Health department representatives from Amsterdam, Nairobi, Paris, San Francisco and São Paulo gathered during a Fast-Track Cities Symposium at the 2017 International AIDS Conference on HIV Science in Paris. They shared their lessons learned and challenges in preventing new HIV infections and addressing barriers to health.

Amsterdam is among the first cities to have reached the 90-90-90 targets whereby 90% of people living with HIV know their HIV status, 90% of people diagnosed are on treatment, and 90% of people on treatment are virally suppressed.

Many other cities like Paris are on the right track and have mobilized political commitment for the Fast-Track Cities agenda.  With support from the core partners of the Fast-Track Cities network, including UNAIDS, International Association of Providers of AIDS Care, the City of Paris and UN Habitat, cities are adopting innovative approaches to reach affected populations, to optimize linkages to HIV treatment and care, and to address different gaps according to the cities.

Early HIV diagnosis has boosted early treatment uptake as has using strategic data to improve various HIV programmes.  The cities of Bangkok, Nairobi and New Orleans launched city dashboards at the conference, illustrating significant progress.  Baseline 90-90-90 data published include 79-57-79 for Bangkok, 77-96-86 for Nairobi, and 87-69-91 for New Orleans.  Additional data presented at the afternoon session showed 87-65-91 for São Paulo, 93-79-91 for San Francisco and 94-90-94 for Amsterdam.

Since the 2014 launch of the Paris Declaration—Fast-Track Cities: Ending the AIDS Epidemic—more than 200 cities and municipalities around the world have committed to the achieving the 90-90-90 targets by 2020. Almaty in Kazakhstan was the latest city to sign the declaration on 20 July 2017.

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UNAIDS has appointed the singer and television presenter Lulu Haangala Wood as a Goodwill Ambassador for Zambia.

Ms Haangala Wood will focus on awareness-raising on HIV prevention and on access to increasing access to treatment by young people and members of key populations. She will use her influence to reach young people and women and will work towards ensuring that no one is left behind in the AIDS response in the country.

Ms Haangala Wood is a passionate advocate for equal rights and women’s empowerment. In 2008, she started the #WeKeepMoving Foundation to work with adolescents and young women and support them with career development. 

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Thailand’s private sector has teamed up with civil society to launch the AIDS Almost Zero campaign, which aims to raise funds for HIV prevention initiatives run by community groups of key populations. Admiral Narong Pipatanasai, Deputy Prime Minister of Thailand, opened the campaign at the Government House of Thailand in Bangkok on 8 May.

Since the early days of Thailand’s epidemic, civil society has a played a crucial role in the HIV response by helping to reach key populations, including sex workers, gay men and other men who have sex with men, people who inject drugs and transgender people. However, much of the funding for community organizations has come from international funding, which is no longer available since Thailand has attained middle-income status.

Since early 2015, UNAIDS in Thailand has been working with more than 30 civil society organizations to develop a resource mobilization consortium, which would help to cover the funding gap left by the withdrawal of international resources. In 2016, the consortium, led by the Raks Thai Foundation and the Thai National AIDS Foundation, organized a series of consultations with private sector representatives that were chaired by Anand Panyarachun, the former Prime Minister of Thailand. Thailand’s leading property developer, Sansiri Public Company Limited, participated in the consultations and provided financial support for the development of the AIDS Almost Zero campaign.

The speakers at the launch included Mechai Viravaidya, former minister of the Prime Minister’s office, Promboon Panitchpakdi, Executive Director of the Raks Thai Foundation, and Steve Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific.

The aim is to raise US$ 1.4 million in 2017. At the launch, organizers announced that more than US$ 60 000 had already been secured from the Siam Commercial Bank, the Sansiri Public Company and other donors. One promoter for Thai boxing plans to organize a match at one of the country’s most famous boxing stadiums, with some of the proceeds going to the fund.

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Veena has been living with HIV for more than 15 years. The community educator, who lives in Bangalore, India, has been on HIV treatment for more than a decade and says antiretroviral medicine has given her back her health and happiness.

“This medicine is very good. I am very happy,” said Veena. “My life has changed. I am learning three languages and working.”

