UNAIDS Executive Director Michel Sidibé (left) met with the Prime Minister of Senegal, Mr Abdoul Mbaye, on 15 October.

Meeting on 15 October with the Prime Minister of Senegal, Mr Abdoul Mbaye, UNAIDS Executive Director Michel Sidibé commended the leadership of Senegal for its success in keeping national HIV prevalence low, at approximately 0.7%.

“Senegal is a model for this sub-region,” said Mr Sidibé. “It has shown that stabilizing the HIV epidemic and reducing the number of new HIV infections is possible. The priority now is to sustain the gains made so far,” he said.

Progress and challenges

In recent years, Senegal has considerably expanded access to antiretroviral therapy (ART), reaching 74% of people eligible in 2011. Between 2006 and 2011, the number of sites offering HIV counselling and testing increased from approximately 100 to more than 1000. In his meeting with the Prime Minister, Mr Sidibé encouraged Senegal’s leaders to move progressively towards routine HIV testing through the use of new technologies.

In 2011, 976 health facilities in Senegal offered services that prevent mother-to-child transmission (PMTCT) of HIV—up from 648 in 2010. Despite progress, national PMTCT coverage remains low, at about 40%. Mr Sidibé commended the progress realized to date while underscoring that extra effort is needed to ensure an HIV-free generation.

Prime Minister Mbaye said that his country was committed to eliminating new HIV infections among children by 2015.  “This will allow us to make the link to HIV testing and reduce maternal mortality,” he added.

Funding the national HIV response

The Prime Minister noted that though Senegal had recently received an HIV grant from the Global Fund to Fight AIDS, Malaria and Tuberculosis, the country would need to seek innovative sources of domestic financing to ensure that its HIV-positive population had access to ART over the long term. In doing so, Senegal could reduce its dependency on external aid for the national HIV response, which currently stands at about 80%, he said.

Mr Sidibé spoke of the need for the local production of antiretroviral therapy—a suggestion well received by the Prime Minister: “It is a very good idea that we will help carry forward. But to achieve a threshold of profitability, we must find sponsors and attract investors. The state is not the solution!” he said.

During his two-day mission in Dakar, the Executive Director attended a UNAIDS regional management meeting and met with the President of the National Assembly of Senegal, Mr Moustapha Niasse.

President of Senegal Macky Sall at Shared Responsibility & Global Solidarity event at UN Headquarters, NYC, on September 26, 2012.
Credit: UNAIDS/B.Hamilton

With new leadership and bold commitments, the Senegal has continued the success of its national AIDS response, keeping HIV prevalence low and earning the recognition of global partners for its progress and achievements.

“This is the time for Africa to intensify its efforts and create a new international compact against AIDS,” said President Macky Sall of Senegal at the recent high-level side event on Sourcing Sustainable Solutions for the AIDS response in Africa at the UN General-Assembly. “With the new vision of Shared Responsibility and Global Solidarity, the African’s Union’s Road Map has enabled Senegal to prioritize HIV prevention and plan to end HIV transmission from mother to child.” President Sall was one of the key African heads of state to join the Chairperson of the African Union, President Boni Yayi and US Secretary of State Hilary Clinton to address this side event that highlighted the AU’s Roadmap on Shared Responsibility and Global Solidarity for the AIDS, TB and malaria response in Africa.

At a recent meeting in Geneva, UNAIDS Executive Director Michel Sidibé also commended the work of Senegal’s National AIDS Council at a recent meeting with its Executive Secretary, Ibrahim N’Doye. During discussions on Senegal’s AIDS response, Dr N’Doye highlighted how political commitment contributed to the scale-up of HIV services in his country.

Under the leadership of President Macky Sall, the contribution of the Government of Senegal continues to increase steadily. The country has also called for greater transparency and initiated a resource tracking exercise with the assistance of UNAIDS aimed at maximizing AIDS investments and impact.

