Newest UN organization joins UNAIDS’ efforts to ensure greater access to HIV services for women and girls

GENEVA, 5 June 2012—The United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) is the eleventh United Nations body to join the Joint United Nations Programme on HIV/AIDS (UNAIDS) as a cosponsoring partner.

The official joining of UN Women as a UNAIDS Cosponsor, which was approved at UNAIDS’ board meeting today, will further strengthen the UNAIDS family’s work on gender equality and HIV and enhance collaboration with governments, international partners, women’s organizations and the women’s rights movement.

“UN Women is proud to join UNAIDS. We believe that the single most important strategy in dealing with HIV is empowering women and guaranteeing their rights—so that they can protect themselves from infection, overcome stigma, and gain greater access to treatment and care,” said Michelle Bachelet, Executive Director of UN Women. “We look forward to expanding our efforts in partnership with the UNAIDS family to address this epidemic.”

Gender equality and respect for women’s sexual and reproductive health and rights, especially for women living with HIV, are essential for an effective response to HIV. Persistent gender inequalities and women’s rights violations are continuing to render women and girls more vulnerable to HIV and prevent them from accessing HIV services. In 2010 there were around 17 million women living with HIV and HIV continues to be the leading cause of death in women of reproductive age.

“I believe we need to and can do much better for women and girls. There are still too few sustainable solutions available for women to protect themselves from HIV, violence and poverty,” said Michel Sidibé, Executive Director of UNAIDS. “Partnering with UN Women will strengthen our efforts to promote gender equality and bolster women’s empowerment globally through the HIV response.”

UNAIDS will collaborate closely with UN Women in a number of areas including: addressing the intersections between HIV and violence against women; integrating gender equality into national HIV planning; and using strategies that promote the leadership and participation of women living with HIV, and women affected by HIV, in decision-making. UNAIDS and UN Women will also work on strengthening national institutions to enable them to deliver on commitments made on gender equality and women’s rights in the context of HIV.

“As a young woman living with HIV, I am heartened to see that UNAIDS and UN Women are joining forces against AIDS. I have experienced first-hand how enabling environments and rights-based services can empower women living with HIV to take control over our bodies and our lives,” said Helena Nangombe Kandali from Namibia. “UN Women becoming a cosponsor of UNAIDS is a positive step forward in supporting women the world over, particularly women living with HIV.”

UN Women, established by the UN General Assembly in 2010 brings together four distinct parts of the UN system which focused exclusively on gender equality and women’s empowerment, namely: the Division for the Advancement of Women; the International Research and Training Institute for the Advancement of Women; the Office of the Special Adviser on Gender Issues and Advancement of Women; and the United Nations Development Fund for Women (UNIFEM).

Message from UNAIDS Executive Director Michel Sidibé

GENEVA, 14 May 2012—In the last year, we have seen greater acceptance of diversity. A new dialogue of openness and tolerance has emerged.

Yet in 79 countries, territories and areas, we still have laws that criminalize same-sex relations between consenting adults. These laws are serious barriers to an effective AIDS response and are driving lesbians, gays, bisexuals and transgender people underground where they cannot access life-saving services.

A society’s value should not be based on money or power. It must be measured by the way it values people, regardless of their sexual orientation or social status. A prosperous society is one that ensures inclusiveness and respects all people.

To our gay, lesbian, bisexual and transgender friends, UNAIDS stands with you.

Your engagement is essential to achieving our vision of Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths.

GENEVA, 8 May 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) today launched a new campaign, "Believe it. Do it.", aimed at bringing attention and action to the global goal of ending new HIV infections among children by 2015 and ensuring mothers living with HIV remain healthy. 

Each year, about 390 000 children become newly infected with HIV and as many as 42 000 women living with HIV die from complications relating to HIV and pregnancy.

In 2011, world leaders at the United Nations High Level Meeting on AIDS committed to ending new HIV infections among children by 2015 and saving mothers’ lives. A bold new global plan was adopted and action is underway.

