Despite significant achievements, too many of the world’s poorest children face inequalities that are having a dramatic impact on their health, education and future prospects, warns UNICEF in a report published on 23 June.

In Progress for children: beyond averages, the final report on child-related Millennium Development Goals (MDGs), UNICEF highlights that millions of children and young people are still dying early, missing out on school, living in poverty and being disproportionately affected by the AIDS epidemic.

“The MDGs helped the world realize tremendous progress for children – but they also showed us how many children we are leaving behind,” said UNICEF Executive Director Anthony Lake. “The lives and futures of the most disadvantaged children matter – not only for their own sake, but for the sake of their families, their communities and their societies,” he added.

The report acknowledges that huge strides have been made in attaining MDG 6–combatting HIV/AIDS, malaria and other diseses.  For instance, between 2001 and 2013 new HIV infections have declined by 58% in children under 15, mainly due to progress in the prevention of mother-to-child transmission of HIV. The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive has helped achieve a rapid expansion in the availability of antiretroviral medicines to pregnant women found to be living with HIV.

However, only 23% of HIV-positive children received such life-saving medicines in 2013 (compared to 37% of adults) and, in addition, adolescents aged 10-19 are the only group that has not seen a decrease in AIDS-related deaths in recent years.

The report also notes that about 35% of the 1.9 million people newly infected with HIV were young people aged 15-24. Adolescent girls are still most affected by HIV and in some countries are two to three times more likely to be infected than their male counterparts.

Progress for Children highlights a number of other such disparities and areas of deep concern across the spheres of health, education and income. It contends that as the era of the MDGs draws to a close, making way for preparations among world leaders to adopt new Sustainable Development Goals, disadvantaged children must be at the heart of these goals and targets.

The report also argues that better data collection, that tells a more rounded story and is not simply reliant on averages such as those used to measure the MDGs, will help identify the most vulnerable children and encourage tailor-made health and education solutions that help them to live longer, happier and healthier lives.

The number of people and families forced to flee their homes has reached an all-time high, with nearly 60 million people worldwide now displaced by conflict and persecution, says a new report published by the Office of the United Nations High Commissioner for Refugees (UNHCR) for World Refugee Day on 20 June. 

According to UNHCR Global trends 2014, this number is accelerating rapidly. At the end of 2014, some 59.5 million were forcibly displaced, compared to 51.2 million in 2013. Every day last year, an average of 42 500 people became refugees, asylum seekers or internally displaced. This fourfold increase in four years has largely been driven by the war in the Syrian Arab Republic, though numbers are rising across the globe as new conflicts break out or reignite.

In highlighting the unprecedented level of forced displacement and people crossing borders, UNHCR acknowledges that anxiety and intolerance towards them is also growing.  

To address this, the theme of World Refugee Day 2015 is to give a human face to the crisis and show who refugees are and why they need help. By reinforcing the fact that they are ordinary people in extraordinary circumstances, UNHCR hopes to galvanize governments and the public into doing more to improve conditions, empathy and opportunities for people who are forced to move.

United Nations High Commissioner for Refugees António Guterres stressed, "With huge shortages of funding and wide gaps in the global regime for protecting victims of war, people in need of compassion, aid and refuge are being abandoned.” He added, “For an age of unprecedented mass displacement, we need an unprecedented humanitarian response and a renewed global commitment to tolerance and protection for people fleeing conflict and persecution."

A critical part of the UNHCR campaign is to tell the stories of a range of refugees and internally displaced people who are attempting to forge new lives. Several such stories revolve around people living with, or affected by HIV. People who are forcibly displaced may become more vulnerable to HIV as health services become harder to access. They might be more likely to engage in transactional sex if basic needs are not met, and rape is also often used as a weapon of war.

This was the case for Maria Kamwendo, featured by UNHCR, who was raped by rebels in the Democratic Republic of the Congo. She managed to escape and found her way to South Africa. After the shock of being diagnosed as HIV-positive, she has built a new life there and is now an HIV counsellor. “I enjoy what I do,” she says. “HIV is not a death sentence but one can be instrumental in empowering people about the disease.”

By encouraging people to get to know the stories of individual refugees, UNHCR aims to make a link between people lucky enough to have living settled lives and those who are struggling to cope with the trauma of having, through no fault of their own, to flee from their homes.

Zimbabwe has one of the largest HIV epidemics in the world, with an estimated adult HIV prevalence of 15% and 1.4 million people living with HIV. However, the country is accelerating action and increasing investment in its HIV prevention and treatment programmes.

