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/ .

(Left to Right): Michel Sidibé, UNAIDS Executive Director; President Bill Clinton; Ban Ki-moon, Secretary General of the UN; Goodluck Jonathan, President of Nigeria; Dr Eric Goosby, US Global AIDS Ambassador, Anthony Lake, UNICEF Executive Director, at launch of the Global Plan towards elimination of new HIV infections among children and keeping their mothers alive, at UN Headquarters, NYC, 9 June 2011.
Credit: UNAIDS/B. Hamilton

NEW YORK/GENEVA, 9 June 2011—World leaders gathered in New York for the 2011 United Nations High Level Meeting on AIDS have today launched a Global Plan that will make significant strides towards eliminating new HIV infections among children by 2015 and keeping their mothers alive.

“We believe that by 2015 children everywhere can be born free of HIV and that their mothers can remain healthy,” said Michel Sidibé, Executive Director of UNAIDS. “This new global plan is realistic, it is achievable and it is driven by the most affected countries.”

“Nearly every minute, a child is born with HIV. Working together, we can reverse this tide as we have done in the United States and they are very close to doing in Botswana,” said Ambassador Eric Goosby, the United States Global AIDS Coordinator. “Preventing new HIV infections among children across the globe is truly a smart investment that saves lives and helps to give children a healthy start in life.”

Providing pregnant women living with HIV with antiretroviral prevention and treatment reduces the risk of a child being born with the virus to less than 5%—and keeps their mothers alive to raise them. Neither technical nor scientific barriers stand in the way of responding to this global call to action. The plan notes that what is needed is leadership, shared responsibility and concerted action among donor nations, recipient countries and the private sector to make an AIDS-free generation a reality. 

In answering the Global Plan’s call to action, the United States President's Emergency Plan for AIDS Relief (PEPFAR) announced an additional US$ 75 million to preventing mother-to-child transmission of HIV (PMTCT) efforts. This funding will be on top of the approximately US$ 300 million that PEPFAR already provides annually for PMTCT.

The Bill & Melinda Gates Foundation pledged US$ 40 million, Chevron committed to US$ 20 million and Johnson & Johnson pledged US$ 15 million.

"Investments in preventing mother-to-child transmission are greatly needed and the Bill & Melinda Gates Foundation is committed to ensuring that such initiatives are fully integrated into family planning and maternal, newborn, and child health programmes," said Stefano Bertozzi, Director of HIV and tuberculosis at the Foundation.

“Chevron understands that its sustainability as a business is inextricably linked to the health and well-being of its employees and the communities in which it operates,” stressed Rhonda Zygocki, Executive Vice President, Policy and Planning, for Chevron Corporation. “We are proud to pledge US$ 20 million, joining in this mission to eliminate mother-to-child transmission of HIV.”

“We have a dream that no baby will be born HIV positive and today’s pledge continues the Johnson & Johnson enduring commitment to eliminating mother-to-child transmission of HIV,” said Brian Perkins, Corporate Vice President, Corporate Affairs. “It is another step in fulfilling our commitment to support achievement of the Millennium Development Goals, and reflects our long-standing dedication to improving maternal and child health.”

In 2009, approximately 370 000 children were born with HIV—almost all of them in low- and middle-income countries, mainly in sub-Saharan Africa. Under the Global Plan, the goal would be to work toward reducing this number by 90% by 2015. All 22 of the countries with the highest burden of new HIV infections among children have contributed to the development of the plan and signed up to implement it.

(Left to Right): Babalwa Mbono, Representative of Women Living with HIV; Michel Sidibé, UNAIDS Executive Director; President Bill Clinton at launch of the Global Plan towards elimination of new HIV infections among children and keeping their mothers alive.
Credit: UNAIDS/B. Hamilton

The Global Plan towards the elimination of new HIV Infections among children by 2015 and keeping their mothers alive was developed by a group of more than 30 countries and 50 community groups, non-governmental and international organizations. The group was convened by UNAIDS and PEPFAR.

Babalwa Mbono found out she was HIV positive when she became pregnant. “Helping pregnant women to protect their babies is really important,” she said. “Like all mothers, I would do anything to give my child a healthy start in life—and this prevention should be available to women everywhere.”

