GENEVA, 5 October 2017—UNAIDS welcomes the appointment by the United Nations Secretary-General of Natalia Kanem as the Executive Director of the United Nations Population Fund (UNFPA).

“As part of the Joint United Nations Programme on HIV/AIDS, the United Nations Population Fund’s work is critical in meeting the reproductive health needs of women and adolescents,” said Michel Sidibé, Executive Director of UNAIDS. “I look forward to working closely with Ms Kanem. Her experience in public health, her strong leadership and her commitment to social justice will be invaluable in our efforts to end AIDS as a public health threat.” 

UNFPA is the lead United Nations agency for delivering a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. UNFPA’s response to HIV is integral to its goals of achieving universal access to sexual and reproductive health and ending gender-based violence. UNFPA promotes integrated HIV and sexual and reproductive health services for young people, key populations, and women and girls, including people living with HIV.

As part of UNFPA’s work on HIV prevention, Ms Kanem is co-convening a meeting of the Global Prevention Coalition with Mr Sidibé to finalize work on the HIV Prevention 2020 Road Map, a road map to accelerate HIV prevention efforts and reduce new HIV infections by 75% by 2020.

UNFPA is one of UNAIDS’ 11 Cosponsors working to end the AIDS epidemic as part of the Sustainable Development Goals. UNFPA is also part of the H6 partnership, which pulls together the collective strengths and distinct capacities of six United Nations agencies, related organizations and programmes to improve the health and save the lives of women and children around the world.

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.

Global HIV Prevention Coalition holds first meeting in Geneva, Switzerland, to find ways to strengthen and sustain political commitment for HIV prevention  

GENEVA, 10 October 2017—As part of global efforts to end AIDS as a public health threat, UNAIDS, the United Nations Population Fund (UNFPA) and partners have launched a new road map to reduce new HIV infections. The HIV prevention 2020 road map was launched at the first meeting of the Global HIV Prevention Coalition. The coalition is chaired by the Executive Directors of UNAIDS and UNFPA and brings together United Nations Member States, civil society, international organizations and other partners as part of efforts to reduce new HIV infections by 75% by 2020.  

Despite progress in reducing AIDS-related deaths, which have fallen by nearly 50% since the peak of the epidemic, declines in new HIV infections among adults are lagging. While new HIV infections among children have fallen by 47% since 2010, new HIV infections among adults have declined by only 11%.

“Scaling up treatment alone will not end AIDS,” said Michel Sidibé, Executive Director of UNAIDS. “We need more energy and action put into HIV prevention—stronger leadership, increased investment and community engagement to ensure that everyone, particularly people at higher risk of HIV, can protect themselves against the virus.”

“In many places, lack of access to education, lack of agency and lack of autonomy over their own bodies keep adolescent girls from claiming their human rights. And the poorest girls have the least power to decide whether, when or whom to marry and whether, when or how often to become pregnant,” said UNFPA Executive Director Dr. Natalia Kanem. “This lack of power makes each one of these girls extremely vulnerable to HIV infection, sexually transmitted infections and unintended pregnancy.”

In 2016, in the United Nations Political Declaration on Ending AIDS, countries committed to reduce new HIV infections by 75%—from 2.2 million in 2010 to 500 000 in 2020. The new road map developed by UNAIDS, UNFPA and partners will put countries on the Fast-Track to achieve this important target.

“The Coalition is here to recognize that we all matter,” said Laurel Sprague, Executive Director, The Global Network of People Living with HIV (GNP+). “That means doing the hard work to ensure that people living with HIV are able to stay healthy, alive, and free from soul-crushing prejudice and discrimination—and the hard work to make sure that everyone who is not HIV-positive has the support and resources they need to remain HIV negative.”

The HIV prevention 2020 road map contains a 10-point action plan that lays out immediate, concrete steps countries need to take to accelerate progress. Steps include conducting up-to-date analysis to assess where the opportunities are for maximum impact, developing guidance to identify gaps and actions for rapid scale-up, training to develop expertise in HIV prevention and on developing networks and addressing legal and policy barriers to reach the people most affected by HIV, including young people and key populations.

The road map identifies factors that have hindered progress, such as gaps in political leadership, punitive laws, a lack of services accessible to young people and a lack of HIV prevention services in humanitarian settings. It also highlights the importance of community engagement as advocates, to ensure service delivery and for accountability.

The road map also identifies serious gaps in funding and budget allocation—UNAIDS estimates that around one quarter of HIV budgets should be allocated to HIV prevention programmes; however, in 2016, many countries were spending less than 10% of their HIV budgets on prevention, and many international donors were spending less than a quarter.

