Communities played a central role in the commemoration of World AIDS Day in South Africa, which was held in the rural community of Orkney, in the North West Province.

At the invitation of the Government of South Africa, the UNAIDS Executive Director, Winnie Byanyima, commemorated her first World AIDS Day as UNAIDS Executive Director in the local community. Ms Byanyima paid tribute to the role of communities in the AIDs response, including communities of people living with HIV and communities of women, girls and others at higher risk of, or affected by, HIV.

Ms Byanyima told the audience of several thousand people that it was an honour to mark World AIDS Day in South Africa—a country that was late to respond to HIV but that had made huge strides over the past decade and now had more than 5 million people on treatment. She noted, however, that there was still a long way to go, especially to protect women and girls.

“Enough is enough. All women and girls must have the right to choose if they have sex and with whom, and how they protect themselves. We need to bring power, equality and agency to all young women and girls,” she said.

Ms Byanyima said we must never accept that people living with HIV are still dying of AIDS. “It is not a question of science. It is a question of inequality, powerlessness and exclusion. The system is still failing for those who are marginalized,” she said.

South Africa’s Deputy President and Chair of the South Africa National AIDS Council, David Mabuza, told the World AIDS Day event audience that South Africa’s AIDS response had succeeded thanks to the work of communities and the contributions of activists and development partners.

“We could not achieve this without partnerships and support from our global partners,” he said. “That is why we must appreciate the contribution of the global campaign by UNAIDS that has galvanized political leadership, civil society and the private sector into coherent action. Community action remains an important pillar in making change happen, and in shaping the policy agenda and outcomes.”

He noted that there was still much work to be done, including intensifying HIV prevention and tackling contributing factors, including providing comprehensive sexuality education and ending gender-based violence.

Mr Mabuza also said he was pleased to be joined by Ms Byanyima. “She is an activist of note and a distinguished advocate for human rights and development,” he said.” We have no doubt that her vast experience in political leadership and human development will take us forward in the struggle to end the AIDS epidemic.”

In the days prior to the World AIDS Day commemoration, Ms Byanyima met with political and civil society leaders, women activists and others to hear their concerns and understand the challenges and opportunities facing South Africa.

She also visited a clinic in Soshanguve, outside Pretoria, to see in action the project Ritshidze (“saving our lives”), which aims to improve the quality of HIV and tuberculosis service delivery in South Africa by empowering people living with HIV to monitor the health services they receive and to advocate for changes needed. The project is funded by the United States of America with support from UNAIDS.

"We can spend billions building beautiful clinics to distribute millions of pills,” Ms Byanyima said. “But only if we empower communities at the grass roots to hold service providers accountable and call out injustices will we make a real difference for people."

1 December 2019

I believe in communities.

Communities make change happen.

Communities are the best hope for ending AIDS because communities have fought against HIV right from the beginning!

As the epidemic raged through our countries, cities, villages, women held communities together and bore the higher burden of care for their families.

For far too long we have taken their volunteerism for granted.

In the face of adversity, communities of gay men, sex workers and people who use drugs have organized themselves to claim their right to health as equal citizens. 

So, we know that communities have proved their worth. There is no debate there.

Without communities, 24 million people would not be on treatment today. Without communities led by women living with and affected by HIV, we would not be close to ending new HIV infections among children, raising orphans and caring for the sick. 

Twenty-five years ago, a Burundi woman called Jeanne was the first person to disclose that she was living with HIV. Today, Jeanne is holding leaders accountable and fighting for the right to health care.

Pioneers like Jeanne have been joined by younger leaders, like 20-year-old Yana, who was born with HIV in Ukraine. Yana founded Teenergizer, a group bringing together young people across eastern Europe. In a world where power resides with old men, she wants her peers to have a voice and a choice.

Consider Fiacre. He lives in Central African Republic, displaced by conflict along with thousands of others. Fiacre cycles to a clinic, crossing barriers and checkpoints to collect antiretroviral medicines for him and members of a group he belongs to. Without this support, each person would have to make the dangerous journey on their own. Simply amazing.

