Health situation rooms—software platforms designed to support decision-making on countries’ health responses—are opening up across Africa, bridging data and decision-making in order to improve the health and lives of tens of millions of the world’s most vulnerable people.

Data integration, data warehousing and data visualization are the core of the situation room concept, providing transparent and improved information on a range of diseases. While situation rooms are virtual working space, some countries also use physical rooms in which the analytics can be discussed and acted upon.

The idea of a health situation room is that data—whether on the availability of HIV medicines, the effects of a strike by health-care workers or diagnoses of cervical cancer—are centralized, yet accessible to everyone. Whereas in the past health data on different diseases would be spread around several databases in assorted government ministries, disease-specific organizations, etc., situation rooms collect the data in one place, on one system, in a form that is easily shared. The information held by the situation room can be utilized on tablets or computers throughout the country.

“We must continue to innovate in our response to HIV,” said Michel Sidibé, the UNAIDS Executive Director. “Having reliable and up-to-date information is vital if the world is to meet its commitment to end AIDS and reach the Sustainable Development Goals.”

By pooling the health data in the virtual situation room, better and more focused health services can be made available to the people who need them. For example, having data on specific parts of a city helps to drive a location–population approach to HIV prevention services, ensuring that the right people are reached in the right place with the right services.

Through combining data on, for example, HIV, tuberculosis and cervical cancer, interlinkages between the diseases can be seen and responded to. Data can be viewed in real time, so, for example, levels of HIV medicines can be monitored in order to anticipate and respond to medicine stock-outs. Studying the effects of HIV test and treat campaigns in Uganda, the effectiveness of cervical cancer screening in Côte d’Ivoire and malaria testing and new diagnoses in Zambia are other examples how health situation rooms are benefiting health responses.

Five countries—Côte d’Ivoire, Kenya, Lesotho, Zambia and Uganda—have launched situation rooms. Data on indicators, including on HIV, tuberculosis, malaria, noncommunicable diseases and reproductive, maternal, newborn and child health are gathered, with different countries collecting different information depending on the local situation. Namibia, Mozambique and Zimbabwe are preparing to launch situation rooms, and several other countries are in the planning stage.

As part of its work, UNAIDS has been helping countries to set up their situation rooms, with UNAIDS working with countries to select the specific indicators and connecting data in the country to their situation room. Countries with existing data collection systems, that collect data separated by age and sex and at the local level, that have good Internet connectivity and that have qualified local staff are best placed to establish their own situation rooms.

The situation room programme has resulted in UNAIDS’ support to countries being enhanced, with UNAIDS able to support health information systems in a way unique in the United Nations system. UNAIDS is therefore supporting country and programmatic monitoring in a more meaningful way in those countries that have invested in situation rooms.

“For us, its strength is in bringing multiple data sets together, and sharing powerful analytics in a visual and understandable way,” said Andrew Kashoka, Deputy Director of Information Technology, Zambia Ministry of Health.

For the future, UNAIDS plans to ensure that countries have technical support so that they can continue to operate their situation rooms without support from UNAIDS. UNAIDS will also work with partners, including the Africa Centres for Disease Control and Prevention, the private sector and others, to reduce the dependency of countries on UNAIDS’ support in setting up and running the platforms.

Such investments in technology and collaboration between UNAIDS, governments and partners are driving innovative approaches to responding to AIDS and to ultimately ending the AIDS epidemic as a public health threat by 2030.

L to R: ONE Senior Advisor and Washington Post Columnist Michael Gerson, South Africa’s Minister of Finance, Honourable Pravin Jamnadas Gordhan, EGPAF Family Ambassadors Fortunata Kasege and her daughter Florida Mwesiga, UNAIDS Executive Director Michel Sidibé, CTAOP Founder and UN Messenger of Peace Charlize Theron, BD CEO, President and Chairman of the Board, Vincent Forlenza, US Global AIDS Coordinator, Ambassador Eric Goosby.
Credit: UNAIDS/C.Kleponis

Shared responsibility of the AIDS response must become part of a new global compact. This was the central message of a high-powered breakfast meeting that took place in Washington, DC on 18 April.

