ANTANANARIVO/GENEVA, 27 March 2024—Despite progress across most of sub-Saharan Africa, UNAIDS warns that gaps in HIV prevention are driving new HIV infections in the Indian Ocean Countries (IOC) and several other countries in Africa. The critical gaps in HIV prevention were the focus of a workshop organized by UNAIDS and UNFPA which was hosted in Madagascar between 18 and 20 March to address some of the barriers to accelerating progress.

Insufficient focus on HIV prevention in a number of African countries including Egypt, Madagascar, Angola, Sudan and South Sudan has resulted in these countries not achieving the proportionate declines in new infections seen in the rest of the region.

For example, the increase in the number of new infections in a country like Madagascar for example, is in stark contrast to the downward trend in Botswana which has seen a 66% decline in new HIV infections since 2010 and 36% decline in AIDS-related deaths during the same period.  As a result, Botswana—along with Eswatini, Rwanda and Zimbabwe— are on the path to end AIDS having achieved the global 95-95-95 targets through strong HIV prevention and treatment interventions.

Madagascar, one of the poorest countries in the region, has been hit by cyclical natural disasters including drought and cyclones, making it difficult for the country to recover and mount an effective response to HIV. Madagascar recorded a 151% increase in the number of new HIV infections since 2010, and a 279% increase in AIDS-related deaths during the same period. In addition, just 18% of the estimated 70 000 people living with HIV in Madagascar had access to treatment in 2022, and 3200 people died of AIDS-related illnesses. Sudan and South Sudan are also falling behind on HIV prevention and treatment efforts. Inequalities are exacerbating people’s vulnerability to HIV.

“Local research indicates increases in new HIV infections among key populations, including people who use drugs, and among young women and girls. This could be attributable to many factors including drug routes, recurring cyclones and deep poverty in some areas that is making people more vulnerable to HIV infections,” said Professor Zely Randriamanantany, Madagascar’s Minister of Public Health. “We need our international partners to invest with us before it's too late. This prevention focus is very welcome indeed."

“It is clear from our visits to communities and from speaking to health specialists in Madagascar, that the HIV epidemic is changing. The persistent rise in new infections in Madagascar since 2010, for example, shows that it could spread rapidly if we do not stop it in its tracks immediately,” said Anne Githuku-Shongwe, UNAIDS Regional Director for Eastern and Southern Africa. “We know the path that ends AIDS. It’s not a miracle. It requires strong political and financial support.”

Gaps identified in some countries include a lack of data that would point to where HIV prevention efforts need to focus. Data gathering interventions are key to implementing evidence-informed and effective programmes. Some countries are also lacking commodities, including HIV testing kits and condoms.

“Inadequate investment in HIV responses is holding back ending AIDS as a public health threat,” said Jude Padayachy, UNAIDS Country Director for Comoros, Madagascar, Mauritius and Seychelles. “We need to accelerate the HIV response in the Indian Ocean Island states by ensuring all the basics—making sure people are informed about HIV and how to prevent it, and making sure people have access to HIV prevention services and commodities, such as condoms. We also need to make sure that people who are HIV-positive know their status and get the treatment they need.”

UNAIDS is committed to support countries to accelerate political leadership, investments and better data for prevention.

The meeting in Madagascar brought together HIV experts and programme leaders from a number of countries across Africa to learn from each other and to review and strengthen their national plans on HIV prevention to support countries in scaling up their HIV responses. The meeting included teams from Comoros, Egypt, Madagascar, Rwanda, Sudan and South Sudan.

Participants explored ways to improve data collection to help develop more of an understanding of the dynamics of their HIV epidemics to ensure an effective, evidence-informed, human rights-based response. They also drafted national assessments which will serve as a guide to facilitate dialogues with communities, governments, and partners. This will aid in refining strategies and setting priorities to implement ambitious HIV prevention plans. UNAIDS will continue to support countries in their internal assessments to strengthen their HIV responses.