“UNAIDS is urging commitment and leadership for measurable results,” said Mr Sidibé. “Leadership to address sensitive political issues and leadership in mobilizing adequate funding of HIV prevention programmes.”

To reduce new HIV infections by 75% will require an intensive focus on HIV prevention, combined with the scale-up of HIV testing and treatment. Taking a location–population-based approach to ensure effective and efficient planning and programming, and a people-centred approach that responds to the needs of people at higher risk of HIV, will be critical.

Concerted efforts will be needed to reach adolescent girls and young women and their male partners, to scale up combination HIV prevention programmes for key populations, to increase the availability and uptake of condoms, to expand voluntary medical male circumcision programmes for HIV prevention and to ensure that people at higher risk of HIV have access to preventative medicines.

The road map encourages countries to develop a 100-day plan for immediate actions, including setting national targets, reviewing the progress made against the plan after 100 days, reassessing their national prevention programmes and taking immediate remedial action. It outlines how different partners can contribute and includes actions for civil society, development partners, philanthropic institutions and the business community. By reaching these targets, progress in reducing new HIV infections should accelerate significantly, setting countries firmly on the path towards ending their AIDS epidemics. 

HIV prevention 2020 road map http://www.unaids.org/en/resources/documents/2017/hiv-prevention-2020-road-map

UNAIDS Executive Director Michel Sidibé met with students and staff during a visit to the Johns Hopkins Bloomberg School of Public Health in Baltimore, United States of America, on 15 September.

During an open dialogue in the school’s Sheldon Hall, Mr Sidibé and the Dean of the school, Michael Klag, joined with students, faculty, researchers, global health leaders and alumni to discuss global health, systems for health, leaving no one behind and social justice. Mr Sidibé expressed his concerns about the fragmented global health system and introduced his vision of systems for health that engage all relevant constituencies, including civil society, governments and scientists, and a global health financing institution that goes beyond HIV, tuberculosis and malaria. In addition, he said, there is an urgent need for an instrument for global health advocacy and accountability. 

The visit also saw Mr Sidibé meet with a group of Sommer Scholars to discuss their future contributions to global public health and with members of the Johns Hopkins University Center for AIDS Research.

Quotes

The challenges for the AIDS response in small island developing states are unique. Increasingly, they face natural disasters, community displacement and migration. On these small islands, HIV is most prevalent among key populations—sex workers, gay men and other men who have sex with men and people who inject drugs—and most HIV infections are among young people.

In a recent visit to Seychelles, Michel Sidibé, the UNAIDS Executive Director, addressed a meeting on laws, policies and strategies to meet the 90–90–90 targets—whereby, by 2020, 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—in small island developing states.

Mr Sidibé highlighted the need for small island developing states to protect the human rights of key populations and to invest in HIV prevention and treatment services for adolescents and young people. He also stressed the importance of improving economic opportunities for communities.

During his visit, Mr Sidibé also addressed the Seychelles National Assembly to stress the importance of ensuring that Seychelles is on the Fast-Track towards ending AIDS. Despite Seychelles’ efforts towards meeting the 90–90–90 targets, new HIV infections among key populations are continuing to grow, highlighting the need to reach populations at higher risk of HIV with effective HIV services.

Mr Sidibé commended the President of Seychelles, Danny Faure, for his bold leadership of the national AIDS response and his commitment to build a generation without AIDS. 

Quotes

The Executive Director of UNAIDS, Michel Sidibé, has highlighted the urgent need to break down silos and integrate HIV and sexual and reproductive health services, including for the prevention and control of cervical cancer, which is an AIDS-defining illness. Mr Sidibé delivered his message at the International Agency for Research on Cancer in Lyon, France, on 3 October.

Leveraging the experience of more than three decades of the AIDS response, Mr Sidibé called for greater mobilization and the breaking down of silos between programmes, movements and services to deliver comprehensive sexual and reproductive health services for women and girls. He also reiterated the need to engage with civil society. 

Women living with HIV have an up to five times greater risk of developing cervical cancer, which is the second most common cancer among women living in low- and middle-income countries. Despite cervical cancer being highly preventable with the human papillomavirus vaccine and generally curable with early diagnosis and treatment, more than 528 000 women are diagnosed with it every year and around 266 000 die needlessly, almost 90% of whom live in low- and-middle-income countries.

