L to R: Timothy E. Wirth, President, United
Nations Foundation and Better World Fund,
Jim Yong Kim, Harvard Medical School,
David Baltimore (moderator), AAAS
President, California Institute of
Technology and UNAIDS Executive
Director Dr Peter Piot.

The 2008 Meeting of the American Association for the Advancement of Science took place in Boston, USA from 14-18 February and brought together science and technology professionals from 56 countries to discuss the latest scientific breakthroughs and challenges.

President of the AAAS, Nobel Prize winner Mr. David Baltimore, said that the event was the ‘largest and most important interdisciplinary scientific gathering of the year’. The main focus of the conference was on the power of science, technology and education, to assist less developed segments of world society while improving cooperation among developed countries and spurring knowledge-driven transformation across scientific disciplines.

Some 10,000 people attended the conference including leading scientists, engineers, educators, and policy-makers as well as members of the national and international media.

The meeting ran under the umbrella theme of "Science and Technology from a Global Perspective" and the program highlighted areas of research, new developments, and cross-cutting activities in support of science, technology and education around the world.

UNAIDS Executive Director Dr Peter Piot
spoke on a plenary panel session on
Global Health Challenges on Monday 18
February.

Among the 150 symposiums and presentations was a round table discussion on the state of public health which focused particularly on AIDS and tuberculosis; presentations on the search for a global AIDS vaccine and the challenge of comprehensive HIV control in sub-Saharan Africa.

UNAIDS Executive Director Dr Peter Piot spoke on a plenary panel session on Global Health Challenges on the closing day of the conference together with Jim Yong Kim from the Harvard School of Public Health and Timothy Worth, President of the UN Foundation and Better World Fund. The session was moderated by AAAS President David Baltimore.

The World Economic Forums’ initiative for health the ‘Global Health Initiative’, supported by UNAIDS, has released the first report on Business Coalitions at the World Economic Forum’s annual meeting in Davos. The report is an in-depth study of the activities of Business Coalitions and will help define how they can better support the private sector in responding to AIDS.

Business Coalitions on AIDS have emerged as an effective platform for the private sector response to the epidemic. AIDS has already claimed the lives of 25 million in the global workforce and remains a serious threat to business.

Although some companies are already effectively addressing AIDS in the workplace, others despite being aware of the risks to their business, simply do not know how or where to start mitigating risks.Business Coalitions have emerged to fill this gap and provide the private sector with the tools and processes it needs to effectively address AIDS in the workplace.

Business Coalitions act as a voice for the private sector, often through representation on national AIDS committees and by interacting with other key stakeholders. They support the business response to AIDS through advocacy and the design, development and implementation of workplace programmes by providing the necessary materials, tools and training.

"UNAIDS has supported the development of a number of national business coalitions on HIV in regions heavily impacted by the epidemic,” said Peter Piot, Executive Director, UNAIDS.   “Business coalitions are a valued and respected partner in the AIDS response. Thanks to their growing influence, more companies are engaging in activities to tackle AIDS.  But such companies remain in the minority. I hope this report will help encourage others to get involved.”

To date, four regional Business Coalitions and 47 national Business Coalitions have been established with a further 10 national Business Coalitions scheduled for launch in 2008-2009. Collectively, these coalitions have already reached over one million organisations with AIDS workplace policies and programmes.

Coalitions have formed partnerships with key stakeholders at national, regional and international levels. In addition to the private sector, these include international donors, other regional and national Business Coalitions, governments and civil society groups. These relationships are critical in delivering a coordinated response to the epidemic.

The regional coalitions serve as a platform for national coalitions to come together, share experiences, exchange expertise and find solutions to some of the more complex challenges, common to the region.   UNAIDS is currently working with over 30 regional and national business coalitions, helping to support the private sector response to AIDS.

Business Coalitions Tackling AIDS: A Worldwide Review , January 2008 presents the current Business Coalition landscape and suggests next steps for all stakeholders to build on the global momentum and success with engaging the private sector.

The report was developed by the GHI in partnership with the World Bank, UNAIDS and Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) and with the support of the Corporate Council of Africa (CCA) and the PharmAccess Foundation.

At the Women Deliver conference in London (18 – 20 Oct 2007), UNAIDS Executive Director called for renewed political support and increased funding to make sure that women’s health become a national priority across the world. He stressed that healthy mothers and children are key to slowing down the AIDS epidemic.

