The Global Fund to Fight AIDS, Tuberculosis and Malaria, the Government of Congo and health partners have announced two new grants worth more than US$ 64 million to strengthen prevention and treatment services to respond to HIV, tuberculosis and malaria and to build resilient and sustainable systems for health in Congo.

The two grants are a 97% increase from the previous allocation against the three diseases and will be spent from 2021 to 2023.

“UNAIDS looks forward to continuing to work closely with all partners to accelerate the elimination of vertical transmission of HIV and paediatric AIDS in Congo and to improve access to HIV/tuberculosis programmes, sexual and reproductive health, and legal services for young women and adolescent girls and all groups at higher risk of contracting HIV,” said Winnie Byanyima, Executive Director of UNAIDS.

The HIV grant will significantly increase the number of people living with HIV who know their HIV status and will expand access to life-saving antiretroviral therapy, particularly for pregnant women. In 2019 in Congo, only 51% of people living with HIV knew their HIV status and only 25% of people living with HIV were accessing antiretroviral therapy. Only 10% of pregnant women living with HIV in Congo were offered antiretroviral medicine to prevent the virus being passed to their babies.

The tuberculosis component of the grant aims to boost the national tuberculosis response, increase the notification of new tuberculosis cases and reach a 90% treatment success rate by 2023, in line with the World Health Organization’s End TB Strategy. The grant will also support the country’s efforts to improve treatment success for people with multidrug-resistant tuberculosis. The malaria grant will support the country’s goal to distribute 3.5 million mosquito nets by 2023 and expand access to quality malaria diagnostics and treatment tools.

“In the context of the country’s financial crisis, exacerbated by the COVID-19 pandemic, the grants allocated to Congo are a breath of fresh air. They provide renewed impetus to the government’s action in favour of populations affected by HIV, tuberculosis and malaria,” said the Prime Minister of Congo, Clément Mouamba.

The United Nations Development Programme will implement the HIV and tuberculosis grant, while Catholic Relief Services will implement the malaria grant.

The transgender community has been severely affected by the COVID-19 pandemic in Asia and the Pacific. “My main worry is about survival and being able to support and cover the essential needs of the transgender community when job security is less and businesses are closing,” said Khartini Slamah, a transgender woman and activist from Sarawak, Malaysia, who is also known as Mama Tini in her community. “Many transgender people are unable to pay rent and utility bills, unable to do sex work, conduct their usual businesses. Some even lost their jobs,” she said.

Mama Tini’s testimony is featured in the COVID-19 Effect Series, a regular newsletter that profiles issues, challenges and solutions from the lesbian, gay, bisexual, transgender and intersex (LGBTI) communities, key populations and people living with HIV across Asia and the Pacific, created by APCOM, a regional network for LGBTI people based in Bangkok, Thailand. Since April 2020, with more than 19 issues, the newsletter has provided a platform to leverage the voices of people living with HIV and LGBTI people and to share stories, highlight challenges, showcase innovation and build strength within these communities.

The articles included in the newsletter show how civil society organizations are playing a critical role in providing essential safety nets for vulnerable communities during the pandemic. Since the first COVID-19 outbreak in Malaysia, Mama Tini has been working closely to provide support to transgender women, gay men and other men who have sex with men and female sex workers to encourage sexual health screening and testing and to raise awareness of HIV and other sexually transmitted infections.

The newsletter is also a testament to how community-led organizations have used the structure and networks from the HIV response to ensure timely access to information about COVID-19 while preventing disruption to HIV services. Examples of these initiatives include how community-led HIV services provide antiretroviral therapy, HIV testing and pre-exposure prophylaxis (PrEP) to key populations and fundraising efforts for food packages.

CARMAH, a partner in Viet Nam, has been implementing the TestSGN initiative to encourage HIV testing in Ho Chi Minh City for several years. Since the beginning of the pandemic, CARMAH has provided PrEP to 450 gay men and other men who have sex with men and transgender people in Ho Chi Minh City. During the COVID-19 outbreak, the organization implemented more flexible working schedules to ensure that PrEP and HIV testing services were not disrupted.

