Russian and international football legends and Russian players living with HIV joined forces on 17 April to play the first football match of the UNAIDS World Cup for Ending AIDS and Discrimination. International and national football stars draw attention to the stigma faced by people living with HIV and demonstrated the value of goodwill, solidarity, and human values towards ending stigma and discrimination.

The match took place in Moscow on the eve of the opening of the Sixth Eastern Europe and Central Asia AIDS Conference. This was the first of a series of matches to be held with support from FIFA in several different countries in the lead up to the 2018 World Cup which will be held in the Russian Federation from 14 June to 15 July 2018. The initiative highlights the need for zero discrimination on the basis of race, nationality or HIV status, both on and off the pitch.  

The Russian FC “Rosich” team was led by its captain, Deputy Prime Minister and Chairman of the Organizing Committee for the FIFA World Cup 2018, Arkady Dvorkovich. Team members included the Minister of Energy, Alexander Novak, the former Russian international and FIFA Anti-Discrimination Officer for the 2018 World Cup, Alexey Smertin, as well as former Russian internationals Dmitry Bulykin, Roman Shirokov, Evgeny Aldonin, Dmitry Sennikov, Oleg Kornaukhov, Marat Makhmutov, Vladimir Leonchenko and Roman Berezovsky.

Michel Sidibe, UNAIDS Executive Director, coached the UNAIDS “Red Ribbon” team, which was captained by former Cameroon international Samuel Eto’o. The Red Ribbon team featured former Senegal international, Abdoulaye Diagne-Faye, former French and Martinique international, Julien Faubert, former French under-21 international, Florent Sinama-Pongolle, former Nigerian international, Peter Odemwingie, former Moroccan international, Jaouad Zairi, Brazilian-born former Bulgarian international, Marcelo da Costa, former Palestinian women international and FIFA official, Hone Thalidjieh, and former Madagascar international, Alister Veerasamy.

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A record 3000 delegates from more than 60 countries, including representatives of civil society, scientific institutions, the private sector and governments, gathered in Moscow from 18 to 20 April 2018 to participate in the Sixth Eastern Europe and Central Asia Conference on HIV/AIDS. The conference focused on four major tracks: prevention, science and treatment, civil society, and international cooperation.

Eastern Europe and central Asia is the only region where the number of new HIV infections and AIDS-related death are still on the rise. The conference provides a unique opportunity to take stock of progress and discuss the challenges and transformation needed to get the eastern Europe and central Asia region on track to end AIDS.

The keynote speakers at the opening ceremony included Michel Sidibé, UNAIDS Executive Director, Olga Golodets, Vice Prime Minster of the Russian Federation, Anna Popova, Head of Russia’s Federal Service for Consumer Protection and Human Wellbeing, Alexsey Tsoy, Deputy Minister of Health of Kazakhstan, Alexander Pankin, Deputy Minister of Foreign Affairs of Russia, Lyudmila Rastokina, a representative of the Kazakhstan’s Union of People Living with HIV, and representatives of the private sector and others.

Despite the overall increase in HIV-related deaths and infections, in the past two years the eastern Europe and central Asia region has made progress in a few areas. For example, Armenia and Belarus were validated by the World Health Organization as having eliminated mother-to-child transmission of HIV. Most countries of the region adopted the test and treat approach and the average cost of first-line antiretroviral treatment has dropped from almost US$ 2000 per person, per year to less than US$ 200 per person, per year.

A number of key challenges were highlighted at the conference, including the fact that only 3% of total HIV expenditures in the region go for programmes focused on key populations, including people who inject drugs, migrants, sex workers, transgender people, prisoners and men who have sex with men. The region also faces the triple epidemics of HIV, tuberculosis and hepatitis C virus which require an integrated approach to prevention, diagnosis and treatment.

The conference was organized by the Russian Federation’s Federal Service for Consumer Protection and Human Wellbeing and UNAIDS.

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On the eve of Zero Discrimination Day on 1 March, more than 890 000 viewers joined the online platform OK.ru/test to discuss zero discrimination and join the launch of the UNAIDS regional #YouAreNotAlone campaign. The discussion was live-streamed on Odnoklassniki, the leading Russian-language social media platform for countries across eastern Europe and central Asia.

The #YouAreNotAlone campaign is raising awareness about the stigma and discrimination faced by children, adolescents and families affected by HIV in eastern Europe and central Asia. The campaign features young Russian artists who each retell the personal story of an adolescent living with HIV in the Russian Federation. Most adolescents in eastern Europe and central Asia still face stigma and discrimination that prevents them from being open about their HIV status.

