On World AIDS Day, mayors meet in Paris as UNAIDS releases a new report on the huge potential of fast-tracking the AIDS response in cities
PARIS/GENEVA, 1 December 2014—On World AIDS Day 2014, mayors from around the world came together in Paris, France, to sign a declaration to end the AIDS epidemic in their cities. In signing the 2014 Paris Declaration, the mayors commit to putting cities on the Fast-Track to ending the AIDS epidemic through a set of commitments. Those commitments include achieving the UNAIDS 90–90–90 targets, which will result in 90% of people living with HIV knowing their HIV status, 90% of people who know their HIV-positive status on antiretroviral treatment and 90% of people on treatment with suppressed viral loads, keeping them healthy and reducing the risk of HIV transmission.
“Ending the AIDS epidemic is achievable if the world’s major cities act immediately and decisively to fast-track their AIDS responses by 2020,” said Michel Sidibé, Executive Director of UNAIDS. “A Fast-Track AIDS response in cities will also encourage new, cutting-edge service delivery programmes that can pave the way for cities to address other public health challenges, including tuberculosis, sexual and reproductive health, maternal and child health, gender-based violence and noncommunicable diseases.”
At the World AIDS Day event in Paris, hosted by the Mayor of Paris, Anne Hidalgo, the mayors joined the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat) and the International Association of Providers of AIDS Care (IAPAC) in signing the Paris Declaration. “Cities all over the world are key players that can fast-track the response in order to ultimately end the AIDS epidemic,” said Anne Hidalgo, Mayor of Paris. “Our duty is above all a human one. As elected representatives, our choice is to demonstrate solidarity. In Paris, we are determined to take our responsibilities and to live up to our commitments.”
The meeting is taking place 20 years after the Paris AIDS Summit, at which world leaders and communities agreed to a set of principles for the greater involvement of people living with HIV. Known as the GIPA principles, the historic commitment continues to guide the global AIDS response today.
During the event, UNAIDS released a report on HIV in cities, which outlines the important role that urban areas will play in ending the AIDS epidemic by 2030. The OUTLOOK: cities report shows how cities and urban areas are particularly affected by HIV, with the 200 cities most affected by the epidemic estimated to account for more than a quarter of the 35 million people living with HIV around the world. In many countries, cities are home to more than half of all people living with HIV across the country. In sub-Saharan Africa, 45% of people living with HIV reside in cities.
According to the report, more than half the world’s population lives in cities, with the proportion set to expand to 60% by 2050. The vast majority of megacities, defined as having populations of more than 10 million people, will be in low- and middle-income countries. Fast-tracking HIV responses in cities—without neglecting efforts in rural and other areas—will therefore be crucial to ending the AIDS epidemic.
The 2014 Paris Declaration includes commitments to focus on the communities most affected by HIV, to mobilize resources for the better integration of public health and development, to build and accelerate urban HIV strategies and to use the AIDS response as a catalyst for positive social transformation.
“Cities provide ready, flexible and creative platforms that can contribute to ending the AIDS epidemic in a pragmatic, balanced and efficient way,” said Joan Clos, Executive Director of UN-Habitat. “Cities can act as the fora where the linkages, trust, respect and inclusiveness that are part of any sustainable solution can be built.”
The Cities report shares the city photography of renowned photographer Richard Silver. It also features testimonies from community activists, health workers and public officials who have been at the forefront of the AIDS response in the world’s cities. Their stories show how the same urban centres that have been most affected by HIV from the beginning of the epidemic are now uniquely positioned to end the AIDS epidemic. It also highlights the importance of ensuring that people who are marginalized and often stigmatized—including sex workers, people who inject drugs and men who have sex with men—have access to HIV prevention and treatment services.
Tackling poverty and inequality will also be essential. Globally, an estimated 1 billion people live in poverty, with access to only a few services. Poverty and inequality are further tested by multiple health challenges, including HIV and related diseases, such as tuberculosis, the leading cause of death among people living with HIV.
“We must seize this moment of unprecedented scientific opportunity to rapidly reduce the number of new HIV infections and end AIDS-related deaths, without ignoring significant barriers to achieving the 90–90–90 targets in cities, including stigma and discrimination,” said José M. Zuniga, President/CEO of IAPAC. “Achieving these targets requires thinking globally and acting locally, leveraging existing city programmes and resources and implementing locally relevant, locally tailored and locally led interventions to address HIV prevention, testing and treatment gaps.”
Ending the AIDS epidemic in the world’s cities will require leaders who can inspire and harness the compassion and generosity of ordinary urban citizens in order to bring about lasting change. It will depend upon energized communities accelerating and sharpening the focus of local AIDS responses and sharing best practices across urban centres.
In addition to the 90–90–90 targets, UNAIDS also calls for reducing the annual number of new adult HIV infections by more than 75%, to 500 000 in 2020, and achieving zero discrimination. UNAIDS estimates that reaching the 90–90–90 Fast-Track Targets will prevent almost 28 million new HIV infections and 21 million deaths by 2030.
Mairie de Paris
Paris, the capital of the French Republic, has been committed to the AIDS response for more than 30 years through its associations, doctors, hospitals and political leaders. Paris also provides € 2 million each year in funding for international assistance for HIV, particularly in sub-Saharan Africa. For more information go to paris.fr/english
UNAIDS
The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners to maximize results for the AIDS response. Learn more at unaids.org and connect with us on Facebook and Twitter.
UN-Habitat
UN-Habitat is the United Nations agency working on sustainable urban development with the mandate of promoting adequate housing and improved livelihoods by harnessing the opportunities that urbanization offers. For more information visit unhabitat.org
IAPAC
The International Association of Providers of AIDS Care (IAPAC) represents more than 20 000 clinicians and allied health care professionals in over 150 countries. Its mission is to improve the quality of HIV prevention, care, treatment, and support services provided to men, women, and children affected by and living with HIV and comorbid conditions such as tuberculosis and viral hepatitis. Visit www.iapac.org for more information about IAPAC, the Fast-Track Cities Initiative, and/or its other global activities.