These efforts were recently backed by an audit by the Office of the Inspector General (OIG) of The Global Fund to Fight AIDS, TB and Malaria. Successful with its application for Phase 2 of an on-going HIV grant, Senegal will receive an additional US$ 33 million for the next three years. The renewed grant, approved by The Global Fund board on 24 September 2012, will contribute to financing the implementation of Senegal’s HIV National Strategic Plan.

According to the Global Fund, Senegal has been a model for the HIV response in the West and Central Africa region with a portfolio of well-performing grants, mobilized in-country partners, and a vibrant civil society. The recent report from the OIG highlighted that overall, results in Senegal were encouragingly positive. The OIG was able to confirm that appropriate oversight arrangements had ensured that all grant funds were properly utilized and produced very good results.

The report from the OIG also provided concrete recommendations to both country partners (Country Coordinating Mechanism and Principal Recipients) as well as the Global Fund Secretariat in order to enhance accountability through a more holistic and integrated approach. These recommendations included the need to strengthen financial management capacity of sub-recipients and the need to improve drug management, distribution and storage.

The country has made major efforts in the past five years to scale-up access to HIV prevention, treatment, care and support for its population, with a focus on key populations at higher risk.  It is one of the few countries in the West and Central Africa region, which has collected robust data on hard to reach populations such as sex workers, men who have sex with men and people who use drugs.

Scaling up HIV services

Dr Ibrahim N’Doye Executive Secretary, National AIDS Council of Senegal and UNAIDS Executive Director Michel Sidibé

The country has scaled up access to antiretroviral treatment (ART) substantially and treatment is now widely available in many parts of Senegal. The number of people receiving ART increased from 5500 in 2006 to 18 352 in 2011. Between 2006 and 2010, the number of sites offering voluntary counselling and testing also increased from 109 to 687 and reach the number of 1023 in 2011. The services to prevent transmission of HIV from mother to child were scaled-up from 404 in 2009 to 648 in 2010 and 976 in 2011.

Such combination of efforts is having positive results. According to UNAIDS, HIV prevalence among the general population remains stable at 0.7%, while HIV prevalence among sex workers has decreased from 19.8% in 2006 to 18.5% in 2011 and new HIV infections among youth has decreased.

L to R: UNAIDS Executive Director Michel Sidibé, Ambassador Sylvie Lucas of Luxembourg, First Secretary of the Republic of Malawi Janet Zeenat Karim, International Treatment Preparedness Coalition (ITPC) co-founder David Barr. United Nations, NYC, on June 11, 2012.
Credit: UNAIDS/B.Hamilton

Coinciding with the 2012 General Assembly AIDS review, the Permanent Missions of Malawi and Luxembourg to the United Nations and UNAIDS organized a panel discussion to further understand the strategic investments needed for the AIDS response. The discussion brought together representatives of member states, UN organizations and civil society.

Participating in the discussion, UNAIDS Executive Director Michel Sidibé stressed the need to focus investments where they can have greater impact. “Proven, effective and context-specific HIV prevention and treatment interventions must be prioritized and scaled up,” said Mr Sidibé. “Approaches that are not tailored to reach people most in need, are at inappropriate scale and intensity, or whose benefits are undercut by persistent inefficiencies, should be discouraged,” he added.

Panellists agreed that incremental yet bold steps must be taken to close the financing gap by 2015, including greater allocations from domestic and international resources. Ambassador Sylvie Lucas of Luxemburg highlighted that in order to achieve the targets, “international donors, emerging economies, affected countries and additional stakeholders must all actively contribute, in accordance with their respective capacities.”

Mrs Janet Karim, speaking on behalf of the Permanent Representative of Malawi, stressed that despite efforts and political will, some countries cannot meet the financial needs required from their domestic sources and called for innovative partnerships to be sought to support governments’ efforts.

