Demographic impact

Feature Story

Cyclone Idai flood survivors ‘just want to go home’

18 April 2019

Bangula settlement in Nsanje District, in the south of Malawi, is an arduous five kilometre walk from the border with Mozambique.

It is a walk that approximately 2 000 Mozambicans have made since they were displaced a month ago by the floods caused by Cyclone Idai. The settlement is also a temporary home to approximately 3 500 Malawians from surrounding villages who were also displaced.

Being predominately a small holder farming community, their homes, belongings and livelihoods were all washed away by the floods. They are now at Bangula, waiting for the earth to dry so they can go home and begin rebuilding their lives.

The emergency response to assist the 81 000 people in the district affected by the floods is being coordinated by the Government of Malawi, the United Nations, development partners and non-governmental organizations.

Upon arrival at the settlement, heads of households are provided with mats and blankets to sleep on and maize meal to cook.

Women and children are housed in 21 tents to the rear of the settlement, while others sleep under open industrial sheds, on concrete floors under tin rooves.

On a visit to the camp, Michel Sidibé, UNAIDS Executive Director, heard that while some amenities are being provided, there is not enough shelter for everyone and there is no lighting at night, which exacerbates vulnerabilities, especially of women and children.

It is well known that sexual and gender-based violence against women and children is heightened in emergency settings such as the one at Bangula. People also spoke of a lack of adequate nutrition, access to clean water and sanitation as well as their experiences of stigma and discrimination.

The small clinic at the settlement mostly focuses on primary health care and offers antenatal and postnatal services, HIV counselling and testing, refills of HIV treatment and psycho-social support.

While at the settlement Mr Sidibé spoke to a group of people living with HIV who had come to the settlement for shelter. They spoke of how, when the floods came, they tried to keep their HIV treatment safe from the water.

“When the floods came, my house was destroyed. But I managed to reach for my plastic bag where I keep my ARVs, because it is one of my most precious possessions,” said Sophia Naphazi, who resides in Jambo village in the district.

Elizabeth Kutenti, another women living with HIV, spoke of how her pills were safe because she keeps them in the roof. “They are my life,” she said.

The support people at the settlement need to return home is modest. “We need three things: a plastic sheet to cover what is left of our homes; maize seeds to plant and a hoe. Then we can go home,” said Miliam Moses.

“The level of resilience I have seen today is just amazing,” said Mr Sidibé. “The most important message I have heard today is one of hope.”

Mr Sidibé was accompanied by Atupele Austin Muluzi, Minister of Health and Population in Malawi. He thanked the UN agencies and the government departments supporting coordinating in the emergency response.

“We need continued support so that all the people in this settlement get the help they need so they can return home and live in dignity,” he said.

Documents

The Sustainable Development Goals and the HIV response Stories of putting people at the centre

12 July 2017

The pages that follow tell the powerful and moving stories of people who are living with or affected by HIV and who have experienced positive improvements in their lives because of the synergies between the AIDS response and the related SDGs. Now more than ever I believe that we have the means, the science and the unity of commitment and spirit to deliver on the SDGs and to transform our world by 2030.

Update

Daily Development book is launched

14 October 2015

In 2013, UNAIDS launched the Daily Development blog to explore, in the run up to the adoption of the Sustainable Development Goals (SDGs), global development and the people behind it. The blog covered the whole range of development issues to be addressed by the SDGs—health, human rights, innovation, the arts, education, economics, the environment and more.

Both high-level policy-makers and people working on the ground in some of the world’s most difficult conditions were asked to give their stories. Erna Solberg, the Prime Minister of Norway, spoke about her passion for ensuring that girls are educated. Edward Tommy, a journalist from Freetown in Sierra Leone, describes his experience of working at the epicenter of the Ebola outbreak in mid-2014. And Aidan McQuade, Director of Anti-Slavery International, wrote about why there is still a need for an anti-slavery organization in the modern world. What unites those authors, and the dozens of other people we spoke to, is their commitment towards improving the lives of others—they were working towards achieving the 17 SDGs even before they were formulated.

Daily Development was founded as both a blog and a book project. With the adoption of the SDGs in New York in September the blog published its last post, but as the culmination of the project UNAIDS has published a book, telling the stories of all who we spoke to over the past two years.

