International News 2017

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Doing More With Less? Challenges and Opportunities for Funding the AIDS Response. 10/10/2017

Published by UNAIDSSPCBNGO

Human ingenuity has proven throughout history that it can do more with less when absolutely necessary, inventing new ways of doing things, creating new tools and methods. Sometimes, it is a matter of survival. Among many innovative and ever-  developing disciplines, process development, planning with creativity, and following through, stand out in establishing consistency that usually drives success.

UNAIDS now faces the challenge of creating new paths to mobilize resources to properly and optimally execute its fast track plans and meet the HIV-related goals within the Agenda 2030. The problem is, although UNAIDS has played a strategic role in responding to AIDS, donors have not responded equitably. The Joint Programme has seen its budget heavily reduced in the last two years, which creates extra stress in the execution of its mandate.  As claimed by the Executive Director himself, this is a critical moment for the AIDS epidemic. “Invest now or run the risk of paying much more later,” means the situation may get worse than imagined or predicted in data charts. And we all know what the data says.

Despite the much praised commitment made to the AIDS-response funds, the fact is that the response has generally been underfunded since the since the beginning of the global financial crisis, which is now close to its tenth anniversary. Nevertheless, the extra effort made to reach tangible results accelerated the implementation of more access to ARTs. But to keep the reality check once again, we must remember that there are still millions of people without access to consistent treatment. Furthermore, millions of those who have access in low- and middle-income countries may experience unstable adherence to the medication due to lack of basic living conditions, such as nutritional security or resources for transportation to reach health services, which are just a few in a long list of identified barriers to access to treatment. In other words, both quantity and quality of existing services are still major issues.

AIDS is a challenge posed upon humanity on many levels, and it is still an exceptional one. Advances in the response is, first and foremost, a consequence of advocacy efforts spearheaded by key populations and affected communities, as well as dedicated people in the scientific field and passionate leaders within States and multilateral agencies. But history shows also that many governments, because of outdated moral values or claiming a competition of priorities, delayed strategic investment when it was needed in crucial moments of the epidemic. Even with commitment from UNAIDS, amplified with the Global Fund, PEPFAR, UNITAID, and the support from key developed countries that have kept their promises — voluntary Member-State financing suffered hard with the Great Recession. And let’s face it, funds have always lagged behind the demand imposed by the challenge. Even with so much investment  in scientific and clinical developments, prevention (including information and education) and community responses have been de-prioritized, a strategic mistake that governments are finally beginning to realize.

2014 International AIDS Conference in Melbourne, Australia; By Malu Marin

Instead of replying to the call for doing more with less resources, long-term financial solutions is what we need for UNAIDS. We must secure a steady stream of resources as a strategic means of implementation, and not only rely on volatile voluntary donations from governments and a few large foundations, which is a highly concentrated funding model (ten donors are responsible for 86% of funds, with the US as the major donor.) We suggest developing concrete strategies to implement innovative financing mechanisms aligned with proper disbursement of funds for projects in strategic areas – including funds for CSO advocacy work – as a way to succeed. UNITAID, for instance, is a strong example of an innovative financing mechanism with steady stream that achieves tangible results.

There is one particular mechanism that has the potential of solving much of the financing for sustainable development paradigm, if it were implemented in a global scale. It is already proven that in its national implementation, taxing financial transactions (FTT) is a highly advantageous double-edged sword of revenue collection and capital markets regulation. Since 2012, France has adopted it, and 10 EU countries are negotiating a multi-jurisdictional treaty on FTTs. In 2016, the UK raised £2.8 billion on Stamp Duty on Shares and Securities. Brazil raises an average 30 billion Reals yearly on a broad FTT legal framework that ranges from securities to insurance contracts, including currency, credit, and gold trading. Contrary to orthodox liberal economics, FTTs have not distorted the capital markets in the countries where they exist, or where they have recently started operating.

In this regard, if UNAIDS starts looking at the global financial picture instead of only thinking about the traditional voluntary ways to fundraise, they will see that the world has become hyper-financialized. The amount of financial resources in the markets is enormous, compared to concrete economics of products and services. This condition of excessive financial liquidity has produced yet another boom in 2017. Though it is a concentrated financial bubble, it is an out-of-proportion revenue source that is not tapped into because of lack of political will from governments.

This is a consistent civil society demand that requires political courage and leadership to exercise sovereignty of States over Markets to benefit all, including the reluctant markets and their liberal pundits. For years, we have provided many concrete suggestions to UNAIDS. And now, after learning from sovereignty-based taxing instrumentality, there is a possibility of implementing an issue-tied model of agreement with one – or all – credit card issuers that can collect an AIDS-related token contribution from billions of users every month in the world. Or, an already tested approach amplified, could be the creation of a Product Red Credit Card that people may carry and frequently use, generating a stream.

Ideas like these are dependent upon the multiplicity of general economic behavior, whether consumption or financial operations. What is really necessary at this point for UNAIDS, is to establish mechanisms of consistent revenue collection that will bring onboard a critical mass of new donors. Such a campaign could also inform the world of the continued relevance of UNAIDS in the global AIDS architecture, properly communicating its values, results, and comparative advantage for contributions – a narrative still to be developed.

Therefore, we hope UNAIDS will consider the suggestions above. We reiterate that  well-designed innovative funding mechanisms, including FTTs, can be a ‘clean’ way to turn idle and speculative capital into social development. Another way could be a token — taken from frequent revenue collection resulting from conspicuous consumption.

A stronger UNAIDS will also mean a stronger political capacity to better respond to challenges like these. Instead of backing down, “step up to the plate,” face up to the challenge, and explore the opportunities of the moment for long-term sustainability.

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HIV-AIDS and State Terrorism. 8/10/2017

Published by DAILYTIMES

Pakistan has promised to wipe out HIV-AIDS by 2030. It is not alone. 190 nations have made this pledge under the UN Sustainable Development Goals.

Yet things are not looking good. Pakistan has been named one of the 10 nations that account for 95 percent of all new HIV infections. It shares this shame with both India and China, one of the world’s largest democracy and the other being a Communist country (or as the Beijing likes to put it, a capitalist economy with Chinese characteristics). All of which is to say that this ought to dispel the long-held myth that the prevalence of HIV-AIDS is linked to cultural norms as well as those of governance. What may or may not be true is that those who are more at risk tend to be sex workers, members of the transgender community, prison inmates, and intravenous drug users. Meaning distinct groups that are usually at the bottom of any government’s priorities, be it East or West, North or South.

So, what is to be done?

Experts say that there is still time to reverse this epidemic that sees 133,529 people living with HIV here in Pakistan; though according to the Health Ministry, in real terms, this represents less than 1 percent of the total population. Yet this is still an increase of nearly 40,000 as compared to figures for last year.

This is where education comes to the fore, namely sex education. But it is hard to envisage this being feasibly implemented at a national level, given the alarming illiteracy rates across the country. For when it comes to any disease, treatment largely depends on if not reading instructions — then at least being able to formulate a non-written method of remembering when to take which drug. It is something that many of us take for granted. And so we should, for it is a fundamental right. But this shouldn’t mean that we stop caring about the majority who have been denied this human right.

This is where the media should take the partial lead, especially broadcast and radio. For while not every household has access to a television or radio — many communities do. Thus the media should run government awareness campaigns in regional languages — much like in the case of the aggressive anti-polio campaign. And at the core of this must be the de-stigmatising of those who suffer from this disease. The victim must never be blamed.

We understand that this does not represent an immediate short-term solution for the 15,370 patients being treated at the 21 treatment centres across the country, as per 2016 figures. But we have to start somewhere. This is not the work of NGOs; nor is it the responsibility of international donors. Any comprehensive approach must be government-led. If it is not — then this is nothing short of state-terrorism against the people of this country. 

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UNAIDS Calls To Quicken The Pace Of Action To End AIDS. 22/9/2017

Published by  BULAWAYO24

The President of Uganda, Yoweri Museveni, in collaboration with UNAIDS, brought together six heads of state or government to accelerate action and get countries on the Fast-Track to end AIDS. World leaders joined around 500 partners from government, the private sector and civil society on the sidelines of the United Nations General Assembly to reinvigorate political leadership around HIV.

The Fast-Track approach is saving more and more lives. In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.

However, the pace of action is still not enough to end the AIDS epidemic as a public health threat by 2030. In order to step up progress and achieve the global targets adopted in the 2016 United Nations Political Declaration on Ending AIDS, all partners need to fully implement their country Fast-Track strategy. Ending AIDS requires steadfast political leadership, commitment to action and accountability towards shared responsibility and reaffirmed global solidarity. Increased effective and efficient investments are, and will continue to be, an essential prerequisite for success. Elimination of stigma and discrimination and full recognition of human rights are cornerstones of sustainable progress.

"Leadership, partnership and innovation will transform the epidemic," said UNAIDS Executive Director Michel Sidibé.

President Museveni was the first head of state in Africa to launch a presidential Fast-Track initiative on ending AIDS as a public health threat, known as "Kisanja Hakuna Mchezo", or "no time for playing games".

"I am confident that working together with you all, we shall attain an AIDS-free Africa. It is possible to end AIDS in our generation!" said President Museveni.

During the event, the speakers outlined the positive impact that the Fast-Track approach to ending AIDS is having on people, health systems and the broader Sustainable Development Goals in Africa and beyond. They noted that addressing HIV within the Sustainable Development Goals will pave the foundation of the AIDS response.

"We must build on the Fast-Track commitments. We cannot stop before we have reached the finish line," said Jacquelyne Alesi, a civil society representative from Uganda.

Speakers made a strong call for political leadership, global solidarity and shared responsibility to build momentum and deliver on the goal of ending AIDS by 2030, highlighting the role that supporting strengthened health systems plays, not just in making progress towards the Fast-Track Targets, but also in addressing stigma and discrimination.

"I am not speaking of a vague hope, but of a willingness of the heart. I do not say "we could defeat AIDS," but rather "we will end AIDS," said Line Renaud, singer and AIDS activist.

Momentum is building, but has not yet reached a critical mass. When the United Nations General Assembly adopted the Political Declaration on Ending AIDS in June 2016, Member States committed to achieve global and regional Fast-Track Targets by 2020.

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Case Study HIV. Global HIV Deaths Per 1,000 People. 18/9/2017

Published by GLOBALGOALS

Starting in the early 2000s, the world made a huge investment to address the crisis, especially through the Global Fund to Fight AIDS, Tuberculosis and Malaria and PEPFAR, the President’s Emergency Plan for AIDS Relief. In the history of global health, there had never been an increase of that magnitude in getting products and services to people who need them. That’s why the curve of AIDS deaths bends so sharply around 2005.

With 35 million dead, AIDS is the worst humanitarian disaster of my lifetime. But when you consider what would have happened if the curve had stayed on its original trajectory, the fight against HIV also has to be counted among our greatest successes.

But it’s a success at risk.

Governments in both donor and developing countries that responded so aggressively to the crisis 15 years ago are now focusing on other things. Funding for HIV control has been flat, and now there’s talk of cuts. In a world of competing priorities and limited resources, these conversations are mandatory, but I want to be sure that the people having them are clear about the consequences.

First, we can treat people more efficiently. Some countries, such as Zimbabwe, have implemented what’s known as differentiated care. Most patients adhere to the treatment regimen closely, so they receive longer-lasting supplies of drugs and go to the health facilities less regularly. More than two-thirds of Zimbabweans on treatment visit a health professional only once every three months. However, patients who are less likely to stick to the regimen get extra support. In this model, no one is wasting money by getting more services than they need, and no one is risking getting sicker by getting less than they need.

Second, the key to solving the AIDS crisis over the long term is prevention. The fewer people infected in the first place, the fewer who will need treatment. We don’t want to just control a disease when we can end it.

We need to identify and promote the best prevention practices so that we can get maximum impact from every dollar we spend.

Unfortunately, the outlook for prevention is also concerning. In the past decade, the rate of decline of new infections has slowed. The current rate of decrease is not nearly enough to offset the population increases we’ll be seeing in Africa over the next generation. Africa’s youth are a reason for optimism—more and more talented young people who want to solve big problems are coming of age every year—but making sure they’re cared for is also a challenge.

In 1990, there were 94 million people on the continent between the ages of 15 and 24, the age range when people are most at risk of contracting HIV. By 2030, there will be more than 280 million.

What that means is pretty clear. If we only do as well as we’ve been doing on prevention, the absolute number of people getting HIV will go up even beyond its previous peak.

We have to do better. Part of that is more funding, not less. And, as with treatment, we need to identify and promote the best prevention practices so that we can get maximum impact from every dollar we spend.

Kenya has been a leader in this area, emphasizing both voluntary medical male circumcision and pre-exposure prophylaxis, or PrEP, two of the most effective prevention methods currently available. Other countries can learn a lot from Kenya’s experience.

Over time, we will need better tools, such as long-acting drugs that prevent HIV infection and, eventually, a vaccine. But the pattern with research and development funding is the same as with delivery funding: it’s been flat, and now it’s targeted for cuts.

That’s a scary prospect. Without R&D investments, we won’t have the new discoveries that will make it easier to prevent transmission of HIV. In the meantime, if we don’t spend more to deliver the tools we have now, we’ll have more cases. If we have more cases, we’ll need to spend more on treatment, or people will die.

I’m not advocating for a blank check for HIV treatment, because I don’t think we need one. But this chain of causation works in the other direction, too. If we invest more, if we are more efficient, if we share what we learn, if we show more leadership, then we will write the story of the end of HIV as a public health threat.

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The Key Priorities That Need UN Action. 14/9/2017

Published by IASOCIETY

The United Nations was born in 1945 to help maintain peace and resolve global conflicts. The founding documents of the UN recognized that peace involves much more than the lack of warfare. A world living in peace is one in which people have the tools they need to live happy, healthy and productive lives. A peaceful world is one in which our natural environment is protected and our fundamental human rights respected and celebrated. It is a world that is just and equitable.

In the opening months of his tenure, United Nations Secretary-General António Guterres confronts a host of extraordinary and complicated challenges. The very founding principles of the UN are being disputed as never before. As democracy and a commitment to human rights recede, repression and inequality increase, unprecedented numbers of people flee their homes as a result of civil conflict, and the future of our planet faces unparalleled threats. In the midst of such profound shifts, the global AIDS epidemic presents the Secretary-General with yet another critical challenge but also a potentially transformative opportunity. During his tenure, the world will have to choose to take the budgetary, policy, and programmatic steps that determine whether or not we end AIDS as a public health threat once and for all.

Taking into account the lessons we have learned from our response to AIDS, here are five actions the Secretary-General can take to promote a healthier, more secure and equitable world:

Lead the fight against social and economic disparities: Although middle-income countries are home to fabulous private wealth, nearly three out of four of the world’s poor people live in these countries as well. Middle-income countries are also where new infections are rapidly increasing among the most socially marginalized populations. As HIV risk has long been correlated with high levels of social and economic inequality, it is hardly surprising that middle-income countries are also where new HIV infections are increasing the fastest. The withdrawal of international health and development assistance from these countries, combined with massive poor populations and still-limited fiscal space in national public sectors, means that many poor people in middle-income countries actually become more deprived of essential health and social services as their own countries develop economically. If we are indeed committed to leave no one behind and to address the needs of the most vulnerable – as the Sustainable Development Goals commit us to do – we must find ways to reduce these inequalities and to reach the poor in middle-income countries with the assistance they need.

