Singing “akouaba” (welcome), a group of young women crowded around Josiane Téty, the director of Bléty, a Côte d’Ivoire organization led by sex workers, as she arrived.

Located in Yopougon, a suburb of Abidjan, Ms Téty explained that in the centre one of the first things they do is give each other nicknames. Names such as Joy, Hope or Chance, because women, she said, often need a confidence boost and a sense of a new beginning.

“We take the time here to work on self-esteem, so that all the girls believe in themselves,” she said.

Most of the women at Bléty are current or former sex workers who carry out peer outreach, ranging from HIV awareness-raising and education about HIV prevention to promoting sex workers’ rights and continuing education.

“We seek to give young women opportunities and alternatives so that they are less vulnerable,” Ms Téty said. Pointing towards a young woman, she said that Happiness had started beginner accounting classes. 

Ms Téty and other sex workers founded Bléty in 2007 because they realized that they had little information regarding their health or their rights and hated feeling stigmatized.

“Getting an HIV test doesn’t mean that you are living with HIV, but that is how we were perceived when we were seen leaving a clinic,” she said.

They set out to correct that and have implanted themselves in the community. 

Marie-Louise Sery came to Abidjan to work following her parents’ death. She didn’t have much schooling and finding a job was difficult, so she started sex work. The 30-year-old, wearing braided pigtails, admitted being completely clueless about the risks she took.

“Bléty got me out of that situation,” Ms Sery said. This past year she became one of Bléty's peer educators.

Most of the time, she said, peer educators target bustling street corners to talk to sex workers, of which there are estimated to be more than 9000 in the country. Aside from handing out condoms, they also conduct rapid HIV tests and hand out cards with the contact details of Bléty’s various focal points, who can be reached day and night in the event of an emergency.

“My work involves giving a lot of support and hand-holding,” Ms Sery said.

Sex work is not illegal in Côte d’Ivoire, but the laws on it are vague. As a result, there is abuse and sex workers are vulnerable to violence. “We really stress to our friends out there that because they’re sex workers, it doesn’t mean people can take advantage of them,” Ms Téty said. If they have been abused they can call a Bléty peer educator and are accompanied to the police station or to the hospital.

Ms Téty said a recent victory had been to negotiate with doctors and health-care providers to provide a medical certificate free of charge, instead of for a US$ 35 fee. The law in the country requires a medical certificate in order to pursue a criminal case.

In its 10-year existence, Bléty has fended off pressure from the police and residents to change their attitudes towards sex work. Bléty has educated the police as well as sex workers in order to break the climate of mistrust between them.

“We have established good relationships with uniformed police, but there is a high turnover, so it can get frustrating to start all over again,” Ms Téty said.

Overall, she remains optimistic. Testing for HIV and sexually transmitted infections among sex workers is up, lawyers have stepped in to give legal advice and she sees her centre growing further.

Civil society leaders from western and central Africa have laid out a road map to take a more active role in scaling up HIV prevention and treatment services in the region. The eight leaders reiterated that without their involvement and help, it would be difficult to reach people and the treatment goals.

“We want to be more involved, because we are on the ground and we are the people concerned,” said Daouda Diouf, Director of ENDA Dakar and rapporteur of a three-day meeting of civil society, UNAIDS and partners held from 19 to 21 February in Geneva, Switzerland.

In 2016, the western and central Africa region faced disproportionately high AIDS-related deaths compared to its share of the world’s population. Although HIV prevalence in the region remains low, few people living with HIV there have access to treatment.

The leaders pointed out the many challenges they face. In many francophone countries, medical care remains too centralized, carried out mostly in clinics, limiting outreach from peer educators and community workers. They also said that stigma and discrimination keeps people away. National health policies often do not allow civil society to deliver key services, such as HIV testing.

Hidden fees for health services paid by the patient also dissuade people from seeking help. And funding and political will have waned in recent years, reducing their capacities.

Aliou Sylla, Director of Coalition Internationale Sida-Plus, stressed that civil society has many solutions and experience from pilot programmes that have been proven to work.

“Because we have clinics that do not look like clinics, because we do peer-to-peer HIV testing and because we offer counselling, we are much more capable of reaching vulnerable people,” he said. “Just have confidence in us.”