“We have an amazing opportunity to change the world,” said Michel Sidibé, Executive Director of UNAIDS. “We have the commitment of world leaders but the clock is ticking and we cannot get from 390 000 to zero without you.” 

UNAIDS Goodwill Ambassadors Naomi Watts and Annie Lennox are among the personalities adding their voices and commitment to “Believe it. Do it.” In addition, UNICEF Goodwill Ambassador Whoopi Goldberg joined Blair Underwood, Denis O’Hare, Alexandra Wentworth, George Stephanopoulos and Sujean Rim to create a public service announcement for the campaign with the message “I believe children everywhere can be born free from HIV—Believe it. Do it.”

Under the premise that ‘every day is Mother’s Day!’ UNAIDS also teamed up with artist Sujean Rim to create a series of e-cards celebrating families. Through public service announcements, an interactive web site and social media outreach, the campaign asks the public to take three simple actions: 

1. Get the facts about ending new HIV infections among children  
2. Send a message about the issue and the actions people can all take
3. Support a mother through one of the great organizations working with families

The campaign will be featured ahead of Mother’s Day on 11 May on the American morning television show Good Morning America and the 30-second public service announcement will appear on CNN International, CNN Domestic (U.S. market) as well as other media outlets.

For more information visit http://www.unaids.org/believeitdoit/

In his report to the UN General Assembly, UN Secretary-General Ban Ki-moon urges stakeholders to redouble efforts to meet the targets outlined in the 2011 Political Declaration on AIDS

GENEVA, 30 April 2012—The United Nations Secretary-General Ban Ki-moon has issued his first report on HIV to the UN General Assembly since the 2011 High Level Meeting on AIDS. In the report, he highlights the urgent need to achieve immediate, tangible results and for the AIDS response to be smarter, more strategic, more efficient, and grounded in human rights.

“I urge the international community to stand up to meet the commitments it has made. I call for a shift from the perception that aid is charity to an understanding that it is our shared responsibility and a smart investment that reaps dividends for all. Together, we must foster a more sustainable response to the HIV epidemic for the sake of our common future.”

Substantial gains have been achieved over the last decade and ground-breaking scientific advances have encouraged leaders to talk about the end of AIDS. The report, ‘United to End AIDS: Achieving the Targets of the 2011 Political Declaration’, outlines that 2.5 million deaths are estimated to have been averted since 1995 due to the increase in access to antiretroviral therapy—and 350 000 new HIV infections averted in children. It also underscores the gains made in HIV prevention with new infections at their lowest levels since the peak in the mid-2000s. 

However, the report also warns that considerable gaps persist in access to HIV services, particularly for people at higher risk of exposure to HIV. Punitive laws, gender inequality, violence against women and other human rights violations continue to undermine national AIDS responses and declines in funding have the potential to jeopardize the capacity to expand access to HIV services and sustain progress over the coming years.

“The fourth decade of AIDS has to be marked as the decade that ushered in the end of AIDS,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “We can make this a reality and seize the opportunity to secure a future free from HIV.”

At the 2011 High Level Meeting on AIDS, UN Member States adopted a Political Declaration on AIDS, providing a roadmap towards achieving the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. The declaration set 2015 as the deadline for achieving a number of specific targets.

Through the Political Declaration, UN Member States pledged to deliver antiretroviral therapy to 15 million people by 2015, eliminate new HIV infections in children, achieve a 50% reduction in new HIV infections among adults, reduce transmission of HIV among people who inject drugs by 50% and reduce TB deaths in people living with HIV also by half.

Countries also committed to closing the resource gap, investing between US$ 22-24 billion each year by 2015, meeting the needs of women and girls, eliminating stigma and discrimination and promoting the integration of the HIV response into broader health and development efforts.

In his report, the Secretary-General underscores that achieving the 2015 goals will require a redoubling of efforts from all stakeholders and that if smarter and more efficient ways of working are not applied to the AIDS response, the goals will not be met.  

