UNAIDS Executive Director Michel Sidibé met with President Boni Yayi of Bénin at the President’s Office in Cotonou on 20 February, pictured here with UN Resident Coordinator and UNDP Representative Ms Nardos Bekele.
Credit: UNAIDS

In an official meeting with President Boni Yayi of Bénin on 20 February, UNAIDS Executive Director Michel Sidibé called on the country’s Head of State to use his position and influence as President of the African Union to accelerate the HIV response across the continent.

“We are counting on you to help us push forward the HIV response in Africa,” said Mr Sidibé, in a meeting with President Yayi in Cotonou. “With your leadership, I know that Africa can achieve the targets in the 2011 Political Declaration on AIDS.”

Mr Sidibé urged President Yayi to encourage his peers to allocate a greater share of domestic resources to the AIDS response. The UNAIDS Executive Director and the President agreed on the need for a high-level debate on how to finance Africa’s AIDS response over the long term.

National progress

During the meeting, the UNAIDS Executive Director congratulated President Yayi and his government on achievements in the national response to HIV. 

According to government figures, HIV prevalence in Bénin has stabilized over the past decade at approximately 2%. An estimated 62 000 people are currently living with HIV across the country and there are some 3300 new HIV infections each year.

At the end of 2010, an estimated 19 000 people were accessing free antiretroviral treatment, up from about 15 000 the previous year.  Access to voluntary testing and counselling (VCT) is also expanding at a rapid rate: 126 sites across the country now offer VCT services, up from just 28 sites in 2006.

Mr Sidibé underscored the importance of using scare resources with greater efficiency, transparency and accountability. He emphasized the need to prioritize HIV resources for key affected populations—particularly women and girls, young people, sex workers,  men who have sex with men and people who use drugs.

Eliminating new infections among children

Despite progress, only half (49%) of pregnant women in Bénin have access to services that can prevent new HIV infections in their children. An estimated 350 000 children were newly infected with HIV in sub-Saharan Africa in 2010.

“As President of the African Union, I would like to launch a vibrant appeal to other African Heads of State, urging them to continue investing in programmes that can eliminate mother-to-child transmission of HIV,” said President Yayi. Following his meeting with Mr Sidibé, the President launched a national plan to eliminate new infections among children by 2015, at the Palais des Congrès in Cotonou.

During the mission, the UNAIDS Executive Director was honoured by Lord Chancellor Osseni Koubourath as a “Grand Officer” of the National Order of Bénin for his global leadership and engagement in the HIV response, and for his strong commitment to promoting human rights and dignity.

Mr Sidibé’s visit to Bénin was the first of a four-country mission in West Africa. He is scheduled to meet this week with high-level representatives from government and civil society in Togo, Ghana and Côte d'Ivoire.

U.S. Secretary of Health and Human Services Kathleen Sebelius speaks at UNAIDS' World AIDS Day event in Washington, DC. Panels from the AIDS Memorial Quilt, including one from TASO Uganda, are displayed behind the Secretary.
Credit: UNAIDS.

On a day when President Barack Obama announced new United States’ commitments to the AIDS response, the U.S. Secretary of Health and Human Services, Kathleen Sebelius, spoke at a Joint United Nations Programme on HIV/AIDS (UNAIDS) hosted World AIDS Day commemoration event entitled "From Local to Global: Finding Common Cause in the AIDS Response."

The event was organized in collaboration with the District of Colombia (DC) Community Coalition for AIDS 2012 to help foster collaboration and shared learning between the United States domestic and the international HIV communities ahead of the International AIDS Conference to be held in Washington, DC in July 2012.

Secretary Sebelius called upon the audience of 300 activists, implementers and policy makers to redouble their efforts to reach an AIDS-free generation and to push towards the “Getting to Zero” vision both in the United States and globally. She reiterated an announcement by President Obama earlier in the day that the United States would support 6 million people on treatment in low- and middle income countries by 2013 and also allocate a further US$50 million to U.S. domestic programs.

The highlight of the event was a performance by the Hope for Africa’s Children Choir from Mukono, Uganda. The choir, which is includes children living with or orphaned by HIV, is visiting the United States at the invitation of the United Methodist Church and with the support of UNAIDS. Their compelling music and story-telling reinforced the tremendous progress made in the AIDS response, but also the substantial work that remains to be done.

Highlighting the HIV epidemic in the United States, Mr. George Kerr, a resident of Washington living with HIV, spoke for an urgent need for improved access to HIV prevention, treatment, care and support for citizens of Washington, DC.

