Economic experts and representatives of national AIDS programmes, health ministries and health professional organizations endorsed the creation of a global coalition of community health workers in UNAIDS-convened consultations in New York, United States of America, on 9 and 10 February.

Community health workers bring cost-effective services to communities and increase service access for marginalized people, who often struggle to access essential health services. More than 6 million community health workers are already in place across the world. However, many are unpaid and are typically not fully integrated into health systems.

The participants called for an urgent initiative to recruit, train and deploy at least 2 million community health workers over the next two years to drive progress towards the 90–90–90 targets—whereby 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing treatment and 90% of people on treatment have suppressed viral loads—and to lay the foundation for sustainable health for all.

The consultations generated strong support for UNAIDS to establish a new international coalition of community health workers by mid-2017. This coalition will help to galvanize the creation of national associations of community health workers, support their harmonization and formalization, advocate for actions that support them and provide a unifying platform.

As a next step, it was agreed that UNAIDS will seek input from country-level community health workers on the vision, mission and structure of the coalition. UNAIDS will lead a global effort to mobilize resources for an emergency fund to support national initiatives for community health workers and to incorporate them as formalized, integral members of the health system.

Funding from Luxembourg supported the consultations. The Earth Institute of Columbia University and the International Association of Providers of AIDS Care were co-hosts.

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On 20 July, at the 21st International AIDS Conference, being held in Durban, South Africa, UNAIDS, the World Health Organization (WHO) and the Global Coalition on Women and AIDS launched a joint report, entitled HPV, HIV and cervical cancer: leveraging synergies to save women’s lives, as part of the work of the United Nations Interagency Joint Task Force on Noncommunicable Diseases. The report was launched during an informal panel discussion with representatives of UNAIDS, WHO and the International Community of Women Living with HIV, East and Southern Africa, moderated by Ebony Johnson of the Athena Network.

The burden that HIV places on women, particularly adolescent girls and young women from low- and middle-income countries, is compounded by the global burden of human papillomavirus (HPV) infection and cervical cancer. Every year more than 260 000 women die from cervical cancer—approximately 85% of whom live in low- and middle-income countries. Women living with HIV have a four to five times higher risk of developing cervical cancer, an AIDS-defining illness that is the second most common cancer among women living in low- and middle-income countries.

HPV is a major contributor to global morbidity and mortality each year, causing diseases that range from benign lesions to invasive cancers. Growing evidence indicates that HPV may also be an important cofactor in HIV acquisition.

Given the association between HPV, cervical cancer and HIV, synergies must be leveraged, and a focused and integrated approach to sexual and reproductive health, and saving women’s lives, must be taken.

The launch of the report engaged advocates, activists, researchers, service providers, the United Nations and development partners in a lively and informal dialogue. Princess Tessy of Luxembourg, Yvonne Chaka Chaka and Prince Africa Zulu of Onkweni attended the event.

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GENEVA, 8 March 2016—UNAIDS and telecommunications operator Orange have signed a memorandum of understanding to collaborate on a new project to strengthen links between health-care providers and people living with and affected by HIV through the use of mobile technology.

Mobile technology will be used to improve HIV services to ensure patient retention in care and treatment adherence and to help break down stigma and discrimination. Data will be collected and analyzed, gaps in services identified and action taken to improve the quality of health care for people living with and affected by HIV. The information collected will be anonymous and full confidentiality will be maintained.

“To achieve UNAIDS’ ambitious Fast-Track Targets by 2020, countries need to innovate,” said Michel Sidibé, Executive Director of UNAIDS. “This partnership with Orange will allow countries to benefit from state-of-the-art technology that is cost-effective and simple to use, to ensure they can provide the highest quality of services for people living with and affected by HIV.”  

UNAIDS and partners will use Orange Mobile Training EveryWhere (M-Tew), a web-based platform that has been designed to be fully integrated into health systems and implemented on a large scale. The M-Tew platform will enable health workers to communicate with people enrolled in care through text messages or by phone and voice messages. Health professionals will be able to send messages, conduct text or voice surveys to evaluate user perceptions on quality of services and answer questions through a virtual call centre.

The technology is simple to use and people enrolled in the project will only need a basic mobile phone and a 2G connection to send and receive messages, with no application to download and no Internet connection needed.

A four-month pilot phase will begin at the end of March 2016 in Abidjan, Côte d’Ivoire, which will involve 1000 people living with HIV who are enrolled in HIV treatment programmes. Participants in the pilot study will include people most affected by HIV, including 300 sex workers and men who have sex with men.

“President Alassane Ouattara has called for a reduction in HIV prevalence in Côte d’Ivoire to below 1% by 2020,” said Raymonde Goudou-Coffie, Minister of Health and Public Hygiene, Côte d’Ivoire. “We are committed to achieving this target and the new platform will help us Fast-Track our efforts to ensure we reach this ambitious goal.”

UNAIDS will collaborate on the project with the Ministry of Health and Public Hygiene of Côte d’Ivoire, the Autonomous District of Abidjan, Orange Côte d’Ivoire and civil society partners, including organizations of people living with HIV. After the pilot phase, the project will be rolled out more widely in health facilities across Abidjan, with plans to expand to other priority countries in the region. 

