West and Central Africa

Girls’ education for HIV prevention at 1st Pan-African Conference on Girls’ and Women’s Education in Africa

08 July 2024

Girls’ education as a tool to prevent HIV infection has been centered at the 1st African Union Pan-African Conference on Girls’ and Women’s Education in Africa. This followed African leaders designating education as the 2024 African Union theme of the year.

At a high-level side event hosted by the Education Plus Initiative on the first day of conference held at the African Union Commission in Addis Ababa, Ethiopia, leaders, girls’ and women’s networks and advocates called for greater investments in girls’ education.

“Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them,” said UNAIDS Executive Director, Winnie Byanyima. “We can get all our girls and boys to complete secondary education; that should be our legacy."

UNICEF calculates that 34 million girls in sub-Saharan Africa are out of secondary school. According to the Global Education Monitoring (GEM) Report 2023, in all regions in Africa, there are more girls out of school at the secondary level than boys, with gender disparities worsening as children move up to higher levels of education in favour of boys over girls. In sub-Saharan Africa, less than half of adolescent girls complete secondary education, their percentage standing at 42% and there has been no progress at all in closing this gap in the past 20 years.  Sub-Saharan Africa is the region furthest from parity at the expense of girls, with no progress since 2011 at the lower secondary level and since 2014 in upper secondary.

Gender is a key factor linked to disparities in enrolment, retention, completion, and learning outcomes through social conditioning, gender-based differences in parental expectations and education-related investments, child marriages and early childbearing, female genital mutilation, child labour, gender-based violence, period poverty and discrimination.

More than forty years into the HIV response, Africa remains an epicenter of the AIDS epidemic with adolescent girls and young women being disproportionately affected. Every week 3100 adolescent girls and young women acquired HIV in sub-Saharan Africa. Every three minutes, an adolescent girl or young woman aged 15-24 years acquired HIV in 2022 in sub-Saharan Africa.  Adolescent girls and young women aged 15-24 years in the region were more than three times as likely to acquire HIV than their male peers in 2022.

UN agencies, African Union representatives, government ministers, and young women leaders called for accelerated actions to translate commitments to action through leveraging girls' education for gender equality and preventing HIV, child marriage, teenage pregnancies, violence, gender-related stigma and discrimination in Africa.

Speakers emphasized the connection between health and education. Ministers spoke about key policy reforms and best practices aimed at promoting girls' education, including creating safe and inclusive school environments, strategies to get girls into secondary school, and the readmission policy that addresses high dropout rates due to pregnancy.  UN co-leads emphasised the need for improved collection of data disaggregated by sex and other relevant population characteristics to better understand educational participation, progression, and learning, and using gender-sensitive data for policymaking and planning. 

Other issues highlighted included the integration of digital literacy programs into the secondary education and vocational training curriculum to facilitate smooth transitions from school to employment; integrate gender equality into all aspects of the education system, including curriculum-based comprehensive sexuality education  and life skills, address gender-based violence  within schools and discriminatory laws and practices, and access to information, non-discriminatory HIV and sexual and reproductive health services access.

Young women leaders spoke on the role of partnerships and young women's leadership. Participants highlighted the upcoming 30th anniversary of the Beijing Declaration as an opportunity moment to accelerate accountability and commitments, as well as the CSW Resolution 60/2, Women, the Girl Child and HIV and AIDS as significant mechanisms to address political and resource gaps so no woman or girl is behind in the HIV response.

Education Plus is a rights-based, gender-responsive action agenda to ensure adolescent girls and young women have equal access to quality secondary education, alongside key education and health services and support for their economic autonomy and empowerment.  Co-led by five UN agencies, the initiative builds on existing frameworks like the Transforming Education Summit, the Continental Education Strategy for Africa (CESA) and the Dakar Education for All (EFA) Declaration to push for access and completion of education for women and girls in Africa.

Quotes

" Some people claim that providing girls with secondary education is too expensive. Such claims fail to consider the exponentially higher cost of not educating them. We know the consequences when girls can’t finish secondary school: higher risks of sexual violence, early marriage, unwanted pregnancy, complications in pregnancy and childbirth, and HIV infection. But when a girl completes secondary school, it helps her to be safe and strong. If all girls complete secondary education, adolescent pregnancy could be cut by 75% and early marriage could be virtually eliminated. An extra year of secondary school can increase women’s eventual wages by 15-25%. We can get all our girls and boys to complete secondary education; that should be our legacy."

Ms.Winnie Byanyima UNAIDS Executive Director

We must recognize the intersecting challenges girls face, including HIV. They face extraordinarily high levels of HIV infections. Women and girls represented 63% of all new HIV infections in Africa in 2022. Empowering girls with knowledge is key to ending AIDS as a public health threat. Education is the best HIV prevention tool available.”