As part of a three-day visit to Zimbabwe, UNAIDS Executive Director Michel Sidibé met with the Vice-President of Zimbabwe, Emmerson Mnangagwa, to discuss the country’s role in the AIDS response. 

During the meeting, Mr Sidibé congratulated the government on progress made in treatment scale-up and prevention, and pointed to the need to Fast-Track the AIDS response to end the epidemic in Zimbabwe by 2030. They talked about securing medicines to keep people living with HIV healthy, as well as the challenges in making sure that adolescent girls are not left behind.

Mr Sidibé also joined the Ministers of Health and Child Care and Finance and Economic Development to discuss with business leaders, civil society and diplomatic missions how to Fast-Track the AIDS response in Zimbabwe.

“The price of medicines has fallen from US$ 10 000 per person per year to under US$ 100,” said Mr Sidibé. “But, to ensure that Africa can deliver a fully sustainable response to HIV, Africa has to start producing its own generic medicines rather than import them from abroad.”

The business leaders present affirmed their commitment to keep investing in the AIDS response even as the country faces severe economic challenges. Pharmaceutical manufacturers pledged to continue looking for ways to be competitive so that the country can play a greater part in the production of antiretroviral and other medicines to lessen its dependence on imports.

The Health Minister, David Parirenyatwa recognized that the AIDS response is a national responsibility. In 2014, Zimbabwe only paid 15% of the response from domestic sources, relying heavily on donor funding to make up the gap. The minister acknowledged that Zimbabwe must do more against stigma and discrimination. Mr Parirenyatwa reaffirmed the government’s commitment to build a concerted strategy to Fast-Track programmes to end the AIDS epidemic by 2030.

To support its response to HIV, in 2000 Zimbabwe introduced an innovative 3% AIDS levy on taxable income. Largely through this levy, domestic financing has increased by 40% in the past three years. To ensure that domestic contributions to Zimbabwe’s response continue to rise, the Minister of Finance, Patrick Chinamasa, said, “Zimbabwe will keep its AIDS levy for the foreseeable future.”

Mr Parirenyatwa said that it is important for Zimbabwe, despite its limited resources, to share a portion of its national trust fund to further the global AIDS response. The government of Zimbabwe presented Mr Sidibé with a cheque for US$ 100 000 to contribute to the UNAIDS core budget for 2015. 

UNAIDS Executive Director Michel Sidibé visited the Mbare City Health Clinic in Harare, Zimbabwe, on 11 June. The public clinic runs an antiretroviral treatment programme that also provides services for victims of rape.

During the visit to the clinic, which is supported by the City of Harare and Médecins sans Frontières, he met people living with HIV, including 19-year-old Thandiwe. Mr Sidibé heard the harrowing story of how she contracted HIV through rape and described her tears as, “A sign of our collective failures. We must do better for her and all women and girls.”

Speaking at the clinic, traditional leader Chief Chiveso denounced violence against women and called on men to be activists against gender-based violence. Mr Sidibé hailed the Chief as a champion for gender equality and for ending gender-based violence and the AIDS epidemic.

Earlier, Mr Sidibé engaged in a dialogue with community leaders, who told him of the challenges that marginalization and unemployment bring. Mr Sidibé said that adolescent girls are affected by the poor economic situation, which has resulted in more girls being infected with HIV compared to their male peers.

Two thirds of the population in Zimbabwe is under 25 years and HIV prevalence is almost two times higher among women aged 15–24 than among men of the same age. Zimbabwe has the sixth highest number of annual adolescent AIDS-related deaths in the world.

Mr Sidibé lauded the combined efforts of Zimbabwe’s civil society and government, which have resulted in a drop in HIV prevalence and the number of AIDS deaths, but warned that the country needs to do more to Fast-Track the response to HIV in order to end the AIDS epidemic in Zimbabwe by 2030. “If we are not careful, after 2015 people will forget about AIDS, complacency will creep in and people will look at other crisis,” he said.

During a three-day visit to Cameroon, UNAIDS Executive Director Michel Sidibé named the First Lady, Chantal Biya, as a Special Advocate. Through her foundation and the non-profit organization African Synergy against AIDS and Suffering, Ms Biya has been advocating for the protection, education and health of women and children for more than 20 years, especially in the context of HIV.

“This award recognizes the work the First Lady has done for decades for mothers and their children, said Mr Sidibé. “We cannot forget the pioneers.”

President Paul Biya, who participated in the ceremony, which was held at the Unity Palace on 1 June, expressed his commitment to the AIDS response and said, “The government and African Synergy against AIDS and Suffering will double their efforts in the response to HIV.”