The event brought together leaders in the response to AIDS with members of United States Congress, the Administration, the private sector and AIDS advocates to emphasize how the adoption of the ‘shared responsibility’ approach is translating joint efforts into real results.

The Executive Director of UNAIDS, Michel Sidibé thanked the United States for its longstanding leadership in the AIDS response through such ground-breaking initiatives as the multi-billion dollar President’s Emergency Plan for AIDS Relief (PEPFAR) and its support to the Global Fund to Fight AIDS, TB and Malaria. “The continued leadership and investment from the United States is not only helping to leverage additional resources from donor governments but also from the domestic budgets of low-and middle-income countries,” said Mr Sidibé.” 

South Africa’s experience, for example, shows how the shared responsibility is being translated into real results on the ground. The government now accounts for some three-quarters of the AIDS spending in the country and, under a Partnership Framework signed with the US, it will finance almost 90% of its response by 2017.

According to South Africa’s Minister of Finance, the Honourable Pravin Jamnadas Gordhan, “South Africans have turned the tide against AIDS. Our achievement is a tribute to the close collaboration between South Africans—government, business, researchers, and community workers—and the steadfast and generous support of our partners in the international community.”

South African film star, United Nations Messenger of Peace and founder of the Africa Outreach Project, Charlize Theron said, “The tipping point is upon us and we have an incredible opportunity to turn the tide on HIV and end the AIDS epidemic for good.  I ask that you please take this opportunity to heart and from wherever you sit—Congress, corporate America, the community—that you continue to use your power and influence to keep creating hope and help moving the AIDS response forward.  We can, we must, and we will overcome this epidemic together.”

Florida Mwesiga, Family Ambassador for the Elizabeth Glaser Pediatric AIDS Foundation, played a special role in highlighting the impact of HIV on young people. “I’m thankful that my mum was able to receive treatment that protected me from HIV while she was pregnant,” said Ms Mwesiga. “My mum continues her fight to ensure all mothers everywhere can experience the gift of an HIV-negative child,” she shared. “My mother’s courage to stand up and demand change inspires me every day. And it’s because of her that I feel so empowered to also make a difference,” added Ms Mwesiga reminding all participants that everyone has an important role to play in the response to AIDS.

It was clear by the end of the meeting that important contributions by the US to the AIDS response are crucial to achieving the ambitious but attainable goal of an AIDS-free generation. Ambassador Goosby concluded that, “Collectively, we've taken great strides in the global AIDS response. PEPFAR is proud of its close collaboration with host countries and other partners in supporting this transformational change. While much work remains to be done, through country ownership, smart investments, and shared responsibility, I am confident that we will create an AIDS-free generation.”

The event was co-hosted by the Charlize Theron Africa Outreach Project, the Elizabeth Glaser Pediatric AIDS Foundation, ONE, the United States Global Leadership Coalition, and UNAIDS. 

Panellists at a conference session on 4 July focused on African innovation. (Left to right): UNAIDS Executive Director Michel Sidibé; Hon. Tim Thahane, Minister of Minerals, Energy and Water Affairs, Lesotho; Mr. Claude Sekabaraga, Senior Health Systems Strengthening and Results Based Financing Specialist, World Bank; Hon. Kebede Worku, State Minister of Health, Ethiopia; Ms Kampeta Sayinzoga, Permanent Secretary, Ministry of Finance, Rwanda.

Addressing 60 Ministers of Finance and Health at a conference in Tunis on 4 July, UNAIDS Executive Director Michel Sidibé praised African leaders for their increased engagement and partnership in HIV responses across the region.

“AIDS investments have fuelled progress across the health and development spectrum,” said Mr Sidibé, who participated in a conference session focused on African innovation.

Strategic HIV investments in Africa have yielded multiple returns. In 22 countries of sub-Saharan Africa, the rate of new HIV infections dropped by more than 25% between 2001 and 2009. More than 5 million Africans are now receiving antiretroviral treatment—up from just 50 000 a decade ago.

However, these gains are fragile. Every day, 3500 Africans die of AIDS. An estimated 5 million Africans who need HIV treatment are still not accessing it. About 300 000 children in Africa continue to be born with HIV every year.

