Report released at AIDS 2012 calls for sustained funding of HIV prevention research to achieve our collective vision of zero new HIV infections

Washington DC (23 July 2012) – A decade of unprecedented investment in HIV prevention research has led to major scientific breakthroughs in vaccines, microbicides, voluntary medical male circumcision, treatment as prevention and pre-exposure prophylaxis, or PrEP, but sustained financing will be needed to capitalize on these breakthroughs to deliver new options that can help end the AIDS pandemic, according to a new report released today at the XIX International AIDS Conference in Washington, DC.

The new report, Investing to End the AIDS Epidemic: A New Era for HIV Prevention Research & Development, tracks investment in prevention research in 2011 and looks back at a decade of tremendous growth in funding, despite sometimes uncertain prospects for some HIV prevention options. Yet the authors note that capitalizing on recent breakthroughs in the field and ensuring a pipeline of new next generation products will require sustained and flexible investments from a range of donors in the coming years.

The eighth annual report from the HIV Vaccines and Microbicides Resource Tracking Working Group shows that funders invested a total of US$1.24 billion in research and development (R&D) for six key prevention options: preventive HIV vaccines, microbicides, PrEP using antiretroviral drugs, treatment as prevention, prevention of vertical transmission and operations research related to medical male circumcision. This investment is down slightly from the US$1.27 billion invested in 2010 for these six research areas. Investments in vaccine and microbicide R&D decreased in 2011, though decreases for microbicide R&D were attributed to funding disbursement cycles and did not represent declines as compared with past investments.

“This is a critical time. We now have 8 million people on antiretroviral treatment and we are seeing reductions in new HIV infections, even in the most affected communities. But it is not enough to think that HIV is a disease that can be managed with pills. HIV has to be brought to an end and funding shortfalls must not become the roadblocks that prevent us from achieving our goals,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS, (UNAIDS).

“Recent advances toward the development of a preventive HIV vaccine have fueled optimism within the AIDS vaccine field. Researchers around the world are now working to build on this progress to develop next-generation vaccine candidates and advance the most promising of these candidates toward large-scale efficacy trials,” said Margaret McGlynn, IAVI President & CEO.  “I am more optimistic now than ever before that the development of a preventive AIDS vaccine is within reach. However, in order to build on this recent progress it is critical that we sustain financial commitment and support for HIV vaccine R&D.”

In the past two years, beginning with results from the landmark CAPRISA 004 microbicide trial announced at the last International AIDS Conference, we have seen tremendous breakthroughs in antiretroviral-based prevention, including TDF/FTC (Truvada) as daily oral PrEP, which was approved by the US Food and Drug Administration as a new prevention option last week, and the HPTN 052 treatment as prevention study which provided evidence that early treatment of HIV-positive people may also protect their HIV-negative partners.

Analyses completed in the past year have unveiled crucial clues as to how the candidate in the RV144 HIV vaccine trial provided protection against HIV. In addition, recent advances in identifying and characterizing broadly neutralizing antibodies to HIV are informing potentially powerful new vaccine candidates.

For microbicides, Phase III clinical trials are underway that could provide the results needed to license and deliver marketable products, including 1 % tenofovir gel and vaginal rings that could offer women protection for a month, two months or longer—and might eventually combine an antiretroviral drug with a contraceptive hormone to provide dual protection. Additional PrEP trials are looking at different drugs and less-than-daily dosing that might be easier for people to adhere to.

Recent positive results underscore the importance of preparing for success and capitalizing on areas of progress and promise. The prevention field continues to need funding structures that can adapt quickly and are sufficiently generous to allow for rapid expansion in the event of positive outcomes.

Indeed, the HIV prevention research field is facing a new and exciting era with many new HIV prevention options becoming available, including female condoms, voluntary medical male circumcision, antiretroviral treatment as prevention and PrEP.  The report notes that additional funding will be needed to effectively roll out all available options, which represents an investment opportunity for countries heavily impacted by HIV, particularly emerging economies.

As the rallying cry to end AIDS is heard this week from policymakers, researchers, funders and advocates gathered in Washington, DC, and as we work together to craft a response to AIDS, the Working Group notes that research to develop and roll out new prevention options is a vital component for success and must be appropriately funded.

“For the first time, the end of the AIDS epidemic is within reach,” said Mitchell Warren, Executive Director of AVAC. “New prevention options – voluntary medical male circumcision, PrEP, treatment as prevention, microbicides and eventually vaccines – will play a critical role in reducing the cycle of new infections.  The past decade has been a period of increasing investment in HIV prevention R&D and has yielded unprecedented success. With sustained and flexible funding, the future of HIV prevention research will be even more promising.”

