiency and effectiveness of HIV programmes in countries.

The report highlights what is already working:

• Improved access to HIV testing services enabled 61% of pregnant women in eastern and southern Africa to receive testing and counseling for HIV - up from 14% in 2005.
• Close to half (48%) of pregnant women in need receive effective medicines to prevent mother-to-child transmission of HIV (PMTCT) in 2010.
• Antiretroviral therapy (ART), which not only improves the health and well-being of people living with HIV but also stops further HIV transmission, is available now for 6.65 million people in low- and middle-income countries, accounting for 47% of the 14.2 million people eligible to receive it.

When people are healthier, they are better able to cope financially. The report acknowledges that investment in HIV services could lead to total gains of up to US$ 34 billion by 2020 in increased economic activity and productivity, more than offsetting the costs of ART programmes.

“2011 has been a game changing year. With new science, unprecedented political leadership and continued progress in the AIDS response, countries have a window of opportunity to seize this momentum and take their responses to the next level,” said Paul De Lay, Deputy Executive Director, Programme, UNAIDS. “By investing wisely, countries can increase efficiencies, reduce costs and improve on results. However, gains made to date are being threatened by a decline in resources for AIDS.”

The report also points to what still needs to be done:

• More than half of the people who need antiretroviral therapy in low- and middle-income countries are still unable to access it. Many of them do not even know that they have HIV.
• Despite the growing body of evidence as to what countries need to focus on to make a real impact on their epidemics, some are still not tailoring their programmes for those who are most at risk and in need. In many cases, groups including adolescent girls, people who inject drugs, men who have sex with men, transgender people, sex workers, prisoners and migrants remain unable to access HIV prevention and treatment services.

Worldwide, the vast majority (64%) of people aged 15-24 living with HIV today are female. The rate is even higher in sub-Saharan Africa where girls and young women make up 71% of all young people living with HIV - essentially because prevention strategies are not reaching them.

Key populations are continually marginalized. In Eastern Europe and Central Asia, more than 60% of those living with HIV are people who inject drugs. But injecting drug users account for only 22% of those receiving ART. 

Although better services to prevent mother to child transmission of HIV have averted some 350 000 new infections among children, some 3.4 million children are living with HIV - many of whom lack HIV treatment. Only about one in four children in need of HIV treatment in low- and middle-income countries received it in 2010, as compared to 1 in 2 adults.

“While there have been gains in treatment, care and support available to adults, we note that progress for children is slower,” says Leila Pakkala, Director of the UNICEF Office in Geneva.  “The coverage of HIV interventions for children remains alarmingly low. Through concerted action and equity-focused strategies, we must make sure that global efforts are working for children as well as adults”.

HIV in regions and countries

In 2010, HIV epidemics and responses in different parts of the world vary with shifting trends, progress rates and outcomes.

Sub-Saharan Africa recorded the biggest overall annual increase--30%--in the number of people accessing ART. Three countries (Botswana, Namibia and Rwanda) have achieved universal coverage (80%) for HIV prevention, treatment and care services. The regional ART coverage rate stood at 49% at the end of 2010. Approximately 50% of pregnant women living with HIV receive treatment to prevent mother-to child transmission of HIV. And 21% of children in need are able to get paediatric HIV treatments. There were 1.9 million new infections in the region, where 22.9 million people are living with HIV. There are some major disparities in progress between different parts of the region. Countries in Eastern and Southern Africa have reached much higher coverage rates for ART (56%) and PMTCT (64%) than countries in Western and Central Africa (30% and 18% respectively).

Asia shows a stabilizing epidemic overall, but new infections are very high in some communities. Of the 4.8 million people living with HIV in Asia, nearly half (49%) are in India. Antiretroviral treatment coverage is increasing with 39% of adults and children in need of HIV treatment having access. Coverage of PMTCT services is relatively low- (16%).

Eastern Europe and Central Asia presents a dramatic growth in HIV, with new infections increasing by 250% in the past decade. Over 90% of these infections occur in just two countries: Russia and Ukraine. The region demonstrates high coverage rates for PMTCT and paediatric HIV treatment (with 78% and 65% coverage rates respectively). However, ART coverage is very low at 23%, particularly among the most affected people- the ones who inject drugs.

Middle East and North Africa records the highest number of HIV infections ever in the region (59 000) in 2010, which represents a 36% increase over the past year. Coverage of HIV services are very low in the region: 10% for ART, 5% for paediatric treatment and 4% for PMTCT.

Latin America and the Caribbean have a stabilizing epidemic with 1.5 million living with HIV in Latin America and 200 000 in the Caribbean. HIV is predominantly among networks of men who have sex with men in Latin America. In the Caribbean though, women are the more affected group accounting for 53% of people living with HIV. The region has ART coverage of 63% for adults and 39% for children.  Coverage for effective PMTCT regimen is relatively high at 74%.