Promote human rights and social justice as essential pillars of global progress: As the recognized leader of the global community, the Secretary-General must articulate an alternative to growing authoritarianism, the declining space for civil society in many countries, and increased acceptance of human rights abuses and social injustice. These trends are fundamentally incompatible with ending AIDS, as widespread discrimination and unjust conditions create a climate that increases vulnerability to HIV and deters the most vulnerable from seeking essential services. As the human rights climate worsens, the global community must push back and advance a positive, people-centred agenda that recognizes respect for human rights and a commitment to social justice as non-negotiable, regardless of setting.

Actively take on the uncomfortable: As more and more countries embrace scapegoating the most vulnerable, the UN must be bold in its opposition. On HIV, the UN must fearlessly and visibly oppose the criminalization of sex work, same-gender relations, and HIV transmission, exposure or non-disclosure. The UN must enthusiastically promote sexuality education, sexual and reproductive health and rights, and legal recognition and protections of gender identity. The UN must champion the causes of the most vulnerable, including poor households, adolescent girls and young women, migrants and prisoners. The UN must boldly lead efforts to rethink global drug policy, including decriminalization of drug possession. As more than three decades of the AIDS response has shown, courage is the only effective choice to end the epidemic.

Promote universal access to affordable medicines: Although historic gains have been made in lowering the prices of antiretroviral medicines, costs remain too high. And the advances seen to date in reducing costs of drugs for HIV are nowhere to be found in the case of cancer, hepatitis and other health problems. The Secretary-General should actively explore and promote a “new deal” for access to medicines. Instead of charging exorbitant prices for a tiny few, makers of medicines should aim for universal access with a reasonable profit margin. In the meantime, urgent steps are needed to preserve the viability of the generic pharmaceutical industry and to strengthen the ability of countries to maximize legal flexibilities to increase access to essential medicines. These reforms will require a rethinking of intellectual property regimes, a re-commitment to global solidarity and an embrace of more socially responsible roles for private enterprises. In addition to the benefits to the AIDS response, promoting access to affordable medicines will also aid in combatting hepatitis, tuberculosis and non-communicable diseases.

Accelerate UN reform: As forces of nationalism increase and hostility to international cooperation intensifies, the UN urgently needs to demonstrate its added value in addressing key global challenges. Marshalling UN system resources and working with partners to end AIDS – an issue on which UN leadership has been especially noteworthy – is an excellent place to demonstrate the UN’s global potential. On AIDS and other key priorities, reform efforts should be redoubled to make the UN leaner, less duplicative, more results-focused, more flexible and quicker to act in the face of both emerging challenges and new opportunities.

In the quest to end AIDS, the world confronts major headwinds. While we have the tools we need to end the epidemic, there are reasons to doubt whether the world has the will to see this fight through to the end. Only courageous global leadership will get us to the “end game” for AIDS. The Secretary-General should own and lead this renewed global commitment to make AIDS a thing of the past.

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A 10% Cut In Funding Could Mean 5.6-Million People Dead From AIDS By 2030. 13/9/2017

Published by BUSINESSLIVE

Potential cuts to foreign aid threaten the world’s chances of ending poverty and eradicating diseases by 2030, with particularly dire consequences for Africa’s HIV/AIDS efforts, Microsoft founder Bill Gates has warned ahead of the upcoming UN General Assembly in New York.

A 10% cut in funding for HIV/AIDS could lead to the deaths of 5.6-million people by 2030, he said ahead of Wednesday’s release of a report from his philanthropic foundation on how the world is progressing towards 18 of the health and poverty-related targets set out in the Sustainable Development Goals (SDGs).

South African officials are anxiously watching to see whether US president Donald Trump’s proposed budget cuts to foreign aid are passed by Congress, as such a move could reduce both the bilateral and indirect support that it provides to South African HIV/AIDS programmes.

SA is also vulnerable to a reduction in other countries’ contributions to international agencies such as The Global Fund to Fight AIDS, Tuberculosis and Malaria.

The US is the world’s biggest contributor to the global fight against HIV/AIDS, and in 2016 contributed $4.9bn through bilateral programmes and international efforts. Trump’s proposed 2018 budget would shave almost $1bn off the US contribution to the figure, including a $222m cut to its contribution to the Global Fund.

"The world really did step up … with an incredible level of generosity, which has meant that AIDS-related deaths have fallen by almost half since the peak in 2005. This commitment to get the drugs to be cheaper and get them out to everybody has made a huge difference. But … we see countries that are considering possible funding cuts," said Gates.

Such cuts would be a big setback to Africa, which is poised for a large increase in the number of people aged between 16 and 24 years, the population most at risk of getting HIV, he said.

Gates said he thought it unlikely that the US Congress would approve Donald Trump’s proposed budget cuts. But in the report, he and his wife, Melinda Gates, expressed concern that shifting priorities could lead the world to waver in its commitments, risking back-sliding on the progress that has been made to cut deaths and improve people’s health and wellbeing.

"This report comes at a time when there is more doubt than usual about the world’s commitment to development. Take it from the point of view of justice, or take it from the point of view of creating a secure and stable world: development deserves our attention," they wrote.

The Bill and Melinda Gates Foundation commissioned the US Institute for Health Metrics and Evaluation to project the likely range of outcomes for selected SDG indicators. It found that the world was on the right track when it came to combating child mortality: 6-million fewer children died in 2016 than in 1990, and if efforts continue at the current pace, the number of children under five years old who die each year could halve, by 2030.

However, progress in tackling malaria deaths looked less promising, unless there were significant new innovations, it warned. It also looked at the effects of missing the SDG targets, and the gains that would be made if they were exceeded.

The Goalkeepers Report is to be released every year until 2030 to coincide with the UN Special Assembly, to hold world leaders to account on progress towards the SDGs, the foundation said.

The report not only showed where the world was falling short, but also highlighted success stories such as Ethiopia’s progress in cutting maternal deaths by getting more women to deliver their babies in health facilities, and Senegal’s work to increase the use of modern contraceptives.

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Bill Gates Says We're On Track For a Record HIV Epidemic. 13/9/2017

Published by YAHOO

The world has made enormous leaps in the fight against HIV/AIDS, to the extent that with the right treatment, someone HIV-positive can expect to live as long as their healthy neighbor.

But as the billionaire Bill Gates recently noted, without the proper funding, the virus could make a dangerous resurgence.

The Bill and Melinda Gates Foundation this week published the first "Goalkeepers" report — an exhaustive document that identifies and tracks more than a dozen measures of global public health, including child mortality and family planning. The foundation plans to release a report every year until 2030, keeping tabs on the progress made on each metric along the way.

HIV infection is one of the first metrics listed in the 2017 "Goalkeepers" report. As of 2015, there were 36.7 million people worldwide living with the virus, roughly 1.8 million of whom were children under 15 years old. Today, the infection rate is about 0.14 people per 1,000 in the population, down from a high of 0.30 in the early 2000s.

global hiv deaths

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global hiv deaths

(Bill and Melinda Gates Foundation)

But funding gains for HIV control are slowing. People seem to be getting complacent with the progress made over the past 15 years, Gates wrote, "and now there's talk of cuts." Models developed by the Gates Foundation in partnership with the Institute for Health Metrics and Evaluation found that a 10% cut in HIV treatment funding could lead to an additional 5.6 million deaths by 2030.

Even if funding stays flat, there could be an explosion of new cases, particularly in Africa, where the virus is most prevalent. The continent was home to 94 million people between 15 and 24 years old, the group most at risk for HIV, in 1990. In the wake of the population boom over the last several years, that group is expected to balloon in size to 280 million, the report said.

"What that means is pretty clear," Gates wrote. "If we only do as well as we've been doing on prevention, the absolute number of people getting HIV will go up even beyond its previous peak."

Gates concludes that is that treatment isn't the only solution.

"I'm not advocating for a blank check for HIV treatment," he wrote, "because I don't think we need one."

Instead, he sees prevention as the biggest factor in driving the infection rate as low as possible.

According to Gates, Kenya is the world leader in adopting preventive strategies. The East African country encourages safe-sex practices found to reduce HIV risks. Additionally, Gates has called on scientists to keep investigating preventive drugs, including a vaccine. But such discoveries require funding for research and development.

"In the meantime, if we don't spend more to deliver the tools we have now, we'll have more cases," Gates wrote. "If we have more cases, we'll need to spend more on treatment, or people will die."

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A Stocktake Review of DFID’s Work on HIV and AIDS. 12/9/2017

Published by STOPAIDS

Today STOPAIDS is releasing a new policy report, A Stocktake Review of DFID’s Work on HIV and AIDS.

You might remember that over the past year the It Ain’t Over campaign and the International Development Committee have both called on DFID to carry out a similar review. Campaigners and parliamentarians felt that in the absence of an HIV strategy, a stocktake review would facilitate DFID to articulate its priorities within the global HIV response and ensure its work is sufficient to deliver and coherent with those priorities.  A stocktake review could then be used to create a roadmap for the UK government to increase financial, programmatic and political commitment to the Global HIV Response as we work towards the SDG target of ending AIDS as a public health threat by 2030.

Despite strong support for a stocktake review from civil society and parliament, DFID indicated they would not carry out a stocktake review.

Reaching the SDG target will require all stakeholders to work together more collaboratively and effectively, and so over the summer STOPAIDS has carried out a civil society review of DFID’s work on HIV and AIDS. Using Statistics for International Development, Dev Tracker and DFID’s public communications we assessed DFID’s current financial, programmatic and political commitment to the HIV response. Today we are publishing our findings in ‘A Stocktake Review of DFID’s Work on HIV and AIDS’.

Our Findings

Financial Commitment

DFID’s overall funding for HIV is falling. Despite the UK’s substantial contribution to the Global Fund, massive cuts to DFID’s country office programmes focused on HIV have led to a decrease in funding from £416m in 2012 to £324 in 2015. At a time when UNAIDS predict that stakeholders need to increase financial resources for the global HIV response by a third, DFID’s funding has decreased by 22%.

Funding for civil society has been particularly hard hit, declining from £30m in 2011 to just £8m in 2015. Civil society is playing a critical role in reaching the most marginalised groups with HIV services and in holding national governments to account. STOPAIDS is recommending that DFID increase funding for civil society by making an increased pledge to the Robert Carr Network Fund, when DFID’s current commitment runs out in 2018.

Programmatic Commitment

DFID’s last HIV strategy expired in 2015. STOPAIDS combed through responses to parliamentary questions, letters from DFID Ministers, and DFID’s speech at the HLM on Ending AIDS in 2016 to piece together a ‘mock strategy’ for DFID.

But most stakeholders will not be so diligent as to piece together DFID’s priorities. STOPAIDS is recommending that DFID formalise and make public their approach to HIV.  

We also looked at how DFID demonstrates impact within the HIV response and found that DFID had no way to cumulatively measure impact. As DFID have shifted to integrating HIV into wider health and development programmes they have used an ‘HIV policy marker’ to identify programmes that ‘significantly affect HIV outcomes’. But when the marker is used, 50% of the project’s budget is automatically attributed as HIV spend, which might mean actual HIV spend is over or underestimated. There are no minimum requirements for the HIV policy marker’s use.  This means that projects might not monitor any HIV related outcomes or indicators and might not even mention HIV in any of the project documentation and could still be tagged with the HIV policy marker, at the discretion of the DFID programme manager. STOPAIDS is recommending that DFID introduce minimum requirements for using the HIV policy marker and allow programme managers to be more specific in attributing the project’s budget to HIV spend.

Political Commitment

Lastly, we assessed DFID’s political commitment to the global HIV response by looking at the inclusion of HIV in DFID strategies and at DFID’s attendance at HIV conferences. HIV is absent from some pretty significant DFID strategies – notably the Strategic Vision on Women and Girls and DFID’s Youth Agenda. But more recently, in the Bilateral Development Review we’ve seen more positive signs of DFID’s commitment to HIV. We’ve also heard promising indications from DFID Secretary of State Priti Patel that HIV will form a critical part of DFID’s strategy on women and girls going forward.

DFID’s attendance at international conferences has also been inconsistent. DFID missed both the 2014 and 2016 International AIDS Society Conferences but recently sent a high level civil servant to the International AIDS Society Conference on HIV Science. We’re recommending that DFID Minister Alistair Burt attend the International AIDS Conference in 2018 and that he includes a young person within the official UK delegation.

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Q&A on HIV/AIDS: "We must not be victims of our own success". 7/8/2017

Published by GLOBALHEALTHACTION

Maternal Health Much has been achieved towards ending the AIDS epidemic says UNAIDS Executive Director, who answers five questions and says it's time to step up action again.

Michel Sidibé, Executive Director, UNAIDS

Pictured: UNAIDS Executive Director Michel Sidibé

We asked Michel Sidibé, about traditional beliefs and complacency hindering the fight against HIV/AIDS, and he explained who is working to combat these ideas, and what the UN are planning next:

 


"We do need to deal with taboos surrounding HIV and completely change the way we talk about sexuality in society. People have to be courageous and speak up for sexual education and highlight just how critical it is. We have to make sure that girls have access to information early and give them the skills to help them deal with their sexuality in a more empowered manner. We have seen that with each additional year of secondary education reduces the risk of HIV infection by about 11 per  cent for adolescent girls and young women."

 


"Our success has been remarkable. It used to take us five or six years to get one million people on treatment; today, it takes us six months; and, today, we have more than 19 million people on treatment globally. Once, the biggest challenge we faced was to break the conspiracy of silence about HIV. Today, however, the biggest challenge we are facing is complacency. We need to make sure that we are not victims of our own success."

 


"I just came from a meeting with the African Union where African heads of state endorsed a plan to deploy two million community health workers across Africa by 2020. That's so important because we need to reinforce the interface between health service providers and the community to better monitor what is going on in each community. That way we can quickly make sure that pregnant women have access to health services and monitor them not only for HIV, but for all health issues. Having a good system at community level could also help monitor and stop epidemic diseases."

 


"I'm convinced we can, but more still needs to be done. We need to deal with underlying causes of HIV: stigma, discrimination, lack of economic empowerment, bad laws, violence against women and the fact that men are not coming forward for testing. We have a major failure on the part of men between 20 – 39 years old. They are not tested, are HIV positive and continue to transmit the virus to young women, and so the cycle starts again."

 


"My parents taught me never to discriminate. They told me I was born on the privileged side of the road — and that I should cross it. They taught me not to build walls or leave anyone behind. For them, it was always about social justice and refusing exclusion. That motivated me and continues to do so. If we can reduce AIDS-related deaths and ensure that more babies are born without HIV by 2020 — well, for me it would be the best success story I could have. And I could retire happily knowing that, at some point, HIV will no longer be a threat to women, and that there is hope for a new generation."

 


 

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AIDS Experts Fear Trump Budget Cuts Could Impact HIV/AIDS Fight. 31/7/2017

Published by CBSNEWS

After President Trump announced a "hard-power" budget plan that prioritizes defense spending over diplomacy and foreign aid, the United Nations programs combating HIV and AIDS recently released some promising news.

The number of people dying from AIDS around the world has been cut nearly in half since 2005, two years after the Bush administration initiated its plan to fight the disease in Africa, known as the President's Emergency Plan for AIDS Relief, or PEPFAR. The U.N. announced the new figures last week.

In Washington, lost amid the evident turmoil in the White House, came another shred of overlooked good news: PEPFAR announced that four African countries are close to getting their HIV/AIDS epidemics under control as a result of investments from the U.S. and global partners.

Since 2011, HIV infections have been nearly halved among adults in Swaziland, the country with the world's highest prevalence of HIV in the world, PEPFAR said. Meanwhile, Malawi, Zambia and Zimbabwe have also made "significant progress towards controlling the HIV epidemic," according to a statement released Monday.

