More than 250 mayors from sub-Saharan Africa and of African descent from the United States, the Caribbean and Latin America focused on strengthening the AIDS response in urban areas during an historic conference held in Dakar, Senegal from 15-19 December.

The 2011 World Summit of Mayors Leadership Conference was hosted by Senegalese President Abdoulaye Wade and co-organized by the US-based National Conference of Black Mayors (NCBM), the National Association of Senegalese Mayors, and UNAIDS.

At a plenary session chaired by the mayors of Dakar and Abidjan, Côte d’Ivoire, delegates engaged in a discussion on HIV risks, prevention strategies and the need to end stigma and discrimination.

“Today we can say with confidence that HIV prevention programmes are producing results. We can report today that 22 countries in Africa have lowered the rate of new HIV infections by 25% since 2001”, said Djibril Diallo, UNAIDS Senior Advisor, in a statement on behalf of UNAIDS Executive Director Michel Sidibé.

Citing the challenges posed by the global financial crisis, Dr. Diallo urged municipal leaders to reinforce their efforts to find ways to take greater ownership of the AIDS response and promote shared responsibility. “This will bring the world closer to the UNAIDS vision of zero new HIV infections, zero discrimination, and zero AIDS-related deaths,” he added.

The plenary session concluded with a proposal for pilot partnerships for HIV prevention between 10 cities and towns in sub-Saharan Africa and the Americas. The proposal was incorporated in the Summit’s action plan. The municipalities will share information on their five most effective activities to reduce HIV infections and ways to increase budget allocations for HIV prevention as well as to improve prevention services. The organizers plan to enlist several large U.S. cities, such as Atlanta, Las Vegas and Washington, DC in the pilot initiative.

“The foundational belief of the Summit is that cooperation between municipalities on the development challenges facing cities on the global landscape, including the HIV epidemic, is essential to the improvement of the well-being of all citizens in urban areas,” said Mayor Robert L. Bowser of East Orange, New Jersey, President of the NCBM, whose membership includes 682 mayors with a constituency of 55 million people across the U.S.

The World Summit of Mayors was convened within the framework of the UN International Year for People of African Descent 2011. Outside of sub-Saharan Africa, an estimated 200 million people in the Americas identify themselves as being of African descent, as do millions more in other parts of the world.

The United Nations Resident Coordinator in Senegal, Bintou Djibo, saluted the Summit’s efforts to forge international partnerships for development between mayors of the Diaspora and in sub-Saharan Africa. “Cooperation between mayors can promote decentralized governance that takes local conditions into account, and advance progress towards the achievement of the MDGs by 2015,” said Ms Djibo.

 

Six Asian countries experiencing rapid economic transition have yet to prioritize HIV prevention resources for high-impact programmes. Political will and social acceptance will be needed to allocate resources for HIV services for sex workers and their clients, injecting drug users and men who have sex with men.

These are the key findings of a study focusing on China, India, Indonesia, Malaysia, Thailand, and Vietnam, carried out under the auspices of the aids2031 initiative.

The study, Asian Economies in Rapid Transition: HIV Now and Through 2031, was launched at the 9th International Congress on AIDS in Asia-Pacific. The report underlines the demographic, economic and social transformation taking place in the six countries and makes an attempt to analyze and project how these rapid changes may impact the spread of HIV in years to come. It also recommends some critical and sustainable long-term measures that will need to be adopted in order to curb the epidemic and its impact in these six countries.

The six countries studied are expected to increase their gross domestic product (GDP) per capita by between 3 and 10 percent per annum over the next 25 years, leading to higher public revenues and health spending. By 2031, each of these countries will need less than a quarter of a percentage point of GDP to pay for universal access to HIV prevention, care, and treatment. Funding for AIDS programmes will need less than one percent of the public health budget, except for Indonesia.

New trends in these six countries are changing the future scenario of the HIV epidemic. The boom in information and communication technologies, heavy migration and population mobility, rising spending power, and the growing use of recreational drugs may lead to an increase in sexual risk behaviors. The impact of these emerging trends on young people, a growing segment of the population in these six countries, is a particular concern.

Policy support and financial resources for interventions targeting most-at-risk populations must go hand in hand to implement innovative outreach programmes, according to the report. At the same time, a human rights perspective is needed to contain the social prejudice and stigma that may prevent these services to reach the most vulnerable groups.

‘If the AIDS epidemic is to be curbed,” says Prof. Myung-Hwan Cho, the Co-chair of the Working Group, “the governments in these countries will need to commit their growing resources and summon the political will to adapt policies and develop sound programmatic approaches that address inequalities, stigma and discriminatory practices”.

Asian Economies in Rapid Transition: HIV Now and Through 2031 is the first report to be launched by aids2031, an international think tank which generates new thinking on what must be done now to better manage AIDS epidemic by the year 2031.

By Sophie Dilmitis,
World YWCA, HIV and AIDS Coordinator
and International Community of Women Living with HIV and AIDS (ICW) European Regional Representative.

Lynde Francis (8 November 1947 - 31 March 2009)

There are some people who leave a mark on you after you have met them and there are some people whose words you hang on to and whose advice you cherish.  Lynde was one such person, not only to me but also to many people around the world. 

