Low- and middle-income countries (LMICs) are becoming increasingly interested in developing the local production of quality-assured medicines and other health technologies. This is due to its potential to assist LMICs in improving access to quality-assured medicines and other health technologies, achieving universal health coverage (UHC), and reaching the health-related targets and broader developmental objectives of the Sustainable Development Goals. 

The term "Local Production" can be defined in various ways. For the purposes of this statement, "local" refers to the geographical location, i.e. occurring in the country or region, and "production" — in regard to pharmaceuticals for example — refers to all activities along the pharmaceutical manufacturing value chain. Within the context of the public health agenda, promoting local production requires a holistic approach that considers policy coherence, regulatory systems strengthening, access to finance for sustainable production, a careful assessment of the business case, development of skilled human resources, access to technology for production and needs-based innovation, creation of investment incentives and other factors, to enable manufacturers to comply with international quality standards, be competitive and engage in sustainable manufacturing. 

The Global Strategy and Plan of Action on Public Health Innovation and Intellectual Property, adopted at the 61st World Health Assembly (WHA) in 2008, cites local production and related transfer of technology as one of the elements to promote innovation, build capacity and improve access. More recently, at the 71st WHA in May 2018, Member States highlighted the importance of local production in the context of the global shortage of, and access to, medicines and vaccines. 

A number of international organizations have also expressed their desire to source quality-assured medical products closer to the point of use. The pull effect of significant market opportunities can be a major factor in driving progress, particularly when aligned with partnerships in supporting the development of the industry and health workforce. 

Strengthening local production is a cross-cutting endeavour. Sustainable local production requires effective multisectoral collaboration in order to promote enabling investment, legal and technical environments. In many LMICs, the capacity of both local manufacturers to produce and supply quality medical products and the national regulatory authority to ensure quality, efficacy and safety is insufficient. Any supply of medical products — both through local production and imports — should go hand in hand with the strengthening of regulatory capacities in order to achieve compliance with international GxP[1] and other quality standards. Close partnership between the international community and LMICs is essential to support countries and regions to build the capacities, institutions and industries that can sustain the progress made. 

With the globalization of the pharmaceutical industry and the variety of country contexts, there is no "one-size fits-­all" approach in promoting local production of quality-assured medicines and other health technologies. However, in recognition of the important role local production can play in improving access to quality-assured medical products and achieving UHC, the undersigned organizations aim to work in a collaborative, strategic and holistic manner in partnership with governments and other relevant stakeholders to strengthen local production. We are committed to contribute based on our respective organizations' expertise and mandate.

Launched in Geneva on 24 May 2019

Dr Tedros Adhanom Ghebreyesus, Director-General, WHO

Mr Li Yong, Director-General, UNIDO

Dr Mukhisa Kituyi, Secretary-General, UNCTAD

Ms Gunilla Carlsson, Executive Director, a.i., UNAIDS

Ms Henrietta H. Fore, Executive Director, UNICEF

Mr Peter Sands, Executive Director, The Global Fund

[1] Good manufacturing practices, good clinical practices, etc. ^

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 24 May 2019 — UNAIDS deeply regrets the decision of the High Court of Kenya to maintain key provisions of Sections 162 and 165 of the Kenyan Penal Code. Those provisions criminalize certain private sexual acts and lead to discrimination and violence against lesbian, gay, bisexual and transgender (LGBT) people in Kenya.

“Today’s ruling is a missed opportunity for Kenya to uphold human rights and to restore privacy, respect and dignity to the lesbian, gay, bisexual and transgender (LGBT) community,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “I share the deep disappointment and frustration felt by LGBT people in Kenya and I want to assure them of UNAIDS’ continued support in reaching justice and equality for all.”

UNAIDS has been working together with the National Gay and Lesbian Human Rights Coalition and other LGBT groups as well as civil society organizations and other partners to promote a more enabling legal environment in Kenya.

There are indications that the judgement will be appealed.

Criminalization of consensual same-sex sexual relations is a violation of human rights and legitimizes stigma, discrimination and violence against LGBT people. Criminalization stops people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV.

“The failure to decriminalize consensual same-sex relations will undermine Kenya’s aim of reaching universal health coverage,” said Ms Carlsson.

