One year ago, on 15 April 2023, armed conflict broke out in Sudan between the Sudanese Armed Forces and the Sudanese Rapid Support Forces. Since then, the situation has worsened. The hostilities, which were initially centred in Khartoum State, have intensified and rendered over half the country inaccessible.

The impact of this conflict has been devastating. Some 8.6 million Sudanese have been forced to flee their homes, 6.8 million are displaced with in the country and 1.8 million have sought refuge in neighbouring countries – Chad, Egypt and South Sudan.

The severity of the humanitarian emergency has been compounded by a deepening famine crisis, with 17.7 million Sudanese facing acute food insecurity, close to 5 million of whom are on the verge of starvation, as reported by OCHA and the Integrated Food Security Phase Classification.

In addition to the humanitarian crisis, the conflict has severely disrupted the healthcare infrastructure. The central depot, which stored all the antiretroviral treatment for people living with HIV in the country is inaccessible and the stock that it holds has since expired.

Before the conflict erupted, 11,000 people living with HIV in Sudan were on HIV treatment, 4000 of whom were lost to follow-up when the war broke out. All HIV prevention and testing services were suspended.

“We are adapting the HIV response in Sudan to the situation in the country. Our priority has been to get anti-retroviral treatment to those who need it, in whatever way we can,” said Elsheikh Ali, UNAIDS Country Director for Sudan.

Despite these challenges, there are unsung heroes who are working tirelessly to ensure that the HIV response continues uninterrupted.

Amidst active war, the displacement of critical partners in the HIV response, poor internet connectivity and communications, sporadic electricity and growing food insecurity, the HIV national response team, with UNAIDS’ support, were able to reconsider, plan and raise resources for this new, national context of the HIV response in the country. The team was able to submit a funding application to the Global Fund to Fight AIDS, TB and Malaria (Global Fund) and to finalize the Global Fund Grant Making process. This secured critical financial support to HIV, TB and Malaria for the next three years. The funds received from previous Global Fund cycles have been used to replace stocks of antiretroviral treatment (ARVs) as well as to establish new HIV treatment storage facilities in safer regions.

During the COVID pandemic, Sudan established a ‘Search and Rescue’ system to track people living with HIV who had  their treatment interrupted. Once the conflict in the country escalated, the HIV national response team were able to draw on the ‘Search and Rescue’ system to locate most of the 4000 people living with HIV who were lost to follow-up because of the war and to re-enrol them again to receive HIV treatment services.

“We have heroes here in Sudan, including networks of people living with HIV, who are working in very difficult circumstances, traveling tens of kilometres and risking their safety, to personally deliver ARVs to the people who need it,” said Elsheikh Ali, UNAIDS Country Director, Sudan. “These are the people we should be applauding; they are the ones keeping the HIV response going in the middle of a war and famine.”

The Ministry of Health, whose infrastructure has been significantly disrupted, is trying to provide critical HIV services including treatment and PEP (emergency medicine for HIV taken to prevent the virus in case of potential exposure to the virus) in regions of the country where there is active warfare. In more stable areas, more comprehensive HIV services are now being offered to those who need them.

In the face of the escalating humanitarian crisis in Sudan, there are dedicated people who remain steadfast in their commitment and working selflessly to mitigate the impact of the conflict on the HIV response.

“The HIV national response team exemplify the resilience  the AIDS response,” said Anne Githuku-Shongwe, UNAIDS Regional Director Eastern and Southern Africa. “In the face of adversity – war, displacement, famine – and against all odds, they have found a way to continue collaborating to uphold the HIV response.” She adds, “They have completed a successful Global Fund grant in the middle of an active war. They have made sure that people living with HIV across Sudan are not being left behind, that they are found, there is treatment available for them and that they receive it.  That is resilience, commitment and leadership.”

GENEVA/MONACO, 11 April 2024— Winnie Byanyima, the Executive Director of UNAIDS—the organization leading the global fight against AIDS—met with HSH Prince Albert II of Monaco and HSH Princess Stéphanie of Monaco and government officials to strengthen Monaco’s collaboration with UNAIDS.

