In the mining town in northern Myanmar where Hla Hla (not her real name) lives, drugs are easy to come by. Hla Hla started using drugs as a teenager. Some years later, an outreach worker friend accompanied Hla Hla to a health drop-in centre, where she discovered that she was living with HIV. She was initially afraid to tell her husband and family, as she was worried about what other people would think.

Hla Hla’s story is not unique. In Kachin State, Myanmar, where an estimated 21 000 people who inject drugs live, two out of five people who inject drugs are estimated to be living with HIV, according to government statistics.

Kachin State has long been affected by socioeconomic challenges, conflict, opium cultivation and drug use. Migrant workers are drawn from across Myanmar and neighbouring countries to work in its jade and amber mines.

There have been harm reduction programmes, including needle–syringe programmes and opioid substitution therapy, in Myanmar for more than a decade, and the government recently reinforced its commitment and support for harm reduction. However, a recent police crackdown resulted in an increase in arrests of people who use drugs, limiting access to services and increasing stigma and discrimination.

In Kachin State, as well as in Shan North State and the Sagaing Region, the USAID HIV/AIDS Flagship Project focuses its support for harm reduction programmes on delivering HIV prevention and treatment services for people who inject drugs. UNAIDS provides technical guidance for the project, which is implemented by Community Partners International.

One gap being addressed by the project is the lack of female-friendly harm reduction services for women who inject drugs and the sexual partners of men who inject drugs. Women who inject drugs in the region often prefer to remain anonymous and may feel more comfortable working with female health workers. One of the implementing partners, Médecins du Monde, designed an initiative to increase service access for women by setting aside one day per week exclusively for women at its drop-in centre. The women-specific service package includes sexual and reproductive health services, gender-based violence counselling and family planning, in addition to harm reduction services provided by female staff.

Hla Hla attends the drop-in centre and enjoys talking with her peers. Although initially afraid to disclose her status to her husband, she eventually did so when he talked about wanting to have a child with her. Disbelief was followed by acceptance and he took an HIV test.

“The drop-in centre is really helpful for me because now I am healthy and can work, thanks to antiretroviral therapy. Furthermore, I am very happy because my husband is HIV-negative. I have more knowledge about health and can share that with my family and friends,” said Hla Hla.

Aside from providing HIV prevention and treatment services for women who inject drugs, the USAID HIV/AIDS Flagship Project supports initiatives such as the Local AIDS Committees, which provide a platform to raise community awareness about the health risks of drug use and the importance of harm reduction programmes.

Saw Yu Htwe is a mother of three and a Local AIDS Committees member. When one of her children started using drugs, she realized that people who use drugs need understanding and support from their family and community. She is determined to help people who use drugs by creating a better environment for them to address their health and socioeconomic needs.

“People ask us why we are helping people who use drugs, since they think these people are not good. People who use drugs are also human. If we, the community, do not change how we think and our attitudes towards them, our region and our country will not be able to develop,” said Saw Yu Htwe.

Only one third of gay men and other men who have sex with men know their HIV status in the Lao People’s Democratic Republic, partly because stigma and discrimination remains a barrier for accessing HIV testing in public hospitals and clinics. Complicated protocols, uneven and at times judgemental treatment by health providers and non-confidentiality of testing results further impact on HIV testing.

“Many of our friends are scared of getting an HIV test because they think the testing steps are challenging and often unfriendly,” said Phoulikhan Siphabouddy, a community-based supporter of LaoPHA, a Lao nongovernmental organization.

To address this, USAID supported the government and LaoPHA to pilot oral fluid screening in three provinces.

Most people assume that testing involves taking a blood sample. But oral fluid testing detects antibodies for HIV, not the virus itself. A test swab is gently wiped along a person’s upper and lower gums once, then the swab is placed inside a test tube containing a reagent. The result is known within 20 minutes.

Members of the community, so-called peer educators, train volunteers for the oral fluid screening. The screening is fast, easy and can be done anywhere.

Around 82% of people reached agreed to have an HIV test through oral fluid screening, compared to only 17% of referrals to clinics, according to the Ministry of Health.

“The new approach dramatically exceeded Laos’ HIV testing targets by more than 200%,” said Bounpheng Philavong, Director of the Lao Centre for HIV/AIDS and STI.

He, along with LaoPHA, are convinced that community-led services provide an enabling environment for key populations to access HIV services in a non-discriminatory manner. Linkages to care and support for people living with HIV has also improved for people who test positive, with the same community volunteers providing support for referral to trusted clinics.

A new data dashboard to enhance the HIV strategic information products that were already available on the AIDS Data Hub for the Asia and the Pacific region was launched on 30 October.