During his visit, Mr Sidibé met with 16 mayors from the cities of Douala, Bamenda and Yaoundé, home to 30% of people living with HIV in Cameroon. The mayors signed the Paris Declaration on Fast-Track Cities, which calls for ending the AIDS epidemic in cities by 2030.

Mr Sidibé also met representatives of civil society, including religious leaders, and joined Minister of Health André Mama Fouda at the launch of an HIV prevention campaign with truck drivers. In a meeting with the minister, Mr Sidibé noted that the country’s increase in national funding for the AIDS response had had good results and would have a positive impact on development.

In the north-eastern city of Malakal in South Sudan, an HIV support network with around 150 members met on a regular basis to talk about the challenges they faced in accessing antiretroviral medicines and the food they needed to stay healthy. But in 2013, when the civil war broke out and fighting reached Malakal, everything changed.

Hundreds of people were killed and thousands more fled their homes, many to the camp run by the United Nations Mission in South Sudan (UNMISS) in the outskirts of Malakal. Only six of the members of the network found their way to the camp. Joseph Leggi Pio, who works at the HIV Unit in UNMISS and was one of the founding members of the group, doesn’t know what happened to the rest.

Life isn’t easy for anyone in the camp, but it can be especially difficult for people living with HIV. Medical facilities inside the overcrowded camp are facing logistical problems, including shortages of antiretroviral medicines and food and long waiting times to see health workers. Mr Pio said one of the patients living with HIV at the camp had recently died. Another person managed to move to Juba, where there is better access to HIV treatment services. Many more people living with HIV regularly visit Mr Pio’s office to find out when the medicine will arrive.

More than 100 000 internally displaced people are crammed into 10 UNMISS protection sites throughout the country, none of which were built to shelter anywhere near that number of people.

“Everything is a priority,” said Leku Dominic Samson, Senior Medical Assistant with the International Organization for Migration. “The HIV needs are only starting to be addressed.” Health workers have focused on emergency first aid, while also dealing with widespread diarrhoea and an increasing number of malaria cases.

The Government of South Sudan and health workers are committed to finding ways of providing HIV prevention and treatment services to internally displaced people in the UNMISS sites. Humanitarian organizations and United Nations agencies, including UNMISS, UNAIDS and the Office for the Coordination of Humanitarian Affairs, provided technical and financial support to open an additional primary health-care centre, where HIV testing and counselling services are available.

These organizations are also advocating to install a CD4 machine at the United Nations Hospital in the Malakal camp to help health workers monitor the viral load of people living with HIV. In the meantime, HIV prevention and treatment messages are being disseminated to more than 20 000 people living in the camp.

“Awareness is always an issue in the camp as people continue to arrive from all over the country, including rural areas where access to health information is limited,” said Mr Pio. He added that people’s behaviour in the camps, where they tend to take more risks, is worrisome. He is especially concerned that young people, many of whom were separated from their families during the fighting, are having unprotected sex, at times due to lack of access  to condoms.

Mr Pio and other health activists are training groups of HIV counsellors to mobilize people around the camp to talk about HIV and encourage them to protect themselves. The counsellors also take this opportunity to distribute up to eight boxes of condoms a day.

The counsellor trainings and community dialogues are beginning to show positive impact. For example, Tungwar Wuor—a resident at the Malakal camp—said he had little knowledge about HIV before he went through the training session to become a counsellor in March. Now he has red ribbons on all his clothes and talks easily about how people can protect themselves and others from HIV infection. “I wanted to help other people know their HIV status and how to prevent HIV,” said Mr Wuor. “HIV infection is something that can be stopped.”

He added that many people are initially wary when he starts talking to them about the virus, because of the stigma associated with HIV. He said some of them associate HIV with immorality. He has also been working with religious leaders to include HIV prevention messaging in their services.

“I explain to them that it is possible for anyone to contract the virus if they do not protect themselves and that people living with HIV can access treatment to lead positive lives,” said Mr Wuor. 

To commemorate this year’s Mother’s Day, UNICEF and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) released a new video and special website featuring mothers who are HIV-positive.

In 2013 and 2014, UNICEF and the Global Fund asked six women in South Africa and Malawi to share their reflections, hopes and fears as they went through their pregnancies and the delivery of their babies, and in the months after their children were born.

A Journey of Motherhood acknowledges the particular challenges HIV-positive mothers experience to give birth to healthy HIV-negative children, and to remain healthy themselves. The initiative also stresses the progress made in providing HIV medicines to prevent new HIV infections among children worldwide.