“It is indeed necessary to actively explore new sources of sustainable financing at all levels, including enhanced support from the private sector, the use of regional development banks, and the introduction of a tax on financial transactions,” said Mrs Karim. “At the same time, let us follow up on the commitment that we made to strengthen existing financial mechanisms, including the Global Fund and relevant United Nations organizations, through the provision of funds in a sustained and predictable manner,” she added.

The UNAIDS Investment Framework was presented as an opportunity for development partners and national governments toward developing a ‘shared responsibility’ agenda and maximizing value for money.

Stressing the need for affected communities to continue to be at the centre of the response, David Barr from the International Treatment Preparedness Coalition (ITPC) emphasized that human rights, equity, inclusion and participation should be seen as high-yield investments rather than avoidable costs. “It is essential that HIV care be centered around the protection of human rights, gender equity and the reduction of stigma,” said Mr Barr. “Without creating a safe environment for those of us at risk, we cannot engage in care and, therefore, all our public health efforts will be wasted.”

Participants agreed that, of the targets set in the 2011 Political Declaration on HIV/AIDS, among the most challenging and crucial was the one focused on “Close the global AIDS resource gap by 2015 and reach annual global investment of US$22-24 billion in low- and middle-income countries”. The AIDS financing target was considered not just a target in itself, but a critical enabler for the achievement of all of the Declaration’s targets.

UNSG Special Envoy on AIDS in Asia, Dr Nafis Sadik with Vice President H.E. Dr Sai Mauk Kham.
Credit: UNAIDS

A high-level United Nations delegation led by Secretary-General’s Special Envoy on AIDS in Asia, Dr Nafis Sadik visited Myanmar to take stock of the progress made and challenges remaining in the AIDS response.

During the visit, representatives from across the political spectrum in Myanmar underlined their commitment to speed up and enhance the country’s response to HIV to ensure that HIV services reach the communities most affected by the epidemic.

Vice President H.E. Dr Sai Mauk Kham, in conversations with Dr Sadik and her delegation, emphasized the need for an inclusive response to AIDS. “To deal with this epidemic, one of the top health challenges in Myanmar, the government, UN, non-governmental organizations and civil society need to work together,” said Vice President Kham.

Representatives from the networks of people living with HIV stressed their willingness to work in close collaboration with government and other partners to ensure effective results. They also highlighted the need to involve people living with HIV during the planning, design and implementation of AIDS programmes. “People living with and affected by HIV know better than anyone else what works and how to get the best impact,” said Myo Thant Aung, Chair of the national network for people living with HIV, Myanmar Positive Group.

The reduced funding available for HIV treatment and prevention was of major concern for Nobel laureate and General Secretary of the National League for Democracy, Aung San Suu Kyi. During a meeting with Dr Sadik, Ms Suu Kyi stressed the importance of a sustained, well-managed response to AIDS in the country. “All the work needs to be closely monitored to assure accountability” said Ms Suu Kyi. She also highlighted the “importance of openness and compassion in government and the community” in the provision of HIV prevention and care programmes.

Dr Sadik called for a rapid increase in resources to ensure the sustainability of AIDS programmes in Myanmar. “Investment on AIDS in Myanmar from international and domestic sources needs to increase dramatically to assist people living with HIV and to prevent more people from becoming infected,” said Dr Sadik.

“In addition, laws, policies and practices that block access to HIV services for people living with and most affected by HIV need to be revised and removed. Only this will enable the provision of effective and sustainable HIV prevention and treatment services,” she added. The official visit to Myanmar was Dr Sadik’s last country missions as Special Envoy before the end of her tenure in July 2012.

In 2011, there were an estimated 216 000 people living with HIV in Myanmar and more than 40 000 adults and children received antiretroviral treatment of an estimated 120 000 people in need. According to the 2011 HIV Sentinel Surveillance data, HIV prevalence was 9.4%, among female sex workers, 21.9%, among people who inject drugs, 7.8% among men who have sex with men and 0.9% among pregnant women attending antenatal care services.