Developed by UNAIDS, the platform allows users to visualize data and indicators related to HIV epidemiology and the AIDS response in the region through customizable maps, graphs, tables and fact sheets by indicator, country and key population. It also facilitates integrated analysis and gives access to granular data. The data dashboard is a one-stop shop that offers HIV-related strategic information, data analysis products and reference documents.

“With concrete targets to be met on the way to end the AIDS epidemic by 2030, it is vital to have the right data tracking whether the Asia and the Pacific region is on course to meet the commitments made in the 2016 United Nations Political Declaration on Ending AIDS. Data show us how far we have come and how far we have to go,” said Eamonn Murphy, Director of the UNAIDS Regional Support Team for Asia and the Pacific.

Accurate and credible data on the HIV epidemic are the cornerstone of the AIDS response. Over the years, a detailed understanding of the HIV epidemic has been built up through the collection, analysis and dissemination of data, helping programmes to reach the right people in the right place and at the right time. Having high-quality data on the AIDS response coupled with cutting-edge analysis has been critical for countries to track their progress towards ending the AIDS epidemic.

UNAIDS and the Data Hub team work with all the countries in the region to collect and analyse data on their AIDS responses and to help build their capacity to generate and use strategic information. In the region, no major report, speech or policy initiative on HIV is launched or made without referring to data collected and released by UNAIDS.

The Data Hub team works closely with civil society, particularly on strengthening the capacity of young community members on data literacy and the interpretation and use of data. “Research and data, coupled with the lived experience of our community, provide the evidence we need for an effective response to HIV. The AIDS Data Hub is an essential tool for helping community-based HIV workers across the Asia–Pacific region access relevant research and data to amplify their advocacy for better services, more funding and the scaling up of programming,” said Midnight Poonkasetwattana, the Executive Director of APCOM.

Twenty-four young people gathered in Suva, Fiji, to take stock of the country’s progress in meeting the commitments in the 2016 United Nations Political Declaration on Ending AIDS and to identify what puts young people at risk of HIV.

The participants recognized that Fiji has taken important steps to establish laws and policies that enhance young people’s access to sexual, reproductive and HIV services. However, they noted that there are many factors that jeopardize young people’s health, including stigma and discrimination, limited access to condoms and a lack of harm reduction programmes for young drug users.

“Many young people have basic knowledge about HIV, its transmission and prevention. Many of them are not aware that antiretroviral treatment exists. It is critical that young people have access to information which is detailed and are informed on where they can obtain it,” said Swastika Devi, from the Reproductive Family Health Association of Fiji.

Greater technical and financial support for participation by young people in community responses to HIV was identified as important. The consensus from the group was that capacity-building of youth leaders should be supported, including leaders from communities, key populations and people living with HIV, in order to enhance their engagement in advocacy and decision-making.

The participants also agreed to form a sexual and reproductive health and rights youth network, which will finalize an advocacy road map focusing on their priority issues, which are youth-friendly services at clinics, developing a standard package of youth-centred services and comprehensive sexuality education that goes beyond puberty. The network has established contact with the Ministry of Health and Medical Services and Fiji’s national steering committee for World AIDS Day to strengthen youth-focused activities for World AIDS Day.

“The #UPROOT consultation has given us the reality of how the commitments in the 2016 United Nations Political Declaration on Ending AIDS affect young people in Fiji,” said Renata Ram, UNAIDS Country Director for Fiji. “Young people continue to be left behind in the AIDS response, despite being the age group most affected by the epidemic. The future of the HIV epidemic in Fiji will be determined by how we package our services towards young people. Failing to do so will push us further from ending AIDS.”

The consultation was part of the #UPROOT youth-led political agenda, launched by the PACT, a global coalition supported by UNAIDS of more than 80 youth organizations and networks working on HIV to respond to the barriers that put young people at risk of HIV. Similar #UPROOT meetings have taken place in Panama, Cameroon and Ghana.

On 28 September, Central Sulawesi, Indonesia, was struck by a powerful earthquake and a subsequent tsunami. Thousands of people are known to have died and tens of thousands of people have been displaced. In the event of a major humanitarian disaster, the basic needs of people are always difficult to fulfil—this is especially true for people living with HIV in Central Sulawesi.

The hospitals in the town of Palu are heavily damaged but remain operational. There are still stocks of antiretroviral therapy in those hospitals, but there are concerns about how long those stocks will last. Before the disaster, according to government data, there were an estimated 1913 people living with HIV in Central Sulawesi, with 334 people, including three children, on antiretroviral therapy.