"The global community decided to move forward on this. No one ever thought that you could control a pandemic without a vaccine or a cure, but we are actually shrinking the pandemic in the future by decreasing the number of new infections," said Ambassador Deborah Birx, the U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy. "And we are doing that without a vaccine or a cure."

ap-081212039622.jpg

A pharmacist packs antiretroviral drugs at the AIDS Care Training and Support Initiative (ACTS) at White River Junction, South Africa, Monday Dec 15, 2008. The center, partly funded by the President's Emergency Plan for AIDS Relief (PEPFAR) supports the development of a community-based palliative care unit which provides care, education and training for staff and community caregivers, volunteer counseling and testing facilities.

Meanwhile in Paris, HIV/AIDS specialists from around the globe gathered for the 2017 Biennial World Conference. Experts trumpeted global strides in curbing the HIV/AIDS epidemic but worried that HIV could once again flourish around the world if the Trump administration's proposed budget cuts to HIV research and treatment in the world's poorest countries come to fruition.

"As we gather today, the largest and most important donor in HIV response has threatened devastating cuts to funding for research and treatment programs," said Linda Bekker, president of the International AIDS Society, who addressed the conference on Sunday. "These onslaughts on funding, principles and programs have already begun to erode the gains we have so painstakingly made."

The optimism expressed by Birx, the U.S. ambassador, is at odds with the uncomfortable reality of Trump's budget proposal. His administration would uproot a public health initiative that has saved millions of lives and provided hope to HIV/AIDS patients around the world.

Mr. Trump's 2018 budget not only slashes PEPFAR by 17 percent -- from $4.6 billion to $3.8 billion -- it cuts global health programs overall by $2 billion. It also downsizes the National Institute of Health's National Institutes of Allergy and Infectious Diseases (NIAID), which funds HIV/AIDS research, by 23 percent.

Overall, the budget of the National Institutes of Health would be cut by $6 billion by the White House.

Experts like Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, project a grim future as a result.

Garrett fears "a massive second global wave of AIDS will come, perhaps within the next 10 years," as new drug-resistant mutations of the disease arise and financial resources dwindle.

But last week, the House Appropriations Committee approved of a State and Foreign Operations Budget and a Health and Human Services budget that rejected much of Mr. Trump's vision.

As Republicans in the White House and Congress clash over a total of $203 billion in proposed administration cuts over the next 10 years, it's possible that funding for both PEPFAR and the NIH, which have historically seen bipartisan support, could be restored in the congressional budget.

"[White House Budget Director Mick] Mulvaney declared this was a hardline budget, but saving lives around the world is a hardline issue," Dr. Jack Chow, the former ambassador and special representative on global HIV/AIDS under President George w. Bush, told CBS News. "It's life or death. What's more hardline than that?"

While Mr. Trump's budget explicitly says that it "reduces funding for several global health program, including HIV/AIDS, with the expectation that other donors can and should increase their commitments," Dr. Birx described Mr. Trump's overall approach towards public health as "results, outcomes and impact focused."

Birx said the programs needed more scrutiny. "Can we draw a straight line from taxpayers in Iowa from the countries and individuals we are serving?" she said in an interview with CBS News.

Birx said that Secretary of State Rex Tillerson expressed his commitment to PEPFAR during his budget and confirmation hearings and pointed to Vice President Mike Pence's support for PEPFAR in 2003 when the program was created. Pence also supported its reauthorization in 2008.

"It must be galling on the one hand to have the good news on the amazing impact that PEPFAR is having in some of the hardest hit countries, yet having this good news obscured by the budget scenario," said Richard Downie, the acting director of the Center for Strategic International Studies' Africa Program. "So I imagine Ambassador Brix is putting a positive slant on this."

"PEPFAR is already a very lean organization and I doubt there are many more efficiencies to be squeezed out of the program that would offset the kinds of cuts Trump is proposing," Downie added.

But Birx, who was first appointed by President Barack Obama, downplayed the budget cuts by touting PEPFAR's self-sustaining infrastructure that has been developed over the past 14 years: supply chains, community access, databases and clinics that now exist. "The exact same things for you need for healthy populations going forward," she said.

"I think we have to recognize that the U.S. government has invested almost $70 billion over the last 14 years," Birx said.

But Downie said a cure is certainly not achievable in the future without continued investment.

He credits PEPFAR for investments since its inception but says it's naïve to expect to walk away from some of the poorest countries on Earth without there being some impact on people living with HIV.

"These are very tricky diseases that are constantly mutating and changing and if you let your foot off the gas for one moment, they can outpace you once again," Downie said.

 

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    New Cheaper, Better ARV’s for SA by April. 28/7/2017

    Published by HEALTHE

    The much anticipated antiretroviral (ARV) dolutegravir will be introduced as the first-line treatment for HIV in South Africa as early as April next year, Deputy Director General for the Department of Health Dr Yogan Pillay told Health-e News from the 9th International AIDS Society (IAS) Conference on HIV Science taking place in Paris this week.

    A dolutegravir-based regimen will be a “game-changer” for South Africa and people living with HIV because it has fewer side-effects and is cheaper than existing regimens, according to Professor Francois Venter from the Wits Reproductive Health and HIV Institute.

    Initially planned to enter the South African market in October next year, Pillay said that the timing of introducing dolutegravir will ultimately depend on when suppliers register the fixed-dose-combination version with the Medicines Control Council.

    Three drugs a day for life

    “During this conference I’ve been meeting with all the suppliers to find out when they will register. We think that definitely two, most likely three, will register this year and if they register we can start earlier,” he said.

    This is the next big step forward in HIV treatment and it’s exciting but it’s not going to solve the systemic problems we are facing.

     

    Antiretroviral (ARV) therapy requires taking three drugs a day, every day, for life, but treatment is made easier when all the drugs are combined into one pill – called a fixed-dose-combination (FDC).

    “That’s why we haven’t introduced it yet, like Botswana, because we’ve been waiting for the FDC. So it won’t make any difference to the patient: they will still be taking one pill a day except that the one pill they take will have less side effects,” said Pillay.

    Bad side-effects

    He said that current treatment based on the drug efavirenz has side-effects that can sometimes be severe and make the medication difficult to take for patients. These include mental health and liver problems. Dolutegravir’s side-effects are milder and much less common and could make taking treatment-for-life much easier.

    According to a January paper published in the South African Medical Journal, a dolutegravir-based regimen could translate into initial cost-savings of 20 percent of the country’s annual ARV budget. When volumes are met, when the majority of patients have been switched to the regimen, cost-savings could reach 50 percent. Venter said this is largely due to the price of the raw materials used to manufacture the drug.

    The cost-savings are highly significant as South Africa runs the largest ARV programme in the world and spends roughly R 10 billion a year on procuring the medicines for local patients.

    Dolutegravir could also potentially solve the country’s ARV-resistance problem, according to Venter. He said reports indicate that more than 10 percent of patients currently on treatment have developed resistance to first-line ARVs. HIV drug resistance occurs when individuals do not take their medicines as prescribed. This gives the virus a chance to mutate to the point where the medications no longer work to suppress the virus.

    Robust against resistance

    But dolutegravir is much more robust against resistance than existing drugs and there have only been two reports of resistance among more than half a million of patients world-wide who have received the drug in the past three years.

    Pillay said that patients new to ARV therapy will be the first to receive dolutegravir, after which existing patients will be switched.

    Venter said “There is a clear acknowledgment that this is the next big step forward in HIV treatment and it’s exciting but it’s not going to solve the systemic problems we are facing. It’s not the magic bullet some are hoping it to be. We still need a radical shift in health care delivery to see a real revolution in healthcare and to see a system that is truly patient-friendly.”

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    Fast-Track Cities Share 90-90-90 Progress. 26/7/2017

    Published by UNAIDS

    Health department representatives from Amsterdam, Nairobi, Paris, San Francisco and São Paulo gathered during a Fast-Track Cities Symposium at the 2017 International AIDS Conference on HIV Science in Paris. They shared their lessons learned and challenges in preventing new HIV infections and addressing barriers to health.

    Amsterdam is among the first cities to have reached the 90-90-90 targets whereby 90% of people living with HIV know their HIV status, 90% of people diagnosed are on treatment, and 90% of people on treatment are virally suppressed.

    Many other cities like Paris are on the right track and have mobilized political commitment for the Fast-Track Cities agenda.  With support from the core partners of the Fast-Track Cities network, including UNAIDS, International Association of Providers of AIDS Care, the City of Paris and UN Habitat, cities are adopting innovative approaches to reach affected populations, to optimize linkages to HIV treatment and care, and to address different gaps according to the cities.

    Early HIV diagnosis has boosted early treatment uptake as has using strategic data to improve various HIV programmes.  The cities of Bangkok, Nairobi and New Orleans launched city dashboards at the conference, illustrating significant progress.  Baseline 90-90-90 data published include 79-57-79 for Bangkok, 77-96-86 for Nairobi, and 87-69-91 for New Orleans.  Additional data presented at the afternoon session showed 87-65-91 for São Paulo, 93-79-91 for San Francisco and 94-90-94 for Amsterdam.

    Since the 2014 launch of the Paris Declaration—Fast-Track Cities: Ending the AIDS Epidemic—more than 200 cities and municipalities around the world have committed to the achieving the 90-90-90 targets by 2020. Almaty in Kazakhstan was the latest city to sign the declaration on 20 July 2017.

     

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    HIV-Prevention Ring a Hit with Teen Girls. 25/7/2017

    Published by BBC

    A vaginal ring to prevent HIV infection is popular with teenage girls, US scientists say.

    Women and girls aged 15-24 account for a fifth of all new HIV infections globally. Nearly 1,000 are infected every day in sub-Saharan Africa.

    Infused with microbicides, the ring, which sits on the cervix, has been shown to cut infections by 56%.

    Experts say it frees women from relying on men to wear condoms and allows them to protect themselves confidentially.

    Dr Anthony Fauci, the director of the US National Institute of Allergy and Infectious Diseases, told the BBC: "If you can give women the opportunity to protect themselves in a way that is completely confidential - that's a long and big step to helping them.

    "In societies where women are, unfortunately but true, somewhat second-class citizens, that makes women extremely vulnerable to getting infected with HIV."

    The flexible ring, similar in size to the contraceptive diaphragm, releases an antiretroviral drug called dapivirine for a month.

    But scientists were unsure it would work in teenagers, who can be notoriously difficult when it comes to health advice.

    The six-month US trial gave the ring to 96 sexually active girls aged 15 to 17, who had not used it before.

    Data presented at the IAS Conference on HIV Science, showed:

    • 87% of the girls had detectable levels of the drug in their vagina
    • 95% said the ring was easy to use
    • 74% said they did not notice the ring in day-to-day life

    There were some concerns before the trial that the girls' partners would not like the feel of the ring, but it reportedly enhanced pleasure.

    Prof Sharon Hillier, one of the researchers at the University of Pittsburgh School of Medicine, said: "HIV doesn't distinguish between a 16-year-old and an 18-year-old.

    "Access to safe and effective HIV prevention shouldn't either, young women of all ages deserve to be protected."

    There are now plans to test the ring with teenagers in Africa.

    If the ring gets regulatory approval, it would be the first method of prevention exclusively for women. 

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    9th AIDS Conference on Science Opens in Paris. 24/7/2017

    Published by UNAIDS

    More than 6 000 HIV professionals from around the world have gathered in Paris for the 9th IAS Conference on HIV Science. The four-day conference is one of the largest open scientific meetings on HIV, organized by the International AIDS Society (IAS) in partnership with the French National Agency for Research on AIDS and Viral Hepatitis (ANRS).

    This year’s conference will prioritize basic science, a prerequisite step to ending the HIV epidemic and feature studies that shine a light on the specific needs of key populations, including young people, transgender people, men who have sex with men, sex workers and people who inject drugs.

    The conference was officially opened on Sunday evening by French Health Minister Agnes Buzyn, UNAIDS Executive Director Michel Sidibé, French economist Esther Duflo, Giovanna Rincon, President of the ACCEPTESS-T association and officiated by Linda-Gail Bekker, President of IAS and International Scientific Chair of IAS 2017 as well as IAS 2017 Local Scientific Chair and former director of ANRS.

    Global HIV funding has many preoccupied at the Paris conference. Funding cuts would devastate HIV research and treatment programmes, stalling or undoing recent progress highlighted in the latest UNAIDS report released 20 July. IAS reiterated that their shared objective was to ensure that science remains the backbone of the global AIDS response saying funding was critical to end the HIV epidemic.

    The conference runs from 23 July to the 26th.

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    Leaders Make Case for Continued Global HIV Funding, Herald Critical Role of Science In The Fight Against HIV. 24/7/2017

    Published by IAS2017

    Experts highlight return on investment and harmful impact of potential funding cuts

    (Paris, France) – HIV experts joined forces in an official press conference at the 9th IAS Conference on HIV Science (IAS 2017) today to issue a strong call for a renewed global commitment to funding for HIV research and programmes, highlighting the return on investment for governments, communities and the private sector.

    IAS 2017 takes place in the context of recent declines in global HIV funding and as major government donors are either calling for or considering further cuts to scientific research funding. A recently released report from UNAIDS and the Kaiser Family Foundation found that government funding for HIV fell for the second year in a row in 2016, declining 7% over the previous year. In current US dollars, this brings disbursements to their lowest level since 2010. Additionally, a new AVAC report found that funding for HIV prevention R&D in 2016 decreased by 3% from the previous year, the lowest annual investment in more than a decade.

    The US – the largest donor in the world’s HIV response – is threatening devastating funding cuts for research and treatment programmes. amfAR and AVAC recently forecast that proposed US funding cuts, if fully enacted, would result in more than 1 million HIV treatment disruptions and nearly 150,000 AIDS-related deaths.

    “Current attacks on HIV research funding threaten to stall or undo recent progress,” Linda-Gail Bekker, the President of the International AIDS Society (IAS) and International Scientific Chair of IAS 2017, said. “Through investments like PEPFAR, we have seen what can be achieved when nations and donors come together to direct meaningful resources toward solutions.  PEPFAR has significantly impacted the global HIV epidemic.”<

    The expert panel included: Gregorio Millett, Vice President and Director of Public Policy at amfAR, who discussed the real-world impact of potential funding cuts; Solange Baptiste, Executive Director of the International Treatment Preparedness Coalition (ITPC Global), who spoke about why community investment and strengthening is critical; Charles Lyons, President and Chief Executive Officer of the Elizabeth Glaser Paediatric AIDS Foundation, who provided the perspective of an organization implementing HIV programmes; and Christine Lubinski, Vice President for Global Health at the Infectious Diseases Society of America, who underscored the need for continued research investments to better understand and respond to the epidemic.

    Several notable IAS 2017 studies examine the return on investment of HIV finances, including:

    • A randomized control trial in South Africa assessing the costs and benefits of integrating HIV and maternal/child health care, which looked at the potential for perinatal home visits to influence better health outcomes for women and their babies (WEAD0106LB)
    • Analyses of community-based HIV care for adolescents (MOPDD0105)
    • An analysis of 38 sub-Saharan African countries with high rates of HIV, assessing whether differentiated care models saved both direct costs and health workers’ time (WEAD0204)
    • A South African case study of the immediate and direct impact of phasing out USAID funding for HIV services and health facility staffing (WEAD0201)

    Contacts

    Mandy Sugrue
    +33 (0)776 15 12 68
    Mandy.Sugrue@iasociety.org

    Leila Darabi
    + 33 (0)776 54 72 13
    leila.darabi@unlimitedgroup.com

    Rob Caruano
    +33 (0)776 54 92 95
    rob.caruano@unlimitedgroup.com

    About the International AIDS Society

    The mission of the International AIDS Society (IAS) is to lead collective action on every front of the global HIV response through its membership base, scientific authority and convening power. Founded in 1988, the IAS is the world’s largest association of HIV professionals, with members from more than 180 countries working on all fronts of the global response to HIV. Together, we advocate and drive urgent action to reduce the global impact of HIV. The IAS is also the steward of the world’s two most prestigious HIV conferences: the International AIDS Conference and the IAS Conference on HIV Science. For more information, visit www.iasociety.org.

