A powerful message about the need to progress on both the response to HIV and the sexual and reproductive rights of young people came out of the seventh Africa Conference on Sexual Health and Rights, which took place in Accra, Ghana, from 8 to 12 February.   

The theme of the conference was “Realizing demographic dividend in Africa: the critical importance of adolescents and youth sexual and reproductive health and rights”. It was hosted by the First Lady of Ghana, Lordina Mahama, who is also the President of the Organisation of African First Ladies against HIV/AIDS (OAFLA), and brought together a broad range of stakeholders from government, the diplomatic community, youth groups, organizations of people living with HIV, the private sector, academia and the media.

The conference concluded that it was possible to end AIDS as a public health threat by 2030 only if the sexual and reproductive rights of young people were respected. The need for multisectoral investment in services for young people, including comprehensive sexuality education, was underlined.

Of the total number of adolescents living with HIV globally in 2014, 83% lived in sub-Saharan Africa. AIDS is now the leading cause of death among adolescents in Africa, and adolescents are the only age group in which AIDS-related deaths are not decreasing. In low- and middle-income countries, one in every three girls is married before reaching the age of 18, and one in nine is married before reaching their 15th birthday. Only a quarter of girls and a third of boys are reported to have a full understanding of how HIV is transmitted or how it can be prevented.

During the conference, Ms Mahama championed OAFLA’s launch of the continental All In campaign to end AIDS among adolescents. OAFLA also launched an initiative to end child marriage by 2020. 

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The President of Côte d'Ivoire, Alassane Ouattara, has promised additional funding for the AIDS response in the country in order to achieve the UNAIDS 90–90–90 treatment target by 2020.

Speaking during a visit by UNAIDS Executive Director Michel Sidibé, Mr Ouattara said all people living with HIV in Côte d'Ivoire must have access to antiretroviral medicines. As well as announcing further resources to reach this goal, Mr Ouattara stressed the importance of strengthening the pharmaceutical industry in western Africa to encourage the local production of medicines, especially for children.       

During their meeting, the two leaders also underlined the importance of the United Nations General Assembly High-Level Meeting on Ending AIDS, which will take place in New York, United States of America, from 8 to 10 June.

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At a ceremony in Abidjan, Côte d’Ivoire, attended by UNAIDS Executive Director Michel Sidibé, the First Lady of Côte d'Ivoire, Dominique Ouattara, has awarded the Dominique Ouattara Prize for Excellence to six service providers making a significant contribution to preventing mother-to-child transmission of HIV in the country.

In the category for the area providing excellence in service, the San Pedro district received first prize, with Grand Lahou coming second. In the category for top performing civil society organization, the Organisation des Femmes Actives de Côte d’Ivoire received first prize, while Femme Egale Vie came second. Amah Yolande and Louis Saba received prizes for the excellence of their work as community service volunteers.

Côte d’Ivoire has made rapid progress in reducing mother-to-child transmission of HIV by scaling up treatment coverage across the country. The proportion of pregnant women receiving antiretroviral medicines to prevent their children being born with the virus reached 80% at the end of 2014, up from around 50% at the end of 2012. The total number of new HIV infections in Côte d'Ivoire has fallen from around 52 000 in 2000 to 25 000 in 2014.

Ms Ouattarra is a Special Advocate for UNAIDS, helping to raise awareness for programmes aimed at preventing new HIV infections among children and advocating for women and children living with HIV to access antiretroviral therapy.

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Meeting in Libreville, Gabon, on 12 February, the ministers of health of the Economic Community of Central African States launched an ambitious programme to strengthen regional cooperation by establishing a community health fund to reinforce the region’s AIDS response.

The ministers also decided to improve coordination by setting up a specialized unit to enhance cross-border HIV prevention strategies and by developing a regional mechanism to source antiretroviral medicines on a larger scale. They also adopted a plan to increase the proportion of pregnant women and children receiving antiretroviral medicines.

The measures are designed to encourage countries to better share their experiences, allowing for a more efficient implementation of recommendations made during a meeting of HIV experts in Dakar, Senegal, in December 2015. 

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As Ghana starts its term as the newly elected Vice-Chair of the UNAIDS Programme Coordinating Board (PCB) for 2016, the President, John Dramani Mahama, underlined how increased advocacy, partnership and investment in the AIDS response will bring results that go beyond health. Such efforts will also improve broader gender, rights and development outcomes across the sustainable development agenda.

President Mahama said during discussions with visiting UNAIDS Deputy Executive Director Jan Beagle that complacency needs to be addressed by expanding evidence-informed and rights-based initiatives, programmes and services. Scaling up capacity for local production of antiretroviral therapy is one way.