The broadcast also featured an interactive online film, It’s Complicated. Based on the lives of adolescents and young people living with HIV in the Russian Federation, the film tells the story of Katya, a Russian girl born with HIV who faces stigma and discrimination but also finds love and support as she grows up and adjusts to life with HIV. Some of the film’s crew and lead actors joined UNAIDS and United Nations Educational, Scientific and Cultural Organization staff in the OK.ru discussion.

“The goal of the #YouAreNotAlone campaign is to promote solidarity with children, adolescents and families affected by HIV in eastern Europe and central Asia for them to live with safety and dignity,” said Vinay P. Saldana, Director for the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

The campaign has been promoted through social media by Vera Brezhneva, UNAIDS Goodwill Ambassador for Eastern Europe and Central Asia, Victoria Lopyreva, UNAIDS Ambassador for the 2018 FIFA World Cup, and others. Everyone is encouraged to support the campaign by posting a photo on social medial with the hashtag #тыНЕодинок (#YouAreNotAlone).

“These young people are inspiring and strong,” said Ms Brezhneva. “Something is very wrong with a society where the human rights and dignity of people living with HIV are not respected. Every person living with HIV should feel our support, #YouARENotAlone!”

The campaign was also launched in Armenia, where it was supported by actors, television presenters and others. Armen Aghajanov is the first person living with HIV in Armenia who publicly disclosed his HIV status during the launch of the #YouAreNotAlone campaign on Zero Discrimination Day. He said: “People are not dying from HIV, they die from discrimination, late diagnosis, lack of access to treatment or from not taking medicines.”

According to the Centre for AIDS Prevention and Control in Saint Petersburg in the Russian Federation, fewer people are becoming infected with HIV in the city. “Ten years ago, Saint Petersburg was among the top five most affected cities in the Russian Federation. Now it is only the 14th most affected,” said Denis Gusev, Head Physician of the AIDS centre. “Saint Petersburg is the first urban metropolis in the Russian Federation where a steady decline in new HIV infections has been recorded,” added Vinay P. Saldana, Director, UNAIDS Regional Support Team for Eastern Europe and Central Asia.

In 2017, there around 1750 people newly diagnosed with HIV in the city, compared to nearly 2200 in 2015. In total, about 42 000 people have been diagnosed as living with HIV in Saint Petersburg, 80% of whom access services at the Centre for AIDS Prevention and Control. The AIDS centre provides not only antiretroviral therapy, but also a full range of specialized medical care and HIV prevention services.

Artem Vereshchagin, who answers calls at the AIDS centre’s hotline, has been a client of the centre for more than 18 years and more recently an employee. He notes that more and more people who call the hotline now ask practical questions, such as “How do I get HIV treatment” and “How much time is needed to get an undetectable viral load”.

Saint Petersburg is one of the few cities in the Russian Federation that provides patients with virtually the entire range of HIV prevention and treatment services, including harm reduction. Prevention services are available at the city AIDS centre, where people can exchange syringes and get sterile equipment and condoms.

Quick testing for HIV is important, according to Mr Gusev, who says that the majority of people who are diagnosed with HIV in Saint Petersburg get immediate access to HIV treatment. “The main thing is for a person living with HIV to see a doctor and start antiretroviral therapy. Then we save a person’s life and help prevent new infections,” he said.

Saint Petersburg provides services for key populations, both in mobile clinics, in partnership with community-based organizations, and at the AIDS centre. “Women can get tested for HIV, receive condoms free of charge and talk to peer consultants,” said Irina Maslova, of the Astra Foundation, which works with female sex workers.

The Centre for AIDS Prevention and Control’s Department of Motherhood and Childhood provides services for women and children affected by HIV. The current level of mother-to-child transmission of HIV at the centre is 1%, but the staff want to reduce that to zero.

Saint Petersburg’s residents have been learning about HIV prevention services from a large outdoor advertising campaign and public service announcements across the city, supported by the city government. The advertising has three key messages—on HIV testing, the availability of HIV treatment and the elimination of all forms of stigma and discrimination against people living with HIV.

Credit for all photos above: UNAIDS/Olga Rodionova

On 11 and 12 December, representatives of four populations at higher risk of HIV infection—people who inject drugs, sex workers, lesbian, gay, bisexual, transgender and intersex people and former prisoners—gathered in Kyiv, Ukraine, for the legal formalization of the National Platform for Key Communities and to agree on key priorities for advocacy and on how the platform will be managed and operated.

