The Chinese news agency Xinhua and UNAIDS have renewed their partnership for the AIDS response through a two-year extension of their memorandum of understanding. The agreement was signed during a meeting between UNAIDS Executive Director Michel Sidibé and Xinhua’s President Cai Mingzhao at UNAIDS headquarters in Geneva, Switzerland, on 18 March.

Mr Sidibé thanked Xinhua for its support of UNAIDS and highlighted the importance of strong public-private partnerships to reach millions of people with life-saving information.

Working together is key, said Mr Cai, who reiterated Xinhua’s commitment to raising awareness and advocating around key issues related to ending the AIDS epidemic in China and globally. 

The UNAIDS–Xinhua memorandum of understanding was first signed in September 2011. Efforts carried out during the past years include global media campaigns to promote public awareness of HIV and support for World AIDS Day activities. The current agreement includes showcasing UNAIDS during the United Nations General Assembly High-Level Meeting on Ending AIDS in June on a giant electronic screen in Times Square, New York, United States of America. In addition, Xinhua will work with UNAIDS to publish and distribute a children’s book in China.

Xinhua is the world’s largest news agency, with more than 170 offices overseas and 31 domestic bureaus.

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On 15 February, on the margins of the 66th Berlin International Film Festival, UNAIDS launched the ProTest HIV campaign.

The event was held to raise HIV awareness among young people in Berlin and to engage them in the response to HIV through #ProTESTHIV and #GenEndit. It attracted young people from across Germany to engage with representatives of the German Government and the German AIDS organization AIDS Hilfe and with Kweku Mandela, AIDS activist and grandson of Nelson Mandela. The participants listened to the moving testimony of Bjorn Beck, the community representative of people living with HIV on the board of AIDS Hilfe, who not only inspired the audience but also reminded everyone why it is essential to keep younger generations engaged in the AIDS response.

The world has committed to ending the AIDS epidemic as a public health threat by 2030 as part of the Sustainable Development Goals. Almost 37 million people around the world were living with HIV in 2014—half of whom did not know that they are HIV-positive.

HIV testing is key to preventing and treating HIV. UNAIDS is working with young people to ensure they have the right information and access to HIV testing, prevention and treatment services. By raising awareness through the ProTest HIV campaign, UNAIDS is empowering young people take action and make informed decisions.

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Embrace diversity, understand and respect our differences, support one another

GENEVA, 25 February 2016—On 1 March, people around the world will be joining together to celebrate Zero Discrimination Day. This year’s theme is Stand Out and encourages everyone to stand for fair and just societies.

Discrimination remains widespread—gender, nationality, age, ethnic origin, sexual orientation or religion can all unfortunately be the basis for some form of discrimination. In only four out of 10 countries worldwide do equal numbers of girls and boys attend secondary school and 75 countries have laws that criminalize same-sex sexual relations.

“When the most marginalized and vulnerable face discrimination and abuse, all of us are diminished,” said United Nations Secretary-General Ban Ki-moon. “The United Nations is strongly committed to upholding human rights and dignity for all.”

Discrimination in health-care settings also continues to be widely reported. Imagine a young woman newly diagnosed with HIV being told by her doctor that she must be sterilized, a sex worker facing violence or abuse from a nurse, a disabled person denied access to proper advice about their sexual health, a gay man frightened of disclosing his sexuality to medical staff, a person who injects drugs dying after being refused treatment or a transgender person attempting suicide after being turned away from a clinic.

Health-care settings should be considered as safe and caring environments, however, such cases are happening too frequently throughout the world. Any obstacles that inhibit access to health-care facilities, including to testing, treatment and care services, must be removed. Access to health must be open to everyone. UNAIDS is partnering with the World Health Organization’s Global Health Workforce Alliance to develop a plan for action to end discrimination in health-care settings.

“On Zero Discrimination Day, stand out and stand together for the right to live free from stigma and discrimination,” said Michel Sidibé, Executive Director of UNAIDS. “By celebrating diversity, we can transform the future.”

On this year’s Zero Discrimination Day, people are being urged to value and embrace diversity and recognize the diverse set of talents and skills that each person brings—talents that enrich society and strengthen communities. Welcoming diversity in all its forms reinforces social cohesion and brings valuable benefits to societies around the world.

People can show their support for #zerodiscrimination through drawings, pictures, audio and video. Contributions can be posted on Facebook, Twitter and Instagram to illustrate personal stories about overcoming discrimination. Several artists, designers and illustrators have created original pieces providing their interpretation of zero discrimination—see @unaidsglobal on Instagram.