As you can see, communities make the difference all over the world.

However, the way communities are being taken for granted has to change.

On World AIDS Day, UNAIDS salutes the achievements of activists and communities in the struggle against HIV. We remember and we honour all those whom we have lost along the way. Activists challenged the silence and brought life-saving services to their communities. But the countless contributions by women and many others can never replace the responsibility of governments.

Let me remind you, governments committed to at least 30% of HIV services being community-led. 

They also agreed that 6% of all HIV funding go to community mobilization, promoting human rights and changing harmful laws that act as barriers to ending AIDS.

Let’s be clear, defending human rights and challenging discrimination, criminalization and stigma is risky work today.

So, we call on governments to open a space so that activists can do the work they do best.

With communities in the lead and governments living up to their promises, we will end AIDS.

Winnie Byanyima

Executive Director of UNAIDS

Under-Secretary-General of the United Nations

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.

Seven years after finding out that he was living with HIV, Jair Brandão was waiting for a medical appointment in a clinic in Recife, north-east Brazil, when a fellow patient informed him he could access psychosocial support at a nearby nongovernmental organization. Although it had taken him many years to accept his HIV status, he needed just three sessions of counselling to realize that he was meant to become an HIV activist.

“I was thrilled and scared at the same time, because I didn’t understand much about political spaces, nor about AIDS and health policies. I didn't know how to engage in political discussion,” recalls Mr Brandão, who two decades later is one of Brazil’s most influential HIV activists. “First, I had to accept myself as a person living with HIV, and this was one of the challenges. And then learn about the virus, take care of myself. Only after that did I start to learn about social and political issues.”

Mr Brandão says he believes that being an activist is natural for him. “Some people are born for that,” he says. “Being an activist is about being restless and not accepting injustices and violations of rights. I think I was born with this gift because I always led processes, even without knowing it was activism, and I was always concerned about helping and empowering others.”

After participating in three of the four United Nations high-level meetings on AIDS and in the 2018 high-level meeting on tuberculosis, Mr Brandão knows how difficult it is to engage in dialogues with other civil society peers and country representatives. His mother tongue is Portuguese, which is not an official United Nations language. “Speaking a foreign language is a major issue for us in Brazil, so we have to know at least Spanish. Very few activists know English fluently enough to be able to make interventions in these spaces.”

In July 2019, Mr Brandão was among the nongovernmental organization delegates at the High-Level Political Forum on Sustainable Development in New York, United States of America, representing RNP+ (the Network of People Living with HIV and AIDS) and his own nongovernmental organization, Gestos: Soropositividade, Comunicação e Gênero.

“It is essential for civil society to participate in the national implementation and monitoring processes of the 2030 Agenda for Sustainable Development effectively. We cannot achieve the Sustainable Development Goals without the full participation of civil society,” he says. “Defending the AIDS agenda also requires discussing other equally important and cross-cutting issues.”

Through his role as Project Adviser at Gestos and as a member of RNP+, Mr Brandão also leads the People Living with HIV Stigma Index 2.0 project in Brazil. With his peers at Gestos and other national networks of people living with HIV, and with the support of the United Nations Development Programme and UNAIDS, he helped train 30 people on interviewing techniques in seven Brazilian cities. In two months, they gathered information about HIV-related stigma and discrimination by conducting around 1800 interviews. The initial results will be released before the end of November.

“This process strengthened the activists who conducted the interviews because they could listen to and experience the stories that many people have been through and could not until now share with anyone,” he recalls. “We are in the fourth decade of the AIDS epidemic and still there is a lot of stigma and discrimination. The Stigma Index 2.0 is an instrument which gives us evidence of that in Brazil. We will be able to advocate for stigma-free, zero discrimination HIV policies and services.”

Mr Brandão says he believes in the power of collaboration and partnership to achieve social progress.