Every minute of every day, a woman dies needlessly during pregnancy or childbirth, most in the developing world. Ten million women are lost in every generation. Huge disparities exist between rich and poor countries, and between the rich and poor in all countries. At the same time, four million newborn babies die every year, also from causes that are mainly preventable. Evidence and experience shows that with increased political will and adequate financial investment, most women and newborns can survive so that families, communities and nations can thrive.

Bringing to light the critical connection between women’s health, rights, education and poverty reduction, the global conference on maternal health ‘Women Deliver’ is taking place in London from 18 to 20 October 2007.

Co-Chaired by Mary Robinson, president of Realizing Rights, former president of Ireland, and former United Nations High Commissioner for Human Rights and by Asha Rose Migiro, Deputy Secretary-General of the United Nations, the conference encourages governments to integrate women’s health and rights into national plans and strategies.

At the Conference opening, UNAIDS Executive Director Peter Piot, underlined a number of similarities between the response to women’s health and the AIDS response. He cited the prevention of mother to child transmission of HIV as an intervention with proven results that is a potential catalyst to strengthen health systems.

Dr Piot noted that women are paying a heavy price today as a result of years of under-investment – including within the AIDS response. Despite accelerating progress in AIDS over the past few years, women and girls are still being left behind. About 18 million women are living with HIV today – many of them poor, most of them stigmatized, some at risk of violence, and too few are able to access HIV treatment. Only one in ten women in developing countries has access to drugs to prevent transmission of HIV to their children.

In his conclusion, Dr Piot suggested that the world should start talking about women’s health, morbidity and mortality and not just maternal mortality. He underlined that taking the issue beyond the health sector and focussing on socio-economic implications would attract governments’ attention in ways that women’s health has not.

The Women Deliver Conference runs until 20 October 2007

Links:

View the video by the Global Coalition on Women and AIDS that is being shown at the conference

From left to right: Norwegian Prime Minister
Jens Stoltenberg, UNAIDS Deputy Executive
Director Michel Sidibe, British Prime Minister
Gordon Brown, and Dr Margaret Chan, Director-
General of the World Health Organization
(Photo:  Richard Lewis/Crown Copyright)  

Leaders from donor countries, funding organizations, developing nations, and international agencies came together in London on Wednesday 5 September to launch a new international partnership to help improve healthcare systems in the developing world.

Led by the government of the United Kingdom, the International Health Partnership was launched formally by UK Prime Minister Gordon Brown at an event at 10 Downing Street, London.

The initiative aims to increase donor, country and international coordination on health and development issues in order to drive forward work on the health-related Millennium Development Goals (MDGs) – reducing child mortality, improving maternal health, and halting and reversing the spread of HIV.

Following a roundtable discussion focusing on implementation, participants signed a compact to work within countries’ national plans and improve coordination in order to address problems related to health worker staffing, infrastructure, health commodities, logistics, tracking progress, and effective financing. Partners will work together to ensure that health plans are well-designed, well-supported and well-implemented and to make their work more effective and better aligned with developing countries’ established priorities.

In a statement released on Wednesday 5 by the United Kingdom, Prime Minister Gordon Brown said, “There is no greater cause than that every man, woman and child in the world should be able to benefit from the best medicine and healthcare. Today we come together – donor governments, health agencies and developing countries – with the certainty that we have the knowledge and the power to save millions of lives through our efforts.”

In an initial phase, seven ‘first wave’ countries – Burundi, Cambodia, Ethiopia, Kenya, Mozambique, Nepal and Zambia – have joined the partnership and participated in the London event. Also attending were Heads of State and ministers from donor countries such as Norway and Canada and senior figures from international agencies, including UNAIDS. Philanthropist Bill Gates attended on behalf of the Bill and Melinda Gates Foundation.

Speaking at the event, UNAIDS Deputy Executive Director Michel Sidibe underlined the importance of the partnership. “To improve global health, it is critical that we have better coordination and mutual accountability from all parties: countries, donors, and the international organizations.” he said. “The International Health Partnership will be crucial in order to deliver on our commitments to the targets of Universal Access to HIV prevention, treatment, care, and support, and in reaching all the health-related Millennium Development Goals. The global response to AIDS has shown us that increased coordination can lead to progress. We also need to stay focused on the concrete results that we are all committed to, at the same time putting in place predictable, scaled-up financing for a long-term sustainable response.”