During his speech, Mr Sidibé highlighted the immense opportunities provided by the Sustainable Development Goals and the 2016 United Nations Political Declaration on Ending AIDS, as well as the resources made available through the Global Fund to Fight AIDS, Tuberculosis and Malaria, which reflect strong global commitment to scaling up integrated services to address coinfections and comorbidities.

Quotes

World leaders come together to renew the urgency around ending AIDS as part of the Sustainable Development Goals

GENEVA/NEW YORK, 21 September 2017—The President of Uganda, Yoweri Museveni, in collaboration with UNAIDS, brought together six heads of state or government to accelerate action and get countries on the Fast-Track to end AIDS. World leaders joined around 500 partners from government, the private sector and civil society on the sidelines of the United Nations General Assembly to reinvigorate political leadership around HIV.

The Fast-Track approach is saving more and more lives. In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.

However, the pace of action is still not enough to end the AIDS epidemic as a public health threat by 2030. In order to step up progress and achieve the global targets adopted in the 2016 United Nations Political Declaration on Ending AIDS, all partners need to fully implement their country Fast-Track strategy. Ending AIDS requires steadfast political leadership, commitment to action and accountability towards shared responsibility and reaffirmed global solidarity. Increased effective and efficient investments are, and will continue to be, an essential prerequisite for success. Elimination of stigma and discrimination and full recognition of human rights are cornerstones of sustainable progress.

“Leadership, partnership and innovation will transform the epidemic,” said UNAIDS Executive Director Michel Sidibé.

President Museveni was the first head of state in Africa to launch a presidential Fast-Track initiative on ending AIDS as a public health threat, known as “Kisanja Hakuna Mchezo”, or “no time for playing games”.

“I am confident that working together with you all, we shall attain an AIDS-free Africa. It is possible to end AIDS in our generation!” said President Museveni.

During the event, the speakers outlined the positive impact that the Fast-Track approach to ending AIDS is having on people, health systems and the broader Sustainable Development Goals in Africa and beyond. They noted that addressing HIV within the Sustainable Development Goals will pave the foundation of the AIDS response.

“We must build on the Fast-Track commitments. We cannot stop before we have reached the finish line,” said Jacquelyne Alesi, a civil society representative from Uganda.

Speakers made a strong call for political leadership, global solidarity and shared responsibility to build momentum and deliver on the goal of ending AIDS by 2030, highlighting the role that supporting strengthened health systems plays, not just in making progress towards the Fast-Track Targets, but also in addressing stigma and discrimination.

“I am not speaking of a vague hope, but of a willingness of the heart. I do not say “we could defeat AIDS,” but rather “we will end AIDS,” said Line Renaud, singer and AIDS activist.

Momentum is building, but has not yet reached a critical mass. When the United Nations General Assembly adopted the Political Declaration on Ending AIDS in June 2016, Member States committed to achieve global and regional Fast-Track Targets by 2020.

Quotes from speakers

“I call for a global solidarity so that the initiative of 2 million community workers in Africa becomes a reality and strengthens our health systems for the benefit of the people.” Alpha Condé, President of Guinea

“We are still facing challenges in addressing the control of new infection rates, particularly among adolescent girls and young women. We must give priority attention to HIV prevention by providing bold political leadership and mobilizing adequate resources for HIV prevention.” King Mswati III, Swaziland

“Now is the time to act. It’s no time for complacency.” Danny Faure, President of Seychelles

“I am delighted to say Botswana has made significant strides towards 90–90–90 because of its robust approach to ensuring access to treatment for all and because of its strong and unflinching leadership and political commitment towards ending AIDS.” Mokgweetsi Masisi, Vice-President of Botswana

“Either we unite in fighting to end AIDS or we lose the cause. With a solid unity of purpose, determination of political will and commitment of resources, we can end AIDS.” Arthur Peter Mutharika, President of Malawi

“Zambia’s commitment to tackling the AIDS epidemic has been durable and consistent.” Edgar Chagwa Lungu, President of Zambia

“I want us to change the African proverb. I want us to go faster and further together so that we can make the impossible possible.” Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy

“We should have no tolerance for discrimination. We can do this together, leaving no one behind.” Lorena Castillo de Varela, First Lady of Panama and UNAIDS Special Ambassador for AIDS in Latin America

“The young people are telling us that parents are not listening. The most important partnership is that of the mother and father, because when that partnership fails to protect our children, particularly our young girls, from harm, our society fails.” Monica Geingos, First Lady of Namibia and UNAIDS Special Advocate for Young Women and Adolescent Girls

“I encourage decision-makers, government and all of our partners to unite more than ever, because it is together that we will defeat this epidemic.” Dominique Ouattara, First Lady of Côte d’Ivoire and UNAIDS Special Ambassador for the Elimination of Mother-to-Child Transmission

“I reaffirm Nigeria’s commitment to achieving the Fast-Track Targets towards ending AIDS by 2030.” Sani Ali-yu, Director, National Agency for the Control of AIDS, Nigeria

“We pledge our long-term support to this noble cause and Fast-Tracking towards the end of AIDS.” Eric Wang, Secretary General, China–Africa Business Council

View event highlights:

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.

