Cervical cancer—an illness that can be prevented by vaccination against the human papillomavirus (HPV) and that is curable if detected and treated early—is developed by more than 500 000 women each year, half of whom die of the disease. If cervical cancer prevention, screening and treatment efforts are not urgently scaled up, it is projected that this number could double by 2035.

Cervical cancer is an AIDS-defining illness, since women living with HIV who become infected with HPV are more likely to develop pre-invasive lesions that can, if left untreated, quickly progress to invasive cancer—women living with HIV are four to five times more likely to develop invasive cervical cancer. HPV infection has been found to significantly increase the risk of HIV transmission for both men and women.

Thanks to HIV treatment, many more women living with HIV are living long and healthy lives, but it is imperative that women living with HIV do not succumb to other illnesses, including cervical cancer. “It makes no sense to save a woman’s life from AIDS, only to let her die from treatable or preventable cancer,” President George W. Bush, whose George W. Bush Institute is leading efforts to end AIDS and cervical cancer, said in October 2015.

Nine out of 10 women who die from cervical cancer live in low- and middle-income countries. Given that the burden of HIV is primarily felt in low- and middle-income countries, and particularly by adolescent girls and young women, responding to both cervical cancer and HIV together in those countries is vital. Unfortunately, however, most low- and middle-income countries with a high prevalence of HIV have limited programmes for cervical cancer prevention and control.

There is a growing awareness of the need to maximize synergies between the AIDS response and efforts to prevent, diagnose and treat cervical cancer through HPV vaccination, education, screening and treatment. Likewise, existing HIV programmes can play a strategic role in expanding cervical cancer prevention services.

Reducing deaths from cervical cancer requires a wide-ranging approach that includes the following:

• Health education, including age-appropriate comprehensive sexuality education.
• HPV vaccination for adolescent girls.
• Screening all women at risk of developing cervical cancer. Screening programmes should include HIV counselling, testing and treatment, as well as other sexual and reproductive health services and treatment of precancerous cervical lesions and invasive and advanced cervical cancer.
• Ensuring access to palliative care, when needed.

“All women living with HIV need access to information on HPV and should be offered cervical cancer screening and treatment if necessary,” said Michel Sidibé, Executive Director of UNAIDS.

In May 2018, the United States President’s Emergency Plan for AIDS Relief, the George W. Bush Institute and UNAIDS launched a joint effort through a US$ 30 million partnership to accelerate efforts in eight sub-Saharan African countries to ensure that women and girls living with HIV are a priority in national cervical cancer prevention and control programmes.

“Thanks to the generosity of the American people, the United States President’s Emergency Plan for AIDS Relief has saved the lives of millions of HIV-positive women around the world,” said Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy, at the launch of the partnership in May 2018. “We must ensure these same women—mothers, daughters, aunts and grandmothers—who are living with HIV and thriving do not succumb to cervical cancer.”

Of the 1.8 million children aged 0–14 years living with HIV globally, 1.7 million are in Africa. As part of efforts to eliminate mother-to-child transmission of HIV in Africa, the African Union and the Organisation of African First Ladies against HIV/AIDS (OAFLA), with support from UNAIDS, and partners launched a campaign called Free To Shine in early 2018.

Now the campaign is ready to be rolled out across 42 African countries but urgently needs funding. To enable the roll-out, the African Union and OAFLA held an event on the margins of the 73rd session of the United Nations General Assembly to help raise much-needed resources to support the campaign.

The roll-out of the campaign will allow OAFLA members to engage in community-level activities to help reduce stigma and discrimination at home and in the community, raise community awareness about the importance of adherence to treatment and retention in care for pregnant women and women who are breastfeeding and to promote male involvement.

As part of the campaign, the first ladies will also leverage their unique position to influence policy-makers and agenda-setters to better address the needs of women living with HIV—advocating for policies and laws that discourage stigma and discrimination based on HIV status and for the removal of user fees for pregnant women and women who are breastfeeding, as well as other barriers that limit access to HIV and health services.

The session was moderated by television and radio journalist Zeinab Badawi. 

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Unjust laws can prevent people from accessing the services they need to prevent or treat HIV, and people who use drugs need help and care, not punishment—these are two of the messages from the new Model Drug Law for West Africa. Launched on11 September in Dakar, Senegal, the model drug law aims to guide policy-makers in the region on how to better frame their drug laws.

It is increasingly recognized that the current drug laws are not effective and result in enormous costs. The model drug law shows how countries can modify their laws in order protect the health and welfare of people while at the same time allowing law enforcement to focus on the most serious drug offences.

“The risk of acquiring HIV is 23 times higher among people who inject drugs, yet they still face human rights abuses, punitive legal environments and are left out of health and HIV programming,” said Michel Sidibé, Executive Director of UNAIDS. “It is essential that countries take a human rights-based approach that is grounded in scientific evidence and includes critical harm reduction services to protect the health and welfare of people who inject drugs and their communities.”