“Monaco is a long-standing and valued partner of UNAIDS. We continue to work together on our broad programme and also in key countries,” said Ms Byanyima. “What we particularly value is how Monaco shows such innovation in fighting HIV, and we learn from each other.”

During a visit to the Fight AIDS Monaco Association, Ms Byanyima and HSH Princess Stéphanie and Ms Byanyima met with volunteers, staff and members of the Association. Fight AIDS Monaco, founded in 2004 by Princess Stéphanie, supports people living with and affected by HIV in Monaco and the neighbouring area. They also fund projects in Madagascar, Burundi, South Africa, Mauritius, and more exceptionally Ukraine, Lebanon and Morocco.

“My heartfelt congratulations to the Fight AIDS Monaco team, celebrating your 20^th year – an important milestone- and one that shows your sustained commitment to ending AIDS,” said Ms Byanyima. “It is organizations like yours that make a difference for people’s overall well-being: a safe space to share, kindness and compassion when it is most needed.”

As they gathered around an AIDS memorial quilt, Princess Stéphanie said, “We are a small country, but we can achieve great things.” She then added, “Our foundation is a place where everyone is treated with dignity and without judgement. Fight AIDS Monaco is about giving life.”

Ms Byanyima also thanked Princess Stéphanie for her unwavering engagement as a UNAIDS Goodwill Ambassador and expressed her appreciation for the Princess’s work to address HIV-related stigma and discrimination.

Despite huge progress in the HIV response, globally AIDS still claimed a life every minute in 2022. Monaco’s Minister of Social Affairs and Health, Christophe Robino, stressed that his government’s low cases of new HIV infections was a victory but one not to be taken for granted.

“This is a cause that we need to tackle daily and one day we will be able to end AIDS but we must keep talking about it while it still exists,” Mr Robino said.

Since 1988, Monaco has been implementing an integrated policy on ending HIV as a public health threat. The policy has resulted in free, anonymous HIV screening centres as well as prevention and testing campaigns in schools and businesses. 

Earlier during her visit, Ms Byanyima had a working meeting with representatives from the Monegasque government and Fight AIDS Monaco.

Isabelle Berro Amedei, Minister of External Relations and Cooperation said, “Health is one of Monaco’s priorities and that includes the fight against HIV in partner countries. We lead cooperation efforts to support countries where HIV prevalence is high like South Africa, Madagascar and Mozambique.”

Monaco signed a framework agreement with UNAIDS in 2007 and has provided support for UNAIDS work in Haiti (2010-2013), Burundi (2014-2016) and South Africa since 2017. The government of Monaco, Fight AIDS Monaco and UNAIDS vowed to continue their close collaboration on ending AIDS and reiterated their commitment to the Global AIDS Strategy 2021-2026 focusing on ending inequalities to end AIDS.  

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

FIGHT AIDS MONACO

Founded in 2004 by Princess Stéphanie of Monaco, Fight AIDS Monaco is a non-profit organization that helps people living with HIV. It also raises awareness about HIV prevention in schools and supports access to treatment and services in countries like Madagascar, Burundi, Mauritius and Ukraine. 

GENEVA/JOHANNESBURG, 3 April 2024—The Constitutional Court of Uganda has today struck down certain sections of the Anti-Homosexuality Act, 2023.

“The Constitutional Court of Uganda made a judgment today to strike down certain sections of the Anti-Homosexuality Act, 2023. Evidence shows that criminalizing populations most at risk of HIV, such as the LGBTQ+ communities, obstructs access to life-saving health and HIV services, which undermines public health and the overall HIV response in the country,” said Anne Githuku-Shongwe, UNAIDS Regional Director for Eastern and Southern Africa. “To achieve the goal of ending the AIDS pandemic by 2030, it is vital to ensure that everyone has equal access to health services without fear."

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

The humanitarian crisis in Haiti is exacerbating the vulnerability of people living with or affected by HIV, particularly women, girls, and key populations. The situation has deepened existing inequalities, and multiplied the risks faced by marginalised communities. In the face of this adversity, UNAIDS continues to work with partners to ensure that people living with or affected by HIV have access to life-saving HIV services, including treatment and prevention services.

