In a strong demonstration of commitment to the global response to HIV and to UNAIDS, the President of Côte d’Ivoire Alassane Ouattara has announced that Côte d’Ivoire will donate US$ 1 million to support UNAIDS work in helping countries to achieve the targets set out in the 2011 Political Declaration on HIV and AIDS.

"I have decided to donate US$ 1 million to UNAIDS because I believe in a society with zero new HIV infections, zero discrimination and zero AIDS-related deaths," said President Ouattara during the meeting of Côte d’Ivoire’s National AIDS Council.

The contribution was confirmed by the Minister of Health Côte d’Ivoire Raymonde Goudou Coffie who was representing Côte d’Ivoire at UNAIDS Programme Coordinating Board meeting in Geneva. "I am delighted to be at the UNAIDS Board and to announce our contribution of US$ 1 million for its essential work and as a sign of shared responsibility," said Ms Coffie.

“This contribution to UNAIDS makes Côte d’Ivoire the first African country to become one of UNAIDS 20 most important donors,” said Michel Sidibé, Executive Director of UNAIDS.

Côte d’Ivoire joins the Republic of the Congo and Senegal in becoming the first African countries to financially contribute to UNAIDS.

Renewed commitment needed in Eastern Europe and Central Asia, the Middle East and North Africa and for key populations.

GENEVA, 20 November 2013—Accelerated progress has been reported in most parts of the world. However, there are worrying signs that some regions and countries are not on track to meet global targets and commitments on HIV.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) reports that new HIV infections have been on the rise in Eastern Europe and Central Asia by 13% since 2006. The Middle East and North Africa has seen a doubling of new HIV infections since 2001.

In many cases stalled progress is due to inadequate access to essential HIV services. Key populations including men who have sex with men, people who use drugs, transgender people and sex workers are often blocked from accessing life-saving services.

“Every person counts,” said Michel Sidibé, Executive Director of UNAIDS. “If we are going to keep our pledge of leaving no one behind—we have to make sure HIV services reach everyone in need.”

Investments focused on reaching key populations have not kept pace. Funding for HIV prevention services for men who have sex with men is especially limited in East Asia, the Middle East and North Africa, and across sub-Saharan Africa. Investments lag in a number of countries where HIV prevalence among people who inject drugs is high. Ten countries in which HIV prevalence among people who inject drugs exceeds 10%, allocate less than 5% of HIV spending to harm reduction programmes. Notwithstanding sex workers’ disproportionate risk of acquiring HIV, prevention programmes for sex workers account for a meagre share of HIV prevention funding globally.

While much work needs to be done in Eastern Europe, for the first time in 2012, Ukraine has reported a decline in the number of newly identified HIV cases, representing a new turning point for the country. There are an estimated 200 000 people living with HIV in Ukraine. At 21.5%, HIV prevalence is highest among people who inject drugs.

However, by working together, the Ukrainian government and civil society organizations are striving to provide essential HIV services to support key populations, using evidence to guide investments and programmes. In 2011, Ukraine also amended its AIDS law which now guarantees harm reduction services for people who inject drugs, confidentiality of HIV status for people living with HIV and removal of HIV-related travel restrictions.

More attention needed for children and adults aged 50 and over

In priority countries, only three in 10 children receive HIV treatment under 2010 WHO treatment guidelines. Children living with HIV continue to experience persistent treatment gaps. In 2012, 647 000 children under 15 years of age were receiving antiretroviral treatment. HIV treatment coverage for children (34% (31-39%)) remained half of coverage for adults 64% (61-69%)) in 2012 under the old guidelines.

“We have seen tremendous political commitment and results to reduce mother-to-child transmission of HIV—but we are failing the children who become infected,” added Mr Sidibé. “We urgently need better diagnostic tools and child-friendly medicines—irrespective of the market size.”

Although the number of children receiving antiretroviral therapy in 2012 increased by 14% in comparison to 2011, the pace of scale-up was substantially slower than for adults (a 21% increase). The failure to expand access in many settings to early infant diagnosis is an important reason explaining why HIV treatment coverage remains much lower for children than for adults. In three priority countries, Chad, Democratic Republic of the Congo and Malawi, coverage of less than 5% was reported for early infant diagnostic services in 2012.