The report is available online at: www.hivresourcetracking.org.

A new report and supplement from UNAIDS shows that as international funding flattens, more countries are increasing their own share of investments for HIV and that a record 8 million people are now receiving antiretroviral therapy

BEIJING, 26 June 2012—Li Congjun, the President of Xinhua News Agency, was awarded today the Joint United Nations Programme on HIV/AIDS (UNAIDS) “Leaders and Innovators Award” in recognition of his leadership and contribution to the AIDS response.

UNAIDS Executive Director Michel Sidibé presented the award to Mr Li in a ceremony at the Great Hall of the People in Beijing, China. The award recognizes the key role that leadership and innovation play in accelerating progress in the AIDS response.

With Mr Li at the helm of Xinhua, China’s all-media news group mobilized its public affairs division and conducted a global media campaign to promote public awareness of HIV. In the lead-up to World AIDS Day on 1 December 2011, the group placed HIV-related public service advertisements in more than 10 newspapers and magazines in China. Xinhua also showcased the World AIDS Day theme of “Getting to Zero” on a giant electronic screen in Times Square, New York.

“From a huge billboard in one of the busiest squares in the world to small community publications, Xinhua has promoted public awareness of HIV to millions of people,” said Mr Sidibé. “Mr Li’s bold leadership is ensuring that HIV remains at the forefront of public awareness. We count on Xinhua to be a brand ambassador for the AIDS response.”

“The award is a great honour not only for me, but also for Xinhua and even the Chinese media,” said Mr Li. “Xinhua, encouraged by such recognition and appreciation by UNAIDS, will further its cooperation with UNAIDS as part of its efforts to shoulder its social responsibility as an international multi-media institution.”

With over 30 domestic branches and nearly 170 offices overseas, the Xinhua news agency is the largest in the world. More than 40 of the organization’s news bureaus are in Africa. Last September, UNAIDS and Xinhua signed a two-year Memorandum of Understanding (MOU) of Strategic Cooperation. The global media campaign was launched as part of the new partnership.

China is a strategic partner of UNAIDS in shaping the future of AIDS. The country has invested heavily in Africa and its cooperation is key in helping the continent achieve important AIDS commitments by 2015. The Forum on China-Africa Cooperation will meet next month and is an opportunity for the two partners to deepen dialogue on cooperation over health and HIV.

Newest UN organization joins UNAIDS’ efforts to ensure greater access to HIV services for women and girls

GENEVA, 5 June 2012—The United Nations Entity for Gender Equality and the Empowerment of Women (UN Women) is the eleventh United Nations body to join the Joint United Nations Programme on HIV/AIDS (UNAIDS) as a cosponsoring partner.

The official joining of UN Women as a UNAIDS Cosponsor, which was approved at UNAIDS’ board meeting today, will further strengthen the UNAIDS family’s work on gender equality and HIV and enhance collaboration with governments, international partners, women’s organizations and the women’s rights movement.

“UN Women is proud to join UNAIDS. We believe that the single most important strategy in dealing with HIV is empowering women and guaranteeing their rights—so that they can protect themselves from infection, overcome stigma, and gain greater access to treatment and care,” said Michelle Bachelet, Executive Director of UN Women. “We look forward to expanding our efforts in partnership with the UNAIDS family to address this epidemic.”

Gender equality and respect for women’s sexual and reproductive health and rights, especially for women living with HIV, are essential for an effective response to HIV. Persistent gender inequalities and women’s rights violations are continuing to render women and girls more vulnerable to HIV and prevent them from accessing HIV services. In 2010 there were around 17 million women living with HIV and HIV continues to be the leading cause of death in women of reproductive age.

“I believe we need to and can do much better for women and girls. There are still too few sustainable solutions available for women to protect themselves from HIV, violence and poverty,” said Michel Sidibé, Executive Director of UNAIDS. “Partnering with UN Women will strengthen our efforts to promote gender equality and bolster women’s empowerment globally through the HIV response.”

UNAIDS will collaborate closely with UN Women in a number of areas including: addressing the intersections between HIV and violence against women; integrating gender equality into national HIV planning; and using strategies that promote the leadership and participation of women living with HIV, and women affected by HIV, in decision-making. UNAIDS and UN Women will also work on strengthening national institutions to enable them to deliver on commitments made on gender equality and women’s rights in the context of HIV.