Dr. Sihaka Tsemo Director of the UNAIDS Liaison Office to the African Union

“African nations should ensure that young people not only gain vital knowledge but also acquire life skills, values, attitudes, and make decisions in order to live healthy and fulfilled lives. Through the AU strategy, we will see increased awareness about the importance of investing in education and the health of children and adolescents.”

Dr. Caseley Olabode Stephens African Union Commission

“Girls’ education is not only a right, but will also result in broad socio-economic development for countries. We are creating a safe and conducive environment for adolescent girls and young through the criminalization of child marriage, FGM, school-related gender-based violence, and sexual harassment, particularly sexual exploitation perpetrated by teachers. We provide life skills and comprehensive sexuality education in schools and ensure an inclusive school environment for children with disabilities, with specific attention to girls. We have enhanced social protection strategies, including cash transfers to poor households to ensure that girls go to school and are not engaged in care work and child labour.”

Hon. Médessè Véronique Tognifode Mewanou Minister of Social Affairs and Microfinance, Benin

“Girls who dropped out due to early pregnancies or early unwanted pregnancies are readmitted. We have a national girls’ education strategy aimed at facilitating the pace at which Malawi may achieve sustainable development goals. We emphasize universal primary education, the promotion of gender equality and empowering women.”

Hon. Nancy Chaola Mdooko Deputy Minister, Ministry of Education, Malawi

“We are trying to remove the cultural norm barriers and negative gender stereotypes that contribute to gender-based violence and discrimination against adolescent girls and young women with a male engagement strategy. Inclusive education provides special provisions for the less privileged and disadvantaged children and youth; user-friendly infrastructure, teaching and learning materials and provision of expert teachers.”

Hon. Nancy Chaola Mdooko Deputy Minister, Ministry of Education, Malawi

“Education is a human right. The Education Plus Initiative is driving policy changes in Africa. Education Plus seeks to keep adolescent girls and young women in school by simply unequivocally saying no to child marriage, no to violence, no to HIV infections, no to gender-related stigma, and of course, no to harmful practices. We want to keep girls in secondary education and make sure they stay there and complete their education. We do that by supporting sexual and reproductive health and rights, comprehensive sexuality education and work for integration HIV awareness, preventing and managing learners pregnancies and addressing school-related gender-based violence.”

Mr. Saturnin EPIE Chief, UNFPA Representation Office to the African Union and UNECA

“We need to scale up effective interventions to increase HIV knowledge and transform gender norms, and hence girls’ access to services. We should explore the potential of innovative solutions offered by digital technologies to mobilize and provide young women and adolescent girls with comprehensive HIV information. Let's do more, particularly for those girls living with HIV to be meaningfully engaged in the HIV response. Young women must have a formal seat and a safe space to raise their needs. let's move from rhetoric to action.”

Ms. Letty Chiwara, UN Women Representative, Malawi

“The numbers are unfortunately very clear: highest adolescent pregnancy rates of the world are in sub-Saharan Africa, highest percentages of women first married or in union before 18, young women more than 3 times as likely of HIV infection, or unacceptably high rates of justification of wife beating among adolescents. Fortunately, we benefit from a strong set of political commitments and strategies to face these issues. There is the Education Plus Initiative, the WCA Commitment for Educated, Healthy and Thriving Adolescents and Young People, the ESA Commitment, and the AU Continental Strategy on Education for Health and Wellbeing of Young People in Africa. It is high time to convert the commitments and strategies in concrete results for adolescent girls and young women.”

Mr. Xavier Hospital Regional Health Education Adviser, UNESCO

“Girls need an affirming environment. Where there's ignorance, there's a lot of resistance to education and sexuality education in the curriculum. We need to engage to change the environment, talking with parents, men and boys, community members and leaders for them to have access to information because they have a great influence on the lives of these young people. We need inclusive advocacy, especially the rural grassroots and true localization of information and interventions.”

Ms. Chidinma Adibeli Young Woman Leader, West and Central Africa

Sudan’s unsung heroes: Protecting people living with and affected by HIV amidst conflict and famine

15 April 2024

One year ago, on 15 April 2023, armed conflict broke out in Sudan between the Sudanese Armed Forces and the Sudanese Rapid Support Forces. Since then, the situation has worsened. The hostilities, which were initially centred in Khartoum State, have intensified and rendered over half the country inaccessible.

The impact of this conflict has been devastating. Some 8.6 million Sudanese have been forced to flee their homes, 6.8 million are displaced with in the country and 1.8 million have sought refuge in neighbouring countries – Chad, Egypt and South Sudan.