“The COVID-19 Effect Series documents the important work carried by our community partners and individuals in the response to COVID-19. The series captures inspiring stories from the grass-roots level on overcoming challenges, sharing best practices and how we are all working tirelessly to ensure access to HIV prevention and treatment services and the protection of LGBTI rights,” said Midnight Poonkasetwattana, the Executive Director of APCOM

The COVID-19 Effect Series also captures the unique voices of outreach workers. One of them is Deepak Tripathi, a Senior Programme Officer at the Committed Communities Development Trust (CCDT), an organization based in Mumbai, India. He has a background in and passion for documentary movies, story-telling and news anchoring, but now works full time at CCDT. Throughout the pandemic, Mr Tripathi has been committed to helping the communities hit hard by the economic fall-out from COVID-19.

“Most nongovernment organizations in India, including CCDT, play a crucial role in continuing improving the health and well-being of their target population or beneficiaries, especially during natural crises or disasters, including the COVID-19 crisis,” said Mr Tripathi. CCDT held fundraising events to support migrant workers and daily-wage communities, donated medical equipment and 3000 personal protective equipment kits to hospitals in Mumbai and supplied nutrition kits or bags to 500 individuals and the families of people living with and affected by HIV.

APCOM has also used the COVID-19 Effect Series to promote fundraising initiatives, such as #CoronaAPCOMpassion, an emergency fund started by APCOM staff donating their salaries. APCOM collaborated with SWING, the Thai Sex Workers Organization, based in Bangkok and Pattaya, and mobilized 20 000 baht (US$ 650) to purchase basic food and supplies for sex workers. Also, APCOM donated 9000 baht (US$ 300) to the Bangkok Rainbow Organization to support the health and well-being of LGBTI people in Thailand. You can watch a video here and read about other communities that have benefited from this emergency funding, and how you can support it.

“The human-interest stories included in the COVID-19 Effect Series raise the visibility of human rights violations and the challenges faced by LGBTI people and people living with HIV in accessing health services. The series amplifies community voices that have often been unheard in COVID-19 narratives,” said Eamonn Murphy, Director of the UNAIDS Regional Support Team for Asia and the Pacific, which has provided financial support to make the newsletter a reality.

To mark Zero Discrimination Day by making the voices of the communities heard, APCOM is launching a short report that compiles stories and articles published in the COVID-19 Effect Series.

On any given day, approximately 11 million people worldwide are in confinement. Drug injection and sexual intercourse occur worldwide in prisons. The risk of sexual violence among prisoners—and their insufficient access to condoms, lubricants, pre-exposure prophylaxis and harm reduction services—heighten their chances of acquiring HIV, hepatitis C and sexually transmitted infections.

Among people who inject drugs, recent incarceration is associated with an 81% and 62% increased likelihood of HIV infection and hepatitis C infection, respectively.

Closed settings should, in theory, favour the delivery of effective testing and treatment services, although treatment interruptions and concerns about confidentiality and discrimination pose challenges. In 2019, 78 countries reported to UNAIDS that HIV testing was available at any time during detention or imprisonment, and 104 countries reported that antiretroviral therapy was available to all prisoners living with HIV. Coverage of antiretroviral therapy is good, although gaps remain.

The 34th Ordinary Assembly of the African Union Heads of States and Government was held virtually on 6 and 7 February 2021.

The President of the Democratic Republic of the Congo and new Chair of the African Union, Félix Tshisekedi, pictured above, urged Member States not to forget devastating global epidemics, such as malaria and AIDS, and learn from them to strengthen health systems, including the reinforcement of the Africa Centers for Disease Control and Prevention. 

“Leveraging the experiences we have gained in the fight against adversity and our ability to adapt, we should not give up. Let us not forget other pandemics, often more deadly, that are still affecting the continent, like malaria and HIV,” said the President of the Democratic Republic of the Congo.

The assembly recognized the African Union’s role in mounting a united, innovative and strong partnership among Member States to address the COVID-19 pandemic, which has had a significant economic impact on Africa and further weakened its health systems.