    About the IAS Conference on HIV Science (IAS 2017)

    The IAS Conference on HIV Science is the largest open scientific conference on HIV- and AIDS-related issues. The 9th IAS Conference on HIV Science (IAS 2017) takes place on 23-26 July 2017 at the Palais des Congrès in Paris, France. More than 6,000 professionals from around the world are convening at IAS 2017 to examine the latest scientific developments in HIV-related research with a focus on moving science into practice and policy. IAS 2017 is organized by the International AIDS Society (IAS) in partnership with the French National Agency for Research on AIDS and Viral Hepatitis (ANRS). For more information, visit www.ias2017.org.

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    Five Key Numbers on AIDS. 21/7/2017

    Published by THEINDEPENDENT

    21st International AIDS Conference (AIDS 2016), Durban, South Africa.  ACTIVITS FOR SEX WORKERS PROTESTING OUTSIDE THE VENUE

    Paris, France | AFP |  Someone is infected with the AIDS virus every 17 seconds in the world, and the disease has killed the equivalent of the population of Canada, figures released Thursday by UNAIDS show.

    Here is a numerical snapshot of the disease.

    – 17 seconds –

    Roughly 1.8 million people worldwide contracted the AIDS virus in 2016. That figure breaks down to about one infection by the human immunodeficiency virus (HIV) that causes AIDS every 17 seconds on average, or almost 5,000 per day.

    – Two-thirds of new cases in Africa –

    Since 2010, the rate of infection among adults has decreased slowly from 1.9 million then to 1.7 million per year in 2016. Two-thirds of new cases occur in Africa.

    – Children’s cases cut almost by half –

    New infections among children have fallen sharply meanwhile, and since 2010 they have been cut almost by half, from 300,000 to 160,000 in 2016.

    A key factor has been detection among pregnant women in Africa, followed by treatment with anti retroviral drugs that protect their baby.

    – Nearing 40 million with HIV –

    Today, close to 40 million people live with the virus. UNAIDS put their number last year at 36.7 million.

    The number continues to increase however owing to continued transmission and increased access to anti-retroviral drugs in developing countries that has raised the survival rate of HIV-positive people.

    – Deaths halved –

    AIDS-related deaths have declined by almost 50 percent since a peak of 1.9 million in 2005, to 1.0 million in 2016.

    Almost 20 million people now have access to effective treatment when followed regularly.

    An estimated 36 million people have died since the AIDS epidemic erupted in 1981 according to the WHO, roughly equivalent to Canada’s population.

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    Ending AIDS: Progress Towards the 90–90–90 Targets. 7/2017

    Published by GLOBALAIDS

    The 90–90–90 targets are galvanizing global action and saving lives. Eastern and southern Africa are leading the way in reducing new HIV infections by nearly 30% since 2010 - Malawi, Mozambique, Uganda and Zimbabwe have reduced new HIV infection by nearly 40% or more since 2010.

    Concerted efforts are still needed for children, adolescents, men and key populations, and in certain regions. 

    You can access the resource here

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    The Global Fund Results Fact Sheet. 7/2017

    Published by THEGLOBALFUND

    Ahead of next week’s International AIDS Society Conference on HIV Science in Paris, France, the Global Fund to Fight AIDS, Tuberculosis and Malaria has released its year-end 2016 results, showing accelerated progress against HIV, tuberculosis and malaria.

    The Global Fund Results Factsheet presents the latest programmatic data from recipients of Global Fund grants. It also outlines some of the common questions and answers regarding results reported by Global Fund-supported programs. 

    You can acess the resource here

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    Over 50% of People Living with HIV on Treatment, says Landmark Global Report. 20/7/2017

    Published by AVERT

    19.5 million people globally are now on life-saving treatment, with AIDS-related deaths halved since 2005, according to UNAIDS.

    Mother kisses baby

    The latest progress report from UNAIDS shows significant strides towards achieving the 90-90-90 targets, with 70% of people living with HIV now aware of their HIV status. Of those who know their status 77% were accessing treatment, and 82% of those accessing treatment were virally suppressed.

    East and Southern Africa, Western and Central Europe, North America, and Latin America are all on track to reach the 90-90-90 targets by 2020. Seven countries, across three continents have already achieved the targets – Botswana, Cambodia, Denmark, Iceland, Singapore, Sweden and the UK.

    UNAIDS Executive Director Michel Sidibé said health outcomes are improving as nations become stronger at bringing the HIV epidemic under control. “We met the 2015 target of 15 million people on treatment and we are on track to double that number to 30 million and meet the 2020 target,” he said.

    The region showing the most progress is East and Southern Africa, which has historically been the area most affected by HIV and is home to over half of all people living with HIV. Since 2010, AIDS-related deaths have declined by 42% and new HIV infections have declined by 29%. This includes a 56% drop in new HIV infections among children.

    Overall in East and Southern Africa, 76% of people living with HIV know their status, 79% have access to treatment, and 83% have undetectable levels of HIV.

    As a result of this progress, life expectancy has increased by nearly 10 years in the region between 2006 and 2016.

    However, progress towards the 90-90-90 targets has been inadequate in the Middle East and North Africa and Eastern Europe and Central Asia.

    Alarmingly, AIDS-related deaths have risen in these two regions by 48% and 38% respectively. Across Eastern Europe and Central Asia only 28% of people living with HIV have access to antiretroviral treatment, even though two thirds of people know their status.

    Young people, who are at particular risk of HIV, are also falling behind – on knowledge of HIV, on HIV testing, and on treatment and prevention. Young women are especially at risk, with 59% of new infections among young people aged 15-24 occurring among this group.

    One of the most worrying findings of the report is that while new HIV infections are falling, they are not declining significantly enough to meet global targets.

    New infections fell by 16% to 1.8 million between 2010 and 2016. The report suggests this may partly be the result of preventative effects of antiretroviral treatment scale-up at the population level. However, in Eastern Europe and Central Asia, significant increases in new HIV infections have been reported.

    The mixed progress comes amid flat-lined resourcing for the AIDS response. An estimated $26 billion is needed for the global response by 2020, but at the end of 2016 only $19 billion was available.

    “We are maximising the use of every dollar of available, but we are still $7 billion short,” said Sidibé. “With more international assistance, increased domestic funding, innovative financing and effective programming can end the AIDS epidemic by 2030.”

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    The Scales Have Tipped—UNAIDS Announces 19.5 Million People on Life-Saving Treatment and AIDS-Related Deaths Halved Since 2005. 20/7/2017

    Published by UNAIDS

    The 90–90–90 targets are galvanizing global action and saving lives. Eastern and southern Africa leading the way in reducing new HIV infections by nearly 30% since 2010—Malawi, Mozambique, Uganda and Zimbabwe have reduced new HIV infection by nearly 40% or more since 2010. Concerted efforts still needed for children, adolescents, men and key populations, and in certain regions.

    UNAIDS has released a new report showing that for the first time the scales have tipped: more than half of all people living with HIV (53%) now have access to HIV treatment and AIDS-related deaths have almost halved since 2005. In 2016, 19.5 million of the 36.7 million people living with HIV had access to treatment, and AIDS-related deaths have fallen from 1.9 million in 2005 to 1 million in 2016. Provided that scale-up continues, this progress puts the world on track to reach the global target of 30 million people on treatment by 2020.

    “We met the 2015 target of 15 million people on treatment and we are on track to double that number to 30 million and meet the 2020 target,” said Michel Sidibé, Executive Director of UNAIDS. “We will continue to scale up to reach everyone in need and honour our commitment of leaving no one behind.”

    The region showing the most progress is eastern and southern Africa, which has been most affected by HIV and which accounts for more than half of all people living with HIV. Since 2010, AIDS-related deaths have declined by 42%. New HIV infections have declined by 29%, including a 56% drop in new HIV infections among children over the same period, a remarkable achievement resulting from HIV treatment and prevention efforts that is putting eastern and southern Africa on track towards ending its AIDS epidemic.

    WHAT’S ON TRACK

    90–90–90 progress

    The report, Ending AIDS: progress towards the 90–90–90 targets, gives a detailed analysis of progress and challenges towards achieving the 90–90–90 targets. The targets were launched in 2014 to accelerate progress so that, by 2020, 90% of all people living with HIV know their HIV status, 90% of all people with diagnosed HIV are accessing sustained antiretroviral therapy and 90% of all people accessing antiretroviral therapy are virally suppressed.

    The report shows that in 2016 more than two thirds (70%) of people living with HIV now know their HIV status. Of the people who know their status, 77% were accessing treatment, and of the people accessing treatment, 82% were virally supressed, protecting their health and helping to prevent transmission of the virus.

    Eastern and southern Africa, western and central Europe and North America and Latin America are on track to reach the 90–90–90 targets by 2020. In eastern and southern Africa, 76% of people living with HIV know their HIV status, 79% of people who know their HIV-positive status have access to antiretroviral therapy and 83% of people who are on treatment have undetectable levels of HIV—this equates to 50% of all people living with HIV in eastern and southern Africa with viral suppression. The Caribbean and Asia and the Pacific can also reach the 90–90–90 targets if programmes are further accelerated.

    Seven countries have already achieved the 90–90–90 targets—Botswana, Cambodia, Denmark, Iceland, Singapore, Sweden and the United Kingdom of Great Britain and Northern Ireland—and many more are close to achieving it.

    “Ending AIDS is possible - it is a shared engagement and aspiration. One that cities can lead while promoting inclusive societies for all,” said Anne Hidalgo, Mayor of Paris.

    The most significant impact of 90–90–90 scale-up has been in reducing AIDS-related deaths, which have been reduced by almost half in the past 10 years. As a result, life expectancy has increased significantly in the most affected countries. In eastern and southern Africa, life expectancy increased by nearly 10 years from 2006 to 2016.

    “Communities and families are thriving as AIDS is being pushed back,” said Mr Sidibé. “As we bring the epidemic under control, health outcomes are improving and nations are becoming stronger.”

    90-90-90: more work to do

    Progress against the 90–90–90 targets has, however, been poor in the Middle East and North Africa and in eastern Europe and central Asia, where AIDS-related deaths have risen by 48% and 38%, respectively. There are exceptions within these regions showing that when concerted efforts are made, results happen. For example, Algeria has increased HIV treatment access from 24% in 2010 to 76% in 2016, Morocco from 16% in 2010 to 48% in 2016 and Belarus from 29% in 2010 to 45% in 2016.

    Globally, progress has been significant, but there is still more work to do. Around 30% of people living with HIV still do not know their HIV status, 17.1 million people living with HIV do not have access to antiretroviral therapy and more than half of all people living with HIV are not virally suppressed.

    Eliminating new HIV infections among children

    Global solidarity to stop new HIV infections among children has produced results. Around 76% of pregnant women living with HIV had access to antiretroviral medicines in 2016, up from 47% in 2010. New HIV infections among children globally have halved, from 300 000 [230 000–370 000] in 2010 to 160 000 [100 000–220 000] in 2016. Five-high burden countries—Botswana, Namibia, South Africa, Swaziland and Uganda—have already met the milestone of diagnosing and providing lifelong antiretroviral therapy to 95% of pregnant and breastfeeding women living with HIV.

    New HIV infections are declining, but not fast enough

    The report also shows that, globally, new HIV infections are declining, but not at the pace needed to meet global targets. Globally, new HIV infections declined by 16% from 2010 to 2016, to 1.8 million [1.6 million–2.1 million]. Declines were estimated in 69 countries, in the majority of which treatment scale-up has been implemented alongside an increase in the availability of combination HIV prevention services and in some countries condom use. However, alarming increases have been seen in new HIV infections in eastern Europe and central Asia.

    Tuberculosis

    Major gains in the global response to tuberculosis and HIV led to a 33% decline in tuberculosis deaths among people living with HIV. As of 2015, only 11% of the 10.4 million cases of tuberculosis globally were among people living with HIV. However, nearly 60% of tuberculosis cases among people living with HIV were not diagnosed or treated.

    Community health workers needed

    Ending AIDS shows that providing services closer to where people live and work will be a key factor in ending the AIDS epidemic. UNAIDS is championing an initiative recently backed by the African Union to recruit and train 2 million community health workers in Africa to further bolster the capacity of health systems to deliver health-care services across the region.

    “When health services reach the doorsteps, the health of families and communities is transformed,” said Mr Sidibé. “Community health workers will become the backbone of strong and resilient health systems across Africa.”

    "I am not alone living with HIV, there are millions of us and we are determined to put an end to AIDS," said Christine Kafando, community health worker and founder of Association Espoir pour Demain. "We have the will to do it and must continue our concerted efforts."

    WHAT’S OFF TRACK?

    Treatment for children living with HIV

    Only 43% of children living with HIV have access to antiretroviral therapy, compared to 54% of adults. Ending AIDS also reveals that as many as two thirds of children under two years old are diagnosed late and start treatment with advanced immunodeficiency, resulting in a high mortality rate for children of this age group. More action is needed to diagnose and treat children living with HIV.

    Young people are lagging behind

    Young people (15–24 years) are lagging behind on multiple fronts—knowledge of HIV, HIV testing, treatment and prevention. Young people continue to be at great risk of HIV infection, especially young women in sub-Saharan Africa. New HIV infections among young women in sub-Saharan Africa are 44% higher than among young men of their age in the region. Around 610 000 new HIV infections occurred among young people aged 15–24 years; 59% of those new infections occurred among young women age 15–24 years.

    In Malawi, Zambia and Zimbabwe, half of young people do not know their status and more than half do not have access to HIV treatment. Only 36% of young men and 30% of young women in sub-Saharan Africa had a basic knowledge of how to protect themselves from HIV. Population-based HIV Impact Assessments (PHIAs) conducted in Malawi, Zambia and Zimbabwe, and supported by the United States President’s Emergency Plan for AIDS Relief, found that less than 50% of young people living with HIV were aware of their HIV status, compared to 78% of adults aged 35–59 years.

    Men not being reached

    The report reveals that less than 50% of young men know how to protect themselves from HIV infection, that men are much less likely to know their HIV status or start treatment than women and that less than 50% of men living with HIV are accessing antiretroviral therapy. Many men who are diagnosed with HIV are diagnosed late and start treatment only when they fall ill, making them much more likely to die of AIDS-related illnesses than women. Deaths from AIDS-related illnesses were 27% lower among women than among men.

    Key populations

    Outside of sub-Saharan Africa, key populations and their sexual partners accounted for 80% of new HIV infections in 2015 and even in sub-Saharan Africa key populations account for 25% of new HIV infections. The report outlines that efforts to reach key populations with integrated HIV services are essential and that a combination approach is needed that includes harm reduction services.

    Regions off track

    Eastern Europe and central Asia is the only region in the world where new HIV infections and AIDS-related deaths are both rising. New HIV infections increased from 120 000 [100 000–130 000] in 2010 to 190 000 [160 000–220 000] in 2016. People who inject drugs accounted for 42% of new HIV infections in the region. In the Russian Federation, newly reported cases of HIV increased by 75% from 2010 to 2016. Several other countries in the region—including Albania, Armenia and Kazakhstan—also have rapidly growing epidemics.

    Even though access to HIV treatment in eastern Europe and central Asia has more than doubled in the past six years, still only 28% of people living with HIV have access to antiretroviral therapy, despite two out of three people living with HIV knowing their HIV status. AIDS-related deaths have increased by 38%.

