The new book No Time to Lose by Peter Piot, the Director of the London School of Hygiene & Tropical Medicine, is garnering praise as a candid and passionate account of a lifetime pursuing and outsmarting deadly viruses.

Author Dr Piot, the former Executive Director of UNAIDS was a co-discoverer of the Ebola virus and a pioneer of the AIDS response.

“In a world where true discovery is rare, Peter’s experiences are beyond remarkable,” said Michel Sidibé, Executive Director of UNAIDS. “And it is from this special vantage point that he takes us on a personal journey—that is equal part adventure thriller and political primer.”

Early in Dr Piot’s career, many tried to dissuade him from entering the field of infectious diseases. The people who did mentor him were often quirky and highly independent—and they set a tone of nurturing curiosity, questioning and not settling—that would serve the young doctor well.

Not yet 30, he vividly recalls a game-changing event in his life, “The unravelling of the first known epidemic of Ebola haemorrhagic fever in Africa was my initiation into scientific discovery, even life-threatening adventure, and into the world of what is now called global health. The AIDS epidemic forced me to confront the extreme complexity of health and disease and to learn the hard way the realities of big and small politics.”

His first international assignment took him to Zaire (now Democratic Republic of Congo) to investigate the deadly outbreak. Dr Piot became known for combining community wisdom, local knowledge and behavioural aspects with bio-medical science to find health solutions—an unheard of combination at that time.

“Ebola showed dramatically that, in contrast to prevailing medical opinion in the 1960’s and ‘70s, the world would experience a seemingly never-ending series of new infectious disease epidemics,” writes Dr Piot—a premonition that would lead him to take on one of the greatest issues of our time—the AIDS epidemic.

As the first Executive Director of UNAIDS he criss-crossed the world convincing global leaders to take on the AIDS epidemic while also working to bring the United Nations system together to support countries. Dr Piot has often said that while he was firmly established as a public health expert, he had to quickly grow into the role of politician. The book recounts how politics were played in the high stakes arena of development and global health.

The scientific nature that allowed him to make discoveries like Ebola also made him a tenacious and effective leader. He was fearless and pushed donors and national leaders to “do the right thing”.

“Peter has been successful because he has always put people first. This was true when there were precious few resources and true when the millions of dollars for the AIDS response turned to billions,” said Mr Sidibé. “He has been both mentor and friend and through his achievements, all of us have learned and benefited.”

His accomplishments have not come without regrets. Dr Piot writes in the epilogue about his last day at UNAIDS, that he was still “haunted by the question of what I could have done earlier and faster.”

Throughout his career Dr Piot has kept his sense of humour and appreciation for life intact. Whether it’s musing about mojitos with Fidel Castro in Cuba or paying his respects to Diago—a sake bar in Tokyo—his love of good food and wine and is apparent and will surely deliver a second book.

No Time to Lose will be launched in New York City at the Council on Foreign Relations on Monday, 18 June 2012.

Many of the poorest children living in the world’s towns and cities are facing profound disparities in health, education and life chances.
Credit: UNICEF

Many of the hundreds of millions of young people living in towns and cities across the globe are facing poverty, social exclusion, health inequity and lack of access to vital services. This is the key finding in UNICEF’s latest flag ship report, The state of the world’s children 2012: Children in an urban world.

The report says that infrastructure and facilities are not keeping pace with urban growth and systems and services are not reaching the poorest children: cities are often the backdrop for some of the greatest disparities in children’s health, education and life chances.

According to UNICEF Executive Director Anthony Lake, “[Children] growing up in slums and shanty towns are among the most disadvantaged in the world, deprived of essential services that can mean the difference between life and death...between opportunity and despair.” This is clearly significant as latest available statistics suggest that nearly half the world’s children live in urban settings, with this proportion set to increase.

HIV services lacking

Children in an urban world cites lack of access to HIV services as a key area where children and young people are being failed. The virus places a heavy burden on the young with an estimated 2 500 people aged 15 to 24 infected every day and around 2 million 10 to 19 year olds living with HIV. Significantly, HIV prevalence is often higher in urban areas. For example, research has shown that girls in towns and cities in southern Africa are markedly more likely to be living with HIV than their rural counterparts.