The severity of the humanitarian emergency has been compounded by a deepening famine crisis, with 17.7 million Sudanese facing acute food insecurity, close to 5 million of whom are on the verge of starvation, as reported by OCHA and the Integrated Food Security Phase Classification.

In addition to the humanitarian crisis, the conflict has severely disrupted the healthcare infrastructure. The central depot, which stored all the antiretroviral treatment for people living with HIV in the country is inaccessible and the stock that it holds has since expired.

Before the conflict erupted, 11,000 people living with HIV in Sudan were on HIV treatment, 4000 of whom were lost to follow-up when the war broke out. All HIV prevention and testing services were suspended.

“We are adapting the HIV response in Sudan to the situation in the country. Our priority has been to get anti-retroviral treatment to those who need it, in whatever way we can,” said Elsheikh Ali, UNAIDS Country Director for Sudan.

Despite these challenges, there are unsung heroes who are working tirelessly to ensure that the HIV response continues uninterrupted.

Amidst active war, the displacement of critical partners in the HIV response, poor internet connectivity and communications, sporadic electricity and growing food insecurity, the HIV national response team, with UNAIDS’ support, were able to reconsider, plan and raise resources for this new, national context of the HIV response in the country. The team was able to submit a funding application to the Global Fund to Fight AIDS, TB and Malaria (Global Fund) and to finalize the Global Fund Grant Making process. This secured critical financial support to HIV, TB and Malaria for the next three years. The funds received from previous Global Fund cycles have been used to replace stocks of antiretroviral treatment (ARVs) as well as to establish new HIV treatment storage facilities in safer regions.

During the COVID pandemic, Sudan established a ‘Search and Rescue’ system to track people living with HIV who had  their treatment interrupted. Once the conflict in the country escalated, the HIV national response team were able to draw on the ‘Search and Rescue’ system to locate most of the 4000 people living with HIV who were lost to follow-up because of the war and to re-enrol them again to receive HIV treatment services.

“We have heroes here in Sudan, including networks of people living with HIV, who are working in very difficult circumstances, traveling tens of kilometres and risking their safety, to personally deliver ARVs to the people who need it,” said Elsheikh Ali, UNAIDS Country Director, Sudan. “These are the people we should be applauding; they are the ones keeping the HIV response going in the middle of a war and famine.”

The Ministry of Health, whose infrastructure has been significantly disrupted, is trying to provide critical HIV services including treatment and PEP (emergency medicine for HIV taken to prevent the virus in case of potential exposure to the virus) in regions of the country where there is active warfare. In more stable areas, more comprehensive HIV services are now being offered to those who need them.

In the face of the escalating humanitarian crisis in Sudan, there are dedicated people who remain steadfast in their commitment and working selflessly to mitigate the impact of the conflict on the HIV response.

“The HIV national response team exemplify the resilience  the AIDS response,” said Anne Githuku-Shongwe, UNAIDS Regional Director Eastern and Southern Africa. “In the face of adversity – war, displacement, famine – and against all odds, they have found a way to continue collaborating to uphold the HIV response.” She adds, “They have completed a successful Global Fund grant in the middle of an active war. They have made sure that people living with HIV across Sudan are not being left behind, that they are found, there is treatment available for them and that they receive it.  That is resilience, commitment and leadership.”

Expertise France partners with UNAIDS to fight HIV stigma and discrimination in western and central Africa

28 February 2024

GENEVA, 28 February 2024—The French public international cooperation agency ‘Expertise France’ and UNAIDS have signed a new partnership agreement to fight stigma and discrimination in six western and central African countries.

The aim of the €1.92 million partnership called, "Community response to stigma and discrimination and legislative reform," is to promote access to inclusive HIV services that respect human rights for key populations, including men who have sex with men, people who inject drugs, sex workers, transgender people and young women and adolescent girls in Benin, Cameroon, Côte d'Ivoire, Central African Republic, Senegal and Togo.

"Stigma and discrimination obstruct HIV prevention, testing, treatment and care, and hold back progress towards ending AIDS by 2030,” said Winnie Byanyima, Executive Director of UNAIDS and Under-Secretary-General of the United Nations. “It is only by protecting everyone’s rights that we can protect everyone’s health, so by joining forces with Expertise France we can uphold rights for those in need in the region.”

In the six countries, key populations are disproportionately affected by HIV. In Benin, for example, HIV prevalence in 2022 was 7.2% among sex workers, 8.3% among men who have sex with men and 21.9% among transgender people—while the rate is 0.8% among the general population. In Cameroon, HIV prevalence was 24.3% among sex workers, 20.6% among men who have sex with men and 4% among prisoners—while the rate is 2.6% among the general population.