    In the Middle East and North Africa, just over half of people living with HIV knew their HIV status, with less than half of those on HIV treatment. Only one out of five people living with HIV was virally suppressed.

    UNAIDS has been working with Doctors Without Borders and the African Union on a catch-up plan for western and central Africa, which is lagging far behind the rest of the continent. Only 42% of the 6.1 million people living with HIV in the region knew their HIV status, just 35% were accessing HIV treatment and only one in four people living with HIV were virally suppressed in 2016.

    “I would like to reiterate our support for the catch-up plan for western and central Africa, launched by UNAIDS and now joined by partners. The adoption of this plan by the heads of state of the African Union is an essential step for mobilization and the efficient implementation of this plan by the countries in the region.” said Michèle Boccoz, French AIDS Ambassador.

    Resources for the AIDS response continue to flatline

    Resources for the AIDS response remain flat. At the end of 2016, around US$ 19 billion was available in low- and middle-income countries, with domestic resources accounting for 57% of the global total. An estimated US$ 26 billion will be needed for the global response to HIV by 2020.

    “We are maximizing the use of every dollar available, but we are still US$ 7 billion short,” said Mr Sidibé. “With more international assistance, increased domestic funding, innovative financing and effective programming can end the AIDS epidemic by 2030.”

                 In 2016 an estimated:

                19.5 million people were accessing antiretroviral therapy

                36.7 million [30.8 million–42.9 million] people globally were living with HIV

                1.8 million [1.6 million–2.1 million] people became newly infected with HIV

    1.0 million [830 000–1.2 million] people died from AIDS-related illnesses

    Ending AIDS: progress towards the 90–90–90 targets can be downloaded from unaids.org. UNAIDS is the global leader and repository of AIDS-related programme data. The full data set can be accessed at http://aidsinfo.unaids.org/

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    World on Track to Meet HIV Goals – UNAIDS. 20/7/2017

    Published by HEALTHE

    We are closer than ever before to ending AIDS but there is much still to do, according to a new report.

    ARV pills © UNAIDS

    For the first time in the world’s history, more than half the people living with HIV are on treatment, according to the latest Ending AIDS report by the Joint United Nations Programme on HIV/AIDS (UNAIDS).

    The UNAIDS targets are that, by 2020, 90 percent of people living with HIV should know their status, 90 percent of these people should be on ARVs and 90 percent of people on treatment should have suppressed viral loads.

    Released this morning (Thursday 20 July), the report notes that as of 2016, 19.5 million people were on antiretroviral treatment (ART), up from 17.1 million in 2015. Six out of 10 people on ART live in eastern and southern Africa.

    Return on investment

    “With science showing that starting treatment as early as possible has the dual benefit of keeping people living with HIV healthy and preventing HIV transmission, many countries have now adopted the gold-standard policy of treat all,” said UNAIDS executive director Michel Sidibé.

    He said these efforts are bringing “a strong return on investment”. “AIDS-related deaths have been cut by nearly half from the 2005 peak. We are seeing a downward trend in new HIV infections, especially in eastern and southern Africa, where new HIV infections have declined by a third in just six years.”

    The southern and eastern African region is the most affected by HIV. Despite having the largest ART programme in the world, South Africa’s treatment coverage – 56 percent of all people living with HIV – was below the regional average of 60 percent. Botswana (83 percent) and Rwanda (80 percent) had the highest treatment coverage in the region.

    Viral load testing technology

    Although South Africa has some way to go to increase access to treatment, the country has played a significant role in making viral load testing available in developing countries, according to the report. This test is important to check that the HIV medication is working to suppress the virus in the blood.

    “This expansion is partly the result of South Africa leveraging its market weight to reduce viral load test prices globally,” noted the report. An agreement entered into between the South African government and the drug company Roche has led to a number of different countries being able to afford to buy the technology including Ethiopia, Kenya and Nigeria.

    “But our quest to end AIDS has only just begun. We live in fragile times, where gains can be easily reversed,” said Sidibé. “The biggest challenge to moving forward is complacency.”

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    UNAIDS Board Seizes Opportunities Of Change To Deliver Results. 30/6/2017

    Published by UNAIDS

    UNAIDS’ 40th Programme Coordinating Board meeting has concluded in Geneva, Switzerland. Important decisions were taken on redefining the ways in which the Joint Programme works to deliver results efficiently and effectively and continues to advance global efforts to end the AIDS epidemic as part of the Sustainable Development Goals.

    The Board affirmed the UNAIDS Joint Programme Action Plan as a way to progressively move towards a refined operating model. The Action Plan strengthens the coherence and effectiveness of UNAIDS’ support to countries and presents clear results and deliverables on joint working, financing, accountability and governance. The Board members also welcomed the final report of the Global Review Panel on the Future of the UNAIDS Joint Programme Model.

    The Executive Director of UNAIDS, Michel Sidibé, presented his report to the Board, which centred around seizing the opportunities of change in order to deliver results. He talked about the importance of understanding a rapidly changing world, threats to global health security and the need to end AIDS by 2030.

    “Ending AIDS is our imperative. We must not let the changes happening around us bend our trajectory or slow us down,” said Mr Sidibé. “We need to connect the dots across issues, mandates and organizations in new ways, confront obstacles with innovation and transformation, reinforce the centrality of community engagement, Fast-Track our efforts to reach everyone in need and leave no one behind.”

    Mr Sidibé also talked Board members through the programme of reform he has led over the past 12 months to reposition the UNAIDS Secretariat and realign to support countries in a new political and financial environment while continuing to ensure maximum support for the work of the entire Joint Programme.

    During the meeting, Mr Sidibé called on the Board to consider gender equality in the governance of UNAIDS. The Board invited all delegations to continue to encourage and support equal representation of women and men in the Board.

    UNAIDS has increased the percentage of women in country director positions from 27% in 2013 to 48% in 2017 through the Gender Action Plan, an initiative championed by the Deputy Executive Director, Jan Beagle, who has been appointed as the new United Nations Under-Secretary-General for Management, a position she will take up in July 2017 after eight years with UNAIDS.

    The Board approved UNAIDS’ 2018–2019 core budget of US$ 484 million. Attentive to the critical importance of a well-resourced Joint Programme, Secretariat and Cosponsors, the Board also encouraged donor governments to make multiyear contributions and release their contributions towards the 2016–2021 Unified Budget, Results and Accountability Framework (UBRAF) as soon as possible. The Board also urged UNAIDS to continue expanding its donor base and encourage new donors to make contributions towards the full funding of the 2016–2021 UBRAF.

    During the meeting, important funding announcements to UNAIDS were made by Germany, which pledged to double its contributions to UNAIDS to €5 million in 2017 and 2018, and by Board Chair Ghana who also announced that Ghana would be doubling its contributions to UNAIDS to US$ 200 000, demonstrating Ghana’s commitment to advancing global efforts to end AIDS.

    Ghana also announced that, despite facing persistent challenges, including funding and commodity gaps, it will be adopting the 2015 World Health Organization guidelines to test and offer immediate treatment to all people living with HIV in Ghana as part of efforts to achieve the 90–90–90 targets. Ghana is also stepping up its HIV prevention efforts and has trained more than 150 000 teachers in public schools to integrate HIV education into their lessons and has trained 300 000 children as peer educators across the country.

    The Board dedicated the final day to a thematic session on the urgent need to scale up HIV prevention. Participants shared best practices from around the world, identified gaps and opportunities in HIV prevention programming and funding and looked at ways of expanding services to people at higher risk of HIV through scaling up primary HIV prevention programmes at the national and local levels.

    Representatives of United Nations Member States, international organizations, civil society and nongovernmental organizations attended the three-day meeting, which was chaired by the Minister of Health of Ghana, Kwaku Agyemang-Manu, with the United Kingdom of Great Britain and Northern Ireland serving as Vice-Chair and Japan as Rapporteur. The keynote speech was given by Lorena Castillo de Varela, the First Lady of Panama and UNAIDS Special Ambassador for AIDS in Latin America, who gave a compelling address on her work around Zero Discrimination.

     

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    Aid Eligibility In a Mobile, High-Velocity World. 20/6/2017

    Published by MEGDAVISCONSULTING

    Global-Migration-Patterns

    Wealthy countries need to invest every penny they can to combat global epidemics. Massive inequity in access to health care means that millions of people die each year of preventable, treatable diseases like HIV, TB and malaria. But who should be eligible for global health aid? Not so easy to answer. We’re stuck with some 20th century tools that don’t fit our high-velocity, globalizing world.

    This blog is thinking aloud sparked by online and offline conversations about how donor states “transition” out of middle-income countries without losing ground in the three diseases. While they try to extricate themselves, new health threats loom: heart disease and stroke head the list of global causes of death, over 65 million people were in displacement last year, and climate change is bringing back old viruses long hidden in ice, to name a few.

    Currently, health aid goes to “developing countries”. The World Bank publishes each country’s GNI per capita. The OECD uses this to classify countries as either Least Developed, Lower Middle Income, or Upper Middle Income; usually only the first two of these groups are eligible for aid. (Not all donors blindly follow the OECD list: the Global Fund combines three years of GNIpc with disease burden for their eligibility list). 

    But however you make the list, it’s based on three assumptions:

    • GNIpc tells you something meaningful about what a country can do about health
    • economic development is a rational linear progression that leads to lower infectious disease burden for all, and
    • infectious diseases can be controlled within national boundaries.

    These assumptions have a lot of truth in them, but they aren’t ironclad.

    First, GNIpc is just one number: a reductionist way to sum up a whole economy. It does not tell you about essential things a country needs to fulfill the right to health: infrastructure, technology, refrigeration, health personnel, health insurance, political stability, health of civil society; it just says that a country has money, but not where that money is or how it’s spent.

    Take the United States, a wealthy country that spends more than any other on health care, with the lousiest results. Or Venezuela, an oil-rich country whose health system is crumbling (and whose demands from PLHIV for support sparked controversy at the Global Fund, which struggled with how to respond as Venezuela is not aid-eligible).

    Second, the OECD list implies a rational, linear process of economic development, with countries moving progressively from least developed at one end of the scale to upper middle income on the other (and then right up to heaven, I guess). It’s a model conceived in the 1950-60s, which development economists now roll their eyes at. Economic development is not linear. Economies boom and bust, skip stages, stagnate, collapse and renew. Countries can “graduate” out of eligibility and pop back up as re-eligible a year or two later.

    Third, while sure, some countries eliminate some diseases, in a globalizing world with porous national boundaries, those wins are hard to sustain. Infectious diseases are driven not by national pride, but by an urge to multiply. They love to travel. They cross borders more swiftly than development finance, and with zero bureaucracy. They fly through migrant social networks, or puddle in forgotten corners of a country far from national capitals, straddling borders. They find a happy, thriving breeding ground anyplace where there’s stark inequity. They multiply wildly among people that national governments fail to acknowledge, let alone care for.

    Europe-wide HIV transmission network: a transmission network constructed by means of selected limit values for the evolutionary distance. The nodal color shows the country of origin of the infected patients.

    Euro network model HIV

    Yet somehow, we are stuck with metrics that allocate funds for health to precisely those national governments who fail to care for or dedicate funding to those vulnerable to infectious diseases, and who make decisions in capitals far from where epidemics thrive.

    The SDGs set global targets for all countries and promote mutual accountability. Yet some of the biggest donors to global health are backsliding at home — which thanks to globalization, will make any success they fund in least developed countries a temporary win. Why are we stuck with a neocolonial paradigm in which aid-recipient countries are expected to meet global health targets that donor countries fail to take seriously?

    We need a paradigm for global health aid that aligns with the vision of the Sustainable Development Goals. We have to balance country ownership, with its related emphasis on strengthening national health systems, with the flexibility to tackle dynamic, networked infectious diseases at the community level where outbreaks take fire. One key lesson from Ebola was that where bureaucracy and politics fail, community-led responses can be powerful.

    What’s the solution? Perhaps in addition to national health aid, we could have regional committees that bring together diverse experts, including from affected communities, to use some part of health aid to zoom in on where the epidemics are in real time, and swiftly direct funds to smaller institutions and community-based programs that are based where the outbreak is and can respond across borders.

    It sounds nice; I don’t know if it would work in practice. But our outmoded concepts of national sovereignty just seem clunky today in the mobile, shifting landscape in which HIV, TB and malaria thrive, and in which the SDGs have directed us to start thinking outside the box.

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    UNAIDS Congratulates Jan Beagle as New United Nations Under-Secretary-General for Management. 1/6/2017

    Published by UNAIDS

    United Nations Secretary-General António Guterres has appointed UNAIDS Deputy Executive Director Jan Beagle as the next Under-Secretary-General for Management.

    “Jan Beagle is a leader who gets results for people,” said Michel Sidibé, Executive Director of UNAIDS. “She will deliver on the Secretary-General’s vision for a more effective and strengthened United Nations. Her commitment to leaving no one behind and advocacy for gender parity are matched by her drive to ensure that the United Nations is best placed to serve the people of the world.”

    Ms Beagle was appointed Deputy Executive Director of UNAIDS in 2009. She led UNAIDS’ work in promoting effective governance of the Joint Programme and provided strategic direction to overarching management functions—in the areas of human resources, finance, budget, information technology and administration—enhancing UNAIDS’ capacity to implement its mandate and vision. She has been instrumental in ensuring UNAIDS is best positioned to deliver the Fast-Track agenda to end the AIDS epidemic as part of the Sustainable Development Goals. 

    She has been a member of, and chaired, a number of United Nations system inter-agency bodies, including the Human Resources Network, the High-Level Committee on Management, and the United Nations Development Group Assistant-Secretary-General Advisory Group. Ms Beagle is an International Gender Champion and Co-Chair of the Champions Working Group on Change Management.

    “On a personal note, I will miss you, your good humour and sound advice,” added Mr Sidibé. “Everyone from your UNAIDS family wishes you the best in your new role and we will continue to count on your commitment to ending AIDS.” 

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    Core Epidemiology Slides 2017. 20/7/2017

    Published by UNAIDS

    You can access the resourse here

     

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    Germany—Ready to Lead by Example to End AIDS. 23/5/2017

    Published by UNAIDS

    During a recent visit to Germany, the Executive Director of UNAIDS, Michel Sidibé, met with representatives of the federal government, local government, civil society, communities affected by HIV and the private sector.

    Under the leadership of Chancellor Angela Merkel and the Minister of Health, Hermann Gröhe, Germany has prioritized global health on the international agenda, culminating in the first ever Group of Twenty (G20) Health Ministers Meeting, which took place in Berlin, Germany, on 19 and 20 May.

    Political commitment

    “Ending AIDS is a historic goal and I firmly believe we can reach it. UNAIDS has to maintain its leadership role in the global AIDS response. We have to increase our joint efforts and UNAIDS is central to that work,” said Mr Gröhe. "Health is a prerequisite for social development. This is one of the reasons why Germany made global health a priority under our G20 presidency. With this decision taken by our Federal Chancellor, Angela Merkel, a global health policy is going to be a hallmark of our country’s international responsibility. Only if we cooperate and work together, we can prepare the world for future health crises,” he added.

    During the meeting, Mr Sidibé thanked the government, and particularly the Minister of Health, for their longstanding support to UNAIDS and commitment to the AIDS response. “Putting health on the agenda of the G20 and particularly holding a meeting of the G20 Health Ministers for the very first time is revolutionary,” said Mr Sidibé. “It highlights the shared understanding that quality health care is essential to social and economic stability.” They agreed on the danger of complacency and the potential reversal of gains it could bring.

    Mr Sidibé also met with the Parliamentary State Secretary for the Ministry of Economic Cooperation and Development, Thomas Silberhorn, where he highlighted the critical role of UNAIDS in ending the AIDS epidemic and the impact it would have on the broader Sustainable Development Goals.