His colleague wholeheartedly agreed. Ibrahima Ba, coordinator at Bokk Yakaar, a nongovernmental organization and leader of the regional network for people living with HIV, added that not only can civil society reach people, it can also monitor the progress of national and regional HIV plans. “Count on us to be implementers, but also watchdogs, so that governments are held accountable.”

The road map includes an upcoming regional meeting bringing together civil society from 12 western and central African countries in order to incorporate their views in national HIV plans. UNAIDS will be advocating for them to have more influence in countries.

In closing the meeting, Deputy Executive Director Luiz Loures said, “The data and the evidence show that we are not optimizing our efforts in the AIDS response in this region.” Looking at the civil society leaders, he concluded, “We need to use civil society as an engine.”

A baby abandoned at a health clinic, an abusive boyfriend, dating woes and fake medicines are all plot twists in C’est la Vie (That’s Life), a television series based in, and produced in, Africa. Shot in Senegal, the sitcom takes place in the fictitious Ratanga health clinic, where midwives interact with patients and work on various cases. Their life stories and office politics come into play, adding intrigue, but the overall aim is to raise health awareness through entertainment.

The series, a first in western Africa, was inspired by Mexican pioneer Miguel Sabido—who used telenovelas to promote literacy and family planning—as well as by the educational television series Shuga. Shuga, the MTV English-language series, is now in its six season and has been so successful that it has moved its filming location from Kenya to capture new stories from Nigeria and South Africa.

Réseau Africain d’Education en Santé (RAES), a nongovernmental organization backed by several United Nations agencies and the French Government, founded Keewu, a production company, to launch the show.

RAES founding member and now Keewu producer Alexandre Rideau’s motivation for launching C’est la Vie was to reach millions via television. “The statistics speak for themselves in western Africa,” Mr Rideau said. “Young people are clueless about sexuality, HIV prevention and simple things like menstruation.” He also added that it was obvious from the many questions received that people had real difficulty in accessing information.

The show highlights many of the realities of the region, from high levels of maternal deaths to HIV infection. Four in five children living with HIV in western and central Africa are still not receiving life-saving antiretroviral therapy and AIDS-related deaths among adolescents aged 15–19 years are on the rise in the region, according to a UNAIDS/United Nations Children’s Fund report, Step up the pace. 

In its second season, C’est la Vie has gained in popularity, so much so that actors are being recognized in the street. Mr Rideau recounted that a toll collector in a toll booth in Dakar would not let an actress who plays an unpleasant character in the series go through in her car.

Broadcast in western and central African countries on A+ and TV5 Monde Afrique, as well as local channels, the show reaches about 100 million viewers. Mr Rideau explained that the series may not necessarily change people’s behaviour, but it gets crucial conversations started about health issues. In Senegal and Togo, open debates about the show’s themes take place in town squares following an airing.

Mr Rideau said that he wants to roll the show out in six other countries in 2018. A radio spinoff in the Hausa language is now being distributed in Niger.

PROMO REEL - C'est la vie! - Saison 1 from Keewu Production on Vimeo.

Despite the scorching Abidjan heat, the Salam Plateau mosque stayed cool as imams, pastors, fathers and members of various religious groups along with women welcomed a UNAIDS delegation.

Imam Djiguiba Cissé gave an overview of his mosque and said that he and all the faith leaders gathered wanted to join UNAIDS in promoting HIV awareness.

Forty years of science and treatment have led to great progress in the AIDS response but now it's time to tackle stigma and discrimination, explained UNAIDS Deputy Executive Director Luiz Loures. Mr Loures reiterated that he needed faith leaders' help in making sure that violence against women is no longer tolerated and that men are better informed regarding HIV.

The imam said that compassion was a guiding principle of all faiths and that it should apply to faith leaders when they interact and care for people living with HIV. He also said that one of their objectives was to promote women. Women carry the greater burden of HIV globally and gender inequality is in large part responsible. Mr Cissé stressed that it was key to end violence against women and female genital mutilation.  Female genital mutilation is  prevalent in the north, north-eastern and western regions of Africa. Not only are there no known health benefits, it is painful and traumatic and can cause immediate and long-term health consequences to girls and women. The imam's final point to the congregation was to engage men to overcome some of these challenges and give young men a chance. More than 60% of Côte d'Ivoire's population is under 25 years of age, he explained, saying that more boys were resorting to migration or terrorism because they feel left out.

