WAD2019

Gunilla Carlsson, the UNAIDS Deputy Executive Director, Management and Governance, commemorated World AIDS Day in Brussels, Belgium, celebrating the power of communities with civil society and Barbara Trachte, the Secretary of State of the Brussels-Capital Region.

Ms Carlsson presented some of the key messages from Power to the people, UNAIDS’ new report, which shows that when people have the power to choose, to know, to thrive, to demand and to work together, lives are saved, injustices are prevented and dignity is restored.

“The AIDS response shows that when communities are empowered and have agency, change happens. Now more than ever we need a fully funded community-led response,” said Ms Carlsson.

She thanked the Regional Government of Brussels and the Federal Government of Belgium for its support for people living with HIV and the organizations working on HIV and related sexual and reproductive health and rights. For many years, Belgium has invested energy and resources to meet the needs of the most vulnerable and communities affected by HIV around the world, with a strong focus on human rights, gender equality, key populations, strengthening health systems and sexual and reproductive health and rights.

"Today, on 1 December, it is important to reinforce that undetectable = untransmittable in order to change society’s view of people living with HIV,” said Thierry Martin, Director of Plateforme Prévention Sida.

During her visit to Belgium, Ms Carlsson also met with the Minister-President of Flanders, Jan Jambon, and signed a new two-year partnership agreement with UNAIDS. Flanders has been a valued and prominent partner since the founding of UNAIDS and has invested energy and resources to meet the needs of communities affected by HIV, with a focus on vulnerable populations and girls in southern Africa.

Mr Jambon expressed confidence in renewing the long-term partnership agreement with UNAIDS. “Since its inception, UNAIDS has been working towards a multisectoral, rights-based and people-centred approach that addresses the determinants of health and well-being for the AIDS response, especially the most vulnerable populations, including the LGBTQI+ communities, and this is now more relevant than ever,” he said.

Mr Jambon also welcomed the reforms within UNAIDS to reinforce a positive workplace culture. “I am confident that with the new policies in place and the new leadership, this will enable staff to deliver at their best and maximize their collective results,” he said.

Ms Carlsson also attended a panel discussion with members of the parliament and representatives of civil society and the United Nations, where she provided an update on the status of the HIV epidemic and response, highlighting key actions for support by the European Parliament and European Union. She emphasized the important role that parliamentarians play in the global response to HIV.

Communities played a central role in the commemoration of World AIDS Day in South Africa, which was held in the rural community of Orkney, in the North West Province.

At the invitation of the Government of South Africa, the UNAIDS Executive Director, Winnie Byanyima, commemorated her first World AIDS Day as UNAIDS Executive Director in the local community. Ms Byanyima paid tribute to the role of communities in the AIDs response, including communities of people living with HIV and communities of women, girls and others at higher risk of, or affected by, HIV.

Ms Byanyima told the audience of several thousand people that it was an honour to mark World AIDS Day in South Africa—a country that was late to respond to HIV but that had made huge strides over the past decade and now had more than 5 million people on treatment. She noted, however, that there was still a long way to go, especially to protect women and girls.

“Enough is enough. All women and girls must have the right to choose if they have sex and with whom, and how they protect themselves. We need to bring power, equality and agency to all young women and girls,” she said.

Ms Byanyima said we must never accept that people living with HIV are still dying of AIDS. “It is not a question of science. It is a question of inequality, powerlessness and exclusion. The system is still failing for those who are marginalized,” she said.

South Africa’s Deputy President and Chair of the South Africa National AIDS Council, David Mabuza, told the World AIDS Day event audience that South Africa’s AIDS response had succeeded thanks to the work of communities and the contributions of activists and development partners.

“We could not achieve this without partnerships and support from our global partners,” he said. “That is why we must appreciate the contribution of the global campaign by UNAIDS that has galvanized political leadership, civil society and the private sector into coherent action. Community action remains an important pillar in making change happen, and in shaping the policy agenda and outcomes.”

He noted that there was still much work to be done, including intensifying HIV prevention and tackling contributing factors, including providing comprehensive sexuality education and ending gender-based violence.