    During his visit he also spoke to Bärbel Kofler, Germany’s Commissioner for Human Rights Policy and Humanitarian Aid. She said, “Access to health is a human right.” They discussed the need for continued engagement to break down discrimination and stop exclusion and prejudice, particularly for people who are vulnerable and are being left behind. Mr Sidibé emphasized that fragile communities not only exist in developing countries, but can be found the world over—from Baltimore to Bamako.

    Working together to Fast-Track the AIDS response in Germany

    Taking the engagement to the local level, Mr Sidibé next met with representatives of the city of Berlin, which joined the Fast-Track cities initiative in 2016. He also met the nongovernmental organization Deutsche AIDS-Hilfe, which recently launched a campaign to End AIDS in Germany by 2020, and its local branch, Berliner AIDS Hilfe, as well as the advocacy group Action Against AIDS Germany.

    During the meeting, Mr Sidibé highlighted that city health systems that are inclusive and accessible have the best chance of engaging people who might otherwise be left behind. “Having a strong civil society has made a big difference in the response to HIV,” he said.

    Private sector engagement

    In addressing the international business community on the eve of the B20 Health Conference Mr Sidibé said. “Today’s global health challenges, including emerging pandemics and antimicrobial resistance, threaten not just individual lives, but impact social cohesion and economic development. The private sector can bring unique innovation, technologies and services and needs to be an integral part of a multisectoral response to build resilient, responsible and responsive health systems.”

    As guest of honour, Mr Sidibé congratulated the winners of the newly launched German Global Health Award—the German Healthcare Partnership (GHP), Bio Deutschland and the Voice of German Industry. The initiative exemplifies how the private sector and civil society alike are needed to drive innovation in the health-care sector.

    Roland Göhde, Chairman of the Board at GHP, said, “With the German Global Health Award launched in this year of Germany’s G20 presidency, we would like to underline our strong private sector commitment towards multi- and inter-sectoral partnerships engaged in health system strengthening and universal health coverage. We are partners and committed to making the world a healthier and safer place.”

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    G20 a Catalyst for Ending Infectious Diseases? 20/5/2017

    Published by BROT

    Will the G20 become a catalyst for achieving an end to communicable diseases (SDG 3.3.) and bolstering universal health coverage (SDG3.8)?

    Health is on the G20 agenda for the first time and the German Government as host of the G20 has to be congratulated for putting this important issue on the table. This historic moment starts this weekend with the G20 Health Ministers Meeting in Berlin. Brot für die Welt alongside many other civil society and faith based organizations in Germany and abroad are keen to see ambitious global health commitments in the final G20 Declaration in early July.

    In the area of health as in so many other areas we have seen that what affects people in one part of the world sooner or later affects us all. This is the case not only for fast spreading epidemics but also for antibiotic resistance, and for the more silent epidemics that still cost more than a million lives a year, the epidemics of TB and HIV. We live in one world and we need solutions which make it possible for everyone to enjoy a healthy life, no matter where people live. The Constitution of the World Health Organization of 1948 already sets out this interconnectedness: The achievement of any State in the promotion and protection of health is of value to all. Unequal development in different countries in the promotion of health and control of diseases, especially communicable disease, is a common danger.

    What are the main global health issues?

    We see that antimicrobial resistances, that is resistance against medicines that are used to treat infections caused by bacteria, parasites, fungi and viruses, are on the increase. Many medicines are not working anymore and this has disastrous results. People need to be switched to other medicines but these medicines often do not exist. In the field of TB, the first effective anti-tuberculosis agent was developed in the 1940s. Other TB medicines followed in the 1950s and these medicines remained in place for decades to come. Why? Because there was nothing else available to treat TB. TB patients still need to take a pill cocktail over 6 months and the medicines have side-effects, so it is not surprising that people default on taking the tablets.

    But it is this non-adherence due to the number and side-effects of the tablets that causes multi-drug resistant (MDR) or even extreme drug resistant (XDR)-TB and then the chances of survival diminish to about 50 percent for people taking medicines for MDR-TB and 25 percent for people on medicines to treat XDR-TB. When people get treated for MDR or XDR TB, the pill cocktail is even greater and needs to be taken for 2 years.  Recently a couple of new TB medicines have been developed. The testing of these medicines is done by MSF – an organization that has never been involved in clinical trials before but stepped in so that the new TB medicines can finally fulfill the criteria for registration and become available for people. And we still need more TB medicines with fewer side-effects. One lesson we have learnt from HIV is that in reducing the number of tablets, in combining substances into one tablet, one can improve adherence – this still needs to be realized for TB. And the G20 is affected as much as the rest of the world. For TB alone, the G20 carry 50 percent of the disease burden, for HIV more than a third of the disease burden.

    But it is not just about TB. We have an increasing problem with antibiotics not being effective anymore due to human overuse and misuse. And we have the problem of overuse of antibiotics in animal farming and soils and rivers being polluted with resistant strains of antibiotics. This clearly calls for changes on many levels: for stricter regulations and more control, for better informed patients, for changes in the way animals are kept and reared, for better control of the waste-waters of firms which produce antibiotics. But it also calls for new antibiotics to be developed. Why is this not happening - is the low price of antibiotics an issue? Most of the much-needed medicines have simply not been financially lucrative for the pharmaceutical industry to produce. It is only now that we thankfully see pharma companies also getting involved in developing some vaccines and medicines for neglected tropical diseases as well as for TB. And yet, it is often still not clear how they will become registered or what price they will be sold at. We also need more medicines for anti-fungal resistance, for antimalarial and anti-viral resistance. And we realize that infections that need life-long treatment like HIV will require newer medicines as resistance increases. These medicines need to become available for people at affordable costs. If this is not the case, people will be treated for a number of years and then die because the medicines to continue therapy are either not there or too expensive for countries to purchase and make available.

    New Incentives for Research and Development Needed

    Now is the time that countries need to re-think the incentives for producing needed medicines. It is clear that we need more research and development of new substances for various infectious diseases. The model used for many decades to reward pharma companies for their investment by granting patents and thus monopoly rights is not the solution for medicines which are potentially very cheap, like antibiotics, or for medicines which are primarily for few people in low-income countries like many medicines for neglected tropical diseases or for a disease like TB. But even for HIV and HCV, where medicines exist, monopoly rights are often a hindrance to making newer medicines available at affordable prices for people globally. With hepatitis C (HCV) we have seen that countries in Europe are also struggling to pay astronomical prices for a medicine which was actually very cheap to manufacture. And in the case of HIV we notice that the 3rd line medicines, which people need when resistance has occurred to 1st and 2nd line medicines, are not available in many countries due to their high prices.

    Business as usual is therefore not an option. The G20, as we have seen, are affected themselves and have an obligation to show solidarity with the rest of the world.  Will the G20 Health Ministers and the Heads of State be visionaries and invest in putting an end to all infectious diseases? This would mean putting more money towards one’s own health budget as well as making more money available internationally to end the deadly diseases of TB, malaria and AIDS as well as all neglected tropical diseases and HCV. This would also require putting public money into R&D, perhaps by setting up a global fund for R&D. And it would also mean finding new ways of offering incentives to the pharmaceutical industry, so that the industry invests in research and clinical trials for needed medicines and gets rewarded without the state having to pay several times for the medicines it needs.

    World Health Organisation Needs to be Strengthened

    And the G20 should ensure that there is a strong and independent World Health Organization that gets the majority of its funding from member states with no strings attached so that it can do the work it is meant to do: to ensure the highest attainable level of health for all people, to combat communicable and non-communicable diseases and to ensure the safety of medicines and vaccines, of food, water and air. For this a 10% rise in the contributions of its member states would be an important step to take.

    The G20 at a historic moment

    The G20 can trigger a lasting change in world health and usher in an end to the deadliest diseases by 2030, if they commit to make SDG 3.3 and SDG 3.8 (two sub-goals of the sustainable development goals which the UN passed in 2015) come true:

    3.3: By 2030 end the epidemics of AIDS, tuberculosis, malaria, and neglected tropical diseases and combat hepatitis, water-borne diseases, and other communicable diseases.
    3.8: achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.

     

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    Global Review Panel Encourages UNAIDS to Build on Its Strengths. 1/5/2017

    Published by UNAIDS

    The Global Review Panel on the Future of the UNAIDS Joint Programme Model has issued its final report, Refining and reinforcing the UNAIDS Joint Programme Model, which offers guidance on ways the Joint Programme can step up efforts to deliver more results for people living with and affected by HIV.

    Around 100 participants, representing a wide range of stakeholders, including United Nations Member States, United Nations agencies and civil society, gathered in Geneva, Switzerland, on 28 April to discuss the findings and recommendations of the panel at a global multistakeholder consultation.

    The panel validated the vision and model of UNAIDS, recognizing its irreplaceable value in the AIDS ecosystem and underscored its strong foundation of assets—among them, country presence, political legitimacy and UNAIDS’ role as an international standard-bearer for producing data and evidence that is used to drive decision-making.

    In its report, the panel recommends that UNAIDS should continue to transfer human and financial resources to the countries most affected by the AIDS epidemic. Other recommendations include reconfiguring United Nations country AIDS teams to be more responsive to the specific nature of the HIV epidemic and to improve accountability, including by engaging a range of stakeholders at all levels in monitoring progress on the AIDS response.

    By refining its ways of working, UNAIDS will be better positioned to fulfil its unique mandate of exercising political leadership, providing strategic information and supporting the engagement of countries with other partners, including the Global Fund to Fight AIDS, Tuberculosis and Malaria.

    The report details how UNAIDS could further enhance its support to countries in reaching the ambitious Fast-Track Targets by 2020—reducing new HIV infections to fewer than 500 000, reducing AIDS-related deaths to fewer than 500 000 and eliminating HIV-related stigma and discrimination—which were adopted by United Nations Member States at the United Nations General Assembly High-Level Meeting on Ending AIDS in June 2016. The report also recognizes UNAIDS as a model and pathfinder for progress on the implementation of the 2030 Agenda for Sustainable Development and as an innovative joined-up approach at the cutting-edge of United Nations reform.

    The Global Review Panel, requested by the UNAIDS Programme Coordinating Board, was set up to make recommendations for a sustainable and fit-for-purpose UNAIDS. It focused on three fundamental pillars of the Joint Programme: financing and accountability, joint working and governance. It was co-convened by Helen Clark, Chair of the United Nations Development Group, and Michel Sidibé, UNAIDS Executive Director. The Panel Co-Chairs were Awa Coll-Seck, Health Minister of Senegal, and Lennarth Hjelmåker, Sweden’s Ambassador for Global Health. It undertook an extensive process of consultations with a wide range of stakeholders, including at the global and country levels. A revised operating model of UNAIDS will be presented at the Programme Coordinating Board meeting in June for consideration and approval, which will take into account the recommendations of the Global Review Panel.

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    Many HIV Patients Stay on First Line Longer - TASO study. 25/4/2017

    Published by NEWVISION

    HIV/AIDS investigators from three institutions have found that over 80% patients living with HIV were able to stay on first line for a long time, meaning they were adhering to their antiretroviral (ARV) treatment very well. It I estimated that 1.5 million Ugandans are living with HIV, out of which 700,000 are accessing ARVs.

    The study, which was conducted by The AIDS Support Organization (TASO) in partnership with Uganda Virus Research Institute/ Medical Research Centre (UVRI/UMR) and University of the British Colombia- Canada at TASO clinic in Jinja between January 1, 2004 and March 31, 2014, also indicated that second line treatment was found to be well tolerated.

    The three principal investigators for this study were Dr. Josephine Birungi, a research manager at TASO, Professor Pontiano Kaleebu, the acting director of UVRI, and Dr. David Moore from the University of British Colombia- Canada.

    Dr. Birungi said the epidemic has matured over 30 years and since we started ART in Uganda on large scale in 2004, there was a need to look at these patients who have been on ART for a long time. The first ever study in Uganda codenamed the “Long Term Outcomes on Antiretroviral Therapy (ART) was disseminated last Friday at TASO- Kanyanya and it looked at HIV positive patients who have been on ART for at least four years.

    “A lot may be known for patients who have just started ART, but there are patients who have been on ART for a long time, 10 years or more. Since we started the ART program in Uganda in 2004, we wanted to know how these patients are doing on adherence, whether their viral load  is low or has increased and if they have developed drug resistance,” said Birungi.

    Viral load is the term used to describe the amount of HIV in one’s blood. The more HIV there is in your blood (and therefore the higher your viral load), then the faster your CD4 cell count will fall, and the greater your risk of becoming ill because of HIV.

    Non-adherence increases the risk of viral mutations, which can result in cross-resistance to other medications or transmission of multi resistant virus strains, and thus the risk for initial therapy failure in subsequently infected individuals.

    One of the biggest challenges for people living with HIV/AIDS is taking medication every day. The drugs weaken the body because they are strong and if your immunity is already weak, you can easily give up medication.

    The study had four objectives. One, to know the prevalence of virological failure-how many people living with HIV had a high viral load. But the study found that many had a low viral load which was good. Another was to find out if counseling was effective if it is done to someone who has been on ART for a long time. The investigator found out that counseling was not as effective as they thought.

    The third objective was to know if one is on the first line, for how long he can stay on that line, and the study found that people stay on the first line for a long time. Among those who were on the first line only 3% crossed over to the second line, meaning that they were adhering well to treatment. The fourth objective was to find how people on the second line were fairing, and investigators found that they were doing well on the second line.

    A total of  1091 HIV positive people were recruited into the study and monitored for three years to see among them how many had greater than 1000 copies/ml, meaning they were failing and how many had less than 1000 copies/ml, meaning they were  doing well on treatment.

    Only about 7% of the 7.5% were failing. The Ministry of Health guidelines say that if you do a viral load and find someone with a first high viral load, don’t change them immediately or do not label them failures immediately. First counsel them they could be having a problem with adhering may be they are not swallowing their pills well, the reason the virus is not being suppressed.

    During the study, those people who were failing were counseled for three months. Of the 1091 patients that were screened, 113 (10.3%) had viral load less than 1000 copies/ml of whom 97(86%) were eventually switched to second line. The study showed that there was no observed increase in reported symptoms after switch. In particular, there was no change in reports of diarrhea, a commonly reported side effect of lopinavir and ritonavir.

    The desire of the Ministry of health is that many people keep on the first line because it is cheaper and easier. But as long as your viral load stays higher you will be switched to the second line. High viral load is therefore an indicator for failure. So long as the pills are not working, you are not taking your pills well, not adhering to your medication, your viral load will always go high.

    Birungi says adherence is imperative to guarantee the effectiveness of ART which has led to a substantial reduction in HIV-associated morbidity and mortality and HIV infection has entered the stage of chronic disease management. Lasting suppression of viral replication is the goal of ART and one of the most important factors influencing long-term prognosis of HIV infection.

    Yet adherence is one of the most crucial issues in the clinical management of HIV-infected patients receiving antiretroviral therapy (ART), and is imperative to guarantee the effectiveness of ART.Non-adherence increases the risk of viral mutations, which can result in cross-resistance to other medications or transmission of multi-resistant virus strains, and thus the risk for initial therapy failure in subsequently infected individuals.

    ARVs attack the virus directly and stop it from multiplying in the body. When you take medicine your immune system improves. But when you do not adhere well, especially if the adherence is very poor, your immune system can go back under 100 cells, which health workers call treatment failure.

    The key consequence of none adherence, according to Birungi, is the virus becomes resistant to the drugs. You take the medicine but the virus continues to multiply, which is drug resistance. Also when they change the medicine to the second line and you don’t adhere the second line also becomes resistant. Drug resistance makes the immune system to start falling again.