To reinforce the finding that young people in urban settings can be highly vulnerable to HIV infection, the report also features a 2009 study carried out among adolescents living on the streets in four Ukrainian cities. It found that 15% injected drugs, 75% were sexually active (most before the age of 15) and nearly 60% of the girls had received payment for sex. Despite their greater vulnerability, it is noted that such adolescents were the most likely to be excluded from HIV-related services.

In addition, the report examines the role of sexual harassment and violence against girls and women in urban settings. Such violence can also heighten the risk of HIV infection as well as limiting rights to education, work, recreation and political expression.

Focus on successful initiatives

A large number of successful initiatives aimed at making cities better places for the most vulnerable children and adolescents are featured. For example, the UN-Women Global Programme on Safe Cities Free of Violence against Women and Girls is working with partners in five cities to help prevent and reduce gender-based violence in public spaces, emphasising good governance, political participation and urban planning.

Children in an urban world stresses the need to invest more in community-based action which allows young people to be central to the planning and implementation of interventions that most affect them. In Nepal, for instance, where drug use among young people is increasing, peer leaders from Kirat Yakthung Chumlung, a community organisation, help to provide services such as needle-syringe distribution programmes and HIV testing and counselling.  In Nairobi, the Safe Spaces community initiative aims to create a secure and nurturing environment for adolescent girls growing up in deprived areas. Forging inclusive partnerships has led to better public infrastructure in Rio de Janeiro and Sao Paulo and more successful disaster preparedness in Manila.

On a global level, UNICEF and UN-Habitat have also been spearheading the Child-Friendly Cities Initiative, providing services and protected areas which seek to put children at the heart of the urban agenda. This is precisely where they need to be, according to the report, if they are to fulfil their potential and lead safer and healthier lives.

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.

“One Day on Earth” is a global initiative involving thousands of filmmakers

On 11 November 2011, UNAIDS teamed up with the global initiative, “One Day on Earth” to film the many faces of the HIV response. More than 50 UNAIDS field offices in all parts of the globe participated in the project and captured different HIV-related events taking place during a 24-hour period.

Using small high definition video cameras donated by “One Day on Earth,” field staff filmed a wide range of activities. For example, in sub-Saharan Africa, UNAIDS employees video-taped the flying doctors that bring HIV services to remote communities in the mountains of Lesotho. In Tajikistan, the focus was on a civil society organization called “Spin Plus,” which provides methadone substitution therapy to injecting drug users and in Sri Lanka a UNAIDS staff member living with HIV filmed a program which encouraged hospital staff to overcome stigma and discrimination.

“Every minute, in every corner of the world there are health care workers, civil society groups and people living with HIV who are working tirelessly to bring much needed HIV prevention, treatment and care and support to communities,” said UNAIDS Executive Director Michel Sidibé. “We wanted to chronicle their efforts and show that everyday we are coming one step closer to reaching the UNAIDS vision of Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths.”

It is the first time that UNAIDS has participated in the collaborative filming experience which is the brainchild of Kyle Ruddick and Brandon Litman, two entrepreneurs from the United States of America. “Our goal was to film on one day in every country of the world. We wanted to show the amazing diversity, conflict, tragedy and triumph that occur in one day,” said Mr. Litman.

The first annual simultaneous filming event took place last year when thousands of documentary filmmakers, students and citizens in over 190 countries recorded a wide range of events on 10 October 2010. Last year’s footage was made into a feature-length documentary film which will be screened globally next February. In addition all the material is publicly available via an online searchable archive.

Understanding the links between sustainability and equality is critical, says the 2011 Human Development Report

Progress in health and development in the poorest countries is in serious danger if the world does not make a concerted effort to reduce inequities, protect the environment and promote sustainability. This is the stark warning highlighted in the 2011 Human Development Report, launched on Wednesday by the United Nations Development Programme (UNDP).