Drawn up by the West Africa Commission on Drugs, a group convened by Kofi Annan comprising experts from western Africa, the model drug law notes that barriers to accessing health services for people who use drugs need to be removed. People who inject drugs are one of the groups at highest risk of exposure to HIV, but they remain marginalized and often out of reach of health and social services.

The model drug law suggests removing criminal penalties for people who use drugs and making harm reduction measures available. It has been shown that harm reduction works—when harm reduction services are made available, new HIV infections fall sharply. For drug use, and possession of drugs for personal use, the model drug law sets out alternatives to conviction and punishment.

“Our current drug laws stigmatize and penalize drug users. However, pushing them to the fringes of society or locking them up in ever increasing numbers will not solve the problem. On the contrary, it worsens health issues and puts enormous pressure on the already over-stretched criminal justice systems,” said Olusegun Obasanjo, former President of Nigeria and Chair of the West Africa Commission on Drugs.

The model drug law also seeks to enhance access to essential medicines such as morphine and other opioids to manage pain. Many people in western Africa are denied the pain-relieving medicines that they need because doctors and other health professionals are not prescribing opioids for fear of prosecution. The model drug law suggests special protection for medical staff to help remove barriers to accessing pain relief.

Experience around the world has shown that it is possible to change drug laws for the better. The new model drug law is a step towards making such changes in western Africa.

GENEVA, 10 August 2018—UNAIDS welcomes the appointment of former Chilean president Michelle Bachelet as the United Nations new human rights chief.

Ms Bachelet ended her second four-year term as president earlier this year, having already held the post between 2006 and 2010. She was the first woman to be elected to Chile’s highest office. After her first term, she was appointed the first ever Executive Director of the UN gender equality office, UN-Women based in New York.

A former paediatrician, the politician also held key government posts as Chile’s Minister of Defence and Minister of Health.

The High Commissioner is the top official who speaks out for human rights across the whole UN system, strengthening human rights mechanisms; enhancing equality; fighting discrimination in all its forms; strengthening accountability and the rule of law; widening the democratic space and protecting the most vulnerable from all forms of human rights abuse. Headquartered in Geneva, the Office of the High Commissioner for Human Rights (OHCHR) is mandated to promote and protect the universal exercise and full realization of human rights, across the world, as established in the UN Charter.

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.

Prosecutions of people living with HIV for acts that pose no risk of HIV exposure or transmission prompt scientists to issue a statement urging the criminal justice system to use science when considering prosecution of HIV non-disclosure, exposure or transmission

AMSTERDAM/GENEVA, 25 July 2018—A group of 20 leading HIV scientists from around the world have issued a scientific consensus statement urging governments and people working in the legal and justice systems to pay close attention to the significant advances in HIV science to ensure that science informs the application of criminal law in cases related to HIV.

“Science has greatly advanced in recent years which has been critical in allowing countries to make evidence informed decisions in their HIV programming,” said Michel Sidibé, Executive Director of UNAIDS. “With all the new scientific advances now available we need to continue to use science as evidence to deliver justice. No one should face criminalization because of a lack of information or understanding by the justice system about the risks of HIV transmission.”

The expert group of scientists, convened by UNAIDS, the International Association of Providers of AIDS Care (IAPAC) and the International AIDS Society, warn that an overly broad and inappropriate application of criminal law against people living with HIV remains a serious concern across the globe. Around 73 countries have laws that criminalize HIV non-disclosure, exposure or transmission, and 39 countries have applied other criminal law provisions in similar cases.

“Many of these laws do not take into account measures that reduce HIV transmissibility, including condom use, and were enacted well before the preventive benefit of antiretroviral therapy or pre-exposure prophylaxis was fully characterized,” said José M. Zuniga, IAPAC President and Chief Executive Officer. “Most people living with HIV who know their status take steps to prevent transmitting HIV to others. Laws that specifically criminalize HIV non-disclosure, exposure, or transmission thus primarily exacerbate HIV-related stigma and decrease HIV service uptake.”

Most prosecutions have occurred based on perceived risk of HIV transmission through sexual activity. Some have also occurred for biting, spitting or even scratching. Prosecutions, and convictions, have often been influenced by a lack of knowledge or appreciation of scientific evidence regarding the possibility of transmission of the virus. In many instances, they have been influenced by deep-rooted stigma and fear associated with HIV, which still exists despite the huge advances in HIV treatment and prevention.