    When there is virological failure, the virus multiplies and that virus destroys your immune system and you get what we call immunological failure and you start getting opportunistic infections.

    Method

    Investigators conducted a retrospective cohort analysis of all patients less than 18 years who initiated ART at TASO –Jinja between January 1, 2004 and July 31, 2009.

    They identified all clients in community and facility-based ART delivery arms using an electronic clinical monitoring database. The catchment area included participants in villages up to 75 kilometers away from Jinja town.

    Enrollees were expected to attend regular clinic or outreach visits every one-to three months. CD 4 cell count testing was offered every six months.  

     

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    India Takes Flawed First Step Towards Ending HIV and AIDS Prejudice. 13/4/2017

    Published  by THEGUARDIAN

    Landmark law banning discrimination against people with HIV criticised for failing to guarantee treatment and potentially flawed enforcement measures.

    Activists in Agartala, in the Indian state of Tripura, light candles as part of an Aids awareness campaign

    Activists in Agartala, in the Indian state of Tripura, light candles as part of an Aids awareness campaign. A new law is designed to end discrimination against HIV-positive people. 

    A landmark law banning discrimination against people living with HIV in India has sparked criticism, with one lawyer claiming the legislation could turn back the clock on tackling the virus to the mid-1990s.

    India is the first state in south Asia to pass legislation prohibiting discrimination against the country’s 2.1 million HIV-positive people, with jobs, housing, education and hospitals particular areas of focus.

    The HIV and Aids prevention and control bill, passed by Parliament on Tuesday, also bans staff in public places such as restaurants and shops from refusing entry to anyone with HIV or Aids.

    Last year, the UN reported that 1 million people in India are now receiving treatment for HIV. There has been a drop in cases of discrimination in the country’s cities, but hostility towards HIV-positive people remains entrenched in small towns and rural areas, which tend to be more socially conservative.

    Children living with HIV have been thrown out of school, while adults have been sacked from their jobs, refused homes and even denied hospital treatment by doctors who refuse to touch them.

    On Tuesday, the health minister JP Nadda hailed the bill – first mooted 15 years ago – as historic and promised action “against those who create hatred against HIV patients”.

    Steve Kraus, director of UNAids’ regional support team for Asia and the Pacific, said: “This is an important step forward for people living with and affected by HIV in India and around the world.

    “This legislation begins to remove barriers and empowers people to challenge violations of their human rights.”

    However, there has been opposition to a requirement that all state governments must establish an ombudsman to investigate violations of the new law, while a stipulation that the government must provide free treatment “as far as possible” has also met with resistance.

    Anand Grover, senior advocate with the Lawyers Collective, said: “This ‘As far as possible’ is a loophole which will turn the clock back to the mid-1990s. Without the guarantee of treatment, HIV will once again become a death sentence. As for the ombudsman, it is neither a full-time post nor is the person required to have any judicial training.”

    Paul Lhungdim, project coordinator for the Delhi Network of Positive People, questioned where the money would come from to pay for an ombudsman. “Where will the state government, particularly if it is small and financially weak, get the funds to set up and maintain such a post?” he asked.

    “It might just leave the post vacant. We would have preferred this responsibility for the ombudsman to have stayed with New Delhi.”

    Lhungdim added that the caveat on treatment would weaken its impact.

    “This is like opening the door and wondering why the horse bolted. How do we hold anyone accountable with a clause like this? Yes, discrimination is a bad thing but it is likely to continue in some form or another given what society is like. For us, treatment is the absolute priority, so that we can be healthy and live. This clause dilutes the impact of the law,” said Lhungdim.

    Anjali Gopalan, founder of the Naz Foundation (India) Trust, which runs a home in New Delhi for orphans who are HIV-positive, said: “These are significant loopholes. When state governments implement federal laws, they make their own rules and these can easily water down the requirement for an ombudsman. That said, nonetheless, the law is welcome because at least it gives people some recourse, some protection.”

     

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    Reinvigorating The AIDS Response to Catalyse Sustainable Development and United Nations Reform. 7/4/2017

    Published by UN

    Bold global commitments, shared financial responsibility and a people-centred approach based on the principles of equity have yielded shared success in the AIDS response. The 90-90-90 initiative has guided a dramatic expansion of antiretroviral treatment  and  greatly  reduced  AIDS-related  deaths,  while  also  contributing  to  a reduction  in  new  HIV  infections.  A  global  plan  to  eliminate mother-to-child transmission of HIV has more than halved the number of new HIV infections among children. The AIDS response has made an important contribution to the demographic dividend of Africa, its recent economic growth and the emerging vision of Africa as a continent of hope, promise and vast potential.

    Global optimism has fuelled the highest ambition within the 2030 Agenda for Sustainable Development: ending the AIDS epidemic by 2030. A fast-track response to reach this target has been agreed by the United Nations General Assembly within the 2016 Political Declaration on HIV and AIDS: On the Fast Track to Accelerating the  Fight  against  HIV  and  to  Ending  the AIDS  Epidemic  by  2030. Achieving  our aims  on AIDS  is  interlinked with  and  embedded  within  the broader  2030 Agenda: both are grounded in equity, human rights and a promise to leave no one behind.

    During my first months as Secretary-General, I have called on the international system to get back to basics: to put greater focus on building more resilient societies by putting respect for human rights at the centre of national and international policy, by reducing disenfranchisement and marginalization and by empowering women and girls. I have also called on the United Nations development system to increase the pace  of  reform —to  become  more  nimble,  efficient  and  effective.  The  AIDS response  is  a  bellwether  for  both  agendas:  sustainable  development  and United Nations reform.

    You can access the report here

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    Global Review Panel Report on the Multi Stakeholder Virtual Consultation. 15/2/2017

    Published by UNAIDS

    The Global Review Panel on the future of the UNAIDS Joint Programme model is tasked with formulating recommendations on how to make UNAIDS sustainable and fit-for-purpose. It focuses on refining and reinforcing 'how' UNAIDS works so it ca better support countries to achieve their global commitments and end AIDS. The Panel Co-Chairs held a virtual stakeholder consultation between 30 Jannuary and 15 February to engage as many stakeholders as possible in the Global Review Panel's work. The consultation was open to everyone, invoting participants to respond to questions on fundamental pillars of the Joint Programme, along with space for general discussion. The consultation received over 400 comments, in six languages and from every UNAIDS region.

    You can acces the report here

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    Strong Science, Bold Activism. Making 2017 a Year of Action. Annual Letter 2017. 2/2017

    Published by IASOCIETY

    Dear IAS Members and Partners

    As 2017 begins, our community is anxious and concerned. Political and societal changes continue to upend our expectations and generate uncertainty about what is ahead of us. We worry about human rights, the plight of refugees and migrants, progress towards gender equality, and the strength of our commitment to each other as human beings.

    Deeply wrapped up in all of this is our fight against HIV – a disease that has shown itself adept at exploiting the very changes that seem to be dominating our world.

    As corners of the planet shift towards nationalism and xenophobia, we wonder where the future of our global cause lies. Is the progress we have made against the greatest pandemic of our time slipping through our hands?

    No, it’s not – at least not yet.

    In the midst of this anxiety and uncertainty, we’ve seen action and defiance against rolling back hard-won gains. The millions of people who participated in Women’s Marches around the world in January are proof that apathy doesn’t rule, that a collective determination is there to resist a new world order that demonizes and isolates those in need.

    Our movement has shown that we know how to make history, not merely observe or survive it. That is our strength. We are not history’s passengers. We are its conductors.

    And let’s remember: 2016 was a remarkable year for our work. In those 12 months: The Global Fund to Fight AIDS, Tuberculosis and Malaria was replenished; the world demonstrated its political commitment at all levels to fight AIDS at the United Nations General Assembly High-Level Meeting on Ending AIDS; and we returned to Durban for the 21st International AIDS Conference (AIDS 2016) for a, yet again, historic meeting on HIV and AIDS.

    Continued progress can be seen across our work – in the development of long-acting antiretrovirals; the launch of the first large-scale HIV vaccine trial in southern Africa in nearly 10 years; the more than 18 million people receiving HIV treatment; and growing momentum for the scale-up of HIV self-testing, spurred in part by the World Health Organization’s (WHO) recommendation.

    The return to Durban reunited and rejuvenated the AIDS community, reminding us how far we have come from the birth of the treatment access movement in 2000. AIDS 2016 sparked a revitalized union between science and activism led by a new generation of leaders as demonstrated by one of the largest youth participation levels ever seen at an AIDS conference.

    But Durban was also a wake-up call. UNAIDS released an alarming report detailing how our prevention efforts have faltered1. And a separate report on funding trends gave rise to genuine fears that international donors are moving on from AIDS2. These signs of trouble came only weeks after the global community wavered in its commitment to address the needs of key populations at the UN High-Level Meeting.

    If 2016 served as a wake-up call from complacency and premature congratulations, 2017 must be the year when the AIDS community confronts our challenges and renews our determination to grasp the historic opportunities that scientific research and community leadership have given us.

    This must also be the year we truly join arms with our colleagues in other disciplines. We must align our cause with the TB community as it prepares for the first-ever High-Level Meeting on TB at the United Nations; with the sexual and reproductive health and rights community as it grapples with the reinstatement of the Global Gag Rule; with the hepatitis community as it works to increase access to affordable medicines and reduce mortality to preventable illness; and the cancer community as we together look for a cure to end HIV and cancer in our lifetimes. Finally, we must all as one global health community work to solidify and entrench human rights and social justice in the pursuit of health.

    In July this year, we reconvene for the 9th IAS Conference on HIV Science (IAS 2017) in Paris, the home of some of the most important breakthroughs in HIV science. The meeting offers a critical opportunity for our community to resist a world turning inward, and to demand that at this pivotal moment – when we can actually see the light at the end of the tunnel – we must keep faith with the tens of millions of people living with and affected by HIV.

    I hope to see you there.

    You can access this report here

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    CROI Shows the Importance of 90–90–90. 21/2/2017

    Published by UNAIDS

    A number of important updates were announced at the annual Conference on Retroviruses and Opportunistic Infections (CROI) that have shown the importance of, and ways to achieve, the 90–90–90 targets, whereby, by 2020, 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads.

    Held in Seattle, United States of America, from 13 to 16 February, CROI, the foremost annual scientific research conference on HIV, brought together around 4000 scientists, researchers, clinicians, students and others working in the response to HIV and related diseases.

    A way of helping to meet the first 90—90% of people living with HIV knowing their HIV status—is the scale-up of self-testing. The STAR project, a four-year programme to build up HIV self-testing, has now distributed around 200 000 self-testing kits in Malawi, Zambia and Zimbabwe and is showing promising results. The project found that self-testing is a good way of reaching people who had previously not been reached before. Research is ongoing into the different ways the kits could be distributed—community-based distribution, pharmacy support, etc. With around 19 million people living with HIV not knowing that they have the virus, HIV self-testing could be a vital step towards ensuring that all who need HIV treatment have access to it.

    The announcement of several promising new medicines in the pipeline may help to meet the second 90—90% of people who know their HIV-positive status are accessing treatment. A range of new single-dose, effective medicines, including new classes of medicine, new examples of existing classes and long-acting preparations that are produced by different manufacturers, will help to increase competition and hence access. Having new medicines will also be good news in the event of the development of resistance to current medicines in the future.

    The importance of the third 90, viral suppression, and of a combination prevention approach to HIV was shown in a study in Rakai, Uganda. Studies of more than 33 000 people from 1999 to 2016 showed that an increase in antiretroviral therapy and hence viral suppression, scale-up of voluntary medical male circumcision and delayed sexual debut contributed to a 42% reduction in HIV incidence.

    Also important for viral suppression is keeping people on treatment. The SWORD-1 and SWORD-2 studies show that a two-medicine regimen is as good as the current three-medicine approach. By reducing the amount of medicines that people living with HIV need to take, side-effects are reduced and adherence improves. Since antiretroviral therapy is taken for life, a simplification in treatment could benefit millions of people. 

     

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    Laws Discriminating Against People with HIV Challenged in New Bill. 6/2/2017

    Published by SFWEEKLY

    The "draconian" laws disproportionately affect women and people of color, who account for the majority of the criminal convictions.

    Senator Scott Wiener and Assemblymember Todd Gloria announced the introduction of a new bill on Monday that would update the state’s antiquated decades-old HIV discrimination laws. 

    Many of the laws were drafted in the 1980s during the peak of the HIV scare, when a diagnosis was equivalent to a death sentence. There were no effective treatments for HIV and misinformation was rampant. During this time several laws were passed which would offer more serious consequences to those who were HIV positive than those who were not. 

    Of the more than 800 HIV-positive people who came into contact with the criminal system under these laws in the past three decades, 95 percent were convicted under the felony solicitation law. Normally a misdemeanor solicitation, the charge would be ramped up to a felony for those who were HIV-positive. The law was wide sweeping and didn’t require a sexual act to be enforced. With this flaw, it was possible for someone to be charged with a felony simply for talking to or engaging money with a potential client. “Activities where there’s no physical contact whatsoever still mean you can be guilty of a felony and go to state prison just because you are HIV-positive,” said Wiener. 

    The bills have not been adapted to accommodate modern medical technology and advancements, meaning someone could be convicted of felony solicitation even if they are on a medicine that prevents transmission, always use condoms, or work exclusively with HIV-positive clients.

    At a press conference announcing the bill, Wiener credited Rick Zbur, the Executive Director of Equality California, for inspiring him to draft the legislation. 

    “Rick came to me even before I won the election, and asked that if things worked out for my campaign if I’d carry this bill, and I immediately said yes,” Wiener stated. Two months into his role as Senator, SB-239—the HIV Criminalization Law—was introduced.

    Under SB-239, all felony charges for solicitation would be lowered to a misdemeanor. A law requiring those who have been caught soliciting for the first time to be tested for AIDS and undergo an AIDS education program, would be repealed. 

    Assemblymember David Chiu, District 8 Supervisor Jeff Sheehy, Senator Scott Wiener, and Assemblymember Todd Gloria at a press conference.

     

    The bill is co-sponsored by Gloria, who represents San Diego. “This new bill is once again proving that California is a leader,” Gloria said Monday. “Not just in the context of HIV/AIDS, but with healthcare, criminal justice reform and on building a just society built around the concept of basic fairness. We will make sure that Sacramento cares about this issue.”

    Also present at Monday’s press conference were several people who worked specifically with the most criminalized group of HIV-positive people: Women. According to Naina Khanna, Executive Director of the Positive Women’s Network, women represent only 13 percent of HIV-positive people in the state, but account for 43 percent of the criminal justice interactions that occur because of their status.

     Dr. Edward Machtinger, the Director of Women’s HIV Program at UCSF, spoke about how these laws nurture stigma around one’s HIV status, making it harder to keep the disease under control, as people are too scared to out themselves and seek treatment.”These laws don’t work for their intended purpose,” he stated. “Instead they actually increase the chance of HIV infection in our communities.” 

    This stigma shows up in treatment centers every day. Machtinger says that in his clinic alone, 50 percent of his patients report depression, 40 percent are dependent on hard drugs to cope, and “far too many” are dying from suicide and overdose in association with an illness that can be completely preventable and treatable. 

    “Since these laws were enacted we have created simple, potent HIV medication that is so effective that it can make the virus completely undetectable in a person’s blood,” Machtinger said. “This allows the person to be completely uncontagious. This fact has been confirmed by two very large international study with thousands of participants, in which there was not a single transmission.” 