“The solidarity and spirit of community that helped create the AIDS movement must come back in our actions and hearts,” he says. “Rethinking strategies and creating new ways to bring about change is fundamental. Empowering new activists, especially young people, is critical. Young people need to be welcomed and open to receive information from experienced AIDS activists. It’s time to join forces, not to be divided.”

In September 2018, on the sidelines of the Forum on China-Africa Cooperation (FOCAC) summit in Beijing, China’s First Lady, Professor Peng Liyuan, and her fellow First Ladies from Africa lit up a Reb Ribbon at the centre of the meeting hall, officially launching the Joint Initiative of the China-Africa Thematic Meeting on HIV/AIDS Prevention and Control.

The 2018 FOCAC summit gathered together over 20 African Heads of State and First Ladies to discuss closer partnership between China and African countries, including on health-related matters. During the thematic meeting, Professor Peng announced a three-year HIV prevention campaign among adolescents to begin in 2019 as well as a community health promotion programme involving China, several African countries and international organizations, including UNAIDS.

For more than 10 years, Professsor Peng has had a particular interest in reducing the impact of HIV among children and adolescents, especially among children orphaned by AIDS. In 2016, she hosted the China-Africa Children Summer Camp that brought together children living with or affected by HIV from China, Ghana, South Africa and Zimbabwe. During the camp, the First Lady helped launch the Chinese version of the Bravest Boy I Know, a book which helps children understand the issues surrounding HIV and reduce the stigma and discrimination faced by children affected by the virus.

In 2015, Professor Peng attended a meeting of the Organization of African First Ladies against HIV/AIDS (OAFLA) in Johannesburg, South Africa, where she underlined the importance of four key issues critical to ending AIDS by 2030: universal access to HIV treatment; public information and education; educational opportunities for adolescents and economic development to eliminate poverty.

Together with national Red Ribbon Ambassadors, Professor Peng has for many years visited communities across China, including schools and universities, to raise awareness about HIV prevention and to reduce the stigma and discrimination associated with the virus.

An acclaimed soprano singer, Professor Peng has proven to be a powerful voice for those living with or affected by HIV.

She has been a World Health Organization Goodwill Ambassador for Tuberculosis and HIV/AIDS since 2011. In 2017, she was awarded a UNAIDS Award for Outstanding Achievement in recognition of her contribution to the response.

“A caring heart is our best weapon against AIDS,” she said in accepting the award. “We can save lives if we take action. We must succeed and we will succeed.”

The International AIDS Candlelight Memorial, coordinated by the Global Network of People Living with HIV, is one of the world’s oldest and largest grassroots mobilization campaigns for HIV awareness in the world. In May, the UNAIDS country office in China invited members of community-based organizations to lead a commemorative event to mark the 36th International AIDS Candlelight Memorial at the United Nations headquarters in Beijing.       

Organized by the Man Wellness Center and Beijing Love Without Border Foundation under the theme of "Ignite Hope, Blessing for Love,” the event brought together community members, activists, young people, healthcare providers, private sector representatives and other people working in the response. They remembered those lost to AIDS-related illnesses and re-committed their efforts to end the AIDS epidemic as a public health threat by 2030.  

During the ceremony, the director of UNESCO’s Beijing office, Ms. Marielza Oliveira, welcomed the significant advances made in the response to AIDS, emphasizing the medical and scientific advances that could now be used to reduce the impact of the epidemic. She called on people to join together to reduce the stigma and discrimination associated with the virus to ensure that everybody could share in the progress being made.

Participants at the event received the latest material about HIV treatment and prevention options.

Civil society activists in China are working hard to get the message across that as long as people living with HIV take treatment regularly and are virally suppressed, they are not infectious: Undetectable = Untransmittable.        

Young people were prominent at the event. Volunteers from the Core Group for AIDS Prevention and the Red Cross Society of China’s Beijing branch attended and committed themselves to creating a discrimination-free environment for people living with and affected by HIV.