Globally, the risk of acquiring HIV is 28 times higher among gay men and other men who have sex with men than among the general population and 13 times higher for transgender women. Prohibitive legal and policy environments and a lack of tailored services for key populations increase their vulnerability to HIV. UNAIDS urges countries to ensure the full respect of the human rights of all people, regardless of their sexual orientation, through repealing laws that prohibit sex between consenting adults in private, enforcing laws to protect people from violence and discrimination, addressing homophobia and transphobia and ensuring that crucial health services are made available.

“We need to move towards a more humane, compassionate and rights-based approach towards same-sex relations worldwide. This decision entrenches unjust laws that criminalize same-sex sexual relations and block people’s access to essential services, including to health care,” said Ms Carlsson.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 18 May 2019—UNAIDS warmly welcomes the appointment by the United Nations Secretary-General of Gunilla Carlsson as Executive Director, a.i., of UNAIDS. Ms Carlsson joined UNAIDS in February 2018 as the Deputy Executive Director for Management and Governance and Assistant Secretary-General of the United Nations.

Ms Carlsson provides strategic direction to management functions and is leading UNAIDS’ work in promoting effective governance of the Joint Programme and ensuring that UNAIDS continues to serve as a pathfinder for United Nations reform.

“It is a great honour for me to serve UNAIDS as acting Executive Director at such a pivotal time for the Joint Programme, the United Nations and global health. The AIDS response cannot afford to be at a standstill,” said Ms Carlsson. “Human rights, gender equality and diversity must be at the centre of all we do. I look forward to continuing to work hand in hand with communities, staff and partners around the globe to achieve the 2020 targets and ultimately end AIDS.”

Prior to joining UNAIDS, Ms Carlsson served as an elected member of the Swedish Parliament and as the Minister for International Development Cooperation. She also served as an elected member of the European Parliament. Ms Carlsson was the Chair of the Swedish-initiated Commission on Climate Change and Development. She was appointed by United Nations Secretary-General Ban Ki-moon to a high-level panel for global sustainability ahead of the United Nations Conference on Sustainable Development and served on the United Nations High-Level Panel on the Post-2015 Development Agenda. Ms Carlsson is an affiliated member of the board of Gavi, the Vaccine Alliance, and has served as its Vice-Chair since June 2017.

A strong leader in global health and development, Ms Carlsson has expertise in policy development on foreign policy, human rights, employment, research, security and defence. She also has extensive experience in the development and implementation of policy reforms and efficiency and accountability in complex organizations, including the private sector.

The process for the nomination of the next UNAIDS Executive Director is ongoing. The Executive Director will be appointed by the United Nations Secretary-General based on recommendations made by the Committee of Cosponsoring Organizations. A search committee established by the UNAIDS Programme Coordinating Board (PCB) and chaired by Yury Ambrazevich, Ambassador Extraordinary and Plenipotentiary Permanent Representative, Permanent Mission of Belarus to the United Nations Office and other International Organizations in Geneva, is preparing a shortlist of candidates for discussion by the PCB.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Discriminatory laws drive key populations out of reach of critical health and social services

GENEVA, 16 May 2019—Ahead of the International Day against Homophobia, Transphobia and Biphobia (IDAHOT), on 17 May, UNAIDS is calling on all countries to remove discriminatory laws against lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

Stigma towards key populations—gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs and prisoners and other incarcerated people—is reinforced by criminal laws. These in turn fuel violence, exploitation and a climate of fear, hindering efforts to make HIV services available to the people who need them.

“We all have a moral and legal obligation to remove discriminatory laws and enact laws that protect people from discrimination,” said Gunilla Carlsson, UNAIDS Executive Director, a.i. “To end the AIDS epidemic, people need to be protected from harm. We need justice and equality for all.”

More than 65 countries criminalize same-sex sexual relations, including at least eight that impose the death penalty. Globally, gay men and other men who have sex with men are around 28 times more likely to acquire HIV than the general population and are much less likely to access HIV services. In 2017, gay men and other men who have sex with men accounted for 18% of new HIV infections worldwide.

“It is critically important that we create a world where all people can access the health and social services they need without the threat of violence and discrimination. Universal health coverage means reaching all people―sexual and gender minorities have the same right to health as everyone else,” said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization.