New York – A breakthrough pricing agreement has been announced which will accelerate the availability of the first affordable, generic, single-pill HIV treatment regimen containing dolutegravir (DTG) to public sector purchasers in low- and middle-income countries (LMICs) at around US$75 per person, per year. The agreement is expected to accelerate treatment rollout as part of global efforts to reach all 36.7 million people living with HIV with high-quality antiretroviral therapy. UNAIDS estimates that in 2016, just over half (19.5 million) of all people living with HIV had access to the lifesaving medicines.

DTG, a best-in-class integrase inhibitor, is widely used in high-income countries and is recommended by the World Health Organization (WHO) as an alternative first-line HIV regimen, as well as a preferred treatment by the U.S. Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents, among many others. In addition to improving treatment quality and retention, widespread use of DTG is expected to lower the cost of first-line HIV treatment regimens while also reducing the need for more expensive second- and third-line regimens. In July 2017, WHO issued guidance to countries on how to safely and rapidly transition to DTG-based antiretroviral treatment.

This agreement, announced by the governments of South Africa and Kenya, together with the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Clinton Health Access Initiative (CHAI), the Bill & Melinda Gates Foundation (BMGF), Unitaid, the United Kingdom’s Department for International Development (DFID), the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. Agency for International Development (USAID), and the Global Fund to Fight AIDS, Tuberculosis and Malaria, with Mylan Laboratories Limited and Aurobindo Pharma, takes an important step toward ensuring the availability of worldwide high-quality treatment for HIV.

“This agreement will improve the quality of life for millions of people living with HIV,” said UNAIDS Executive Director Michel Sidibé. “To achieve the 90-90-90 treatment targets, newer, affordable and effective treatment options must be made available—from Baltimore to Bamako—without any delay.”

WHO Director-General, Dr. Tedros Adhanom stated, "WHO welcomes this agreement which will make it possible to reach millions of people with better, more affordable and durable HIV drugs. This will save lives for the most vulnerable, bringing the world closer to the elimination of HIV. We congratulate South Africa, Kenya, CHAI and others on this landmark agreement. WHO will support countries in the safe introduction and a swift transition to this game-changing new treatment."

This one pill, once-a-day generic fixed-dose combination of tenofovir disoproxil fumarate, lamivudine, and dolutegravir (TLD) was developed by Mylan and Aurobindo under licensing agreements from ViiV Healthcare, the original developer of DTG. Mylan and Aurobindo both recently received tentative approval from the U.S. Food and Drug Administration (FDA) for their products under the United States PEPFAR program. Clinical studies demonstrated that treatment regimens that use DTG result in more rapid suppression of viral load, fewer side effects, and greater potency against drug resistance than current regimens used in LMICs.

“I am excited about this innovative agreement which will allow the government of South Africa to accelerate the introduction of the dolutegravir-based fixed-dose combination which will greatly benefit our patients due to its superior therapeutic qualities,” said Minister of Health of South Africa Dr. Aaron Motsoaledi. “The considerable price reductions could yield savings of up to US$900 million over the next six years for us, which means that we can initiate additional patients on treatment with the same amount of resources. Ramping up treatment with good viral suppression will enable us to reach HIV epidemic control more quickly. We are aiming at launching the new tender in April 2018.”

“In the antiretroviral therapy guidelines launched in July 2016, the Ministry of Health made provisions for use of newer antiretroviral medicines such as dolutegravir,” said Dr. Cleopa Mailu, Cabinet Secretary of Health in Kenya. “Research has shown that dolutegravir offers better tolerability, fewer adverse drug reactions, fewer drug interactions, and higher genetic barrier to resistance. It is with this in mind that, in July this year, Kenya approved its inclusion in the National ART Program.”

“The Global Fund is excited to be part of this great initiative that will help us save more lives,” said Marijke Wijnroks, Interim Executive Director of the Global Fund. “As we strive to end HIV as an epidemic, we are committed to supporting people affected by diseases to access better products.”