A joint statement from international health partners – UNAIDS, The GAVI Alliance, Global Fund to Fight Aids, Tuberculosis and Malaria, UNICEF, United Nations Population Fund, World Bank and the World Health Organization – welcomed the initiative: “We, as international health partners committed to improving health and development outcomes in the world, welcome and fully support the International Health Partnership's mission to strengthen health systems, and we congratulate those involved for setting it in motion.”

“We will be coordinated and accountable in this work and take every opportunity to capture knowledge and lessons learned in improving health programmes,” the partners stated.

The International Health Partnership is the first of several complementary initiatives being launched by donor countries over the next several weeks as part of a new Global Campaign for the Health Millennium Development Goals. More information will be featured in the coming weeks on the UNAIDS website.

Links:

"Leadership" has been chosen by the World AIDS Campaign as the theme for World AIDS Day 2007 and 2008. This theme will continue to be promoted with the slogan "Stop AIDS. Keep the Promise."—the World AIDS Campaign (WAC) emphasis from 2005-2010.

On December 1 every year, the world comes together to commemorate World AIDS Day. The theme for World AIDS Day has been determined by the World AIDS Campaign since 1997.

“We know that significant advances in the response to HIV have been achieved when there is strong and committed leadership. Leaders are distinguished by their action, innovation and vision; their personal example and engagement of others; and their perseverance in the face of obstacles and challenges,” said the World AIDS Campaign. “Leadership must be demonstrated at every level to get ahead of the epidemic- in families, in communities, in countries and internationally.”

“Much of the best leadership on AIDS has been demonstrated within civil society organisations challenging the status quo. Making leadership the theme of the next two World AIDS Days will help encourage leadership on AIDS within all levels and sectors of society,” the Campaign added.

The 2007/8 theme of “Leadership” will build on the 2006 World AIDS Day focus on accountability, and was selected by the Global Steering Committee of the World AIDS Campaign during their meeting held in Geneva in February.

“We are still dying! Leadership requires that we face this reality. While scaling up of HIV care is now prioritized, it is under funded and poorly implemented,” said WAC Steering Committee Member and Chairperson, Global Network of People Living with HIV/AIDS Deloris Dockrey.

“Leadership can imply the power and authority to make a difference, to lead by action and example,” added fellow Steering Committee member and Coordinator for the Ecumenical Advocacy Alliance, Linda Hartke. “By taking on the global theme of leadership for World AIDS Day, faith leaders and the communities they are a part of can help articulate a vision, build relationships and take concrete action in solidarity with all people committed to reaching universal access for HIV prevention, treatment and care.”

The overall purpose of the World AIDS Campaign from 2005 to 2010 is to ensure that leaders and decision makers deliver on their promises on AIDS, including the provision of Universal Access to Treatment, Care, Support and Prevention services by 2010. Within that five-year mission, annual campaigning themes are selected which are timely, relevant and adaptable to a number of different regions and issues.

The issue of continued and increased leadership on AIDS and it’s importance to a long-term sustainable AIDS response was underlined by UNAIDS Executive Director Peter Piot at the European AIDS Conference held in Bremen, Germany on 12-13 March. “ Leadership makes or breaks the response against AIDS,” he said.

The Global Steering Committee of World AIDS Campaign is comprised of the Global Network of People Living with HIV/AIDS, the International Community of Women Living with HIV/AIDS, the Youth Coalition, the Global Unions Programme on HIV/AIDS, the International Council of AIDS Service Organisations, the Ecumenical Advocacy Alliance, and the International Women’s AIDS Caucus. UNAIDS and the Global Fund to Fight AIDS, TB and Malaria are non-voting members.

Geneva/Lilongwe, 19 June 2013—Ahead of the first meeting of the UNAIDS and Lancet Commission: From AIDS to Sustainable Health, the esteemed Commissioners who will be working together on HIV and global health in the post-2015 debate have been announced.

More than 30 Commissioners, including heads of state, policy makers, people living with HIV, development experts, scientists, young people, AIDS advocates and private sector leaders, will come together for the first time in Lilongwe, Malawi on 28-29 June to explore how the AIDS response can be used to shape the future of global health.

“This is the first time that such a diverse group of experts has been brought together for frank discussions about the future of global health,” said Michel Sidibé, Executive Director of UNAIDS. “We will be encouraging them to think about what will it take to reach the end of AIDS; how the AIDS response can serve as a transformative force in our approach to global health; and how to modernize the global AIDS architecture for a more equitable, effective and sustainable future for global health.”