"We can only achieve a generation free of HIV and AIDS by focusing our efforts on the mothers and children at greatest risk and in greatest need," urged UNICEF Executive Director Anthony Lake. "The investments we make in preventing maternal-to-child transmission of HIV—and in expanding more women's access to quality care—will yield tremendous returns, not only in the lives of children and families affected by HIV and AIDS, but in improving mothers' and children's health in the poorest countries that bear the greatest burden of the AIDS epidemic."

The plan focuses on a series of specific policy and programmatic measures which countries will take to ensure that all pregnant women living with HIV have access to HIV prevention and treatment services and that new HIV infections among children are eliminated by 2015. The plan also includes efforts to provide treatment to mothers and children living with HIV during breastfeeding and referral to ongoing HIV prevention and treatment programmes thereafter.

The key elements of the Global Plan include ensuring that:

• All women, especially pregnant women, have access to quality life-saving HIV prevention and treatment services—for themselves and their children.
• The rights of women living with HIV are respected and women, families and communities are empowered to fully engage in ensuring their own health and, especially, the health of their children.
• Adequate resources—human and financial—are available from both national and international sources in a timely and predictable manner while acknowledging that success is a shared responsibility.
• HIV, maternal health, newborn and child health and family planning programmes work together, deliver quality results and lead to improved health outcomes.
• Communities, in particular women living with HIV, are enabled and empowered to support women and their families to access the HIV prevention, treatment and care that they need.
• National and global leaders act in concert to support country-driven efforts and are held accountable for delivering results.

The plan also includes a detailed timetable for action at community, national, regional and global levels to ensure rapid progress towards elimination of new HIV infections in children by 2015 and keeping their mothers alive.

About the Global Plan

This Global Plan provides the foundation for country-led movement towards the elimination of new HIV infections among children and keeping their mothers alive. The Global Plan was developed through a consultative process by a high level Global Task Team convened by UNAIDS and co-chaired by UNAIDS Executive Director Michel Sidibé and United States Global AIDS Coordinator Ambassador Eric Goosby. It brought together 30 countries and 50 civil society, private sector, networks of people living with HIV and international organizations to chart a roadmap towards achieving this goal by 2015.

This plan covers all low- and middle-income countries, but focuses on 22 countries ^[1] with the highest estimate of HIV-positive pregnant women. Exceptional global and national efforts are needed in these countries that are home to nearly 90% of pregnant women living with HIV in need of services. Intensified efforts are also needed to support countries with low HIV prevalence and concentrated epidemics to reach out to all women and children at risk of HIV. The Global Plan supports and reinforces the development of costed, country-driven national plans.

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.

PEPFAR

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is the U.S. Government initiative to help save the lives of those suffering from 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. Learn more at www.pepfar.gov.

^[1] Angola, Botswana, Burundi, Cameroon, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Ethiopia, Ghana, India, Kenya, Lesotho, Malawi, Mozambique, Namibia, Nigeria, South Africa, Uganda, United Republic of Tanzania, Swaziland, Zambia and Zimbabwe.

First Ladies join forces to call for integration of HIV and maternal, newborn and child health programmes at special event during United Nations High Level Meeting on AIDS

(Left to Right): Michel Sidibé, Executive DIrector of UNAIDS; HE Mrs. Azeb Mesfin, First Lady of Ethiopia; Mrs. Ban Soon-taek, Spouse of Secretary General of the United Nations; Dr. Bun Rany Hun Sen, Cambodia.
Credit: UNAIDS/B. Hamilton

NEW YORK/GENEVA, 8 June 2011—Thirty First Ladies from Africa, Asia, Latin America and the Caribbean gathered at a special event in New York to mobilize support around achieving the Joint United Nations Programme on HIV/AIDS’ (UNAIDS) vision of Zero new HIV infections among children by 2015. The event was held on the opening day of the UN High Level Meeting on AIDS which is taking place in New York from 8-10 June.

Mrs Ban Soon-taek, wife of the United Nations Secretary-General;  Mrs Azeb Mesfin, First Lady of Ethiopia and President of the Organization of African First Ladies Against HIV/AIDS; and Mr. Michel Sidibé, Executive Director of UNAIDS co-hosted the New York event. 

Around 1,000 babies are infected with HIV each day, 90% of whom are in countries in sub-Saharan Africa. HIV is also the leading cause regarding mortality among women of reproductive age in developing countries. The First Ladies agreed to advocate for comprehensive and integrated access to maternal and child health services that include services to prevent HIV transmission among infants and which keep mothers and children healthy. 