An increasingly significant trend in the global HIV epidemic is the growing number of people aged 50 years and older, who are living with HIV. Worldwide, an estimated 3.6 [3.2–3.9] million people aged 50 years and older are living with HIV. This “aging” of the HIV epidemic is mainly due to three factors: the success of antiretroviral therapy in prolonging the lives of people living with HIV; decreasing HIV incidence among younger adults shifting the disease burden to older ages; and the often-unmeasured, and thus often overlooked, fact that people aged 50 years and older exhibit many of the risk behaviours also found among younger people.

Global AIDS data

New HIV infections among adults and children were estimated at 2.3 million in 2012, a 33% reduction since 2001. New HIV infections among children have been reduced to 260 000 in 2012, a reduction of 52% since 2001. AIDS-related deaths have also dropped by 30% since the peak in 2005 as access to antiretroviral treatment expands.

By the end of 2012, some 9.7 million people in low- and middle-income countries were accessing antiretroviral therapy, an increase of nearly 20% in just one year. In 2011, UN Member States agreed to a 2015 target of reaching 15 million people with HIV treatment. However, as countries scaled up their treatment coverage and as new evidence emerged showing the HIV prevention benefits of antiretroviral therapy, the World Health Organization set new HIV treatment guidelines, expanding the total number of people estimated to be in need of treatment by more than 10 million.

Significant results have also been achieved towards meeting the needs of tuberculosis (TB) patients living with HIV, as TB-related deaths among people living with HIV have declined by 36% since 2004.

Despite a flattening in donor funding for HIV, which has remained around the same as 2008 levels, domestic spending on HIV has increased, accounting for 53% of global HIV resources in 2012. The total global resources available for HIV in 2012 was estimated at US$ 18.9 billion, US$ 3-5 billion short of the US$ 22-24 billion estimated to be needed annually by 2015.

During a meeting on May 23 in Geneva, the Minister of Health of the Kingdom of Bahrain, Dr Sadiq AbdulKarim Al Shehabi and UNAIDS Executive Director Michel Sidibé pledged to strengthen cooperation between UNAIDS and the Ministry of Health.

Mr Sidibé commended the leadership of the Minister Al Shehabi in Bahrain in responding to the AIDS epidemic. He also asked Dr Al Shehabi to champion national and regional initiatives to prevent new HIV infections among children by 2015 and to accelerate scale up of HIV treatment in the Arab Region.

Dr Al Shehabi welcomed the partnership with UNAIDS and committed to putting HIV on the agenda of the Gulf Cooperation Council, currently chaired by the Kingdom of Bahrain.

The Arab Region has one of the fastest growing HIV epidemics in the world. Between 2001 and 2011, the estimated number of people living with HIV in Arab countries increased from 170 000 to 230 000. The numbers of AIDS-related deaths and new HIV infections have also increased significantly. Between 2001 and 2011, there was a 32% increase in AIDS-related deaths and since 2001, the number of people newly infected with HIV in Arab countries has increased by more than 47%—from 19 000 to 28 000. Recent studies suggest that concentrated epidemics are emerging among key populations at higher risk of HIV infection in many countries of the region.

Quotes

The President of South Africa, Jacob Zuma met with UNAIDS Executive Director, Michel Sidibé, on 18 January at the president’s official residence in Pretoria. Mr Sidibé congratulated President Zuma on the country’s achievements in the AIDS response in recent years and reiterated the support of UNAIDS. President Zuma acknowledged that although South Africa has in the past suffered from adverse policy decisions, the current leadership in the country is moving the AIDS response forward.

They discussed the role of South Africa in promoting the African Union’s Roadmap for Shared Responsibility and Global Solidarity, which outlines the long-term sustainable strategies to finance and providing access to HIV treatment and prevention services in Africa. The two leaders also talked about the need to reduce external financial dependency and use the HIV response to encourage technological innovation. South Africa is one of the few countries in Africa to produce antiretroviral medicine for HIV treatment and could serve as a model for the rest of the continent.

Mr Sidibé and the President also discussed the development agenda beyond 2015 and the influence that South Africa can have on the global debate around reaching new development goals.

Quotes

UNAIDS Executive Director, Michel Sidibé met with the Deputy President of South Africa, Kgalema Motlanthe and the Minister of Health, Dr Aaron Motsoaledi on 18 January. The meeting began with a review of the progress made in the HIV response in South Africa in recent years. The Deputy President attributed much of the success of the country to the Health ministry and in particular, the Minister of Health. Dr Aaron Motsoaledi spoke about the country’s achievements, especially in reaching 70% of people, who need HIV treatment with life-saving antiretrovirals.