For example, in the West Department, over 50,000 people are receiving antiretroviral treatment and are at high risk of disruption. HIV prevention and health care services also face disruption. The recent violence continues to leave thousands of families traumatized. Thousands of people now find themselves unsafe and exposed to all types of risks. Displaced people and vulnerable populations need emergency aid and safe, protected spaces.

"Communities already at risk of HIV in Haiti have been made even more vulnerable, and people living with HIV are facing greater challenges in accessing treatment and care", said UNAIDS Regional Director for Latin America and the Caribbean, Luisa Cabal. "Together with all the United Nations agencies, and with partners, UNAIDS is advocating for safe and unhindered humanitarian access, and the protection health facilities and health workers."

The situation in Haiti is dire, with over 5.5 million people in need of assistance, including more than three million children. The World Food Programme has noted that around 1.4 million Haitians are "one step away from famine." The UN Humanitarian Coordinator for Haiti has noted that the humanitarian response plan is only six percent funded. Less than half of the health facilities in Port-au-Prince are functioning at their average capacity, and there is a pressing need for safe blood products, anesthetics, and other essential medicines.

In the face of these challenges, UNAIDS and its Cosponsors, together with the United States President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the Observatory of Civil Society for HIV/TB/Malaria are supporting Haiti’s National AIDS Program.

UNAIDS has been working with the Ministry of Health and Population Unit for Management of Health Emergencies to support HIV treatment delivery. This support includes programmes to provide a broad package of support to affected communities. For example, together with the United Nations High Commissioner for Refugees (UNHCR) and in collaboration with the Organisation de Développement et de Lutte contre la Pauvreté (ODELPA), UNAIDS supports girls and women who are survivors of gender-based violence by training community leaders and granting empowerment funds for women and men's income-generating activities.

"We are working to ensure that people living with HIV have continuity of antiretroviral treatment as well as access to essential needs, especially including the most vulnerable people across the most affected areas," explains Christian Mouala, UNAIDS Country Director for Haiti. "UNAIDS remains committed to not let the humanitarian crisis disrupt the progress that has been made in the HIV response.  The United Nations stand together to support the people of Haiti."

ANTANANARIVO/GENEVA, 27 March 2024—Despite progress across most of sub-Saharan Africa, UNAIDS warns that gaps in HIV prevention are driving new HIV infections in the Indian Ocean Countries (IOC) and several other countries in Africa. The critical gaps in HIV prevention were the focus of a workshop organized by UNAIDS and UNFPA which was hosted in Madagascar between 18 and 20 March to address some of the barriers to accelerating progress.

Insufficient focus on HIV prevention in a number of African countries including Egypt, Madagascar, Angola, Sudan and South Sudan has resulted in these countries not achieving the proportionate declines in new infections seen in the rest of the region.

For example, the increase in the number of new infections in a country like Madagascar for example, is in stark contrast to the downward trend in Botswana which has seen a 66% decline in new HIV infections since 2010 and 36% decline in AIDS-related deaths during the same period.  As a result, Botswana—along with Eswatini, Rwanda and Zimbabwe— are on the path to end AIDS having achieved the global 95-95-95 targets through strong HIV prevention and treatment interventions.

Madagascar, one of the poorest countries in the region, has been hit by cyclical natural disasters including drought and cyclones, making it difficult for the country to recover and mount an effective response to HIV. Madagascar recorded a 151% increase in the number of new HIV infections since 2010, and a 279% increase in AIDS-related deaths during the same period. In addition, just 18% of the estimated 70 000 people living with HIV in Madagascar had access to treatment in 2022, and 3200 people died of AIDS-related illnesses. Sudan and South Sudan are also falling behind on HIV prevention and treatment efforts. Inequalities are exacerbating people’s vulnerability to HIV.