As dusk fell, people lit candles in memory of those that have been lost to AIDS-related illnesses.

At the end of the ceremony, people came together to place their candles on a commemorative red ribbon.

The event once again demonstrated the central role played by communities in the response to the AIDS epidemic.

Isaac Ahemesah has been involved in the AIDS response for almost 25 years, the last 16 of which were spent working for UNAIDS in various positions across Africa. His most recent assignment has been as a Fast-Track Adviser in the UNAIDS Country Office in Malawi.

Mr Ahemesah’s interest in the AIDS response started in 1995, when he was studying social work at university in Ghana. As part of his studies, he was required to carry out field work at the local hospital, where there was a hospice for the many people dying from AIDS-related illnesses.

“At that time, there was no treatment for HIV. There was nothing for people living with HIV at all,” he says. “I didn’t know what I was getting myself into,” he continues. I just knew I needed to help.”

This was the beginning of his long involvement in the AIDS response. He started his professional career at the Catholic Relief Service as an HIV and AIDS Programme Officer and went on to join UNAIDS in 2003 in the UNAIDS Country Office in Ghana. Since then, he has held various positions, including Institutional Development Adviser, Human Rights, Gender and Community Mobilization Adviser in Liberia and currently Fast-Track Adviser in Malawi.

Having survived the terrorist attack on the United Nations complex in Abuja, Nigeria, in 2011 and the outbreak of Ebola in Liberia in 2013, Mr Ahemesah remains undeterred in his passion for a people-centred AIDS response.

“People living with HIV need their voices to be amplified in a way that affords them dignity and respect. Everyone needs access to HIV prevention, treatment, care and support services that are free from stigma and discrimination. We need to ensure that no one is left behind,” he continues. “UNAIDS provides me with an opportunity to turn these important principles into reality.”

Among the achievements he is most proud of during his time in Malawi is the advocacy work that he and his colleagues have been able to carry out with partners such as the United Nations Development Programme and civil society organizations. Together, they worked on the country’s HIV and AIDS Management and Control Act in 2018 to strike out or amend all provisions that criminalized people or discriminated against certain groups. This partnership ensured that the final legislation was consistent with international human rights standards and in line with model laws developed by the South African Development Community and Law Commission.

The new law has helped to create an enabling environment in which HIV services can be provided to everyone in Malawi, including lesbian, gay, bisexual, transgender and intersex people and female sex workers, who are at higher risk of acquiring HIV than the general population.

“The changes to the legal environment have allowed UNAIDS and its partners to work more openly and effectively with key populations such as sex workers and lesbian, gay, bisexual, transgender and intersex (LGBTI) people,” says Mr Ahemesah. “Six LGBTI community-led organizations are now officially registered, which means they can apply for funding, follow training opportunities and be run as fully functional organizations.”

Mr Ahemesah is happy that Malawi is making good progress towards reaching the AIDS targets, including the 90–90–90 targets. There are around 1 million people living with HIV in Malawi, of whom 90% know their HIV status. It is estimated that 71% of people living with HIV are now on treatment and that 61% of people living with HIV have suppressed viral loads.

Advances against HIV have contributed to an increase in the country’s life expectancy, from 46 years in 2000 to 64 years in 2018. Malawi was also the first country in Africa to adopt the Option B+ strategy, which ensures that pregnant women living with HIV have immediate and lifelong access to treatment to ensure that they stay healthy and that their children remain HIV-free.

During the 15 years he has spent working at UNAIDS, Mr Ahemesah has occupied many different roles. His experience will stand him in good stead as he prepares to leave Malawi later this year to take up his next assignment, as the UNAIDS Country Director in Sierra Leone, but it is his passion and commitment to improve the lives of people living with and affected by HIV that continue to be his most valuable attribute.

During a visit to South Africa, UNAIDS Executive Director, Michel Sidibé, has warned that the global AIDS response is at an inflection point, at which gains to date could easily be reversed unless urgent efforts are made to reach targets for 2020 and achieve ambitious goals for the decade beyond.

