On World AIDS Day, mayors meet in Paris as UNAIDS releases a new report on the huge potential of fast-tracking the AIDS response in cities

PARIS/GENEVA, 1 December 2014—On World AIDS Day 2014, mayors from around the world came together in Paris, France, to sign a declaration to end the AIDS epidemic in their cities. In signing the 2014 Paris Declaration, the mayors commit to putting cities on the Fast-Track to ending the AIDS epidemic through a set of commitments. Those commitments include achieving the UNAIDS 90–90–90 targets, which will result in 90% of people living with HIV knowing their HIV status, 90% of people who know their HIV-positive status on antiretroviral treatment and 90% of people on treatment with suppressed viral loads, keeping them healthy and reducing the risk of HIV transmission.

“Ending the AIDS epidemic is achievable if the world’s major cities act immediately and decisively to fast-track their AIDS responses by 2020,” said Michel Sidibé, Executive Director of UNAIDS. “A Fast-Track AIDS response in cities will also encourage new, cutting-edge service delivery programmes that can pave the way for cities to address other public health challenges, including tuberculosis, sexual and reproductive health, maternal and child health, gender-based violence and noncommunicable diseases.”

At the World AIDS Day event in Paris, hosted by the Mayor of Paris, Anne Hidalgo, the mayors joined the Joint United Nations Programme on HIV/AIDS (UNAIDS), the United Nations Human Settlements Programme (UN-Habitat) and the International Association of Providers of AIDS Care (IAPAC) in signing the Paris Declaration. “Cities all over the world are key players that can fast-track the response in order to ultimately end the AIDS epidemic,” said Anne Hidalgo, Mayor of Paris. “Our duty is above all a human one. As elected representatives, our choice is to demonstrate solidarity. In Paris, we are determined to take our responsibilities and to live up to our commitments.”

The meeting is taking place 20 years after the Paris AIDS Summit, at which world leaders and communities agreed to a set of principles for the greater involvement of people living with HIV. Known as the GIPA principles, the historic commitment continues to guide the global AIDS response today.

During the event, UNAIDS released a report on HIV in cities, which outlines the important role that urban areas will play in ending the AIDS epidemic by 2030. The OUTLOOK: cities report shows how cities and urban areas are particularly affected by HIV, with the 200 cities most affected by the epidemic estimated to account for more than a quarter of the 35 million people living with HIV around the world. In many countries, cities are home to more than half of all people living with HIV across the country. In sub-Saharan Africa, 45% of people living with HIV reside in cities.

According to the report, more than half the world’s population lives in cities, with the proportion set to expand to 60% by 2050. The vast majority of megacities, defined as having populations of more than 10 million people, will be in low- and middle-income countries. Fast-tracking HIV responses in cities—without neglecting efforts in rural and other areas—will therefore be crucial to ending the AIDS epidemic.

The 2014 Paris Declaration includes commitments to focus on the communities most affected by HIV, to mobilize resources for the better integration of public health and development, to build and accelerate urban HIV strategies and to use the AIDS response as a catalyst for positive social transformation.

“Cities provide ready, flexible and creative platforms that can contribute to ending the AIDS epidemic in a pragmatic, balanced and efficient way,” said Joan Clos, Executive Director of UN-Habitat. “Cities can act as the fora where the linkages, trust, respect and inclusiveness that are part of any sustainable solution can be built.”

The Cities report shares the city photography of renowned photographer Richard Silver. It also features testimonies from community activists, health workers and public officials who have been at the forefront of the AIDS response in the world’s cities. Their stories show how the same urban centres that have been most affected by HIV from the beginning of the epidemic are now uniquely positioned to end the AIDS epidemic. It also highlights the importance of ensuring that people who are marginalized and often stigmatized—including sex workers, people who inject drugs and men who have sex with men—have access to HIV prevention and treatment services.

Tackling poverty and inequality will also be essential. Globally, an estimated 1 billion people live in poverty, with access to only a few services. Poverty and inequality are further tested by multiple health challenges, including HIV and related diseases, such as tuberculosis, the leading cause of death among people living with HIV.

“We must seize this moment of unprecedented scientific opportunity to rapidly reduce the number of new HIV infections and end AIDS-related deaths, without ignoring significant barriers to achieving the 90–90–90 targets in cities, including stigma and discrimination,” said José M. Zuniga, President/CEO of IAPAC. “Achieving these targets requires thinking globally and acting locally, leveraging existing city programmes and resources and implementing locally relevant, locally tailored and locally led interventions to address HIV prevention, testing and treatment gaps.”

Ending the AIDS epidemic in the world’s cities will require leaders who can inspire and harness the compassion and generosity of ordinary urban citizens in order to bring about lasting change. It will depend upon energized communities accelerating and sharpening the focus of local AIDS responses and sharing best practices across urban centres.  

In addition to the 90–90–90 targets, UNAIDS also calls for reducing the annual number of new adult HIV infections by more than 75%, to 500 000 in 2020, and achieving zero discrimination. UNAIDS estimates that reaching the 90–90–90 Fast-Track Targets will prevent almost 28 million new HIV infections and 21 million deaths by 2030.