“Local research indicates increases in new HIV infections among key populations, including people who use drugs, and among young women and girls. This could be attributable to many factors including drug routes, recurring cyclones and deep poverty in some areas that is making people more vulnerable to HIV infections,” said Professor Zely Randriamanantany, Madagascar’s Minister of Public Health. “We need our international partners to invest with us before it's too late. This prevention focus is very welcome indeed."

“It is clear from our visits to communities and from speaking to health specialists in Madagascar, that the HIV epidemic is changing. The persistent rise in new infections in Madagascar since 2010, for example, shows that it could spread rapidly if we do not stop it in its tracks immediately,” said Anne Githuku-Shongwe, UNAIDS Regional Director for Eastern and Southern Africa. “We know the path that ends AIDS. It’s not a miracle. It requires strong political and financial support.”

Gaps identified in some countries include a lack of data that would point to where HIV prevention efforts need to focus. Data gathering interventions are key to implementing evidence-informed and effective programmes. Some countries are also lacking commodities, including HIV testing kits and condoms.

“Inadequate investment in HIV responses is holding back ending AIDS as a public health threat,” said Jude Padayachy, UNAIDS Country Director for Comoros, Madagascar, Mauritius and Seychelles. “We need to accelerate the HIV response in the Indian Ocean Island states by ensuring all the basics—making sure people are informed about HIV and how to prevent it, and making sure people have access to HIV prevention services and commodities, such as condoms. We also need to make sure that people who are HIV-positive know their status and get the treatment they need.”

UNAIDS is committed to support countries to accelerate political leadership, investments and better data for prevention.

The meeting in Madagascar brought together HIV experts and programme leaders from a number of countries across Africa to learn from each other and to review and strengthen their national plans on HIV prevention to support countries in scaling up their HIV responses. The meeting included teams from Comoros, Egypt, Madagascar, Rwanda, Sudan and South Sudan.

Participants explored ways to improve data collection to help develop more of an understanding of the dynamics of their HIV epidemics to ensure an effective, evidence-informed, human rights-based response. They also drafted national assessments which will serve as a guide to facilitate dialogues with communities, governments, and partners. This will aid in refining strategies and setting priorities to implement ambitious HIV prevention plans. UNAIDS will continue to support countries in their internal assessments to strengthen their HIV responses.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Mayor Aquiles Alvarez Henriques of Guayaquil, Ecuador's largest city and the nation's main port, signed the Paris and Sevilla Declarations on February 28, placing the city among the almost 500 municipalities around the world that are committed to fast-tracking action at local level to improve the quality of life of people living with and affected by HIV. Through this commitment, the city pledges to contribute to the country's goal of ending AIDS as a public health threat by 2030.

Guayaquil is the capital of the province of Guayas, Ecuador's most populated province and the most affected by HIV, with over a third of all new HIV infection notifications in the country, according to the Ministry of Public Health of Ecuador. It has a concentrated epidemic among key populations, with an HIV prevalence of 7.3% among gay men and other men who have sex with men (MSM), for example. 

"A significant number of cases reported with HIV in 2023 live in Guayaquil", said Andrés Díaz, Technical Director of the city's Infectious Disease Prevention Unit of the Health and Hygiene Directorate. "We know that the best way to improve HIV prevention is through education and sensitization of citizens so that they can get tested." 

Guayaquil has made significant efforts to intensify HIV screening and has increased the detection of HIV-positive cases by 1.6%. Diagnosed people are immediately linked to the public health system to start first-line antiretroviral treatment, which is universally available to nationals and migrants in Ecuador. 

Nonetheless, the Health Department of the Guayaquil Municipality has developed a plan with key actions to be implemented as a result of the city’s commitment to the Fast-Track initiative. Some of the most strategic priorities incorporate the scale up of HIV services, including HIV prevention, early diagnosis, and timely treatment of HIV and other sexually transmitted infections; the sensitization of civil servants on issues of stigma, discrimination, and gender-based violence linked to HIV; and facilitate the engagement of communities, specially from key and vulnerable population, in the definition and implementation of HIV programmes at community level.

