During her meeting with UNAIDS Executive Director Michel Sidibé on 8 September, President Michelle Bachelet of Chile reaffirmed her commitment to ending mother-to-child transmission of HIV in the country.

Mr Sidibé, who visited Chile from 7 to 8 September, congratulated the President for the decisive steps the country has taken to improve the quality of maternal and child health services and to expand HIV testing, treatment and follow-up. 

Chile has put in place pre-natal care policies aiming to scale up services to help stop new HIV infections among children. In 2014, more than 95% of pregnant women living with HIV in Chile had access to antiretroviral medicines, compared to 78% for Latin America as a whole. The percentage for Chile represents an increase in coverage of close to 25% since 2012.

Mr Sidibé spoke about the importance of expanding and integrating HIV services with other health and maternal care services to increase the number of women reached. He also stressed the importance of ensuring that the most vulnerable have access to HIV prevention and treatment without fear of discrimination.

Mr Sidibé and President Bachelet agreed that the country should continue improving access to information and knowledge on maternal health, including HIV, to meet the needs of indigenous and other communities, who may be missed by current programmes.

While in Chile, Mr Sidibé also met with the Minister of Health, the mayor of Santiago, people living with HIV and representatives of civil society. 

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Latin American and Caribbean countries have called for sharply reducing the number of new HIV infections and HIV related discrimination in the region and have set new prevention targets to be met by 2020.

The new regional prevention targets, adopted at the Second Latin American and Caribbean Forum on the HIV Continuum of Care, include reducing by 75% the number of new HIV infections among adults and young people, and increasing to 90% the percentage of men who have sex with men, sex workers and transgender people who have access to HIV prevention packages.

More than 150 representatives of national HIV programmes, civil society, people living with HIV, academia and the scientific community participated in the event, held in Rio de Janeiro, Brazil, from 18 to 20 August.

Civil society and people living with HIV advocated that countries invest more to Fast-Track the HIV response. Countries in the region agreed to increase funding for prevention programmes for key populations from 7% of the total regional investment in HIV to 25%.

The participants also agreed that the way forward must include removing laws and policies that discriminate against people living with HIV and key and vulnerable populations. Countries committed to adopting a people-centred approach to end the AIDS epidemic by 2030. 

In 2014, an estimated 2 million people were living with HIV in Latin America and the Caribbean and 100 000 people became newly infected. Although the HIV response has been scaled up in several countries, regionally there has been little change in the annual number of new infections over the past five years. A major challenge is reaching vulnerable populations, who are often marginalized due to discrimination and encounter legal barriers in accessing services.

Participants recognized that a focus on location and population, a human rights approach, implementing innovative programmes in HIV combination prevention, and ensuring civil society and community involvement are all important to Fast-Tracking the HIV response in the region.

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The Economic Commission for Latin America and the Caribbean (ECLAC) and UNAIDS signed a cooperation agreement this month to strengthen the response to HIV in the Latin America region.

The objective is to join efforts to promote universal access to HIV prevention, treatment, care and support services. The cooperation will focus on developing studies of existing inequalities faced by the people most affected by HIV, analysing the efficiency and sustainability of the regional HIV responses, monitoring the achievement of the internationally agreed development goals and positioning HIV as a priority within the post-2015 agenda.

As part of the ongoing collaboration, Social panorama of Latin America 2014 includes a joint analysis of the shared responsibilities in funding the HIV response in Latin America. Upcoming joint publications will put special emphasis on raising awareness about the inequalities among the populations being left behind and the efficiency and sustainability of HIV programmes in the region.

ECLAC, one of five United Nations regional commissions, was founded in 1948 to contribute to the economic development of Latin America; the promotion of the region's social development was later included among its primary objectives.

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Health ministers from Brazil, Russian Federation, India, China and South Africa (BRICS) have committed to adopting the UNAIDS Fast-Track strategy to end the AIDS epidemic as a global health threat by 2030.

The decision was announced at a meeting of the ministers of health of the BRICS countries, held in Brasilia, Brazil, from 4 to 5 December. The ministers agreed to endeavour to achieve the 90–90–90 HIV treatment target by 2020, which is to rapidly reduce new HIV infections and AIDS-related deaths and to put countries on the Fast-Track to ending the AIDS epidemic by 2030. They also committed to ambitious tuberculosis (TB) targets and to advance cooperation and action on TB and HIV in the BRICS countries, such as the production of quality assured drugs and diagnostics for TB cases.

In 2013, the BRICS countries accounted for about 30% of new HIV infections worldwide. Estimates are that nearly half of all TB cases, 55% of multidrug resistant TB cases and 38% of all TB/HIV cases occur in the BRICS countries.

The adoption of the Fast-Track strategy by the health ministers demonstrates the renewed political commitment of the BRICS countries to work together to lessen the impact of TB/HIV coinfection. According to UNAIDS, the majority of people living with HIV will live in middle-income countries in the near future. In this regard, the BRICS countries can serve as a reference to provide solutions and exchange experiences with emerging economies.