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.

VIENNA/GENEVA, 22 March 2024— UNAIDS welcomes the adoption of a key resolution today at the 67th session of the United Nations Commission on Narcotic Drugs (CND), recognizing harm reduction for the first time as an important part of an effective public health response. The resolution encourages member states to develop and implement harm reduction measures to minimize the adverse public health and social consequences of the non-medical use of illicit drugs. UNAIDS congratulates the CND and the CND Chair for this historic milestone.

The resolution represents a landmark in political commitment to a rebalancing of drug policy towards a public health approach. Such a shift is critical to meeting the targets in the 2021-2026 Global AIDS Strategy.

Harm reduction is a “a comprehensive package of evidence-based interventions, based on public health and human rights, including needle syringe programmes (NSPs), opioid agonist maintenance therapy (OAMT) and naloxone for overdose management. Harm reduction also refers to policies and strategies that aim to prevent major public and individual health harms, including HIV, viral hepatitis and overdose, without necessarily stopping drug use.” (World Health Organization, 2022).

Since 2018 only five countries have reported achieving the target of providing 200 sterile needles and syringes per person who inject drugs. In that same timeframe only three countries reported achieving the target of 50% coverage of opioid agonist maintenance therapy among people who inject drugs.

The criminalization of drug use and possession for personal use in at least 145 countries, along with stigma, discrimination and violence, continues to restrict both the provision of and access to life-saving harm reduction services.

A failure to invest in harm reduction services or remove the structures that inhibit access, including those relating to gender, have led to a situation where HIV prevalence among people who inject drugs is 7 times that of the rest of the population, and people who inject drugs have the highest incidence globally of any key or vulnerable population. In countries with data, median HIV prevalence among women who inject drugs is almost twice that of men who use drugs.

Under the UN Common Position on Drugs, UNAIDS collaborates with other UN agencies and partners with governments, community-led organizations and donors to increase the provision of harm reduction services and remove harmful laws and policies which create barriers to accessing such services, such as the criminalization of possession of drugs for personal use. UNAIDS works to ensure all efforts relating to drug policy are in conformity with international human rights, as outlined in the international guidelines on human rights and drug policy.

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.

Mayor Aquiles Alvarez Henriques of Guayaquil, Ecuador's largest city and the nation's main port, signed the Paris and Sevilla Declarations on February 28, placing the city among the almost 500 municipalities around the world that are committed to fast-tracking action at local level to improve the quality of life of people living with and affected by HIV. Through this commitment, the city pledges to contribute to the country's goal of ending AIDS as a public health threat by 2030.

Guayaquil is the capital of the province of Guayas, Ecuador's most populated province and the most affected by HIV, with over a third of all new HIV infection notifications in the country, according to the Ministry of Public Health of Ecuador. It has a concentrated epidemic among key populations, with an HIV prevalence of 7.3% among gay men and other men who have sex with men (MSM), for example. 

"A significant number of cases reported with HIV in 2023 live in Guayaquil", said Andrés Díaz, Technical Director of the city's Infectious Disease Prevention Unit of the Health and Hygiene Directorate. "We know that the best way to improve HIV prevention is through education and sensitization of citizens so that they can get tested." 

Guayaquil has made significant efforts to intensify HIV screening and has increased the detection of HIV-positive cases by 1.6%. Diagnosed people are immediately linked to the public health system to start first-line antiretroviral treatment, which is universally available to nationals and migrants in Ecuador. 

Nonetheless, the Health Department of the Guayaquil Municipality has developed a plan with key actions to be implemented as a result of the city’s commitment to the Fast-Track initiative. Some of the most strategic priorities incorporate the scale up of HIV services, including HIV prevention, early diagnosis, and timely treatment of HIV and other sexually transmitted infections; the sensitization of civil servants on issues of stigma, discrimination, and gender-based violence linked to HIV; and facilitate the engagement of communities, specially from key and vulnerable population, in the definition and implementation of HIV programmes at community level.