Mr Mabuza also said he was pleased to be joined by Ms Byanyima. “She is an activist of note and a distinguished advocate for human rights and development,” he said.” We have no doubt that her vast experience in political leadership and human development will take us forward in the struggle to end the AIDS epidemic.”

In the days prior to the World AIDS Day commemoration, Ms Byanyima met with political and civil society leaders, women activists and others to hear their concerns and understand the challenges and opportunities facing South Africa.

She also visited a clinic in Soshanguve, outside Pretoria, to see in action the project Ritshidze (“saving our lives”), which aims to improve the quality of HIV and tuberculosis service delivery in South Africa by empowering people living with HIV to monitor the health services they receive and to advocate for changes needed. The project is funded by the United States of America with support from UNAIDS.

"We can spend billions building beautiful clinics to distribute millions of pills,” Ms Byanyima said. “But only if we empower communities at the grass roots to hold service providers accountable and call out injustices will we make a real difference for people."

UNAIDS employee Peter Koopmans will attempt to break the world record for the number of Murphs on World AIDS Day, 1 December, while fundraising for an HIV charity.

Named after a United States Navy officer killed in Afghanistan in 2005, the workout was one of Michael Murphy’s favorites. Originally called a Body Armor, a Murph consists of wearing a 10-kilo vest while:

• Running for one mile (1.6 km).
• Doing 100 pull-ups.
• Doing 200 push-ups.
• Doing 300 squats.
• Running for another mile.

Mr Koopmans will attempt to do 15 Murphs over a 24-hour period at UNAIDS headquarters in Geneva, Switzerland. Fifteen Murphs will see him run 30 miles and do 1500 pull-ups, 3000 push-ups and 4500 squats. He has been training for the record attempt for the past eight months, logging countless hours in the gym.

“I have always wanted to try this challenge, and this allows me to have a direct impact on the lives of others,” Mr Koopmans said. Staff and friends will cheer him on throughout, and some will even attempt to do Murphs with him.

All funds raised will go to Operation Bobbi Bear, a human rights organization committed to helping sexually abused children, and raising awareness about HIV, in KwaZulu-Natal, South Africa.

You can donate and/or follow Mr Koopmans as he accomplishes this amazing feat on this website, while this video gives a brief overview of the challenge. 

Game-changing approaches, such as medicine to prevent HIV (PrEP), integration of contraceptive services with HIV testing, viral load suppression (U = U), harm reduction, and comprehensive sexuality education, give people the power to protect themselves from HIV and, for people living with HIV, the power to thrive

NAIROBI/GENEVA, 26 November 2019—A new report by UNAIDS, Power to the people, released ahead of World AIDS Day, shows that where people and communities living with and affected by HIV are engaged in decision-making and HIV service delivery, new infections decline and more people living with HIV gain access to treatment. When people have the power to choose, to know, to thrive, to demand and to work together, lives are saved, injustices are prevented and dignity is restored.

“When people and communities have power and agency, change happens,” said Winnie Byanyima, Executive Director of UNAIDS. “The solidarity of women, young people, gay men and other men who have sex with men, sex workers, people who use drugs and transgender people has transformed the AIDS epidemic—empowering them will end the epidemic.”

The report was launched in Kenya on 26 November by the Executive Director of UNAIDS, the Cabinet Secretary of Health of Kenya and community representatives. It shows that significant progress has been made, particularly in expanding access to treatment. As of mid-2019, an estimated 24.5 million of the 37.9 million people living with HIV were accessing treatment. As treatment roll-out continues, fewer people are dying of AIDS-related illnesses.

“The partnership between government and civil society, together with the meaningful involvement of communities, has allowed us to significantly reduce new HIV infections and AIDS-related deaths,” said Sicily Kariuki, Cabinet Secretary for Health in Kenya. “Communities are the very centre of the AIDS response and are critical to ending AIDS.”

Progress in reducing HIV infections, however, is mixed and 1.7 million people were newly infected with the virus in 2018. New HIV infections declined by 28% from 2010 to 2018 in eastern and southern Africa, the region most affected by HIV. In a promising sign, the incidence rate of HIV among adolescent girls and young women aged between 15 and 24 years in the region declined from 0.8% in 2010 to 0.5% in 2018, a 42% decline. However, young women and girls still bear the brunt of new HIV infections—four out of five new HIV infections among adolescents in sub-Saharan Africa are among girls.

