WASHINGTON D.C./GENEVA, 8 November 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) commends the United States Government on its continued leadership in the AIDS response following the call by the US Secretary of State Hillary Rodham Clinton for global solidarity to “change the course of the epidemic and usher in an AIDS-free generation”.

“Leadership from the United States has been vital to the AIDS response to date and will be key to seizing this historic opportunity,” said Michel Sidibé, Executive Director of UNAIDS. “Secretary Clinton has reaffirmed the United States’ Government’s strong commitment to this effort and has described a vision that should inspire us all. I hope that her call will galvanize leadership from around the globe to accelerate efforts to end the AIDS epidemic.”

In her speech, the US Secretary of State outlined the far-reaching impact of scaling up scientifically proven prevention strategies in combination with new and emerging developments in HIV science and research. These strategies include: elimination of new HIV infections among children, increased voluntary medical male circumcision, and expanded access to treatment.

Earlier this year UNAIDS highlighted the significance of the recent research demonstrating that people who access treatment early can reduce their likelihood of transmitting HIV to a partner by 96%. The potential impact of treatment for prevention will change attitudes, connect communities and motivate millions of people find out their HIV status and to talk openly with their partners about HIV.

To achieve an AIDS-free generation, the US Secretary of State reiterated UNAIDS’ call for greater engagement and investment in the global AIDS response by both donor and recipient countries.

UNAIDS underlines the importance of shared responsibility in the AIDS response. Shared responsibility is one of the central pillars of UNAIDS’ strategy to reach zero new HIV infections, zero discrimination and zero AIDS-related deaths by 2015.

UNAIDS is already working closely with PEPFAR and other partners around the world to achieve the ambitious goals UN member states committed to in the 2011 Political Declaration on HIV/AIDS. Achieving these goals will bring the world one step closer to an AIDS-free generation.

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

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

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

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

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

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

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

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

ROME/GENEVA, 20 July 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes new results confirming that scaling-up adult male circumcision works to prevent HIV in men. The study, which was carried out in the township of Orange Farm in South Africa, resulted in a 55% reduction in HIV prevalence and a 76% reduction in HIV incidence in circumcised men.

The results were announced today in Rome at the 6th IAS Conference on HIV Pathogenesis, Treatment and Prevention by the French National Agency for Research on AIDS and Viral Hepatitis. It is the first time a study has shown that male circumcision roll-out is effective at community level in preventing HIV.

“Science is proving that we are at the tipping point of the epidemic,” said Michel Sidibé, Executive Director of UNAIDS. “Urgent action is now needed to close the gap between science and implementation to reach the millions of people who are waiting for these discoveries. Scaling up voluntary medical male circumcision services rapidly to young men in high HIV prevalence settings will help reach the 2015 goal of reducing sexual transmission of HIV by 50%.”

During the study, free circumcision services offered to all men over 15 years of age resulted in 20 000 circumcisions over a three-year period.  From 2007 to 2010 the percentage of circumcised men increased from 16% to 50% among men between the ages of 15 and 49 years, peaking at 59% in young men aged 15 to 24 years. Community-based surveys reveal no changes in sexual behaviour. The total population of the township of Orange Farm is estimated to be around 110 000.

Many African countries are strongly supporting the scale-up of male circumcision. Kenya has taken the lead, providing voluntary male circumcision to 290 000 men over the past three years, mostly in the province of Nyanza. As reported today at the Rome conference, the men who were circumcised did not increase their risk behaviour. In Tanzania, where the government announced plans to circumcise at least 2.8 million men and boys between the ages of 10 and 34 over a five-year period, a rapid results campaign in early 2011 saw more than 10 000 boys and men circumcised over six weeks.

His Majesty King Mswati III of Swaziland, together with the Swazi Ministry of Health and the US President’s Emergency Plan for AIDS Relief, has recently launched a plan to provide voluntary medical male circumcision to the 152 800 men living in Swaziland between the ages of 15-49 years. Swaziland has the highest HIV prevalence rate in the world, estimated at 26% of adults aged 15-49 years. A statement released by the US Embassy in Swaziland estimated that the circumcision plan could avert nearly 90,000 new HIV infections and save more than US$ 600 million over the next decade.     