    Wiener’s successor as Supervisor to District 8, Jeff Sheehy, spoke openly about his HIV-positive status at Monday’s press conference. “You have someone who is HIV-positive like me, where their disease is completely suppressed, who can have sex with someone who is on PreP, and the risk of transmission is zero. Yet according to the way this law is written, the HIV-positive person would be liable for prosecution. This law should never have been written in the first place, it’s absolutely terrible public health.” 

    The bill has a strong backing for its next step in Sacramento: Los Angeles LGBT Center, the Los Angeles HIV Law and Policy Project, the Transgender Law Center, Mexican American Legal Defense and Education Fund, the Free Speech Coalition, Sex Workers Outreach Project and Erotic Service Providers’ Legal, Education, and Research Project all support this change to the state’s current law. 

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    China Issues Five-Year Plan on AIDS Prevention. 5/2/2017

    Published by ENGLISH.GOV

    The State Council has released a plan for AIDS prevention and treatment to be implemented during the 13th Five-Year Plan period, aimed at deepening healthcare reform and safeguarding people’s health.

    The main objective of the plan is to promote proper prevention and treatment services, as well as implement more measures regarding prevention of needle sharing, illegal blood transfusions and mother-to-child transmission, in an effort to minimize the fatality rate and improve patients’ quality of life.

    The plan involves several major tasks, such as increasing AIDS prevention awareness to over 85 percent of residents and using education to reduce AIDS-related homosexual behavior by at least 10 percent.

    To achieve these goals, related departments are required to promote targeted education to increase public awareness of AIDS prevention, improve the effectiveness of intervention on transmission through sexual behaviors and drug injections, enhance the regulation on blood testing and follow-up services, fully apply the nucleic acid test to prevent mother-to-child transmission while delivering proper medical assistance and stimulating more efforts from society.

    Publicity campaigns and education for key groups, such as the migrant population, teenagers, the elderly, overseas workers and people in detention, are underlined to improve their self-protection.

    Efforts are also called for to crackdown on illegal activities that are closely related to the transmission of AIDS, including prostitution, drug abuse and drug trafficking.

     

    To better prevent blood transmission of AIDS, related departments are asked to establish a long-term mechanism for blood donation and crack down on illegal blood sales while enhancing the prevention of mother-to-child transmission in remote and minority group regions.

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    The Global Fund to Fight AIDS, Tuberculosis and Malaria. 26/1/2017

    Published by THEGLOBALFUND

    Latest results show that programs supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria have achieved significant increases in the number of people receiving treatment for HIV, diagnosis and treatment for TB and having an insecticide treated net to prevent malaria. The new results, highlighting cumulative progress by pro- grams supported by the Global Fund since 2002, show that the number of people currently on antiretroviral therapy increased 8.5 percent to 10 million. New smear-positive TB cases detected and treated rose by 9.4 percent to more than 16.6 million. Over 713 million insecticide treated nets were distributed to help families protect themselves from malaria, an increase of 8.1 percent. The results are based on data from the first half of 2016. 

    You can access the resource here

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    Review Panel Meets to Strengthen UNAIDS Model. 24/1/2017

    Published by UNAIDS

    A special panel has begun deliberations on how to strengthen UNAIDS’ unique model and further align it to international efforts to achieve the 2030 Agenda for Sustainable Development.

    The Global Review Panel on the Future of the UNAIDS Joint Programme Model includes representatives of United Nations Member States, key populations affected by HIV, United Nations agencies and other multilateral organizations and private foundations. Established by the UNAIDS Programme Coordinating Board, the panel is co-convened by Helen Clark, Chair of the United Nations Development Group, and UNAIDS Executive Director Michel Sidibé and co-chaired by Awa Coll-Seck, Health Minister of Senegal, and Lennarth Hjelmåker, Sweden’s Ambassador for Global Health.

    At the first meeting of the panel, held on 20 January in Geneva, Switzerland, Ms Clark called on the panel to ensure that UNAIDS remains at the forefront of United Nations reform, while Mr Sidibé challenged panel members to develop bold ideas for the future of the Joint Programme.

    Mr Hjelmåker praised UNAIDS for its leadership, advocacy and catalytic role within the global response to HIV. He also highlighted that key aspects of the Joint Programme need to be refined and reinforced to ensure that joint United Nations efforts on AIDS are fully integrated within the broader health agenda and the Sustainable Development Goals.

    During the meeting, panel members achieved consensus on key issues to be addressed within three fundamental pillars of the Joint Programme: joint working, governance, and financing and accountability. Moving forward, these issues will be further discussed in February within a public virtual consultation. The panel will meet again in March to consider the results of the public consultation and agree on a set of recommendations. 

    Quotes

    “The Joint Programme is unique. We have been able to demonstrate that we can mobilize diverse partnerships, engage in different forms of governance, deliver results and ensure people are not left behind. We need to retain these fundamental elements while introducing innovations that will accelerate the AIDS response.”

    Michel Sidibé Executive Director, UNAIDS, Global Review Panel on the Future of the UNAIDS Joint Programme Model Co-Convener

    "Having accompanied UNAIDS on its journey for two decades, I can say confidently that it has many strengths that are extremely relevant to current efforts around United Nations reform. But even UNAIDS must adapt to the current environment. We are tasked with identifying key challenges and making recommendations that will generate real change and that are feasible to implement.”

    Lennarth Hjelmåker Special Ambassador for Global Health, Sweden, Global Review Panel on the Future of the UNAIDS Joint Programme Model Co-Chair

    “UNAIDS continues to be heralded as an innovative good practice 20 years later. Its efforts to include civil society, key population communities and those most affected by HIV showcase how the Joint Programme values a responsive approach towards addressing the epidemic, and accountability to those most affected. This must continue.”

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    TAG Statement for the Record in Opposition to the Nomination of Tom Price for HHS Secretary. 24/1/2017

    Published by THEBODY

    Treatment Action Group (TAG) releases this statement in strong opposition to the nomination of Representative Tom Price (R-GA) for Secretary of Health and Human Services (HHS). We urge critical community action and implore the Senate Finance Committee to challenge his nomination to helm an agency that plays an exceedingly important and complex role in ending the HIV, tuberculosis (TB) and hepatitis C (HCV) epidemics in the United States and ultimately around the world.

    Tom Price's questionable fitness to head a multi-agency cabinet-level department charged with the health of U.S. residents can simply be ascertained from his own record as a Congressional representative to parts of Atlanta's northern suburbs -- a district and metro area with extremely high rates of HIV and a flourishing opioid epidemic. Despite the abundance of epidemiological data illustrating the impact of the HIV epidemic in his own district and in the Southeastern United States, Rep. Price has spent the last eight years undermining efforts aimed at providing health care and social services to communities both living with, and vulnerable to, HIV and other health conditions. These actions include voting to repeal the Affordable Care Act (ACA) multiple times, pushing for the privatization Medicare, threatening to cap and block-grant Medicaid, supporting to defund Planned Parenthood, pledging cuts to social service and safety net programs -- all while demonstrating a hostile voting record on lesbian, gay, bisexual, transgender and queer (LGBTQ) issues. Throughout the recent hearing before the Senate Committee on Health, Education, Labor and Pensions (HELP), Price made several indications to continue a trend to dismantling existing systems, without details of a replacement that sustains access to health care and social services.

    At a time when we are at the forefront of new science to deliver better antiretroviral therapies for HIV, breakthroughs in cures for HCV, and pathways for making TB treatments shorter and more tolerable, the nomination of Tom Price threatens to impede the progress of both research and implementation. Upon confirmation, Tom Price will, as promised, oversee the dismantling and overhaul of health care systems that are responsible for delivering many of these medical advances to people in the United States, particularly those communities impacted by health, social and economic disparities as well as stigma.

    Before the ACA, hundreds of people every year were waitlisted for the AIDS Drug Assistance Program (ADAP). People living with HIV (PLHIV) would need an AIDS diagnosis to be eligible for Medicaid. Pre-existing conditions would also disqualify many PLHIV from gaining insurance. While the ACA is not perfect, thousands of PLHIV have been transitioned onto insurance through marketplaces and have become eligible for Medicaid benefits. This has provided many with access to comprehensive health care for the first time, with profound effects on public health and prevention outcomes. Much of the success we're seeing in increasing viral suppression rates and reducing the number of diagnoses annually will be put in jeopardy if the ACA is repealed without replacement. Without replacement and stewardship by the incoming Secretary of Health and Human Services, access to treatment, prevention and other services will remain out of reach for many of these communities.

     

    HHS is not just the department that oversees our health care system, but also governs our public health, research, and regulatory agencies, such as the Centers for Disease Control and Prevention (CDC), Indian Health Services (IHS), National Institutes of Health (NIH), and the Food & Drug Administration (FDA). The recent revelation of ethics violations and refusal to clearly answer questions on these issues during the Senate HELP hearing clouds any trust in Price to ensure the sanctity and impartiality of these agencies. Trust in HHS leadership is needed in prioritizing pressing public health challenges, ensuring drug and device safety, and countering emerging threats such as Zika, Ebola, drug-resistant TB and antimicrobial resistance through robust R&D, proactive epidemiology, pharmacovigilance, and accelerated research and response.

    Price's worrisome background as a member of the American Academy of Physicians & Surgeons -- an organization that promotes and endorses the theory that HIV does not cause AIDS, despite a substantial evidence base to the contrary -- puts into question his capabilities to end an epidemic. Health conditions like HIV thrive on stigma. Yet Price has only perpetuated stigma and marginalized vulnerable communities by voting against bills that afford protections to the LGBTQ community. With attention needed for other neglected populations, such as prisoners impacted by HIV and HCV, it becomes less likely under a Price-led HHS that key populations will be able to access health care and treatment.

    Now more than ever, ending the epidemics of HIV, TB and HCV requires a combination of bipartisan federal and state leadership, evidence-based policies, and adequate resources in proper alignment to deliver the promise of biomedical and public health advances. Efforts to lower drug prices for HIV and HCV while sustaining U.S. leadership in R&D for TB and other neglected diseases remain inevitable challenges to the successor of HHS and the Trump administration. Tom Price, however, remains a concerning and unqualified candidate to lead HHS given a track record that only marginalizes communities, raises questions on his ethics and integrity to run an expansive $1 trillion department, and putting forth policy proposals that seek to fast-track the loss of lifesaving health care for 18 million Americans. Ending the epidemics remains impossible by destroying access to health care and treatment. With Price's support of the repeal of ACA and efforts to defund Medicaid, the hopes and vision of providing health care -- including ending the HIV epidemic, curbing HCV transmission, eliminating TB -- among the poorest, sickest, most disenfranchised, most vulnerable Americans will vanish. 

     

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    Experts Warn about Social Care ‘Timebomb’ from Ageing HIV-Positive Population. 19/1/2017

    Published by PINKNEWS

    George and Chris are both living with HIV (Photos: Natasha Valentino/J. McGill Winston/Terrence Higgins Trust)

    George and Chris are both living with HIV 

    A report on the first generation of people growing old with HIV has warned they are facing poverty, loneliness and discrimination.

    The groundbreaking ‘Uncharted Territory’ report, released today by HIV and sexual health charity Terrence Higgins Trust, looked at issues facing over-50s living with HIV, who now account for 1 in 3 HIV-positive people in the UK.

    The charity warned of a social care ‘timebomb’ ahead due to the scale of challenges faced.

    Nearly 6 out of 10 (58%) of people 50 and over living with HIV who were surveyed are living in poverty – double that seen in the general population. Meanwhile 84% of respondents were concerned about future financial plans.

    The survey of over 240 older people living with HIV also showed that 82% experienced moderate to high levels of loneliness – three times more than the general population of the same age.

    A quarter of respondents said they would have no one to help them if they ever needed support with daily tasks.

    Eight out of ten (82%) of people living with HIV aged over 50 are concerned about whether they will be able to access adequate social care in the future.

    Ian Green, Chief Executive of Terrence Higgins Trust, said: “Advances in HIV treatment mean that people with HIV are living longer and we are now seeing the first generation of people growing old living with HIV. This is good news – but it also means we’re entering uncharted territory.

    “Many of these individuals were diagnosed when HIV was considered fatal and never expected to live beyond a couple of years – as a result, they’re less likely to have savings or pensions, and many have become socially isolated. And since then thousands more have been diagnosed with the highly stigmatised condition.

    “These statistics should be a wake-up call to governments. People aged 50 and over are now the fastest growing group of people living with HIV, and new diagnoses in older people continue to rise. The issues they face can no longer be ignored, as the challenges of poverty, loneliness and social care grow more acute.

    “As it stands, our welfare, health and social care systems are simply not ready for this and we could see a timebomb in the years to come. We must ensure our GPs, our care homes and our communities are ready to support people with HIV to live well in later life, while facing the uncertainty of what lies ahead.”

    One in three people seen for HIV care in 2015 were aged 50 and over, compared to one in five in 2011. New diagnoses among older people have nearly doubled in the last decade.

    He added: “We’ve heard stories of how older people with HIV searching for care homes have been turned away or treated in a way that reflects outdated awareness of HIV.

    “One lady living with HIV in a care home was encouraged to spend as much time as possible in her room to avoid contact with other residents. When she did leave her room she was only allowed to sit on one chair and the television remote was wiped down with antibacterial wipes after she’d used it.

    “This is shocking. A major shift in awareness and training for social care staff and support services on HIV and ageing is needed, to ensure they have the skills and knowledge to support the increasing numbers of people growing older with HIV.”

    Darren Ardron, 51 year old from Salford who was diagnosed with HIV in 2008, said he had experienced a lot of stigma from medical professionals.

    He said: “As people grow older with HIV, including me, they’re going to have other medical needs, and we haven’t had to deal with that before. I don’t think the health and social care systems really are prepared for this.

    “One thing that concerns me about getting older is forgetting to take my tablets that are keeping me healthy. I know from my volunteer work that there are other older people that are reluctant to leave their house because they fear stigma and discrimination – they will simply go to the hospital or clinic and back again. They’re on their own a lot and are lonely and isolated.”

    Kevin Burgess, 65, said: “I was diagnosed with HIV in 1991, before any treatment was available. People were told they had just a couple of years to live, so they spent their money at the time, thinking they didn’t have a future.

    “Nobody realised we would still be alive today, so there’s been no consideration for us. Here we are 20 odd years later and we’re not prepared, and the leftover attitudes from the 1980s are very much still around.

    “Going into a care home is a big fear for me. I used to live in sheltered housing and I couldn’t be open about my HIV status there, so I know what it’s like to have to lead a different life in your home. I wouldn’t want to have to do that again.”

    Mark Budden, 56, who was diagnosed with HIV in 1997, said: “Living with HIV is like coming out of the closet again and again. Every time you disclose your HIV status to someone, you know to expect all the myths and you have to go into a long explanation about the facts.

    “I’m gay, I’m a Christian, I’m getting older, and I’m living with HIV. These are integral parts of who I am, but none of these labels alone defines me.

    “You just assume you’ll be looked after in old age in this country. It’s only when you have an elderly or ill relative that you realise that social care is not a given, you need to have savings as the government alone won’t look after you. If you’re isolated or financially struggling, as many people with HIV are, that is going to be a lot harder.”

    George Rodgers, 56 years old, living with HIV since 1994, said: “Growing older with HIV, you wonder what’s going to happen long term? You can feel left on your own. Those of us who are living with HIV long term are having more health problems it seems.

    “No-one actually knows how HIV interacts with other things. I’ve got diabetes as well as HIV and sometimes it’s hard to tell the difference between what symptoms are linked to what.”

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    90–90–90 - An Ambitious Treatment Target To Help End The AIDS Epidemic. 1/1/2017

    Published by UNAIDS

    By 2020, 90% of all people living with HIV will know their HIV status. By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy. By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression. 

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