Sustainability and Equity: A Better Future for All, explores in great detail the relationship between health, education, income, gender disparities, sustainability and social inequalities. Significant progress cannot be achieved in one area without progress in all. If such gains are not attained, the least developed countries could see themselves diverging significantly from global patterns of development by 2050. The ideas expressed in the document are very much intended to provide a key focus of debate in the run up to the 2012 UN Conference on Sustainable Development (Rio+20).

As the UNDP Administrator Helen Clark states in the report’s foreword, understanding the links between sustainability and equality is critical, “if we are to expand human freedoms for current and future generations.” She adds, “The remarkable progress in human development over recent decades cannot continue without bold global steps to reduce both environmental risks and inequality.”

According to the Human Development Report, sustainability does not touch only on the environment but on the very way we choose to live our lives, with full awareness that our actions will have potentially profound consequences for coming generations. 

A Better Future for All notes that although the majority of people across the globe are becoming healthier and living longer, sub-Saharan Africa has not seen the same decline in health inequality. This is especially the case in southern Africa which is still bearing the brunt of the HIV epidemic with adult prevalence exceeding 15 percent in several countries. The report highlights the need to address the social, educational and gender inequities to successfully respond to the AIDS epidemic.

Gender disparity, evidenced by a lack of access to reproductive health products and services for many of the world’s women, is also shown in the report to have a profound effect on health, environmental sustainability and poverty.

An expansion in reproductive health rights, health care and contraceptive access will not only benefit individual women and their families but could have a marked effect on slowing global population growth.  According to the report, some 215 million women in developing countries have unmet family planning needs. However, in every country where such needs are met and women have comprehensive reproductive options, fertility rates are at, or below, replacement level.

The report concludes that it is possible to implement programmes which have an impact on sustainability and equity, with benefits for both people who are most disadvantaged and for the environment itself. Such programmes have sustainability and equality etched into policy and programme design and reserve a critical space for the voices of the most deeply affected.

UNDP has commissioned the editorially-independent Human Development Reports each year since 1990, when its Human Development Index (HDI), a composite measure of health, education and income, first challenged purely economic measures of national achievement and called for consistent global tracking of progress in overall living standards.

More than 1 200 leading figures from the worlds of science, politics, economics and civil society are at the World Health Summit taking place from 23 – 26 October in Berlin to discuss some of the major challenges in global health today.

Under theme Today’s Science - Tomorrow’s Agenda five main issues are being addressed at the conference: the impact of climate change on health; the rapid increase in chronic diseases in developing and industrialized countries; the worldwide burden caused by mental diseases; vaccine strategies; and international health policy.

HIV featured high on the agenda as one of the greatest health crises of modern times. The urgent need to integrate HIV with other health services was stressed along with the importance of comprehensive and sustained access to health for the billions of people in need.

UNAIDS Deputy Executive Director, Programme, Paul De Lay gave the key note speech on the third day of the conference and outlined the need to successfully integrate non-communicable diseases with HIV.

“It is critical to scale up the response to infectious diseases to save millions of people,” said Dr De Lay. “This is where the AIDS response can help. Thirty years of innovation, expertise and highly developed service platforms can successfully inform and be integrated with responses for non-communicable diseases.”

Dr De Lay also chaired a working session on the role of new technologies in HIV prevention which looked at how the scientific breakthroughs of the past year have added to the set of tools available to stop HIV transmission. The session focused on how, by using the most effective set of actions within an enabling environment, numbers of new HIV infections could be significantly reduced.

“We are at a very unique time in the HIV epidemic,” said Dr De Lay. “The recent scientific advances are initiating some essential changes in HIV prevention and treatment. The main question now is one of implementation and scale up.” 

At the close of the summit a set of recommendations will be put forward to decision-makers from the relevant fields. Such recommendations will aim to address some of the urgent challenges in medical research, global health and health care delivery discussed at the conference.