The Secretary-General outlines a number of recommendations that need to be implemented to reach the 2015 targets. For instance, to meet the target of reducing sexual transmission by 50%, the report outlines that the number of new sexually transmitted HIV infections will need to decline by at least 1 million by 2015. To achieve this, HIV prevention programmes need to enhance efforts to reinforce, sustain and extend behaviour change by promoting gender equality and mutual respect, as well as better focus on where the new infections are occurring.

To reduce HIV transmission among people who use drugs by 50%, the number of new HIV infections must fall by at least 120 000 per year. The Secretary-General encourages stakeholders to summon the wisdom, courage and commitment required to implement strong, evidence-informed prevention programmes that empower key populations including people who inject drugs.

At least 180 000 fewer TB-related deaths among people living with HIV will be required to achieve a 50% reduction by 2015. To realize this, from 2010 to 2015, TB cure rates need to increase from 70% to 85% and rates of TB detection among people living with HIV must rise from 40% to 80%. Achieving the target would reduce TB-related deaths by 80% and save a million lives.

In his recommendations, the Secretary-General urges countries to undertake immediate, comprehensive reviews of national, legal and policy frameworks to remove obstacles to effective and rights-based responses. He also calls for new partnerships and a new approach for HIV investment to mobilize necessary resources. In 2010, a total of US$ 15 billion was available for the AIDS response from all sources. The report highlights that to reach the 2015 target of US$22-24 billion for the response to HIV by 2015 an additional US$ 8 billion will be required.

Report of the Secretary-General: United to end AIDS: achieving the targets of the 2011 Political Declaration

New guidelines released for couples HIV testing and counselling and for treatment and prevention in serodiscordant couples

GENEVA, 19 April 2012—New guidelines have been issued encouraging couples to go together for HIV testing in order to know their HIV status. The guidelines, released by the World Health Organization (WHO), also recommend that in couples who are serodiscordant—where one partner is living with HIV and the other not—antiretroviral therapy is offered to the person living with HIV to prevent his or her partner from becoming infected with the virus.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes the new guidelines and calls on all countries to implement them to reach the targets set in the United Nations 2011 Political Declaration on AIDS.

“Couples can now reap the benefits of antiretroviral therapy, to improve their own health, and to protect their loved ones,” said UNAIDS Executive Director Michel Sidibé. “By encouraging couples to test together, we can provide comprehensive options for HIV prevention and treatment—that they can discuss and manage jointly.”

New evidence now shows that antiretroviral therapy reduces the risk of HIV transmission from a person living with HIV to their sexual partners. WHO recommends that antiretroviral therapy be offered to HIV-positive individuals in discordant relationships even when they do not require it for their own health. The guidance also states that it is possible for couples to stay HIV serodiscordant indefinitely if they consistently practice safer sex using condoms.

“I am excited that with the roll out of these new guidelines, millions of men and women have one additional option to stop new HIV infections,” said Mr Sidibé. “This development begins a new era of HIV prevention dialogue and hope among couples.”

According the new guidelines, “couples who test together and mutually disclose their HIV status are more likely than those testing alone to adopt behaviour to protect their partner. Another potential benefit of couples testing together and sharing their results is that they can support each other, if one or both partners are HIV-positive, to access and adhere to treatment and prevent transmission of HIV to children”.

UNAIDS recommends that HIV testing and counselling should always be confidential and initiation of treatment must always be voluntary and never mandatory or coercive. Couples should have access to the full range of HIV prevention options available including the use of male and female condoms and medical male circumcision. They should also be provided with access to health services such as tuberculosis screening and reproductive health services including family planning with access to effective contraceptives and conception counselling for sero-discordant couples.

According to UNAIDS estimates, around 14 million people are eligible for antiretroviral treatment. At the end of 2011, only 6.6 million people were receiving the life-saving medicines. The guidelines recommend that in situations of limited or inadequate resources, people who require antiretroviral therapy for their own health should always be given priority.