These results and announcements follow other recent scientific breakthroughs in HIV prevention: the HPTN 052 trial announced in May showed that early initiation of antiretroviral therapy can reduce the risk of transmission to an uninfected partner by 96%; the Partners PrEP and TDF2 studies announced last week show 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%; in November 2010, the iPrEx trial among men who have sex with men reported a 44% reduction in HIV acquisition among HIV negative men who took a daily antiretroviral tablet; and the CAPRISA gel study results announced in July 2010 showed that an antiretroviral gel—when used as a vaginal microbicide—was 39% effective in reducing a woman’s risk of becoming infected with HIV during sex.

UNAIDS stresses that despite the recent scientific discoveries there is still no single method which is fully protective against HIV. To reach UNAIDS vision of Zero new HIV infections, UNAIDS strongly recommends a combination of 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, avoiding penetrative sex and ensuring that as many people as possible in need of antiretroviral therapy have access to it.

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.

Medicines Patent Pool sign historic agreement with Gilead Sciences to increase access to HIV medicines in developing countries

GENEVA, 12 July 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes the new license agreement between the Medicines Patent Pool and the pharmaceutical company Gilead Sciences to increase access to antiretroviral therapy in developing countries. This is the first time a pharmaceutical company has signed an agreement with the Medicines Patent Pool and marks a turning point for future private sector collaboration in sharing innovation to advance the response to HIV. 

Under the agreement, Gilead will share intellectual property on a range of medicines to treat HIV. The agreement will allow for the production of the HIV medicines tenofovir, emtricitabine, cobicistat, and elvitegravir as well as a combination of these products in a single pill known as the “Quad.” Cobicistat, elvitegravir and the Quad are products still in clinical development. Companies interested in producing generic versions of the medicines for developing countries will be able to approach the Patent Pool to negotiate licensing terms.

“This agreement between the Medicines Patent Pool and Gilead signals a new era in the response to HIV with private and public sectors working hand in hand for the best interests of public health,” said Michel Sidibé, Executive Director of UNAIDS. “I hope today’s announcement will inspire other pharmaceutical companies to follow suit to share intellectual property and innovation to make new technological advances in HIV treatment available sooner to the people that need them most.” 

The agreement is particularly significant and represents a major step forward as Tenofovir is one of the first-line medicines for HIV recommended for use by the World Health Organization as per guidelines released in 2010. Under the new agreement Tenofovir will also be licensed for use to treat Hepatitis B, a common and serious co-infection of HIV.

The inclusion of products still under development is a rare and important advance and will allow for generic versions of new medicines to rapidly enter the market, lessening the inequality between developed and developing countries in accessing new medicines. 

In low- and middle-income countries, UNAIDS estimates that around 6.6 million people are currently accessing HIV treatment––however a further 9 million are still in need. At the recent United Nations High Level Meeting on AIDS, UN Member States unanimously adopted a declaration which set bold new targets which included increasing access to antiretroviral therapy to 15 million people by 2015. 

The Medicines Patent Pool is a creative new approach which was established in 2010 with the support of UNITAID to increase access to newer antiretroviral medicines by creating a
pool of patents and intelligence on antiretroviral production donated by medicine producers. It is currently in negotiations with six other patent holders.

Use of TRIPS flexibilities, including compulsory licensing and rejection of data exclusivity clauses, in trade agreements by India to ensure sustained access to life-saving medicines for people living with HIV

India’s Commerce Minister Mr Anand Sharma (left) met with UNAIDS Executive Director Mr Michel Sidibé at the Ministry of Commerce and Industry on 6 July 2011.
Credit: Sarabjeet Singh

NEW DELHI/GENEVA, 6 July 2011—UNAIDS welcomes the assurance given by India’s Commerce Minister, Mr Anand Sharma, that India will reject any efforts to include ‘data exclusivity’ clauses in bilateral trade agreements. This assurance came at a meeting between Mr Sharma and UNAIDS Executive Director Michel Sidibé, held today at the Ministry of Commerce and Industry.