The Commission is co-chaired by Malawi President Joyce Banda, African Union Commission Chairperson Nkosazana Dlamini Zuma and London School of Hygiene and Tropical Medicine Director Peter Piot. Its aim is to catalyse expertise and political momentum to shape the debate on the future of health in the post-2015 development agenda and accelerate progress towards the end of AIDS.

Drawing from the pioneering experience of the global AIDS response, during the meeting in Malawi, the Commissioners will be encouraged to engage in informal and dynamic dialogue. By exchanging perspectives, exploring options and seeking consensus, Commissioners will begin extracting the lessons learnt from the AIDS response to be used in the transformation of global health and development in the post-2015 debate.

During the meeting a high-level roadmap for the continued work of the Commission will be developed. A preliminary version of the Commission report will be prepared by a team of expert writers who will work closely with the Commissioners and other key stakeholders over the coming months. A draft of the report will be considered in the second and final meeting of the Commission at the beginning of 2014.

For more information on the UNAIDS and Lancet Commission and list of Commissioners go to: http://www.unaids.org/en/resources/campaigns/post2015/

UNAIDS and Lancet Commission: From AIDS to Sustainable Health The UNAIDS and Lancet Commission: From AIDS to Sustainable Health was launched in May 2013 and is co-Chaired by President Joyce Banda, Chairperson Nkosazana Dlamini Zuma and Professor Peter Piot. Drawing from the pioneering experience of the global AIDS response, the Commission brings together heads of state, policy makers, people living with HIV, development experts, young people and private sector leaders. The Commission aims to catalyse expertise and political momentum to shape the debate on the future of health in the post-2015 development agenda and accelerate progress towards the end of AIDS.

WASHINGTON, DC/GENEVA, 20 July 2012—The United Nations has announced the appointment of Michel Kazatchkine as the Secretary-General’s new Special Envoy for HIV/AIDS in Eastern Europe and Central Asia, one of only two regions in the world where HIV is continuing to grow.

In 2011, there were 1.5 million people living with HIV in Eastern Europe and Central Asia, and 170 000 people were newly infected with the virus. New infections have risen by more than 22% in the region since 2005 and there is no sign that the epidemics are slowing down.

“Eastern Europe and Central Asia are still facing huge challenges in responding to HIV,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “With his experience and leadership I am convinced that Mr Kazatchkine will do an excellent job in helping to reverse the epidemic in this pivotal region.”

Michel Kazatchkine is an internationally recognized physician who has devoted thirty years of his professional life to the AIDS response. From 2007 to 2012 he served as the Executive Director of the Global Fund to fight AIDS, Tuberculosis and Malaria and from 1998 to 2005 he was Director of the French National Agency for AIDS Research.  Between 2005 and 2007 he served as France's Global Ambassador for HIV and Communicable Diseases.

“I am committed to encouraging countries in this region to turn the tide of the epidemic and save millions of lives”, said Mr Kazatchkine. “Together with UNAIDS, I will advocate for an urgent mobilization to respond to the HIV epidemic in Eastern Europe and Central Asia”

As Special Envoy on HIV/AIDS, Mr. Kazatchkine will advocate at the highest levels for the implementation of the 2011 Political Declaration on HIV/AIDS and its targets.

GENEVA, 13 July 2012—United Nations Secretary-General Ban Ki-Moon has appointed Asha-Rose Migiro as his Special Envoy for HIV/AIDS in Africa.  “Ms Migiro’s experience in responding to AIDS as UN Deputy Secretary-General, combined with her many years as an advocate for health and social justice in Africa, make her uniquely qualified for this important role,” said Mr Ban.

Ms Migiro served as the United Nations Deputy Secretary-General from 2007 to 2012. In that role, she was integrally involved in promoting the AIDS response globally and within Africa, with special emphasis on reducing the vulnerability of women and girls and ensuring the rights of people living with HIV.

“I am honoured to accept this appointment at this crucial moment in the African AIDS response,” said Ms Migiro. “A decade ago, HIV in Africa was almost entirely an epidemic of despair. Today, we celebrate progress against AIDS that we never thought possible. Now is the time to take our efforts to a new level––I am committed to the Secretary-General’s vision that the beginning of the end of AIDS in Africa starts now.”

Ms Migiro served as Tanzania’s Minister of Foreign Affairs and International Cooperation from 2006 to 2007—the first woman to hold that position since the country’s independence. She was previously the Minister for Community Development, Gender and Children for five years. Prior to Government service, she pursued a career in academia, and, served as a member of Tanzania’s Law Reform Commission in 1997 and as a member of the United Nations Committee on the Elimination of Discrimination against Women in 2000.