Gender inequality, gender violence, discrimination and inequitable laws prevent pregnant women from accessing HIV testing and counselling, prevention, treatment and support services. “Women and girls must be at the centre of the AIDS response,” said Michel Sidibé. “When women protect themselves from HIV, they protect a whole new generation from HIV.”

More than 2 million children worldwide are living with HIV, mostly in sub-Saharan Africa. In Western Europe only 1,400 children are living with HIV, highlighting the global injustice of unequal access to maternal and child health services and the urgent need to increase access to HIV services for pregnant women in low- and middle-income countries.

“If women around the world are not involved in facing the challenge of preventing mother-to-child transmission of HIV, we cannot win. If we all play our part, we cannot fail.” said Mrs Mesfin.

In recent years, a number of countries have made great strides in reducing the rate of new HIV infections among children and globally in 2009, new HIV infections among children dropped by 25%.

“The fact that, in still too many places, HIV positive women are denied the right to give birth to healthy babies is a global injustice that we can end by 2015,” said Mrs Ban.

On return to their respective countries, the First Ladies agreed to advance ten action steps to ensure that children are born free from HIV and to promote lifesaving HIV services for women and children. These include supporting efforts to; increase the number of centres providing free maternal, newborn and child health services, including treatment to prevent the transmission of HIV from mothers to children; strengthen sexual and reproductive health programs for adolescents living with HIV; ensure meaningful engagement of people living with HIV; and promote zero tolerance for stigma and discrimination against people living with HIV.

(Left to Right): United Nations Secretary-General Ban Ki-moon, President of Rwanda Paul Kagame, United States Global AIDS Coordinator Ambassador Eric Goosby, President of the General Assembly Joseph Deiss at the Heads of State event - AIDS, Health, and Development, held at UN Headquarters, NYC, on June 8, 2011
Credit: UNAIDS/B.Hamilton

NEW YORK/GENEVA, 8 June 2011­­—More than 20 Heads of State and Government have come together at a special event focusing on leadership, cooperation and country ownership in the response to HIV. The event, attended by close to 400 people, was held during the United Nations General Assembly High Level Meeting on AIDS to renew commitment and identify opportunities in scaling up the HIV response, improving health and achieving the 2015 Millennium Development Goals.

The President of Rwanda, Paul Kagame, hosted the debate which outlined ways of accelerating action to help countries move closer towards universal access to HIV prevention, treatment, care and support.

He outlined three main areas as key to the success of the AIDS response: leadership, ownership and collaboration. “Not a single country, not a single individual, business or entity can win this struggle alone,” he said. “Once the leadership and commitment is there in any country and any community, results begin to show.”  

The need to increase access to services for people most vulnerable to HIV and respect for human rights was central to the discussions. Strong and visionary leadership combined with commitment and global solidarity around HIV were underlined as essential to moving the response forward.

“We can bring HIV deaths and new HIV infections to zero,” said United Nations Secretary-General Ban Ki-moon. “Our targets may seem ambitious but they are achievable if we are united.”

Leaders at the event also looked to the future of the HIV response and the importance of investing in youth as the leaders of tomorrow and encouraging their full engagement in the AIDS response.

“If we want to transform the response, we have to bring a new agenda for the future,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “This will only be achieved if we engage young people to lead a new social movement around AIDS and ensure a sustainable response.”

The speakers stressed the need to overcome the challenges to sustainable and predictable financing. In a report launched ahead of the High Level Meeting on AIDS, UNAIDS outlined that US$ 22 billion will be needed by 2015 to halve new HIV infections and expand access to HIV treatment. However, the report also revealed that international funding for HIV had declined from 2009 to 2010.

“What we need is resources, best policy, and law to ensure and protect the rights of people living with HIV,” said Ms Anandi Yuvuarj, Regional Coordinator of the International Community of Women Living with HIV. “Everyone must have access to HIV prevention, treatment, care and support, particularly people most vulnerable to HIV.”

Speakers emphasized the need for systematic improvement of the efficiency and effectiveness of existing AIDS and health spending, as well as the importance of ensuring the best value for money through effective and efficient HIV programming. In addition, they discussed the need for countries to look for new streams of revenue from domestic, regional and international sources.

Success in South-South cooperation efforts were discussed as an effective way of finding new paradigms of development and sharing innovation within regions for an accelerated response to HIV.