Sustaining the HIV response through the next 10 years

• Countries are already showing marked efficiency gains in HIV programmes: South Africa reduced HIV drug costs by more than 50% over a two-year period by implementing a new tendering strategy for procurement. Uganda saved US$2 million by shifting to simpler paediatric regimens. Such efficiencies are promoted through Treatment 2.0 - an initiative launched by WHO and UNAIDS in 2010 to promote simpler, cheaper and easier-to-deliver HIV treatment and diagnostic tools, combined with decentralized services that are supported by communities.
• WHO is developing new guidance on the strategic use of antiretroviral drugs for both prevention and treatment.
• WHO's "Global Health Sector Strategy on HIV/AIDS, 2011-2015", endorsed by the World Health Assembly in May 2011 highlights the importance of continuing efforts to optimize HIV treatment and "combination" prevention - the use of a range of different approaches to reduce people's risk of infection.

The 2011 "Report on the Global HIV/AIDS Response" is the comprehensive report on both the epidemiology and progress rates in access to HIV services globally and in regions and countries. It has been jointly developed by WHO, UNICEF, UNAIDS, in collaboration with national and international partners.

The full report is available from: http://www.who.int/hiv/pub/progress_report2011/.

Korean footballer Myung-Bo Hon with the UNAIDS Executive Director Michel Sidibé. Seoul, 28 November 2011.

SEOUL, Republic of Korea, 28 November 2011— Iconic Korean football star, Myung-Bo Hong, was appointed as a UNAIDS International Goodwill Ambassador during a press conference held at Yonsei University in Seoul. In this capacity, Myung-Bo Hong will raise awareness on HIV prevention among young people and help break down the barriers of stigma and discrimination surrounding HIV, particularly within the Republic of Korea and across Asia.

“As one of the greatest Asian football players of all time, Myung-Bo Hong will be a compelling advocate on HIV prevention for young people and football fans worldwide,” said Michel Sidibé, UNAIDS Executive Director. “I am honoured UNAIDS will work with such an inspiring athlete to disseminate vital messages about HIV to young people.”

“Accelerated efforts are needed on HIV to ensure zero new HIV infections, zero discrimination and zero deaths,” said Mr Byeongleul Jun, Director of the Korean Centre for Disease Control and Deputy Minister of Health and Welfare. “The involvement of a sporting hero as great as Myung-Bo Hong can greatly advance this important agenda and make a difference in the AIDS response around the world,” he said.

Myung-Bo Hong joins prominent individuals from the world of arts, science, literature, entertainment as an advocate for zero new HIV infections and zero discrimination. Other UNAIDS Goodwill Ambassadors include Naomi Watts, Annie Lennox, and Michael Ballack.

“People living with HIV are people like you and me,” said Myung-Bo Hong during the appointment ceremony. “They have rights and should not be discriminated against. I am delighted to be working with UNAIDS to use sport to help bring an end to AIDS.”

Currently Korea’s National Olympic Football Team Manager, Myung-Bo Hong, played for the country’s national football team in four consecutive World Cups (1990-2002) and was chosen among the “FIFA 100”, a selection of the 125 greatest living footballers in the world made by Brazilian football legend Pelé. He was the first Asian footballer to receive FIFA’s World Cup Bronze Ball in 2002.

“We are very glad UNAIDS has recognized Myung-Bo Hong as both a sports celebrity and a prominent humanitarian. Mr. Hong has established a great level of influence in football worldwide, and his appointment as the UNAIDS Goodwill Ambassador has great potential to make a critical push against HIV infections and discrimination,” said Mr Soo-Gil Park, President of World Federation of United Nations Associations.

Globally there are more than 5 million young people living with HIV and every day 2400 young people become infected with the virus. Although young people are increasingly learning how to protect themselves, only one-third of young people globally have accurate and comprehensive knowledge of how to protect themselves from HIV.

Substantial scale up, even during the financial crisis, highlights country driven commitments—new investment framework will help countries save more lives and money

L to R: German Federal Minister of Health (BMG), Daniel Bahr, UNAIDS Executive Director Michel Sidibé, German Federal Minister for Economic Cooperation and Development (BMZ), Dirk Niebel.
Photo credit: UNAIDS/ C. Koall

BERLIN/GENEVA, 21 November 2011—A new report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), released today shows that 2011 was a game changing year for the AIDS response with unprecedented progress in science, political leadership and results. The report also shows that new HIV infections and AIDS-related deaths have fallen to the lowest levels since the peak of the epidemic. New HIV infections were reduced by 21% since 1997, and deaths from AIDS-related illnesses decreased by 21% since 2005.

“Even in a very difficult financial crisis, countries are delivering results in the AIDS response.” said Michel Sidibé, Executive Director of UNAIDS. “We have seen a massive scale up in access to HIV treatment which has had a dramatic effect on the lives of people everywhere.”