Representatives of community and civil society organizations such as Corporación Kimirina, the Ecuadorian Coalition of People Living with HIV, and the Silueta X LGBT+ Trans Association attended the event. These organizations play a crucial role in the city's efforts to respond to HIV. "Citizen involvement under the local authority's leadership, with emphasis on the most vulnerable and at-risk community groups, is vital to achieving the goal of ending AIDS by 2030,” emphasized the delegates of Corporacion Kimirina Maria Elena Acosta and Lily Marquez. Similarly, Joan Morales from the Ecuadorian Coalition of People Living with HIV stressed that "By signing the Paris and Sevilla Declarations, Guayaquil joins many other cities that have committed to provide accelerated and sustained health services that allow us to eradicate not only AIDS but also TB, Malaria, and other tropical diseases, with actions that contribute to reducing discrimination towards people living with HIV and other affected communities."

Created in 2014, the Paris Declaration on Fast-Track Cities Ending the HIV Epidemic is a political declaration with commitments and targets that include ending urban AIDS and tuberculosis (TB) epidemics, as well as eliminating viral hepatitis (HBV and HCV). It also articulates a mandate to place people at the center of the response. To define and facilitate that mandate, the Sevilla Declaration on the Centrality of Communities in Urban HIV Responses was created in 2022, outlining the 10 commitments that cities and municipalities are asked to make to increase the engagement of and promote leadership by affected communities in attaining the Fast-Track Cities initiative's goals, objectives, and targets.

"We congratulate the Mayor's Office of Guayaquil for its commitment to contribute to Ecuador’s efforts to reach the 2025 Global AIDS Strategy targets, reducing the number of new HIV infections and AIDS-related deaths and eliminating stigma and discrimination in all its forms,” said Andrea Boccardi Vidarte, Director of the UNAIDS Office for the Andean Countries. "This commitment is also a recognition of the leadership of communities most affected by HIV and their support to the city's goals." 

One-third of people living with HIV in Asia and the Pacific are women. But their issues are often hidden.

Gender-based violence. Restricted economic opportunities. Child marriage. Underage pregnancy. Denial of property rights.

A UNAIDS-supported initiative by the International Community of Women Living with HIV Asia and Pacific (ICWAP) supports positive women’s organising. The Feminist School is a learning and consciousness raising programme that began in South Africa, and has been utilised in Asia-Pacific since 2016. The methodology, anchored in feminist principles, is specifically designed to enable women living with HIV to understand their personal experiences, locate them politically and develop strategies for community-driven advocacy. 

“Marching in the month of March is not enough to realize women’s rights,” insists ICWAP Regional Director, Sita Shahi. “We need to speak up on the issue of gender inequality in the HIV response and the need for increased investments in women and girls. Women and girls living with HIV are going through serious human rights violations that, in turn, undermine their right to health.”

The Feminist School brings together women living with HIV, women from key populations, and young women from across the region.  In the past two years, with support from UNAIDS, ICWAP has made adaptations to include modules on sexual and reproductive health and rights, movement building, leadership skills and the elimination of mother-to-child transmission (EMTCT).

“Feminist leadership training reveals the challenges faced by women living with HIV in the region. I have gained a lot of knowledge from the cross-country discussions and learned lessons about how women from different countries are breaking down human rights-related barriers, including stigma and discrimination,” said Salina from Malaysia.

Last year, a new module on the Global Fund processes was added.

“We recognized the importance of ensuring that interventions led by women living with HIV are included in Global Fund funding requests,” explained UNAIDS Asia Pacific Regional Adviser for Community-Led Responses, Michela Polesana.

UNAIDS supported a Global Fund Grant Cycle Seven (GC7) project focused on supporting the engagement of networks of women living with HIV in Cambodia, India, Thailand and Viet Nam in the current process. It found that organizations in these countries were at different stages of readiness and involvement. For example, India’s Positive Women Network (PWN+) was already participating in the process and benefitted from ICWAP’s technical support to strengthen their advocacy and organization.

Another UNAIDS-supported strategy ICWAP employed to bolster GC7 engagement was the facilitation of peer-to-peer growth by and for women living with HIV through the roll-out of an online Feminist School training. Through this initiative, country networks were supported in engaging in the Global Fund process and learned about its gender equality strategy, including the gender equality markers (GEM). They also received training to support them in their work to hold governments accountable.

