L to R: UNAIDS Country Coordinator Tatiana Shoumilina, Chief Chiveso, traditional leader, Ms Beagle, and Provincial Governor Martin Dinha, in the area of Bindura, Zimbabwe. Credit: UNAIDS

Zimbabwe is an example of political commitment and progress in the AIDS response. Although it is one of the countries most affected by the HIV epidemic in sub-Saharan Africa, with an adult HIV prevalence of 15%, the country has achieved and sustains universal coverage of treatment to prevent mother-to-child-transmission of HIV (93%) and adult antiretroviral therapy (ART) with 95% of adult Zimbabweans eligible for HIV treatment receiving it.

This scale up of comprehensive HIV prevention, treatment, care and support services in the country has resulted in the decline in the rate of new HIV infections from a peak of 5.21% in 1994 to 0.86% in 2012.

Zimbabwe’s progress in the AIDS response is largely credited to the country’s capacity to mobilize and sustain domestic resources for the response through its innovative AIDS levy—a 3% tax on all taxable individual and institutional income. In 2012 alone, the levy generated US$ 32 million. Zimbabwe also successfully mobilized US$ 311 million from the Global Fund to Fight AIDS, TB and Malaria under its new funding model. A further US$ 244 million, from Zimbabwe’s quality request, is pending the outcome of the upcoming Global Fund replenishment.

In early May 2013, UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle, undertook a country visit to Zimbabwe to witness the progress made. She also looked at challenges ahead in achieving the targets of the 2011 General Assembly Political Declaration on HIV and AIDS and discussed the role of Zimbabwe, as a new member to the UNAIDS Programme Coordinating Board this year, in the governance of UNAIDS and the AIDS response. 

During a meeting with the Vice President Hon Joice Mujuru, Ms Beagle commended the Government of Zimbabwe for its leadership in the AIDS response and encouraged the country to scale-up paediatric ART coverage, which by end of 2012 remained at 42%, and to accelerate efforts to reduce maternal mortality.

Communities leading the way

Ms Beagle travelled to Bindura, a rural area located about 90 km north-east of the country’s capital Harare, where she talked to community representatives, traditional leaders, local service providers, and district and provincial administrators. With support from the non-governmental organization PADARE, a movement of men advocating for gender justice, the community champions male involvement in preventing new HIV infections among children and increasing uptake of HIV prevention and treatment services. It also focuses on strengthening sexual and reproductive health services for young people, especially girls, and addressing gender-based violence.

PADARE concentrates on men in all settings and uses communication and networking tools, workshops and training, lobbying and advocacy to achieve social and behaviour change. The organization works through 65 chapters and has a membership of more than 3 000 in the country’s ten provinces.

“The communities are doing exemplary work, addressing issues related to gender equality and the empowerment of women, using community dialogue and facilitating community actions and solutions,” said Ms Beagle. She urged the communities to ensure that the needs of populations at higher risk of HIV infection—such as women, young people, people with disabilities, sex workers and men who have sex with men—are recognized and appropriately met.

NOTE: As part of her official programme in Zimbabwe, Ms Beagle also met Hon Dr H. Madzorera, Minister of Health and Child Welfare; Hon Dr O. Muchena, Minister of Women Affairs, Gender and Community Development; Hon Dr D. Parirenyatwa, Chair, Parliamentary Portfolio Committee on Health; leadership of the National AIDS Council; members of the Country Coordinating Mechanism; members of the Executive Committee of the Zimbabwe Parliamentarians against HIV network; and the Steering Committee of Zimbabwe GlobalPOWER Chapter. She also interacted with civil society representatives and young people, and engaged with the UN Resident Coordinator and the UN Country Team. She visited the Beatrice Road Infectious Disease Hospital, a public health care organization providing adult and paediatric Opportunistic Infections and ART services.