Dr Ibahim Assane Mayaki, CEO of NEPAD and UNAIDS Executive Director Michel Sidibé signing the collaboration agreement at the Africa Union Headquarters in Addis Ababa, Ethiopia 27 March 2012.
Credit: UNAIDS/Jiro Ose

ADDIS ABABA, 27 March 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the New Partnership for Africa’s Development (NEPAD) Agency today signed a memorandum of understanding (MoU) calling for strategic collaboration to advance sustainable responses to HIV, health and development across the African continent. The MoU was signed by UNAIDS Executive Director Michel Sidibé and Chief Executive Officer of NEPAD Agency, Dr Ibrahim Mayaki, on the sidelines of a colloquium marking the 10^th anniversary of NEPAD in Addis Ababa, Ethiopia.

Under the terms of the agreement, UNAIDS and the NEPAD Agency will work with partners to: support the development of common African positions for the AIDS response, with an emphasis on sustainable financing; address constraints in access to HIV medicines; facilitate policies and partnerships to eliminate new HIV infections in children and improve the health of mothers; enhance country ownership and accountability; and encourage South-South cooperation.

“This new partnership will bring us one step closer to our goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths,” said the UNAIDS Executive Director, at a press conference on 27 March after the signing of the MoU. Mr Sidibé said that “getting to zero” would demand effective and inclusive partnerships, shared responsibility, greater transparency and a focus on results—areas in which NEPAD is known to excel.

Speaking alongside Mr Sidibé at the press conference, Dr Ibrahim Mayaki said that country ownership would be critical to advancing AIDS and development responses in the coming decade. “Partnerships for development can only succeed if they are led by developing countries,” said the Chief Executive Officer of NEPAD Agency. “AIDS programmes must be financially sustainable over the long term and tailored to specific national settings,” he added.

Sub-Saharan Africa carries the highest HIV burden of any region in the world. In 2010, about 68% of all people living with HIV resided in sub-Saharan Africa, a region with only 12% of the global population.

About two-thirds of all AIDS investments in Africa currently come from external sources. According to UNAIDS estimates, Africa will require between US$ 11-12 billion for its regional AIDS response by 2015—US$ 3-4 billion more than the current expenditure.

Message from UNAIDS Executive Director Mr. Michel Sidibé

UNAIDS Executive Director (center) visited the Prince Cyril Zulu TB and STD Clinic and the CAPRISA eThekwini Research Clinic on September 2011 during an official visit to South Africa. The Prince Cyril Zulu clinic treats about 8 000 new TB patients a year with an HIV prevalence of 74%. The SAPiT TB-HIV trial which provided the evidence for the current WHO TB-HIV co-treatment guidelines was conducted in the adjoining CAPRISA clinic.
Credit: UNAIDS/A. Debiky

GENEVA, 22 March 2012—On World TB Day, let’s celebrate a partnership, which in just a few years is helping to transform the AIDS epidemic.

By improving collaboration between HIV and TB services almost one million lives around the world have been saved in the past six years.

The number of people living with HIV screened for TB increased almost 12-fold from 2005 to 2010.

For patients, integrating HIV and TB services means a better quality of life. They spend less time going from clinic to clinic and waste less money on visits to multiple care providers.

It can also mean the difference between life and death.

Together we can be proud of our achievements.

But we haven’t reached our goal of stopping TB-related HIV deaths.

Every day a thousand people living with HIV die of TB.

These deaths just aren’t acceptable when TB is preventable and curable with inexpensive drugs.

We need to intensify the integration of HIV and TB services at every level of the health system.

We need a stronger focus on preventing, diagnosing and treating TB in children living with HIV, who are particularly vulnerable to TB infection.

All TB patients living with HIV must be put on antiretroviral therapy as quickly as possible.

Last year countries committed for the first time to cut in half the number of deaths among people living with HIV by 2015.

Having travelled so far together, I am sure we will reach the final mile.