UNSG Special Envoy on AIDS in Asia, Dr Nafis Sadik with Nobel laureate and leader of the National League for Democracy, Aung San Suu Kyi.
Credit: T.M. Aung

The United Nations delegation noted the significant progress made in the national AIDS response where despite limited resources, HIV prevalence among key populations at higher risk has begun to decline and the number of people receiving antiretroviral treatment has grown substantially. However, the delegation also highlighted that two thirds of people living with HIV do not yet have access to life saving treatment and that available financial resources for AIDS in the country are expected this year to fall below levels of 2011.

“Additional resources are needed to build upon the progress made to date,” said the member of the delegation and UNAIDS Director of the Asia Pacific Regional Support Team Steven Kraus. “The necessary scale-up of HIV services will not be possible without this accelerated response.”

During the seven-day country visit, Dr Sadik and the delegation also met with the Union Minister of Health, Union Minister for Labour and for Social Welfare, Attorney-General and chairpersons of parliamentary committees.

UNAIDS Deputy Executive Director, Management and External Relations Jan Beagle giving her opening remarks at the AIDS Solidarity Gala.
Credit: Gettyimages

Europe’s biggest AIDS charity event was held on 19 May in the Austrian city of Vienna. Organized by AIDS LIFE, the Life Ball 2012 brought together celebrities and influential leaders in the global AIDS response to celebrate the 20th anniversary of what has become one of the largest AIDS fundraising events worldwide since it was first held in 1993.

This year’s Life Ball was held under the theme “Fight the Flames of Ignorance”. The theme provides the conclusion to the four-year cycle of elements that began in 2009 with water and was aimed at contributing to the removal of the taboos surrounding AIDS in society.

The AIDS Solidarity Gala, a high-level dinner preceding the Life Ball opening ceremony, was organized under the patronage of the President of the Republic of Austria Heinz Fischer and co-hosted by UNAIDS for the second consecutive year. Former United States President Bill Clinton, UNAIDS Deputy Executive Director, Management and External Relations Jan Beagle, amfAR spokesperson Milla Jovovich, actor Sean Penn and art collector Francesca Habsburg also participated in the event.

Proceeds from the gala will be used, in part, to support the work of UNAIDS in the Russian Federation. Donations will be dedicated to improve the lives of children orphaned by AIDS and families affected by HIV as well as to strengthen HIV prevention among women of childbearing age.  

In her opening remarks Ms Beagle noted that, despite progress made in the global AIDS response, the AIDS epidemic is not over. “The epidemic is still a magnifier for social injustice. Stigma and discrimination, criminalization of HIV, gender inequity and numerous forms of human rights violations continue to fuel new HIV infections and block people from accessing lifesaving treatment,” said Ms Beagle.

This is relevant to the epidemic in Eastern Europe and Central Asianoted Ms Beagle since unlike most other regions, AIDS-related deaths continue to rise. “I am grateful to AIDS LIFE for being such a strong, committed supporter of UNAIDS work in this region. With your help, we will break the trajectory of HIV in Eastern Europe and Central Asia and achieve the same success we are seeing in Africa and the rest of the world” added Ms Beagle.

President Clinton noted in his statement that "The UN has a goal of making sure children are born free of HIV in the first place. Resources raised at the Gala for the Clinton Foundation will be used in Zambia and Uganda to prevent mothers to pass HIV to their children."

Every year, the Life Ball recognizes the work and dedication of pioneers in the AIDS response through the “Crystal of Hope” award. Supermodel Naomi Campbell and Hollywood actor Antonio Banderas presented this year’s award of EUR 100 000 to Jackie Branfield, founder of “Operation Bobbi Bear”—a project dedicated to respond to child abuse and sexual crimes in South Africa.

Nearly 40 000 people and famous celebrities have come out in support of the AIDS response at this year’s Life Ball. The charity event, organized by AIDS LIFE, raised over  US$ 2,3 million last year for AIDS programmes worldwide through partnerships with amfAR, the William J. Clinton Foundation, MTV Staying Alive Foundation, and UNAIDS.