“We support this globally relevant expert consensus statement, for which we have been long-time advocates,” said HIV Justice Network’s Senior Policy Analyst Sally Cameron, on behalf of the Steering Committee of HIV Justice Worldwide, a global civil society coalition campaigning to end unjust prosecutions. “HIV criminalization is a growing global phenomenon that unfairly targets people living with HIV through criminal prosecutions and harsh penalties. This welcome statement makes the case that our current understanding of HIV science, alongside key human rights and legal principles, does not support this miscarriage of justice.”

The peer-reviewed consensus statement, endorsed by 70 additional scientists from around the world, was released today in the Journal of the International AIDS Society. It describes scientific evidence on the possibility of HIV transmission under various circumstances, the long-term impact of HIV infection and the means of proving HIV transmission so that it is better understood in criminal law contexts.

Based on a detailed analysis of the best available scientific evidence on HIV transmission and treatment effectiveness, the statement notes that there is no possibility of HIV transmission through saliva as a result of biting or spitting, even where saliva contains small quantities of blood. There is no to negligible possibility of HIV transmission where a condom is used correctly during sex, or where a partner living with HIV has an undetectable viral load.

In addition, effective antiretroviral therapy, low viral load, the use of pre-exposure prophylaxis (antiretroviral drugs taken by an HIV-negative person before a possible exposure), or post-exposure prophylaxis (antiretroviral medicines taken after a possible exposure) all significantly reduce the possibility of HIV transmission.

International guidance on HIV in the context of the criminal law recommends that “proof of causation, in relation to HIV transmission, should always be based on evidence derived from a number of relevant sources, including medical records, rigorous scientific methods and sexual history” (Ending overly broad criminalization of HIV non-disclosure, exposure and transmission: critical scientific, medical and legal considerations).

The experts recommend strongly that more caution be exercised when considering criminal prosecution, including careful appraisal of current scientific evidence on HIV risk and harms. The consensus statement is expected to help policymakers, prosecutors and courts be guided by the best available science and thereby avoid the misuse of the criminal law, as is currently happening in many countries worldwide.

Read the full Expert Consensus Statement on the Science of HIV in the Context of Criminal Law

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.

There has been global progress in accelerating towards the 90–90–90 targets—whereby, by 2020, 90% of people living with HIV will know their HIV status, 90% of people who know their HIV-positive status will be accessing treatment and 90% of people on treatment will have suppressed viral loads—since their launch at the International AIDS Conference in 2014 in Melbourne, Australia.

Four years later, global leaders from civil society, governments, the private sector and academia came together for a two-day workshop, on 21 and 22 July in Amsterdam, Netherlands, to highlight the successes, identify gaps and share best practices in order to reach 90–90–90.

By the end of 2017, the world had achieved 75–79–81. Globally, 75% of people living with HIV know their status, 79% of people living with HIV who know their status are accessing antiretroviral therapy and 81% of people accessing treatment had suppressed viral loads.

The participants at the workshop reviewed the progress made with the rapid adoption of global policies, political commitment, the engagement of civil society and regular evaluation of progress and gaps.

Despite the global successes, evidence presented at the workshop showed that entire regions and populations are still being left behind. Progress in eastern Europe and central Asia, western and central Africa and the Middle East and North Africa is falling behind. Key populations, adolescents and men are not being reached by traditional health facility-based HIV testing services. Lack of political commitment, user fees and stigma and discrimination are some of the barriers to progress.

During the session, the participants discussed ways to identify and correct gaps and direct resources to where they are most needed, including by investing in data collection, reducing the turnaround time from testing to treatment initiation, prioritizing adherence and retention in care, increasing access to affordable viral load testing and the meaningful engagement of civil society in order to reach the people currently being left behind.

The participants also called for the political commitment and financial resources needed to make 90–90–90 a reality everywhere.

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On 23 July, the Global HIV Prevention Coalition brought together HIV prevention leaders in Amsterdam, Netherlands, to discuss the urgency of scaling up HIV prevention services. They shared the progress made and looked at the challenges, including policy barriers and inadequate funding for prevention.

The speakers highlighted the initial progress made since the launch of the Global HIV Prevention Coalition in October 2017. National prevention coalitions engaging many sectors and civil society organizations have been established to better coordinate responses. Ambitious prevention programme targets have been set in many countries and newly launched HIV strategies focus on prevention.

However, the limited capacities of national programmes and a steady decline in prevention funding have put the end of AIDS at risk. Policies on age of consent in about half of all coalition countries remain major barriers to adolescents’ access to HIV and sexual and reproductive health services. Many countries lack sufficient data on key populations and hence reach few of them. Stigma and discrimination further prevent key populations from accessing services.

The heads of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and the United States President’s Emergency Plan for AIDS Relief (PEPFAR) underlined the need for adequate investments focused on the people with the highest HIV prevention needs.