Anne-Claire Amprou, Global Health Ambassador for France, Ms Byanyima, Jérôme Bonnafont, Permanent Representative of France to the United Nations and Jérémie Pellet, Director General of Expertise France, attended the signing ceremony at the Permanent Mission of France to the United Nations in Geneva, Switzerland.

"This agreement aims to reduce inequalities in access to care and treatment for populations most vulnerable to HIV in western and central Africa. France is thus making a commitment to global health alongside UNAIDS, in an approach based on equity, solidarity and development," said Mr Bonnafont.

Ms Amprou added, "Through this partnership, France is pleased to be able to reaffirm its commitment to strengthening healthcare systems, as well as combatting stigmatization, discrimination and gender inequalities in access to healthcare for the most vulnerable populations, by supporting for community-led efforts.”

As part of the Global AIDS strategy both France and UNAIDS are striving to improve legal and social responses to HIV with a particular focus on reducing gender inequalities and gender-based violence. This new initiative will also aim to reduce systemic barriers by promoting a more favorable legal framework that respects human rights and facilitates better access to legal services.

Jérémie Pellet, Director General of Expertise France said, "This partnership with UNAIDS embodies our commitment to supporting the most vulnerable communities and promoting a more just and inclusive society."

Expertise France via ‘L'Initiative’, an organization which helps national partners prepare and implement projects using funds from the Global Fund to Fight AIDS, Tuberculosis and Malaria, is funding the project. The funds complement efforts under the Global Fund's 7th round of funding, underlining the importance of coordinated action to remove human rights barriers to accessing health services.

Led by the UNAIDS western and central Africa regional office, based in Dakar, the project will be implemented with the support of the Civil Society Institute for HIV and Health, Alliance Côte d'Ivoire and Coalition PLUS.

 

Expertise France

Expertise France is the French public international cooperation agency. It designs and implements projects which aim to contribute to the balanced development of partner countries, in line with the Sustainable Development Goals (SDGs) of the 2030 Agenda and long-term development.

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.

L’Initiative

France created L’Initiative in 2011 in response to the difficulties that certain countries, particularly French-speaking ones, were having in accessing Global Fund grants. The French Ministry for Europe and Foreign Affairs and Expertise France, the government agency for international technical cooperation, oversee L’Initiative.

Contact

Expertise France
Eric Fleutelot
eric.fleutelot@expertisefrance.fr

Contact

UNAIDS Geneva
Charlotte Sector
sectorc@unaids.org

UNAIDS Executive Director Winnie Byanyima responds to the passage of the Human Sexual Rights and Ghanaian Family Values Bill in Ghana’s parliament

28 February 2024

Responding to the passage of the Human Sexual Rights and Ghanaian Family Values Bill in Ghana’s parliament, UNAIDS Executive Director Winnie Byanyima said:

“The Human Sexual rights and Ghanaian Family Values Bill, a private member’s bill passed by parliament, has not yet become a law in Ghana. 

If the bill does become a law, it will affect everyone. 

Ghana is respected as a stable country where the rule of law prevails, a member of the Human Rights Council, and a global leader in fighting inequality. African values and principles of Ubuntu, dignity, non-discrimination, equality, empathy, protection from violence and care for each other shaped Ghana’s independence struggles, and have continued to be at the heart of Ghana’s society and constitutional democracy. Approaches rooted in inclusion of all people have been crucial to Ghana’s progress in the HIV response. To achieve the goal of ending AIDS as a public health threat by 2030, it is vital to ensure that everyone has equal access to essential services without fear, stigma or discrimination, and that providers of life-saving HIV prevention, testing, treatment and care services are supported in their work.  

If Human Sexual rights and Ghanaian Family Values Bill becomes a law, it will exacerbate fear and hatred, could incite violence against fellow Ghanaian citizens, and will negatively impact on free speech, freedom of movement and freedom of association.

If it becomes law, it will obstruct access to life-saving services, undercut social protection, and jeopardize Ghana’s development success.

Evidence shows that punitive laws like this Bill are a barrier to ending AIDS, and ultimately undermine everyone’s health.”

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.

Holy Disrupters: Interview with Reverend Godson, Presiding Bishop of the Methodist Church of Togo

17 November 2023

Holy Disrupters: Interviews with Religious Leaders and advocates on HIV and Compassion

Reverend Godson Dogbéda Téyi LAWSON KPAVUVU, Presiding Bishop of the Methodist Church of Togo

UNAIDS speaks to Reverend Godson about his work on HIV and about some of the challenges he is facing

What was your experience working on HIV in the early days?