“I look forward to working closely with Ms Migiro in helping African countries reduce their AIDS dependency and provide universal access to HIV prevention, treatment, care and support services,” said UNAIDS Executive Director Michel Sidibé. “Her experience and leadership will promote African ownership of the AIDS response at the highest levels and reduce the inequities of people affected by AIDS in the continent.”

Africa remains the continent most affected by HIV. In 2010, about 68% of all people living with HIV resided in sub-Saharan Africa. The region also accounted for 70% of all new HIV infections worldwide.

(RED) to join movement to eliminate new HIV infections among children by 2015  

Geneva, 21 September 2011—The Joint United Nations Programme on HIV/AIDS (UNAIDS) congratulates Deborah Dugan on her appointment as the new CEO for (RED).

A media pioneer, Ms Dugan brings diverse experience from television and film to the world of publishing and will lend her expertise as (RED) expands its successful partnerships with global brands.

“Ms Dugan has hit the ground running—and UNAIDS is excited to be partnering with such a dynamic leader,” said Michel Sidibé, Executive Director of UNAIDS. “We have a shared goal to end new HIV infections among children by 2015 and UNAIDS is counting on (RED) to engage new partners and resources in this movement.”

The organization is joining the global health community in raising funds and awareness to help eliminate new HIV infections among children by 2015 and realize the first AIDS-free generation in 30 years.

(RED) partners and events have raised more than USD$ 175 million for the AIDS response—reaching more than 7.5 million people affected by AIDS in Africa. Its partners include: American Express in the UK, Apple, Bugaboo, Converse, Dell, Gap, Hallmark in the US, Nike, and Starbucks.

New UNAIDS report shows AIDS epidemic has been halted and world beginning to reverse the spread of HIV. New HIV infections have fallen by nearly 20% in the last 10 years, AIDS-related deaths are down by nearly 20% in the last five years, and the total number of people living with HIV is stabilizing.

GENEVA, 23 November 2010—A new report by the Joint United Nations Programme on HIV/AIDS (UNAIDS), released today, shows that the AIDS epidemic is beginning to change course as the number of people newly infected with HIV is declining and AIDS-related deaths are decreasing. Together, this is contributing to the stabilization of the total number of people living with HIV in the world.

Data from the 2010 UNAIDS Report on the global AIDS epidemic shows that an estimated 2.6 million  [2.3 million–2.8 million] people became newly infected with HIV, nearly 20% fewer than the 3.1 million  [2.9 million–3.4 million] people infected in 1999.

In 2009, 1.8 million [1.6 million–2.1 million] people died from AIDS-related illnesses, nearly one-fifth lower than the 2.1 million [1.9 million–2.3 million] people who died in 2004. 

At the end of 2009, 33.3 million [31.4 million–35.3 million] people were estimated to be living with HIV, up slightly from 32.8 million[1] [30.9 million–34.7 million] in 2008. This is in large part due to more people living longer as access to antiretroviral therapy increases.

 “We are breaking the trajectory of the AIDS epidemic with bold actions and smart choices,” said Mr Michel Sidibé, Executive Director of UNAIDS. “Investments in the AIDS response are paying off, but gains are fragile—the challenge now is how we can all work to accelerate progress.”

Prevention is working

The 2010 report contains basic HIV data from 182 countries and includes country-by-country scorecards. The report gives new evidence that investments in HIV prevention programming are producing significant results in many of the highest burden countries.

From 2001 to 2009, the rate of new HIV infections stabilized or decreased by more than 25% in at least 56 countries[2] around the world, including 34 countries in sub-Saharan Africa. Of the five countries with the largest epidemics in the region, four countries—Ethiopia, South Africa, Zambia and Zimbabwe—have reduced rates of new HIV infections by more than 25%, while Nigeria’s epidemic has stabilized.

Sub-Saharan Africa continues to be the region most affected by the epidemic with 69% of all new HIV infections. In seven countries, mostly in Eastern Europe and Central Asia, new HIV infection rates have increased by 25%.

Among young people in 15 of the most severely affected countries, the rate of new HIV infections has fallen by more than 25%, led by young people adopting safer sexual practices. In South Africa, the rate of new HIV infections among 18-year-olds declined sharply from 1.8% in 2005 to 0.8% in 2008 and among women 15–24 years-old it dropped from 5.5% to 2.2% between 2003 and 2008.