The organization partnered with Ikatan Perempuan Positif Indonesia (IPPI), the Thai Positive Women’s Network, Viet Nam’s Women’s Network, the Association of Positive Women Advocates Inc (APWAI) from the Philippines, Women affected by HIV and AIDS (WABHA) from Papua New Guinea and an informal network of women living with HIV in Cambodia.

The groups identified priority issues for advocacy and recommendations for next steps and devised country-specific advocacy plans.

The advocates agreed on a set of three shared priorities. First, a seat for women living with HIV on each Country Coordinating Mechanism. Second, for positive women networks to reclaim antenatal care activities in prevention of mother-to-child transmission programmes. And finally, for capacity building for young positive women leaders.

Feminist school is helping women living with HIV to organize to secure their human rights. To protect women’s health it is vital to protect women’s rights. And to protect women’s rights it is vital to support women’s leadership.

“This is all about bridging the gap between outgoing leaders and an incoming, new generation,” Ms. Shahi said.

Ibu Mawar (not her real name) learned she was living with HIV after receiving a test during an antenatal care visit.

 “I was surprised, of course, when they told me. But I didn’t really doubt or deny the result,” she remembered from the Sorong City Health Office in West Papua. She immediately started treatment to prevent transmission to her son. “Even though I’m positive,” she said, “our child is not.”

In principle, since 2009 every pregnant woman receiving antenatal care in Indonesia should receive an HIV test. And every woman found to be living with HIV should receive medicines to prevent transmission to their babies just as Ms Mawar did.

But this isn’t yet the reality.

In 2022 more than one-third (37%) of all pregnant women in Indonesia did not get screened for HIV and just 18% of mothers living with HIV had access to antiretroviral therapy. There were an estimated 2800 new HIV infections among children that year.

But now stakeholders in Indonesia are mobilising. Not only will they scale-up prevention of mother-to-child HIV transmission services, but they will work toward eliminating vertical HIV transmission while assuring the health and wellbeing of women and children living with HIV. At the centre of this approach is the engagement of women, who comprise roughly one-third of the adult population living with HIV.

In June 2023 Indonesia established the National Alliance to End AIDS in Children. This partnership between government, civil society and international organizations seeks to provide access to health services and support for women and children living with HIV. It has committed to three main priorities. The first is advocacy for the needs of adolescent girls and children living with HIV. Second is promotion and dissemination of information on Prevention of Mother-to-Child Transmission (PMTCT), Early Infant Diagnosis, treatment literacy and comprehensive sexual education. And third is the empowerment of communities regarding issues pertaining to children living with HIV.

The Alliance’s first major initiative was an Elimination of Mother-to-child Transmission symposium—the first ever in Indonesia. Partners have embraced the World Health Organization (WHO) triple target of eliminating mother-to-child transmission of HIV, syphilis and hepatitis B by 2030. A series of sessions were delivered in-person and online. A total of 115 participants from the government, communities, academia, healthcare and media joined the EMTCT Symposium in Jakarta.

Dr. Laila Mahmudah, Head of the Neo Maternal Division at the Ministry of Health, underlined the importance of accelerating EMTCT efforts across the range of issues. She noted that currently 66% of pregnant women received hepatitis B early detection services while just 25% of pregnant women are tested for syphilis.

Multisectoral stakeholders and participants discussed strategies with participants from Malaysia and Thailand, which have both received EMTCT validation for HIV. Dr Anita Suleiman, Director of Disease Control of the Ministry of Health of Malaysia, pointed to the importance of effective leadership and health system governance for country-wide implementation.

“One of the lessons from countries that achieved EMTCT is that it is possible to end AIDS and vertical transmissions, especially in low-prevalence regions like Indonesia, through robust governance and good-quality performance. Indonesia can also achieve EMTCT by 2030, and I hope this symposium leverages the coordination efforts towards the elimination of HIV, syphilis and hepatitis B,” said Dr Shafflq Essajee, Senior Advisor, HIV, UNICEF New York.