Heads of states committed to sustaining efforts to curb the spread of the virus and mitigate its socioeconomic impact by using the Africa Continental Free Trade Agreement and to implement a coordinated vaccination programme through the Africa Vaccine Acquisition Task Team to ensure that no country is left behind.

“In responding to the pandemic, we have been at the forefront of innovation. We established the groundbreaking Africa Medical Supplies Platform to assist African Union Member States to access affordable medical supplies and equipment,” said the President of South Africa, Cyril Ramaphosa, pictured above.

The President of South Africa commended heads of states for their extraordinary and decisive leadership in tackling the COVID-19 crisis. He expressed dismay at the increase in violence against women and called on the continental body to prioritize women’s economic empowerment and develop a convention to promote, protect and fulfil women’s rights. He called on Member States to ratify International Labour Organization Convention No. 190 on eliminating harassment and violence in the world of work. 

Aside from the African Union Chair’s handover from South Africa to the Democratic Republic of the Congo, the two-day assembly marked critical decisions on the implementation of the African Union’s institutional reform, including its Commission, and the election of four new commissioners. Moussa Faki Mahamat was re-elected as the African Union Commission Chairperson for a second four-year term and newly elected Monique Nsanzabaganwa, the first female in the history of the Commission, as his deputy. 

“I congratulate the President of the Democratic Republic of the Congo, Félix Tshisekedi, for taking the reins as the Chair of the African Union for 2021 and commend him for calling on his peers to sustain efforts in the AIDS response and strengthen health systems in Africa while we are still facing the COVID-19 pandemic. I reaffirm UNAIDS’ support to the African Union. Saving lives, tackling inequalities and advancing universal health care are lessons learned from AIDS to address current and future pandemics successfully,” said Clémence Aissatou Habi Baré, Director of the UNAIDS Liaison Office to the African Union and United Nations Economic Commission for Africa.

The risk of developing tuberculosis among the 38 million people living with HIV in 2019 was 18 times higher than in the rest of the world’s population. Tuberculosis remains the single largest cause of premature death among people living with HIV.

Scale-up of antiretroviral therapy and improvements in the integrated delivery of HIV and tuberculosis services have reduced tuberculosis-related deaths among people living with HIV by 69% globally, from 678 000 in 2000 to 208 000 in 2019. Among the 131 countries that reported data to UNAIDS and the World Health Organization in 2020, 48.9% of the estimated 815 000 people living with HIV who developed tuberculosis (incident cases) received treatment for both HIV and tuberculosis. 

The tuberculosis testing gap—the gap between the number of people living with HIV who are estimated to have tuberculosis and the number of people living with tuberculosis who have tested positive for HIV—is narrowing. However, the 456 426 tuberculosis cases among people living with HIV that were notified in 2019 represented just 56% of the estimated number of incident tuberculosis cases among people living with HIV that year. Among people living with HIV who were notified tuberculosis cases, 88% were on antiretroviral therapy in 2019.

Estimated global number of incident HIV-positive TB cases compared with the global number of notified new and relapse tuberculosis cases known to be HIV-positive and the global number of tuberculosis patients started on antiretroviral therapy, 2004-2019

At the end of January 2021, the Kyrgyzstan Constitutional Court decided to exclude HIV from the list of diseases that prevent people from adopting children or becoming guardians or foster parents. The barrier to parenting for people living with HIV in the country had been in effect for many years.

The change—brought about by a joint effort of activists, lawyers and human rights defenders, but primarily by people who personally suffered from discrimination and fought for their rights—is a victory against stigma and discrimination against people living with HIV in Kyrgyzstan.

Baktygul Israilova, pictured above and who leads the Country Network of Women Living with HIV, is one of those who were affected. Several years ago, she wanted to adopt a child. “At that time, I did not fully understand the depth of the problem. I thought that if I prepared all the necessary documents, submitted them to the right department, they would consider me and make a positive decision,” Ms Israilova said. “I am a mother of two wonderful girls, I have a job, a stable job, so at that time it seemed that everything should be on my side.”