People in the region have been rallying as champions for people living with HIV. Yuli works for the Indonesia AIDS Coalition, a civil society organization monitoring support for antiretroviral therapy, in Makassar in South Sulawesi, Indonesia. On 2 October, while on her way to Donggala, a region affected by the earthquake, to check on her family, she heard from her employer about severe disruptions in the supply of antiretroviral medicines in Palu.

Yuli and her colleagues headed to Palu to provide help, contacting hospitals and other service providers to gather the remaining stocks of antiretroviral medicines to distribute to those in need. Her mission quickly became a commitment to support the HIV response in Palu, including helping in contact tracing and providing social support for people living with HIV in the region.

“The reason I’m still here more than two weeks after the disaster is because it is impossible to see the conditions and not lend a helping hand,” Yuli said, explaining that, in addition to antiretroviral medicine, people in Central Sulawesi need support for their basic needs and psychosocial support.

By 16 October, 92 out of the 344 people previously on antiretroviral therapy had accessed a one-month supply of antiretroviral medicines, either from Yuli and her team or directly from clinics.

“My main concern is that I want to make sure that even though the disaster happened, people living with HIV still get access to antiretroviral therapy and not stop their treatment,” Yuli said.  

UNAIDS and partners in the region have joined together as the National Core Team for HIV Response in Humanitarian Settings. The team is actively working to support the HIV response in the affected areas, trying to find out the status of the people living with HIV yet to be found and ensuring the distribution of antiretroviral medicines to those who need them. A command post for HIV has been established in Palu, with a team monitoring the availability of antiretroviral medicines in the affected region.  

“HIV is often overlooked in emergency situations. We must work hard to ensure that people living with HIV are not forgotten in times of need. We applaud the quick initiative and commitment of Yuli and her fellow outreach workers and will continue to provide them with support,” said Krittayawan Tina Boonto, UNAIDS Country Director for Indonesia.

The UNAIDS office in Indonesia has mobilized resources to fund six field visits by peer supporters for people living with HIV to Palu to provide immediate assistance. UNAIDS will also conduct a full needs assessment for HIV, tuberculosis and malaria in Central Sulawesi to develop funding requests for medium- and long-term assistance and will establish contingency plans for use in the event of future disasters in Indonesia.

Leaders from African countries and China met in Beijing, China, during the 2018 Beijing Summit of the Forum on China–Africa Cooperation (FOCAC) on 3 and 4 September to accelerate the social and economic development of Africa. Under the theme of “China and Africa: toward an even stronger community with a shared future through win–win cooperation”, the two-day summit served to further enhance Africa–China collaboration in eight key areas: industrial promotion, infrastructure connectivity, trade facilitation, green development, capacity-building, health care, people-to-people exchanges and peace and security. China’s President, Xi Jinping, also announced a US$ 60 billion package of aid, investments and loans to Africa.

During the official opening, the President of China emphasized that Africa has a lot of potential and is a continent full of hope. He said that China would launch a health-care initiative and that information cooperation and exchange on public health would be intensified. Cooperation programmes will be launched on the prevention and control of emerging and re-emerging communicable diseases, schistosomiasis, HIV and malaria.  

The current Co-Chair of FOCAC, Cyril Ramaphosa, the President of South Africa, welcomed the new FOCAC initiatives, which will have a significant and lasting impact on peace, stability and sustainable development on the African continent. The current Chairperson of the African Union, Paul Kagame, the President of Rwanda, said that African countries will intensify work on industry, infrastructure and trade. Antonio Guterres, the United Nations Secretary-General, described FOCAC as an embodiment of two major priorities of the United Nations: to pursue fair globalization and to promote development that leaves no one behind. The Chairperson of the African Union Commission, Moussa Faki Mahamat, highlighted the need to further create synergy between the African Union’s Agenda 2063 and China’s Belt and Road Initiative.

Leaders agreed the Beijing Declaration and the Beijing Action Plan, which will serve as a blueprint for further cooperation between China and Africa in the next three years. The outcome documents, which list ending AIDS and halting and reversing HIV (together with tuberculosis and malaria) as part of the China–Africa health cooperation, also focus on sustainability in health and included the local production of medicines in Africa, strengthening systems and developing public health worker capacity as essential to achieving universal health care.

In bilateral meetings with the Presidents of Côte d’Ivoire, Equatorial Guinea, Mali and Sierra Leone, Michel Sidibé, the Executive Director of UNAIDS, highlighted the important contribution that China–Africa health cooperation can make to improving access to medicines and local pharmaceutical production in Africa.

The African Union endorsed the 2 million community health workers for Africa initiative, which was raised in the bilateral meeting with the President of Sierra Leone. Explaining to Mr Sidibé that he had recently visited a maternity hospital and learned that there are just two gynaecologists in the entire country, the President sees the community health worker approach as a key way to ensure that people are reached with essential health services.