Quotes

“We hope that the Daily Development book will serve as inspiration for all who work to achieve the Sustainable Development Goals over the next 15 years.”

Michel Sidibé, UNAIDS Executive Director

Debrief

Using new media for the health and well-being of gay men and other men who have sex with men

22 May 2015

New information and communication technologies are changing the way in which gay men and other men who have sex with men meet their sexual partners. Today, men who have sex with men, including those who are not openly gay or who fear stigma, are able to arrange to meet other men, look for entertainment, find health information and mobilize through dating applications, the Internet and other digital media.

Such technologies also represent an important resource for extending the reach and enhancing the effectiveness of HIV prevention programmes among gay men and other men who have sex with men. They hold the potential to drive measurable programmatic improvements by collecting and disseminating information, linking virtual content to physical services and complementing offline components of HIV programmes.

In order to improve the reach of HIV services and the impact of HIV prevention programmes, UNAIDS, in collaboration with the Global Forum on MSM & HIV, the USAID funded LINKAGES programme and Health Policy Project, organized a consultation to develop a framework to engage the private and public sectors and communities in using new media technologies for HIV prevention among gay men and other men who have sex with men.

Participants

The participants included experts in the area of new media and HIV among gay men and other men who have sex with men, including some of the largest private companies that own dating platforms, programme implementers, researchers and advocates.

Key messages

  • A number of large, for-profit, gay dating applications and Internet companies with a very large number of clients already support initiatives to foster the health and well-being of their clients. They have the potential to reach people at higher risk of HIV infection with information and refer them to HIV service providers.   
  • Public–private partnerships on new media technologies for the health of gay men and other men who have sex with men need to be strengthened. A better understanding of the strengths and limitations of the private and public sectors as well as community organizations and networks is required. 
  • Innovative projects are increasingly using new information technologies to strengthen the HIV response among gay men and other men who have sex with men across the project cycle, from planning to implementation to monitoring and evaluation. These need to be evaluated and scaled-up.
  • National AIDS programmes need to increasingly include the use of new information and communication technologies in their strategies and policies, build their own information and communications technology capacity and fund such programmes.
  • Data safety issues need to be addressed.  
  • The use of new media should be included in core HIV packages and programmes; international guidance should be developed regarding minimum standards, training requirements or measures of success.

Quotes

“It's encouraging to see the United Nations reach out to emerging technologies to discover ways that our platform may help stop the spread of AIDS in the world.”

Steve Levin, Head of Sales, Grindr

“It’s a rare opportunity to have the private sector, implementers and community all in the same room—there has been loud and clear message from this meeting that we do have the same goals, we do have the same concerns and we do share common ground from which it is possible to move forward together.”

Matt Avery, Strategic Behavioural Communications Officer, Linkages Project, Asia Pacific

“The evidence that information and communications technology have significant reach and offer considerable potential for public health and HIV prevention, especially in the field of mobile apps, is extremely encouraging.”

Jack Mackenroth, Senior Communications Officer, Global Forum on MSM & HIV

“I was thrilled to be part of this important consultation on building effective public–private partnerships to address sexual health issues of gay, bisexual and other men who have sex with men. We look forward to working more closely with the United Nations to find meaningful solutions in reducing HIV/sexually transmitted infections across the globe.”

David Novak, Managing Director, Online-Buddies Research Institute

“Undeniably, gay social networking applications can be a great tool. Blued, as a gay dating application with social responsibility, is keen to make our platform available for HIV interventions. We just need to learn how to work more effectively and innovatively.”

Geng Le, Chief Executive Director, Danlan, China

Feature Story

Harnessing the power of technology for social transformation

27 October 2014

Civil society, public and private organizations and UNAIDS are leveraging advances in mobile technology to empower communities. Together they have produced a new mobile application called iMonitor+, which enables users to access HIV prevention and treatment services and provide feedback on the quality of such services.

The Deputy Governor of Bangkok, Pusadee Tamthai, the UNAIDS Executive Director, Michel Sidibé, the Public Campaign Officer of the Indonesian AIDS Coalition, Ayu Oktariani, and the Director of Service Workers in Group Foundation (SWING), Surang Janyam, launched iMonitor+ on 27 October in Bangkok, Thailand.