“We reject data exclusivity clauses in free trade agreements,” said Mr Sharma. Welcoming the Minister’s assurance, Mr Sidibé said: “Millions of people will die if India cannot produce generic antiretroviral drugs, and Africa will be the most affected. For me, it is an issue of life or death.”

India’s pharmaceutical industry produces more than 85% of the first-line antiretroviral drugs used to treat people living with HIV. The cost of the least expensive first generation treatment regimen has dropped to less than US$ 86 per patient per year. But as increasing numbers of people move towards more efficacious and tolerable first-line treatment, drug prices could double compared to first-generation regimens. In addition, as patients develop drug resistance and require more expensive and patent-protected second- and third-line antiretroviral medicines, some projections indicate treatment costs escalating by as much as twenty-fold.

“The Government of India reaffirms its full commitment to ensure that quality generic medicines, including antiretroviral drugs, are seamlessly available, and to make them available to all countries,” said Mr Sharma. “India will also use the flexibilities allowed under TRIPS, including the use of compulsory licensing, to ensure that people living with HIV have access to all life-saving medicines,” Mr Sharma added.

“India, together with Brazil, South Africa, China and Russia, must forge an alliance with other high-income countries to ensure that no single person in the world dies because they could not afford to buy life-saving medicines or health care,” Mr Sidibé said.

An estimated 15 million people are eligible for antiretroviral treatment in low- and middle-income countries, and about 6.6 million people have access to HIV treatment. The Government of India provides free antiretroviral treatment to more than 420 000 people living with HIV in India.

Current treatment approaches are not sufficient to provide access to all who need it. UNAIDS and other partners advocate for Treatment 2.0—a framework that seeks to simplify the way treatment is currently provided. For this approach to succeed, TRIPS flexibilities as well as innovation and protection of intellectual property rights will play an important role for treatment access in the future.

Efforts to increase access to HIV prevention and treatment services must be scaled up alongside societal efforts to eliminate homophobia

NEW DELHI, 5 July 2011—UNAIDS lauds efforts by India’s National AIDS programme to provide HIV services for men who have sex with men and transgender people. Currently around 67% of men who have sex with men in India are accessing prevention services. According to estimates of the National AIDS Control Organization, there are more than 400 000 men who have sex with men inIndia; HIV prevalence in this population is about 7.3% compared to a national adult HIV prevalence of 0.31%.

“India’s rich tradition of inclusivity and social justice must include men who have sex with men and transgender people,” said Michel Sidibé, UNAIDS Executive Director, on the side lines of the National Convention of Parliamentarians and elected representatives. “India’s successful AIDS response has been possible due to the strong participation of communities of men who have sex men, sex workers, people who inject drugs and transgender people backed by a strong and progressive National AIDS policy.”

UNAIDS welcomes the call by the Prime Minister of India, Dr Manmohan Singh, to have an “HIV sensitive” policy and programmes so that the marginalized populations affected by HIV are not denied the benefits of health and development programmes. “We should work to assure for them a life of dignity and wellbeing. We have to ensure that there is no stigma and discrimination towards HIV infected and affected persons,” said Dr Singh. During the inauguration of the National Convention, Dr Singh reiterated his government’s strategy to provide HIV services to groups at higher risk of HIV infection.

“There is no place for stigma and discrimination on the basis of sexual orientation,” said Mr Sidibé. “I welcome the bipartisan call by Mrs Sonia Gandhi and Mrs Sushma Swaraj to end all forms of stigma and discrimination against people at increased risk of HIV infection.”

In 2009 the Delhi High Court overturned a law that criminalized consensual adult sexual behaviour. This stand was also supported by the Government of India in its affidavit filed with the Supreme Court.

“Consistent with WHO’s disease classification, UNAIDS does not regard homosexuality as a disease,” said Mr Sidibé. According to the recently released UNAIDS and WHO guidelines on prevention and treatment of HIV and other sexually transmitted infections among men who have sex with men and transgender people, legislators and other government authorities should establish anti-discrimination and protective laws in order to eliminate discrimination and violence faced by men who have sex with men and transgender people.