In the current economic downturn, scarce resources must be used with greater efficiency, transparency and accountability, said the UNAIDS Executive Director, in a presentation entitled African solutions to achieve greater value for money. He highlighted cost-effective policies and programmes that have delivered sustainable results on the ground.

In South Africa, for example, unit costs of HIV drugs have been significantly reduced as more people access treatment—from US $500 to $200 per person. Other countries have reduced programme costs by eliminating parallel structures and stand-alone health services.

Investing in innovation

African leaders can accelerate progress by investing in innovation, said Mr Sidibé. Through partnerships with emerging and industrialized economies, they should facilitate the transfer of technologies for medicines and commodities. By focusing resources on HIV research and development, they could build Africa’s knowledge-based economy, he added.

Mr Sidibé encouraged ministers attending the conference to reduce Africa’s dependency on imported HIV medicines through the local production of antiretroviral drugs. He said that a single drug regulatory authority in Africa could ensure the faster roll out of quality-assured medicines.

A new paradigm

Africa is poised to transcend the outdated donor-recipient paradigm, said the UNAIDS Executive Director. Leaders are beginning to embrace a new global compact for shared responsibility and national ownership, he said.

Organized by Harmonization for Health in Africa and hosted by the African Development Bank, the two-day conference in Tunis brought together ministers, parliamentarians and high-level representatives from international organizations, civil society and the private sector.

Secretary-General Ban Ki-moon speaks to reporters on arrival in Busan, Republic of Korea, to address the Fourth High-Level Forum on Aid Effectiveness.
Credit: UN News

Some 3500 delegates, including heads of state, ministers, civil society, the private sector and leaders of international organizations have come together for the Fourth High-Level Forum on Aid Effectiveness in Busan, Korea, from 29 November to 1 December to review the impact of development aid and chart a bold course for how the future of development cooperation will support the achievement of the Millennium Development Goals.

Speaking at the opening, UN Secretary General Ban Ki-moon underlined the need to move towards a “new cooperation partnership” based on shared responsibility where traditional donors continue aid programmes despite the economic crisis; where countries receiving aid set clear development priorities, deliver on commitments and work more with civil society; and where emerging aid donors and the private sector increase aid efforts and commitments.

"Our agenda today is very clear," Ban said. "We are here to ensure that aid reaches those most in need, the most vulnerable people who we have to take care of."

Underlining how commitment to development assistance has helped to slow the spread of HIV and reduce child mortality, the Secretary General emphasized the urgent need to continue support for “highly productive multilateral initiatives such as the Global Fund to Fight AIDS, TB and Malaria.”

Towards a “new global partnership for development” the Secretary General stressed three principles as the basis for effective aid:  accountability, flexibility and ownership. 

“Countries that are accountable, countries that receive flexible aid, countries that have the most ownership -- will be best placed to achieve the best results,” he said.

New partnership for Africa’s development

In Busan on Tuesday 29 November, UNAIDS Executive Director Michel Sidibé stressed that the time is right for new paradigms for international development cooperation to transform the concept of aid effectiveness. Mr Sidibe spoke at a side event on the impact of development aid in Africa, organized by the New Partnership for Africa’s Development (NEPAD) and the United Nations Development Programme (UNDP).

“At this game-changing moment in the AIDS response, today’s development paradigms look tired and confused – no longer responding to the needs of a changing world,” said Michel Sidibé, UNAIDS Executive Director. “We need to broaden the discourse beyond a focus on just financial sustainability. A socially sustainable agenda for Africa must be agreed upon in Busan.”

Although sub-Saharan Africa remains the region worst-affected by HIV with nearly 70% of the 34 million people living with HIV worldwide, the countries of sub-Saharan Africa have the potential to lead the AIDS response as they have increased access to technology, economic growth and a growing workforce, he stressed.

Youth as ‘transformers’

Mr Sidibé also joined the Korean Minister of Education, Science and Technology, Dr LEE Ju-Ho, at the Youth Forum to hear the perspectives of young people on effective aid and development. The Youth Forum, hosted by the Korean government and organized by the Korean National Commission for UNESCO, addressed ways to increase young people’s participation in aid and development.

Speaking to young people at the opening of the Youth Forum, Mr Sidibé said, “You are not spectators in development architecture—you are transformers. You are the leaders of today - transforming the world and the way development is done through your bold ideas and the innovative use of technology.”