Transgender people, who account for an estimated 0.1–1.1% of the global population, often face stigma, discrimination and social rejection in their homes and communities. Discrimination, violence and criminalization prevent transgender people from accessing the HIV services they need to stay healthy. It is estimated that transgender women are 13 times more likely to acquire HIV than other adults of reproductive age and that 16.5% of transgender women are living with HIV.

“Justice and protection for all are central to driving progress on the 2030 Agenda for Sustainable Development and the Sustainable Development Goals. Enacting and enforcing non-discriminatory laws and policies, repealing punitive laws and ensuring access to justice for all are critical to delivering on the commitment to leave no one behind,” said Achim Steiner, Administrator of the United Nations Development Programme.

UNAIDS joins with the United Nations Secretary-General and the United Nations High Commissioner for Human Rights in calling for the decriminalization of LGBTI people and for LGBTI people to be protected from violence and discrimination and to have full access to health and other social services.

IDAHOT, a worldwide celebration of sexual and gender diversity, is commemorated annually on 17 May.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS extends its heartfelt thanks to the Executive Director of UNAIDS for his outstanding contribution to the global response to HIV

GENEVA, 8 May 2019—UNAIDS congratulates Michel Sidibé on his appointment as the Minister of Health and Social Affairs of Mali. Mr Sidibé served as the Executive Director of UNAIDS for more than 10 years after being appointed as the second Executive Director of UNAIDS and Under-Secretary-General of the United Nations in January 2009.

A true champion for a people-centred approach to health and development and a strong advocate for social justice, Mr Sidibé has made a remarkable contribution to the AIDS response, helping to save and improve the lives of millions of people around the world.

Since Mr Sidibé took up his position as Executive Director of UNAIDS, there has been a 170% increase in the number of people accessing antiretroviral therapy, from 8 million in 2010 to 21.7 million in 2017. There has also been a 45% drop in AIDS-related deaths—from 1.7 million in 2008 to 940 000 in 2017—and new HIV infections have been reduced by 22%—from 2.3 million in 2008 to 1.8 million in 2017.

“It has been an honour for me to serve UNAIDS as its Executive Director and contribute to the global AIDS response,” said Mr Sidibé. “I would like to thank all UNAIDS partners and staff and especially community members affected by HIV, who have made our successes possible. With their steadfast commitment and resolve, we have been able to bring life-saving services to millions of people. If we stay the course and do the right thing, always—putting people first and delivering results for people—we will succeed in ending AIDS.”   

Mr Sidibé’s vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths, and his tireless advocacy to ensure that all people have access to health services, have kept HIV at the top of the global agenda. His calls for global solidarity and shared responsibility have seen resources for HIV increase by more than one third, from US$ 15.9 billion in 2010 to US$ 20.6 billion in 2017 in low- and middle-income countries. His advocacy for country ownership helped to ensure that 56% of HIV resources in low- and middle-income countries now come from domestic sources, promoting long-term sustainable responses to HIV.  

His commitment to the concept of universal access to HIV prevention, treatment, care and support meant that the goal of reaching 15 million people living with HIV with antiretroviral therapy by 2015 was achieved seven months ahead of schedule. His focus on the most vulnerable and marginalized has given a voice to the voiceless, including gay men and other men who have sex with men, sex workers, transgender people, people who inject drugs, prisoners and other incarcerated people, and people on the move.

A strong believer that no child should be born with HIV, his leadership in calling for the elimination of new HIV infections among children contributed to a 60% reduction in new paediatric HIV infections since 2009 in the 21 priority countries of the Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive.

During his tenure, Mr Sidibé spearheaded two of the most successful United Nations General Assembly political declarations on HIV, which named key populations and included ambitious regional and global Fast-Track Targets. He has successfully advocated to take AIDS out of isolation, encouraging a holistic human-rights based approach to include HIV as part of sexual and reproductive health and integrate responses to interlinked diseases, including tuberculosis and cervical cancer.

“I would like to thank United Nations Secretary-General António Guterres for his long-standing support to UNAIDS,” said Mr Sidibé. “I am also grateful to the United Nations system for allowing me to develop my career, from when I started as a short-term junior professional in the Democratic Republic of the Congo for the United Nations Children’s Fund in 1987 to becoming Under-Secretary-General of the United Nations some 20 years later—I am eternally thankful for the opportunities I have been given.”