UNAIDS is committed to providing support to India’s successful AIDS response, which has seen new HIV infections drop by more than 50% in the last decade. India currently produces more than 85% of high-quality generic antiretroviral drugs for the majority of low- and middle income countries.India’s courts have progressively protected the human rights of people living with HIV and men who have sex with men by striking down discriminatory laws. 

UNAIDS will work with the Government of India, civil society and community groups in realizing the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths in India.

Unprecedented global participation at UN General Assembly High Level Meeting on AIDS leads to new commitments, targets, and momentum in the AIDS response

Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), addresses the opening of the General Assembly High-Level Meeting on AIDS on 8 June 2011.
Credit: UN Photo/Paulo Filgueiras

NEW YORK/GENEVA, 10 June 2011­­—The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes the bold new targets set by world leaders at the United Nations General Assembly High Level Meeting on AIDS which concluded in New York today. Countries agreed to advance efforts towards reducing sexual transmission of HIV and halving HIV infection among people who inject drugs by 2015.

They also agreed to push towards eliminating new HIV infections among children in the next five years. Leaders pledged to increase the number of people on life saving treatment to 15 million and to reduce tuberculosis related deaths in people living with HIV by half in the same time period.

“This Declaration is strong, the targets are time bound and set a clear and workable roadmap, not only for the next five years, but beyond,” said Joseph Deiss, President of the United Nations General Assembly. “UN Member States have recognized that HIV is one of the most formidable challenges of our time and have demonstrated true leadership through this Declaration in their commitments to work towards a world without AIDS.”

The bold targets come at a time when international assistance for the AIDS response has dropped for the first time since 2001. Member States agreed to increase AIDS-related spending to reach between US$ 22 billion and US$ 24 billion in low- and middle-income countries by 2015.

These far reaching goals are set in the Political Declaration on HIV/AIDS: Intensifying our Efforts to eliminate HIV/AIDS adopted by the General Assembly on 10 June, 2011. The declaration notes that HIV prevention strategies inadequately focus on populations at higher risk—specifically men who have sex with men, people who inject drugs and sex workers, and calls on countries to focus their response based on epidemiological and national contexts.

“These are concrete and real targets that will bring hope to the 34 million people living with HIV and their families,” said Michel Sidibé, Executive Director of UNAIDS. “Through shared responsibility, the world must invest sufficiently today, so we will not have to pay forever.”

The declaration calls on all UN Member States to redouble their efforts to achieve universal access to HIV prevention, treatment, care and support by 2015 as a critical step towards ending the global AIDS epidemic. A pledge to eliminate gender inequality, gender based abuse and violence, and to increase the capacity of women and adolescent girls to protect themselves from HIV infection was also made.

The Declaration recognizes that access to sexual and reproductive health has been and continues to be essential to the AIDS response and that governments have the responsibility of providing public health services focused on the needs of families, particularly women and children. Member states also agreed to review laws and policies that adversely impact on the successful, effective and equitable delivery of HIV prevention, treatment, care and support programmes to people living with and affected by HIV.

With nearly 7000 new HIV infections each day, the declaration reaffirms that preventing HIV must be the cornerstone of national, regional and international responses to the AIDS epidemic. It calls for expanding access to essential HIV prevention commodities, particularly male and female condoms and sterile injecting equipment. Calling for intensifying national HIV testing campaigns; it urges countries to deploy new bio-medical interventions as soon as they are validated including earlier access to treatment as prevention.

Taking note of the UNAIDS strategy, the Declaration commends UNAIDS for its leadership role on AIDS policy coordination and support to countries and calls on the joint programme to revise indicators for success and support the Secretary-General of the United Nations in providing an annual report on the progress made by Member States in realizing the commitments made in the declaration.