Outside of eastern and southern Africa, new HIV infections have declined by only 4% since 2010. Of increasing concern is the rise of new HIV infections in some regions. The annual number of new HIV infections rose by 29% in eastern Europe and central Asia, by 10% in the Middle East and North Africa and by 7% in Latin America.

“In many parts of the world, significant progress has been made in reducing new HIV infections, reducing AIDS-related deaths and reducing discrimination, especially in eastern and southern Africa, but gender inequality and denial of human rights are leaving many people behind,” said Ms Byanyima. “Social injustices, inequality, denial of citizenship rights and stigma and discrimination are holding back progress against HIV and the Sustainable Development Goals.”

Power together

The report shows that when people and communities have power and agency, change happens. Communities have put rights-based, people-centred principles at the heart of HIV programmes, ensuring that AIDS responses tackle the inequalities and injustices that fuel the epidemic.

Women and girls are the backbone of care support in their families and communities, providing unpaid and often undervalued work in caring for children, the sick, the elderly and the disabled and underpinning fragile social support systems. This must change. The involvement and leadership of communities of women is vital in the response to HIV.

“As a community leader, I am able to relate to people and understand their background better than someone from the outside. I have been living openly with HIV for 25 years, so people come to me with their issues, such as HIV-related stigma, disclosure and adherence. I have never stepped back from this role as I am part of this community,” said Josephine Wanjiru, an HIV community activist Kiandutu, Thika, Kenya.

The power to choose

Women and girls are demanding integrated contraception and HIV and sexually transmitted infection testing, prevention and care options. Almost 40% of adult women and 60% of adolescent girls (aged 15–19 years) in sub-Saharan Africa have unmet needs for modern contraception.

In several countries in sub-Saharan Africa, young women’s uptake of medicine to prevent HIV—pre-exposure prophylaxis (PrEP)—has been shown to be high in projects that integrate PrEP into youth-friendly health services and family planning clinics and when provision of PrEP is separated from treatment services.

Eleven million voluntary medical male circumcisions to prevent HIV have been performed since 2016, 4 million in 2018 alone in the 15 priority countries.

The power to know

The power to know allows people to keep themselves free from HIV or, if living with the virus, keep healthy. However, people are finding out their HIV status too late, sometimes years after they became infected, leading to a delay in starting treatment and facilitating HIV transmission. In Mozambique, for example, the average time for diagnosis after infection for men was four years.

Adherence to effective treatment suppresses the virus to undetectable levels, keeping people healthy and preventing transmission of the virus. Knowing this allows people living with HIV the opportunity to lead normal lives, confident that they are protecting their loved ones, and confronting stigma and discrimination.

HIV self-testing is now helping more people to find out their HIV status in privacy, breaking the barriers of stigma and discrimination and facilitating linkage to treatment.

Knowledge of HIV among young people is alarmingly low in many regions. In countries with recently available survey data, just 23% of young women (aged 15–24 years) and 29% of young men (aged 15–24 years) have comprehensive and correct knowledge of HIV. Studies show that comprehensive sexuality education does not lead to increased sexual activity, sexual risk-taking or higher infection rates for HIV or other sexually transmitted infections.

The power to thrive

The power to thrive is ensuring that people have the right to health, education, work and a standard of living adequate for health and well-being.

New HIV infections among children have declined by 41% since 2010 and nearly 82% of pregnant women living with HIV are on antiretroviral therapy. However, thousands of children are falling between the cracks. Half of all children born with HIV who are not diagnosed early will die before their second birthday, but, globally, only 59% of HIV-exposed children were tested before two months of age.

In 2018, 160 000 children (aged 0–14 years) became newly infected with HIV, and 100 000 children died from an AIDS-related illness. They died either because they weren’t diagnosed, or because of a lack of treatment—a shocking indictment of how children are being left behind.