Ghana has made significant strides in its AIDS response through integrated multisectoral HIV responses that provide lessons learned for western Africa. Ghana reduced new HIV infections by 53% between 2001 and 2014 and AIDS-related deaths by 45% in the same period. According to 2008 and 2014 demographic and health surveys, HIV testing among women almost doubled between 2008 and 2014.

While in Ghana, Ms Beagle met with key stakeholders from government, civil society and international partners to prepare the country’s Vice-Chairmanship of the PCB and its role at the UN General Assembly High-Level Meeting on Ending AIDS.

Welcoming Ghana’s new role within the PCB, Ms Beagle commended the country’s comprehensive and cross-sectoral approach, which has shown particular collaboration across government sectors of health, education, gender, culture and justice. She noted the importance of continued focus on addressing social drivers of HIV in Ghana and the broader western Africa region, underlining the need for particular populations at highest risk, including, critically, adolescent girls.

Minister of Health Alexander Segbefia underlined that by focusing the response in locations and among populations where HIV risk and vulnerability is highest, Ghana will be able to build on the gains made, sustain momentum and move towards an AIDS-free generation. 

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UNAIDS Executive Director Michel Sidibé hailed Nigeria for having halted the spread and reversed the trend of its AIDS epidemic during a visit to the country from 7 to 10 February. He also urged the political leadership to increase domestic funding for the response from 22% in 2012 to 45% by 2020.

During his visit, Mr Sidibé met with the Vice-President of Nigeria, Yemi Osinbajo, and urged the government to increase its support for the Maternal, Neonatal and Child Health Week, with the aim that all pregnant women are tested for HIV by the end of 2016 and all women who test HIV-positive have immediate access to antiretroviral therapy. The health week has proven to be an excellent opportunity for pregnant women to know their HIV status. During the health week in 2015, for example, Kaduna State reported testing 84 000 pregnant women for HIV in a first round and an additional 126 000 in a second round.

Mr Osinbajo told Mr Sidibé during the meeting that Nigeria was making huge budget allocations for social investment programmes, in part to increase access to health care and help end the AIDS epidemic.

Nigeria was invited to participate in the United Nations General Assembly High-Level Meeting on Ending AIDS, scheduled for 8 to 10 June, and to play a leading role in the development and adoption of its political declaration.

Nigeria has the second largest HIV epidemic in the world, with 3.4 million people living with HIV in the country in 2014. However, with increased investment in the AIDS response from Nigeria and its partners, the situation has improved in the past decade. New HIV infections dropped from 310 000 in 2004 to 230 000 in 2014, and coverage of antiretroviral therapy increased from 13% in 2011 to 22% in 2014, providing more than 747 000 people living with HIV with access to life-saving medicine.

During his visit, Mr Sidibé also met with the Secretary to the Government of the Federation, the Minister of Budget and National Planning, the Minister of Finance, the Minister of Health, the Minister of Environment, development partners, the Dangote Foundation; pharmaceutical companies and civil society; as well as the UNAIDS Champion and former President of Nigeria, Olusegun Obasanjo. 

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Isah Mohammed Takuma is married and has a one-year-old daughter. At 32, he is a university graduate and currently serves as the National Coordinator of the Association of Positive Youths Living with HIV/AIDS in Nigeria.

He says he draws daily inspiration from his personal experience to support HIV prevention efforts in Nigeria. “I was 19 when I first had sex. I thought one time was not enough to get infected with HIV,” he said.

Even when he started to fall sick, he simply could not believe that HIV was the cause of his health troubles. He was 23 when he tested HIV-positive and his life changed forever.

“It was a nightmare and I had to go through hurdles to recover. My CD4 count was low; my viral load was high. I was like a walking corpse,” Mr Takuma recalled.

Antiretroviral treatment soon put him back in good health. He returned to university and completed his studies much later than planned, but he was happy to be alive and healthy again.

At university, he started a support group for young people living with HIV. He told his story to peers as a way to prevent new HIV infections. “Many other people in my class got to know their HIV status because of my efforts, and I am really proud about that,” Mr Takuma said.

The Nigerian Government reports that more than 6.7 million people were tested for HIV in 2014 and that it continues its efforts to expand treatment, with coverage at 22% in 2014. The global treatment target set for 2020 is that 90% of people living with HIV are on life-saving antiretroviral therapy.

Despite the challenges that people living with HIV face in the country, Mr Takuma said the fact that he and his wife have an HIV-free child “tells the story of what Nigeria’s HIV response has done in the lives of many young people like me.”