Representatives of community and civil society organizations such as Corporación Kimirina, the Ecuadorian Coalition of People Living with HIV, and the Silueta X LGBT+ Trans Association attended the event. These organizations play a crucial role in the city's efforts to respond to HIV. "Citizen involvement under the local authority's leadership, with emphasis on the most vulnerable and at-risk community groups, is vital to achieving the goal of ending AIDS by 2030,” emphasized the delegates of Corporacion Kimirina Maria Elena Acosta and Lily Marquez. Similarly, Joan Morales from the Ecuadorian Coalition of People Living with HIV stressed that "By signing the Paris and Sevilla Declarations, Guayaquil joins many other cities that have committed to provide accelerated and sustained health services that allow us to eradicate not only AIDS but also TB, Malaria, and other tropical diseases, with actions that contribute to reducing discrimination towards people living with HIV and other affected communities."

Created in 2014, the Paris Declaration on Fast-Track Cities Ending the HIV Epidemic is a political declaration with commitments and targets that include ending urban AIDS and tuberculosis (TB) epidemics, as well as eliminating viral hepatitis (HBV and HCV). It also articulates a mandate to place people at the center of the response. To define and facilitate that mandate, the Sevilla Declaration on the Centrality of Communities in Urban HIV Responses was created in 2022, outlining the 10 commitments that cities and municipalities are asked to make to increase the engagement of and promote leadership by affected communities in attaining the Fast-Track Cities initiative's goals, objectives, and targets.

"We congratulate the Mayor's Office of Guayaquil for its commitment to contribute to Ecuador’s efforts to reach the 2025 Global AIDS Strategy targets, reducing the number of new HIV infections and AIDS-related deaths and eliminating stigma and discrimination in all its forms,” said Andrea Boccardi Vidarte, Director of the UNAIDS Office for the Andean Countries. "This commitment is also a recognition of the leadership of communities most affected by HIV and their support to the city's goals." 

Despite substantial declines in new HIV infections globally, the HIV/AIDS epidemic continues to disproportionately impact adolescent girls and young women in many countries, particularly in sub-Saharan Africa. In 2022, there were 3,100 new weekly infections among adolescent girls and young women aged 15-24 years.  In sub-Saharan Africa, adolescent girls and young women accounted for more than 77% of new infections among people aged 15-24 years in 2022.

That’s why Education Plus Initiative co-hosted with the Grand Duchy of Luxembourg a high-level side event on the margins of the 68^th Commission on the Status of Women (CSW68) to bring attention to the cost of inaction, calling for more consistent investment in education, health and economic rights of adolescent girls and young women in Africa. The CSW, which runs from 11- 22 March 2024, is the United Nations largest annual gathering on gender equality and women’s empowerment, with this year’s priority theme, Accelerating the achievement of gender equality and the empowerment of all women and girls by addressing poverty and strengthening institutions and financing with a gender perspective.

Speakers included four ministers from Luxembourg, Benin, Sierra Leone, and Uganda, senior government officials from Cameroon and South Africa, and heads of UN agencies who co-lead Education Plus, ATHENA network. Hannah Dolly Kargbo, a young activist from Freetown, Sierra Leone, and founder of the Girls Advocacy Development Network (GADNET), pre-recorded a video that showed her work with young people to advance rights.

The event, Education Plus investment cases for transformative results: leveraging girls completion of secondary education for gender equality and HIV prevention mobilized government, partners and key stakeholders towards accelerated actions and translate commitments to action for gender equality and HIV prevention in Africa.