Gender inequalities, patriarchal norms and practices, violence, discrimination, other rights violations and limited access to sexual and reproductive health services exacerbate the risk of HIV infection among adolescent girls and young women, particularly in sub-Saharan Africa. Each week, an estimated 6000 young women (aged 15–24 years) are infected with HIV.  

In Eswatini, a recent study showed that adolescent girls and young women who experienced gender-based violence were 1.6 times more likely to acquire HIV than those who did not. The same study also showed that the economic empowerment of women and girls helped in reducing new HIV infections among women by more than 25% and increased the probability of young women and girls going back to school and finishing their education.

Key populations are being left behind

Key populations and their partners account for at least 75% of new HIV infections outside of sub-Saharan Africa and are less likely to be on treatment than others. More than one third of key populations do not know their HIV status. Community-led support among gay men and other men who have sex with men is effective in increasing the uptake of PrEP, promoting safer sex, increasing HIV testing rates and supporting treatment adherence.

Transgender people are subjected to discrimination in every sphere of life, including education and employment—only 10% work in the formal economy. But community activism has led to long overdue attention to the rights and realities of transgender people.

Community empowerment activities among sex workers have been shown to increase the odds of condom use with clients by three times and reduce the odds of HIV infection by more than 30%.

The power to demand

The power to demand gives communities and individuals the power to participate in the decisions that affect them. There have been reports of crackdowns, restrictions and even attacks on groups and campaigns supporting key populations. Some governments refuse to recognize, support or engage community organizations in their national responses to HIV and are subsequently missing out on their enormous potential to reach the people most affected by HIV.

People and communities will end AIDS

The work of community-led organizations is unique and powerful and can have a substantial impact on how the world fairs towards ending AIDS. UNAIDS urges all countries to fully support and enable their community-led organizations, ensure they have a seat at all decision-making tables concerning the health and well-being of their community members and remove any barriers to their active engagement in the response to HIV. Only by fully funding and fully supporting the work of community organizations will the end of AIDS become a reality.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

1 December 2019

I believe in communities.

Communities make change happen.

Communities are the best hope for ending AIDS because communities have fought against HIV right from the beginning!

As the epidemic raged through our countries, cities, villages, women held communities together and bore the higher burden of care for their families.

For far too long we have taken their volunteerism for granted.

In the face of adversity, communities of gay men, sex workers and people who use drugs have organized themselves to claim their right to health as equal citizens. 

So, we know that communities have proved their worth. There is no debate there.

Without communities, 24 million people would not be on treatment today. Without communities led by women living with and affected by HIV, we would not be close to ending new HIV infections among children, raising orphans and caring for the sick. 

Twenty-five years ago, a Burundi woman called Jeanne was the first person to disclose that she was living with HIV. Today, Jeanne is holding leaders accountable and fighting for the right to health care.

Pioneers like Jeanne have been joined by younger leaders, like 20-year-old Yana, who was born with HIV in Ukraine. Yana founded Teenergizer, a group bringing together young people across eastern Europe. In a world where power resides with old men, she wants her peers to have a voice and a choice.

Consider Fiacre. He lives in Central African Republic, displaced by conflict along with thousands of others. Fiacre cycles to a clinic, crossing barriers and checkpoints to collect antiretroviral medicines for him and members of a group he belongs to. Without this support, each person would have to make the dangerous journey on their own. Simply amazing.

As you can see, communities make the difference all over the world.

However, the way communities are being taken for granted has to change.

On World AIDS Day, UNAIDS salutes the achievements of activists and communities in the struggle against HIV. We remember and we honour all those whom we have lost along the way. Activists challenged the silence and brought life-saving services to their communities. But the countless contributions by women and many others can never replace the responsibility of governments.

Let me remind you, governments committed to at least 30% of HIV services being community-led. 

They also agreed that 6% of all HIV funding go to community mobilization, promoting human rights and changing harmful laws that act as barriers to ending AIDS.

Let’s be clear, defending human rights and challenging discrimination, criminalization and stigma is risky work today.

So, we call on governments to open a space so that activists can do the work they do best.

With communities in the lead and governments living up to their promises, we will end AIDS.

Winnie Byanyima

Executive Director of UNAIDS

Under-Secretary-General of the United Nations

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.