In a meeting with South Africa’s Minister of Health, Aaron Motsoaledi, Mr Sidibé congratulated the country on its progress made to date and encouraged the government to accelerate action to reach ambitious targets that will put the HIV response on a sustainable path to ending the AIDS epidemic by 2030. Mr Sidibé said it was time to fully leverage the power of communities to close the remaining gaps to the UNAIDS 90–90–90 treatment targets. 

In a meeting with the First Lady of South Africa, Tshepo Motsepe, Mr Sidibé encouraged her to use her voice and outreach capacity to empower people who lacked visibility and access to services, particularly emphasizing the importance of adolescent girls to have access top the human papillomavirus vaccine to prevent cervical cancer. 

Ms Motsepe indicated her willingness to engage on national and international issues for the sake of social development. “Health is not simply the absence of disease,” she said. “Some call me the First Lady, some call me the President’s spouse, but whatever you call me I am a social worker for South Africa.”

Mr Sidibé also met with former South Africa President Kgalema Motlanthe and urged him to keep people alert to the serious risks of losing momentum in the AIDS response and especially the need to engage more men in HIV testing and sustained treatment. 

Mr Motlanthe, who is a member of the Champions for an AIDS-free Generation in Africa, expressed his appreciation for the efforts of Mr Sidibé over the course of his career, including as UNAIDS Executive Director. He noted that Mr Sidibé has repeatedly identified and advocated for crucial steps to advance the AIDS response.

“Your timing has always been spot-on,” he said.  

While in Johannesburg, Mr Sidibé addressed the directors of UNAIDS country offices across eastern and southern Africa. He reminded them of the primary purpose of UNAIDS—to serve the needs of people living with HIV and those at risk of infection. As a health organization, he stressed that UNAIDS plays a unique role in advocating for the rights of vulnerable people, engaging strongly with civil society and insisting that nobody should face discrimination for how they live or who they love. 

“UNAIDS is not an organization driven by logistics or materials,” he said. “It is an organization that puts people at the centre.”

“The AIDS response, especially in eastern and southern Africa, offers lessons and approaches to ensure sustainability through political leadership, resource mobilization and community engagement,” he continued.

“With people behind you, you can really make the world better.”

On Zero Discrimination Day, UNAIDS calls on countries to examine discriminatory provisions in their laws and policies and make positive changes to ensure equality, inclusion and protection

GENEVA, 1 March 2019—In 2018, a number of countries made landmark decisions to change discriminatory laws and bills. The Supreme Court of India struck down Section 377 of the Penal Code, which criminalized same-sex sexual relations, the Philippines lowered the age of consent for voluntary HIV testing without the need to obtain consent from a parent or guardian to 15 years and Malawi removed provisions from a draft bill that would have criminalized HIV non-disclosure, exposure and transmission.

On Zero Discrimination Day, UNAIDS recalls the equal dignity and worth of every person, as enshrined in the Universal Declaration of Human Rights, and is calling for action to change discriminatory laws and practices, which are a significant barrier for access to health and other services.

“Human rights violations are happening all over the world because of discriminatory laws and practices,” said Michel Sidibé, Executive Director of UNAIDS. “Laws must protect, not cause harm. All countries must carefully examine their laws and policies in order to ensure equality and protection for all people, without exception.”

Raising awareness, mobilizing and taking action are essential. On Zero Discrimination Day, UNAIDS is proposing specific actions that individuals, civil society organizations, parliamentarians and donor organizations can take to change discriminatory laws. These range from being an ally to someone affected by a discriminatory law to joining a nongovernmental organization, tabling amendments to laws and calling for reviews of legislation.

