Fifteen Senegalese mayors have endorsed the Paris Declaration to end the AIDS epidemic in their cities. Since the majority of people living with HIV reside in urban areas, accelerating the AIDS response in cities could considerably contribute to reaching the HIV treatment target by 2020 and eliminating mother-to-child transmission in Senegal.

The cities that have committed to Fast-Tracking the HIV response are Dakar, Guédiawaye, Pikine, Rufisque, Ziguinchor, Saint Louis, Kaolack, Mbour, Tambacounda, Kolda, Thiès, Bignona, Bounkiling, Kaffrine and Fatick.

The mayors of these and 30 other cities participated in an event on 3 November in Dakar, when the Association of Senegalese Mayors signed a memorandum of understanding with Microsoft. The partnership, part of Microsoft’s CityNext programme, will help Senegalese cities innovate and better serve their citizens in areas such as health, education and transportation. 

Quotes

NAIROBI/GENEVA, 18 September 2015—A new report by UN-Habitat and UNAIDS urges cities to do more to respond to HIV epidemics in urban areas. The report outlines that cities and urban areas are particularly affected by HIV, with the 200 cities most affected by the epidemic estimated to account for more than a quarter of all people living with HIV around the world.

The report, Ending the AIDS epidemic: the advantage of cities, was launched in Nairobi, Kenya, by the Executive Director of UN-Habitat, Joan Clos, and the Executive Director of UNAIDS, Michel Sidibé. It reveals that in many countries, rapidly growing cities are home to more than half of all people living with HIV and that many are facing challenges in ensuring access to HIV services.

“Although cities often have resources, viable health systems and the capacity for innovation and service delivery, they sometimes struggle to design and implement focused, effective and rights-based AIDS responses, often leaving behind the most vulnerable and marginalized populations,” said Mr Clos. “Cities are central to bringing a paradigm shift to the AIDS response—a concerted move towards shared responsibility between national and city authorities and community-based organizations in support of local leadership and local evidence to transform the social, political and economic determinants of HIV risk and vulnerability.”

The report highlights that city leaders have a unique opportunity to seize the dynamism, innovation and transformative force of the AIDS response to not only expand HIV services in cities but also address other urban challenges, including social exclusion, inequality and extreme poverty.

“Cities can lead change,” said Mr Sidibé. “As centres for innovation, cities can broker broad partnerships and use their vast resources to provide an inclusive, effective response to HIV based on evidence and grounded in human rights—to leave no one behind.”

In almost half (94) of the 200 cities most affected, HIV is transmitted mainly through unprotected heterosexual sex. In the remaining 106 cities, sex work, unprotected sex between men and injecting drug use are the main drivers of the epidemics. In the Asia–Pacific region, about 25% of all people living with HIV are estimated to reside in 31 major cities, while in western and central Europe, an estimated 60% of all people living with HIV reside in just 20 cities.

According to the new report, data from 30 countries that have conducted nationally representative household-based population surveys show that HIV prevalence among people 15–49 years old living in urban areas is higher than among those living in rural areas in most countries.

Even in countries that are still predominantly rural, cities are often home to disproportionate numbers of people living with HIV. For example, urban areas account for only 18% of Ethiopia’s population but for almost 60% of people living with HIV nationally.

The report outlines the need for cities to establish renewed efforts for an urban health approach that serves the evolving needs of cities and the people who live and work within them. It adds that these measures would help reach the UNAIDS Fast-Track Targets to end the AIDS epidemic as a global health threat by 2030.

The UNAIDS Fast-Track approach requires rapidly scaling up and focusing the implementation and delivery of proven, high-impact HIV prevention and treatment services: an approach that increasingly relies on urban leadership.

A number of countries have introduced specific legislation, national policies or strategies to respond to the needs of people living with and affected by HIV. However many countries continue to lag behind in allocating adequate resources and implementing inclusive and urban-friendly HIV programmes.

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.

