Photo credits : UNAIDS/C. Giray

In Malawi, the involvement of civil society in the process of setting targets for universal access to HIV prevention, treatment, care and support has resulted in ambitious targets addressing the needs and expectations of those living with or affected by HIV.

“Malawi is well on the way to endorsing targets,” said Desmond Johns, UNAIDS country coordinator in Malawi. “We’ve seen a process with limited civil society involvement grow into a process with meaningful dialogue and participation. All of this is producing a much better end result,” he added.

The process of setting targets for universal access in Malawi began early in 2006 when a small group of partners made up of representatives from the national ministries, donor organizations, the United Nations and non-governmental organizations met to identify the objectives and challenges to scaling up the country’s national response. Only two national and two international civil society umbrella organizations took part to this initial consultation.

Noting the limited role attributed to national civil society at this stage, a group of 20 organizations, led by Action Aid and the National Association of People Living with HIV & AIDS in Malawi (NAPHAM), decided in March 2006 to form a coalition in order to articulate a stronger position on the question of universal access. Starting a parallel process, the coalition undertook to review and if necessary challenge the preliminary targets set by the working groups.

The incentive to combine both processes and establish a truly inclusive mechanism to set targets for scaling up the response to AIDS came after the Global Fund review in June and July which revealed that many of the targets established by the working groups had already been exceeded.

“We were in presence of two parallel processes which did not communicate and could not benefit from each other’s strengths,” said Johns. “This situation underlined how important it is to bring all stakeholders around the same table. As of October, this became UNAIDS priority,” he added.

A three-day consultation was held soon after which brought together 350 participants from a wide range of stakeholders. Sixteen representatives from faith and community based organizations and groups of people living with HIV gave presentations on their experiences and the challenges they faced in responding to the epidemic in their communities. The presentations added a new and fresh perspective to the discussions.

In November consultations were extended to the provincial and district levels to ensure the widest possible participation. An international consultant facilitated the discussions to give everyone an opportunity to contribute. He also arranged to seek and incorporate the views of those who could not attend the meetings and gave them time to review the targets and submit comments before they were consolidated.

“We finally felt that our voices were being heard and taken into account,” said Sembereka from Malawi Network of Religious Leaders living with or Personally affected by HIV and AIDS, and member of the secretariat of the Civil Society coalition on Universal Access. “We represent people living with or affected by HIV and this is an unprecedented opportunity to make a difference in the response to HIV. There remains a lot of room for improving civil society participation. Our contribution should be an integral part of planning and monitoring the scale up of the response to AIDS,” he added.

The final national level stakeholder meeting took place on 29 November to communicate the proposed targets and the revised and costed National Action Framework. The targets are due to be endorsed by a Cabinet of Ministers before the end of the year.

“The inclusive process in November was an opportunity to bring a greater level of ambition to the universal access targets, develop consensus and build ownership of the targets and to prioritize and cost the National AIDS Framework, so that it would constitute the implementation plan for Universal Access. This is a great example of the Global Task Team recommendations and Paris Declaration actually taking life,” concluded UNAIDS Country Coordinator Desmond Johns.

The number of people living with HIV in the Middle East and North Africa has risen to 460,000 and some 68,000 people were newly infected in 2006 alone. In a bid to curb the region’s growing epidemic, countries have been working with UNAIDS to secure additional funding to scale-up the AIDS response in the region.

Securing external funding is particularly challenging in the Middle East and North Africa due to limited support from external donors. One of the donors operating in the region is the Global Fund to fight AIDS, Tuberculosis and Malaria which has now become one of the main sources of AIDS funding for the region. The fund was created in January 2002 to attract, manage and disburse additional financing to support locally-driven strategies in response to AIDS, TB and malaria.

To date, the Global Fund has approved a total of US$ 6.6 billion to over 450 grants in 136 countries. Of the US$ 6.6 billion approved, US$ 2.9 billion has been disbursed to public and private recipients in 129 countries.

The grant application process can be complex and many countries in the region have solicited UNAIDS to assist in processing their applications. UNAIDS has played a role in raising awareness and creating a climate which has enabled countries to establish a country coordination mechanism thus making it possible to develop their grant proposals. UNAIDS facilitates provision of technical expertise to these areas and helps countries not only to develop their grant applications but also to implement the grants once approved.

In the most recent round of grants (Round Six) UNAIDS Regional Support Team and Country Offices in the Middle East and North Africa worked with five countries in the region to help formulate their proposals. Grants were approved for four out of the five countries with funding amounting to some US$ 26 million.