L to R: UNAIDS Deputy Executive Director, Programme, Paul De Lay; UNAIDS Deputy Executive Director, Management and Governance, Jan Beagle; UN Deputy Secretary-General, Jan Eliasson; UN Secretary-General’s Special Adviser on the Post-2015 Development Agenda, Amina Mohammed; Political and Public Affairs Director, Luiz Loures; Executive Office Director, Tim Martineau. Credit: UNAIDS

UNAIDS welcomed the visit from the United Nations Deputy Secretary-General, Jan Eliasson to its headquarters in Geneva on 25 October. Accompanied by the United Nations Secretary-General’s Special Adviser on the Post-2015 Development Agenda, Ms Amina Mohammed, Mr Eliasson discussed with the UNAIDS Deputy Executive Directors and the Director of Political and Public Affairs the need to address peace and security, development, human rights and the rule of law, in an integrated way.

During the meeting, Mr Eliasson commended the ‘horizontal’ approach pursued by UNAIDS in bringing together different actors and interests around a common thematic agenda. He stressed the need for the United Nations system to work more coherently, and noted that “such an approach can inform the future direction for UN reform and delivering as one.” Such approaches will be crucial in the implementation of a post-2015 development agenda.

Thailand’s Deputy Prime Minister and chair of the National AIDS Committee, H.E. General Yuttasak Sasiprapha giving an address at the launch of Thailand’s new national AIDS plan.
Credit: UNICEF Thailand / P.Kitatnaruyuth

Thailand has become the latest country in the Asia and the Pacific region to align its national AIDS strategy with the UNAIDS vision of getting to zero new HIV infections, zero discrimination and zero AIDS-related deaths.

Launching the country’s new national strategy on HIV/AIDS 2012-2016—entitled ‘AIDS Zero’—the chair of the National AIDS Committee, H.E. the Deputy Prime Minister General Yuttasak Sasiprapha noted that, “Thailand has a long tradition of close cooperation between government, non-government organizations, civil society, communities and private sector, and this working together will lead Thailand to ‘AIDS Zero’.”

Over the past 25 years, Thailand has become known as a model for its rapid and multi-sectoral HIV response. Early investments in the HIV epidemic have shown concrete results including in the elimination of new infections among children—nearly 97% of women living with HIV in Thailand are now accessing services for the prevention of mother-to-child transmission. There has also been a dramatic increase in providing access to HIV treatment which is now a reality for nearly 80% of all in need.

However, despite significant progress, the country is still experiencing concerning trends among key populations at highest risk including people who inject drugs, men who have sex with men and sex workers, particularly in urban centres. National spending data shows that investments in HIV prevention are under-resourced, particularly for programmes focused on populations most at risk of HIV.

The new national AIDS strategy addresses two critical questions: What is Thailand doing well that should continue, and what needs to change to get to zero new HIV infections, zero AIDS-related deaths, and zero discrimination? Accordingly, the plan has two main strategic directions: ‘Innovation and Change’ and ‘Optimization and Consolidation’.

The ‘Innovation and Change’ prong focuses on promoting strategies to better prevent new HIV infections—particularly among key affected populations; to better localize responses and ownership at the sub-national level; and to better address the socio-environmental factors which hinder access to HIV prevention and care services, and fuel stigma and discrimination.

Under the ‘Optimization and Consolidation’ section, strategies aim at continuation, optimization and sustainability of proven programmes already carried out in the country. Examples of strategies falling under this area are on the elimination of new infections among children and HIV prevention among young people, where Thailand has already seen significant progress.

Among the strategic goals emphasized in the new plan is the aim to reduce new HIV infections by two thirds by 2015—over and above the global goal agreed through the 2011 Political Declaration on AIDS of reducing new infections by 50%. The strategy also aims for total elimination of new HIV infections among children.

“The new approach recognizes that while impressive progress has been made in a number of areas in Thailand, there is still room to push forward on certain priorities that may have already been defined in the past but have thus far not been implemented,” said UNAIDS Country Coordinator for Thailand, Michael Hahn. “By operationalizing these new strategies—and ensuring dedicated resourcing through domestic and international sources—Thailand is taking critical steps towards making ‘getting to zero’ a reality in the country.”

Representatives from government, civil society and the international community agreed that the most important thing now is turning the strategy into action as soon as possible. It was also highlighted the need for stakeholders to mobilize adequate resources, national leadership, and effective management to ensure that the Thai national AIDS strategy moves from principle to reality. 