L to R: United States Global AIDS Coordinator Ambassador Eric Goosby, Anglo American's chief medical officer Brian Brink, UNAIDS Executive Director Michel Sidibé and President of GBCHealth John Tedstrom.
Credit: GBCHealth

Taking stock of the successes, challenges and future of the global AIDS response after three decades was at the core of the Global Business Coalition annual conference on Health (GBCHealth) held from 14-15 May in New York.

Under the theme of “Defining forward: Business, health and the road ahead” the conference brought together corporate executives, government leaders, policy makers, multilateral organizations, civil society and the media to discuss the most serious global health issues of today.

Headline speakers included Michelle Bachelet of UN Women, Barbara Bush of Global Health Corps, Deepak Chopra, Muhtar Kent of The Coca-Cola Company, Madam Bongi Ngema-Zuma, South Africa’s First Lady and UNAIDS Executive Director Michel Sidibé. 

Considerable progress made

AIDS@30 was the first, tone-setting session in the GBCHealth conference, where the UNAIDS Executive Director Michel Sidibé shared a platform with Anglo American's chief medical officer Brian Brink, the United States Global AIDS Coordinator Ambassador Eric Goosby and President of GBCHealth John Tedstrom. Mr Sidibé highlighted the considerable progress that has been made in the international AIDS response. He emphasized the fact that almost 60 countries—34 in sub-Saharan Africa—have stabilized or reduced the number of new HIV infections. This was attributed in part to extensive collaboration between a range of partners.

“Local governments are taking greater responsibility for their epidemics. But HIV is a shared responsibility that involves governments, donors, civil society and the private sector."

Mr Brink agreed that the private sector has a key role to play in ensuring the success in the response to AIDS and described Anglo American’s efforts to implement workplace policies to keep its workforce and their families healthy.

“Anglo American has demonstrated that investing in HIV prevention, treatment and care has measurable and positive impact on the bottom line,” said Mr Brink. “By investing in your employees, you reduce absenteeism, increase productivity and contribute to the wellbeing of the company."

The debate was wide-ranging and touched on a number of issues, including how the epidemic has evolved; the necessary and sufficient conditions for a truly sustainable response and the prospects for AIDS funding in an uncertain economic climate.

"30 years ago, access to HIV treatment in the countries hardest hit by the epidemic was not deemed possible. Today's increased access to treatment is a tangible prove of what can be achieved when all sectors join forces to address the AIDS epidemic," said Ambassador Goosby.

It was also stressed that one of the major achievements of the AIDS response is the fact that it has been an entry point to larger social issues, giving vulnerable people a voice and the power to use it. As Michel Sidibé contended, "HIV should not be seen as a disease but an opportunity and entry point to address critical issues in society including human rights and gender equality."

Participants concluded that businesses, from the largest global corporations to micro enterprises, private sector associations and coalitions need to lend their resources and expertise in order to effectively respond to AIDS. Businesses should move beyond ensuring the well-being of their employees and actively contribute to the response by disseminating vital AIDS information through print, broadcast and billboard advertising space; lobbying for effective AIDS policies and providing financial resources to life-saving programmes.

Donations have double benefit

Donating to UNAIDS in the United States of America has become easier. ‘UNAIDS USA’, a 501c3—a tax-exempt nonprofit organization in the United States of America —has been set up to facilitate the engagement of alternative sources of financing. This will make it easier for individuals, foundations and the private sector to contribute to the work of UNAIDS and its 10 cosponsors.

“I believe we can make real advances in the AIDS response in the next five years, but to do so we need to join forces not just with governments but with private individuals, activists, corporations and foundations,” said UNAIDS Executive Director Michel Sidibé. “Every small contribution helps to reach UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS related deaths.”