I had been studying abroad and when I came back in 1992I found that members of my community were dying. But people weren’t talking about what was causing it, they were giving it nick names. It was of course AIDS. During a pastoral meeting I spoke with the Bishop who told me, ‘young man, this thing is a sin, you can’t talk about it openly here, the community won’t accept it’.  

This was until two or three years later when some of our colleagues from the church became sick and were dying of AIDS. I went back to the bishop and said now we have to talk about HIV. So, I created a small group and I joined up with the association of people living with HIV in Lomé – it was a safe space where people living with HIV could speak openly.

“Young man this thing is a sin, you can’t talk about it openly here, the community won’t accept it.”

We began to advocate with the government, working with the association and with churches and religious leaders in the country. But theologically, HIV was still spoken about as a sin, so if theologically the narrative isn’t correct, it will damage the whole process. So we corrected the narrative to make it clear that HIV is a virus, not a sin. This was the starting point.

“HIV is a virus, not a sin - this was the starting point.”

From then we created small teams within the communities to support people living with HIV and especially to support the families. To break down the stigma we had to start with the families and then the communities. We published books for academics so they could use them to teach, and we trained the young pastors.

Your work with key populations is well known – how did this come about?

I realized the importance of working with key populations when my uncle died in 2000. He was a gay man who contracted and died of AIDS.  I drew on my personal experience with my own family to start working with key populations.

“My uncle died in 2000. He was a gay man who contracted and died of AIDS.”

Today the government has put in place a framework to ensure that everyone living with HIV has access to treatment, but there is still a lot of stigma and discrimination. The loudest voices who have been speaking out are women, the mothers who are saying these are our children, how can we discriminate against our own children. So, we have engaged them in our efforts to break down the stigma around HIV and around key populations.

How has your work changed today?

Treatment is there, Togo has a plan for treatment and treatment is free of charge. But a real issue is adherence and how people can maintain their treatment within the communities amidst the ongoing stigma. We are training mentors and supporting volunteers to encourage people to stay on treatment.  It’s how best to support people in their families and within their communities.

“Togo has a plan for treatment and treatment is free of charge. But a real issue is adherence”

The human and social dynamics around HIV in Africa are complex. We have three generations now of children who are living with HIV, many who have been orphaned because of epidemic and having to explain to them that their parents loved them and didn’t want to pass on the virus, this can be hard. I have had experience with young people who have attempted to take their own lives because it’s too much for them, and we are there, the church is there to support them.

“I have had experience with young people who have attempted to take their own lives because it’s too much for them”

We are due to end AIDS among children in Africa by 2025 but to do this we are facing many challenges, not just access to testing and treatment, it’s about poverty, local contexts, social conflicts, military coups and migration. But if you put paediatric HIV at the top and give faith leaders the opportunity to organize women’s desks and children’s activities around that we can start educating children and young people about HIV, how to prevent it and they can have their own language to communicate among themselves.

I’m asking my colleagues from the religious communities to come to the forefront of the fight against AIDS and to integrate HIV into their messages especially around ending AIDS among children in Africa. 

Related: Interview with Professor Mohamed Karama, working with Islamic Relief on the HIV programme, Kenya

Related: Interview with Thabo Makgoba, Archbishop of Cape Town

Related: Interview with Thabo Makgoba, Archbishop of Cape Town

Related: Compendium of Promising Practices on the Role of African Faith Community Interventions to End Paediatric and Adolescent HIV

Related: Communities of Faith Breakfast: Building Partnerships for a One-Community Response to HIV. Prioritizing Children in the HIV Response

UNAIDS appoints the First Lady of Sierra Leone as a champion for adolescent girls and young women

19 September 2023

NEW YORK/GENEVA, 19 September 2023—UNAIDS has named the First Lady of Sierra Leone, Fatima Maada Bio, as a UNAIDS champion for the empowerment and engagement of adolescent girls and young women in Sierra Leone. UNAIDS Executive Director, Winnie Byanyima, confirmed the appointment during a meeting with Mrs Maada Bio and her husband President Julius Maada Bio at the 78th session of the United Nations General Assembly taking place in New York.

“I am delighted to welcome Her Excellency Mrs Fatima Maada Bio to the UNAIDS family as a champion for adolescent girls and young women,” said Ms Byanyima. “The First Lady is a strong advocate for the empowerment of women and girls. I look forward to continuing to work together to end gender inequalities that drive HIV including sexual and gender-based violence, and to ensuring that our girls and young women have all the information and knowledge they need to lead healthy lives.”