The AIDSImpact 2015 conference held in Amsterdam from 28 to 31 July has heard appeals for the better integration of behavioural and psychosocial scientific research in the AIDS response. Researchers from around the world presented the latest findings in behavioural and psychosocial science related to HIV prevention, treatment and care, focusing both on the global level and on specific countries and communities hardest hit by the epidemic.

The conference promoted pioneering work on understanding the dynamics of a changing epidemic. There was a particular focus on new opportunities for HIV prevention thanks to the increased availability of biomedical interventions as well as of increased HIV-testing options. The key to their future success, however, lies in understanding the behavioural and psychosocial consequences, advantages and challenges in integrating such programmes within different global contexts.

Fast-Track cities

The Fast-Track cities approach was also covered during a special session on “The Tale of 3 Cities” where health officials from Sao Paulo, Amsterdam and San Francisco shared their experiences of the AIDS response. All three cities are signatories to the Paris Declaration, which commits authorities to putting their cities on the Fast-Track to ending the AIDS epidemic.   

During the conference, the economic returns of the Fast-Track approach were also discussed. Each dollar invested in ending AIDS by 2030 can generate more than US$ 17 in net returns.

Focusing on key population groups

Participants also discussed issues faced by key population groups, with a particular emphasis on the gay community and men who have sex with men. Participants heard that stigma and discrimination continue to be a major obstacle to the Fast-Track approach.

Delegates heard that the Internet and other new technologies are increasingly important in the AIDS response, offering opportunities for innovative HIV prevention programmes. 

Quotes

African mayors and mayors of African descent from more than 30 countries participating in a global conference in Accra, Ghana, explored how cities can accelerate the AIDS response and deliver specific results in HIV prevention, testing and treatment in the next five years.

The Fourth World Summit of Mayors and Leaders from Africa and of African Descent was held from 1 to 3 June and was hosted by the Lord Mayor of Accra, Alfred Vanderpuije.

During the summit, participants committed to the goal of ending the AIDS epidemic and discussed how to increase HIV testing, access to antiretroviral therapy and stopping new HIV infections among children.

Following a series of regional consultations, 18 mayors from Africa, Latin America and the United States of America signed the Paris Declaration on Fast-Track Cities, which calls for ending the AIDS epidemic in cities by 2030. The mayors agreed that by putting people at the centre of the response and addressing underlying issues, such as poverty, discrimination and violence against women and girls, their societies can be transformed.

The summit was convened within the framework of the International Decade for People of African Descent (2015–2024). It featured other thematic pillars, including gender equality and women’s empowerment, youth entrepreneurship and employment.

The event was co-organized by the Global Alliance of Mayors and Leaders from Africa and of African Descent, the African Renaissance and Diaspora Network, Inc., in partnership with the City of Accra, la Asociación Nacional de Alcaldes de Municipios con Población Afrodescendiente and UNAIDS.

Quotes

Mayors from major cities and urban areas in Côte d’Ivoire have come together to sign the Paris Declaration, pledging their support to accelerate the response to HIV over the next five years.

Thirteen mayors from the Abidjan district and around 20 from other major cities across the country joined UNAIDS Executive Director Michel Sidibé and the Governor of Abidjan, Beugré Mambé, to sign the Paris Declaration, putting their cities on the Fast-Track to ending the AIDS epidemic by 2030.

The Paris Declaration includes commitments to reach ambitious 90–90–90 targets by 2020, which will mean 90% of people living with HIV knowing their HIV status, 90% of people who know their HIV-positive status on antiretroviral therapy and 90% of people on treatment with suppressed viral loads.

It is estimated that around 40% of people living with HIV in Côte d’Ivoire live in Abidjan, which has an HIV prevalence of 3.6%, compared with 2.7% nationally.

The Paris Declaration was signed in Paris on World Aids Day 2014 by the Mayor of Paris, Anne Hidalgo, and more than 20 of her counterparts from cities around the world. Other mayors are now being invited to join the initiative. 

Quotes