Calling on young people to engage in the development of UNAIDS’ new youth strategy, Mr Sidibé highlighted how social media is a powerful tool for development and innovation. UNAIDS is using crowdsourcing to empower young people, including young people living with HIV, to take ownership and develop the strategy online. To participate in this initiative, go to www.crowdoutaids.org.

UNAIDS Executive Director Michel Sidibé and Director-General of Australia’s AID Program (AusAID) Peter Baxter in Canberra. Credit: Australian Department of Health and Ageing

Concluding his first official visit to Australia, UNAIDS Executive Director Michel Sidibé stressed the need for the international community to mobilize an additional US $10 billion to meet country-set targets for universal access to HIV prevention, treatment, care and support.

Just weeks before the upcoming replenishment meeting of The Global Fund to Fight AIDS, Tuberculosis and Malaria, Mr Sidibé discussed sustaining and enhancing investments in AIDS with the Director-General of Australia’s AID Program (AusAID) Peter Baxter in the capital Canberra.

“There are currently 10 million people living with HIV who are waiting for life-saving treatment. Unless we close the funding gap, millions of people will be turned away from the promise of universal access,” said Mr. Sidibé during the bilateral.

The Executive Director thanked Mr. Baxter for AusAID’s support to the HIV response, particularly in the Asia-Pacific region, and its recent commitment to increase funding to UNAIDS by almost US $900 000. However, he also expressed his concerns that after steady and significant increases in HIV investments, other donors might for the first time flat-line or even reduce funding.

In Canberra, Mr. Sidibé also met with the Secretary of the Department of Health and Ageing, Jane Halton, and the Deputy Director-General of the Office of National Assessments, Bruce Miller.

Mr Sidibé’s five-day trip to Australia began in Sydney at the Lowy Institute for International Policy where he spoke on the state of the epidemic and imperatives for reshaping the global AIDS response. In Sydney, he visited the renowned medically supervised injecting centre in Kings Cross, the only such facility in the Southern Hemisphere. He commended the facility’s work, calling it a ''pragmatic, cost-effective'' model to halt HIV transmission and prevent illness and death among the most vulnerable intravenous drug users in New South Wales.

Mr. Sidibé was presented with an award from a coalition of organizations involved in Australia’s HIV response that recognized his personal contribution to overcoming the AIDS response.

Jane Halton PSM, the Secretary of the Australian Department of Health and Ageing, and UNAIDS Executive Director Michel Sidibé in Canberra. Credit: Australian Department of Health and Ageing

In Melbourne, the Executive Director delivered the keynote address at the 63rd UN DPI/NGO conference. UN Secretary-General Ban Ki-Moon opened the health-themed conference with a video message in which he underscored the many gains made in global health, including greater access to HIV treatment. But he cautioned delegates stating “We still have some distance to go. Meeting our commitments on health is central to meeting all of the Millennium Development Goals.”

Following the UN DPI/NGO conference – the largest UN event ever held in Australia – Mr. Sidibé joined the launch of the Michael Kirby Centre for Public Health and Human Rights. This new research centre, which focuses on the link between human rights and public health, is a collaborative venture between scientists, lawyers, medical practitioners and academics at the School of Public Health and Preventive Medicine at Monash University. Former Justice of the High Court of Australia, Michael Kirby is a renowned human rights expert and was recently appointed to the new Global Commission on HIV and the Law.

Also in Melbourne, Mr. Sidibé met with Australian business leaders at the Asia Pacific Business Coalition on AIDS (APBCA), which is leading the region's private sector response to HIV. He congratulated the business coalition for its engagement and encouraged even greater involvement of Australia’s dynamic private sector in delivering innovative solutions to respond to HIV across the region.

The Executive Director visited the HIV research laboratory of the Burnet Institute, Australia's largest virology and communicable disease research institute. Professor Sharon Lewin showcased the Institute’s cutting-edge research on low-cost laboratory diagnostic tools and the eradication of HIV reservoirs among people living with HIV.

Mr. Sidibé will conclude his Asia-Pacific tour in Japan where he will meet with Japanese Government officials and business leaders in Tokyo.