UNAIDS Executive Director Michel Sidibé, speaking at a breakfast meeting on 27 March with African Ministers of Finance and other high-level officials.
Credit: UNAIDS/J.Ose

How can African countries ensure a financially sustainable response to HIV? UNAIDS Executive Director Michel Sidibé explored this topical issue in a breakfast briefing on 27 March with African Ministers of Finance and other high-level participants from the region. Co-convened by UNAIDS and the African Development Bank, the round-table discussion was held on the sidelines of the African Union Conference of Ministers of Economy and Finance.

During the briefing, Mr Sidibé congratulated African Ministers of Finance for their increased engagement in HIV responses across the continent. He underscored that HIV investments have yielded prevention dividends, including a more than 25% reduction in new infections in 22 African countries. More than 5 million people in sub-Saharan African are currently receiving antiretroviral therapy, noted Mr Sidibé—up from just 50 000 in 2002.

Mr Sidibé cautioned, however, that progress would stall without a shift in the current HIV funding architecture. “Dependency on foreign technologies, foreign drugs, foreign regulatory systems, and foreign production lines are holding the continent hostage,” he said. “Global solidarity is essential, but it must be complemented by a new financing paradigm—one that is reflective of the regional context, inclusive in its design and predictable in its implementation.”

An estimated two-thirds of HIV expenditures in Africa are currently financed through external aid, according to the UNAIDS issues brief “AIDS dependency crisis: sourcing African solutions.” The vast majority of life-saving antiretroviral medicines prescribed in Africa are imported from generic manufacturers.

Several participants in the round-table discussion emphasized the importance of viewing AIDS through the twin lens of health and economic development.  “We cannot reach any type of sustained growth if our human capital is not healthy and productive,” said Lamin Barrow, Ethiopia Country Director for the African Development Bank.

“Health is a fundamental component of a strong and productive labor force,” said the Ethiopian State Minister of Finance, Ahmed Shide, echoing Mr Barrow’s remarks. “Developing a sustainable framework for financing is the missing gap in the health sector,” he added.

Others highlighted the need for home-grown solutions to ensure sustainable HIV responses in Africa. Pedro Couto, Deputy Minister of Finance for Mozambique, urged the African Development Bank to support local and regional investments in the production of HIV medicines through the use of soft loans. 

UNAIDS Executive Director highlights global inequities in the AIDS response

In a meeting on 28 March with Ambassadors for African and BRICS (Brazil, Russia, India, China, South Africa) countries, Mr Sidibé described AIDS as a metaphor for inequality. While nearly 400 000 babies in Africa are born each year with HIV, virtually all children in developed countries are born HIV-free, he noted.

Mr Sidibé added that while a staggering number of people continue to die of AIDS in sub-Saharan Africa—an estimated 1.8 million each year—AIDS-related deaths in the West have been largely curtailed through universal access to antiretroviral treatment. “I ask you to dream about a world where social justice and social inclusion prevail over inequality and exclusion,” he said.

African countries should team together to negotiate more favourable prices for HIV drugs and ensure wider access to medicines, said Mr Sidibé. A single African drug regulatory agency could ensure the faster roll-out of quality assured antiretroviral drugs, he added.

During the meeting, Mr Sidibé called for innovative solutions to Africa’s HIV funding shortfall, such as a tariff on the use of mobile phones or a tax on alcohol and cigarette consumption. He said that through strengthened partnerships with BRICS nations, African countries could benefit from the exchange of scientific knowledge and technical expertise.

UNAIDS estimates that Africa will require between US$ 11-12 billion for its AIDS response by 2015—US$ 3-4 billion more than the current expenditure.

UNAIDS Executive Director Michel Sidibé (left) met with the President Alassane Ouattara of Côte d’Ivoire on 27 February in Abidjan.

Meeting on 27 February with President Alassane Ouattara of Côte d’Ivoire, UNAIDS Executive Director Michel Sidibé noted with concern that the country relies heavily on external aid to finance its national AIDS response—a trend seen in many countries across Africa.