The 7 Billion Actions campaign is intended to act as a rallying point for collective action to improve life for present and future generations.

By the end of this year there will be 7 billion people on the planet. To mark this global milestone, which represents both significant opportunities and challenges, the United Nations Population Fund (UNFPA) and its partners have launched an innovative campaign.

Called 7 Billion Actions, the platform is designed to promote a healthy and sustainable world. It brings together a wide range of UN bodies, including UNAIDS, governments, businesses, NGOs, academics, media practitioners, grass roots organizations and individuals. The campaign, according to UNFPA, will act as a rallying point for collective action to improve life for present and future generations.

According to UNFPA Executive Director Dr Babatunde Osotimehin the campaign aims to realize untapped potential, “It is about embracing the dignity and human rights of every individual. We need to create conditions for each one of us to live on a healthy planet, so we can all reach our full potential. In a world of 7 billion people, we need to count on each other.”

On September 14 the UN Secretary-General, Ban Ki-moon, will host an interactive discussion for its official launch. The event will be live streamed and participants from around the world can be part of the global conversation through questions and comments. The campaign’s key launch activities will take place in September and October, culminating in 7 Billion Day on 31 October.  

There are a number of thematic areas that the 7 Billion Actions will address. These include: breaking the cycle of poverty and inequality; promoting the empowerment of women and young people and reproductive health and rights; and focusing on the environment, ageing populations and urbanization.

“This inspirational campaign connects people, ideas and actions. UNAIDS looks forward to joining the effort to ensure all voices are heard as we reach this important milestone,” said UNAIDS Executive Director Michel Sidibé.

The challenge to HIV is a critical component of several themes. Greater empowerment of women and girls will have an impact on the AIDS epidemic. For example, many women are subjected to gender-based violence and this may severely hamper their ability to protect themselves against HIV. In the area of the right to an education; increasing girls’ access to schooling has been seen as a ‘social vaccine’ against the virus.

Dealing with HIV and maternal and reproductive health and rights in an integrated way also makes for stronger and more effective service provision. Where HIV testing, eliminating new HIV infections among children, access to condoms, contraception and correct information are all ‘under one roof’ women are more likely to stay healthy.  AIDS is still the leading cause of death and disease among women of child-bearing age in low- and middle-income countries.

How to support the initiative

In practical terms, support for the initiative can be shown in a number of ways. For instance, its main messages can be integrated into partners’ programme development; a commitment to the platform championed in statements and public appearances; financial contributions made on individual and corporate levels, and projects, work and best practices shared using the 7 Billion Actions online tools, such as the global website, Twitter and Facebook. 

According to the campaign, it is possible to not only build on the work of UN bodies, companies and NGOs, but also on the efforts of individuals: in a world of 7 billion people, incremental actions can create exponential results.

For more information on how to become part of the campaign visit:
www.7billionactions.org

Credit: UNAIDS

In the sidelines of the World Health Assembly, taking place in Geneva from 16-24 May, UNAIDS Executive Director Michel Sidibé and Brazilian Minister of Health Alexander Padilha met to discuss the global AIDS response and promote South-South cooperation.

Mr Sidibe and Mr Padilha talked about the participation and role of Brazil during the upcoming General Assembly High Level Meeting on AIDS that will take place in New York from 8-10 June 2011.

HIV treatment for prevention was highlighted as one of the country’s success stories and an area where Brazil could drive the push for innovation and transfer of technologies between countries. Both leaders also reflected the sports and HIV advocacy opportunities provided by the FIFA World Cup that will be hosted by Brazil in 2014.

The UN climate change summit taking place in Copenhagen marks a global effort to forge a new deal to curb climate change. Secretary-General Ban Ki-moon warned that the world stood at the crossroads between a sustainable future and a path to catastrophe. “Now is the moment to act,” he told a news conference at United Nations Headquarters in New York.

“Seldom in history has a choice been so clear. We can move toward a future of sustainable green growth, or we can continue down the road to ruin. We can act on climate change now, or we can leave it to our children and grandchildren – a debt that can never be paid, that threatens our planet and its people,” he added.