Each year, approximately 1.5 million women living with HIV give birth. With no medical intervention, the risk of passing on the virus to their babies during pregnancy, delivery and the breastfeeding period can be as high as 45%. But today, medicine to prevent mother-to-child transmission of HIV—a single, daily pill—reduces that risk to 5% or less.

The man known as Geng Le, who launched Blued, the world’s largest gay dating smartphone application, was a respected police officer in China almost 20 years before he left the force in 2009 after fellow officers objected to working with him because of his sexual orientation.

Now Geng Le is the Chief Executive Officer of the Danlan gay men’s network, the non-profit organization behind Blued. During a meeting 6 May with UNAIDS Executive Director Michel Sidibé in Beijing, China, Geng Le pledged to expand Danlan’s HIV prevention programme.

Blued has almost 15 million users, mostly in China, but its popularity is growing outside the country. As a service to its users, it provides information on the risks of unsafe sex and the rights of men who have sex with men. Users are asked questions aimed at increasing their knowledge of HIV treatment, prevention tools and care options. In addition, they are pointed to locations where they can access HIV testing and counselling.

Geng Le said, “We are doing our best to use science and technology to improve the lives of lesbian, gay, bisexual and transgender communities, including their health. Our vision is that all young people can live in dignity, be free of stigma and discrimination and share love no matter where they come from, what they are doing, what their sexual orientation is and what their HIV status is.”

Mr Sidibé’s visit included a demonstration of the application and an online exchange with users.

Danlan runs a free HIV rapid testing outlet, which provides services to men who have sex with men in partnership with public health agencies. “Danlan is an example of an organization for the future. It protects the rights of people not reached by services, everywhere," said Mr Sidibé.

Danlan has organized campaigns against discrimination and gives technical support on web-based HIV prevention and treatment initiatives. It is expanding into other countries and is currently establishing offices in the United States of America and Thailand. 

The clean energy company Hanergy Holding Group and UNAIDS have agreed to cooperate on philanthropic and corporate responsibility initiatives to achieve zero new HIV infections, zero discrimination and zero AIDS-related deaths in Africa.

The Chair of Hanergy, Li Hejun, and the Executive Director of UNAIDS, Michel Sidibé, signed a memorandum of understanding in Beijing, China. Under the deal, UNAIDS and Hanergy will work together on a number of social development programmes and will partner to bring clean power solutions to the continent. They will work directly with communities, focusing on the health and education sectors.  

Li Hejun said, “We are committed to building on our work on AIDS and expanding our initiatives to African countries. It is not only a responsibility, it’s the right thing to do.”

Mr Sidibé said, “The provision of clean energy to households, schools and health facilities within Africa is central to ensuring that the total well-being of people is at the centre of a healthy society.”

The agreement was signed during a joint mission to China by Mr Sidibé and Mark Dybul, the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund). One of the objectives of the visit was to encourage new strategic partnerships between China and Africa, including investments in infrastructure and the economy and innovation in health and human development.

Africa imports 80% of its antiretroviral medicines. Many of the active ingredients come from China. Mr Sidibé and Mr Dybul met with Chi Jianxin, Chief Executive Officer of the China–Africa Development Fund, to promote joint ventures between China and African countries on the local production of medicines and health commodities. They also offered technical support from both organizations on enabling strategic partnerships.

Mr Dybul said, “There is huge potential for cooperation between China and Africa on innovation and the transfer of technology in many sectors and we look forward to taking this further.”

The China–Africa Business Council will promote communication and understanding between young people in China and Africa with the Towards Zero AIDS youth social benefit campaign. Mr Sidibé attended the launch of the campaign at Beijing’s University of Science and Technology and encouraged young Chinese people to show leadership in the AIDS response. The campaign is organized and run by young people from 60 universities in China.

Wenxia Li, a student from Beijing Forestry University, said, “We call for action on safe sex, we call for using condoms properly so that we and others can enjoy a healthy life.”

Mr Sidibé also participated in a policy dialogue on better health in China and Africa. Also present were the Ambassador of Djibouti, Abdallah Abdillahi Miguil, Feng Yong, Director for Africa at the Department of International Cooperation, China National Health Family Planning Commission, and Christoph Benn, Director of External Relations at the Global Fund.

Ambassador Abdullah Abdillahi Miguil said, “For the African continent to go beyond where it is now for its people, we need to build the capacity of our people for innovation.”

The dialogue sought to identify areas of cooperation and innovation and the types of strategic partnership between China and African countries that can be galvanized to support better health.