The costs of inaction on the rates of HIV in adolescent girls and young women remain significant, not only counted in terms of the harmful impacts on girls’ lives but in how they undermine prospects for poverty eradication and the well-being and resilience of families, communities, societies and national economies.  For instance, the lack of educational and economic opportunities that result in women’s diminished labour force participation is estimated to cost the African region US$60 billion in economic losses every year. And yet Africa could gain US$500 billion per year through multi-sectoral investments in adolescents and youth, especially girls, by capitalizing on demographic windows of opportunity.

Education Plus calls for investment in the education and empowerment of adolescent girls and young women, and 15 champion countries are already committed to using education as a means to reduce high HIV rates.  Investments that guarantee education for all young people, violence-free school environments, provision of stigma-free health services, comprehensive sexuality education, access to sexual reproductive health and rights services and economic autonomy and empowerment are key to ending AIDS as a public health threat by 2030. When adolescent girls and young women complete secondary school, their risk of getting HIV is reduced significantly.

Quotes

VIENNA/GENEVA,14 March 2024—At the 67th meeting of the United Nations Commission on Narcotic Drugs taking place in Vienna, UNAIDS has called for the urgent scaling up of services to prevent new HIV and viral hepatitis infections among people who use drugs. Addressing delegates in her video message, UNAIDS Executive Director, Winnie Byanyima, commended some countries for making progress in implementing evidence-based programmes but called for bolder action.

“Gathered here are leaders whose decisions can save and transform lives, tackle social exclusion, and protect public health for everyone. As leaders you can deliver on the shared pledge to end AIDS as a public health threat by 2030 – if all people can secure the HIV prevention, testing, treatment and care services they need. To end AIDS we need to ensure that no one is excluded,” said Ms Byanyima.

Since the 2019 Ministerial Declaration of the United Nations Commission on Narcotic Drugs (CND) there has been some progress in a rebalancing of drug policy towards public health. Several countries have moved towards a more public health-based approach to drug use, with some, such as Ghana, decriminalizing all personal drug use. UNAIDS is supporting Brazil in engaging transgender women in harm reduction programming.

The context of the COVID-19 response led some countries to increase the availability of take-home doses of opioid agonist maintenance therapy, such as in Vietnam. Communities have been central to progress in programmes and policy reforms; in Kenya, Tanzania and Uganda peer groups have been instrumental in delivering harm reduction interventions, law enforcement training sessions and awareness-raising initiatives, including women-centred harm reduction services in Kenya.

But progress remains piecemeal. Services such as needle-syringe programmes, and opioid agonist maintenance therapy, crucial for reducing HIV and other health risks among people who inject drugs, only exist in around 50% of countries. In 2019, UNAIDS reported that only 1% of people who inject drugs had access to recommended harm reduction services, and since then no additional country has reported achieving recommended levels of coverage.

Too often, laws and policies continue to exacerbate exclusion, and people who use drugs are today seven times more likely to be living with HIV than other adults. Drug possession for personal use is still criminalized in 145 countries – with 34 countries retaining the death penalty. The stigma, and outright fear, that this exacerbates is driving people away from vital health services.

Attending the meeting in Vienna, UNAIDS Deputy Executive Director, Christine Stegling said:

“We know that drug prohibition has failed. Punitive drug laws and law enforcement practices create significant barriers for people who inject drugs to access a range of services, increasing their risk of acquiring HIV and reducing their access to services. To protect public health, we need to decriminalize possession of drugs for personal use, we need to significantly scale up harm reduction service provision, and we need to make sure that communities of people who use drugs are adequately resourced and in the lead in the response.” 

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.

13 March 2024—A new report, HIV Prevention: From Crisis to Opportunity shows that HIV infections continue to decline in countries that are part of the Global HIV Prevention Coalition (GPC) faster than in the rest of the world.

Eleven GPC focus countries have reduced their annual number of new HIV infections by at least 66% since 2010. By comparison, the average reduction in new HIV infections since 2010 globally is 38%. The GPC is a coalition of 38 countries working together to accelerate declines in new HIV infections to achieve the target of having 95% of the people who are at risk of HIV accessing effective combination prevention options.