UNAIDS Deputy Executive Director Luiz Loures called for an increased leadership by the BRICS countries to motivate the global community to implement the 90–90–90 treatment target and also fast-track the response to AIDS.

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The Vice-President of Costa Rica, Ana Helena Chacón, committed to ensuring access to inclusive HIV services and to promoting respect for human rights during a meeting with UNAIDS Deputy Executive Director Jan Beagle, held on 6 November at the Presidential Palace in San José, Costa Rica.

According to Ms Chacón, it is necessary to strengthen legal and social environments in order to promote human rights and remove barriers to accessing HIV testing, treatment and prevention services as well as social protection for the key populations most vulnerable to HIV. In Costa Rica, men who have sex with men are the most affected population, with an HIV prevalence of 10.9% compared to 0.3% among the general population. The Vice-President noted that social justice and inclusion are critical to ending the AIDS epidemic in the country by 2030.

Early last week, a bill to amend the national law on HIV was presented to the Legislative Assembly for discussion. The new bill intends to decriminalize HIV transmission and to reform the Penal Code to ensure legal protection against discrimination based on sexual orientation or gender identity.

Ms Beagle recognized the leadership that Costa Rica has shown in the AIDS response and noted its progress on the path to eradicating stigma and discrimination. She also commended the country for its efforts in scaling up HIV services to prevent new HIV infections among children and urged accelerated action in order for Costa Rica to become one of the first Latin American countries to reach zero new HIV infections among newborn children by 2015.

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UNAIDS appointed Brazilian actor Mateus Solano, best known for his role in the popular television soap opera Amor à Vida, as its first National Goodwill Ambassador for Brazil on 22 August.

Mr Solano’s character in the show gave the first gay kiss on Brazilian television. The kiss, which was widely watched across the country, inspired millions to reflect on stigma and discrimination, and is considered to be an important step forward in the struggle against discrimination in Brazil. In his new role, Mr Solano will promote human rights and be a spokesperson against discrimination, one of the factors that makes people vulnerable to HIV infection.

Mr Solano’s popularity is expected to bring young people closer to the AIDS response in the country. In 2013, in Brazil 730 000 people were living with HIV and 44 000 people became newly infected with the virus. 

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The Latin America and Caribbean regions have set new targets for expanding HIV testing and treatment by 2020 to reduce new HIV infections, late diagnosis and AIDS-related deaths, as well as to improve the quality of life of people living with HIV.

Named 90–90–90, the new benchmarks were adopted during the First Latin American and Caribbean Forum on the HIV Continuum of Care, which was held in Mexico City, Mexico, from 26 to 28 May. During the meeting, the participants endorsed a call to action to adopt the UNAIDS and Pan American Health Organization (PAHO) 2020 treatment cascade targets for the two regions. These targets include increasing to 90% the proportion of people living with HIV who know their diagnosis, increasing to 90% the proportion of people living with HIV receiving antiretroviral treatment and increasing to 90% the proportion of people on HIV treatment who have an undetectable viral load.

Representatives of national HIV programmes, civil society, people living with HIV, academia and the scientific community were among the 141 people from 26 countries who participated in the forum. The meeting was organized by a coalition of partners, including UNAIDS, PAHO, the Governments of Mexico and Brazil and other regional partners.

The bold targets are a response to recent scientific evidence that diagnosing HIV and starting treatment earlier can prevent its transmission and dramatically improve health outcomes. Suppressed viral load is critical for reducing both the harmful effects of HIV infection on people’s health and the risk of infecting others.

“The expansion of early diagnosis and treatment combines individual clinical benefits of early treatment with the benefits of preventing transmission in the community,” said César Núñez, UNAIDS Regional Director for Latin America. “Many people living with HIV first learn they are infected late in the course of infection, undermining the effectiveness of HIV treatment and facilitating the continued spread of HIV.”

According to the participants, increasing demand for HIV testing is essential to reducing the number of new HIV infections and requires robust and sustained investment in community-based HIV literacy programmes as well as strengthened community systems. To do this, countries agreed to review their models of care in order to make them more accessible to patients. 

“If we want more people undergoing treatment with an undetectable viral load, it is essential that they know their diagnosis and begin treatment early,” said Massimo Ghidinelli, head of the HIV, Hepatitis, Tuberculosis and Sexually Transmitted Infections Unit at PAHO.

During the last three years, HIV responses have been scaled up in several Latin American and Caribbean countries. According to new PAHO/WHO 2013 estimates, about 70% of the population currently knows their HIV status. However, 35% of new HIV diagnoses present late with a CD4 count below 200. At present, 48% of eligible people living with HIV are on HIV treatment, and, of these, 66% are virally suppressed.

UNAIDS Caribbean Director Ernest Massiah emphasized that although reaching the new targets will be challenging, the regions have a good track record of working towards ambitious goals.

“The Caribbean and Latin America treat a higher proportion of people living with HIV than any other low- and middle-income region. In most of the Caribbean we are close to eliminating HIV in children because of the excellent rates of antenatal testing and treatment. With the combined efforts of HIV programmes, civil society and international partners on these new targets, we can accelerate progress towards ending the AIDS epidemic,” said Mr Massiah.