Mrs Maada Bio is a leading advocate for the Hands Off Our Girls Campaign, a movement launched by President Maada Bio in December 2018 to ban early child marriage and end sexual violence against women and girls. In 2022, she spearheaded the adoption of the first ever World Day for the Prevention of, and Healing from Child Sexual Exploitation, Abuse and Violence, which is commemorated annually on 18 November.

Mrs Maada Bio is also a champion of Education Plus, an initiative launched by UNAIDS, UNESCO, UNICEF, UNFPA and UN Women to prevent HIV infections through free universal, quality secondary education for all girls and boys in Africa, reinforced through comprehensive empowerment programmes.

“My hope is for a future where all women have equal rights,” said Mrs Maada Bio. “Where women and men can sit at the same table and make decisions together, where women are given the space to lead. That is my hope because then we will know that real equality has arrived for us all.” 

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.

Contact

Leave no one behind and that includes people who use drugs

04 May 2023

Daouda Diouf comes daily to the Fann Hospital compound daily. He is one of 250 people enrolled in CEPIAD*’s opioid substitution therapy programme (OST). OST is a globally recognized intervention to reduce injecting behaviours that put people who inject drugs at risk of contracting HIV and other blood-borne diseases, such as viral hepatitis.

“I am here to take my treatment and I am also a tailor, so I teach a few other users of drugs how to sew,” Mr Diouf said, cutting fabric in his makeshift outdoor workshop. Keeping occupied and selling his wares has helped him stay healthy for the last seven years.

Another enrollee agrees. He has found a passion for gardening and now oversees other patients at the centre’s green area.

For El Hadj Diallo, planting seeds, pruning trees is like a type of therapy. “When we are here, we forget our problems, I am happy doing it and it’s therapeutic for me,” he said.

Their other therapy consists of a daily dose of methadone. Mangane Boutha, the centre’s pharmacist carefully measures and distributes each dose in his office.

“Methadone is a medicine that acts as a heroin substitute, in our case it’s a syrup that is dosed in 10mg/ml portions with doses varying from patient to patient,” he explained.

Founded in 2014, CEPIAD has cared for more than one thousand people and is one of the first harm reduction centres in West Africa. Aside from opioid substitution, clean needle exchange and psychosocial support, they also offer health care.

“CEPIAD has become a testing and diagnostics center for HIV, and also tuberculosis as well as hepatitis and we distribute condoms,” said Dr Idrissa Ba, who coordinates the centre.

In Senegal, HIV prevalence among people who inject drugs is 9%, well above the 0.5% among the general population. Globally, due to stigma and criminalization, people who inject drugs face a 35 times higher risk of acquiring HIV than people who do not inject drugs.

Three-quarters of patients here are men but CEPIAD has been working hard to reach more women. Among people who use drugs, women are more likely to live with HIV, according to Dr Ba.  

Mariama Ba Thiam, who formerly used drugs, lived for years on the streets. She is now a peer educator in Dakar.  “I go out into the community and visit colleagues to raise awareness about getting off drugs and also how to reduce health risks so I refer them to CEPIAD and they can do like me, stop drugs,” she said.

Her plea: Get more funds to get more women and young people to come to the centre.

In Senegal, whilst drug use is a criminal offense, CEPIAD’s work has the support of the government, the United Nations as well as other partners.

On international Harm Reduction day, UNAIDS firmly believes that if we are to end AIDS by 2030, we can’t leave anyone behind. And that includes people who use drugs.

*The Centre de Prise en Charge Intégrée des Addictions de Dakar (CEPIAD)

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Dangerous inequalities and overcoming them

18 November 2022

Grace Amodu was 7 years old when she found out she was living with HIV. Until then she had been told to take pills daily for malaria or for headaches but she grew tired of it. Screaming and kicking she told her brother that she was going to stop taking her medicine and that she wanted answers. Her mother took her aside and explained that she was born with HIV and that the treatment would keep her healthy like other kids.

She remembers crying a lot and refusing to leave the house.

To keep her from spiraling out of control her mom encouraged her to join a support group, which she says turned her life around.

As she proudly says she has two children who are both free of HIV. Taking her medication at the same time every day throughout her pregnancy and afterwards meant she was not going to transmit HIV to her babies. "When you take medicine it suppresses the virus and even though I feared my children may have HIV they both tested negative.”

She credits International Community of Women Living with HIV (ICW) Nigeria chapter for giving her hope and confidence.

“ICW was like a backbone, they were there for me like the colleagues, everyone around was standing for me, even the boss, Assumpta Reginald, was like a mother figure to me,” Ms Amodu said. “She held me by the hand telling me that, ‘You can do this and you can become a better person.’