GENEVA, 8 March 2012—On this International Women's day the world has a lot more to do if it is to be a place where:

• Women and men, girls and boys are treated as equal
• Girls shape their own future
• Boys challenge social norms that block opportunities
• HIV does not take away people’s dignity and rights.

The reality is very different:

• Every minute, a young woman is newly infected by HIV
• At the same time, girls lack equal access to education
• Far too many women lack control over their finances and assets
• And too many women continue to lack control over their bodies and lives.

It is clear, governments and communities are failing women and girls. There are few sustainable solutions that enable women and girls to protect themselves from HIV, violence and poverty. This is grossly unacceptable, particularly because the world can do much better.

Empowered women and girls are critical agents of change in reversing the epidemic. If society invests in the health of women and girls, it is possible for them to have the future they want.

This is why UNAIDS prioritizes gender equality and why UNAIDS is calling for zero tolerance for violence. Together, we will reach the future we want: zero new HIV infections, zero discrimination and zero AIDS-related deaths among women and girls.

WHO recommendations related to use of hormonal contraceptives remain unchanged. The use of condoms—male and female—is a reliable method of HIV prevention.

GENEVA, 16 February 2012—A stakeholder consultation convened by the World Health Organization (WHO) in Geneva has reviewed recent epidemiological studies related to HIV transmission and acquisition by women using hormonal contraceptives. After careful review of all available evidence, the stakeholders found that the data were not sufficiently conclusive to change current guidance.

In light of this review, WHO today announced that its current recommendation­­—no restrictions on the use of hormonal contraceptives to avoid unintended pregnancies—remains unchanged. They also recommend that women using progestogen-only injectable contraceptives also use condoms or other measures to prevent HIV infection. This information must be communicated to sexually active women and girls by health workers pro-actively.

About half of the 34 million people living with HIV are women. In sub-Saharan Africa, the region most affected by the epidemic, nearly 60% of all new HIV infections occur in women.

The level of unmet family planning need among the 1.18 billion women aged 15–49 worldwide is estimated to be 11%. Among the 128 million women (married or in a union) aged 15–49 in sub-Saharan Africa, the estimated unmet need for family planning is more than twice as high, at 25%. This highlights the urgency of finding innovative solutions that address the dual needs of women in preventing HIV and stopping unintended pregnancies.

While a range of contraceptives protect against unintended pregnancies, only condoms, male and female, provide dual protection by stopping HIV transmission and preventing unintended pregnancies.  

The Joint United Nations Programme on HIV/AIDS (UNAIDS) recommends that people who are sexually active—particularly women and girls—have full access to information and counselling to make evidence informed choices about their sexual and reproductive health needs. Women and girls must also have access to the widest range of contraceptive and HIV prevention options. Such services must be provided in an integrated manner by health workers.

The lack of female controlled methods of HIV prevention and low levels of condom use place women and girls at increased vulnerability to HIV infection. “Women need safe contraceptive and HIV prevention options that they can own and manage,” said Michel Sidibé, Executive Director of UNAIDS. “New investments into research for female controlled HIV prevention options and safe contraceptive methods are essential.”

From left to right: UNAIDS Executive Director Michel Sidibé, former president of Botswana, Mr Festus Gontebanye Mogae, Ambassador Eric Goosby, United States Global AIDS Coordinator call for accelerated access to voluntary medical male circumcision in eastern and southern Africa, at ICASA 2011. 5 December 2011.
Credit: UNAIDS/ P. Wiggers

ADDIS ABABA, 5 December 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) today launched a five-year action framework to accelerate the scale-up of voluntary medical male circumcision (VMMC) for HIV prevention. The framework—developed by the World Health Organization (WHO), UNAIDS, PEFPAR, the Bill & Melinda Gates Foundation and the World Bank in consultation with national Ministries of Health—calls for the immediate roll-out and expansion of VMMC services in 14 priority countries of eastern and southern Africa.