“UNAIDS works with countries at every opportunity to help ‘make the money work’ so that funds reach the people that need them most,” said Michel Sidibe, Director of UNAIDS Country and Regional Support Department. “As countries move towards the goal of universal access to HIV prevention, treatment, care and support, adequate funding from both external and domestic sources is absolutely vital.”

Currently, 13 out of the 22 countries in the Middle East and North Africa meet the eligibility criteria for Global Fund support and 10 out of 11 countries who have applied for Global Fund funding for AIDS to date have succeeded in obtaining funds, amounting to a total of US$ 127 million.

The UNAIDS Secretariat has provided assistance in developing 73% of all the proposals on AIDS in the region that have been approved between Rounds One and Six, including support to proposals from Algeria, Djibouti, Jordan, Morocco, Somalia, Sudan, and Tunisia.

As well as working with countries on grant proposals, UNAIDS also continues to support the implementation of grants and resolve major coordination and implementation difficulties or capacity-building challenges in all countries where grants were already in place from earlier rounds. Through the Global Implementation Support Team – GIST - UNAIDS, together with Cosponsors and the Global Fund headquarters, are providing a common action plan to support counties in solving bottlenecks, at the request of countries.

Typically the activities funded by the grants are wide-ranging and include development of second-generation surveillance and monitoring and evaluation; working with people most at risk of HIV infection such as young people, people who inject drugs and sex workers; reinforcing civil society––including non-governmental organisations, community-leaders and people living with HIV; increasing access to care, treatment, and psycho-social support of people living with HIV; and other specific interventions, such as coordination, blood safety, voluntary counselling and testing, and sexually transmitted infections.

“The availability of Global Fund resources in the region have created a new reality and represents a critical turning point in the national responses in the Middle East and North Africa,” said Oussama Tawil, Director of UNAIDS Regional Support Team for the Middle East and North Africa. “This is essential in particular in a context where the allocation of public resources remains relatively limited and primarily oriented to health care responses and other donor resources generally still represent limited support.”

The assistance UNAIDS provides to countries is coordinated with the World Health Organisation and other Cosponsors through an agreement which ensures complementary responses to countries and joint funding of regional training on the development of Global Fund proposals.

“Using the frameworks of the 'Three Ones' and 'Universal Access', UNAIDS will focus in 2007 on resolving bottlenecks, supporting the implementation process with scaled-up and diversified technical assistance ensuring that efforts in countries go beyond the 'project-mode' with regards to the Global Fund grants,” said Tawil.

Photo credit : UNICEF/S.Noorani

The State of the World’s Children 2007 report published on 11 December by UNAIDS Cosponsor UNICEF underlines that empowering women is pivotal to the health and development of families, communities and nations.

The report emphasizes the fact that gender inequality and the low status of women in society are two of the principal drivers of HIV. Latest data show that women now make up 48% of all people living with HIV, and the proportion of women infected with HIV is increasing in Asia, Eastern Europe and Latin America. In sub-Saharan Africa, the region most affected by AIDS, 60% of all adults and three out of four young people living with the virus are female.

“When women are empowered to lead full and productive lives, children and families prosper,” said UNICEF Executive Director Ann M. Veneman.

Despite progress in women’s status in recent decades, the lives of millions of girls and women are overshadowed by discrimination, disempowerment and poverty. Girls and women are disproportionately affected by AIDS and women in most places earn less than men for equal work. Millions of women throughout the world are subject to physical and sexual violence, with little recourse to justice. As a result of discrimination, girls are less likely to attend school; nearly one out of every five girls who enroll in primary school in developing countries does not complete a primary education. Education levels among women, says the report, correlate with improved outcomes for child survival and development.

“If we care about the health and well-being of children today and into the future, we must work now to ensure that women and girls have equal opportunities to be educated, to participate in government, to achieve economic self-sufficiency and to be protected from violence and discrimination,” Veneman said.

The AIDS epidemic illustrates all too vividly how much needs to be done to overcome the social, cultural and economic factors that put women at risk of HIV and that unduly burden them with the epidemic’s consequences.

“Governments have made repeated commitments to improve the status of women and acknowledged the linkage with HIV,” said Sarah Russell of the UNAIDS-led Global Coalition on Women and AIDS. “In some areas, they have made progress. But by and large, efforts have been small-scale and haphazard. There is an urgent need for more systematic approaches.”

The State of the World’s Children shows how promoting gender equality and empowering women – Millennium Development Goal number 3 – will propel all of the other goals, from reducing poverty and hunger to saving children’s lives, improving maternal health, ensuring universal education, combating AIDS, malaria and other diseases, and ensuring environmental sustainability.