Lynde was one of the first women in Zimbabwe to disclose her HIV-positive status and did this to support the people of Zimbabwe. She started an organization called the Centre in her own living room at home and this grew into community based organization that supported thousands of people and was run by and for people living with HIV. The centre and the work she did nationally, regionally and internationally have become her legacy.

Lynde will be remembered and respected around the world for her advocacy and education efforts on all aspects of holistic management of HIV, as well as an advocate for the meaningful involvement of People Living with HIV (MIPA). Lynde was also the Southern African Regional Representative for the International Community of Women living with HIV (ICW) and a founding member of the Pan African Treatment Activists movement (PATAM). She served on the boards of Women and AIDS Support Network (WASN), Cedas Trust, Zimbabwe Activists on HIV and AIDS (ZAHA) and was a member of the regional reference group for the ecumenical HIV and AIDS initiative in Africa (EHEIA). Lynde was part of the Country Coordinating mechanism for Zimbabwe and a founding member of the Zimbabwe National Network of People Living with HIV.

Lynde’s achievements, especially in HIV and AIDS are too many too mention in this article – what she managed to achieve in a lifetime – some never do in ten lifetimes. 

Lynde had some wonderful qualities and in so many ways Lynde was a pioneer.  She was a great listener and a healer, a brave advocate, an inspirational teacher, a friend and a mother to so many of us who were diagnosed HIV positive.

I met Lynde over ten years ago at the age of 22. I had just been diagnosed HIV positive and my doctor had very little information on HIV. Life felt overwhelming and it was Lynde that explained to me what HIV was, how it worked and how I could look after my body. Lynde nurtured and invested in me so that I am fortunate enough to be in the position that I am in today. Ten years ago HIV treatment (ARVs) were not that accessible in Zimbabwe and totally unaffordable to almost all. I was confused and was trying to process many different opinions about what I should be doing. It was Lynde’s calm voice that resonated with me in my decisions about how to deal with my life with HIV. It was Lynde that took the time to deal with the rage that consumed me and she did this whilst working with so many others, running an organization and leading national campaigns.

It is with unforgettable gratitude that I reflect and remember on how available she was to me and I wondered if she was like this with everyone that she worked with.  The more I saw of Lynde the more I realised that she was like this with everyone and always gave so much of herself.  With everything she had going on she really cared about people and I knew Lynde would always be there for me.

I learnt many things from Lynde and would like to share the following with you:

1. You life is your responsibility – Lynde once told me and many others, that she had a little box of tricks that she could have used to end her life.  She had created it when she first found out she was positive but she had such a passion for life that it was only ever used a reminder to her that life is worth fighting for and taught many people how to fight for their own lives and to take responsibility for their lives.
2. Lynde had the greatest respect for people and their culture.  She had an incredible ability to empathise with people and put herself in their shoes, no matter how uncomfortable this may have been sometimes. Lynde taught me that it is important to meet people where they are mentally, emotionally and culturally instead of pushing them to meet you.
3. As activists we don’t have to be at every meeting in the world. The world won’t collapse without us. Things do carry on and we can’t be everywhere and do everything. Some people living with HIV have a sense of urgency and this was something that Lynde herself struggled with.

Lynde lived a full life and it is so clear that many people deeply loved Lynde and celebrate all that she was and did.  Like some of us, Lynde may have been afraid sometimes but in all the time that I knew her, I never saw her back away from a challenge. She was open and available to all who needed her and she had a heart of gold.

Lynde we will all miss you. You were so much to all of us and all we can do now is hold onto the memory of your great and powerful spirit and ensure that you live on in all of us whose lives you transformed.  We celebrate your life and all that you gave.

Lynde celebrated 23 years of living with HIV in March this year. She leaves behind a huge family around the world that includes ten grandchildren. We extend our sincere condolences to Lynde’s family and friends. We cry with you as we appreciate her life of service to women and men, especially those living with HIV and her unwavering commitment to young people.

Lynde will remain a beacon of hope for all of us.

As high-level participants and international experts gather to discuss Africa’s development needs and challenges at UN headquarters in New York on 22 September, we take a look at how HIV and the AIDS response is impacting development on the continent.

In countries in Africa most heavily affected by HIV, the epidemic has reduced life expectancy by more than 20 years, slowed economic growth and deepened household poverty. However effective, sustainable AIDS responses offer an opportunity to overturn the critical development challenges to overcoming poverty, improving education, extending life expectancy and reducing child mortality.

Development needs leveraged through AIDS leadership

When committed national leadership on AIDS is combined with long-term coordinated financing, dividends beyond the epidemic are being seen in Africa. Scaling up HIV services means addressing years of under-investment in health human resources in resulting in strengthened health systems which lead to improved maternal and child health. As individuals benefit from antiretroviral treatment, they live longer and their labour productivity rises, lifting households from poverty and improving food security for their families.