The countries most affected by HIV have rallied behind Mr Sidibé’s call to reach the 90–90–90 targets, whereby 90% of people living with HIV know their status, 90% of people who know their status are accessing treatment and 90% of people on treatment have a suppressed viral load. Some 75% of all people living with HIV now know their HIV status, and focus has been increased on HIV testing and expanding antiretroviral therapy.

His call with partners to establish an HIV prevention coalition led to a new HIV Prevention 2020 Road Map to strengthen and sustain political commitment for primary HIV prevention and establish accountability for delivering services at scale in order to stop new HIV infections.

His commitment to improving the lives of women and girls galvanized action for Security Council resolution 1983 in 2011, which focused on ensuring access to HIV prevention and treatment for women and girls, on the prevention of, and response to, sexual violence related to conflict and on post-conflict peacebuilding.

Mr Sidibé’s strong belief in the power of communities has paved the way for community-led responses to HIV, which have proved to be a gamechanger in increasing the uptake of HIV services and in creating support networks to improve adherence to treatment and quality of life for people living with HIV.  

His undeterred commitment, dedication and passion has allowed Mr Sidibé to engage heads of state, people living with HIV, affected communities, donors, first ladies, parliamentarians, Mayors, civil society, scientists, young people and HIV programme leaders alike, bringing everyone around the same table to galvanize action to end AIDS by developing focused and sustainable solutions that leave no one behind.

Mr Sidibé has been an inspirational leader of UNAIDS and for the global response to HIV, and UNAIDS extends its heartfelt thanks for his years of dedicated service. Mr Sidibé will take on his new role as Minister of Health and Social Affairs of Mali with immediate effect and will be replaced ad interim by UNAIDS Deputy Executive Director, Management and Governance, Gunilla Carlsson.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Results from a large-scale European study among serodiscordant gay couples show that adherence to effective treatment prevents transmission of HIV

GENEVA, 3 May 2019—UNAIDS warmly welcomes the PARTNER2 study results that show that HIV transmission does not occur when a person living with HIV is on effective antiretroviral therapy. The study, which enrolled nearly 1000 gay couples in which one partner was living with HIV and the other was not, showed that where the person living with HIV was taking effective antiretroviral therapy and had a suppressed viral load, there was no HIV transmission within the couple.  

“This is excellent news. People living with HIV now have confirmation that provided they take treatment regularly and are virally suppressed, they are not infectious,” said Michel Sidibé, Executive Director of UNAIDS. “This gives a strong, positive message that will help to reduce the stigma around HIV and improve the self-esteem and self-confidence of people living with HIV.”

By the end of the eight-year study, 15 people did become infected with HIV. Virus screening showed that none of the new infections were linked to the HIV-positive partners in the study, but came from a sexual partner outside of the couple. The researchers estimate that within the study, which took place across 14 European countries, around 472 HIV transmissions were averted over the eight years.

UNAIDS hopes that the results will encourage more people to get tested early and take effective treatment. In recent years there has been a huge scale-up in the roll-out and uptake of antiretroviral therapy. In 2017, of the 36.9 million people living with HIV, 59% (21.7 million) had access to treatment and 47% were virally suppressed. Concerted efforts are needed to ensure that all people living with HIV have access to and adhere to effective antiretroviral therapy.

A large proportion of HIV transmission still occurs before people know their HIV status. The risk of HIV transmission is highest in the weeks and months immediately after infection, when the viral load is high and the person who has contracted the virus is unlikely to know their status, is not on treatment and is not virally suppressed. This demonstrates the critical importance of continuing HIV prevention efforts, including condom use and pre-exposure prophylaxis—medicine taken by an HIV-negative person to prevent HIV.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 8 April 2019—UNAIDS welcomes the announcement that David Malpass will be the new President of the World Bank, beginning his five-year term on Tuesday, 9 April 2019.

“UNAIDS’ work with the World Bank to address the interrelated challenges of HIV, inequality and extreme poverty is critical,” said Michel Sidibé, Executive Director of UNAIDS. “I warmly welcome the appointment of David Malpass as the new President of the World Bank and look forward to a continued close collaboration towards ending AIDS as a public health threat, increasing economic opportunities and building shared prosperity.”