Nigeria has the second largest HIV epidemic in the world. In 2014, 3.4 million people were living with HIV in the country, of which 380 000 were children below the age of 14. HIV prevalence among young women between the ages of 15 and 24 was 1.3% in 2014, almost twice as high as it was for their male counterparts.

Like Mr Takuma, Faith, 16, is passionate about advocating for HIV prevention among young people.

The soft-spoken and cheerful student was born with HIV but only got to know her status at the age of 10. However, she started on antiretroviral treatment when she fell ill two years ago.

She is now healthy and advocates for treatment for all. “I have even been on radio to speak about HIV,” she said. “We want adolescents and youth to understand that it is possible to have a normal life without any stress.”

“We also want to take part in international engagements to share our stories and be an inspiration to other girls and young people,” she said.

Faith views her involvement with the Association of Positive Youths Living with HIV in Nigeria as vital to ensuring that women and girls enjoy healthy and productive lives.

She aspires to graduate as a nurse to help save lives in Nigeria.

A regional platform to accelerate access to HIV testing and antiretroviral therapy in western and central Africa was launched by UNAIDS and partners on 7 December in Dakar, Senegal. The platform will enable scale-up of the test and treat approach, which calls for increasing HIV testing and immediately supporting people who test HIV-positive to have access to life-saving treatment.

The regional platform is an innovative mechanism—both a think tank and a task force—that aims to identify and analyse bottlenecks and quickly propose corrective actions to increase access to HIV testing, treatment and viral load tests. The platform will encourage operational research and new solutions, support monitoring to measure progress and allow partners to share experience and best practices. It will also support countries in mobilizing resources for a sustainable AIDS response.

Partners include United Nations agencies, national AIDS committees, technical and financial organizations, civil society and community organizations, and laboratories, researchers and experts.

All partners are committed to collectively contribute to this platform in order to meet the UNAIDS 90–90–90 treatment target in western and central Africa and put the region on track to end the AIDS epidemic as a public health threat by 2030.  

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UNAIDS Executive Director Michel Sidibé met with the President of Equatorial Guinea, Teodoro Obiang Nguema Mbasogo, on 26 November in Malabo. During the meeting, Mr Sidibé stressed the need for Equatorial Guinea to decentralize HIV testing and access to treatment to the district level.

With HIV prevalence estimated at 6.2% in 2014, Equatorial Guinea has taken steps to scale up its response to HIV. The country is fully funding its HIV response and access to treatment is free of charge. The opening of additional health centres has allowed Equatorial Guinea to scale up its programme to eliminate mother-to-child transmission of HIV. Estimated coverage of pregnant women who access antiretroviral medicines increased from 61% in 2011 to 74% in 2014.

The President said the country is committed to working closely with UNAIDS towards ending the AIDS epidemic by 2030. He thanked UNAIDS for opening an office in Equatorial Guinea.

During his visit to the country from 25 to 26 November, Mr Sidibé signed a host agreement with the Minister of Foreign Affairs. He also met the Prime Minister, the Minister of Health and the minister in charge of HIV.

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ProTest HIV, a global initiative that encourages young people to get tested for HIV, was launched by UNAIDS Executive Director Michel Sidibé in Libreville, Gabon, on 28 November. At the event, Mr Sidibé called on young people worldwide to join the movement and get involved in ending the AIDS epidemic.

Young ProTest HIV ambassadors selected by their peers participated in the launch, which was held at an HIV testing site set up at the Gabon marathon. UNAIDS is working with young people on the initiative to spread the word on the importance of HIV testing.

UNAIDS estimates that 17.1 million of the 36.9 million people living with HIV worldwide do not know they have the virus. Getting tested is a crucial first step for people living with HIV to access life-saving antiretroviral therapy.

Mr Sidibé urged young ambassadors to take the lead in Gabon on the first 90 of the UNAIDS 90–90–90 treatment target and to invite their peers to get tested, too. The UNAIDS 90–90–90 treatment target is that, by 2020, 90% of people living with HIV know their HIV status, 90% of people who know their HIV-positive status are accessing antiretroviral treatment and 90% of people on treatment to have suppressed viral loads.

In Gabon, new HIV infections among children, adolescents and young people have largely declined since 2001, but AIDS-related deaths of adolescents have increased. This is partly due to the lack of integrated youth-friendly services and HIV-related stigma and discrimination. Adolescent girls in Gabon are particularly vulnerable—in 2014, 80% of adolescents newly infected with HIV were girls. 

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