In January 2018, faith leaders led by Mr Cissé and with the help of UNAIDS are to attend an HIV awareness training encompassing the issues of stigma, status and empowerment. 

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There is a consensus among political leaders, civil society and development partners that ending AIDS as a public health threat in Nigeria will require increased domestic funding.

In the past 10 years, Nigeria has made progress in its AIDS response. The number of people living with HIV on life-saving antiretroviral therapy in the country grew to more than one million by mid-2017. AIDS-related deaths have been reduced from 210 000 in 2006 to fewer than 160 000 in 2016. Although only 30% of people living with HIV in Nigeria are now on treatment, 81% of people on treatment are virally suppressed.

According to the Society for Family Health, Nigeria, spending on the AIDS response in Nigeria increased from US$ 300 million in 2007 to US$ 730 million in 2013. But the AIDS response has been largely sustained through external funding, especially from the United States President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

In order to increase domestic funding for the AIDS response, efforts are under way for each of Nigeria’s 36 states to contribute up to 1% of their monthly allocations from the federal government to the response to HIV. The Government of Nigeria, with technical support from UNAIDS and the World Health Organization, is also establishing an HIV trust fund aimed at increasing private sector contributions from 2.1% in 2014 to 10% by the end of 2018.

Increases in domestic funding will boost efforts to diagnose the estimated two million people living with HIV in Nigeria who do not know their HIV status and are not yet on treatment. In December 2016, the President of Nigeria, Muhammadu Buhari, launched a Fast-Track plan using domestic resources to maintain 60 000 people living with HIV on HIV treatment and to ensure that an additional 50 000 people access treatment each year. 

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New report highlights urgent need for an improved HIV response for children and adolescents

ABIDJAN/DAKAR/NEW YORK/GENEVA, 5 December 2017 – More than four decades into the HIV epidemic, four in five children living with HIV in West and Central Africa are still not receiving life-saving antiretroviral therapy, and AIDS-related deaths among adolescents aged 15-19 are on the rise, according to a new report released today.

While acknowledging progress in several areas, the report Step Up the Pace: Towards an AIDS-free generation in West and Central Africa, jointly published by UNICEF and UNAIDS, shows that West and Central Africa is lagging behind on nearly every measure of HIV prevention, treatment and care programmes for children and adolescents. In 2016, an estimated 60,000 children were newly infected with HIV in West and Central Africa.

“It is tragic that so many children and adolescents today are not receiving the treatment they need just because they have not been tested,” said Marie-Pierre Poirier, UNICEF’s West and Central Africa Regional Director. “We need to make better use of innovations to increase early diagnosis and improve access to HIV treatment and care for children. For example, the point-of-care technology diagnostic brings testing closer to where children attend health services and self-testing can be a good option for adolescents who may be more comfortable with it.”

The region’s coverage of life-saving antiretroviral therapy among children living with HIV is the lowest in the world because many countries have limited capacity to perform the tests needed for early infant diagnosis of HIV. Without knowing a child’s HIV status, his or her family is less likely to seek the treatment that could prevent the tragedy of a child’s death from AIDS-related illnesses.

The situation is worse among adolescents. The annual number of new HIV infections among those aged 15–19 years in the region now exceeds that of children aged 0-14 years. These new infections occur mostly through unprotected sexual contact and among adolescent girls. Equally concerning, according to the report, is that West and Central Africa has recorded a 35 per cent increase in the annual number of AIDS-related deaths among adolescents aged 15-19 years — the only age group in which the number of AIDS-related deaths increased between 2010 and 2016.

With the region’s youth population expected to grow significantly within the coming decades, especially in countries like the Democratic Republic of the Congo and Nigeria, the numbers of children and adolescents becoming infected with HIV and dying from AIDS is likely to remain high, unless the HIV response – both prevention and treatment – improves dramatically.

The report highlights that the 24 countries that make up the West and Central Africa region are home to 25 per cent of children aged 0–14 years living with HIV worldwide.