The platform’s priorities will include influencing policies and decision-making processes, the development of a package of HIV prevention services that respond to the needs of key populations and responding to discrimination.

The participants decided on the positioning, role and contributions of the platform in the national AIDS response, the implementation of a Fast-Track strategy and the form of an HIV prevention 100 days of action campaign. They also enthusiastically welcomed continued Dutch, UNAIDS and civil society collaboration and agreed on a unified strategic vision for the participation of civil society and the platform in key events, including the International AIDS Conference, to be held in Amsterdam, Netherlands, in 2018.

The three key advocacy areas for the platform will be:

• The participation of communities in decision-making on health, an effective response to HIV and tuberculosis and the protection of human rights.
• The provision of access to services for key groups focused on the needs of communities that are implemented by the communities and funded by national and local budgets.
• The protection of rights and the prevention of discrimination.

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Mahabad Asanova’s first daughter was found to be living with HIV after being rushed to hospital with a high fever. For her second pregnancy, Ms Asanova had to wait 18 months before finding out that her son was HIV-negative.

By the time of her third pregnancy, however, things had changed dramatically. Within a month of her birth, Ms Asanova had been told that her daughter was HIV-negative. A revolutionary method of HIV testing of infants, dried blood spot (DBS) testing, had by then been introduced, significantly cutting the time for diagnosis.

“Waiting 18 months to know about the HIV status of my child was terrible,” Ms Asanova said. “I’m so relieved—dried blood spot testing completely changed my life.” Before DBS, children had to wait a year or more to be tested.

DBS is simple: no sophisticated equipment or invasive testing methods are needed. After a prick on the newborn’s heel, a drop of blood is collected on filter paper and dried. The sample is sent to a laboratory for testing and the results are known before the infant is a month old, allowing infants living with HIV to be treated immediately with life-saving antiretroviral medicines.

“Before dried blood spot testing was widely introduced in 2013 in Kyrgyzstan, only around 15% of infants were diagnosed early,” said Edil Tilekov, HIV Programme Officer for the United Nations Children’s Fund (UNICEF). “In 2017, that figure grew to nearly 90%.”

Today, HIV science and diagnostics are becoming ever-more sophisticated. UNICEF is promoting point-of-care HIV diagnostic methods for infants that would yield an HIV diagnosis a mere two hours after collecting blood.

The introduction of DBS and improved training for doctors has helped to defuse some of the stigma against people living with HIV.

“Stigma among medical staff began to decrease as antiretroviral medicines were integrated into the primary health-care system,” Elmira Narmatova, Director of the Osh Oblast AIDS Centre, said. “It became more like a chronic disease, mortality declined.”

Children who are treated early fare better and the more the medicines work, the more confident parents become. Today, in part as a result of DBS, more than 95% of children living with HIV in Osh, Kyrgyzstan, access antiretroviral therapy.

Yet pockets of resistance remain. Despite early diagnosis, not all infants receive the medicines they need. “We are interviewing parents and medical staff to find out why some parents still don’t want to give their infants antiretroviral medicines,” said Mr Tilekov.

Informal conversations already provide clues: resistance may be due to religion, to scepticism about immunization or even to urban myths.

“Although much has been done to provide parents with information and train medical staff, there is still a lack of resources and trained personnel, so some parents will slip through the net and might not be briefed properly about side-effects,” said Mr Tilekov. “So, if their infants lose weight or don’t eat well after starting antiretroviral therapy, parents blame the medicines.”

When an infant or mother is tested for HIV in Osh, the laboratory sends the results to the Osh AIDS Centre, a pleasant house set among trees in a leafy suburb, its gates open in welcome. The hallways are decorated with images of the popular Vitaminka fairy tale, a comic strip that helps health workers and parents explain to children the importance of taking their antiretroviral medicines regularly.

By providing child-friendly spaces and psychosocial support in addition to medical treatment, the centre makes parents feel welcome and encourages them to visit, pick up prescribed medication and get tested regularly.

The centre, upgraded by the Ministry of Health together with UNICEF and UNAIDS with support from the Government of the Russian Federation, now treats more than 200 children and a psychologist provides psychosocial support to children living with HIV.

Away from social pressures and among friends, parents can exchange hopes for the future and find much needed support at the centre.