Helene Gayle, President and CEO of CARE USA moderated the programme which also included remarks from Deborah von Zinkernagel, Principal Deputy Coordinator for the President’s Emergency Plan for AIDS Relief (PEPFAR), U.S. Congressman Donald Payne, and Mr Kerr of the DC Community Coalition for AIDS2012.

Three quilt panels from the AIDS Memorial Quilt Project, which documents the life stories of more than 40,000 lives lost to AIDS, were also exhibited during the event.

Functioning ARV dispensing site in Port-au-Prince after the devastating 12 of January earthquake. Credit: UNAIDS

Haitian civil society representatives visited Washington, D.C. on 6 April to mobilize political support for reconstructing the AIDS response in Haiti.

The civil society delegation, with support from UNAIDS, gave a testimony of their experiences with the earthquake and highlighted the importance of reconstructing the AIDS response with direct involvement of affected communities, especially people living with HIV. The briefing was held at Capitol Hill during a US Congressional briefing sponsored by US Senator Kirsten Gillibrand (D-NY) and attended by congressional staff, AIDS advocates and US civil society representatives.

Later that same day, the delegation from Haiti visited US Global AIDS Coordinator Ambassador Eric Goosby and his colleagues from USAID. The US government team pledged its support to encourage the Haitian government to include the involvement of people living with HIV in planning the reconstruction of the AIDS response in Haiti.

On 24 March, US President Obama asked the US Congress to approve $2.8 billion as an emergency requirement for relief and reconstruction support for Haiti following the devastating earthquake of 12 January 2010. The request is now pending before US lawmakers who will very soon vote on the proposal.

There were an estimated 120 000 people living with HIV in Haiti before the earthquake. Most of the structural damage happened in the three departments (Ouest, Sud-Est and les Nippes) that accounted for nearly 60% of the population of people living with HIV.

Following an initial rapid assessment of the situation with the Ministry of Public Health and Population, UNAIDS released a concept note Helping Haiti rebuild its AIDS response. The report explains the current situation in Haiti and what may be required to meet the immediate and intermediate AIDS response needs.

Civil society networks of people living with HIV as well as many of the organizations providing HIV services have been affected by the earthquake and are in need to be strengthened.

Geneva 03 May 2010—UNAIDS commends the Global Fund to Fight AIDS, Tuberculosis and Malaria Board’s decision to launch its next round of grants in mid-May of this year. This will allow countries to continue their momentum towards achieving the universal access targets. Particularly, during these difficult financial times, the launch of Round 10 shows that the global community is committed to making important investments in the AIDS response.

“AIDS is not over in any part of the world,” said Mr Michel Sidibé, UNAIDS Executive Director. “It is imperative that we keep resources flowing to people and communities struggling daily with the impact of HIV.”

UNAIDS also welcomes the decision of the Board to continue financing proposals addressing the needs of most-at-risk populations. Sex workers, injecting drug users, men who have sex with men and other key marginalized populations are often ignored by funding mechanisms. Setting aside resources for the most vulnerable people will ensure that communities can rapidly scale-up their AIDS response and meet the goal of zero new HIV infections.

This Board decision will allow upper-middle-income and lower-middle-income countries, which often have concentrated epidemics among populations at higher risk, to access these resources. While the special window of funding currently is only for Round 10, it is important that the international community and countries continue to invest in areas that demonstrate results and have an impact on the epidemic.

“I am glad the Global Fund Board has approved this new reserve. Funding decisions for HIV should have a human face,” said Mr Sidibé. “Resources must go to the communities that need them most and should not be based on economic indicators alone.”

With proper funding, new HIV infections in vulnerable populations can be prevented. By introducing needle exchange and drug replacement programmes many developed countries have been able to virtually eliminate transmission of HIV among injecting drug users. Similar investments in developing countries can achieve similar results.

UNAIDS will continue to provide technical assistance to countries, civil society organizations and the Global Fund to ensure that evidence-informed proposals are submitted for funding and produce results for people.

Calls for $25 billion investment to ensure countries reach 2010 targets

CAPE TOWN, South Africa, 10 February 2009—On his first country visit, the new executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), Mr Michel Sidibé outlined his vision and priorities for UNAIDS in the township of Khayelitsha.

Speaking to community and political leaders, Mr Sidibé praised the resilience and perseverance of the community working together to achieve goals in the face of incredible challenges. “I wanted to begin my public journey here, where the community response together with government, civil society and key stakeholders lead the way towards universal access in South Africa. Together they are meeting the demand for HIV prevention, treatment, care and support,” said Mr Sidibé.