“UNICEF’s new report calls for seven key interventions to empower women,” noted Russell.

A roadmap to gender equality

• Education : Key actions include abolishing school fees and encouraging parents and communities to invest in girls’ education.
• Financing : Little recognition has been given to the resources needed to meet the goal of gender equality and women’s empowerment. Investment to eliminate gender discrimination must be integrated into government budgets and plans.
• Legislation : National legislation in property law and inheritance rights should ensure a level playing field for women, alongside measures to prevent and respond to domestic violence and gender-based violence in conflict.
• Legislative quotas : Quotas are a proven method of ensuring women’s participation in politics. Of the 20 countries with the most women in parliament, 17 use some form of quota system.
• Women empowering women : Grassroots women’s movements have been vocal champions for equality and empowerment and should be involved in the early stages of policy formation so that programmes are designed with the needs of women and children in mind.
• Engaging men and boys : Educating men and boys, as well as women and girls, on the benefits of gender equality and joint decision-making can help nurture more cooperative relationships.
• Improved research and data : Better data and analysis are critical, especially on maternal mortality, violence against women, education, employment, wages, unpaid work and time use, and participation in politics.

“Immediate and sustained action on all seven tracks will be critical if the world is to make meaningful progress towards universal access to HIV prevention, treatment, care and support,” she added.

Some 260 participants gathered in Lusaka for the 19th Joint United Nations Programme on HIV/AIDS governing board meeting. The meeting brought together representatives from government, civil society, donors and the United Nations to push for greater UN action to strengthen country efforts against AIDS.

General view of the participants attending the 19th PCB meeting hold in Lusaka, Zambia, 6-8 December 2006

Mr. Ruphia Banda, Vice-President of Zambia, Mrs. Gunilla Carlsson, Minister of International and Cooperative Development of Sweden, Mrs. Silvia T. Masebo, Acting Minister of Health, Zambia and Dr. Peter Piot, Executive Director, UNAIDS, during a meeting prior to the PCB session.

One of the 19th PCB sessions was chaired by: (from left to right) Dr. Peter Piot, Executive Director, UNAIDS, Mrs. Gunilla Carlsson, Minister of International and Cooperative Development of Sweden, Mr. Ruphia Banda, Vice-President of Zambia, Mrs. Silvia T. Masebo, Acting Minister of Health, Zambia.

Namwene Phiri addressing the participants to the "Keep the Promise" session after receiving a prize for her contribution to the New York and Toronto banners.

Dr. Peter Piot, Executive Director, UNAIDS addressing the participants to the reception hosted by the Minister of Health of Zambia and the Swedish Minister of the International and Cooperative Development at the 19th PCB meeting hold in Lusaka, Zambia, 6-8 December 2006

UNAIDS Executive Director Dr Peter Piot met with the Delegation from the Democratic Republic of the Congo during the PCB. The DRC has just completed its first democratic elections with the election of President Joseph Kabila. The DRC has been wracked by civil war for a number of years and the elections herald the start of a new era for the DRC. Dr Piot said in the opening plenary that the new era provides an opportunity to step up the pace of the AIDS response in the DRC.

From left to right: Dr Engwanda, Head of NGO’s Forum for HIV/AIDS, DRC, Mr Eusebe Honsounko, UNHCR Representative, DRC, Prof Mashako Mamba, Academic Member of Delegation, DRC, Dr Peter Piot, Executive Director, UNAIDS, Mme Jaynet Kabila, Head of Kabila Foundation, Dr Pierre Somse, UNAIDS Country Coordinator: DRC, Mr Jean-Pierre Bongo, Head of DRC Network of People living with HIV/AIDS, Mme Annie Faray, Head of NGO Fighting against Sexual Violence, Mr Dede Watchiba, Head of M&E Unit, National Multisectoral Programme.

Photo credit : Palace of Monaco

Bringing together musicians, artists and other famous faces, UNAIDS Special Representative HSH Princess Stephanie of Monaco continues her creative efforts to raise awareness and resources for the AIDS response.

The Princess is teaming up with the artists from the acclaimed musical Le Roi Soleil, as well as other famous international performers, to host two shows early next year at the Grimaldi Forum in Monaco.

Audiences attending the performances will be treated to an extraordinary “medley” show featuring selected songs from the musical accompanied by the Monaco Philharmonic Orchestra. In addition to raising funds, as with all her AIDS activities, Princess Stephanie also hopes the event will bring the issues of AIDS and stigma and discrimination to the forefront.