Mr Sidibé welcomed the advances the country has made but added that stigma and discrimination are still barriers to accessing treatment and that the silence surrounding people living with HIV needs to be broken. 

Quotes

UNAIDS Executive Director Michel Sidibé speaking at the 2nd Health Ministers’ meeting of the BRICS countries held in New Delhi, India from 10-11 January. Credit:UNAIDS/N.Raveendran

The 2nd Health Ministers’ meeting of the BRICS countries (Brazil, Russia, India, China and South Africa) concluded in New Delhi, India on January 11, with a strong call for strengthened cooperation in the implementation of affordable, equitable and sustainable solutions for common health challenges.
During his opening remarks, the Honourable Ghulam Nabi Azad, the Minister of Health and Family Welfare of India, highlighted the progress of the BRICS countries in the global AIDS response. “In India, we have reduced new HIV infections by 57% in the last decade, which puts us on track to halt and reverse the spread of HIV.” He was making reference to reaching one key HIV-related development goal by 2015.

Addressing the participants, UNAIDS Executive Director Michel Sidibé emphasized the unique role of the BRICS countries to draw on their positive experience with HIV to serve as an engine for innovation, research and development of health solutions for other developing countries. “Today, the BRICS are demonstrating how health is increasingly a tool of foreign policy and a vehicle for promoting global health and development for the entire world,” said Mr Sidibe. He also described global health as going through an important transition beyond disease specific approaches and adopting a people-centered approach to global health.

Several of the other BRICS Ministers highlighted their national commitments to HIV and the need to create a BRICS platform to enhance cooperation on global health, including HIV.

The five BRICS countries represent 43% of the global population, giving them a unique and growing role in contributing to global health. According to the Minister Azad, “the BRICS are very mature in our outlook, and have almost achieved adulthood. Let us now work together to consolidate our gains and collaborate at the bilateral and multilateral levels to provide global leadership in many areas.”

From L-R: Deputy Health Minister of Russia, Sergey Velmyaykin, UNAIDS Executive Director, Michel Sidibé, South African Health Minister Pakishe Aaron Motsoaledi, Indian Health minister Ghulam Nabi Azad, Chinese Health Minister Chen Zhu and Brazil Health Secretary Jarbas Barbosa shake hands during the 2nd BRICS Health Ministers meeting in New Delhi on January 11, 2013. Credit:UNAIDS/N.Raveendran

The meeting adopted the Delhi Communique, which calls for the BRICS to renew efforts to face the continued challenge posed by HIV.  The Delhi Communique reiterated the commitment of the BRICS countries to “ensure that bilateral and regional trade agreements do not undermine TRIPS flexibilities so as to assure the availability of affordable generic antiretroviral drugs to developing countries.”

Intellectual property and trade flexibilities within the intellectual property rights system were set out in the World Trade Organization Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS).  Evidence from countries across the world shows that the use of TRIPS flexibilities has helped substantially lower the costs of HIV treatment.

At the closing of the meeting, it was announced that the next BRICS Ministerial meeting will be hosted by South Africa in January 2014.

UNAIDS Executive Director Michel Sidibé meets with the President of Burkina Faso, Blaise Compaoré in Ouagadougou, Burkina Faso on 20 December 2012.

UNAIDS Executive Director Michel Sidibé congratulated the President of Burkina Faso, Blaise Compaoré for his personal engagement in his country’s AIDS response during a meeting held on 20 December in the country’s capital of Ouagadougou. New HIV infections in Burkina Faso have dropped by 60% in the past ten years.

“You are a model of good governance and a promoter of peace on the continent,” said Mr Sidibé. “You have invested in the AIDS response. You have shown that when there is strong leadership change is possible.”

The number of people living with HIV who are receiving life-saving treatment have increased significantly. The Burkina Faso Health Ministry’s latest figures show HIV treatment coverage increased by 19% between 2010 and 2012, reaching 60% of people eligible for antiretroviral therapy.

“Burkina Faso has produced remarkable results in its treatment coverage. Making antiretroviral treatment free in 2011 not only symbolizes President Compaoré’s commitment to social justice but is extremely effective,” said Mr. Sidibé.