“As a young woman living with HIV, I am heartened to see that UNAIDS and UN Women are joining forces against AIDS. I have experienced first-hand how enabling environments and rights-based services can empower women living with HIV to take control over our bodies and our lives,” said Helena Nangombe Kandali from Namibia. “UN Women becoming a cosponsor of UNAIDS is a positive step forward in supporting women the world over, particularly women living with HIV.”

UN Women, established by the UN General Assembly in 2010 brings together four distinct parts of the UN system which focused exclusively on gender equality and women’s empowerment, namely: the Division for the Advancement of Women; the International Research and Training Institute for the Advancement of Women; the Office of the Special Adviser on Gender Issues and Advancement of Women; and the United Nations Development Fund for Women (UNIFEM).

 

Message from UNAIDS Executive Director Michel Sidibé

GENEVA, 14 May 2012—In the last year, we have seen greater acceptance of diversity. A new dialogue of openness and tolerance has emerged.

Yet in 79 countries, territories and areas, we still have laws that criminalize same-sex relations between consenting adults. These laws are serious barriers to an effective AIDS response and are driving lesbians, gays, bisexuals and transgender people underground where they cannot access life-saving services.

A society’s value should not be based on money or power. It must be measured by the way it values people, regardless of their sexual orientation or social status. A prosperous society is one that ensures inclusiveness and respects all people.

To our gay, lesbian, bisexual and transgender friends, UNAIDS stands with you.

Your engagement is essential to achieving our vision of Zero new HIV infections, Zero discrimination and Zero AIDS-related deaths.

GENEVA, 8 May 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) today launched a new campaign, "Believe it. Do it.", aimed at bringing attention and action to the global goal of ending new HIV infections among children by 2015 and ensuring mothers living with HIV remain healthy. 

Each year, about 390 000 children become newly infected with HIV and as many as 42 000 women living with HIV die from complications relating to HIV and pregnancy.

In 2011, world leaders at the United Nations High Level Meeting on AIDS committed to ending new HIV infections among children by 2015 and saving mothers’ lives. A bold new global plan was adopted and action is underway.

“We have an amazing opportunity to change the world,” said Michel Sidibé, Executive Director of UNAIDS. “We have the commitment of world leaders but the clock is ticking and we cannot get from 390 000 to zero without you.” 

UNAIDS Goodwill Ambassadors Naomi Watts and Annie Lennox are among the personalities adding their voices and commitment to “Believe it. Do it.” In addition, UNICEF Goodwill Ambassador Whoopi Goldberg joined Blair Underwood, Denis O’Hare, Alexandra Wentworth, George Stephanopoulos and Sujean Rim to create a public service announcement for the campaign with the message “I believe children everywhere can be born free from HIV—Believe it. Do it.”

Under the premise that ‘every day is Mother’s Day!’ UNAIDS also teamed up with artist Sujean Rim to create a series of e-cards celebrating families. Through public service announcements, an interactive web site and social media outreach, the campaign asks the public to take three simple actions: 

1. Get the facts about ending new HIV infections among children  
2. Send a message about the issue and the actions people can all take
3. Support a mother through one of the great organizations working with families

The campaign will be featured ahead of Mother’s Day on 11 May on the American morning television show Good Morning America and the 30-second public service announcement will appear on CNN International, CNN Domestic (U.S. market) as well as other media outlets.

For more information visit http://www.unaids.org/believeitdoit/

In his report to the UN General Assembly, UN Secretary-General Ban Ki-moon urges stakeholders to redouble efforts to meet the targets outlined in the 2011 Political Declaration on AIDS

GENEVA, 30 April 2012—The United Nations Secretary-General Ban Ki-moon has issued his first report on HIV to the UN General Assembly since the 2011 High Level Meeting on AIDS. In the report, he highlights the urgent need to achieve immediate, tangible results and for the AIDS response to be smarter, more strategic, more efficient, and grounded in human rights.

“I urge the international community to stand up to meet the commitments it has made. I call for a shift from the perception that aid is charity to an understanding that it is our shared responsibility and a smart investment that reaps dividends for all. Together, we must foster a more sustainable response to the HIV epidemic for the sake of our common future.”