When she found out that she could not adopt a child because of her HIV status, she was shocked. “I’m used to the fact that people living with HIV are constantly discriminated against, but why can’t they become parents and give their love and care to a child from an orphanage?” she said.

At that time, Ms Israilova was starting on her path in HIV activism. “Until that time I was always afraid of something, at first my HIV status. I was worried for my girls, I was worried that I would not find a job, I was afraid that people would not understand me, I was worried that I would not achieve anything in my life. But then I became tired of being afraid. It was a turning point in my life. It was then that I openly declared my HIV status and became the first woman in the country openly living with HIV.”

According to the Kyrgyzstan National Statistical Committee, in 2019 there were more than 2000 children and adolescents under the age of 18 years who were left without parental care, of which 592 were orphans.

In 2018, Ms Israilova met Svetlana Izambayeva, pictured above, an activist from the Russian Federation who is living with HIV and who became one of the first women in the Russian Federation to declare her HIV status openly. Ms Izambayeva had extensive and successful experience in the struggle for the right to adopt in her home country and helped and advised the women in Kyrgyzstan in their battle.

A similar case was being considered by the Kyrgyzstan courts in which the Kyrgyz lawyer Ainura Osmonalieva and lawyers from the Adilet legal clinic were trying to help a woman living with HIV to get custody of her nephew after the death of his mother.

The activists joined forces and resources and studied the entire existing legal framework, international obligations, ratified conventions and the United Nations Political Declaration on Ending AIDS, which the country had committed to implement. The process lasted for two years. Activists from other countries, particularly from the Eurasian Women’s Network on AIDS, helped to collect evidence. The activists highlighted examples of changes in legislation in three eastern European countries—the Republic of Moldova, the Russian Federation and Ukraine. The UNAIDS Country Office in Kyrgyzstan supported the advocacy efforts of the Country Network of Women Living with HIV at all stages and provided technical support to strengthen its organizational and advocacy capacity.

Ms Israilova said that when she had to speak and defend her position before the Constitutional Court judges, she was ready for any developments. “Even if we were given a negative decision, we would not have given up, but tried again and again to achieve a result where every person living with HIV can adopt or become a guardian of a child.”

“When we received a positive decision, I came home and told my girls about what we had achieved. They have long dreamed of a brother and even came up with a name for him. My girls are my light, which illuminates my path. I have managed to achieve a lot in life thanks to the fact that I have them. Now I must prepare all the necessary documents to give happiness to another child,” said Ms Israilova.

Photos: November 2019. Credit: UNAIDS

Ralph Ivan Samson, the President of Y-PEER Pilipinas, and his team of young volunteers have been working tirelessly throughout the COVID-19 pandemic to supply antiretroviral therapy to young people struggling to get refills. “How could I sleep at night knowing that community members were depressed and anxious about their refills. I had young people texting me they were down to their last couple of pills,” said Mr Samson, remembering the initial COVID-19 outbreak in the Philippines in March 2020. It was at this moment that he knew he had to do something.

Throughout the region, civil society organizations like Y-PEER Pilipinas began looking into ways of overcoming the barriers and challenges that prevent young people from accessing HIV services due to COVID-19 restrictions. For example, Y-PEER gained support from local governments with special travel passes to enable the delivery of antiretroviral therapy from the hospital straight to the doorsteps of young people living with HIV.

Y-PEER Pilipinas was one of several beneficiaries of the COVID-19 Emergency Relief Fund, a regional small-grants programme established by Youth LEAD to support initiatives led by young people across Asia and the Pacific during the COVID-19 pandemic. The COVID-19 relief fund supported 12 organizations led by young people in nine countries with various projects, including the delivery of antiretroviral therapy, hygiene products, opioid substitution therapy, emergency supplies and food, cash transfer programmes for businesses run by transgender people and housing for key populations.