UNAIDS

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

At a ceremony in Abidjan, Côte d’Ivoire, attended by UNAIDS Executive Director Michel Sidibé, the First Lady of Côte d'Ivoire, Dominique Ouattara, has awarded the Dominique Ouattara Prize for Excellence to six service providers making a significant contribution to preventing mother-to-child transmission of HIV in the country.

In the category for the area providing excellence in service, the San Pedro district received first prize, with Grand Lahou coming second. In the category for top performing civil society organization, the Organisation des Femmes Actives de Côte d’Ivoire received first prize, while Femme Egale Vie came second. Amah Yolande and Louis Saba received prizes for the excellence of their work as community service volunteers.

Côte d’Ivoire has made rapid progress in reducing mother-to-child transmission of HIV by scaling up treatment coverage across the country. The proportion of pregnant women receiving antiretroviral medicines to prevent their children being born with the virus reached 80% at the end of 2014, up from around 50% at the end of 2012. The total number of new HIV infections in Côte d'Ivoire has fallen from around 52 000 in 2000 to 25 000 in 2014.

Ms Ouattarra is a Special Advocate for UNAIDS, helping to raise awareness for programmes aimed at preventing new HIV infections among children and advocating for women and children living with HIV to access antiretroviral therapy.

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Meeting in Libreville, Gabon, on 12 February, the ministers of health of the Economic Community of Central African States launched an ambitious programme to strengthen regional cooperation by establishing a community health fund to reinforce the region’s AIDS response.

The ministers also decided to improve coordination by setting up a specialized unit to enhance cross-border HIV prevention strategies and by developing a regional mechanism to source antiretroviral medicines on a larger scale. They also adopted a plan to increase the proportion of pregnant women and children receiving antiretroviral medicines.

The measures are designed to encourage countries to better share their experiences, allowing for a more efficient implementation of recommendations made during a meeting of HIV experts in Dakar, Senegal, in December 2015. 

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UNAIDS and the One Million Community Health Workers (1mCHW) initiative have announced a major strategic partnership to support the achievement of the 90–90–90 treatment target and to lay the foundation for sustainable health and development.

The new partnership emerged at a high-level meeting of eight African health ministers and other stakeholders in Addis Ababa, Ethiopia, held on 1 February, which focused on the 90–90–90 treatment target and human resources for health. The participants of the meeting called for the world to leverage the aim of achieving the 90–90–90 treatment target to strengthen human resources for health.

In his opening address, Marc Angel, UNAIDS champion for the 90-90-90 treatment target, told participants that increased human resources for health would be essential.     

“Achieving the 90-90-90 target requires health workers, specific expertise and laboratories equipped with the necessary materials,” said Mr Angel.

Jeffrey Sachs, director of the Earth Institute at New York’s Columbia University and founder of the 1mCHW initiative, emphasized his commitment to the 90–90–90 treatment target. As the United Nations Secretary-General’s Special Adviser on the Sustainable Development Goals (SDGs), Mr Sachs pledged to place 90–90–90 at the centre of advocacy for the SDGs.

“The 90–90–90 effort of UNAIDS is historic: a rigorous, scientific and bold approach to end the AIDS epidemic,” Mr Sachs said. “The end of AIDS is within reach, and community health workers will play a pivotal role in empowering communities to end deaths from AIDS and to break the transmission of the virus. The 1 Million Community Health Worker campaign is honoured to join UNAIDS in its path-breaking programme.”

Cosponsored by UNAIDS, the African Union and Ethiopia’s Ministry of Health, the meeting revealed both strong support for the 90–90–90 treatment target and agreement that it offers a unique opportunity to recruit and mobilize hundreds of thousands of community health workers.

“Ethiopia will spare no efforts to reach the 90–90–90 treatment target,” said Kesetebirhan Admasu, Ethiopia’s Minister of Health. “We are determined to relegate AIDS to the books of history.”

To reach the 90–90–90 treatment target, the number of people accessing antiretroviral therapy will need roughly to double over the next five years. While HIV programmes have pioneered innovative strategies to enhance the efficiency of service delivery, it is clear that reaching the target will require expanding the number of health workers available to deliver HIV services.

However, many African countries, as well as countries in other regions, have an acute shortage of health workers. Although Africa accounts for 25% of the global health burden, the region is home to only 3% of all health workers.