There are 2.1 million people living with HIV in India, which has the third largest HIV epidemic in the world. On 28 April, during an event in New Delhi, Jagat Prakash Nadda, the Minister of Health and Family Welfare, announced a new test-and-treat policy that commits to providing access to HIV treatment for everyone living with HIV in the country. Prior to the change in policy, people living with HIV could only access antiretroviral medicine for free if their CD4 cells had decreased to less than 500 cells/mm³.

Mr Nadda also said that the ministry’s 90–90–90 strategy will identify 90% of people living with HIV, place 90% of people identified as living with HIV on treatment and ensure that 90% of people on treatment have sustained viral load suppression. “This strategy will offer us an opportunity to work towards our commitment made during the United Nations High-Level Meeting on Ending AIDS.”

People living with HIV in India often access treatment late. This was the case for Veena when she began taking medicine.

“I had lost a lot of weight and I had a high fever. I was tired and I couldn’t work,” said Veena. Initially she did not respond well to treatment, but slowly her weight started to increase and her immune system became better.

UNAIDS has called on all countries to provide HIV treatment to anyone who tests positive for HIV, because treatment keeps a person living with HIV healthy and has the double benefit of stopping the transmission of the virus to other people.

“The Government of India is showing bold leadership and commitment to people living with HIV,” said Steve Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific. “This new policy will bring life-saving treatment within reach of more than one million people living with HIV. It will keep individuals, families and communities healthy and productive and ensure that India ends its AIDS epidemic by 2030.”

To rapidly scale-up treatment, India will rely on its network of facilities spread across the country providing HIV services. Rolling out the new policy will also entail strengthening the procurement and supply chain management system as well as sustained community participation.

According to the country’s national AIDS programme, annual AIDS-related deaths declined by 54% between 2007 and 2015, while new HIV infections dropped by 32%. As more people living with HIV follow Veena onto treatment, the double benefits of antiretroviral medicines are expected to lead to a further decline in deaths and new HIV infections.

Veena has managed what she never thought possible: watch her daughter grow into a young adult.

“My life has a future. I don’t have a proper education, but my daughter has completed her degree. She is working. She is an empowered woman,” said Veena.

UNAIDS is working with countries to ensure that 30 million people living with HIV have access to HIV treatment by 2020.

UNAIDS has appointed Pia Wurtzbach, Miss Universe 2015, as a Goodwill Ambassador for Asia and the Pacific. The announcement was made at a special event with students at Ateneo de Manila University in Quezon City, Philippines.

“I am very happy to be a UNAIDS Goodwill Ambassador for Asia and the Pacific,” said Ms Wurtzbach. “I’m overwhelmed. It’s been a dream of mine to work with the United Nations. I will do my best. I will use my voice for this cause.”

In her new role, Ms Wurtzbach will raise HIV awareness among young people and promote zero discrimination towards people living with HIV and key populations, including men who have sex with men and transgender people.

“Many young people still do not have the skills and knowledge to protect themselves from HIV,” said Steve Kraus, Director of the UNAIDS Regional Support Team for Asia and the Pacific. “With her huge popularity among young fans and immense following on social media, Ms Wurtzbach will amplify our efforts and help end the AIDS epidemic in the region.”

Ms Wurtzbach has been actively involved in humanitarian affairs, speaking out against cyberbullying and supporting people living with HIV, as well as the lesbian, gay, bisexual, transgender and intersex (LGBTI) community. During her reign as Miss Universe, she had an HIV test in front of cameras to encourage people to know their HIV status, and attended the United Nations General Assembly High-Level Meeting on Ending AIDS in New York, United States of America.

The appointment event was attended by young people from different universities in the Metro Manila area, as well as representatives of the United Nations, government officials, the media and the Act!2030 Philippines network and other community groups representing young people and key populations.

The Asia and Pacific region has made progress in its HIV response, with new infections dropping by 5% among people of all ages between 2010 and 2015. However, in 2015, young people accounted for 37% of new HIV infections and data analysis indicates that there is a significant epidemic of HIV among an increasingly younger group of gay men and other men who have sex with men in urban areas of South-East Asia and China.

Surveys conducted in eight countries in Asia found that comprehensive knowledge of HIV among young people is low, increasing their vulnerability to HIV. UNAIDS and its partners are conducting an HIV awareness campaign for youth on social media with the hashtag #Live2LUV and Ms Wurtzbach will be helping to promote this campaign as part of her new advocacy role.

