Gita and her husband arrived at the Sir Jamsetjee Jeejebhoy (Sir J.J.) Hospital more than 15 years ago desperately wanting to have children. Because they were living with HIV, doctors had discouraged them from becoming parents, so they travelled five hours to bustling Mumbai, India, to see Rekha Daver, with the hope of finding a solution. Any solution.

Ms Daver is a doctor who heads the gynaecology department at the state-run hospital. Under her leadership, the hospital has become a referral centre for HIV-positive pregnant women, who are often turned away from other health facilities.

“Back then I could not guarantee that their child would not be HIV-positive, but I enrolled Gita on our antiretroviral therapy programme,” Ms Daver recalled. Subsequently, Gita’s husband was enrolled on the programme. Within a year Gita gave birth to a baby girl at the hospital.

“They never missed an appointment and when their daughter was born HIV-negative you should have seen their happiness,” she said. The couple, with their teenager in tow, still visit Ms Daver, which delights her. “It is not just a question of preventing mother-to-child transmission of HIV, it’s also having two adults living healthy lives.”

Ms Daver knows all about giving life. Since 2000 her team has performed more than 1 000 deliveries of HIV positive women. As of late there is cause to celebrate because in the last two years 100 women on the new three-drug regimen have had children born HIV-free.

Sarita Jadav, the New Delhi United Nations Educational, Scientific and Cultural Organization Focal Point for HIV and School Health Education, praised Ms Daver. “Maternal and child health is one of her passions and she has dedicated more than 37 years to servicing underprivileged women,” she said. Ms Jadav stressed the fact that despite having studied and worked in the United States of America and obtained a green card, Ms Daver chose to return to India and work in state hospitals and to train thousands of medical students.

“Her tireless efforts to bring about change and to save lives have been admired by all,” Ms Jadav added.

Ms Daver talked about the importance of counselling. “When I see women who are HIV-positive and their husbands HIV-negative there are often societal pressures on the couple, not so when the man is HIV-positive and the woman is negative,” she said. “My team and I have been trying to raise awareness about safe sex practices and family planning.” She credits her work at the Human Reproduction Research Centre and at the Indian Council of Medical Research in broadening her scope regarding women’s health.

Supporting women has driven Ms Daver’s career. She always knew she wanted to be a doctor and had set her sights on being a surgeon, but growing up in a small town she realized that helping women was key and that she could make a bigger impact as an obstetrician/gynaecologist.

After attending medical college in India, she spent three years at the Texas Medical Center in Houston, United States. When she decided to move back to India her husband Dr Gustad (medical school sweetheart) and two children moved back with her.

In 1990, she started at the Sir J.J. Hospital and it was then that she started to see more and more women living with HIV.

“I realized there was no cure and that perhaps my best bet was to focus on prevention, especially from mother-to-child.”

After studying programmes in Thailand and Uganda, Ms Daver’s team started providing access to antiretroviral medicine to mothers living with HIV during their pregnancy. Without antiretroviral medicine, between 33% and 45% of infants born to women living with HIV will become infected with HIV. The Sir J.J. Hospital project became a pilot programme and Ms Daver trained other doctors from across India.

With the success of programmes to prevent mother-to-child transmission of HIV, Ms Daver can once again promote breastfeeding. “Before I worried so much because I was saving the child but mortality rates remained high because of a lack of antibodies,” she said. “Now women can safely breastfeed, which makes me so happy,” she said.

Her enthusiasm for her work is infectious, explains her daughter. “I always saw my mother’s devotion to people living with HIV, as well as her passion regarding women’s issues,” said the New York based Roshni Daver. “In fact she inspired me to become a doctor.”

“The key to my mother’s long and successful career is her excellent time management, or perhaps it’s because she wakes up very early,” said her daughter.

Her mother sees it another way, saying, “It gives me a great sense of satisfaction to help all these underprivileged women as well as to train the future generation of doctors.” 

Youth activists from around the world call for comprehensive sexuality education and better HIV, sexual and reproductive health and rights services tailored to the needs of adolescents and young people. The activists came together at the ACT!2015 Global Youth Summit, 19 to 21 October 2016 in New Delhi, India from Algeria, Bulgaria, India, Jamaica, Kenya, Mexico, Nigeria, Philippines, South Africa, Uganda, Zambia and Zimbabwe.