According to UNAIDS and WHO estimates, 47% (6.6 million) of the estimated 14.2 million people eligible for treatment in low- and middle-income countries were accessing lifesaving antiretroviral therapy in 2010, an increase of 1.35 million since 2009. The 2011 UNAIDS World AIDS Day report also highlights that there are early signs that HIV treatment is having a significant impact on reducing the number of new HIV infections.

In Botswana, patterns in sexual behaviour have remained relatively stable since 2000. The country scaled up access to treatment from less than 5% in 2000 to over 80% which it has maintained since 2009. The annual number of new HIV infections has declined by over two thirds since the late nineties and data suggests that the number of new HIV infections in Botswana is 30% to 50% lower today than it would have been in the absence of antiretroviral therapy. As treatment reduces the viral load of a person living with HIV to virtually undetectable levels, it also reduces the risk of transmitting the virus to an uninfected partner. Recent studies show that treatment can be up to 96% effective in preventing HIV transmission among couples.

At the end of 2010 an estimated:

• 34 million [31.6 million – 35.2 million] people globally living with HIV
• 2.7 million [2.4 million – 2.9 million] new HIV infections in 2010
• 1.8 million [1.6 million – 1.9 million] people died of AIDS-related illnesses in 2010

Treatment has averted 2.5 million deaths since 1995

People living with HIV are living longer and AIDS-related deaths are declining due to the lifesaving effects of antiretroviral therapy. Globally there were an estimated 34 million people [31.6 million – 35.2 million] living with HIV in 2010, and since 2005, AIDS-related deaths decreased from 2.2 million [2.1 million – 2.5 million] to 1.8 million [1.6 million – 1.9 million] in 2010. Around 2.5 million deaths are estimated to have been averted in low- and middle-income countries due to increased access to HIV treatment since 1995.

Progress in HIV prevention

New HIV infections have been significantly reduced or have stabilized in most parts of the world. In sub-Saharan Africa the number of new HIV infections has dropped by more than 26%, from the height of the epidemic in 1997, led by a one third drop in South Africa, the country with the largest number of new HIV infections in the world.

In the Caribbean, new HIV infections were reduced by a third from 2001 levels—and by more than 25% in Dominican Republic and Jamaica. Similarly the number of new HIV infections in South and South-East Asia dropped by more than 40% between 1996 and 2010. In India new HIV infections fell by 56%.

However, the number of new HIV infections continues to rise in Eastern Europe and Central Asia, Oceania and Middle-East and North Africa, while it has remained stable in other regions of the world.

Declines in new HIV infections are also being spurred by changes in sexual behaviour, particularly in young people, as people reduce their numbers of sexual partners, increase condom use and are waiting longer before becoming sexually active. HIV prevalence declined among young people in at least 21 of 24 countries with national HIV prevalence of 1% or higher. Five additional countries, Burkina Faso, Congo, Ghana, Nigeria, and Togo have seen HIV prevalence decline by more than 25% between 2001 and 2010 among young people.

The rate of new HIV infections in urban Zimbabwe fell from almost 6% in 1991 to less than 1% in 2010. Without changes in behaviour, studies estimate that there would have been an additional 35 000 new infections annually.

The report highlights that an increase in uptake of male circumcision is also starting to contribute to declines in new HIV infections. Studies show that 2000 new HIV infections were averted among men in Kenya’s Nyanza province after scale up of voluntary male circumcision. Estimates in the report highlight that circumcising 20 million more men across Eastern and Southern Africa would avert around 3.4 million new HIV infections by 2015.

Around 400 000 new HIV infections in children are estimated to have been averted since 1995 due to increased access to effective antiretroviral regimens in low- and middle income countries by 2010, almost half (48%) of all pregnant women living with HIV were able to access effective regimens to prevent their child from becoming infected with the virus.

Smarter investments to deliver a better package

UNAIDS has mapped a new framework for AIDS investments which are focused on high-impact, evidence-based, high-value strategies.

"The investment framework is community driven not commodity driven. It puts people at the centre of the approach, not the virus," said Mr Sidibé.

This new strategic approach to investments would achieve extraordinary results; at least 12.2 million new HIV infections would be averted, including 1.9 million among children between 2011 and 2020; and 7.4 million AIDS-related deaths would be averted between 2011 and 2020.

The framework is based on six essential programme activities: focused interventions for key populations at higher risk (particularly sex workers and their clients, men who have sex with men, and people who inject drugs); prevention of new HIV infections in children; behaviour change programmes; condom promotion and distribution; treatment, care and support for people living with HIV; and voluntary medical male circumcision in countries with high HIV prevalence.

For the framework to be effective, programme activities must recognise critical enablers, such as reducing stigma, respect for human rights, creating a protective legal environment and capacity building for community based organizations, which are crucial to overcoming the barriers to successful programme outcomes.

Using the framework to achieve universal access to HIV prevention, treatment, care and support by 2015 requires a scaling up of funding to US$ 22-24 billion in 2015, in line with the targets in the 2011 United Nations Political Declaration on HIV/AIDS. If full implementation of the new framework is achieved in the next four years, global resource needs would peak in 2015 and decline gradually thereafter; making the AIDS response an excellent investment opportunity where returns will offset the upfront cost in less than one generation.