Francophone mayors gathered in Côte d’Ivoire’s capital, Abidjan, on 23 and 24 March to discuss the HIV responses in their cities. Abidjan’s Governor, Robert Beugré Mambe, and the Mayor of Paris, Anne Hidalgo, convened, with the help of UNAIDS, the two-day meeting with 20 mayors, mostly from western and central Africa.

The meeting comes more than two years after mayors from around the world signed the Paris Declaration to end the AIDS epidemic in their cities.

The mayors who signed the Paris Declaration committed to putting cities on the Fast-Track to ending the AIDS epidemic through a set of commitments. Those commitments include achieving the 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 treatment and 90% of people on treatment with suppressed viral loads. Several cities, including Paris, are already close to reaching 90–90–90.

Niamey (Niger), Nouakchott (Mauritania), Tunis (Tunisia), Antananarivo (Madagascar) and L’Acul (Haiti) signed the Paris Declaration in Abidjan, bringing the total number of signatory cities worldwide to 215.

During the opening ceremony, UNAIDS Executive Director Michel Sidibé congratulated Côte d’Ivoire for being one of the countries with the most cities to have signed the Paris Declaration.

In western and central Africa, three out of four people living with HIV do not have access to treatment. This is a sharp contrast with eastern and southern Africa, where average treatment coverage in 2015 was 54%. UNAIDS and partners have therefore launched a catch-up plan to ensure that 1.8 million people in eight western and central African countries access treatment. The plan, Mr Sidibé said, can only succeed with cities and mayors as focal points throughout the region.

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Participants at the HIV and Women Forum, held in Saint Petersburg, Russian Federation, on 6 and 7 October, joined the new UNAIDS campaign Hands up for #HIVprevention and took a series of photos illustrating what needs to be done to strengthen HIV prevention.

Leading HIV experts from 37 Russian regions and representatives of civil society and UNAIDS addressed the issues facing women affected by the country’s HIV epidemic during the annual forum. The Russian Federation has the largest HIV epidemic in the region, with more than 100 000 new HIV infections reported by the government in 2015. In eastern Europe and central Asia, 1.5 million people were living with HIV in 2015, up from 1 million in 2010.

One of the key topics discussed at the annual forum, organized by the Ministry of Health of the Russian Federation, was how to deal with women’s vulnerability to HIV. Russian experts talked about the feminization of the HIV epidemic in the Russian Federation, where the government reports that more than 38% of all new cases of HIV infection in 2015 were among women.

Women face multiple challenges and barriers to accessing HIV services, such as stigma, discrimination, gender stereotypes, barriers to sexual and reproductive health, and violence. The forum highlighted the essential role of nongovernmental and civil society organizations in promoting women’s rights and increasing access to HIV prevention, treatment, care and support services.

The 2016 Political Declaration on Ending AIDS highlights that, globally, women and girls are disproportionately affected by HIV and bear a larger share of caregiving for family members affected by HIV. 

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Red paper ribbons with inscriptions hang like leaves from a baobab-like papier mâché tree. Standing by her creation in the middle of the Global Village at the 21st International AIDS Conference, being held in Durban, South Africa, Michelle Vogelzang is beaming. Her AIDS SolidariTree has travelled far.

Made of the dense foam used to make surfboards, children in Lesotho covered the 11-part sculpture with paper, giving it a bark-like exterior. School students painted the tree in Pretoria, South Africa, writing words related to solidarity in the 11 official languages of both countries.

Unity, stop discrimination and ubuntu wind their way around the branches in multicoloured lettering.

“SolidariTree is a visual declaration designed by youth as a way for them to communicate on how to end HIV stigma and for everyone else to add their voice,” said Ms Vogelzang.

Originally from Durban, she now works in Lesotho. She said the idea of the interactive ribbon sculpture came to her because, in her opinion, HIV is not the killer, discrimination is.

“There is no way we should not be ending this epidemic because we have treatment and health-care facilities, but if you have stigma you are not going to get people tested, treated or even sharing their status,” she said as passers-by stared at the multiple ribbon leaves.