Adolescents aged 10-19 years and young people aged 15-24 are among the groups most affected by HIV globally. However, they continue to face tremendous barriers to access services that are youth-friendly and targeted to meet their needs.

Anupriya Patel, Minister of State, Ministry of Health and Family Welfare, India opened the summit stressing the need to ensure meaningful engagement of young people in decision-making processes, especially concerning young people’s health. She committed to engage Indian youth in the national HIV response and achievement of the SDGs. Janine Kuriger, Director, Cooperation in India, Swiss Agency for Development and Cooperation highlighted now was the time to act and ensure that we achieve the youth-related SDGs.

Summit participants agreed that they need to document the challenges youth face in accessing HIV, sexual and reproductive health and rights services. This evidence can be used to develop national youth advocacy campaigns and establish greater accountability frameworks for national governments. National youth alliances can use the frameworks to monitor country progress towards the youth targets and commitments established in the 2016 United Nations Political Declaration on Ending AIDS and the Sustainable Development Goals (SDGs).

At the meeting, organized by UNAIDS, the International Planned Parenthood Federation, and The Dove Foundation—an ACT!2015 national partner in India—each country delegation produced a national plan outlining how young people will gather evidence, use it for advocacy at all levels, and to evaluate national progress towards ending AIDS among youth by 2030.

In South Africa the youth alliance plans to make youth and adolescent health service standards accessible and acceptable to young people in three provinces. In Bulgaria, youth networks will ensure that the comprehensive sexuality education law that was recently approved is being implemented at the local level, and that pending quality gaps are addressed. “We will identify those gaps, advocate for the government to strengthen the law, and push for its full implementation,” said Dina Tomas, ACT!2015 national youth alliance member, Bulgaria.

ACT!2015 is a youth-led social action initiative supported by UNAIDS, IPPF and The PACT, financed by the Swiss Government, aimed at strengthening young people’s evidence gathering and data analysis skills to facilitate advocacy and accountability around policies that limit young people’s access to services. ACT!2015 national youth alliances are composed of 12-15 youth-led and youth-serving organizations and networks per country, which work together to advance young people’s access to HIV and sexual and reproductive health, human rights, participation and leadership in the HIV response.

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The Pakistan Institute for Parliamentary Services (PIPS) and UNAIDS have signed an agreement to strengthen collaboration to protect the rights of people living with and most at risk of HIV. The Memorandum of Understanding was signed in Islamabad, Pakistan on 21 October by Zafarullah Khan, Executive Director, PIPS and Mamadou Sakho, UNAIDS Country Director for Pakistan and Afghanistan in the presence of Marriyum Aurangzeb, National Convener, Parliamentary Sustainable Development Goals.

With the new agreement UNAIDS and PIPS will work together to raise public awareness of Pakistan’s commitment to the AIDS response. They will also build the capacities of parliamentarians to find solutions for HIV-related problems at district level and to create a protective legal environment for an effective AIDS response. The partnership will also encourage parliamentarians to call for budgetary allocations for the AIDS response at the national and provincial levels.

During the signing ceremony, Ms Aurangzeb highlighted the importance of parliamentary oversight to advocate for the public’s basic health and education rights. She reiterated the strong resolve of the national parliament to take up a people-centric development agenda and improve the service delivery of government through legislation.

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In Viet Nam, the Authority for HIV/AIDS Control and the Ministry of Health piloted outreach HIV testing services to increase uptake among people who inject drugs and their partners. Bi-monthly HIV testing was offered in villages where there were large communities of people who inject drugs.

The outreach team included two health service staff, one village health worker and one peer educator. People who inject drugs and their partners were invited to a convenient location and offered HIV counselling and rapid HIV tests. Reactive test results were sent for confirmatory testing and clients with a confirmed diagnosis of HIV were counselled and linked to clinics for treatment and care.

From September 2014 to January 2015, 8.9% of people tested were newly diagnosed with HIV—approximately four times higher than the percentage observed at district primary health-care facilities. The results of this pilot programme suggest that the provision of community-based HIV testing services is a feasible and efficient method of increasing knowledge of HIV status among people who inject drugs and their partners, as well as other key populations. Peer educators and village health workers were instrumental in reaching the target population. This model will inform the development of national guidelines on community-based HIV testing. Source: http://who.int/hiv/pub/guidelines/hiv-testing-services/en/.

To find out more about harm reduction, please go to the World Health Organization harm reduction page at http://who.int/hiv/topics/idu/en/ .