At the end of 2010 around US$ 15 billion was available for the AIDS response in low- and middle-income countries. Donor funding has been reduced by 10% from US$ 7.6 billion in 2009 to US$ 6.9 billion in 2010. In a difficult economic climate the future of AIDS resourcing depends on smart investments.

To rapidly reduce new HIV infections and to save lives, the 2011 UNAIDS World AIDS Day report underscores that shared responsibility is needed.

UNAIDS will use crowdsourcing technologies and social media platforms to engage young people in developing AIDS policy

GENEVA, 25 October 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) is launching CrowdOutAIDS.org, an online collaborative project to crowdsource its new strategy on youth and HIV—a first in the UN system.

Crowdsourcing is a technique used to rapidly engage large numbers of interested people to develop strategies, solve problems or propose relevant and fresh ideas. With around 3000 young people aged 15-24 becoming infected with HIV daily, leveraging new modes of communication and online collaboration with young people is essential for an effective response to HIV.

“We’re asking youth around the world to debate, draft and work with UNAIDS to implement this new strategy,” said Michel Sidibé, Executive Director of UNAIDS. “It is absolutely critical that we engage young people—not as recipients of our messages but as the actors and creators of change.”

CrowdOutAIDS.org is a completely new way for UNAIDS to develop policy on HIV. It will use crowdsourcing technologies and familiar online tools such as Facebook, Twitter and Renren to ensure youth engagement and action in the AIDS response.

CrowdOutAIDS.org follows a four-step model and is open to anyone aged 15-29. Young people will be able to shape the new strategy from conceptualization to final drafting via a wiki-platform.

“It is important to involve young people in policy development in order for our views, expectations and aspirations to be fully represented,” said Jennifer Ehidiamen, a blogger and journalist from Nigeria, and online content curator for CrowdOutAIDS.org. “CrowdOutAIDS.org is an innovative way to build a strong community, interested in sharing solution-based ideas and actions on AIDS.”

The project will run over a period of two months with the final crowdsourced strategy being produced in January, 2012. To find out more, visit www.CrowdOutAIDS.org, and follow @UNAIDS and #CrowdOutAIDS on Twitter.

President of Xinhua News Agency Li Congjun and UNAIDS Executive Director Michel Sidibé signing a Memorandum of Understanding of Strategic Cooperation between Xinhua and UNAIDS. 15 September 2011. Geneva.
Credit: UNAIDS

GENEVA, 15 September 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) and Xinhua, China’s all-media news group, announced Thursday a plan to launch a media campaign globally on World AIDS Day 2011.

This cooperation is part of the two institutions’ new strategic partnership, which aims to raise public awareness of the HIV epidemic.

Li Congjun, the President of Xinhua News Agency and Michel Sidibé, Executive Director of UNAIDS participated in a signing ceremony of a Memorandum of Understanding (MOU) of Strategic Cooperation between Xinhua and UNAIDS.

Mr. Li signed the MOU during a visit to UNAIDS’ headquarters in Geneva, while  Mr. Sidibé joined in the ceremony through a video conference from Washington DC.

Both organizations will leverage their expertise to reach universal access goals towards HIV prevention, treatment, care and support. UNAIDS will provide its knowledge concerning the epidemic in China and worldwide, while Xinhua will mobilize its all-media service around the world to promote HIV issues and call for support from countries, civil society, businesses and other key players in the AIDS movement.

Xinhua is China’s most influential news institution with over 30 domestic branches and 150 branches outside of China.

Group picture of the Xinhua News Agency delegation with UNAIDS Deputy Executive Director Dr Paul De Lay (center) and UNAIDS Executive Director Michel Sidibé (on screen).
Credit: UNAIDS

Mr. Li, who is in Geneva as part of an European working tour said, “The MOU lays a solid foundation for Xinhua and UNAIDS’ long term cooperation. The World AIDS Day 2011 news campaign is a great starting point for this strategic partnership.”

Mr. Sidibé said, “I welcome this new partnership with Xinhua which combines the power of Xinhua’s extensive global media presence with UNAIDS’ in-depth knowledge of the AIDS epidemic worldwide to promote a revitalized AIDS movement. Together we can reach Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths.”

UNAIDS’ vision of “Getting to Zero” has been chosen as the main theme for World AIDS’ Day during the next five years. Millions of people around the globe mark World AIDS day on December 1 by commemorating the lives lost to AIDS and recommitting to the AIDS response.

The New MOU between UNAIDS and Xinhua is for an initial period of two years, ending in September 2013.

Xinhua has formed partnerships on important development projects with several UN agencies, including the United Nations Children’s Fund (UNICEF), the United Nations Educational, Scientific and Cultural Organization (UNESCO), United Nations Environment Programme (UNEP), United Nations Development Programme (UNDP) and the United Nations Framework Convention on Climate Change (UNFCCC) Secretariat.