The BMGF, with the support of CHAI, recently completed ceiling price agreements with Mylan and Aurobindo with the goal of accelerating the availability of the new fixed-dose combination to the public sector in over 90 LMICs at reduced pricing. The agreements, which set an upper price limit for TLD, are by some estimates expected to save public sector purchasers over US$1 billion over the next six years.

“As a doctor with deep, personal experience of the heartache and despair caused by HIV and AIDS, I’m excited by the prospect of bringing better treatment to more people than ever before,” stated BMGF CEO Sue Desmond-Hellmann. “This unprecedented new partnership - the largest of its kind ever seen in

global health - will transform millions of lives by making a highly-effective drug more affordable to countries with the largest numbers of people living with HIV. The Bill & Melinda Gates Foundation is uniquely placed to help in this endeavor - and I’m delighted that our investment will give millions more people a shot at leading a healthy, productive life.”

Ministries of Health and program managers should anticipate being able to order TLD in 2018 at around a projected average price of US$75 per patient, per year. Further pricing details are available upon request to Mylan or Aurobindo. The ceiling price agreements apply to purchases for public sector use in all 92 countries covered under ViiV Healthcare’s dolutegravir licensing agreement, representing over 90 percent of people in LMICs currently living with HIV.

To build momentum for TLD and familiarize healthcare workers with the drug in resource-limited settings, Unitaid partnered with CHAI beginning in late 2016 to make generic DTG single tablets available in three early adopter countries: Kenya, Nigeria, and Uganda. Partnering with WHO, USAID, and the Ministries of Health, this innovative initiative is giving countries an opportunity to improve treatment offerings for their patients while also generating critical evidence on the use of DTG in certain populations, including pregnant women and tuberculosis (TB) co-infected patients.

“Unitaid’s investments have laid the foundation for the ground-breaking introduction of TLD at an affordable price,” said Lelio Marmora, Unitaid’s Executive Director. “Through our catalytic work we are overcoming barriers, thereby enabling countries like Kenya to access the latest HIV treatments on the market.” 

“This groundbreaking agreement will help improve the lives of millions of patients by reducing costs and increasing availability of a one pill, once daily fixed-dose-combination including dolutegravir,” stated Ira Magaziner, CEO of CHAI. “This drug combination is better tolerated and more effective and will lead to improved health outcomes by ensuring that fewer HIV patients develop drug resistance and that more remain on treatment.”

About 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.

About the Clinton Health Access Initiative

Founded in 2002, by President William J. Clinton and Ira C. Magaziner, the Clinton Health Access Initiative, Inc. (“CHAI”) is a global health organization committed to saving lives, reducing the burden of disease and strengthening integrated health systems in the developing world. Learn more at www.clintonhealthaccess.org                

About the Bill & Melinda Gates Foundation

Guided by the belief that every life has equal value, the Bill & Melinda Gates Foundation works to help all people lead healthy, productive lives. In developing countries, it focuses on improving people's health and giving them the chance to lift themselves out of hunger and extreme poverty. In the United States, it seeks to ensure that all people—especially those with the fewest resources—have access to the opportunities they need to succeed in school and life. Based in Seattle, Washington, the foundation is led by CEO Sue Desmond-Hellmann and Co-chair William H. Gates Sr., under the direction of Bill and Melinda Gates and Warren Buffett.

About Unitaid

Unitaid invests in new ways to prevent, diagnose and treat HIV/AIDS, hepatitis C, tuberculosis and malaria more quickly, affordably and effectively. It brings the power of new medical discoveries to the people who most need them. And it helps set the stage for the large-scale introduction of new health products by collaborating with Governments and funding partners such as PEPFAR and the Global Fund.

About the Global Fund

The Global Fund is a 21st-century partnership designed to accelerate the end of AIDS, tuberculosis and malaria as epidemics. As a partnership between governments, civil society, the private sector and people affected by the diseases, the Global Fund mobilizes and invests nearly US$4 billion a year to support programs run by local experts in more than 100 countries. The Global Fund’s operating costs are approximately 2 percent of grants under management, reflecting an exceptionally high degree of efficiency. By challenging barriers and embracing innovative approaches, we are working together to better serve people affected by the diseases.

About USAID

USAID is a key implementing agency of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and is responsible for over half of all PEPFAR programs with activities focused in 35 priority countries and regions, mainly in sub-Saharan Africa and Asia. For more information, please visit: www.usaid.gov