A Chinese delegation visited Phnom Penh, Cambodia, from 11 to 13 October to promote innovative partnerships between the government and civil society. Both countries have partnered with communities and tailored their AIDS response to the specific needs of key populations at higher risk of HIV.

The mission was organized on the eve of an official visit by China’s President, Xi Jinping, to Cambodia, with support from the UNAIDS China and Cambodia country offices and the Gates Foundation. It included representatives of the National Health and Family Planning Commission, the National Center for AIDS/STD Control and Prevention, the Chinese Preventive Medicine Association and the Chinese Association of STD/AIDS Prevention and Control.

The delegation was welcomed by the National Center for HIV/AIDS, Dermatology and STD, the National AIDS Authority and KHANA, the largest Cambodian nongovernmental organization (NGO) working on HIV.

Sun Xinhua of the National Health and Family Planning Commission headed the Chinese delegation and commended the progress achieved by the Government of Cambodia in decreasing HIV prevalence among the general population. Mr Sun noted that, “This visit is a great opportunity to better understand the strategies and approaches for reaching key populations and opens new avenues for South–South cooperation.” Ly Penh Sun, Director of the National Center for HIV/AIDS, Dermatology and STD, explained that, “Cambodia has recently adopted the “treat all” policy, which is a key step forward to achieving the 90–90–90 targets by 2020.”

The Chinese delegation presented the experience of civil society’s participation in the HIV response in China, noting in particular the China AIDS Fund for NGOs funding process for community organizations. Most international funding for the AIDS response in China ended in 2013, which affected civil society’s participation in the response. The Government of China committed to fill the gap with domestic resources, leading to the establishment of the China AIDS Fund for NGOs in 2015, which in its first year awarded US$ 7.5 million to more than 460 civil society organizations, with 41% of the funds going to support programmes for men who have sex with men.

“Learning from China’s transition towards more sustainable national funding was very useful, as Cambodia faces declining international funding. A key factor of success for both countries is the strong cooperation between government and civil society,” said Ieng Mouly, Chair of the National AIDS Authority, at an event organized to highlight civil society’s experience.

In Cambodia, the government works closely with civil society organizations to provide HIV prevention and support for enrolling key populations in treatment and care. Their efforts help bring services closer to key populations. The delegation visited a karaoke bar where peer counsellors provide rapid finger-prick HIV screening for entertainment workers as they wait for customers. The group also toured a club where men who have sex with men can access HIV prevention services.

“China and Cambodia are on the Fast-Track and building the sustainability of their AIDS response. UNAIDS values South–South sharing and cooperation, which promotes the scale-up of innovative approaches to better reach people,” concluded Marie-Odile Emond, UNAIDS Country Director for Cambodia.

George started using drugs more than 10 years ago. At the time he lived in Jakarta, Indonesia, and worked as a driver for an international company. About one third of people who inject drugs globally live in the Asia and the Pacific region. (Photo 1)

As George’s dependence on drugs became severe, he lost his job and could no longer provide for his wife and young children. “All I could think about was where I would get my next hit. I lied. I stole. I hated myself,” recalled George. (Photo 2)

One day George heard about a novel programme based in a large house in Bogor, Indonesia. Rumah Singgah PEKA is a community-based harm reduction programme that aims to empower people who use drugs to take back control of their lives. (Photo 3)

Sam Nugraha is the Executive Director of Rumah Singgah PEKA, which he founded in 2010. He said, “Rumah Singgah PEKA is different from other treatment centres, because it is fully voluntary. Every client has made their own decision to participate.” (Photo 4)

Most of the staff at Rumah Singgah PEKA have experience with drug dependence. The facility provides a range of services, including group and individual counselling. (Photo 5)

The organization works with public health facilities to help clients access key services. Deni Subhan, Programme Manager at PEKA, often accompanies clients to get their daily dose of methadone. (Photo 6)

Siti Nurfaiza, Programme Manager at Gedung Badak Health Clinic, finds the collaboration with PEKA good. She said, “Methadone is very helpful for the heroin user, since it helps people with drug dependence to maintain their physical, psychological and social activities.” (Photo 7)

Deni Subhan picks up a five-day supply of methadone for clients, who can then access their daily dose at PEKA, which has much more flexible hours than public health facilities. (Photo 8)

George has gradually decreased his methadone dose. He now works for PEKA and is once again able to provide for his family. (Photo 9)

George said, “All of us are entrusted to make our own decisions. If we wish to make a good decision, the community is here to help.” (Photo 10)

The village of Jiele is where China’s first HIV cases were reported in 1989. Located in Dehong prefecture in Yunnan province, the village experienced an AIDS epidemic that resulted in almost 200 deaths. However, a quarter of a century later, the village is now brimming with hope and renewed energy.