“How we fare in fighting AIDS will impact all our efforts to cut poverty and improve nutrition, reduce child mortality and improve maternal health, curb the spread of malaria and tuberculosis.” - United Nations Secretary-General Ban Ki-Moon speaking at the General Assembly High Level Meeting on HIV/AIDS, New York, June 2008

In addition, an AIDS response that addresses deep seated drivers or causes of vulnerability to HIV infection—stigma, discrimination, gender inequality and human rights—will impact wider development.

Successes and progress

Affected countries in Africa are showing strengthening leadership in addressing challenges by increasing the use of their own resources. The per capita domestic public HIV expenditure (from governments’ own sources) in sub-Saharan Africa was six times greater than other parts of the world after adjusting by income level (2008 Report on the global AIDS epidemic).

The substantial increases in AIDS funding and the investment in prevention and treatment of recent years are producing encouraging results in a number of countries in Africa.

In Rwanda and Zimbabwe changes in sexual behaviour—waiting longer before becoming sexually active, having fewer multiple partners, increased condom usage among people with multiple partners—have been followed by declines in the number of new HIV infections. Condom use is increasing among young people with multiple partners in Benin, Burkina Faso, Cameroon, Chad, Ghana, Kenya, Malawi, Namibia, Uganda, Tanzania and Zambia.

HIV epidemics in Malawi, South Africa and Zambia appear to have stabilized and most of the comparatively smaller HIV epidemics in West Africa are stable or are declining, as is the case for Burkina Faso, Cote d’Ivoire, Mali and Nigeria. HIV prevalence in HIV epidemics in East Africa have either stabilized or are receding.

Gains in access to antiretroviral treatment

More people have access to HIV treatment than ever before. Of the 3 million people who received HIV treatment in 2007, more than 2 million of them are in sub-Saharan Africa. In the period 2003 to 2007, Namibia scaled up treatment from 1% to 88%, Rwanda from 3% to 71%. As a result we’ve seen number of AIDS-related deaths decline over the past two years from 2.2 million to 2 million in 2007.

This is paying incalculable dividends for African countries. HIV treatment means that HIV-positive people are living longer, in better health and with a higher quality of life. They can continue to be productive within their workplace and community and there is less risk of their household falling into poverty and food insecurity.

Good progress has also been made in the prevention of mother-to-child transmission of HIV with increases in coverage of services in countries including Botswana, Namibia, Swaziland and South Africa.

This progress suggests a return on the investments made on different fronts, particularly in HIV prevention and treatment, and shows that with continued commitment, countries can overcome the development challenge that the epidemic poses.

Demographic impact of HIV

However, in spite of successes the epidemic continues to outstrip the response. The 2008 report on the global AIDS epidemic released by UNAIDS shows that AIDS continues to be the leading cause of death on the continent of Africa. In southern Africa, the average life expectancy at birth is estimated to have declined to levels last seen in the 1950s—below 50 years for the sub-region as a whole.

The numbers are stark: 67% of all people living with HIV and almost 90% of children living with HIV are in sub-Saharan Africa. In Botswana and Zimbabwe more than one third of all deaths in children under 5 are due to AIDS.

Progress, but gaps remain

As pointed out in the UN Secretary-General’s Report to the June 2008 High-level meeting on AIDS, countries need to sustain the progress that they have already made and continued leadership is required for the implementation of fully funded and sustainable national strategies and programmes on HIV.

HIV: A public health and a development issue

HIV is both a public health and a development issue which requires a sustained, inclusive and multi-sectoral response.

The Commission on HIV/AIDS in Africa (CHGA) issued a report earlier this year which included a call for leadership at all levels to be mobilized and coordinated for a concrete HIV response and broader development plan. The report also calls for addressing gender inequalities in national strategies as 60% of people living with HIV in sub-Saharan Africa are women.

High-level meeting on Africa’s development needs

At the high-level meeting on Africa’s development needs taking place in New York on 22 September, heads of State or Government, ministers as well as civil society organizations, intergovernmental organizations, UN agencies, funds and programmes, as well as the Bretton Woods institutions will gather to discuss “Africa’s development needs: State of implementation of various commitments, challenges and the way forward.” The meeting will conclude with the adoption of a Political Declaration. UNAIDS Secretariat, its cosponsors and partners will host a series of side events.

– In many low and middle-income countries, growing levels of HIV are continuing to cause serious economic and development set backs. Companies are loosing a significant part of their workforce, particularly in high prevalence countries.

An Independent Commission set up

Geneva, 26 September 2008 – It is with profound sadness that UNAIDS mourns the death of Jan-Olof Morfeldt, executive director of Noak’s Ark, a Swedish AIDS organization active in prevention and providing care and support for people living with HIV.

Jan-Olof passed away on 22 September 2008 after a short battle with cancer.

A pioneer in Sweden’s work around HIV, Jan-Olof was one of the founders of Noah’s Ark – Sweden’s first organization dedicated to AIDS – and devoted tremendous energy to reaching out to people living with HIV. He took a particular interest in exploring the links between AIDS and issues such as human rights and social and economic development.

Jan-Olof was an invaluable partner to UNAIDS. He will be remembered for his efforts to increase awareness of AIDS and for speaking out on the rights of people living with HIV, not only in Sweden but globally.