“Leaders of the region have endorsed a Catch-Up plan aiming to triple the number of people on treatment in the region – including children – by the end of 2018, the key issue now is to accelerate implementation,” said Luiz Loures, UNAIDS Deputy Executive Director. “Countries should urgently put in place more effective strategies for early infant diagnosis of HIV, and start reducing inequity in children’s access to treatment.”

The report proposes key strategies that will enable countries to accelerate progress in curbing the spread of disease. These include:

1. A differentiated HIV response focusing on unique epidemiological and local contexts in each country and community.
2. The integration of HIV services into key social services including health, education and protection.
3. Community ownership and local governance of the HIV response including working with families, better placed to help reduce stigma, access prevention and treatment.
4. Investment in innovations to remove barriers to scale-up including new diagnostic and biomedical approaches such as point of care diagnostics, HIV self-testing and pre-exposure prophylaxis.

UNICEF announced last week that at the current pace of progress, the global 2020 Super-Fast-Track targets to end AIDS among children will not be achieved.

***

Key facts from the report:

• Prevention of mother-to-child transmission of HIV coverage has increased 2.5-fold between 2010 and 2016 (from 21 per cent to 49 per cent), with some countries such as Benin, Burkina Faso and Cabo Verde now providing these services to more than 80 per cent of the pregnant women living with HIV.
• West and Central Africa has the lowest paediatric antiretroviral treatment coverage in the world, with only 21 per cent of the 540,000 children (0-14) living with HIV receiving antiretroviral treatment in 2016 – compared to 43 per cent globally.
• Today, West and Central Africa accounts for 37 per cent of the world’s AIDS-related deaths among children: about 43,000 AIDS-related deaths occurred among children in West and Central Africa in 2016, a decrease of 31 per cent compared to 2010.
• There were 62,000 adolescents (15-19) newly infected with HIV in 2016, unchanged compared to 2010.

• Adolescent girls and young women continue to be the most affected, with women making up nearly three out of five of all adolescents aged 10-19 years living with HIV across West and Central Africa.

Note to editors:

The Report is available at: https://www.unicef.org/publications/index_101480.html

More information is available at: www.childrenandaids.org

About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across 190 countries and territories, we work for every child, everywhere, to build a better world for everyone. For more information about UNICEF and its work for children, visit www.unicef.org

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. For more information about UNAIDS and its work, visit www.unaids.org   

On 14 August, heavy rains, a mudslide and flash floods destroyed hundreds of homes and left many dead, injured or missing in Sierra Leone. In all, more than 500 houses were buried and destroyed and some 6000 people were severely affected. So far, more than 500 bodies have been recovered, with the number expected to rise. A mass burial for 300 people brought the country together and hardened the commitment to collectively recover from the tragedy.

An estimated 200 people living with HIV and their families were affected, with around 54 among the dead. Relief and rescue efforts by community members and first responders immediately began providing life-saving support.

People living with HIV and people at higher risk of HIV infection often become more vulnerable in times of emergency, owing to a lack of prioritization of their needs, lack of prevention services and disruption of treatment. In addition, people living with HIV, especially with weakened immune systems, are at higher risk of contracting malaria and waterborne diseases.

In the immediate aftermath of the disaster, UNAIDS’ priority has been to ensure the continuation and scale-up of antiretroviral therapy services, provide technical support to the Network of HIV Positives in Sierra Leone (NETHIPS), generate strategic information for fundraising and facilitate access for people living with HIV to food and non-food resources. UNAIDS has been participating in the broader disaster coordination structure within the United Nations and is supporting NETHIPS in the registration of people living with HIV affected by the disaster and in finding out their immediate needs.

In the medium and long term, UNAIDS, in collaboration with the United Nations interagency team, the National HIV/AIDS Secretariat, NETHIPS and the wider national disaster response coordination unit, will ensure that people living with HIV have access to support that includes the restoration of livelihoods, shelter construction and psychosocial services.

This crisis has put into sharp focus the fragility of Sierra Leone’s post-Ebola social safety nets. It is critical that the resources required for the response to HIV be included in the emergency fundraising appeals and that the country’s HIV catch-up plan be financed and implemented effectively.

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As a young volunteer in a Burkina Faso hospital, Christine Kafando, had a lot of convincing to do. In 1997, HIV meant deadly illness so no one believed her when she told people living with HIV that she was positive.