“In the past, everyone was so scared of HIV, but now we are getting great health services and we are living normal healthy lives. We are not afraid of HIV anymore,” said a resident of Jiele.

The more than 100 people currently living with HIV in the village are receiving regular check-ups and almost all are on HIV treatment. The village’s success is echoed across Dehong prefecture, which was at the heart of China’s early AIDS epidemic.

Located near the opium producing areas of the Golden Triangle and the major drug trafficking routes, Dehong’s initial HIV cases were among people who inject drugs, as well as sex workers and their clients. In the past 15 years the prefecture has worked with community organizations, the central government and international organizations and has implemented a wide range of innovative measures, leading to a remarkable turnaround in the AIDS epidemic.

During a week-long mission to China, UNAIDS Executive Director Michel Sidibé witnessed the achievements made in Dehong. He met with officials and community groups and visited a range of sites, including Ruili Hospital on 7 September. He saw how the city hospital provides one-stop-shop HIV prevention and treatment services, including health education, HIV testing, methadone for people who inject drugs and prevention of mother-to-child transmission of HIV services.

In 2009, Dehong started to decentralize antiretroviral therapy management down to the community level for people living with HIV who had been accessing treatment for more than a year. Ruili Hospital provides assistance and technical support to the community-level antiretroviral therapy sites, which in 2014 were providing treatment to more than 600 people living with HIV.

“Ruili Hospital is a model of how one-stop-shop HIV services save lives and money,” said Mr Sidibé. “It’s remarkable how the hospital is spreading its know-how down to the community level and ensuring that quality health care is available in even the most remote corners of China.”

“The fourth round of the People’s War against AIDS has just been launched in Yunnan,” said Gao Feng, Vice-Governor of Yunnan. “We are confident we will achieve the 90–90–90 targets by 2020 in Yunnan.”

Dehong’s HIV response has evolved to meet the new challenge of providing quality health care to cross-border migrants. While in most parts of China access to key HIV services, such as treatment and methadone, require a Chinese identification card, in Dehong, HIV treatment is available to non-Chinese people who can present residence and employment permits and health certificates.

Mr Sidibé visited Jiegao, which is a district of Ruili where around 50 000 Burmese people are estimated to live. The Needle Exchange and Methadone Maintenance Treatment Extension (MMT) sites provide services to mainly migrants who inject drugs. Truck drivers crossing the China and Myanmar borders are provided with comprehensive services at a government-funded truck driver action spot. The services include health education, HIV counselling and testing, condom distribution, and referral to HIV treatment.

The local government in Dehong has a strong partnership with community-based organizations, which have played a key role in reaching migrants and people who use drugs, engage in sex work or are living with HIV.

Owing to these effective strategies, Dehong is the only prefecture in Yunnan province to receive public recognition for having reversed its AIDS epidemic. Health authorities report that HIV treatment coverage is around 60% of all people living with HIV, while prevention of mother-to-child transmission of HIV programme coverage is 100%. In Ruili, among people living with HIV eligible for antiretroviral therapy, the mortality rate has decreased by 95% compared to 2005. There were zero new HIV infections reported among people who use drugs attending MMT clinics from 2008 to 2014 and no babies born to pregnant women living with HIV have been reported to be HIV-positive since 2008. Dehong’s success is all the more remarkable as neighbouring prefectures in Yunnan province continue to experience expanding epidemics.

“Political leadership and engagement with communities and programmes based on scientific evidence can inspire other communities in China to end the AIDS epidemic,” said Mr Sidibé.

The First Lady of China, Peng Liyuan, and her counterparts from other Group of 20 (G20) countries have taken part in an event at Zhejiang University in Hangzhou to raise awareness of HIV among students. The Red Ribbon Health Ambassador’s Campus Tour campaign event took place on the sidelines of the 2016 G20 summit, where leaders of the world’s foremost economies have gathered for their annual meeting.

The first ladies, China’s Minister of the National Health and Family Planning Commission, Li Bin, and UNAIDS Executive Director Michel Sidibé also participated in the event. They met students and made a symbolic gesture of placing red ribbons on a banner.