Substantial gains have been achieved over the last decade and ground-breaking scientific advances have encouraged leaders to talk about the end of AIDS. The report, ‘United to End AIDS: Achieving the Targets of the 2011 Political Declaration’, outlines that 2.5 million deaths are estimated to have been averted since 1995 due to the increase in access to antiretroviral therapy—and 350 000 new HIV infections averted in children. It also underscores the gains made in HIV prevention with new infections at their lowest levels since the peak in the mid-2000s. 

However, the report also warns that considerable gaps persist in access to HIV services, particularly for people at higher risk of exposure to HIV. Punitive laws, gender inequality, violence against women and other human rights violations continue to undermine national AIDS responses and declines in funding have the potential to jeopardize the capacity to expand access to HIV services and sustain progress over the coming years.

“The fourth decade of AIDS has to be marked as the decade that ushered in the end of AIDS,” said Michel Sidibé, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS). “We can make this a reality and seize the opportunity to secure a future free from HIV.”

At the 2011 High Level Meeting on AIDS, UN Member States adopted a Political Declaration on AIDS, providing a roadmap towards achieving the vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. The declaration set 2015 as the deadline for achieving a number of specific targets.

Through the Political Declaration, UN Member States pledged to deliver antiretroviral therapy to 15 million people by 2015, eliminate new HIV infections in children, achieve a 50% reduction in new HIV infections among adults, reduce transmission of HIV among people who inject drugs by 50% and reduce TB deaths in people living with HIV also by half.

Countries also committed to closing the resource gap, investing between US$ 22-24 billion each year by 2015, meeting the needs of women and girls, eliminating stigma and discrimination and promoting the integration of the HIV response into broader health and development efforts.

In his report, the Secretary-General underscores that achieving the 2015 goals will require a redoubling of efforts from all stakeholders and that if smarter and more efficient ways of working are not applied to the AIDS response, the goals will not be met.  

The Secretary-General outlines a number of recommendations that need to be implemented to reach the 2015 targets. For instance, to meet the target of reducing sexual transmission by 50%, the report outlines that the number of new sexually transmitted HIV infections will need to decline by at least 1 million by 2015. To achieve this, HIV prevention programmes need to enhance efforts to reinforce, sustain and extend behaviour change by promoting gender equality and mutual respect, as well as better focus on where the new infections are occurring.

To reduce HIV transmission among people who use drugs by 50%, the number of new HIV infections must fall by at least 120 000 per year. The Secretary-General encourages stakeholders to summon the wisdom, courage and commitment required to implement strong, evidence-informed prevention programmes that empower key populations including people who inject drugs.

At least 180 000 fewer TB-related deaths among people living with HIV will be required to achieve a 50% reduction by 2015. To realize this, from 2010 to 2015, TB cure rates need to increase from 70% to 85% and rates of TB detection among people living with HIV must rise from 40% to 80%. Achieving the target would reduce TB-related deaths by 80% and save a million lives.

In his recommendations, the Secretary-General urges countries to undertake immediate, comprehensive reviews of national, legal and policy frameworks to remove obstacles to effective and rights-based responses. He also calls for new partnerships and a new approach for HIV investment to mobilize necessary resources. In 2010, a total of US$ 15 billion was available for the AIDS response from all sources. The report highlights that to reach the 2015 target of US$22-24 billion for the response to HIV by 2015 an additional US$ 8 billion will be required.

Report of the Secretary-General: United to end AIDS: achieving the targets of the 2011 Political Declaration

New guidelines released for couples HIV testing and counselling and for treatment and prevention in serodiscordant couples

GENEVA, 19 April 2012—New guidelines have been issued encouraging couples to go together for HIV testing in order to know their HIV status. The guidelines, released by the World Health Organization (WHO), also recommend that in couples who are serodiscordant—where one partner is living with HIV and the other not—antiretroviral therapy is offered to the person living with HIV to prevent his or her partner from becoming infected with the virus.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes the new guidelines and calls on all countries to implement them to reach the targets set in the United Nations 2011 Political Declaration on AIDS.

“Couples can now reap the benefits of antiretroviral therapy, to improve their own health, and to protect their loved ones,” said UNAIDS Executive Director Michel Sidibé. “By encouraging couples to test together, we can provide comprehensive options for HIV prevention and treatment—that they can discuss and manage jointly.”

New evidence now shows that antiretroviral therapy reduces the risk of HIV transmission from a person living with HIV to their sexual partners. WHO recommends that antiretroviral therapy be offered to HIV-positive individuals in discordant relationships even when they do not require it for their own health. The guidance also states that it is possible for couples to stay HIV serodiscordant indefinitely if they consistently practice safer sex using condoms.