Last year the news organization worked with one of UNAIDS’ Co-Sponsors, WFP on a special report to coincide with World Food Day. Earlier this year, Xinhua worked on an photo exhibition with another UNAIDS’ Co-Sponsor, UNESCO.

Pink Ribbon Red ribbon partnership expands critically needed breast and cervical cancer interventions in sub-Saharan Africa

President George W. Bush together with UNAIDS Executive Director Michel Sidibé at the launch of the Pink Ribbon Red Ribbon initiative.
Credit: Bush Center

WASHINGTON, D.C., 13 September 2011—The George W. Bush Institute, the U.S. Department of State, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), Susan G. Komen for the Cure®, and the Joint United Nations Programme on HIV/AIDS (UNAIDS) will today announce Pink Ribbon Red Ribbon®, an innovative partnership to leverage public and private investment in global health to combat cervical and breast cancer — two of the leading causes of cancer death in women - in Sub-Saharan Africa and Latin America. Pink Ribbon Red Ribbon will expand the availability of vital cervical cancer screening and treatment and breast care education—especially for women most at risk of getting cervical cancer in developing nations because they are HIV-positive.

"It’s time to take the next step in building on the progress that has been made over the past decade in the fight against HIV and AIDS,” said President George W. Bush. “Many women who seek AIDS services also face the challenge of cancer.  It’s not enough to save a woman from AIDS, if she is then left to die of another very preventable disease."

The cervical cancer partnership will leverage the platform and resources of PEPFAR  — established under President Bush and a cornerstone of President Obama’s Global Health Initiative (GHI) — and will draw from lessons learned in the significant scaling-up of access to HIV interventions in recent years. As breast cancer has not been linked to HIV, PEPFAR funds will not be used for direct support of breast cancer activities.  However, other Pink Ribbon Red Ribbon partners will leverage the PEPFAR platforms, using other sources of funding, to support breast cancer efforts.

“Investing in women’s health is the right thing to do and the smart thing to do.  Pink Ribbon Red Ribbon will save women’s lives and in turn help families and whole communities. Through this new partnership, the U.S. Government has committed an additional $10 million, which brings our total PEPFAR investment to $30 million over the next five years. Under the leadership of Secretary Clinton and U.S. Global AIDS Coordinator Ambassador Eric Goosby, the State Department is proud to join this important and ambitious partnership to address breast and cervical cancer globally,” said Ambassador Melanne Verveer, Ambassador-at-Large Global Women's Issues.

Women whose immune systems are compromised by HIV are more likely to develop cervical cancer.  Through PEPFAR, there is already screening and treatment of women at more than 250 clinics in 11 African countries.  Through PRRR PEPFAR has committed an additional $10 million, which will bring the total PEPFAR investment to $30 million over the next five years and ensure more women will be able to be screened and saved.

“Today the majority of women in Sub-Saharan Africa do not have access to critical breast and cervical cancer screening and treatment services and we must move quickly to address this growing epidemic,” said Ambassador Nancy G. Brinker, founder and CEO of Susan G. Komen for the Cure. “The PRRR partnership builds on our long-standing efforts in Africa and globally to support innovative models that will save lives by detecting breast and cervical cancer earlier, when there is still time to treat it.”

With initial indications of interest, PRRR expects to have commitments of up to $75 million across 5 years, which will grow to include additional participants and services. The goals are to reduce deaths from cervical cancer by an estimated 25% among women screened and treated through the initiative, significantly increase access to breast and cervical cancer prevention, screening and treatment programs, and create innovative models that can be scaled up and used globally.

This public-private initiative includes initial commitments from founding corporate participants Merck, Becton Dickinson, QIAGEN, Caris Foundation, Bristol-Myers Squibb, GlaxoSmithKline and IBM.

“The rapid expansion of HIV prevention and treatment services over the past decade has saved millions of lives,” said Michel Sidibé, Executive Director of UNAIDS. “Uniting the efforts of two vital health movements means more women around the world will be reached with integrated—not isolated care.”

Infection with HIV weakens the immune system and reduces the body’s ability to fight infections that may lead to cervical cancer. Cervical cancer is 4-5 times more common among women living with HIV than women who are HIV-negative. 

There is an urgent need to develop innovative and sustainable solutions to addressing women’s cancers in developing nations, where these diseases are often neglected and associated with stigmas that discourage women from accessing life-saving prevention, care and treatment programs. By leveraging the significant investments made in HIV prevention, care and treatment, it is possible to integrate simple, cost-effective preventions, screening and testing methods and dramatically reduce mortality and late-stage diagnosis of cervical cancer, while continuing to increase access to breast care education.

UNAIDS

UNAIDS, the Joint United Nations Programme on HIV/AIDS, is an innovative United Nations partnership that leads and inspires the world in achieving universal access to HIV prevention, treatment, care and support. Learn more at unaids.org.