Youth LEAD’s efforts to mobilize resources during the early days of the pandemic are a testament to young people rising up to the occasion and working in coordination with regional partners of the HIV response in Asia and the Pacific. In their efforts to raise funds, Youth LEAD relied on the findings of a regional assessment on the needs of young key populations and young people living with HIV during the COVID-19 pandemic conducted by the Inter-Agency Task Team on Young Key Populations Asia Pacific (IATT on YKP), a regional coordinating platform comprised of United Nations agencies and young key populations regional networks. The results of this assessment helped to inform the IATT on YKP and its regional and national partners on ways to support organizations led by young key populations during the COVID-19 response. The evidence gathered through the survey was used to inform preparedness response plans and local strategies on providing timely information on COVID-19 prevention, supporting the delivery of antiretroviral therapy and tackling stigma and discrimination. 

With the support received from Youth LEAD, Mr Samson and his team of volunteers provided condoms and lubricant and emergency supplies to young key populations and young people living with HIV across several provinces in the Philippines. The programme is known online as #GetCondomsPH, and a similar initiative led by young people from the COVID-19 Emergency Relief Fund supported the delivery of antiretroviral therapy to people’s doorsteps in Goa, India.

Aadi Baig, Programme Manager, and his team at Wasaib Sanwaro, an organization that works with gay men and other men who have sex with men and male sex workers in Pakistan, have also benefited from the COVID-19 Emergency Relief Fund. Mr Baig revealed a troubling picture of how the COVID-19 pandemic has made things worse for key populations. “The pandemic has created a greater divide among people, socially and economically, and has uncovered the lack of social security and protection programmes for key populations.”

With the support received, Wasaib Sanwaro donated food and supplies to key populations and provided basic HIV and COVID-19 training. Although there are limited funding schemes for organizations of young people across the region to access grants, regional networks of young people, such as Youth LEAD, Y-PEER and YVC, and the coordinated response by the IATT on YKP, which in 2020 was co-chaired by the UNAIDS Regional Support Team for Asia and the Pacific, the APCASO nongovernmental organization and the United Nations Development Programme, have stepped in to provide support.

As part of the work of the IATT on YKPs, a website that pools together COVID-19 resources for young key populations and showcases how young people have stepped up to respond to the COVID-19 pandemic was developed. The website also focuses on resources on the mental health of young key populations and the well-being of adolescents and young people at higher risk of HIV.

The most crucial aspect of all these activities was visibility, the visibility of young people, to ensure that young key populations and young people living with HIV had a voice during the pandemic. To keep the issues and needs of young key populations on the top of the advocacy agenda in the region, the IATT on YKP, with support from the UNAIDS Regional Support Team for Asia and the Pacific and Youth LEAD, held the first Spill the T with YKPs webinar—an online panel with young people from across the region that offered a platform for young people to talk about their initiatives and their roles in the COVID-19 response. The series continued through the collaboration of the IATT on YKP with partners and explored issues of young people’s leadership, mental health and sexual and reproductive health and rights. 

As COVID-19 vaccination begins around the world, UNAIDS spoke to Peter Godfrey-Faussett, UNAIDS Senior Science Adviser and Professor of International Health and Infectious Diseases at the London School of Hygiene and Tropical Medicine, about what is holding up an HIV vaccine.

Many people are asking, “How was a COVID-19 vaccine found so quickly?”

The SARS-CoV-2 virus, which is the virus that causes COVID-19, jumped from animals into humans in 2019. Whereas for HIV, that jump occurred 100 years ago in around the 1920s, and it became a problem in the 1980s when it started spreading among humans to a much greater extent.

The reason we’ve seen such a push on the COVID-19 vaccine is because of the urgency. In 2020, COVID-19 has infected almost 100 million people on the planet. COVID-19 has already killed 2 million people in 2020.

So, this urgency comes about, despite the fact that we’ve seen dramatic changes in everybody’s life, with changes to travel and social distancing and masks and hand washing and sanitizer, and yet we've still seen a rapid rise in infections. This produces a huge urgency to make a vaccine. And, of course, it has a massive economic impact.

HIV and SARS-CoV-2 are quite different, right?