Leaders attending the event pledged to increase efforts to improve the effectiveness, efficiency and sustainability of their national AIDS responses to accelerate progress towards achieving universal access to HIV prevention, treatment, care and support services.

Principal actors in the AIDS movement join world leaders at critical crossroads

(Left to Right): Interpreter; Tetyana Afanasiadi, Human Rights and Community Activist; Paul De Lay, UNAIDS Deputy Executive Director, Programmes; Joseph Deiss, President of the UN General Assembly; Jean-Victor Nkolo, Spokesperson, UN General Assembly President at Opening Press Conference on June 7, 2011 at UN Headquarters, NYC. Credit: UNAIDS/B.Hamilton

NEW YORK, 7 June 2011—More than 3000 people will come together at the United Nations in New York tomorrow for the UN General Assembly High Level Meeting on AIDS. The meeting, which runs from 8-10 June, will provide an opportunity to take stock of the progress and challenges of the last 30 years and shape the future AIDS response.

The High Level Meeting on AIDS is taking place 10 years after the historic 2001 United Nations Special Session on HIV/AIDS, and the 2006 signing of the Political Declaration where UN Member States committed to moving towards universal access to HIV prevention, treatment, care and support. More than 30 Heads of State, Government and Vice Presidents are expected to attend the meeting which will include official plenary and five panel sessions along with 40 individual side events. On the final day of the High Level Meeting on AIDS, UN Member States are expected to adopt a declaration which will guide country responses to HIV over the next five years.

The opening and closing plenary sessions will be presided over by Joseph Deiss, President of the United Nations General Assembly. He said, “The momentum around this meeting is unprecedented and promises to make this an historic event. We are looking to UN Member States to make bold commitments which will help us reach our shared goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths.”  

Although some countries are still struggling to reach their universal access targets, many have made significant strides in responding to their epidemics. Twenty-two countries have achieved universal access to services which prevent mother-to-child transmission of HIV.

As well as country-led successes, considerable progress has been made in the global response to HIV since the 2001 UN Special Session on HIV/AIDS. The rate of new HIV infections has decreased by 25% in the last 10 years, deaths have reduced by 20% in the last 5 years and 6.6 million people are now accessing antiretroviral therapy, compared to just a few thousand in 2001. Progress has also been made in breaking down barriers to stigma and discrimination and in removing punitive laws such as travel restrictions for people living with HIV.

“Inequity, discrimination and laws against people living with or at risk of HIV continue to block access to HIV services for people most in need,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “We need a response to HIV that is grounded in human rights and one which promotes equality and equity. Achieving this will open the way to a world free from HIV.”

UNAIDS recently reported that despite successes in HIV  prevention and treatment, more people than ever before were living with the virus, 34 million according to latest estimates. They also reported that international funding for AIDS had declined.

“If resources go down—people most in need will suffer,” said Tetyana Afanasiadi, Human Rights activist from Ukraine. "The lives of millions of people directly depend on the resources allocated. Today I am alive thanks to antiretroviral therapy and opioid substitution therapy which I had access to through prevention and support programmes. Reducing of the resources allocated to those programs is a direct threat for me and for millions of people around the world."

The High Level Meeting on AIDS is taking place from the 8-10 June at the United Nations in New York. It will bring together UN Member States, International Organisations, Civil Society, people living with HIV and public and private sector partners.

For more information and to see the full program and access feature stories, webcasts, videos, media information and related documents please visit the official website at: http://www.un.org/en/ga/aidsmeeting2011/

As the world marks 30 years of AIDS, UNAIDS estimates 34 million [30.9 million–36.9 million] people are living with HIV and nearly 30 million [25 million–33 million] people have died of AIDS-related causes since the first case of AIDS was reported on 5 June 1981

(From left): Michel Sidibé, UNAIDS Executive Director; Christina Rodriguez, Co-Founder, Smart Youth; Asha-Rose Migiro, Deputy Secretary-General at Press conference on AIDS at 30: Progress of nations, held at UN Headquarters, New York City on June 3, 2011.
Credit: UNAIDS/B. Hamilton

NEW YORK/GENEVA, 3 June 2011—About 6.6 million people were receiving antiretroviral therapy in low- and middle-income countries at the end of 2010, a nearly 22-fold increase since 2001, according to a new report AIDS at 30: Nations at the crossroads, released today by the Joint United Nations Programme on HIV/AIDS (UNAIDS).