Ms Asanova looks relaxed as her fingertips touch across her lap, her olive-green dress contrasting with her cream-coloured hijab. Mahabad Asanova isn’t her real name, since she still worries about stigma and discrimination beyond the centre’s walls. But she isn’t afraid anymore, even though she is now expecting another child. Whatever happens, thanks to DBS, she will no longer face painful months of waiting for a diagnosis.

A global ministerial conference held in Moscow, Russian Federation, on 16 and 17 November that united more than 1000 participants, including 75 ministers and 114 country delegations, concluded with the adoption of the Moscow Declaration to End TB.

The Moscow Declaration to End TB is a new commitment to increase multisectoral action and enhance accountability in the global TB response towards ending tuberculosis (TB) by 2030. The declaration will also inform the first United Nations General Assembly High-Level Meeting on TB, in 2018, which will seek to advance commitments to end TB from heads of state and government.

The declaration outlines the importance of international action to address key areas to respond to TB: sustainable financing, pursuing science, research and development and the establishment of a multisectoral accountability framework.

The conference, the First World Health Organization Global Ministerial Conference on Ending Tuberculosis in the Sustainable Development Era: a Multisectoral Response, was opened by the President of the Russian Federation, Vladimir Putin. It was attended by high-level United Nations leaders, including Amina J. Mohammed, the United Nations Deputy Secretary-General, Tedros Adhanom Ghebreyesus, the World Health Organization Director-General, and Michel Sidibé, the UNAIDS Executive Director.

TB is the world’s leading cause of death from infectious disease—in 2016, 1.7 million people died from the disease—and has profound economic and social consequences. The public health crisis of multidrug-resistant TB continues to deteriorate and TB is the leading cause of death among people living with HIV. 

During the conference, Mariam Avanesova, who was treated for multidrug-resistant TB in Armenia from 2010 to 2012 and represents the organization TBpeople, the Eurasian network of people living with TB, handed over the #StepUpforTB petition. The petition is an urgent call for health ministers in key TB-affected countries to ensure that their TB policies and practices are in line with international standards, as defined by the World Health Organization, including testing and treatment of TB and its drug-resistant forms. Initiated by Médecins Sans Frontières and the Stop TB Partnership, the petition has been signed by more than 30 000 people from 120 countries.

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Victoria Lopyreva has been appointed as a UNAIDS Special Ambassador, tasked with highlighting HIV awareness and promoting zero discrimination during the 2018 FIFA World Cup, which will be held in the Russian Federation. The announcement was made by UNAIDS in Moscow, Russian Federation, on the eve of World AIDS Day and the final draw for the 2018 FIFA World Cup at the State Kremlin Palace.

“In her new capacity as a UNAIDS Special Ambassador, Victoria Lopyreva will highlight HIV awareness and prevention during the 2018 FIFA World Cup. She will encourage millions of people coming to the World Cup to protect themselves from HIV and champion zero discrimination on the basis of race, nationality or HIV status,” said Vinay P. Saldanha, Director for the UNAIDS Regional Support Team for Eastern Europe and Central Asia.

“It is my pleasure to accept the role as UNAIDS Special Ambassador for the 2018 FIFA World Cup,” said Ms Lopyreva. “Football is a unique global phenomenon, uniting players, teams and fans from different countries, nationalities and ages. The 2018 FIFA World Cup is a unique opportunity to promote another amazing goal—to unite a winning team to end the AIDS epidemic and reach zero discrimination.”

"I appreciate and value every day Victoria Lopyreva's commitment as FIFA World Cup 2018 Ambassador in Russia. Her passion, her dedication and her energy will definitely help raise awareness on HIV and AIDS in and outside Russia. Victoria's contribution to fighting all forms of discrimination in and off the pitch is something that FIFA can be proud of and I wish her full success in her additional role as UNAIDS Special Ambassador in Russia,” said  Fatma  Samoura, FIFA Secretary General.

Since the beginning of the AIDS epidemic, 78 million people have become infected with HIV and 35 million have died from AIDS-related illnesses. In 2016, around 1.8 million people were newly infected with HIV, a 39% decrease from the 3 million who became newly infected at the peak of the epidemic in the late 1990s. In eastern Europe and central Asia, new HIV infections have risen by 60% since 2010 and AIDS-related deaths by 27%. According to government data, more than 900 000 people are currently living with HIV in the Russian Federation.

Ms Lopyreva was crowned Miss Russia in 2003 and since October 2015 has been an official Ambassador of the 2018 FIFA World Cup. Ms Lopyreva also served as an Ambassador for the XIX World Festival of Youth and Students 2017, held in Sochi, Russian Federation, and works as a television presenter, event host, motivational speaker and model.