The GPC countries that have prioritised primary prevention and treatment and that have focused on reaching people most at risk have secured the strongest consistent declines in new HIV infections.

Globally, progress in HIV prevention has been highly uneven and a majority of the world’s countries are not currently on track to achieve the 2025 targets. Indeed, several countries are experiencing prevention crises with low access to services and face record rising new HIV infections.

“The findings of this report offer crucial lessons for action,” said Angeli Achrekar, Deputy Executive Director Programme, UNAIDS. “The report shows that sustained political leadership, investment in effective HIV prevention programmes, and an enabling policy environment are crucial to end AIDS as a public health threat by 2030.”

Declines in new HIV infections have been boosted by the cumulative impact of combination HIV prevention options and increased access to antiretroviral treatment which has also increased viral suppression in people living with HIV. People who are on treatment and are virally supressed cannot transmit HIV.

“It’s remarkable to see what has been achieved in the AIDS response in the past 20 years. But the progress to date has not been equitable and is not yet sustainable, and we must never confuse progress with being sure of success,” said Mitchell Warren, GPC co-chair and Executive Director, AVAC. “Our progress is fragile, and what we’ve achieved today could slip away even more quickly than it was achieved if we let complacency take hold.”

Key populations and adolescent girls and young women are still at high risk of new infections

HIV incidence remains unacceptably high among populations where gaps in HIV prevention investments persist. This includes key populations in all regions globally and adolescent girls and young women in parts of sub-Saharan Africa.

Around 3100 young women and girls aged 15-24 became newly infected with HIV every week in sub-Saharan Africa in 2022 and HIV incidence declined less rapidly than it has among young men. Only 43% of the sub-national areas in which there is elevated HIV incidence among young women are being reached with dedicated prevention programmes for young women.

Although GPC countries have shown solid gains in reducing new HIV infections, challenges remain worldwide in reaching key populations most at risk of new HIV infections including men who have sex with men, sex workers and people who inject drugs. Every week, more than 11 000 new HIV infections occur among key populations and their sexual partners globally.

Only 44% of sex workers, 28% of gay men and other men who have sex with men, and 37% of people who inject drugs accessed two or more HIV prevention services in the previous three months according to median values reported by GPC countries ––against a target of 90%.

HIV prevention is being obstructed by shortfalls in prevention financing, and by punitive laws. Social stigma, violence, discrimination and social exclusion are barriers to key populations’ access to health-care services and information, exacerbating their risk of acquiring HIV. Law reform is a crucial enabler of prevention programmes. Protecting the human rights of everyone is vital for protecting the health of everyone.

Investments in both condom and voluntary medical male circumcision programmes, which are both effective in preventing HIV, have fallen in some of the countries with the largest HIV epidemics. In addition, breakthrough HIV prevention options such as pre-exposure prophylaxis (PrEP), medicine to prevent HIV, are still only available to a small fraction of the people who need them.

There are unprecedented opportunities for HIV prevention in 2024. There is a growing array of prevention options including existing tools and new long-acting prevention technologies, as well as country examples of how to implement prevention at scale and increase choices available to communities.

HIV Prevention programmes need to be at scale, efficient and equitable. The actions that are needed for success and sustainability are known, have been shown to work, and have been agreed: collaborate, follow science, tackle inequalities, protect everyone’s rights, let communities lead, and invest in what is needed. Sliding back on resourcing or inclusion would hurt everyone. Solidarity will benefit everyone. Communities, countries and international partners can prevent new infections – together.

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.

GENEVA/NEW YORK, 11 March 2024 - UNAIDS is gearing up for the 68th session of the Commission on the Status of Women (#CSW68) which begins today and will run until 22 March 2024. #CSW68, the United Nations largest annual gathering on gender equality and women’s empowerment, is being held this year under the priority theme, Accelerating the achievement of gender equality and the empowerment of all women and girls by addressing poverty and strengthening institutions and financing with a gender perspective.