As a result, Ms Amodu has become an HIV advocate and a community pharmacist.

"We go to the hospital and get medicine for people and give them to patients who are maybe not able to access their drugs because they have no transport fare or they are far away or due to the stigma in the hospital they don’t want to come to have nurses and doctors shout at them so we take these drugs down to their doorstep and give it to them,” she explained.

More than 90% of people living with HIV in Nigeria are on antiretroviral medicine but stigma and discrimination are still rampant.

For Ms Amodu the solution is simple. Give people the right information about HIV to break the cycle.

“We need to make people understand that you being HIV positive is not making you less of a human, you are also a human being and you deserve equal rights,” the 28-year-old said.

Stella Ebeh knows all about stigma. She started volunteering in 2004 helping people living with HIV like herself. Then she started working in a health center and became a public health officer. Over the years Ms Ebeh said she has cared for more than 7000 patients and also became a mentor-mother (giving HIV advice to pregnant women and counselling), and an anti-stigma ambassador.

She is very proud of overcoming stigma and as she called it, “walking on it,” but despairs that she is still not a full-time staff member. People living with HIV are very capable and yet we are often overlooked she said, adding, “I work like an elephant but eat like a rat.”

Patients pour in and out of the Marabara health centre on the outskirts of Abuja all day. Ms Ebeh goes from one person to another. She lingers a while with a pregnant woman who also prepares lunch on the premises, Ngozi Blessing.

Ms Ebeh insists on pregnant women taking all the precautions they can to give birth to healthy babies. Her husband and their five children are all HIV negative. Sadly, in Nigeria this is an exception.

Vertical transmission is 25% in the country - that is when a mother passes on the virus to her child during pregnancy or breastfeeding- a record high in the region.

UNAIDS Country Director Leopold Zekeng says this is unacceptable. For him it is a demonstration of the inequalities in terms of access to services.

“Two thirds of the 8 million women who get pregnant every year in Nigeria do not have access to PMTCT (prevention between mother to child transmission of HIV) services during ante-natal care,” he said.  

This is why Nigeria and UN organizations along with other partners are spearheading an effort to end AIDS in children.

Dr Akudo Ikpeazu, Director and National Coordinator, National AIDS and STDs Control Programme (NASCP) said that in the last 2 years they have done an enormous amount of work first trying to get a mapping to understand where all the women are having babies and where they receive ante-natal care if at all.

“A lot of them are in birth homes, they go to traditional birth attendants and many deliver at home and receive services at home and so we have a got new strategy which aims to find them where they are, ensure that they are treated, ensure that we can find them first, ensure that we can  test them, link them into treatment and count every single one that has gained access to care,” she said.

In other words, find all, test all, treat all and report all which happens to be Nigeria’s slogan encapsulating their strategy.

Once that vertical transmission tap, as she called it, is closed, then there will be a smaller pool of children to look after regarding treatment. Dr Ikpeazu said Nigeria intends to put in place an acceleration plan to have more children and adolescents on treatment and push for them to stay on treatment.

For Toyin Chukwuduzie, Director of Education as a Vaccine (EVA), HIV is one part of a larger equation.

“We see the number of unintended pregnancies, we see the burden of HIV especially among  adolescent girls, we also see the sexual and gender based violence happening in our society so these things are in existence, these things are happening, yet adolescents and young people don’t have the information they need to make decisions whether we are talking about schools, whether we are talking about health facilities or even in the homes where there are other adults so there are huge gaps,” she said.

The 35-year-old works with young people to fill those education gaps and build support. She is convinced that a main driver of these gaping holes are inequalities, one in particular.  

"I believe gender inequality is the root cause of many other inequalities so if had a magic wand gender inequality would be the one I would address the first because it’s key,” she said. “Addressing gender inequality is key to unlocking potential, potential of women and girls everywhere in this country.”

Hammering in her point, she added that despite everyone stressing the fact that young people are the force of the future Ms Chukwudize said, "If you are not providing that safe environment, if they are not healthy, if their dreams and aspirations are thrown off the path, how do they become the future that we want to see.”

UNAIDS is deeply concerned that rising violence in the Democratic Republic of Congo threatens HIV treatment and prevention services

02 November 2022

GENEVA/KINSHASA, 2 November 2022—UNAIDS is alarmed that fighting between government forces and rebels in the east of the Democratic Republic of Congo is causing serious disruption and harm to treatment, prevention and care services for people living with and affected by HIV.

In the health zones of Rutshuru and Rwanguba where some of the heaviest fighting has been reported, the AIDS Control Programme (PNLS) in North Kivu has registered 1155 people living with HIV currently on treatment including 102 pregnant women and 46 children. As the violence has escalated, large numbers of people have fled these areas in the past few days, most of them south towards Goma.