In Asia and the Pacific, a number of countries and regional bodies have realigned their national strategies and goals around the ‘Getting to Zero’ vision. At their 2011 Summit, the ASEAN Heads of State adopted a Declaration to ‘Get to Zero’ on HIV and reaffirmed their commitment in working towards realizing an ASEAN community with Zero HIV Infections, Zero Discrimination and Zero AIDS-related Deaths.

L to R: Director-General of WHO Dr Margaret Chan, UNAIDS Executive Director Michel Sidibé and Ms Agnieszka Pachciarz Under-Secretary of State, Ministry of Health, Warsaw.
Credit:UNAIDS/C.Rousset

UNAIDS governing body, the Programme Coordinating Board (PCB) is holding its 30^th Board meeting from 5-7 June in Geneva.

In the opening session, UNAIDS Executive Director Michel Sidibé addressed the Board giving an overview of progress made in the last six months by UNAIDS. In his report, Mr Sidibé also outlined the organizational changes that the Joint Programme undertook in order to increase efficiency in helping countries achieve the goals set for 2015.

This year’s thematic segment will take place on the second day of the meeting and will focus on combination prevention or the urgent need to reinvigorate HIV prevention responses globally by scaling up and achieving synergies to halt and begin to reverse the spread of the AIDS epidemic.

As the world enters into the 30^th year of the AIDS epidemic, UNAIDS will work to position the HIV response in a new global environment. Ten years after the United Nations Special Session on HIV/AIDS and the landmark adoption of the Declaration of Commitment on HIV/AIDS, member states are now preparing for the 2011 High Level Meeting on AIDS to review and renew future commitments for the AIDS response.

UNAIDS will be guided by the new UNAIDS strategy 2011–2015 , which aims to advance global progress in achieving country set targets for universal access to HIV prevention, treatment, care and support and to halt and reverse the spread of HIV and contribute to the achievement of the Millennium Development goals by 2015.

“This strategy was developed through a highly inclusive and open process—reflecting the needs and opportunities ahead of us,” said Michel Sidibé, Executive Director of UNAIDS. “It is about fundamentally transforming the global AIDS response.”

Adopted by the Programme Committee Board in December 2010, the strategy will also serve as reference in the lead up to the UN High Level Meeting on AIDS.

“The High Level Meeting will be a major milestone in the history of the AIDS response. Only by working together to set our future course can we accelerate greater results for people,” added Mr Sidibé.

The strategy will be underpinned by a new unified budget and accountability framework. The framework will operationalize the strategy, mobilize and allocate resources for its implementation, measure progress and report on results.

Countries with the highest rates of new HIV infections in children will meet in South Africa to assess opportunities for scaling up programmes.

Johannesburg, 28 September 2011—The Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) announced today that with political will and focused resources—countries can meet the 2015 target to eliminate new HIV infections amongst children and ensure mothers living with HIV remain healthy through pregnancy, delivery and after the birth of their child. 

UNAIDS estimates about 90% of new HIV infections amongst children are concentrated in 22 countries across sub-Saharan Africa and India. In June 2011, a global pan to eliminate new HIV infections among children by 2015 and keeping their mothers alive was launched at the United Nations High Level meeting on AIDS. The plan was developed by a Global Task Team Co-Chaired by UNAIDS and United States President’s Emergency Plan on AIDS Relief (PEPFAR).   

Speaking from the Zola clinic in Soweto, South Africa one of the 22 most affected countries with 14% of the global burden, Michel Sidibé said, “Mother by mother, clinic by clinic, and country by country we can reach pregnant women with HIV services, to ensure their babies are born free from HIV and to improve their own health.

During the country visit to South Africa, Mr Sidibe met with parents and healthcare workers to talk about what can be done to accelerate progress. Zola clinic sees about 15 pregnant women each day, the majority do not know their HIV status. South Africa has an ambitious HIV testing and counselling programme that has reached more than 13 million people from April 2010 to September 2011.