Alvaro Bermejo, the Director-General of the International Planned Parenthood Federation, made a passionate appeal to donors and programmes not to forget condoms. All young people and members of key populations need easy access, he said, which was why the current gap in condom programming has to be closed.

For prevention efforts to be sustainable, civil society should be meaningfully engaged in national coalitions and their expertise and comparative advantage in implementation used and linked to adequate funding.  

Given these challenges and an ambitious prevention agenda to be implemented in only two and a half years, rapid action is required. The call made by the prevention leaders was a clear step in the right direction.

The participants of the event included the Minister of Health of South Africa, Aaron Motsoaledi, representatives of civil society and the heads of PEPFAR and the Global Fund. Michel Sidibé, the Executive Director of UNAIDS, and Natalia Kanem, the Executive Director of the United Nations Population Fund, convened the high-level panel.

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The 22nd International AIDS Conference opened on 23 July in Amsterdam, Netherlands. Under the theme “Breaking barriers, building bridges”, the conference will draw attention to the need of rights-based approaches to more effectively reach key populations. 

This year’s theme echoes one of the messages in UNAIDS’ latest report, Miles to go—that key populations are not being considered enough in HIV programming. Key populations and their sexual partners account for 47% of new HIV infections worldwide and 97% of new HIV infections in eastern Europe and central Asia, where one third of new HIV infections are among people who inject drugs.

The International AIDS Conference, which will run from 23 to 27 July, is the largest conference on any global health issue in the world and provides a unique forum for the intersection of science, advocacy and human rights. Bringing more than 15 000 participants together, the conference is an opportunity to strengthen policies and programmes that ensure an evidence-informed response to the epidemic.

The conference was officially opened by Princess Mabel van Oranje, the International AIDS Conference Chair, Linda-Gail Bekker, the UNAIDS Executive Director, Michel Sidibé, the Director-General of the World Health Organization, Tedros Adhanom Gebreheyesus, and artist and winner of the Eurovision Song Contest in 2014, Conchita Wurst.

Speaking at the opening ceremony, Mr Sidibé stressed that the pace of progress is not fast enough to meet the 2020 targets. He sounded the alarm on the growing inequalities and intolerance for diversity that are resulting in an HIV prevention crisis. He noted the need to break barriers that exclude people from their rights.

He also highlighted the need to close the gaps, specially the funding gap. “Like you, I worry about the funding gap. There is a persistent 20% gap between what is needed and what is available. We know small cuts can have big consequences. A fully funded AIDS response is non-negotiable,” said Mr Sidibé.

The conference is set to emphasize the need to promote human rights-based and evidence-informed HIV responses that are tailored to the needs of vulnerable communities, activate and galvanize political commitment and accountability among governments, donors, the private sector and civil society and address gaps in and highlight the critical role of HIV prevention.

During the coming days there will be opportunities for sharing knowledge, ideas and good practices through plenary discussions, abstract presentations, symposia, skills-building workshops, attendance at the Global Village community space and numerous independent events.

GENEVA, 20 July 2018—Following the call by the Executive Director of UNAIDS, Michel Sidibé, for an external high-level independent panel to provide recommendations to UNAIDS to further strengthen implementation of its zero tolerance policy on sexual harassment, the UNAIDS Programme Coordinating Board agreed to create an Independent Expert Panel. The panel will:

• Review the current situation in the UNAIDS Secretariat with regard to harassment, including sexual harassment, bullying and abuse of power and retaliation, including by looking back over the past seven years, to assess the organizational culture at headquarters and the regional and country offices.
• Evaluate the effectiveness of existing policies and procedures to prevent and address harassment, including sexual harassment, bullying, retaliation and abuse of power, in the UNAIDS Secretariat workplace.
• Recommend a comprehensive set of prioritized measures on organizational culture, policies and fair and due process procedures with respect to harassment, including sexual harassment, bullying, retaliation and abuse of power in the workplace.

The UNAIDS Programme Coordinating Board Bureau has now announced that the panel will be comprised of:

• Professor Gillian Triggs (Australia)—Chair
• Sir Robert Francis (United Kingdom of Great Britain and Northern Ireland)
• Ms Vrinda Grover (India)
• Dr Fulata Moyo (Malawi)
• Ms Charlotte Petri Gornitzka (Sweden)

The Chair of the panel, Professor Gillian Triggs, has issued a statement inviting confidential written submissions on matters related to the work of the panel to be sent to IEPChair@qedconsulting.com.

The UNAIDS Programme Coordinating Board Bureau has also selected QED Consulting to perform the function of secretariat to the Independent Expert Panel. The selection was made through a competitive tendering process. The appointment of QED Consulting as the secretariat will support the independent functioning of the Independent Expert Panel.

More details about the Independent Expert Panel and its functioning can be found at http://www.unaids.org/en/whoweare/pcb/iep.

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.