The World Bank is one of UNAIDS’ 11 Cosponsors and helps countries to provide HIV prevention, care and treatment services by offering financing, specialized technical support and knowledge. The World Bank is the lead agency for support to strategic planning, including costed and prioritized multisectoral national AIDS plans and analysis to underpin evidence-informed policies.

UNAIDS looks forward to continuing to work closely with the World Bank and with Mr Malpass in his new role as President. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

GENEVA, 4 April 2019—UNAIDS and UNFPA, the United Nations sexual and reproductive health agency, are seriously concerned by new criminal law provisions that came into force yesterday, 3 April 2019, in Brunei Darussalam. The provisions, which impose the death penalty for same-sex sexual activity, adultery and for having a child outside of marriage, breach a number of international human rights norms, including the right to be free from torture and from cruel, inhumane or degrading treatment. The provisions will have a significant negative impact on overall health and well-being.  

“These extreme and unjustified punishments will drive people underground and out of reach of life-saving HIV treatment and prevention services,” said Michel Sidibé, Executive Director of UNAIDS. “I strongly urge Brunei Darussalam to suspend or repeal the amendments to the Syariah Penal Code and I offer UNAIDS’ support to ensure that laws are grounded in human rights, based on evidence and protect the most vulnerable.”

Laws that punish sexual orientation, same sex relations and reproductive health care are discriminatory, and have a disproportionate impact on women, creating barriers to accessing health information and services, which in turn increases vulnerability to HIV and other health concerns. Impeding access to sexual and reproductive health and rights, including HIV services, negatively affects public health.

“Every person, without any distinction on any grounds, has an equal right to live free from violence, persecution, discrimination and stigma of any kind. Human rights are universal. Cultural, religious and moral practices and beliefs, and social attitudes must not be invoked to justify human rights violations against any group regardless of gender or sexual orientation,” stated Natalia Kanem, Executive Director of UNFPA.

Criminalization of same-sex sexual conduct has been shown to increase stigma and give license to discrimination, violence and harassment. Evidence shows that where communities are criminalized, they are more vulnerable to violence, less likely to access necessary HIV and other health services, and less able to protect themselves against HIV infection. Criminalizing people also works against reaching the Sustainable Development Goals agreed by the United Nations General Assembly.     

UNAIDS and UNFPA are concerned by increasing conservative and discriminatory policies and rhetoric in a number of countries, which may potentially give rise to violence, stigma and discrimination against people on the basis of gender, gender identity and sexual orientation. Recent discussions with governments in the Asia–Pacific region and beyond have highlighted the need to put evidence-informed and human rights-based laws and policies in place. 

Last December, Brunei Darussalam called for more and better data on its key affected and higher-risk populations in order to ensure more effective outreach. The production of those data, which would help improve Brunei Darussalam’s health-care provisions for key affected and higher-risk populations, will be undermined by the Syariah Penal Code.

UNAIDS and UNFPA support the calls of the United Nations High Commissioner for Human Rights and the open letter of the five United Nations human rights mandate holders to suspend the implementation of the revised penal code and urge all governments to protect the human rights of all people. This includes repealing criminal laws against adult consensual sexual conduct and decisions on reproduction, implementing laws to protect all people from violence and discrimination and ensuring that adequate health services, including sexual and reproductive health services, are accessible, affordable and acceptable to address their needs.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNFPA

UNFPA is the United Nations sexual and reproductive health agency. Our mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. Learn more at www.unfpa.org.

SEATTLE/GENEVA, 6 March 2019—UNAIDS welcomes the results from the HPTN 071 (PopART) trial.  The results showed a 30% decline in new HIV infections where HIV prevention, including home-based HIV counselling and testing, was provided, as well as referral to HIV care and treatment for people testing positive for HIV according to country guidelines. The study took place between 2013 and 2018 and included 21 urban communities in Zambia and South Africa, covering a total population of 1 million people, the largest study of its kind.

“UNAIDS congratulates the PopART team on this important study, which clearly demonstrates the critical impact of community-based HIV prevention, testing and linkage to treatment,” said Michel Sidibé, Executive Director of UNAIDS. “It reinforces UNAIDS’ call for more community health-care workers across Africa, the need for increased investment in HIV prevention and treatment, including new and better tools and systems to deliver them. It also shows the urgent need to reach men and young people.”