Approximately 87% of HIV investments in Côte d’Ivoire are financed through external sources. A vast majority of HIV medicines used in the country are imported. The Government of Côte d’Ivoire recently reported a funding gap of approximately
US $20 million for its national HIV programme.

To bridge the HIV resource gap, Mr Sidibé urged President Ouattara and his government to explore more diversified sources of financing such as low-interest loans from the African Development Bank and taxes on the use of mobile phones.“Côte d’Ivoire needs home-grown solutions for a sustainable response to the national HIV epidemic,” said the UNAIDS Executive Director, while meeting with President Ouattara in Abidjan.

A call for the local production of HIV drugs

By manufacturing antiretroviral drugs within Africa, Côte d’Ivoire and neighboring countries across the region could avoid drug shortages and benefit from lower drug prices, said Mr Sidibé. The UNAIDS Executive Director also spoke of an urgent need for a single African drug regulatory agency to ensure the faster roll-out of quality-assured HIV medicines to the African population.

Stating that increased domestic financing for HIV is a “national priority,” President Ouattara said that his government would seek innovative funding solutions to reduce its dependency on external aid. He pledged to use his platform as President of the Economic Community of West African States (ECOWAS) to mobilize other African leaders to catalyze the local production of antiretroviral medicines.

Progress in the national response

Mr Sidibé commended the Government of Côte d’Ivoire for the more than four-fold increase in access to HIV treatment over the past five years—from approximately 18 500 to more than 75 000 people. He urged President Ouattara to build on these gains and close the remaining treatment gap of 150 000 people.

The UNAIDS Executive Director praised the Government of Côte d’Ivoire for its efforts to reduce new HIV infections among children: As of end-2011, 54% of HIV-positive pregnant women in the country were able to access services that prevent HIV transmission from mother to child. Mr Sidibé called on the leadership of Côte d’Ivoire to champion the UNAIDS vision of “Zero new HIV infections in children.”

Remaining challenges

During his meeting with President Ouattara, Mr Sidibé noted that the dynamic flow of migrants between Côte d’Ivoire and neighboring countries poses a major challenge to the HIV response in West Africa. A failure to contain the HIV epidemic in Côte d’Ivoire would have negative consequences across the region, he warned. An estimated 3.4% of the population in Côte d’Ivoire is living with HIV—the second highest national HIV prevalence in West Africa.

The UNAIDS Executive Director spoke of the importance of addressing the widespread stigma and discrimination against people living with and affected by HIV. He said that reaching minority and vulnerable groups in Côte d’Ivoire with HIV services would be critical to reversing the epidemic—particularly men who have sex with men, sex workers and people who use drugs.

UNAIDS Executive Director Michel Sidibé (left) met with the President John Evans Atta Mills of Ghana on 24 February in Accra.
Credit: UNAIDS/R.Chintoh

Meeting today with John Evans Atta Mills, President of the Republic of Ghana, UNAIDS Executive Director Michel Sidibé sounded a theme from his recent missions in Bénin and Togo: sustainability of the AIDS response in Africa.

Noting that a vast majority of antiretroviral medicines consumed in Africa are imported from overseas, Mr Sidibé underscored the urgent need for home-grown solutions to ensure the long-term availability of these drugs at affordable prices.

“African countries must catalyse the local production of high-quality medicines,” said Mr Sidibé, while meeting with President Mills at his offices in Accra. “Ghana can develop centres of excellence and lead the way in an effective continental response to HIV,” he added.

President Mills said he looked forward to the day when Ghana was able to manufacture HIV medicines for its population at large and neighboring countries in the region. “This will a major boost for us,” he said.

Preventing HIV among children

During the meeting, the UNAIDS Executive Director expressed concern over the low coverage (51%) of services in Ghana to prevent HIV transmission from mother to child (PMTCT). He said that it is ethically unacceptable for any child to be born with HIV and emphasized the economic rationale for expanding PMTCT services: preventing HIV is far less costly than life-long treatment.