To ease health worker shortages, the meeting focused on the importance of training and employing trained, provisioned, supervised and remunerated community health workers to expand access to HIV services. “We must reinforce the interface between communities and the service provider,” said UNAIDS Executive Director Michel Sidibé. “We need to use communities and civil society organizations to reach people who are difficult to reach.”

The 1mCHW campaign unites more than 150 organizations worldwide in a major global effort to recruit and deploy trained, equipped, supervised and remunerated community health workers, with particular attention to especially underserved rural communities.

Countries such as Ethiopia, Ghana and Malawi have already taken major steps to train and deploy community health workers to deliver community-based health services. Ethiopia, for example, has trained tens of thousands of health extension workers, who have substantially increased access to good-quality health services. Creation of the community health worker programme in Ethiopia has been associated with a 19-year increase in life expectancy over two decades. Ghana is in the process of deploying 20 000 community health workers in a national scale-up effort. 

Other countries are moving to emulate these successful national efforts to expand human resources for health. Lesotho, for example, is embarking on a national effort to create a cadre of health extension workers, with mentoring provided by Ethiopia and Malawi.

Much of the discussion during the one-day meeting focused on how the push to achieve the 90–90–90 treatment target can help drive a sustainable expansion of human resources for health. The global effort to achieve the 90–90–90 treatment target will involve the delivery of simplified, decentralized care to millions of healthy people living with HIV. Self-care, including through such innovations as peer-driven adherence clubs and community distribution of antiretroviral therapy, will play a vital role in the delivery of HIV chronic care management.

Community health workers will be essential for providing these simplified, decentralized services. The Fast-Track approach calls for a sharp increase in financing for community service delivery and an increase in the proportion of HIV services that are delivered through community channels from 5% currently to 30%.

The same community-centred models that will be critical for ending the AIDS epidemic as a public health threat also have a potentially key role to play in addressing the other health targets in the SDGs. Community health workers mobilized through the push to achieve the 90–90–90 treatment target can also help in the delivery of other important health services. Similarly, the chronic care models generated by HIV treatment scale-up are applicable to the management of the growing burden of noncommunicable diseases, such as hypertension and diabetes.

Although the road map for action is clear on 90–90–90 and the health workforce, financing remains a potential obstacle, as investments will be needed for training, supervision and compensation for community workers. There was agreement among health ministers and other participants that mobilizing the necessary investments for expanding the health workforce will require both increased domestic outlays and further increases in international assistance. Mr Sachs called for the creation of a fund for strengthening health systems.

“Here in Africa, we must commit our own domestic resources for health,” said Olawale Maiyegun, Director of Social Affairs for the African Union Commission. “We must live up to our commitments in the Abuja Declaration to dedicate at least 15% of our domestic budget to health.”

“Health is not a cost,” Mr Sidibé said. “Health is not expenditure. Health is an investment. If we scale up, we can bring the epidemic to an end. Yet if we don’t come up with the resources we need, AIDS will rebound, and all our investments in the last 30 years will be lost.”

In planning the meeting, the cosponsors worked with the World Health Organization, the African Society for Laboratory Medicine, the International Association of Providers of AIDS Care, the International Federation of Red Cross and Red Crescent Societies, the Office of the United States Global AIDS Coordinator, Columbia University, the Sustainable Development Solutions Network, the One Million Community Health Workers campaign and the Government of Luxembourg.

Ahead of the United Nations High-Level Meeting on AIDS, which will take place in New York in June, the Organisation of African First Ladies against HIV/AIDS (OAFLA) has called for the response against the epidemic to be stepped up.   

Meeting in Addis Ababa, Ethiopia, OAFLA First Ladies recognized the huge progress already made in reducing the impact of HIV, but warned against complacency, calling on stakeholders to increase investment in the response. The First Ladies said more resources were required to prevent new HIV infections among children and keep their mothers healthy and alive and to broaden access to testing services. They also said that increased resources were necessary in order to ensure that people access treatment immediately if need be, to allow young people, particularly young women and girls, to access combination prevention services, and to end gender-based violence, which increases the risk of HIV exposure.

Addressing the OAFLA General Assembly, UNAIDS Executive Director Michel Sidibé congratulated the First Ladies for playing a transformative role by championing social justice and keeping the issue of HIV high on the political agenda. He added that achieving zero mother-to-child transmission of the virus, reaching universal health access for children and ending the AIDS epidemic by 2030 were possible if the right decisions were made now.

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