George W. Bush Institute

The George W. Bush Institute seeks to improve the human condition through human freedom, educational reform, global health, and economic growth. In all its programming, the Institute integrates initiatives that empower women and support social enterprise as proven catalysts for change. The Bush Institute is the innovation policy arm of the George W. Bush Presidential Center, which promotes the Presidential library, located on the campus of SMU in Dallas. For more information, please visit www.bushcenter.com.

PEPFAR

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is the U.S. Government initiative to save the lives of those affected by HIV/AIDS around the world. This historic commitment is the largest by any nation to combat a single disease internationally, and PEPFAR investments also help alleviate suffering from other diseases across the global health spectrum. PEPFAR is driven by a shared responsibility among donor and partner nations and others to make smart investments to save lives. For more information about PEPFAR, visit www.PEPFAR.gov, http://twitter.com/uspepfar, or www.facebook.com/PEPFAR.

Susan G. Komen for the Cure

Nancy G. Brinker promised her dying sister, Susan G. Komen, she would do everything in her power to end breast cancer forever. In 1982, that promise became Susan G. Komen for the Cure and launched the global breast cancer movement. Today, Komen for the Cure is the world's largest grassroots network of breast cancer survivors and activists fighting to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Komen Race for the Cure and Komen 3-Day for the Cure, we have invested more than $1.9 billion to fulfill our promise, becoming the largest source of nonprofit funds dedicated to the fight against breast cancer in the world. For more information about Susan G. Komen for the Cure, breast health or breast cancer, visit komen.org or call 1-877 GO KOMEN.

Impressive gains across the region, but most countries need greater and sustained efforts to ‘get to zero’

BUSAN, South Korea, 26 August 2011—The AIDS epidemic in Asia and the Pacific is at a crossroads, according to a new report from the Joint United Nations Programme on HIV/AIDS (UNAIDS). While the region has seen impressive gains—including a 20% drop in new HIV infections since 2001 and a three-fold increase in access to antiretroviral therapy since 2006—progress is threatened by an inadequate focus on key populations at higher risk of HIV infection and insufficient funding from both domestic and international sources.

Launched at the 2011 International Congress on AIDS in Asia and the Pacific (ICAAP), the report, titled HIV in Asia and the Pacific: Getting to Zero, found that more people than ever before have access to HIV services across the region. However, most countries in the region are a long way from achieving universal access goals for HIV prevention, treatment, care and support.

“Getting to zero new HIV infections in Asia and the Pacific will demand national responses based on science and the best available evidence,” said UNAIDS Executive Director Michel Sidibé. “HIV programmes must be sufficiently resourced and solidly focused on key populations. Investments made today will pay off many-fold in the future.”

Gains in the regional HIV response, but progress is fragile

According to the report, an estimated 4.9 million [4.5 million–5.5 million] people were living with HIV in Asia and the Pacific in 2009, a figure that has remained relatively stable since 2005. The majority of people living with HIV in the region are in 11 countries: Cambodia, China, India, Indonesia, Malaysia, Myanmar, Nepal, Pakistan, Papua New Guinea, Thailand and Viet Nam.

Across Asia and the Pacific, there was a 20% decline in new HIV infections between 2001 and 2009—from 450 000 [410 000–510 000] to 360 000 [300 000–440 000]. Cambodia, India, Myanmar and Thailand have reduced their HIV infection rates significantly with intensive, wide reaching HIV prevention programmes for people who buy and sell sex.

The number of people accessing life-saving antiretroviral treatment in the region has tripled since 2006, reaching some 740 000 people at the end of 2009. Cambodia is one of only eight countries in the world to provide antiretroviral therapy to more than 80% of the people eligible for it. However, as of end-2009, more than 60% of people in Asia and the Pacific who were eligible for treatment still could not access it.

The report found an estimated 15% decrease in new HIV infections among children since 2006. But regional coverage of HIV services to prevent new HIV infections in children continues to lag behind global averages, particularly in South Asia.

According to the report, HIV epidemics can emerge even in countries where HIV prevalence was previously low. After a more than 20-year ‘low and slow’ HIV epidemic in the Philippines, for example, the country now has a rapidly expanding epidemic among key populations. In the city of Cebu, HIV prevalence among people who inject drugs increased from 0.6% to 53% between 2009 and 2011. In Manila and Cebu, HIV prevalence among men who have sex with men is estimated at 5%.

Key populations at higher risk of HIV infection

According to the report, new HIV infections in the region remain concentrated among key populations: people who buy and sell sex, people who inject drugs, men who have sex with men, and transgender people. Most programmes to protect key populations and their intimate partners from HIV infection are inadequate in size and scale.

Across the region, stigma and discrimination against people living with HIV and populations at higher risk of infection remain rife. About 90% of the countries in the region retain punitive laws and policies that effectively prevent people living with HIV and key populations from accessing life-saving HIV services.