Mr Sidibé urged the President to champion the UNAIDS vision of “Zero new HIV infections among children” across the country. “No baby born with HIV by the year 2015—this can be your legacy for Ghana,” he said, adding that keeping their mothers alive is equally imperative.

Addressing stigma and discrimination

During his meeting with President Mills, the UNAIDS Executive Director noted with concern that stigma and discrimination continue to block an effective response to HIV in Ghana—especially for people living with HIV and key populations at higher risk of infection, such as sex workers, men who have sex with men, and people who use drugs.

The President said that he was hopeful a new nation-wide campaign called “Heart to Heart” would help reduce the widespread stigma and discrimination in his country. Launched on World AIDS Day 2011, the campaign aims to re-engineer deep-rooted beliefs and behaviors towards people living with HIV by giving a “human face” to the epidemic.

Roundtable discussion with partners

At a roundtable discussion earlier in the day with high-level representatives from government, civil society and the private sector, Mr Sidibé said that he was encouraged by the more than 25% reduction in new HIV infections among young Ghanaians between 2001 and 2010.

He commended the leadership of Ghana for the dramatic increase in national spending on AIDS, from a less than US$ 1 million contribution last year to a US $100 million pledge over the next five-year period.  The UNAIDS Executive Director noted, however, that—even with the recent pledge—Ghana continues to rely on external aid to finance more than 70% of its national AIDS response.

As part of his three-day official visit to Ghana, Mr Sidibé participated in a series of events marking the 10th anniversary of the Ghana AIDS Commission. Additionally, he toured a hospital that provides comprehensive PMTCT services and visited a local production plant that manufactures antiretroviral medicines.

Mr Sidibé’s official visit in Accra was part of a four-country mission to Ghana, Bénin, Togo and Côte d'Ivoire.

UNAIDS Executive Director Michel Sidibé (left),
photographed here with Prime Minister Gilbert Houngbo of Togo on 21 February.
Credit: UNAIDS/J-C Abalo

Sustainable financing for the AIDS response was a key topic of discussion in a meeting on 21 February between UNAIDS Executive Director Michel Sidibé and Prime Minister Gilbert Houngbo of Togo.

Noting with concern that Togo relies on external sources to finance more than 80% of its HIV response, the UNAIDS Executive Director urged the leadership of Togo to take on a greater share of national AIDS investments.

“We cannot put a person on antiretroviral treatment for 30 years and depend on external aid to cover the bill,” said Mr Sidibé, while meeting with Prime Minister Houngbo in LoMÉ, Togo’s capital city. “We need an African solution,” he added.

Mr Sidibé emphasized that HIV resources in Togo should be prioritized for populations at higher risk of HIV infection, such as sex workers and men who have sex with men. To that end, a comprehensive understanding of the national epidemic, including good data, was vitally important, he added.

During the meeting, Mr Sidibé congratulated the leadership of Togo for progress in the national HIV response. According to government figures, knowledge on HIV prevention and transmission among the population is relatively high, at 80%. Access to antiretroviral treatment in Togo has more than doubled since 2008, from approximately 11 000 people to more than 25 000. Mr Sidibé urged the leadership of Togo to build on these gains and ensure treatment access for all people living with HIV.

The UNAIDS Executive Director expressed concern that a majority (56%) of pregnant women in Togo lack access to services that prevent HIV transmission from mother to child. He commended Togo’s leaders for their efforts to develop a national plan to eliminate new HIV infections among children.

Acknowledging the gaps in access to services for HIV-positive pregnant women, Prime Minister Houngbo said that the leadership of Togo was fully committed to the UNAIDS target of Zero new HIV infections among children. The Prime Minister expressed his commitment to achieving the targets in the 2011 Political Declaration on AIDS and echoed Mr Sidibé’s call for increased domestic spending on AIDS.

Mr Sidibé’s official visit in LoMÉ was part of a four-country mission to Togo, Bénin, Ghana and Cote d’Ivoire.