(Left to Right): Ban Ki-Moon, Secretary-General of UN; President Bongo Ondimba of Gabon (speaking) at the United Nations Security Council on June 7, 2011 at UN Headquarters, NYC. Credit: UNAIDS/B.Hamilton

NEW YORK, 7 June 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) welcomes a new United Nations (UN) Security Council resolution on HIV which has been adopted at the UN Security Council in New York. The resolution calls for increased efforts by UN Member States to address HIV in peacekeeping missions. It also calls for HIV prevention efforts among uniformed services to be aligned with efforts to end sexual violence in conflict and post-conflict settings.

"The Security Council has made major strides in addressing sexual violence in conflict. But rape is still a weapon of choice. This is an atrocious human rights violation and a public health threat,” said United Nations Secretary General Ban Ki-moon. “I urge all Member States to link efforts to combat HIV with our campaigns against sexual violence and for the rights of women."

The resolution builds on the previous UN Security Council resolution 1308, which was adopted in 2000. The new resolution calls on the United Nations and UN Member States to bolster global and regional partnerships and integrate comprehensive HIV programmes into efforts to prevent conflict, ensure security and build peace.

“Global, national and personal insecurity undermine efforts to prevent new HIV infections and increase access to HIV services for both peacekeepers and civilians,” said the President of Gabon, Ali Bongo Ondimba. “This resolution will help to mitigate the impact of HIV among uniformed services and civilian populations affected by conflict and increase access to HIV services.”

The resolution, which was tabled by Gabon, President of the Security Council for June 2011, recognises that HIV can have a uniquely devastating impact on all sectors and levels of society and that in conflict and post-conflict situations these impacts may be felt more profoundly. It also recognizes that conditions of violence and instability in conflict and post-conflict situations can exacerbate the spread of HIV because of displacement, conflict-related sexual violence and reduced access to HIV services.

Since the adoption of resolution 1308 in 2000, progress has been made in addressing HIV and security. About 60% of UN Member States have integrated HIV programmes for military, police and other uniformed personnel. However the quality of programmes is variable and resources to fund the programmes are often insufficient.

“Peacekeepers can play a leading role in HIV prevention as they secure peace around the world,” said Michel Sidibé, Executive Director of UNAIDS. “Uniformed personnel can act as agents of positive change, particularly in relation to preventing sexual violence in conflict and post-conflict situations.”

Evidence shows that the threat AIDS poses to peace and security is far more nuanced than initially thought. Both the characteristics of conflict and the epidemic itself have evolved significantly over the past 10 years with sexual violence being increasingly used as a tactic of war. Addressing this requires a broadening and strengthening of HIV programmes for peacekeepers to ensure an effective response to HIV and sexual violence in conflict and post-conflict settings.

“Renewed commitment around the new agenda is needed to ensure that the AIDS response effectively contributes to all UN peacekeeping efforts to ensure security and promote and build peace,” said Alain Le Roy, Under-Secretary General for United Nations Peacekeeping Operations.

During the UN Security Council session, both the United Nations Secretary-General Ban Ki-moon and the Executive Director of UNAIDS paid tribute to the late US Ambassador to the United Nations, Richard Holbrooke, for championing resolution 1308. In 2000, Ambassador Holbrooke said, “Resolution 1308 should be well known and it should be fully implemented. It should not be the end of the process, but only a cornerstone for the future.”

Reinvigorated efforts around a new HIV security agenda will be instrumental in addressing the impact of AIDS on peace and security. UNAIDS will work with member states to scale-up access to HIV prevention, treatment, care and support for all uniformed services, including police, immigration, prison and the navy, to prevent HIV and end violence against women and girls.

Message from UNAIDS Executive Director Mr. Michel Sidibé

GENEVA, 17 May 2011—The world is faced with stigma and discrimination that can lead to violence and block the AIDS response. This impacts the lives of lesbians, gays, bisexuals and transgender people.

The AIDS response has shown that when people are stigmatized because of their sexual orientation or gender identity, they are less likely to access the HIV services they need. This leads to new HIV infections and AIDS deaths.

We must replace violence and discrimination with acceptance and tolerance.

I call on governments to create social and legal environments that ensure respect for human rights and universal access to HIV prevention, treatment, care and support.

http://www.youtube.com/watch?v=vFSqHH1iXXg