“This is a data revolution: real-time, mobile health information systems. iMonitor+ is not just a gadget, but a tool for social transformation. It will empower people to demand services and foster public accountability,” said Mr Sidibé.

iMonitor+ uses global positioning satellite technology to locate a user, who can then receive information on where to access condoms, HIV testing, counselling and treatment and other key services. If there are stock-outs of antiretroviral medicine and other HIV commodities, the user can send alerts to a central dashboard and be directed in real time to other services nearby.  Users can also report any experience of stigma or violation of their rights in HIV service and other delivery settings to the dashboard. Public health authorities and community partners are working together to resolve as quickly as possible issues raised by the alerts.

“iMonitor+ has great potential as an important early warning tool, which can notify public health authorities of gaps in key services,” said the Deputy Governor of Bangkok. “By working with civil society to develop iMonitor+ we have opened up an important channel for dialogue and strengthened key partnerships for social transformation.” 

Since early June more than 100 volunteers from five community networks in Thailand, Indonesia, India and the Philippines have been pilot testing iMonitor+ to provide feedback and adapt the application to each network’s specific needs. In Thailand, the Bangkok Metropolitan Administration has partnered with SWING to test and fine-tune the application.

“iMonitor+ is an effective platform with which to work with public health authorities,” said the Director of SWING. “It is providing us with an opportunity to directly influence the way the services are delivered to communities.”

The Indonesian AIDS Coalition has been running a trial with iMonitor+ in four cities, including Jakarta. Ayu Oktariani said, “We are finding that health authorities are taking the real-time alerts we register with iMonitor+ seriously and that they move much more rapidly than before to close service delivery gaps.”

The feedback from communities and service providers will ensure continuous innovation and adaptability of the app. This participatory monitoring tool is not only an important community tool for quality assurance and responsiveness of HIV services, but can give people the power to monitor services in many areas aside from public health and serve as an instrument for improved public accountability.

Feature Story

South Sudan: raising HIV awareness among displaced communities

08 September 2014

Anywur Mayan took her first HIV test two years ago. A health worker came to her house in rural Jonglei State and briefly explained that he was checking her for a virus. He pricked her finger and drew some blood. A few minutes later he told her the test had come back negative and left.

She did not really learn what HIV is or how it is spread until early June this year, after she had moved hundreds of miles from her Jonglei home to escape fighting there. Her new settlement Nimule—a border town near South Sudan’s border with Uganda—is safer, but has much higher HIV prevalence.

Behind there, there is nothing,” said Anywur, pointing in the direction of Jonglei. “Our houses, our belongings, they were all destroyed.

Fighting broke out in the South Sudanese capital, Juba, in mid-December and spread rapidly across nearly half the country. The United Nations Office for the Coordination of Humanitarian Affairs estimates that tens of thousands of people have been killed and more than 1.7 million have fled from their homes since December 2013—about 1.3 million displaced internally and 448 000 seeking refuge in neighbouring countries.

Raising awareness

Anywur, with her husband and infant son, set out in January for Nimule, where the HIV prevalence—estimated at 4.4%, according to the 2012 Antenatal Clinics Surveillance Report—is well above the national average of 2.6%.

In Anywur’s new home in Nimule a collection of local organizations has taken on the task of raising awareness about HIV. Anywur said she only found out what HIV is when a team of community educators gave a detailed presentation about the virus with the aid of information, education and communication materials created by the South Sudan AIDS Commission (SSAC) and UNAIDS.

Where we came from, this kind of education, it is not there,” she said.

But local activists and health workers said they still have thousands more people they need to reach and not enough resources to do it. At the same time, the new arrivals add a layer of complexity to the work they were already doing in the community.

HIV services

The highway connecting Juba to Uganda and the rest of eastern Africa cuts through Nimule, which hosts the country’s most active border crossing. Overloaded trucks rumble through the town at all hours, carrying fruits and vegetables, mattresses and anything else that can be sold in Juba’s markets.