Around 15,000 participants from 192 countries representing governments, UN participants, the business community, and civil society have gathered for the largest international political conference ever held in Denmark.

The final high-level segment of the summit will begin this evening and is due to be attended by around 120 heads of state and government and UN Secretary-General Ban Ki-moon.

The Secretary-General will host a breakfast meeting tomorrow for United Nations system heads. UNAIDS Executive Director Michel Sidibé will be in attendance and will also participate in the High-level Chief Executive Board side event later in the day.

Any meaningful response to climate change must involve a strong participation by civil society and other key stakeholders, including the private sector, working hand-in-hand with national health authorities and the United Nations.

“Just as the AIDS response requires all partners from governments to civil society and the private sector to work together—so must we work together to reach goals in addressing climate change,” said Mr Michel Sidibé.

The partnerships of the AIDS response can serve as models for the types of response that will be required in adapting to climate change-related health, social and economic development challenges.

The response to climate change must ensure that the countries and communities that are most threatened are at the core of all thinking and planning. In the case of AIDS, it was the most affected communities—represented by civil society—that were able to generate the social engagement that galvanized political support, increased financing, improved accountability and tailored specific responses.

During the quest to tackle climate change, much can be learned from the solutions derived by the AIDS response as it has confronted crises and often transformed societies in the process.

State of the Worlds Population, 2009
Credit: UNFPA

The success of the global response to AIDS will rely on tackling not only the encroaching virus itself but also the affects of climate change such as food and water shortages, growth in poverty and an increase in natural disasters, argues the State of World Population 2009, released today by the United Nations Population Fund (UNFPA).

The report also contends that, equally, strengthening the response to the AIDS epidemic will mean that individuals, communities and societies will have greater social resilience in the face of a range of climate change threats and will be better able to deal with their consequences. HIV and climate change are perceived as profoundly linked, a perception shared by a range of UN bodies, including UNAIDS and the United Nations Environment Programme, UNEP.

Subtitled, ‘Facing a changing world: women population and climate’, The State of World Population places women at the very centre of the attempt to confront climate change and maintains that policies, programmes and interventions are more likely to mitigate its worst effects if they reflect the rights and needs of women.

Women are said to bear the brunt of climate change, partly because in many countries they make up the majority of the agricultural workforce hard hit in an environmental crisis, and because they often do not have sufficient control of their lives and access to as many opportunities to generate income as men – they are more likely to be poor and to see their poverty increase. As UNFPA Executive Director Thoraya Ahmed Obaid has it, “Poor women in poor countries are among the hardest hit by climate change, even though they contributed the least to it.”

Numerous examples of extreme climate change are cited, from melting glaciers in Bolivia, to the destruction of crops by typhoons in the Philippines, and from drought in east and southern Africa to floods in Vietnam. In each scenario, women are shown struggling to keep their livelihoods and families intact, and, in some cases, fighting for their lives.

According to the report, empowering women and girls, especially through investments in health and education, help boost economic development and reduce poverty, thus having a beneficial impact on coping with climate change. Girls with more education are more likely to protect themselves against HIV and to have smaller and healthier families as adults. In general, access to reproductive health services such as family planning means lower fertility rates and this has a clear bearing on lessening the potential impact of environmental crises and making sustainable development more likely.

“Women should be part of any agreement on climate change—not as an afterthought or because it’s politically correct, but because it’s the right thing to do,” says Ms Obaid. “Our future as humanity depends on unleashing the full potential of all human beings, and the full capacity of women, to bring about change.”

The State of World Population 2009 argues that ensuring gender inequity is challenged in all its facets is an urgent necessity, not just to improve the lives of individual women but to stave off the worst consequences of environmental crisis. This sense of urgency is relayed to the leaders and negotiators due to meet in Copenhagen for December’s critical climate change conference. They are urged to “think creatively” not just about emissions and targets but about population, reproductive health and gender equality and how they can contribute to “a just and environmentally sustainable world.”