In 59 countries including 18 of the 25 countries with the highest HIV prevalence, less than 25% of men reported having sex with more than one partner in the last 12 months. Eighty-four countries reported the same behaviour trends for women.

Condom use and availability have increased significantly. Eleven countries—from Burkina Faso, to India, and Peru—report more than 75% condom use at last higher-risk sex. Data from 78 countries show that condom use among men who have sex with men was more than 50% in 54 countries. Reports of condom use by sex workers are also encouraging. In 69 countries, more than 60% of sex workers used a condom with their last client.

Access to HIV prevention services including harm reduction programmes for people who inject drugs has reached 32%—far short of what is needed to protect drug users from HIV worldwide. Even though many countries have included male circumcision in their prevention programmes, uptake at a population level remains low, and has not made a significant impact on the rate of new HIV infections.

New HIV infections slowing but still outpace treatment success by 2:1

Even though the number of new HIV infections is decreasing, there are two new HIV infections for every one person starting HIV treatment.

Investments in HIV prevention programmes as whole have not been adequate or efficiently allocated. HIV prevention investments comprise about 22% of all AIDS-related spending in low- and middle-income countries.

Declines in AIDS-related deaths

More people are living longer and AIDS-related deaths are declining as access to treatment has expanded. The total number of people on treatment increased by seven and half times over the last five years with 5.2 million people accessing life-saving drugs in 2009, compared to 700 000 in 2004. Over the course of the last year alone, an additional 1.2 million people received treatment—a 30% increase compared to 2008. In addition, there has been a secondary dividend of stopping new HIV infections with increased access to HIV treatment.

However, nearly twice the number of people—10 million—are waiting for treatment. New evidence shows that scaling up treatment has led to reductions in population mortality in high-prevalence settings. The results could be better—most people receiving antiretroviral therapy in sub-Saharan Africa start treatment late, which limits the overall impact of HIV treatment programmes. Countries have made slow but good progress in integrating tuberculosis and HIV programmes.

Significant progress in the virtual elimination of HIV to babies—handful of countries hold key to success

As more countries are using effective treatment regimens to prevent HIV transmission to babies, the total number of children born with HIV has decreased. An estimated 370 000 [230 000–510 000] children were newly infected with HIV in 2009, representing a drop of 24% from five years earlier.

Significant gains were observed in sub-Saharan Africa where new HIV infections among children have fallen 32%.

Just 14 countries now account for more than 80% of the gap in providing services to prevent mother-to-child transmission. Nigeria alone contributes to 32% of the worldwide gap.

Human rights are part of AIDS strategies but not fully implemented

The report also contains new data which shows that human rights efforts are increasingly being integrated into national AIDS strategies, with 89% of countries explicitly acknowledging or addressing human rights in their AIDS strategies and 91% having programmes in place to reduce stigma and discrimination. However, punitive laws continue to hamper access to AIDS-related services—79 countries worldwide criminalize same sex relations and six apply the death penalty. In the Asia-Pacific region, 90% of countries have laws which obstruct the rights of people living with HIV.

Resource demand outstripping supply

UNAIDS estimates that a total of US$ 15.9 billion was available for the AIDS response in 2009, US$ 10 billion short of what is needed in 2010 and funding from international sources appears to be reducing. Donor governments’ disbursements for the AIDS response in 2009 stood at US$ 7.6 billion, lower than the US$ 7.7 billion available in 2008. Declines in international investments will affect low-income countries the most—nearly 90% rely on international funding for their AIDS programmes.

The report highlights the urgent need to sustain and scale up good investments and for countries to share the financial burden of the epidemic. Many countries are under-investing and need to increase their domestic financial commitments to sustain and scale up the AIDS response. A new Domestic Investment Priority Index developed by UNAIDS shows that almost half of the 30 countries in sub-Saharan Africa are spending less than their capacity— commensurate to their disease burden and availability of government resources. The index also shows that some developing countries with strong economies can meet a substantial portion of their resource needs from domestic sources alone.

[1] The 2008 estimate for the number of people living with HIV was revised to 32.8 million [30.9 million–34.7 million] within the range of the previous estimate. The revision was based on new data from countries, including data from population-based surveys such as in Mozambique.

[2] A total of 63 countries were studied. For some countries with complex epidemics including multiple population groups with different risk behaviours as well as major geographic differences, such as Brazil, China and the Russian Federation, this type of assessment is highly complex and could not be concluded in the 2010 HIV estimation analysis.