Despite progress, no country has achieved gender equality to date, and violations of women’s human rights and gender-based violence are continuing to fuel the AIDS pandemic. The world is off track to meet the gender targets set out in the Sustainable Development Goals (SDGs) and in many of the world’s poorest countries, the debt crisis is squeezing out investment in education, health, and social protection, particularly hurting women and girls.

Around the world today, 129 million girls are out of school, denying them lifesaving information on how to protect themselves from HIV. Every three minutes, an adolescent girl or young woman (15-24 years) acquired HIV in 2022 in sub-Saharan Africa, and across Africa, AIDS remains the leading cause of death among women of reproductive age.

"There can be no more excuses. Ending AIDS among women and girls is not only a moral imperative but also a strategic priority for achieving the Sustainable Development Goals,” said Winnie Byanyima, Executive Director of UNAIDS. “Only by protecting and investing in the rights of women and girls can we protect their health, and only by protecting women’s health can we end the AIDS pandemic. We must seize this opportunity to accelerate progress towards a world where every woman and girl can, not just survive, but thrive."

During #CSW68 UNAIDS will be co-hosting several key events including a high level meeting co-convened by the Grand Duchy of Luxembourg and Education Plus (a joint initiative of UNAIDS, UNESCO, UNFPA, UNICEF and UN Women) which will mobilize government, partners and stakeholders to accelerate scaled up actions on women’s rights and leverage girls’ education for gender equality and HIV prevention across Africa.

UNAIDS is urging renewed action and anticipates strong outcomes from #CSW68. UNAIDS looks forward to the partnerships that will be forged to accelerate progress towards gender equality and ending AIDS as a global public health threat.

UNAIDS remains steadfast in its commitment to working collaboratively with governments, civil society, and other partners to create a world where the rights and dignity of all women and girls are respected and protected, including women and girls living with, at risk of and affected by HIV.

#CSW68, hosted by the United Nations, will convene leaders, advocates, governments, civil society organizations, activists and experts to discuss, agree on actions and investments that can end women’s poverty and advance gender equality.

Follow the Education Plus event live on Tuesday 12 March at 08:00 – 09:30 EST - Making Education Investment Cases Work for Gender Equality and HIV Prevention  

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.

One-third of people living with HIV in Asia and the Pacific are women. But their issues are often hidden.

Gender-based violence. Restricted economic opportunities. Child marriage. Underage pregnancy. Denial of property rights.

A UNAIDS-supported initiative by the International Community of Women Living with HIV Asia and Pacific (ICWAP) supports positive women’s organising. The Feminist School is a learning and consciousness raising programme that began in South Africa, and has been utilised in Asia-Pacific since 2016. The methodology, anchored in feminist principles, is specifically designed to enable women living with HIV to understand their personal experiences, locate them politically and develop strategies for community-driven advocacy. 

“Marching in the month of March is not enough to realize women’s rights,” insists ICWAP Regional Director, Sita Shahi. “We need to speak up on the issue of gender inequality in the HIV response and the need for increased investments in women and girls. Women and girls living with HIV are going through serious human rights violations that, in turn, undermine their right to health.”

The Feminist School brings together women living with HIV, women from key populations, and young women from across the region.  In the past two years, with support from UNAIDS, ICWAP has made adaptations to include modules on sexual and reproductive health and rights, movement building, leadership skills and the elimination of mother-to-child transmission (EMTCT).

“Feminist leadership training reveals the challenges faced by women living with HIV in the region. I have gained a lot of knowledge from the cross-country discussions and learned lessons about how women from different countries are breaking down human rights-related barriers, including stigma and discrimination,” said Salina from Malaysia.

Last year, a new module on the Global Fund processes was added.

“We recognized the importance of ensuring that interventions led by women living with HIV are included in Global Fund funding requests,” explained UNAIDS Asia Pacific Regional Adviser for Community-Led Responses, Michela Polesana.