“This meeting is another expression of China’s strong commitment towards ending AIDS by 2030,” said Ms Li.

Mr Sidibé expressed his appreciation for China’s efforts following the event. “We will not end the AIDS epidemic unless we stop new HIV infections among young people. China’s HIV campaign in universities is a great start,” he said. 

The Red Ribbon Health Ambassador’s Campus Tour campaign was launched in November 2014 to improve knowledge of HIV prevention and to promote a healthy lifestyle among students. Nearly 20 colleges and universities and 10 medical schools have participated in the campaign, reaching around 400 000 students.

Young people are at higher risk of HIV. In 2015, globally there were 3.9 million young people aged 15 to 24 living with HIV and there were 670 000 new HIV infections among this age group. To reach the global commitment of ending AIDS by 2030, countries have pledged to ensure that, by 2020, 90% of young people have the skills, knowledge and capacity to protect themselves from HIV and have access to sexual and reproductive health services.

Mr Sidibé is on a week-long mission to China and participated in the G20 summit, which focused on promoting stable economic growth. He also met with international business leaders at the B20 summit, which looked at how the business community could contribute to sustainable and balanced growth in the global economy.

While in China, Mr Sidibé also discussed the financing challenges for the global HIV response with Roberto Azevêdo, Director-General of the World Trade Organization, Jim Yong Kim, President of the World Bank Group, and Christine Lagarde, Managing Director of the International Monetary Fund.

The Executive Director of UNAIDS, Michel Sidibé, and the Director-General of the World Health Organization, Margaret Chan, held wide ranging discussions with Vice-Premier of China, Liu Yandong in Beijing on 28 July.

The discussions touched on global and domestic health issues including China’s own health care reform programme and moves towards universal access to healthcare through the uptake of its medical insurance system. Mrs Liu underlined China’s commitment to improving health outcomes and welcomed the strength of the country’s partnerships with both UNAIDS and the World Health Organization.

Mr Sidibé congratulated the Chinese authorities for significantly reducing the number of AIDS-related deaths in the country and for expanding HIV prevention programmes nationwide to stop children from becoming infected with HIV. Since 2014, Beijing has reported that no babies have been born with HIV. Mr Sidibé also mentioned China’s highly successful harm reduction programmes, which continue to reduce the number of new HIV infections among people who inject drugs.   

China’s contribution to the international AIDS response was also discussed, particularly the country’s support to some of the world’s most affected countries in Africa. The importance of building robust health systems and ensuring the local production of pharmaceuticals were both stressed as being key to the future response to the HIV epidemic in Africa.   

Earlier in the week, Mr Sidibé met with the Vice-Chairman of the China-Africa Business Council, Xu Zhiming and thanked him for the organization’s ongoing support to the Organisation of African First Ladies Against HIV/AIDS. During his five-day visit, Mr Sidibé also met with Li Bin, the Minister for National Health and Family Planning, and discussed scaling up HIV prevention efforts among men who have sex with men and other key populations.

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Two major stars of the footballing world have joined forces to encourage young people in China to get informed and protect themselves from HIV. UNAIDS Special Ambassador for Youth and China-Africa Collaboration, Gervinho, and UNAIDS National Goodwill Ambassador for China, Shao Jiayi took part in an event with Chinese media called Sports For Change which was moderated by another UNAIDS National Goodwill Ambassador, the television personality, James Chau. The Executive Director of UNAIDS, Michel Sidibé, also attended the event in Beijing.

The event on 26 July honoured Gervinho in his new role. The football star, whose full name is Kouassi Gervais Yao moved to China in January 2016 to play for the Chinese Super League team, Hebei China Fortune. Originally from Côte d’Ivoire, Gervinho is already active in promoting HIV awareness and prevention to young people in Africa and will expand this work in China.

Shao Jiayi has actively used his popularity in China to speak up on issues surrounding HIV, highlight the challenges faced by people living with HIV in their everyday lives and encourage young people to take up leadership roles in the AIDS response.

Mr Sidibé, who is on a five-day visit to China, thanked the two football stars and Mr Chau for their continued efforts to reduce the impact of the AIDS epidemic in China and around the world. He also underlined how new HIV infections had to be stopped and stressed the role that Gervinho and Shao Jiayi could play in raising HIV awareness among young people.        

At the end of 2015, there were 3.9 million young people aged 15 to 24 living with HIV and 670 000 new HIV infections among this age group. 

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