Data suggest that a significant proportion of new HIV infections within key populations are among young people under the age of 25. In most settings, HIV prevention programmes are failing to sufficiently reach young people most at risk.

More AIDS resources urgently needed

The AIDS response in Asia and the Pacific is underfunded, the report found. In 2009, an estimated US$ 1.1 billion was spent on the AIDS response in 30 countries across the region—approximately one third of the funding needed to achieve universal access goals to HIV services.

Though China, Malaysia, Pakistan, Samoa and Thailand are funding the bulk of their HIV response from domestic resources, many countries in Asia and the Pacific depend heavily on foreign funding, particularly for the provision of antiretroviral therapy. Increased investment of domestic resources, especially in middle-income countries, is critical for the ongoing regional response to HIV.

Funding cutbacks from international donors also threaten progress in the regional AIDS response. In 2009, international assistance for the global AIDS response leveled off for the first time in a decade, and in 2010 it declined.

According to the report, investments to protect key populations from HIV remain insufficient. Among countries reporting detailed expenditure data in 2010, only 8% of total AIDS spending in South Asia and 20% in Southeast Asia focused on HIV prevention among key populations at higher risk of HIV infection.

New data from studies in Kenya, Uganda and Botswana confirm major role of antiretroviral medicine in preventing heterosexual HIV transmission

GENEVA, 13 July 2011—Results announced today from two studies reveal that a daily antiretroviral tablet taken by people who do not have HIV infection can reduce their risk of acquiring HIV by up to 73%. Both daily tenofovir and daily tenofovir/emtricitabine taken as preventive medicine (PrEP - pre-exposure prophylaxis) can prevent heterosexual transmission of HIV from men to women and from women to men.

The Partners PrEP trial, conducted by the University of Washington’s International Clinical Research Center, followed 4758 sero-discordant couples (in which one person had HIV infection and the other did not) in Kenya and Uganda. Couples received counselling and free male and female condoms. The uninfected partner took a once-daily tenofovir tablet or a tenofovir/emtricitabine tablet or a placebo pill. There were 62% fewer HIV infections in the group receiving tenofovir and 73% fewer HIV infections in the group that took tenofovir/emtricitabine than in the group receiving the placebo.

The TDF2 trial, conducted by the United States Centers for Disease Control, followed 1200 men and women in Botswana who received either a once-daily tenofovir/emtricitabine tablet or a placebo pill. The antiretroviral tablet reduced the risk of acquiring HIV infection by roughly 63% overall in the study population of uninfected heterosexual men and women.

“This is a major scientific breakthrough which re-confirms the essential role that antiretroviral medicine has to play in the AIDS response,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “These studies could help us to reach the tipping point in the HIV epidemic.”

The medicines are available generically in many countries at prices as low as US$ 0.25 per tablet. In November 2010, the iPrEx trial among men who have sex with men in six countries reported a 44% reduction in HIV transmission among those who took a daily tenofovir/emtricitabine tablet.

“Effective new HIV prevention tools are urgently needed, and these studies could have enormous impact in preventing heterosexual transmission,” said Dr Margaret Chan, WHO's Director-General. “WHO will be working with countries to use the new findings to protect more men and women from HIV infection.”

UNAIDS and WHO have already been working with countries in sub-Saharan Africa, Latin America and Asia to explore the potential role of pre-exposure prophylaxis in HIV prevention. This news will encourage more people to get tested for HIV, discuss HIV prevention options with their partners and access essential HIV services.

It is currently estimated that only about half of the 34 million people living with HIV know their HIV status. An increase in the uptake of testing for HIV would have a significant impact on the AIDS response, particularly if more people gain access to new HIV prevention technologies in light of the new findings.

UNAIDS and WHO recommend that individuals and couples make evidence-informed decisions on which combination of HIV prevention options is best for them. No single method is fully protective against HIV. Antiretroviral drugs for prevention need to be combined with other HIV prevention options. These include correct and consistent use of male and female condoms, waiting longer before having sex for the first time, having fewer partners, medical male circumcision and avoiding penetrative sex.

GENEVA, 24 June 2011—Captains of national football teams competing in the upcoming FIFA Women’s World Cup 2011 soccer championship in Germany are signing up to the Give AIDS the Red Card appeal in support of a global plan to eliminate new HIV infections among children by 2015. The Give AIDS the Red Card appeal, which was launched by the Joint United Nations Programme on HIV/AIDS (UNAIDS) one year ago at the FIFA 2010 World Cup in South Africa, uses the power and outreach of football to unite the world around stopping new HIV infections in children.

UNAIDS Executive Director Michel Sidibé said, “As the most important international competition in women's football, this tournament provides a platform to raise global awareness about the campaign to keep babies from becoming infected with HIV, and their mothers from dying from AIDS.”

Every day more than 1000 babies are born with HIV. However with access to HIV counseling and testing for pregnant women and their partners, and treatment when needed, the risk of transmission can be brought down to less than 5%.