UNAIDS supported a Global Fund Grant Cycle Seven (GC7) project focused on supporting the engagement of networks of women living with HIV in Cambodia, India, Thailand and Viet Nam in the current process. It found that organizations in these countries were at different stages of readiness and involvement. For example, India’s Positive Women Network (PWN+) was already participating in the process and benefitted from ICWAP’s technical support to strengthen their advocacy and organization.

Another UNAIDS-supported strategy ICWAP employed to bolster GC7 engagement was the facilitation of peer-to-peer growth by and for women living with HIV through the roll-out of an online Feminist School training. Through this initiative, country networks were supported in engaging in the Global Fund process and learned about its gender equality strategy, including the gender equality markers (GEM). They also received training to support them in their work to hold governments accountable.

The organization partnered with Ikatan Perempuan Positif Indonesia (IPPI), the Thai Positive Women’s Network, Viet Nam’s Women’s Network, the Association of Positive Women Advocates Inc (APWAI) from the Philippines, Women affected by HIV and AIDS (WABHA) from Papua New Guinea and an informal network of women living with HIV in Cambodia.

The groups identified priority issues for advocacy and recommendations for next steps and devised country-specific advocacy plans.

The advocates agreed on a set of three shared priorities. First, a seat for women living with HIV on each Country Coordinating Mechanism. Second, for positive women networks to reclaim antenatal care activities in prevention of mother-to-child transmission programmes. And finally, for capacity building for young positive women leaders.

Feminist school is helping women living with HIV to organize to secure their human rights. To protect women’s health it is vital to protect women’s rights. And to protect women’s rights it is vital to support women’s leadership.

“This is all about bridging the gap between outgoing leaders and an incoming, new generation,” Ms. Shahi said.

Ibu Mawar (not her real name) learned she was living with HIV after receiving a test during an antenatal care visit.

 “I was surprised, of course, when they told me. But I didn’t really doubt or deny the result,” she remembered from the Sorong City Health Office in West Papua. She immediately started treatment to prevent transmission to her son. “Even though I’m positive,” she said, “our child is not.”

In principle, since 2009 every pregnant woman receiving antenatal care in Indonesia should receive an HIV test. And every woman found to be living with HIV should receive medicines to prevent transmission to their babies just as Ms Mawar did.

But this isn’t yet the reality.

In 2022 more than one-third (37%) of all pregnant women in Indonesia did not get screened for HIV and just 18% of mothers living with HIV had access to antiretroviral therapy. There were an estimated 2800 new HIV infections among children that year.

But now stakeholders in Indonesia are mobilising. Not only will they scale-up prevention of mother-to-child HIV transmission services, but they will work toward eliminating vertical HIV transmission while assuring the health and wellbeing of women and children living with HIV. At the centre of this approach is the engagement of women, who comprise roughly one-third of the adult population living with HIV.

In June 2023 Indonesia established the National Alliance to End AIDS in Children. This partnership between government, civil society and international organizations seeks to provide access to health services and support for women and children living with HIV. It has committed to three main priorities. The first is advocacy for the needs of adolescent girls and children living with HIV. Second is promotion and dissemination of information on Prevention of Mother-to-Child Transmission (PMTCT), Early Infant Diagnosis, treatment literacy and comprehensive sexual education. And third is the empowerment of communities regarding issues pertaining to children living with HIV.

The Alliance’s first major initiative was an Elimination of Mother-to-child Transmission symposium—the first ever in Indonesia. Partners have embraced the World Health Organization (WHO) triple target of eliminating mother-to-child transmission of HIV, syphilis and hepatitis B by 2030. A series of sessions were delivered in-person and online. A total of 115 participants from the government, communities, academia, healthcare and media joined the EMTCT Symposium in Jakarta.