Making a positive change is possible and there are many ways a law can be amended or abolished. These include:

• Reforming or removing laws through parliamentary processes and the votes of parliamentarians.
  • Raising awareness among parliamentarians is therefore essential, as was done in the revision of the HIV laws in the Philippines and bills in Malawi.
• In many countries, courts have the power to strike down laws that are discriminatory. This can be done if an individual or organization affected by the law takes legal action and wins the case for change.
  • The case of India’s Supreme Court, which removed Section 377 in 2018, was a striking example.
• In some countries, people or politicians can propose law reform through a petition and request a national vote or referendum.
  • This is a standard method of legislating in Switzerland.

UNAIDS has identified a range of laws that are discriminatory, impede access to health and social services, restrict freedom of movement and violate human rights.

In 2018:

• At least 20 countries imposed travel restrictions of some form against people living with HIV.
• Around 29 countries reported that they require the consent of a woman’s husband or partner to access sexual and reproductive health services.
• Fifty-nine countries reported mandatory HIV testing for marriage, work or residence permits or for certain groups of people in the law, regulations or policies.
• Seventeen countries criminalized transgender people.
• Forty-five countries had laws that impose the need for parental consent for adolescents and young people below 18 years to access HIV testing services.
• Thirty-three countries imposed the death penalty for drug offences in law.
• Same-sex sexual relations were criminalized in at least 67 countries and territories worldwide.

UNAIDS is actively working with United Nations partners, governments and civil society organizations to change those laws as part of the Global Partnership for Action to Eliminate all Forms of HIV-Related Stigma and Discrimination. 

Zero Discrimination Day campaign 2019—act to change laws that discriminate.

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.

“If I am meant to be a leader, I needed to be truthful,” said Lloyd Russell-Moyle, British Member of Parliament, reflecting on his bold move to reveal his HIV-positive status in the House of Commons in late November 2018, days before World AIDS Day.

He explained that for years he would honour people for their outstanding work in the HIV field and yet he never opened up and was honest with people about living with HIV.

“The more people don’t talk about it, the harder it is for everyone. As a Member of Parliament my job involves speaking out, being an advocate and helping people in their journey,” Mr Russell-Moyle said.

In his speech to the House of Commons, he described the sense of fear he had when he learned that he was living with HIV nearly 10 years ago. In his view, there is internal stigma, which kept him from speaking about his status for fear of “spreading” what used to be a deadly disease and the fear that people may reject him if they knew he was living with HIV.

“All that stigma makes a treatable disease life-threatening due to the impact on an individual’s mental health and access to medication,” he said in his emotional 28 November speech. In a telephone interview with UNAIDS, he specified that, “In no way should we glorify HIV, but it is liveable and manageable.” And living with HIV should not hold anyone back in any way, shape or form, he stated.

He desperately wants people to understand HIV better. “I want to get to the stage where I don’t have to explain that if you take one pill a day, you [have a viral load that is] undetectable and if you become undetectable you cannot pass the virus on to anyone,” he said. 

That’s why, with the leading British association representing professionals in HIV care, BHIVA, Mr Russell-Moyle wants to reform certain laws. One European Union law forbids people living with HIV from obtaining a full pilot licence.

“It’s outdated considering that HIV treatment now involves a pill a day with no side-effects,” he said.

He also has been vocal about the British Government’s public health spending cuts. “We are at a crossroads right now, having made so much progress,” Mr Russell-Moyle said. “We are in danger of lifting our foot off the pedal so close to the finish line.”

Not funding vaccine research and reducing sexual health screening and prevention will cost the government in the long run and ruin lives, he predicted. “It’s a race against the disease, and if we slow down at this stage we will likely see a rebound,” he said.

According to Public Health England, 12% of people living with HIV in England are unaware of their diagnosis. A Brighton-based foundation launched a Making HIV History campaign to improve knowledge and encourage people to come forward for testing—Mr Russell-Moyle noted that the Stigmasaurus video animations were a great tool to correct stereotypes.

“We have got the drugs, the tools to allow everyone to live happily, so for those who don’t know their status: get tested, get treatment, it will be okay.” He concluded, “It is okay.”