On signing the pledge, team captains appeal to football players and fans across the world to ‘celebrate life and support the global campaign to prevent mothers from dying and babies from becoming infected with HIV’.

The FIFA Women’s World Cup 2011 is taking place from 26 June to 17 July. So far five captains have signed the appeal; Faye White (England), Sandrine Soubeyrand (France), Rebecca Smith (New Zealand), Ingvild Stensland (Norway), and Christie Rampone (United States).

“One of the great things about representing our country on the big stages is the opportunity for us to support causes we care about,” said U.S. Women’s World Cup Team captain Christie Rampone. “I signed onto a global campaign called Give AIDS the Red Card which helps to generate political action towards ending the AIDS epidemic among babies and young children around the world. I am confident about linking this noble cause with the game we all cherish.”

Rampone, who is among the more experienced U.S. players and will be playing in her fourth World Cup added, “UNAIDS asked the U.S. soccer team to help lead this campaign around the world, and we are happy to lend our support on a global stage to a global problem. The UN wants to end pediatric AIDS by 2015 and so do we!”

The captains of the other competing teams, including Australia, Brazil, Canada, Colombia, Equatorial Guinea, Germany, Japan, DPR Korea, Mexico, Nigeria, and Sweden, will also be encouraged to become “Red Card Advocates” by signing the appeal during the tournament and publicize global efforts to eliminate mother-to-child transmission of HIV by 2015.

There are 34 million people globally living with HIV, of whom 22.5 million are in sub-Saharan Africa. Despite progress towards the goal of eliminating new HIV infections among children , in 2009 alone there were 370,000 children born with HIV, bringing to 2.5 million the total number of children under 15 living with HIV.

The 2011 Women’s World Cup is one of several high-profile football championships, including the 2012 African Nations Cup and UEFA Euro 2012, leading up to the 2014 FIFA World Cup in Brazil, that can provide platforms for raising wide awareness about the campaign to eliminate HIV in children.



GENEVA, 21 June 2011—New public health recommendations from the World Health Organization (WHO) and partners aim to help policymakers and doctors scale up access to treatment and prevention services for HIV and sexually transmitted infections among men who have sex with men and transgender people. These are the first global public health guidelines to focus on these specific population groups.

There has been a recent resurgence of HIV infection among men who have sex with men, particularly in industrialized countries. Data are also emerging of new or newly identified HIV epidemics among men who have sex with men in Africa, Asia, the Caribbean andLatin America. Generally, men who have sex with men are nearly 20 times more likely to be infected with HIV than general populations. HIV infection rates among transgender people range between 8 to 68% depending on the country or region.

One reason for this is the stigma experienced by many men who have sex with men and transgender people. In many countries, criminalization of same sex relationships drives such relationships underground, making people afraid to seek HIV prevention and treatment services. WHO and its partners advise more inclusive approaches and suggest some practical ways to improve their access to HIV prevention, diagnosis, treatment and care services.

"We cannot imagine fully reversing the global spread of HIV without addressing the specific HIV needs of these key populations," said Dr Gottfried Hirnschall, WHO's Director of HIV/AIDS Department. "We are issuing these guidelines to help countries and communities scale up the services needed to reduce new infections and save lives."

"Men who have sex with men and transgender people everywhere face huge difficulties in accessing HIV services," said George Ayala, Executive Director of the Global Forum MSM & HIV (MSMGF), a key partner in producing the recommendations. "The guidelines both present evidence for effective prevention interventions for these populations and provide recommendations to help ensure that pervasive barriers like stigma and criminalization no longer stand in the way of life-saving services.” 

The new guidelines "Prevention and treatment of HIV and other sexually transmitted infections (STIs) among men who have sex with men and transgender people: Recommendations for a public health approach" provide 21 recommendations for actions to be taken by multiple stakeholders, in close cooperation with men who have sex with men and transgender people, including:

• For national policy-makers: To develop anti-discrimination laws and measures to protect human rights, and to establish more inclusive services for men who have sex with men and transgender people based on their right to health
• For health service providers: To offer HIV testing and counselling followed by treatment for patients with CD4 count 350 or below as recommended in the WHO 2010 HIV treatment guidelines
• For communities: To scale up behavioural interventions for the prevention of HIV and STIs among men who have sex with men and transgender people
• For affected individuals: Practice consistent condom use over choosing partners based on HIV infection status (sero-sorting)

"Urgent action is needed to ensure that the basic human rights of people most at risk of HIV infection are respected and that they have the information and tools to protect themselves against HIV and gain access to antiretroviral therapy if needed,” said Mariângela Simào, Chief, Prevention, Vulnerability and Rights, UNAIDS.

The WHO guidelines have been developed over the past year through global consultations involving public health officials, scientists, and representatives from donor organizations, civil society and health service providers. The new guidelines can be found at: http://www.who.int/hiv/pub/guidelines/msm_guidelines2011/en/ .