Dr. Laila Mahmudah, Head of the Neo Maternal Division at the Ministry of Health, underlined the importance of accelerating EMTCT efforts across the range of issues. She noted that currently 66% of pregnant women received hepatitis B early detection services while just 25% of pregnant women are tested for syphilis.

Multisectoral stakeholders and participants discussed strategies with participants from Malaysia and Thailand, which have both received EMTCT validation for HIV. Dr Anita Suleiman, Director of Disease Control of the Ministry of Health of Malaysia, pointed to the importance of effective leadership and health system governance for country-wide implementation.

“One of the lessons from countries that achieved EMTCT is that it is possible to end AIDS and vertical transmissions, especially in low-prevalence regions like Indonesia, through robust governance and good-quality performance. Indonesia can also achieve EMTCT by 2030, and I hope this symposium leverages the coordination efforts towards the elimination of HIV, syphilis and hepatitis B,” said Dr Shafflq Essajee, Senior Advisor, HIV, UNICEF New York.

However, it was emphasised that political commitment must be bolstered by community-led strategies to reach and retain mothers living with HIV. Community mobilization and community health workers are critical approaches. Ikatan Perempuan Positif Indonesia (IPPI), the national network of women living with HIV, also endorsed the Thai approach of providing free formula for mothers living with HIV in low-resource districts.

Ayu Oktariani, IPPI National Coordinator and a member of the National Alliance to End AIDS in Children reiterated her organization’s commitment to implementing the community-led strategies in support of EMTCT in the coming years.

“This Symposium means more than words I can explain,” said Ayu Raka from the Akar Cinta Kasih Foundation, a community organisation in Bali. “When I return to Bali, I will advocate for EMTCT with local multisectoral stakeholders and communities in my region. I am confident we can make a healthier society and improve health for all mothers and babies.”

UNAIDS Country Director for Indonesia, Krittayawan Boonto, promised the continuous backing of UNAIDS.

“We will continue to support not only mothers, but also fathers, in protecting babies from new HIV infections. I wish for Indonesia to become the fifth country in Asia Pacific to achieve EMTCT. But we can only do it with the leadership of communities,” she ended.

GENEVA, 6 March 2024— Ahead of International Women’s Day, celebrated on 8 March, UNAIDS is calling for the protection of women’s rights to protect their health.

The world is way off track to meet the gender, equality and HIV targets that are part of the Sustainable Development Goals. At the current rate of progress, it will take an estimated 300 years to end child marriage, 140 years for women to be represented equally in positions of power and leadership in the workplace, and 47 years to achieve equal representation in national parliaments.

In addition, around the world at least five women or girls are killed every hour by someone in their own family. One in three women worldwide experience sexual or gender-based violence.

Women who experience violence are more at risk of acquiring HIV. This risk is heightened for the 600 million women and girls who live in the world’s conflict-affected countries, facing an increased danger of sexual violence. And in the majority of the world’s poorest countries, the debt crisis is squeezing out investment in education, health, and social protection, particularly hurting women and girls.

Women are further threatened by the organized pushback against women’s rights. “Today, women’s hard-won rights are under a globally coordinated, ruthless attack. Those facing the most vicious attack are already the most marginalized women,” said Winnie Byanyima, Executive Director of UNAIDS. “The injustices faced by women are not natural disasters to prepare for, like hurricanes or storms. They are man-made, and, as such, we can unmake them.”

The good news is that across the world, women and girls are leading struggles for equality and rights. Women are standing up against oppression in their homes, workplaces, and communities. Women’s movements are providing direct support to women and girls who face violence, and marching and striking for equality. To protect women’s rights, it is vital to support and resource these community organizations, civil society groups and women’s organizations—the frontline defenders of those rights.

Like justice, health is never given, it is won.

UNAIDS’ call this International Women’s Day, is to protect women and girls’ health, protect women and girls’ rights. In doing so, the world will end AIDS, and will overcome the inequalities driving it.

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.