A new mobile app for people living with HIV, Life4me+, is now available for free in 156 countries and in six languages—Armenian, English, Estonian, German, Russian and Ukrainian. The app was created by a German–Russian activist living with HIV and his team and aims to simplify medical information and treatment for people living with HIV in eastern Europe and central Asia and beyond.

The app was developed based on the experiences of its developers and HIV activists. For people living with HIV, the app works like a personal electronic patient card. It allows users to stay in touch with doctors online, saving and displaying test results, a calendar of blood tests and a prescription history, and sets up reminders about when to take medication and schedule appointments. There are also functions for recording weight, chest volume, blood pressure, disease history, HIV drug resistance, etc.

It has an interactive map that shows the location of medical centres and nongovernmental organizations supporting people living with HIV, daily HIV-related news and up-to-date information and popular scientific articles on HIV. A help button contains links to hotlines on HIV treatment and prevention and psychological and legal support for women, adolescents and drug users. Currently, the links to the hotlines are available only to people living in some countries in eastern Europe.

With the patient’s permission, doctors can monitor medicine intake and track adherence. The app has special provisions to protect anonymity and confidentiality. All the data are depersonalized, so there is no risk of a person being identified as living with HIV, even if a user’s phone or computer is used by someone else. Life4me+ can be downloaded from Google Play and the Apple App Store.

An updated version of the app will be released on 1 December, which will include functions aimed at preventing new HIV infections, hepatitis C and sexually transmitted infections such as syphilis and gonorrhoea, with automatic reminders to test for those diseases. 

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From 14 to 21 October, almost 25 000 young people from 188 countries gathered in Sochi, Russian Federation, for the XIX World Festival of Youth and Students. The festival provided a space for young people to unite in addressing global challenges, with a special focus on the Sustainable Development Goals (SDGs).

Through the leadership of the PACT youth coalition against HIV and with support from UNAIDS and participation of UNFPA and UNESCO, the issues of ending AIDS and sexual and reproductive health and rights were high on the agenda.

Three sessions focused on comprehensive sexuality education, modern epidemics and the role of young people in ending AIDS by 2030. The overarching theme of the discussions was that although much progress has been achieved in the response to HIV, there are still persistent challenges that put young people at risk, including discrimination, exclusion, violence and lack of access to services such as comprehensive sexuality education.

Speakers at the comprehensive sexuality education session highlighted that the absence of quality comprehensive sexuality education remains one of the largest gaps in ensuring that young people know how to protect themselves from HIV. Speakers also presented key new products and platforms, including a comprehensive sexuality education hub, teensLIVE.info, a video lesson developed for schoolchildren in eastern Europe and central Asia featuring UNAIDS Goodwill Ambassador Vera Brezhneva and a series of videos by the NauchPok channel.

The PACT youth coalition met with the United Nations Secretary-General’s Envoy on Youth, Jayathma Wickramanayake, who said, “I am looking forward to working with all of you through UNAIDS and other partners. My goal is to ensure that young people have a voice in all United Nations processes and to help them address issues that are relevant to them and their communities, including those issues that may be perceived as sensitive or challenging.”

Lack of access to information on HIV leads to new HIV infections and sustains the root causes that put young people at risk, including inequality, discrimination, violence and exclusion. Dilyara Vagapova, from the Russian rock group Murakami, said, “Without open conversations with young people about HIV, sex and the harm done by drugs, we will not succeed in ending the HIV epidemic in eastern Europe and central Asia.”

To ensure that the targets in the 2016 United Nations Political Declaration on Ending AIDS are met, accountability is key. Young leaders from Bulgaria, India, South Africa, Tajikistan, Ukraine and the United Kingdom of Great Britain and Northern Ireland shared best practices in peer education and youth-led accountability for the SDGs and the HIV response. Yana Mladenova from Bulgaria, said, “A policy on paper is not the same as a policy in practice. Successful advocacy results in action in practice.” Yana Valchuk, from the Teenergizer adolescent network, said, “To end the epidemic, we need to end discrimination, so adolescents stop living in fear.”

Vinay P. Saldanha, the UNAIDS Regional Director for Eastern Europe and Central Asia, spoke at several sessions. “Achieving the Sustainable Development Goals, including ending AIDS by 2030, does not depend on those that negotiated them. It depends on the personal commitment of each young person at this festival. This is your world—these are your goals!,” he said.