“I am extremely worried about the health and well-being of people living with and affected by HIV both in the areas affected by the fighting and in communities hosting those who have been displaced. People may have had to leave their homes at a moment’s notice without time to pick up essential medicines,” said UNAIDS country director, Susan Kasedde. “I am especially concerned about the situation of pregnant and breastfeeding mothers living with HIV and their babies. The interruption to treatment for these mothers will have catastrophic implications for their infants. It is a race against time and we must do everything possible to find these women urgently and link them to care.”

UNAIDS is working closely with national HIV programme managers, civil society groups, community organizations and all partners to support an emergency response to the current situation.

The following activities are being conducted as a priority:

  • Verifying the numbers of people living with HIV currently on treatment to inform needs and planning going forward in the affected communities of Rutshuru and Rwanguba and in the host communities
  • Conducting an assessment with humanitarian partners to enable the integration of HIV-related services into the joint response. This includes working with partner United Nations agencies including UNOCHA, UNICEF, WFP, UNFPA and UNHCR to gather information from civil society organizations to understand needs and capacities both in conflict-affected areas and communities hosting displaced people
  • Rebuilding community support networks by contacting focal points of civil society organizations, community organizations such as mentor mothers, and service providers to establish a network with the capacity to help track and trace people living with HIV and to support the continuity of HIV services for them, including psycho-social services for victims of gender-based violence, and nutritional support to enable HIV treatment to be taken  
  • Supporting community-level efforts to ensure more effective messaging for people living with HIV and related to the protection of the rights of people living with HIV. UNAIDS is also conducting ongoing advocacy to strengthen the integration of HIV needs into the emergency response.

UNAIDS fully supports calls for the immediate cessation of hostilities made by the United Nations Secretary General, Antonio Guterres, and by the African Union.

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.

Nigeria calls for a successful 7th Global Fund Replenishment

12 September 2022

Nigeria has hosted a meeting of key stakeholders in the country’s HIV and wider health response to call for a successful 7th Global Fund Replenishment meeting. The meeting took place in Abuja and included ambassadors of key donor and recipient countries and heads of United Nations agencies, including UNAIDS.

During the event, the Minister of State for Health, Ekumankama Joseph Nkama, expressed his appreciation for Nigeria’s partnership with the Global Fund to Fight AIDS, tuberculosis and malaria. He said Nigeria included one of the Global Fund’s most important recipients of Global Fund disbursements over the last 20 years and reiterated Nigeria’s commitment to increase domestic funding for health.

‘I applaud countries who have already made their pledges to the Global Fund including the United States, Germany, Japan and Luxemburg,” said Mr Nkama.” I encourage other countries to rise up to this noble call by increasing their pledge by at least 30% to enable the Global Fund to meet its target.” he concluded.

David Green, the United States chargé d’affaires commended the partnership with the Nigeria that had he said enabled an incredible acceleration of HIV treatment coverage, registering the largest treatment growth in the history of the HIV programme, despite the COVID 19 pandemic. This was made possible through national surge and alignment efforts that saw the aligning of technical and financial resources behind a single national programme for intensified case-finding, allowing rapid expansion of access to antiretroviral treatment.

‘Sustaining this success depends upon contributions to the Global Fund and all of us standing in solidarity to fight for what counts. We are close to the finish line, but with Nigeria still accounting for one out of seven children born globally with HIV, the race is not yet over,’ said Mr Green.

For the Global Fund, Linda Mafu, highlighted the importance of Nigeria.

“Nigeria is one of our most important portfolios at the Global Fund and achievement of our ambitious targets is critical both for the health of the people of Nigeria and the ability of the Fund to raise additional funding and make an impact at the global level in saving lives,” she said.

Leo Zekeng, UNAIDS country director reiterated the importance of the Global Fund in the collective global response to end AIDS as a public health threat by 2030 and called on countries to stand in solidarity for a successful 7th Global Fund Replenishment. ‘Investing in global health is not only the right thing to do but the smart thing to do as it guarantees a good return of investment. Every $1 invested in fighting AIDS, TB and malaria yields $31 in health and economic returns,” he added.

The Global Fund investment case of the 7th Replenishment conference was presented to those attending the meeting, highlighting the achievements of the investments and the remaining gaps in reducing the burden of HIV, tuberculosis and malaria. The 7th Global Fund Replenishment conference seeks to raise at least US$ 18 billion to save 20 million lives, reduce deaths associated with HIV, TB and Malaria by 65% and strengthen systems for health to build a healthier, more equitable world.

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