A record 1.4 million people started lifesaving treatment in 2010—more than any year before. According to the report, at least 420 000 children were receiving antiretroviral therapy at the end of 2010, a more than 50% increase since 2008, when 275 000 children were on treatment.

“Access to treatment will transform the AIDS response in the next decade. We must invest in accelerating access and finding new treatment options,” said Michel Sidibé, UNAIDS Executive Director. “Antiretroviral therapy is a bigger game-changer than ever before—it not only stops people from dying, but also prevents transmission of HIV to women, men and children.”

His statement follows the recent HPTN052 trial results which found that if a person living with HIV adheres to an effective antiretroviral regimen, the risk of transmitting the virus to his or her uninfected sexual partner can be reduced by 96%.

“Countries must use the best of what science can offer to stop new HIV infections and AIDS-related deaths,” said UN Deputy Secretary-General Asha-Rose Migiro. “We are at a turning point in the AIDS response. The goal towards achieving universal access to HIV prevention, treatment, care and support must become a reality by 2015.”

HIV prevention efforts showing results

According to the report, the global rate of new HIV infections declined by nearly 25% between 2001 and 2009. In India, the rate of new HIV infections fell by more than 50% and in South Africa by more than 35%; both countries have the largest number of people living with HIV on their continents.

The report found that in the third decade of the epidemic, people were starting to adopt safer sexual behaviors, reflecting the impact of HIV prevention and awareness efforts. However, there are still important gaps. Young men are more likely to be informed about HIV prevention than young women. Recent Demographic Health Surveys found that an estimated 74% of young men know that condoms are effective in preventing HIV infection, compared to just 49% of young women.

In recent years, there has been significant progress in preventing new HIV infections among children as increasing numbers of pregnant women living with HIV have gained access to antiretroviral prophylaxis during pregnancy, delivery and breastfeeding. The number of children newly infected with HIV in 2009 was 26% lower than in 2001.

About 115 low- and middle-income countries are providing optimal treatment regimens for pregnant women living with HIV as recommended by the World Health Organization (WHO). There are 31 countries that still use sub-optimal regimens in many of their HIV prevention programmes. UNAIDS urges all countries using sub-optimal regimens to revise their treatment guidelines and make the transition to optimal WHO recommended regimens.

AIDS is not over—significant challenges remain

According to the latest estimates from UNAIDS, 34 million [30.9 million–36.9 million] people were living with HIV at the end of 2010 and nearly 30 million [25 million–33 million] have died from AIDS-related causes since AIDS was first reported 30 years ago.

Despite expanded access to antiretroviral therapy, a major treatment gap remains. At the end of 2010, 9 million people who were eligible for treatment did not have access. Treatment access for children is lower than for adults—only 28% of eligible children were receiving antiretroviral therapy in 2009, compared to 36% coverage for people of all ages.

While the rate of new HIV infections has declined globally, the total number of HIV infections remains high, at about 7000 per day. The global reduction in the rate of new HIV infections hides regional variations. According to the report, above-average declines in new HIV infections were recorded in sub-Saharan Africa and in South-East Asia, while Latin America and the Caribbean experienced more modest reductions of less than 25%. There has been an increase in the rate of new HIV infections in Eastern Europe and in the Middle East and North Africa.

In virtually all countries, HIV prevalence among populations at increased risk of HIV infection—men who have sex with men, people who inject drugs, sex workers and their clients, and transgender people—is higher than among other populations. Access to HIV prevention and treatment for populations at higher risk of infection is generally lower due to punitive and discriminatory laws, and stigma and discrimination. As of April 2011, 79 countries, territories and areas criminalize consensual same-sex relations; 116 countries, territories and areas criminalize some aspect of sex work; and 32 countries have laws that allow for the death penalty for drug-related offences.

According to the report, gender inequalities remain a major barrier to effective HIV responses. HIV is the leading cause of death among women of reproductive age, and more than a quarter (26%) of all new global HIV infections are among young women aged 15-24.

AIDS resources declining

According to the report, investments in the HIV response in low- and middle-income countries rose nearly 10-fold between 2001 and 2009, from US$ 1.6 billion to US$ 15.9 billion. However, in 2010, international resources for HIV declined. Many low-income countries remain heavily dependant on external financing. In 56 countries, international donors account for at least 70% of HIV resources.