Proceeds from the event will go to the Fight AIDS Monaco organization and the building of a special house – the ‘Maison la Vie’ - in Provence, France which will be a centre for dialogue for people living with HIV and will offer care and support services. The house is planned for opening by 2008 and Princess Stephanie hopes people living with HIV will come and “recharge their batteries”,gain self-confidence and build skills to face the challenges posed by AIDS.

The planned musical event is one of a several activities organized by the Princess for the benefit of people living with HIV. On World AIDS Day she hosted a charity auction in Monaco and earlier this year Princess Stephanie again showed her creative fundraising skills by launching a charity pop single “L'Or De Nos Vies” (The Gold of Our Lives).

Photo credit : B. Hamilton

UN Secretary General Kofi Annan, UNAIDS Executive Director Peter Piot, AIDS activist Lynn Murchison and Hunger Project President Joan Holmes took part in an event in New York to commemorate World AIDS Day.

Speaking at the event, the UN Secretary-General highlighted the importance of accountability – the theme of this year’s Worlds AIDS Day – by saying, “ Accountability requires every President and Prime Minister, every parliamentarian and politician, to decide and declare that “AIDS stops with me”.

Dr Piot gave a brief overview of the epidemic saying that the latest global AIDS figures give reason for concern and for some hope. He also highlighted the need for more attention to be brought to women and girls.

Ms Holmes took the opportunity to endorse the recent recommendation of the Secretary General’s High-Level Panel on UN System-wide Coherence for the creation of a new, unified and ambitiously funded agency for gender equality and women’s empowerment.

The event was chaired by Rev. Kevin Bean and attended by approximately 400 people. It was organized by The Hunger Project, UNAIDS and St. Bartholomew’s Church and co-sponsored by African Regional Youth Initiative, EngenderHealth, The Interfaith Center of New York, Islamic Cultural Center of New York, MaAfrika Tikkun, Mosque of Islamic Brotherhood, Muslim Women’s Institute for Research and Development, Population Council, World Council of Churches and World Council of Conservative Synagogues. Entertainment was provided by PG and Love Choir and Salah.

UN Secretary-General Kofi Annan was joined by UNAIDS Executive Director Dr Peter Piot and leaders of different faiths to commemorate World AIDS Day at St. Bartholomew’s Episcopal Church in New York. The gathering in New York was one of a host of events taking place around the world to mark World AIDS Day 2006.

All photo credit : B. Hamilton

The red ribbon has become an internationally recognized symbol for AIDS awareness, worn by people throughout the year in support of people living with HIV and in remembrance of those who have died. On 1 December this year, people around the world will be pinning on their red ribbons as they commemorate World AIDS Day. But where did the ribbon come from?
In 1988, a group called Visual AIDS was founded by arts professionals as a response to the effects of AIDS on the arts community and as a way of organizing artists, arts institutions, and arts audiences towards direct action on AIDS.

Three years later, in 1991, some of the Visual AIDS artists came together to design a visual symbol to demonstrate compassion for people living with HIV and their care givers. Inspired by the yellow ribbons honoring American soldiers serving in the Gulf war, the artists chose to create a red ribbon to symbolize support and solidarity for people living with HIV and to remember those who have died from AIDS-related illnesses. The color red was chosen for its, "connection to blood and the idea of passion -- not only anger, but love, like a valentine," the Project founders say. The project was to become known as the Red Ribbon Project.

In a spontaneous campaign in 1991, Red Ribbon Project volunteers sent letters and red ribbons to all attendees at the Tony Awards in the United States where actor Jeremy Irons stepped out on national television with a red ribbon pinned prominently on his lapel.

The symbol came to Europe on a mass scale on Easter Monday in 1992, when more than 100,000 red ribbons were distributed during the Freddie Mercury AIDS Awareness Tribute Concert at Wembley stadium. More than one billion people in more than 70 countries worldwide watched the show on television. Throughout the nineties many celebrities wore red ribbons, encouraged by Princess Diana’s high profile support for AIDS.

“The fact that it was so widely imitated was amazing. We couldn't believe it,” said Allan Frame, one of the Visual AIDS artists involved in the creation of the red ribbon symbol.

Today the Red Ribbon has become an international symbol of solidarity and support for people living with HIV. Wearing a red ribbon is a simple and powerful way to challenge the stigma and prejudice surrounding AIDS .Wear yours with pride this World AIDS Day.

For more information on World AIDS Day activities around the world please visit the World AIDS Campaign website at: www.worldaidscampaign.info

Note: The red ribbon is a non copyrighted image that can be used freely around the world as an awareness-raising tool.