There are fundamental differences between SARS-CoV-2 and HIV. Although they are both viruses, SARS-CoV-2 is a very simple infection. The disease can be complicated, and sometimes mysterious, but almost everyone infected with SARS-CoV-2 develops antibodies to the spike protein and this neutralizes the virus and leads to recovery with a clearance of the virus.

In contrast, almost everybody infected by HIV develops antibodies and we use those antibodies in regular HIV tests. But, unfortunately, very few clear the infection and those antibodies are not sufficient to neutralize the HIV. The HIV envelope, which is more or less like a spike, is a complex structure on the surface of the virus. It’s coated with sugars and the active site is deep inside, so it’s hard to engage with it.

Over time, as people are infected with HIV some people do develop antibodies able to neutralize HIV, but that can take many years, and furthermore HIV is a retrovirus—that’s why we talk about antiretrovirals. A retrovirus is a virus that copies its genetic code and integrates it into the human genetic code. And as it copies, it copies its genetic code, but it doesn’t do it accurately, it makes many mistakes. What that means is that the envelope protein and the HIV itself is constantly changing, shifting its shape, making it difficult for antibodies to protect against it, so even the neutralizing antibodies from one individual often fail to neutralize the virus from a different individual.

We have now found some so-called broadly neutralizing antibodies, as in antibodies that neutralize many different strains of HIV. And those are the antibodies that people are studying at the moment and trying to see whether or not they protect people from catching different strains of HIV. They could be an important part of the process for developing a vaccine against HIV if we could get broader neutralizing antibodies to be generated before the HIV infection occurred.

Finally, we have to remember that, unlike COVID-19, or maybe partly unlike COVID-19, HIV depends a lot on T-cells—the other half of the human defence system. The human immune system has antibodies, but it also has so-called cellular immunity, which is led by T-cells, and that’s much harder to study and much more varied and it also makes HIV difficult and different from COVID-19 when it comes to developing a vaccine.

How much money is being invested in HIV vaccines?

Each year for the past decade we’ve invested around US$ 1 billion in research and development to try to produce an HIV vaccine. Is that a lot or is it not enough? It’s about 5% of the global HIV response budget. There has been some limited success.  Back in 2009 there was great excitement when a vaccine candidate in Thailand did produce some protection against HIV infection, but not enough for it to be taken into widescale production.

And then over the next decade, subsequent trials have taught us a lot about the immunology, about the way human bodies and immune systems interact with HIV, but they haven’t led to a reduction in new HIV infections. Hope is currently resting on two large studies that are in the field at the moment, and there are many other candidates in the pipeline. So, I think there is hope, but we clearly won’t have a vaccine in the short term in the way that we have with COVID-19.

COVID-19 has taken the headlines—what about other infectious diseases?

In Africa, tuberculosis, malaria and HIV each kill more than five times as many people per year as COVID-19 has killed in Africa this year. These are huge problems and they've been going on for a long time. We have a vaccine against tuberculosis, the BCG vaccine, first used 100 years ago, starting in 1920, but unfortunately it doesn't really protect against the common adult forms of tuberculosis. Just recently, new vaccines have been discovered against both tuberculosis and malaria, but they don’t work particularly well. There are discussions about whether to scale them up because they only have a protective efficacy of 30% or less.

The good news is that a new malaria vaccine has just gone into big phase three trials in Africa, and in fact it’s produced by the same setup that has produced the AstraZeneca Oxford COVID-19 vaccine, so the hope is that the research that’s being done on COVID-19 vaccines may act as a shot in the arm for all the other important infectious disease killers that actually kill many, many more people in Africa and other resource-constrained parts of the world.

Watch: UNAIDS Science Adviser explains some differences between HIV and COVID-19

Violence impacts the lives of women and girls, people living with HIV and key populations in myriad negative ways. National authorities and civil society representatives in dozens of countries reported to UNAIDS in 2019 that various provisions and services were in place to protect the health, safety and security of survivors of domestic and sexual violence. However, the degree to which policies and legislation are implemented and enforced—including their coverage and quality—varies widely.