There were three arms in the study. Arms A and B delivered the PopART package of HIV prevention, which includes annual household-based HIV counselling and testing, linkage to care at the local health centre for people living with HIV, follow-up visits to people living with HIV to ensure that they were linked to care and to support adherence to treatment, promotion of voluntary medical male circumcision for men who tested HIV-negative, services to prevent mother-to-child transmission of HIV, referral for treatment of sexually transmitted infections, provisions of condoms in the community and screening and referral for tuberculosis.

Arm A offered immediate initiation of antiretroviral therapy to people testing positive for HIV irrespective of CD4 count. Arm B offered antiretroviral therapy only to people who were eligible in accordance with the country guidelines—this was a CD4 count of 350 at the beginning of the trial, which moved to 500 and in 2016 treatment was offered to all people living with HIV, as in arm A. Arm C had no household intervention, but people did have access to HIV testing and treatment services in accordance with the country guidelines.

Both arms A and B reached the 90–90–90* targets overall. In arm B, HIV incidence declined by 30% compared to the basic standard of care offered by the countries involved in the study. In arm A incidence declined by just 7%, which, although not statistically significant, is surprising; ongoing transmission was also at a considerable rate (1.5%) in arm A. Further analysis is under way to help explain why the decline in incidence was not higher in arm A despite high viral suppression (viral suppression was 72% in arm A, 68% in arm B and 60% in arm C).

Subgroup analysis also showed that in both arm A and arm B antiretroviral therapy coverage was high in women older than 25 years and in men older than 40 years, but men and younger people had a much lower coverage. It also showed that men and younger people were much less likely to be virally suppressed. This emphasizes the importance of ensuring that 90–90–90 is reached at the country level but also that each population group reaches 90–90–90.

The impact of community-based access to testing, treatment and primary prevention in the trial is evident and supports UNAIDS’ focus on strengthening community platforms. UNAIDS promotes this work through the 90–90–90 initiative, the Fast-Track cities initiative and the Global HIV Prevention Coalition, a coalition convened by UNAIDS and the United Nations Population Fund to accelerate access to combination HIV prevention in settings with high HIV incidence. The work of the coalition includes a particular focus on young women and their male partners—groups that were found to require better access to services in the PopART trial.

UNAIDS underscores that there is still no single HIV prevention method that is fully protective against HIV. To end the AIDS epidemic, UNAIDS strongly recommends a combination of HIV prevention options. These include ensuring that all people living with HIV have immediate access to antiretroviral therapy, the correct and consistent use of male or female condoms, starting having sex at an older age, having fewer partners, voluntary medical male circumcision, and the use of pre-exposure prophylaxis for people at higher risk of HIV infection.

The results of the PopART trial were presented at the Conference on Retroviruses and Opportunistic Infections, taking place in Seattle, United States of America from 4-7 March 2019.

* By 2020, 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

SEATTLE/GENEVA, 5 March 2019—UNAIDS is greatly encouraged by the news that an HIV-positive man has been functionally cured of HIV. The man was treated by specialists at University College London and Imperial College London for advanced Hodgkin’s lymphoma in 2016 using stem cell transplants from a donor who carried a rare genetic mutation. Researchers report that HIV has been undetectable in the man since he stopped taking antiretroviral medicine 18 months ago.

“To find a cure for HIV is the ultimate dream,” said Michel Sidibé, Executive Director of UNAIDS. “Although this breakthrough is complicated and much more work is needed, it gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure. However, it also shows how far away we are from that point and of the absolute importance of continuing to focus HIV prevention and treatment efforts.”

Stem cell transplants are highly complex, intensive and costly procedures with substantial side-effects and are not a viable way of treating large numbers of people living with HIV. However, the results do offer a greater insight for researchers working on HIV cure strategies and highlight the continuing importance of investing in scientific research and innovation.

The result, reported at the Conference on Retroviruses and Opportunistic Infections in Seattle, United States of America, is one of only two cases of reported functional cures for HIV. The first was the case of the Berlin patient, Timothy Ray Brown, who received similar treatment for cancer in 2007.

There is currently no cure for HIV. UNAIDS is working to ensure that all people living with and affected by HIV have access to life-saving HIV prevention, treatment, care and support services. In 2017, there were 36.9 million people living with HIV and 1.8 million people became newly infected with the virus. In the same year, almost 1 million people died of AIDS-related illnesses and 21.7 million people had access to treatment. 

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.