Representatives from the 22 high burden countries will meet in South Africa next week to assess country plans. The two-day meeting will focus on country gap analysis and creating momentum. Since the launch, global interest in supporting the elimination goal is high—with innovative fundraising organizations such as (RED) joining to promote and raise needed resources. The African Development Bank and the Islamic Development Bank are also considering funding national plans in support of the Global Plan.

NEW YORK, 7 June 2011—As the world marks 30 years of AIDS, the Joint United Nations Programme on HIV/AIDS (UNAIDS) unveils OUTLOOK 30, a book with a compilation of 30 milestones, images, tributes, breakthroughs, art and inspirations in the epidemic’s 30-year history.

“AIDS has united the world, broken the conspiracy of silence, connected the north and the south to find solutions, and forged a social movement,” said UNAIDS Executive Director, Michel Sidibé. “AIDS has mobilized the world to deliver an unprecedented response which has saved millions of lives.”

The book was released ahead of the UN General Assembly High Level Meeting on AIDS taking place in New York from 8-10 June. More than 3000 people are expected to assemble at the meeting, which will be instrumental in moving the AIDS response forward. More than 30 Heads of State and Government will join Ministers, private sector partners, civil society and people living with HIV from 8-10 June, to shape the future of the response to HIV.

AIDS timelines

The special edition of OUTLOOK illustrates timelines on three issues that have shaped the AIDS response—the evolution of access to antiretroviral treatment; HIV/Tuberculosis (TB) and the use of condoms.

The treatment timeline traces the path that has led to a record number of people living with HIV receiving life-saving antiretroviral therapy —6.6 million in 2010, a nearly 22-fold increase since 2001—thanks to the combined efforts of government, civil society and the international community.

The HIV-TB timeline presents major developments in the joint response to HIV and TB. These include the first reports in 1983 of an association between TB and HIV among people living with AIDS in Haiti; a finding 20 years later, in 2003, that only about 3% of people with TB are tested for HIV; and the release of 2009 estimates showing that TB continues to be a leading cause of death among people living with HIV, accounting for about 380 000 deaths.

The condom timeline traces the history of the condom—from ancient Egypt through modern times. “Many people made their own condoms at home before the 20th century,” says historian Aine Collier. “In fact, it was very much a cottage industry, as most condom ‘manufacturers’ worked from their own kitchens.”

Art and AIDS

The book presents a range of posters from around the world that show the diverse visual strategies used over the years to communicate messages on AIDS awareness and safer sex.

It also features a selection of paintings by celebrated New York artist Keith Haring, who died of an AIDS-related illness in 1990, as well as Canadian graphic designer Morgan McConnell and New Delhi-based artists Jiten Thukral and Sumir Tagra. The publication also includes a reproduction of the Keiskamma Altarpiece, an extraordinary message of peace through art which was created by a group of 130 women from Hamburg and neighbouring villages in the Eastern Cape Province of South Africa, an area deeply affected by the AIDS epidemic.

Faces of AIDS

Two chapters in the book bring out the human face of the epidemic. Six activists who have lost their lives to AIDS are remembered through their writings, speeches and recollections by their friends. The book also profiles people living with HIV. These include Olympian Greg Louganis, Miss Positive from Russian Federation Svetlana Izambaeva, a student form Brazil, Micaela Syrina, a Constitutional Judge from South Africa, Edwin Cameron and Member of the House of Lords of the United Kingdom Chris Smith.

“I wanted my story to motivate the people living with HIV to be responsible and to understand that life isn’t over yet,” said Mr Louganis. “Some people don’t think that AIDS has touched their lives. A lot of people saw me at the Olympics and they were cheering for me. All those people cannot say that they have not been affected by AIDS.”

Looking into the future

The book also presents an analysis of current HIV prevention approaches, human rights and AIDS, gender disparities, HIV data, resources available for the AIDS response and recent advancements in the field of science.

“OUTLOOK 30 will inspire a new generation to learn from the lessons of the last three decades and take the AIDS response forward,” said Mr Sidibé. “The book is both a reminder of the past and I hope an inspiration for the future.”