Prevention efforts are also lagging significantly, as evidenced by the high levels of intimate partner violence reported in surveys conducted around the world. Surveys conducted in 46 countries between 2014 and 2018 show that 19.7% of ever-married or partnered women and adolescent girls (aged 15 to 49 years) experienced physical and/or sexual violence by an intimate partner in the past 12 months.

Countries with service delivery points providing appropriate medical and psychological care and support for women and men who have experienced sexual violence, countries with available data, 2019

Countries with provisions related to domestic violence, countries with available data, 2019

A spontaneous HIV test that yielded a positive result changed Martha Clara Nakato’s life forever. When Ms Nakato, who lives in Uganda, found out she was living with HIV, she was 14 years old and had never had sex.

“I accompanied my twin brother only to support him to take up the test. I didn’t know taking one too would change my life forever,” she says as she recalls her shock and confusion at her result.

Her brother’s HIV test came out negative. 

Ms Nakato soon discovered from her father that she was born with HIV. She is the only one of her eight siblings who contracted HIV from her mother. She lost her mother to AIDS-related illnesses when she was just five years old. 

“I don't know why this had to happen to me. Maybe I was the lucky one; maybe there was a purpose meant for me. When I look back, I now know the only way you can find your purpose in life is to think about that one thing that hurt you the most,” Ms Nakato says.

Ms Nakato has transformed her pain to power and works as a human rights defender and HIV advocate with the Uganda Network of Young People Living with HIV/AIDS (UNYPA). 

In 2019, she was recognized as one of the Global Fund to Fight AIDS, Tuberculosis and Malaria’s five faces that championed the worldwide sixth replenishment campaign.

“I do a lot of mentorship and motivational speaking,” says Ms Nakato, who uses her own story to demonstrate how adherence to HIV treatment can help people living with HIV live a full and healthy life. 

Much of Ms Nakato’s advocacy and mentorship involves interacting with young people in their communities with in-person dialogue. Following the COVID-19 outbreak, she had to rethink how to reach young people while adhering to the social distancing measures that followed because of the pandemic.

“Most of those engagements that involved face-to-face were not able to happen. Looking at young people in the rural areas who don’t have access to the Internet or a smartphone, we really had challenges reaching out to them,” Ms Nakato says.

However, Ms Nakato and her team realized the importance of reaching out to young people on social media platforms, such as Facebook, to get her message across. 

UNAIDS provides financial and technical support to the annual Y+ beauty pageant and youth summit, events that are organized by UNYPA. The pageant crowns a Mr and Miss Y+, encouraging young people living with HIV to come together, celebrate their beauty and address HIV-related stigma and discrimination.

During the COVID-19 outbreak, UNAIDS ensured that community-based organizations such as UNYPA had access to national platforms—for instance, the national COVID-19 national secretariat—so that organizations could engage in dialogue with the government and thereby provide better relief and food support to communities in need.

Ms Nakato was born in 1996, a time when HIV treatment was inaccessible in Uganda. In that year alone, 34 000 children between the ages of 0 and 14 years acquired HIV. 

Today, 95% of women living with HIV in Uganda have access to services to prevent vertical (mother-to-child) transmission of HIV. There has been a significant drop in vertical transmission and the country has achieved an 86% reduction in HIV infections among children since 2009. 

“I don’t want to give birth to a child who is HIV-positive or see any other young woman do so. We now have the power to prevent this from happening, not like many people in the past who didn’t have that chance,” she says. 

As an AIDS activist, Ms Nakato has plans for herself and society, hoping to see an AIDS-free world. She stresses the importance of adhering to HIV treatment to help make that a reality.

“One thing I know is that I am the proof of treatment. I am proof of what self-love is,” she says.

UNAIDS provides financial and technical support to the annual Y+ beauty pageant and youth summit, events that are organized by UNYPA. Above, Nabanoba Vivian Alice and Niwamanya Hillary, winners of the Y+ beauty pageant. Kampala, Uganda, October 2019. Credit: UNAIDS