President Compaoré is also committed to reducing his country’s dependence on external funding and he has taken the initiative by expanding the share of domestic resources allocated to the HIV response from 15% to 25%.

“From the beginning of the epidemic, we considered AIDS was not only a public health problem but a major threat to development and social stability,” said the President of Burkina Faso. “AIDS is threatening the most important resource for development, which is people.”

Earlier in the week, Mr Sidibé had also met with Burkina Faso’s Minister of Health, Professor Adama Traoré and discussed challenges including stopping new HIV infections among children and the country’s reliance on external funding.

Minister Adama Traoré stressed his country’s commitment to the AIDS response and said that his country’s financial resources are limited and they must be used in the best way in order to get results as human lives are at stake.

In a meeting with Minister of Justice Salamata Sawadogo, Mr Sidibé underlined the progress the country has made and the challenges around the criminalisation and stigmatisation of key populations at higher risk and HIV prevention, treatment and care for prisoners.  Minister Sawadogo said she is focused on human rights including the rights of people in prison.

Mr Sidibé will wrap up his four-day visit to Burkina Faso on 21 December.

Michel Sidibe meeting with Prime Minister Hailemariam Desalegn in the Prime Minister's Office, Addis Ababa, Ethiopia, on December 17, 2012
Credit: UNAIDS/A.Fiorente 

UNAIDS Executive Director Michel Sidibé congratulated the country on the dramatic decline in new HIV infections it has achieved during the past ten years on 17 December, while on an official visit to Ethiopia. Between 2001 and 2011, the rate of new HIV infections in Ethiopia among adults has been reduced by 90%.

“This drop in new HIV infections is a huge breakthrough,” said Mr Sidibé. “Ethiopia’s achievement demonstrates to the world that it is possible to prevent HIV in sub-Saharan Africa.”

Mr Sidibé met with Ethiopia’s new Prime Minister Haile Mariam Desalegn, who took over as the country’s leader when Prime Minister, Meles Zenawi died in August this year. UNAIDS Executive Director congratulated Prime Minister Haile Mariam on his appointment and expressed confidence that he will continue the legacy of his predecessor, who was known as an important advocate for the AIDS response.

Prime Minister Haile Mariam said that his country’s development agenda was people centered and that it was designed to improve the health status of families with their full participation, using local technologies and community skills and wisdom.

Mr Sidibé called on the prime minister, as the incoming Chairperson of the African Union and as the chair of AIDS Watch Africa (AWA), to strengthen AWA as an accountability mechanism. Mr Sidibé also asked for the prime minister’s help in translating into action a new roadmap adopted by African heads of State at the 19th summit of the African Union held in Addis Ababa in July. The roadmap charts a new course for the continent’s responses to AIDS, tuberculosis and malaria and emphasizes the importance of shared responsibility and global solidarity.

The Minister of Foreign Affairs, Dr Tedros Adhanom, acknowledged the support of UNAIDS in helping Ethiopia make a dramatic reduction in new HIV infections. He also stressed that the new road map on shared responsibility was an innovative approach that encouraged African leaders to own the transformation of health responses on their continent.

While Ethiopia has made huge progress in reducing new HIV infections, it still faces challenges in stopping new HIV infections among children. UNAIDS’ latest World AIDS Day Report finds only 24% of pregnant women living with HIV receive antiretroviral therapy to reduce HIV transmission. Mr Sidibé met with Dr Kesetebirhan Admassu, Minister of Health, who briefed him on the country’s new accelerated plan for eliminating new HIV infections in children and providing paediatric antiretroviral treatment to children. Dr Kesetebirhan Admassu emphasized that preventing new HIV infections among children will be given more focus in Ethiopia’s health programme.

During his one day visit to Ethiopia, Mr Sidibé also met with Commissioner for Social Affairs at the African Union Commission, Mustapha Sidiki Kaloko. The Commissioner requested UNAIDS support to the African Union Commission in developing a cross-cutting programme for the AIDS response involving all sectors of the African Union Commission.

Mr Sidibé met with Commissioner for Peace and Security at the African Union Commission, Ramtane Lamamra and called for the commissioner’s support in pushing for the implementation of the United Nations Security Council Resolution 1983, which was adopted in June 2011. The resolution calls for HIV prevention efforts among uniformed services to be aligned with efforts to end sexual violence in conflict and post-conflict settings.