Sub-Saharan Africa remains the region most heavily affected by HIV worldwide, accounting for two thirds (67%) of all people living with HIV and for three quarters of AIDS deaths in 2007. The nine countries in southern Africa continue to bear a disproportionate share of the global burden—35% of HIV infections and 38% of deaths due to AIDS.

Like other regions of the world, southern Africa is feeling the effects of the global economic crisis. Mr Sidibé stressed the need for follow through on domestic and international investment commitments to meet 2010 country targets.

“We cannot let the economic crisis paralyze us,” said Mr Sidibé. “Stimulus packages and economic adjustments should be made with a human face in mind. A mother should not have to choose between continuing AIDS treatment and feeding her children. We cannot let down the 4 million people on treatment and millions more in need today.”

Most countries have set universal access targets for 2010 that are ambitious and reach real people. For countries to reach the specific targets they have set, an estimated investment of US$ 25 billion will be required in 2010, which is US$ 11.3 billion more than is available today.

A new report today released by UNAIDS, What countries need: Investments needed for 2010 targets anticipates that nearly one third of the US$ 25 billion investment will come from domestic sources. Investments from multilateral and bilateral sources are needed for the remaining US$ 17 billion.

More than US$ 9 billion will be used for strengthening health systems and an additional US$ 9 billion will be used for providing HIV-specific health services. The investments needed would also ensure a fully funded Global Fund to Fight AIDS, Tuberculosis and Malaria, an innovative financing mechanism that countries depend on to help fund national AIDS plans.

Countries reaching their 2010 AIDS targets would show dramatic results:

1. An estimated 2.6 million new HIV infections will be averted, cutting HIV incidence by nearly 50%.
2. 1.3 million deaths in the next two years can be avoided.
3. Approximately 6.7 million individuals will be receiving antiretroviral treatment.
4. More than 70 million pregnant women will be screened and receive prevention of mother-to-child transmission services.
5. HIV prevention programmes will reach 20 million men who have sex with men, 7 million sex workers, 10 million people who inject drugs, and nearly 8.1 billion male and female condoms would be distributed.
6. Seven million orphans and vulnerable children would have been supported by social support programmes.

“It will not be easy to close this gap but it is achievable and absolutely necessary if we are to accelerate the pace of the response to the AIDS epidemic,” said Mr Sidibé. “Together we will help save lives—by putting more people on treatment, ensuring that pregnant women receive comprehensive antenatal care including HIV services, and that a whole generation of children will graduate from school.”

The Executive Director also called for greater accountability to make the money work better for people in need. He highlighted the need for programmes to be cost effective, strive to eliminate inefficiencies in service delivery and reduce unit costs. Better aligned and coordinated donor support will also increase the impact of investments.

In a letter to partners also to be released today, Mr Sidibé wrote that UNAIDS would re-double its efforts in helping countries realize their universal access goals including indicator mapping and targeted country support for countries that might be lagging. The letter also outlines ten areas needed to achieve universal access goals.

1. Deliver results country by country - by setting ambitious targets.

2. Promote the human rights of people living with and affected by HIV - by ending laws that impede delivery and use of AIDS related services.

3. Support political demand for universal access - by strengthening links with civil society and community groups.

4. Invest in research and apply the evidence - by continued investment in pre-exposure prophylaxis, microbicides and vaccines.

5. Prioritize prevention efforts - by making pediatric AIDS history and giving young people skills to protect themselves from HIV and violence.

6. Mobilize the resources countries need - including fully funding the Global Fund.

7. Optimize and expand partnerships - by expanding the partnership platform to bring new partners together.

8. Leverage AIDS responses to deliver broader results for people - revitalize health systems to ensure that people living with HIV do not die of TB and have access to primary health care.

9. Monitor progress - country by country and donor by donor - by ensuring transparency and accountability at all levels.

10. Plan to sustain the gains - by empowering and restoring dignity to communities and families affected by HIV and ensuring sustainable and predictable financing.

Since 2001, there has been substantial progress in delivering HIV services to millions of people, especially in low- and middle-income countries. Today, nearly 4 million people are on antiretroviral treatment. By the end of 2007, the annual number of new HIV infections had fallen to 2.7 million from 3 million in 2005. New infections among children have dropped, thanks to rapid scale up of services to prevent mother-to-child transmission of HIV. Young people in many parts of the world are waiting longer to become sexually active; having fewer sexual partners; or are using condoms. And millions of children orphaned by AIDS now have access to social support and protection. These gains have to be sustained in these tough economic times.