Mr Sidibé met with the China–Africa Business Council, which also chairs the China–Africa Health Industry Alliance. China–Africa cooperation can generate transformational changes in health and provide a platform to find people-centred solutions for ending AIDS and expanding universal health coverage.

GENEVA, 6 September 2018—UNAIDS welcomes the decision of the Supreme Court of India to annul key provisions of Section 377 of the Indian Penal Code. Section 377 criminalizes sexual relations between lesbian, gay, bisexual, transgender and intersex (LGBTI) people.

“Today is a day of gay pride, a day of celebration, a day when respect and dignity was finally restored in India for lesbian, gay, bisexual, transgender and intersex people,” said Michel Sidibé, Executive Director of UNAIDS. “I applaud the brave activists, civil society organizations and community groups that have fought long and hard for this injustice to be reversed.”

Criminalization of consensual same-sex sexual relations is a violation of human rights and legitimizes prejudice and violence against LGBTI people. Criminalization hinders people from accessing and using HIV prevention, testing and treatment services and increases their risk of acquiring HIV.

In India, HIV prevalence among gay men and other men who have sex with men is 2.7% and among transgender people is 3.1%, compared to the national HIV prevalence among all adults of just 0.26%. Around three out of ten gay men and four out of ten transgender people in India who are living with HIV do not know their HIV status. Many LGBTI people living with HIV do not have access to HIV treatment.

Gay men account for 18% of all new HIV infections worldwide. UNAIDS urges countries to ensure the full respect of the human rights of all people, regardless of their sexual orientation, through repealing laws that prohibit sex between consenting adults in private, enforcing laws to protect people from violence and discrimination, addressing homophobia and transphobia and ensuring that crucial health services are made available.

“I hope this decision sets the trend and is followed by similar decisions in other countries that remove unjust laws criminalizing homosexuality,” said Mr Sidibé.

In June 2016, United Nations Member States committed in the Political Declaration on Ending AIDS to promote laws and policies that ensure the enjoyment of all human rights and fundamental freedoms for children, adolescents and young people, particularly those living with, at risk of and affected by HIV, so as to eliminate the stigma and discrimination that they face.

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.

First ladies from across Africa and the First Lady of China, Peng Liyuan, have reaffirmed their commitment to a future free from AIDS by spearheading a new joint initiative to prevent HIV among young people. China will work with African countries and international organizations to implement a three-year health promotion and HIV prevention advocacy programme for adolescents, starting in 2019.

The China–Africa advocacy campaign was launched on 4 September on the margins of the 2018 Beijing Summit of the Forum on China–Africa Cooperation (FOCAC), in Beijing, China. The campaign aims to increase young people’s access to integrated sexual and reproductive health and HIV services and strengthen their engagement in the AIDS response.

Globally, there are around 3.9 million young people between the ages of 15 and 24 years living with HIV. Around 1600 young people acquire HIV every day and a young person dies every 10 minutes from of an AIDS-related illness.

Michel Sidibé, the Executive Director of UNAIDS, thanked the first ladies for their collective action in the AIDS response and urged them to continue their high-level advocacy to mobilize resources to support youth engagement for HIV prevention, treatment and care. “Engaging young people means supporting them as partners and leaders in the AIDS response,” said Mr Sidibé. “We will only pick up the pace if we work closely with young people.”

Discussions during the event focused on addressing what puts young people at risk of HIV, including stigma, discrimination, gender-based violence and limited access to reproductive health services and information. The first ladies recognized that ending the AIDS epidemic among adolescents and young people requires amplifying investments where they can make the most difference, such as comprehensive sexuality education, and fostering innovative and multisectoral HIV prevention programmes.

During the event, Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization, spoke about HIV/tuberculosis coinfection. Tuberculosis is a leading cause of death of people living with HIV. 

The first ladies of Africa and China will join forces to stop new HIV infections among young people by sharing information, helping each other to build expertise and mobilizing resources for joint advocacy for HIV prevention.

The first ladies’ HIV advocacy event concluded with the endorsement of a joint statement that calls on governments to ensure HIV prevention, treatment, care and support services and universal health coverage, especially for young people, in order to ultimately reach the goal of ending the AIDS epidemic by 2030.

On the sidelines of FOCAC, Mr Sidibé and the First Lady of Malawi, Gertrude Mutharika, met with StarTimes to explore how best to harness new technologies to reach young people with HIV prevention services. StarTimes is using its platform to share HIV prevention and awareness messages through digital television and its new social media application.