“I am worried that international investments are falling at a time when the AIDS response is delivering results for people,” said Mr Sidibé. “If we do not invest now, we will have to pay several times more in the future.”

A 2011 investment framework proposed by UNAIDS and partners found that an investment of at least US$ 22 billion is needed by the year 2015, US$ 6 billion more than is available today. When these investments are directed towards a set of priority programmes that are based on a country’s epidemic type, the impact is greatest. It is estimated that the return on such an investment would be 12 million new HIV infections averted and 7.4 million AIDS-related deaths averted by the year 2020. The number of new infections would decline from about 2.6 million in 2009 to about 1 million in 2015.

Perspectives on AIDS from leaders around the world

The report features commentaries from 15 leaders in the global AIDS response, including South Africa’s President Jacob Zuma, former United States President Bill Clinton, former President of Brasil Luiz Inácio Lula da Silva, the President of Mali, Amadou Toumani Touré, and Jean Ping, Chairperson of the African Union Commission. The commentaries cover a range of areas, such as AIDS funding, South-South cooperation, youth leadership, the empowerment of women, key affected populations, injecting drug use, human rights, stigma and discrimination and systems integration.

Young people leading the HIV prevention revolution

AIDS at 30: Nations at the crossroads also includes an article on a recent event held on Robben Island, South Africa, where Archbishop Desmond Tutu, Co-chair of the UNAIDS High Level Commission on HIV Prevention, passed the baton of leadership in the AIDS response to a new generation of young leaders.

According to the report, some of the most important HIV prevention successes have been led by young people. Data indicate that young people in many heavily affected countries are increasingly adopting safer sexual behaviours.

Charity event spotlights HIV epidemics in Eastern Europe and Central Asia

VIENNA, 23 May 2011—Celebrities and influential leaders in the global AIDS response gathered at Vienna’s City Hall on 21 May for the 2011 Life Ball, Europe’s largest annual AIDS charity event. This year’s Life Ball commemorated 30 years of AIDS and focused on the rapidly growing HIV epidemics in Eastern Europe and Central Asia.

“The Life Ball is not only about celebrating life, but also about creating a social movement to stop stigma and discrimination,” said Michel Sidibé, Executive Director of UNAIDS, speaking at a press conference on 21 May. “Gery (Keszler) and AIDS LIFE are a voice and force of change in this movement,” he added.

Mr Sidibé was joined at the press conference by Gery Keszler, co-founder and Chairman of AIDS LIFE, a non-profit organization that organizes the Life Ball. Other speakers included singer Janet Jackson representing amfAR, clothing designers Dean and Dan Caten of Dsquared2, and Hollywood actress Brooke Shields.

Before the opening ceremony of Life Ball, a number of eminent guests attended the AIDS Solidarity Gala, a fundraising dinner co-hosted by UNAIDS and AIDS LIFE under the patronage of the President of the Republic of Austria, Heinz Fischer. Proceeds from the event will be used, in part, to support UNAIDS programmes in the Russian Federation and Ukraine.

Over the past decade, the number of people living with HIV in Eastern Europe and Central Asia nearly tripled—from an estimated 530 000 in 2000 to 1.4 million in 2009. The Russian Federation and Ukraine together account for nearly 90% of newly reported HIV infections in the region. Though the epidemics in Eastern Europe and Central Asia are mainly concentrated among people who inject drugs, sex workers and men who have sex with men, these populations have limited access to HIV services.

At the Life Ball opening ceremony, 30 international personalities presented milestones in the epidemic’s 30-year history. The UNAIDS Executive Director highlighted the founding of UNAIDS in 1996 and the “glimmer of hope” that same year when combination antiretroviral therapy proved effective in keeping people living with HIV alive.

Former United States President Bill Clinton noted in his remarks that substantial price reductions in antiretroviral medicines since the year 2002 had greatly expanded access to treatment for millions of people. However, he said, a major treatment gap remains: “Ten million people in poor countries still need to be on (antiretroviral) medicines. If you want to cut the infection rate, if you want to cut the death rate, we have to finish the job.”

Every year, the Life Ball recognizes the work and dedication of pioneers in the AIDS response through the “Crystal of Hope” award. This year’s award of 100 000 EUR was presented to Anya Sarang, President of the Andrey Rylkov Foundation for Health and Social Justice, a non-governmental organization based in the Russian Federation that advocates for the human rights of people who use drugs.