The partnership will advance efforts to Fast-Track the response to HIV towards ending the AIDS epidemic as a public health threat by 2030. To do this will require new innovations, front-loading investments over the next five years, reaching the UNAIDS 90–90–90 treatment target, expanding access to HIV prevention services and ensuring zero discrimination. 

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 towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

UNAIDS and the Global Health Workforce Alliance are launching an Agenda for Zero Discrimination in Health Care. The agenda supports a vision for a world where everyone, everywhere, enjoys health services without discrimination and where the health workforce is empowered to provide discrimination-free services to all.

Many people around the world face barriers to accessing quality health-care services and realizing the highest attainable standard of health. The multiple reasons for this vary across countries and communities. Even where health-care services are available and of good quality, people often experience or fear stigma and discrimination, which prevent them from accessing the health services they need and are entitled to receive.

A new report by Asia Catalyst produced in collaboration with eight community-based organizations in Cambodia, China, Myanmar and Viet Nam has documented discriminatory practices in health-care settings specifically against people living with HIV. Findings include experiences of involuntary HIV testing, involuntary disclosure of status, segregation, arbitrary additional expenses imposed due to HIV status and medical advice against pregnancy and for sterilization on the sole basis of HIV status.

The agenda offers a space for collaboration between countries, the World Health Organization, UNAIDS, other United Nations and intergovernmental organizations, professional health-care associations, civil society, academics and others to take coordinated action for achieving zero discrimination in health care.

The agenda will prioritize coherent joint actions in three critical areas:

• Political support: by increasing political commitment through mobilization of all key constituencies, to secure prioritization of this agenda at all levels.
• Implementation: by fostering scale-up of implementation of effective actions to achieve discrimination-free health care.
• Accountability: by promoting monitoring and evaluation frameworks and mechanisms to build evidence, monitor progress and ensure accountability.

The action plan outlines seven priorities; these include: building and sharing evidence and best practices; standard-setting; ensuring meaningful engagement of the people most affected by discrimination in the development, implementation and monitoring of policies and programmes; and strengthening the leadership of professional health-care associations.

A virtual community of practice has been created to mobilize more partners around the shared vision and action plan, to join contact ghwa@who.int. 

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The German Healthcare Partnership (GHP) celebrated its five-year anniversary on 24 November in Berlin, Germany. GHP was founded in 2010 by the German Federation of Industries and the Federal Ministry for Economic Cooperation and Development to strengthen health systems in developing countries.

Speaking at the event, UNAIDS Deputy Executive Director Luiz Loures pointed out that the AIDS response has been unique in terms of the partnerships it has created, bringing together political commitment, social mobilization and science. He also highlighted the added value of private sector engagement in public health and especially in the context of HIV, where it has made significant contributions in terms of innovation, technical knowledge and resources.

The event was also attended by Parliamentary State Secretary and Vice Minister of the German Federal Ministry for Economic Affairs and Energy, Brigitte Zypries and Parliamentary State Secretary and Vice Minister of the German Federal Ministry for Economic Cooperation and Development,  Thomas Silberhorn, who stressed that funding for development and cooperation is important, but that the private sector also needs to invest in improving health infrastructure, education and capacity-building, which are all key elements of health systems strengthening.

Mr Loures met with Tobias Bergner, Coordinator for the Foreign Policy Dimension of Global Health Issues for the German Foreign Office, and representatives of the Federal Ministry of Health. He praised Germany’s leadership on global health and its engagement with regard to global health architecture reform and encouraged Germany’s continued commitment to ending the AIDS epidemic by 2030.

While in Berlin, Mr Loures also presented the 2015 UNAIDS World AIDS Day report, together with Elisabeth Pott, Chief Executive Officer of the German AIDS Foundation.

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UNAIDS is joining with Cervical Cancer Action (CCA)—a global coalition to stop cervical cancer among women and girls in developing countries—to launch a new five-year initiative.

Taking Cervical Cancer Prevention to Scale: Protecting All Women and Girls, an initiative spearheaded by Ambassador Sally Cowal, is convening a partnership committed to prioritizing investments in the health of women and adolescent girls. It will build momentum for action on global cervical cancer prevention over the next five years.

Cervical cancer is preventable through vaccination and can be easily diagnosed, but prevention and diagnostic programmes are not widely available in the developing world. Rates of cervical cancer are four to five times higher among women living with HIV than among HIV-negative women, while the overall risk of acquiring HIV among women doubles when women are infected with the human papillomavirus, a cause of cervical cancer.

More than 80% of all cervical cancer cases and deaths occur in developing countries, where cervical cancer is the second most common cancer-related cause of death among women. Every year, cervical cancer affects nearly 500 000 women and takes the lives of over a quarter million women worldwide.

UNAIDS will use the political and programme platforms of the Fast-Track approach to end the AIDS epidemic by 2030 as part of the initiative to prevent cervical cancer.

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