Like many border towns, Nimule has its share of sex workers and their clients, especially long-distance truck drivers. The 2013 South Sudan Global AIDS Response Progress Report estimates that 62.5% of all new adult HIV infections in the country last year arose from sex work, the majority being clients of female sex workers.

Before the fighting broke out, Patrick Zema, Nimule Hospital’s HIV testing and counselling supervisor, said they were making significant progress in increasing awareness about the virus, reducing stigma and linking people to services. The hospital currently has 1 300 clients enrolled in antiretroviral therapy.

But now they are starting from the beginning with the displaced communities. “They come and they fear to test their blood,” said Pascalina Idreangwa Enerko, the chairperson of the local Cece Support Group of People Living with HIV, who attributes this behaviour to a combination of a lack of knowledge about the virus and stigma that comes with an HIV-positive diagnosis. “Thanks to the health education provided, they come out. It is important that they know their status.

Since April, Cece has teamed up with two community-based organizations—Humans Must Access Essentials (HUMAES) and Caritas Torit—to do near-daily mobile awareness-raising campaigns within the far-flung displaced community.

The community mobilizers begin with an hour-long presentation on HIV awareness and prevention. Then they encourage people to visit different stations, including one for paediatric consultations, a free drug dispensary and an HIV testing centre.

Reena’e Awuor Ondiek, Caritas Torit’s HIV counsellor, said her table was not popular when they first started in February, but she has noticed a change in people’s attitudes as she has made repeated visits to the same communities.

The programme has also helped address one of the other major challenges created by the crisis. “The conflict moved people from one place to another and interrupted follow up,” said Habib Daffalla Awongo, SSAC’s director general for programme coordination. “Some patients have been lost within host populations.” During their community visits, a Caritas team has already located people who stopped treatment as they fled the fighting and restarted them on antiretroviral therapy.

The team is still facing challenges, the most critical being a shortage of money. They are unable to hire the vehicles they need to reach thousands of displaced people who are camping outside of Nimule and who have almost no access to HIV services.

But Ondiek said there is no shortage of people like Anywur who need their services in the communities they can reach.

Press Release

Global leaders commit to ending the AIDS epidemic in cities by 2030

MELBOURNE, 20 July 2014—In a meeting initiated by UNAIDS and hosted by the city of Melbourne, Australia, global leaders agreed that cities and local leadership are the key to ending the AIDS epidemic by 2030. The inaugural Cities for Social Transformation meeting took place on the sidelines of the 20th International AIDS Conference. Mayors and representatives of 18 cities, governors, senior members of parliament, health ministers, a Head of State and senior health professionals attended the event.

The leaders committed to a rapid scale-up of prevention, treatment, care and support programmes, as well as addressing the needs of people at higher risk of HIV infection.

“It’s time to focus on local epidemics and city governments will be the driving force for change. They have the resources and the architecture to deliver essential social and health services,” said Michel Sidibé, Executive Director of UNAIDS. “They are the catalyst for forging new partnerships between communities, civil society and government. We will not end the AIDS epidemic without harnessing the power of cities.”

Ratu Epeli Nailatikau, the President of Fiji, Nafsiah Mboi, the Health Minister of Indonesia, Powes Parkop, the Governor of Papua New Guinea’s capital Port Moresby, Dhlomo Sibongiseni, the Health Minister of KwaZulu-Natal Province in South Africa, and Robert Doyle, Lord Mayor of Melbourne, shared their experiences.

"It’s an honour to be hosting this inaugural cities initiative mayors’ meeting. This is an important moment because I believe the world’s cities—our cities—have a pivotal role to play in leading the HIV response … and fulfilling the vision of an HIV-free generation,” said the Lord Mayor of Melbourne.

Current data show that 15 countries account for 75% of global HIV infections, with the majority found in urban centres. It is estimated that 220 cities globally account for over a third of HIV prevalence. In the Asia and the Pacific region, 30 cities account for over a million people living with HIV.

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 onFacebook and Twitter.

Contact

UNAIDS
Saya Oka
tel. +41 79 540 83 07 or +61 4 7507 1409
okas@unaids.org
UNAIDS Bangkok
Artan Jama
tel. +66 94894 9235
jamaa@unaids.org

Press centre

Download the printable version (PDF)

Subscribe to Demographic impact