“Voluntary medical male circumcision is a high-impact and cost-effective prevention tool that will bring us one step closer to our goal of an HIV-free generation," said UNAIDS Executive Director Michel Sidibé, who unveiled the action framework at the 16th International Conference on AIDS and STIs in Africa (ICASA), together with partners. “Each HIV infection averted is money in the bank and fiscal space for the future,” he added. Joining Mr Sidibé at the launch in Addis Ababa, Ethiopia, were the U.S. Global AIDS Coordinator Dr Eric Goosby and the former President of Botswana, Festus Mogae.

There is compelling evidence that VMMC, when provided by well-trained health professionals, reduces the risk of sexual transmission of HIV from women to men by approximately 60 per cent. Since 2007, WHO and UNAIDS have urged countries with high HIV prevalence and low levels of male circumcision to expand access to safe VMMC services.

VMMC offers excellent value for money. Recent modelling commissioned by PEPFAR and UNAIDS found that reaching 80% coverage of adult VMMC in the 14 priority countries would entail performing approximately 20 million circumcisions on men aged 15-49 by the year 2015. Such a scale-up would cost a total of US$1.5 billion and would result in a net savings of US$16.5 billion by 2025 due to averted treatment and care costs. An estimated 3.4 million new HIV infections would be averted through 2025.

To date, the scale-up of VMMC has been modest in most countries. According to the joint framework, more than 550 000 men aged 15-49 had been circumcised in the 14 priority countries by the end of 2010. The greatest success in scaling up adult VMMC has occurred in Kenya, particularly in Nyanza Province. While progress in implementing VMMC programmes has been more limited in the other priority countries, nearly all countries saw the pace of scale-up quicken in 2010.

Acknowledging the important role of country ownership and accountability in health systems, U.S. Global AIDS Ambassador Dr Eric Goosby stated, “PEPFAR strongly supports heightened and immediate national ownership in all priority countries to implement safe, efficient voluntary medical male circumcision scale-up strategies. VMMC offers men an unprecedented opportunity to assume a proactive role in reducing their risk of contracting HIV, empowering them to protect their health and the health of their partners."

The new framework proposes strategic and coordinated action among partners at local, national and global levels to harness resources and focus on reaching adult and adolescent men with VMMC services as quickly and safely as possible. It underscores that country leadership is critical to the success and sustainability of this initial phase of VMMC programmes. The longer-term goal is to offer VMMC for all infants in the priority countries—replacing the need for adolescent and adult VMMC.

Innovation in service delivery, supply chain logistics, human resource deployment and medical devices is encouraged to improve efficiency, access, and safety, while creating demand for VMMC services. The framework urges governments in the 14 priority countries to seek funding from a range of domestic and international sources—with a view, over time, to a greater reliance on national on and local resources.

Speaking at today’s press briefing, Mr Festus Mogae called on leaders to support and scale up VMMC programmes in the 14 priority countries. “Strong collaboration between political, traditional and religious leadership will be critical to the safe and effective scale up of VMMC services,” said Mr Mogae, who is the chairman of Champions for an HIV-Free Generation, a non-governmental organization. “The key role of religious and traditional leaders is to ensure that there is a working partnership with the communities so that while the circumcision is done medically as an add-on HIV prevention strategy, it still retains its religious or cultural significance to the communities,” he added.

VMMC is an important component of a comprehensive HIV prevention package. WHO, UNAIDS and PEPFAR recommend a combination approach to HIV prevention that includes the correct and consistent use of male and female condoms; treatment for sexually transmitted infections; the promotion of safer sexual practices such as avoidance of penetrative sex; the provision of antiretroviral therapy for HIV-positive people who are eligible for treatment; and voluntary medical male circumcision in certain settings. 

VMMC is a life-saving HIV intervention with major cost benefits. A one-time health intervention, VMMC confers life-long partial protection against HIV. The joint framework launched today embraces urgent and widespread scale-up of VMMC in all priority countries through a coordinated, country-driven effort.