However, it was emphasised that political commitment must be bolstered by community-led strategies to reach and retain mothers living with HIV. Community mobilization and community health workers are critical approaches. Ikatan Perempuan Positif Indonesia (IPPI), the national network of women living with HIV, also endorsed the Thai approach of providing free formula for mothers living with HIV in low-resource districts.

Ayu Oktariani, IPPI National Coordinator and a member of the National Alliance to End AIDS in Children reiterated her organization’s commitment to implementing the community-led strategies in support of EMTCT in the coming years.

“This Symposium means more than words I can explain,” said Ayu Raka from the Akar Cinta Kasih Foundation, a community organisation in Bali. “When I return to Bali, I will advocate for EMTCT with local multisectoral stakeholders and communities in my region. I am confident we can make a healthier society and improve health for all mothers and babies.”

UNAIDS Country Director for Indonesia, Krittayawan Boonto, promised the continuous backing of UNAIDS.

“We will continue to support not only mothers, but also fathers, in protecting babies from new HIV infections. I wish for Indonesia to become the fifth country in Asia Pacific to achieve EMTCT. But we can only do it with the leadership of communities,” she ended.

GENEVA, 28 February 2024—The French public international cooperation agency ‘Expertise France’ and UNAIDS have signed a new partnership agreement to fight stigma and discrimination in six western and central African countries.

The aim of the €1.92 million partnership called, "Community response to stigma and discrimination and legislative reform," is to promote access to inclusive HIV services that respect human rights for key populations, including men who have sex with men, people who inject drugs, sex workers, transgender people and young women and adolescent girls in Benin, Cameroon, Côte d'Ivoire, Central African Republic, Senegal and Togo.

"Stigma and discrimination obstruct HIV prevention, testing, treatment and care, and hold back progress towards ending AIDS by 2030,” said Winnie Byanyima, Executive Director of UNAIDS and Under-Secretary-General of the United Nations. “It is only by protecting everyone’s rights that we can protect everyone’s health, so by joining forces with Expertise France we can uphold rights for those in need in the region.”

In the six countries, key populations are disproportionately affected by HIV. In Benin, for example, HIV prevalence in 2022 was 7.2% among sex workers, 8.3% among men who have sex with men and 21.9% among transgender people—while the rate is 0.8% among the general population. In Cameroon, HIV prevalence was 24.3% among sex workers, 20.6% among men who have sex with men and 4% among prisoners—while the rate is 2.6% among the general population.

Anne-Claire Amprou, Global Health Ambassador for France, Ms Byanyima, Jérôme Bonnafont, Permanent Representative of France to the United Nations and Jérémie Pellet, Director General of Expertise France, attended the signing ceremony at the Permanent Mission of France to the United Nations in Geneva, Switzerland.

"This agreement aims to reduce inequalities in access to care and treatment for populations most vulnerable to HIV in western and central Africa. France is thus making a commitment to global health alongside UNAIDS, in an approach based on equity, solidarity and development," said Mr Bonnafont.

Ms Amprou added, "Through this partnership, France is pleased to be able to reaffirm its commitment to strengthening healthcare systems, as well as combatting stigmatization, discrimination and gender inequalities in access to healthcare for the most vulnerable populations, by supporting for community-led efforts.”

As part of the Global AIDS strategy both France and UNAIDS are striving to improve legal and social responses to HIV with a particular focus on reducing gender inequalities and gender-based violence. This new initiative will also aim to reduce systemic barriers by promoting a more favorable legal framework that respects human rights and facilitates better access to legal services.

Jérémie Pellet, Director General of Expertise France said, "This partnership with UNAIDS embodies our commitment to supporting the most vulnerable communities and promoting a more just and inclusive society."

Expertise France via ‘L'Initiative’, an organization which helps national partners prepare and implement projects using funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria, is funding the project. The funds complement efforts under the Global Fund's 7th round of funding, underlining the importance of coordinated action to remove human rights barriers to accessing health services.