“I am excited that with the roll out of these new guidelines, millions of men and women have one additional option to stop new HIV infections,” said Mr Sidibé. “This development begins a new era of HIV prevention dialogue and hope among couples.”

According the new guidelines, “couples who test together and mutually disclose their HIV status are more likely than those testing alone to adopt behaviour to protect their partner. Another potential benefit of couples testing together and sharing their results is that they can support each other, if one or both partners are HIV-positive, to access and adhere to treatment and prevent transmission of HIV to children”.

UNAIDS recommends that HIV testing and counselling should always be confidential and initiation of treatment must always be voluntary and never mandatory or coercive. Couples should have access to the full range of HIV prevention options available including the use of male and female condoms and medical male circumcision. They should also be provided with access to health services such as tuberculosis screening and reproductive health services including family planning with access to effective contraceptives and conception counselling for sero-discordant couples.

According to UNAIDS estimates, around 14 million people are eligible for antiretroviral treatment. At the end of 2011, only 6.6 million people were receiving the life-saving medicines. The guidelines recommend that in situations of limited or inadequate resources, people who require antiretroviral therapy for their own health should always be given priority.

ADDIS ABABA, 27 March 2012—The Joint United Nations Programme on HIV/AIDS (UNAIDS) and the New Partnership for Africa’s Development (NEPAD) Agency today signed a memorandum of understanding (MoU) calling for strategic collaboration to advance sustainable responses to HIV, health and development across the African continent. The MoU was signed by UNAIDS Executive Director Michel Sidibé and Chief Executive Officer of NEPAD Agency, Dr Ibrahim Mayaki, on the sidelines of a colloquium marking the 10^th anniversary of NEPAD in Addis Ababa, Ethiopia.

Under the terms of the agreement, UNAIDS and the NEPAD Agency will work with partners to: support the development of common African positions for the AIDS response, with an emphasis on sustainable financing; address constraints in access to HIV medicines; facilitate policies and partnerships to eliminate new HIV infections in children and improve the health of mothers; enhance country ownership and accountability; and encourage South-South cooperation.

“This new partnership will bring us one step closer to our goal of zero new HIV infections, zero discrimination and zero AIDS-related deaths,” said the UNAIDS Executive Director, at a press conference on 27 March after the signing of the MoU. Mr Sidibé said that “getting to zero” would demand effective and inclusive partnerships, shared responsibility, greater transparency and a focus on results—areas in which NEPAD is known to excel.

Speaking alongside Mr Sidibé at the press conference, Dr Ibrahim Mayaki said that country ownership would be critical to advancing AIDS and development responses in the coming decade. “Partnerships for development can only succeed if they are led by developing countries,” said the Chief Executive Officer of NEPAD Agency. “AIDS programmes must be financially sustainable over the long term and tailored to specific national settings,” he added.

Sub-Saharan Africa carries the highest HIV burden of any region in the world. In 2010, about 68% of all people living with HIV resided in sub-Saharan Africa, a region with only 12% of the global population.

About two-thirds of all AIDS investments in Africa currently come from external sources. According to UNAIDS estimates, Africa will require between US$ 11-12 billion for its regional AIDS response by 2015—US$ 3-4 billion more than the current expenditure.

Message from UNAIDS Executive Director Mr. Michel Sidibé

GENEVA, 22 March 2012—On World TB Day, let’s celebrate a partnership, which in just a few years is helping to transform the AIDS epidemic.

By improving collaboration between HIV and TB services almost one million lives around the world have been saved in the past six years.

The number of people living with HIV screened for TB increased almost 12-fold from 2005 to 2010.

For patients, integrating HIV and TB services means a better quality of life. They spend less time going from clinic to clinic and waste less money on visits to multiple care providers.

It can also mean the difference between life and death.

Together we can be proud of our achievements.

But we haven’t reached our goal of stopping TB-related HIV deaths.

Every day a thousand people living with HIV die of TB.

These deaths just aren’t acceptable when TB is preventable and curable with inexpensive drugs.

We need to intensify the integration of HIV and TB services at every level of the health system.

We need a stronger focus on preventing, diagnosing and treating TB in children living with HIV, who are particularly vulnerable to TB infection.

All TB patients living with HIV must be put on antiretroviral therapy as quickly as possible.

Last year countries committed for the first time to cut in half the number of deaths among people living with HIV by 2015.

Having travelled so far together, I am sure we will reach the final mile.