“People accused me of lying saying I was too healthy looking,” she said. One time, Ms Kafando took her treatment with someone to show them that she was indeed living with HIV.

Despite patients’ resistance, she persevered.  She even started going to people’s homes to do routine check-ups.

“At the time,” she explained, “the hospitals and staff did not know how to handle HIV, so we stepped in and filled the gap.”

It had been a year since Ms Kafando had found out that she was living with HIV. She and her university sweetheart (and now husband) had gone for a test together. He was negative but she was not.

She describes being very scared and her dreams dashed. Her husband desperately wanted children and left her six months after her diagnosis.  With her family’s support, she started raising awareness about HIV. Ms Kafando became the first HIV positive woman to reveal her status publicly in Burkina Faso.

“I realized that people thought HIV happened to others but I proved to them that it can happen to anyone,” she said.

Having joined the newly formed REVS+ organization - run and led by people living with HIV- as a volunteer, she found her purpose.

She became as trusted as the various doctors and often acted as a liaison between families and the hospital.

It dawned on her that helping people access treatment and monitor their health was one thing but more needed to be done on the prevention front.

She split her time between the hospital and testing clinics.

Tirelessly Ms Kafando hammered over and over the same message, “Better to know what ails you than live in ignorance. Get tested.”

The ‘loudmouth’ as her peers call her even got Burkina Faso’s president to pay attention. “I told him, ‘if you do nothing about HIV, you will have no one left to govern,’” she said proudly.

Suddenly she knew that her fighting spirit paid off because the then president Blaise Compaoré not only got tested but treatment costs decreased and testing became free of charge for women and children.  

Burkina Faso sociologist and HIV technical coordinator Dao Mamadou describes Christine as someone who puts words into actions.

“She has dedicated nearly 20 years of her life helping women and children living with HIV who has never ceased to serve others,” Mr Mamadou said.  

She adopted two children and furthered her experience in the health sector.

Reflecting back to 2003, she said that as community healthworkers, they had forgotten a key component.  

“A few times, couples living with HIV would come to see me and I would inquire about their baby and the mom would say, ‘he died,’” she said.

No one had thought about HIV transmission to babies and the children’s well-being beyond birth so Ms Kafando founded the Association Espoir pour Demain (AED).

Her organization raised HIV awareness among expectant mothers and in maternity wards. In no time, AED became the reference for all pregnant women living with HIV.

Mr Mamadou, the HIV technical coordinator, said he had seen Christine become an icon.

“She is considered to be our Mother Teresa for countless orphans and vulnerable children,” he said.

Through time her  organization branched out beyond Bobo Dioulasso. She got various HIV organizations to join together to coordinate funding and resources better.

Her proudest moment, she said, was getting French and Burkina Faso national recognition in 2011.

“I realized upon getting those honors that I saved lives,” she said.   

Her current schedule has her shuffle back and forth from the capital city to Bobo almost twice a week.

She is frustrated because young people these days seem impermeable to HIV.

“HIV treatment has coaxed people into thinking that they can beat this, but that’s not the way to think about it,” she said.

Her current battle entails launching new HIV prevention campaigns and getting the word out although she admitted, “I will always be a fighter in the AIDS response.”   

GENEVA, 3 July 2017—Ghana has pledged US$ 200 000 to support the work of UNAIDS. The pledge was made at the close of the 40th meeting of the UNAIDS Programme Coordinating Board (PCB), which was held in Geneva, Switzerland, from 27 to 29 June 2017.

Speaking in his role as Chair of the PCB for 2017, the Minister of Health of Ghana, Kwaku Agyeman-Manu, said, “Through our pledge we demonstrate our willingness to contribute to the fight against the disease.”

The contribution makes Ghana one of the leading African donors to UNAIDS and follows recent commitments on funding for UNAIDS by other African countries. On becoming the Chair of the PCB earlier in 2017, Mr Agyeman-Manu stressed that Ghana would work closely with UNAIDS to achieve the collective goal of ending AIDS by 2030.

The Executive Director of UNAIDS, Michel Sidibé thanked Ghana for its pledge. “Ghana’s pledge of US$ 200 000 for UNAIDS is another example of Africa increasing its investment in the AIDS response,” he said. “Shared responsibility is vital if the world is to meet its commitments to ending the AIDS epidemic by 2030,” he added.

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.