Led by the UNAIDS western and central Africa regional office, based in Dakar, the project will be implemented with the support of the Civil Society Institute for HIV and Health, Alliance Côte d'Ivoire and Coalition PLUS.

Expertise France

Expertise France is the French public international cooperation agency. It designs and implements projects which aim to contribute to the balanced development of partner countries, in line with the Sustainable Development Goals (SDGs) of the 2030 Agenda and long-term development.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

L’Initiative

France created L’Initiative in 2011 in response to the difficulties that certain countries, particularly French-speaking ones, were having in accessing Global Fund grants. The French Ministry for Europe and Foreign Affairs and Expertise France, the government agency for international technical cooperation, oversee L’Initiative.

UNAIDS is concerned about the impact on peoples’ health and rights following the decision of the High Court of St. Vincent and the Grenadines regarding sections 146 and 148 of the Criminal Code, which upholds discriminatory and harmful laws against LGBTQ people.

On Friday, February 16, 2024, the High Court, in an oral delivery, denied the claim by two Vincentian nationals, who reside outside of the country, that sections 146 and 148 of the Criminal Code criminalising buggery between any two persons with a penalty of up to 10 years imprisonment, violate the fundamental rights to privacy, personal liberty, freedom of conscience, freedom of expression and protection from discrimination. The Court dismissed in their entirety all claims by the two Claimants and awarded the sum of EC$7,500 prescribed costs to the Attorney General to be paid by each of the Claimants. 

In the written decision published February 22, 2024, the Court in dismissing the consolidated claims of Javin Johnson and Sean MacLeish held that the Claimants had failed to establish on the evidence, a present or existing breach of any alleged rights due to lack of locus standi (the requisite standing to invoke a review by the Court) as the Claimants do not reside in the State and had not for years prior to the filing of the claims.

UNAIDS is particularly concerned that the judgment referred to protecting public health and tackling the HIV epidemic as justifying punitive anti-LGTBQ laws, because the evidence shows that such laws hinder efforts to protect public health and tackle the HIV epidemic. At paragraph 267 of the judgment the court asserted: 

“to my mind the thought of a public health crisis occasioned by an unstemmed deluge of new HIV cases is a real and serious concern which reasonably justifies a public health response of the kind embedded in the challenged provisions”.

In fact, studies show that these laws have negative health outcomes. A punitive legal environment, including criminalisation of same sex relationships, drives people underground and away from vital health services, including HIV prevention, testing, treatment, and care. To achieve the goal of ending AIDS as a public health threat by 2030, it is vital to ensure that everyone has equal access to essential services without fear, stigma or discrimination.

UNAIDS has estimated that not achieving decriminalization of key populations in all countries would result in about 750 000 cumulative new HIV infections from 2020 to 2030.

The decision made in the High Court of St. Vincent and the Grenadines stands in stark contrast to the rulings in Belize, Guyana, Trinidad and Tobago, Antigua and Barbuda, St. Kitts and Nevis and Barbados where the courts ruled that laws which criminalise persons based on sexual orientation and gender identity violate the protected rights to dignity, privacy, personal liberty, freedom of conscience, freedom of expression and protection from discrimination.

Regardless of the outcome of this court decision, UNAIDS holds hope that the courts will serve as a vital last resort for social justice, the protection of human rights and the advancement of public health for improved health and wellbeing for all. UNAIDS work to end AIDS and to leave no one behind will continue in partnership with communities and with all branches of government, including the courts.

Punitive laws obstruct the end of AIDS and ultimately hurt everyone’s health. As we prepare for observance of the tenth anniversary of Zero Discrimination Day on March 1^st, 2024, we pay tribute to the courage of communities, and call on all duty bearers to protect the health of all by protecting the human rights for all.

NOTE FOR THE EDITORS:

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals.

ZERO DISCRIMINATION DAY

March 1^st this year is the tenth anniversary of Zero Discrimination Day. Upholding everyone’s rights is the responsibility of us all. Everyone can play a part in ending discrimination. On 1 March, and across the whole month of March, events, activities and messages will remind the world of this vital lesson and call to action: to protect everyone’s health, protect everyone’s rights. #ZeroDiscrimination