Photo courtesy of "In these times" Magazine 

AIDS and human rights are inextricably linked as demonstrated by Beatrice Were, a leading advocate for the rights of people living with HIV in Uganda who recently received the Human Rights Watch Defender Award in recognition of her work.

Mrs. Were is the co-founder of the National Community of Women Living with AIDS (NACWOLA), a grassroots organization that provides services to more than 40,000 women in 20 districts of Uganda. She has served as Executive Coordinator of the International Community of Women Living with HIV/AIDS, Uganda, has worked with UNAIDS over the years and was formerly a member of the UNAIDS Reference Group on HIV and Human Rights. Beatrice Were is currently working as the National HIV/AIDS coordinator for ActionAID International and has collaborated with different organizations to re-address the HIV prevention policies towards a more evidence and rights based response to AIDS in Uganda.

Beatrice Were talks to UNAIDS about the implications of the award on her work and on the rights of people living with HIV.

What does this award mean to you?

Basically this award means that my work is being recognised but also, in a much broader sense, it means that there is recognition of HIV as a Human Rights issue and more specifically there is recognition of the rights of women living with HIV. This award has also challenged me to do more to sustain the visibility of the rights of the people living with HIV as part of the Human Rights.

Is this award going to have any repercussions on your work?

As an HIV positive activist, my work towards the promotion of Human Rights and specially those of women living with HIV has been regarded by governments or scientists as emotional or unscientific. The award gives me the opportunity to show that contributions from activists like me and contributions from women living with HIV are essential to an effective response to AIDS and specifically in protecting the rights of people living with HIV.

Please, tell us about your professional trajectory.

I started from the grassroots level by working with home-based-care programmes for people living with HIV. Soon after, I decided to start an organization to support women living with HIV, addressing issues of property rights, doing advocacy, awareness raising and fighting stigma and discrimination. Today I focus my work on policy issues, accountability and critical engagement with government, donors and stakeholders to ensure that HIV is treated as a Human Rights issue. I’m also working to address gender inequality and access to treatment and prevention as well as dealing with issues of government corruption on abuse of funds committed to AIDS programmes.

What inspires your work?

After my husband’s death, I also tested HIV positive. My in-laws wanted to grab my property, take my children and marry me to my brother in law. Although I was still a young woman then I struggled, I fought back for my rights and I started speaking out. My inspiration today comes from the fact that what I started as a personal struggle when my own rights were abused has helped and improved the live of thousands of women. I am encouraged because I have seen that the power that lies within me has changed things and I believe that any woman once they are informed and supported can also make that change happen.

What do you think the role of the community is in promoting human rights in relation to HIV?

First of all communities need to be conscious that human rights are not a favour from government, that they own those rights and that they have the power to demand governments, NGOs and civil society to respect and fulfil those rights. Communities can do a lot by mobilising themselves and use the power of numbers to speak loud to address human rights and HIV, issues of property rights of women, gender violence or marital rape. The other thing that communities can do is protect the rights of people affected by HIV by respecting them and reducing stigma. The engagement of community leaders is particularly important to lead this process.

What has changed in the last ten years in Uganda?

On the positive side, what has changed is the recognition, even up to the UN level, that people living with HIV are critical partners in the response to the epidemic. There is also consciousness and high level of awareness of women’s rights and to some extent acknowledgement of those rights has been important. However, on the negative side, what is changing in Uganda is that we are seeing a new wave of stigma through a moralisation of the disease by new and radical evangelical groups. The influence of US policy on Uganda’s prevention strategy is undermining the efforts that Uganda has made in the last 25 years. There is also corruption in Uganda, embezzlement of the Global Fund money, reduced political will by government over HIV prevention and care programmes, and when a lot of money is coming into the country to strengthen the health system, we are seeing ARVs expiring and an incompetent health system unable to deliver antiretroviral therapy to the 130.000 Ugandans who need it consistently. So it is quite disappointing that Uganda which has been a success story in its response to AIDS is now undermining human rights not respecting the right to health or the right to information by only promoting abstinence-until-marriage prevention programmes.

How do you see the future in terms of Human Rights and HIV?

Personally I see a lot of opportunities in the near future because now there is recognition by international human rights groups like Human Rights Watch or UNAIDS through its Gender and Human Rights department. I see the opportunity of using these spaces to really amplify the issues of HIV and human rights. I also see opportunities for the activism of people living with HIV (PLHIV) and the networks of PLHIV who are at grassroots level. However, it is critical for those networks to be supported so they can grow strong. I also see opportunities in the other human rights groups who are now beginning to work closely with AIDS activists. Finally, there are many treaties on HIV and Human Rights that we need now to start using as guidelines more than ever instead of having those documents lie on the shelves.

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