On opening day, the SolidariTree had 500 “leaves”—red ribbon messages from children who could not attend the conference.

Albertina Nyatsi took one of the red paper strips lying on a table. Without hesitating, she wrote something down quickly. The Durbanite stapled the strip, creating a ribbon, and pinned it on the sculpture.

“I was one of the first women in Swaziland to show what HIV looked like, so I wanted to make sure that I got my message across that we should not discriminate,” she said. “I am here because in 1997 I had tuberculosis and then I was tested for HIV and was found to be HIV-positive.”

The tree has grown and now has more than 4000 ribbons hanging from it. The project, entirely crowdfunded, cost around US$ 4000.

“Contributions came mostly from the United States of America and Canada,” Ms Vogelzang explained. In a way, all those people who supported the art exhibition are in South Africa with the tree,” she added. A true sign of solidarity.

Ms Vogelzang is hoping her tree will grow roots beyond the conference and will live on to inspire children, teenagers and adults alike.

In recent years, the AIDS response in China has seen increasing civil society involvement in focused, community-based HIV prevention and treatment programming, which has contributed to maintaining low levels of HIV prevalence in the country and ensuring an increasingly evidence-informed, tailored response.

The strategies, progress and achievements of Chinese civil society organizations were the focus of a session at the 21st International AIDS Conference, taking place in Durban, South Africa, which brought together representatives of the Government of China, Chinese civil society, the World Health Organization and UNAIDS.

The session, held on July 20, showcased the China State Council approved Fund for Participation of Civil Society Organizations in AIDS Prevention and Care, which has invested 50 million renminbi (nearly US$ 7.5 million) to support the work of nongovernmental organizations in education, communication, testing, counselling, care and support, including with key populations.

Although overall HIV prevalence continues to be low, the absolute number of people living with HIV and the annual number of new HIV infections remain significant, particularly among key populations. Recognizing that social and community organizations that have the trust of key populations are best able to reach at-risk communities, the fund—which has been designed, established and implemented in partnership with UNAIDS—is playing an important role in increasing prevention and treatment programmes for key populations in China.

Opening the session in Durban, UNAIDS Executive Director Jan Beagle underlined how China has undertaken impressive efforts to analyse its epidemic and tailor its response. Recalling the visit of a delegation from the UNAIDS Programme Coordinating Board (PCB) to China in May 2016 to explore the national response and the role of communities, Ms Beagle noted how the PCB delegation had seen first-hand that cost-effective and rights-based approaches that focus on populations and locations were proving to have impact.

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Photographs line the walls of the rotunda in Durban’s City Hall. The light streams in from the windows of the cupola and recorded voices of the “artivists,” as they are known, speak to all who enter. The exhibition is called Through Positive Eyes: 10 Years. 9 Cities. My Photo. My Story.

Storytelling is revealed in several forms as visitors immerse themselves in the exhibition. Over the course of 10 years, co-directors of the Through Positive Eyes project David Gere and Gideon Mendel have brought together from around the world people living with HIV.

In each of the nine cities, the process began the same way—a group of people, strangers to each other, were given a camera. What started as a foreign object quickly became an extension of themselves.

Mr Mendel, an award-winning photographer, leads photo education workshops alongside his associate, Crispin Hughes. Mr Gere, a professor at the University of California, Los Angeles, conducts the story interviews.

“It was therapeutic to hear other people’s stories,” said artivist Simiso Msoni of Durban. “Overall, it was just fun to tell your story and what it means to live with HIV through pictures.”

The Durban exhibition brings many of the past participants together, as well as their art. An innovative feature is the live dialogue sessions, in which two of the participants speak to each other about their experiences and visitors can listen as their stories unfold.

Edwin Cameron, a Judge of the Constitutional Court of South Africa, called the exhibition extraordinary. “This exhibition is important for what it does for visibility, for what it does for voices,” he said. He underlined the need to listen and learn from people living with and affected by HIV and the need to break down barriers caused by stigma and discrimination. 

The exhibition includes works by Adriana Bertini, Mandisa Dlamini, Daniel Goldstein, Ross Levinson, Gordon Mundie and Parthiv Shah and is co-curated by Stan Pressner, Carol Brown and Mr Gere.