Mairie de Paris
Paris, the capital of the French Republic, has been committed to the AIDS response for more than 30 years through its associations, doctors, hospitals and political leaders. Paris also provides € 2 million each year in funding for international assistance for HIV, particularly in sub-Saharan Africa. For more information go to paris.fr/english

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

UN-Habitat
UN-Habitat is the United Nations agency working on sustainable urban development with the mandate of promoting adequate housing and improved livelihoods by harnessing the opportunities that urbanization offers. For more information visit unhabitat.org

IAPAC

The International Association of Providers of AIDS Care (IAPAC) represents more than 20 000 clinicians and allied health care professionals in over 150 countries. Its mission is to improve the quality of HIV prevention, care, treatment, and support services provided to men, women, and children affected by and living with HIV and comorbid conditions such as tuberculosis and viral hepatitis. Visit www.iapac.org for more information about IAPAC, the Fast-Track Cities Initiative, and/or its other global activities.

On 18 November, the University of California, Los Angeles (UCLA), welcomed UNAIDS onto its prestigious campus for the launch of the 2014 UNAIDS World AIDS Day report, Fast-Track: ending the AIDS epidemic by 2030. Held for the first time in Los Angeles, the World AIDS Day report launch brought together students, policy-makers, scientists, AIDS advocates and celebrities to create a new movement of solidarity around ending the AIDS epidemic by 2030.

Leading AIDS advocate David Gere, Professor and Director of the UCLA Art & Global Health Center, hosted the launch, which took the form of an interactive dialogue with the UNAIDS Executive Director, Michel Sidibé. Mr Sidibé shared with the audience his vision for the future of the AIDS response and how the AIDS epidemic could be ended by 2030.

The event was opened with an invigorating clip featuring the UCLA Sex Squad, a group of undergraduate students dedicated to ensuring the sexual health and well-being of high school and college students in Los Angeles.

The Sex Squad is part of a broad nexus of HIV programmes and research at UCLA, which includes vaccine development at the UCLA AIDS Institute, health research at the Fielding School of Public Health and arts-based interventions, such as the Sex Squad, devised by the UCLA Art & Global Health Center. Sex squad member Zakk Marquez gave a live performance, sharing his personal story about the complexities of being in a serodiscordant relationship—a couple in which one person is HIV-negative and the other HIV-positive.

Special guest Charlize Theron, United Nations Messenger of Peace and Founder of the Charlize Theron Africa Outreach Project, welcomed Mr Sidibé to the stage and expressed her support for UNAIDS’ new Fast-Track Targets. She also urged for continued efforts to address the specific needs of adolescents affected by HIV to ensure that no one is left behind.

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Female leaders from the Middle East and North Africa, meeting in Algiers, Algeria, on 10 and 11 November, called for advancing gender equality, the HIV response and universal access to HIV treatment and prevention in the region.

Organized by UNAIDS in collaboration with the Government of Algeria, the League of Arab States and UN Women, the high-level meeting was a first in a series aiming for all sectors of society to take action towards the implementation of the Arab AIDS Strategy. The strategy addresses HIV as a public health and social issue and builds a foundation for halting and eventually ending the AIDS epidemic in the Middle East and North Africa by 2030.

UNAIDS Executive Director Michel Sidibé joined the leaders in their deliberations and emphasized that the implementation of the Arab AIDS Strategy could pave the way for the region to end the AIDS epidemic. To do so, countries should ensure their societies are more inclusive, reach people who are being left behind in the AIDS response, mobilize civil society and seize the momentum initiated by female leaders to bring about change.

Algeria has shown a strong political commitment to gender equality, with women holding 21% of ministerial positions and 31% of seats in parliament. The country’s HIV response is also an example to follow in the region. Algeria’s policy is to provide universal access to HIV prevention and treatment services, including free antiretroviral medicines to those in need, with up to 97% of funding coming from domestic sources. Algeria has also succeeded in building a strong partnership with its dynamic civil society.

Speaking to Mr Sidibé during his visit, Minister of Foreign Affairs Ramtane Lamamra commended UNAIDS for its efforts in reinforcing global partnership. Abdelmalek Boudiaf, the Minister of Health, reaffirmed his commitment towards the creation of the Research Centre of Excellence on Health and AIDS in Algeria.

Mr Sidibé also participated in an event to belatedly mark United Nations Day, held each year on 24 October. The event demonstrated the strength and unity of the United Nations system in Algeria, which is working together to advance the AIDS response in the country.

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The Association of National Olympic Committees of Africa (ANOCA) and UNAIDS signed a partnership agreement to work together in the AIDS response, particularly in the response among young athletes.

The agreement was signed in Bangkok, Thailand, on the sidelines of the XIX General Assembly of the Association of National Olympic Committees by ANOCA President Lassana Palenfo and Djibril Diallo, on behalf of UNAIDS Executive Director Michel Sidibé.

UNAIDS and ANOCA agreed to carry out joint advocacy and communication activities in sporting events organized by ANOCA in support of the UNAIDS Protect the Goal campaign. They will also work together to raise HIV awareness, particularly among sportspeople, to promote HIV prevention and towards the elimination of all forms of stigma and discrimination of people affected by HIV.

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