LGBT in Zimbabwe still queer

 Picture taken from www.milehighgayguy.com

The first reported case of AIDS in Zimbabwe occurred in 1985.  By the end of the 1980s, around 10 percent of the adult population was thought to be infected with HIV. However, 30 years later stigma and discrimination based on sexual orientation or gender identity continues to drive new HIV infections and is an obstacle to treatment efforts.

The right to health is entitled to everyone. Access to HIV treatment, care and support belongs to everyone. Can the same be said when it comes to Lesbian Gay Bisexual Transgender (LGBT) communities in Zimbabwe?

Censual sexual intercourse between men is still criminalised in Zimbabwe.  This criminalisation of consensual intercourse between people of the same sex fuels  homophobic and transphobic which is arguably the number one factor that has made it hard for the LGBT community to access sexual reproductive health and rights (SRHR) services.

The LGBT community in the country seems to be invisible and almost non-existent. Barriers of stigma, human rights violations continue to dog this community especially for people that don't have the financial muscle to seek assistance from private health institutions. SRHR services are so far accessible when preferred identity is assumed. 

I spoke to quite a number of people from the LGBT community at the sexual rights centre (SRC) stand and they shared with me several obstacles faced when it comes to the right to health.

“I went to the clinic the other day. I was consulted by a nurse. I shared with her my fears that I could be infected with an STI. She was polite, understood my fears at first but her attitude changed until I revealed to her that my partner - female, wasn’t aware of what I had been facing. She closed her book and told me to leave because; it wasn’t possible for one female to infect the other with an STI. I left without getting any help. Weeks later, when I had enough money, I went to a private surgeon, who treated me this infection without questions asked,” said Ramone*

According to a survey conducted by the SRC, it was revealed that people from the LGBT communities are more afraid of the attitudes they have to deal with when testing for HIV rather than knowing their HIV status.

 “While total engagement with the government and main health institutions remains a hard to reach goal due to the level of homophobia and transphobia in the country, much can still be done to increase access to health services in Zimbabwe by the LGBTI community. In the fight and reduction of HIV, there is need for increased awareness of transmission of HIV and STIs to decrease the vulnerability for this community,” said Samantha Ndlovu, SRC programs coordinator.

UNAIDS has set a 90:90:90 target for 2020 to accelerate reaching epidemic control 90 percent of PLHIV know their status, 90 percent of those that know their status are adherent on ART, 90 percent of those on ART are virally suppressed.

This year World Aids Day 2015 Theme has been envisaged to be “Getting to Zero” by the World AIDS Campaign. There will never be a “getting to zero” when stigma and discrimination is not completely wiped out especially on key populations such as LGBT. Until Zimbabwe comes to point when access to HIV treatment, care, support and all forms of health services, favours no sexuality, efforts made to reduce Africa’s prevalence rate will just go unnoticed.

40 % of minors in Zimbabwe sell sex

Picture taken from chronicle.co.zw

Forty percent of young people in Zimbabwe started selling sex before the age of 18, it has been revealed.

According to The Aids Fonds – Stepping Stones, Sexual Rights Centre (SRC), a Bulawayo based organisation, conducted a needs assessment among young people selling sex.

The findings stress the importance of recognised minors and young people selling sex as a reality that requires a pragmatic response to ensure protection of their SRH rights, as well as their human rights

The Aids Fonds – Stepping Stones project is funded by the Ministry of Foreign Affairs of the Netherlands is being implemented in 18 countries across Latin America, the Middle East, Africa and Asia. Community based organisations conducted needs assessments in Botswana, Egypt, Ethiopia and Zimbabwe. The research entailed in-depth interviews (Unstructured and semi-structured), a section of survey and focus group discussions in 12 countries, with 635 participants between 14-28 years of age.

Topics included needs, desires and obstacles in daily life; the context of selling sex; experiences with violence; knowledge of their; ways of generating income; and access to health services.

“Poverty, escaping a restrictive home environment and peer pressure to upgrade lifestyle, None of the participants consider themselves forced to sell sex by others.”

The human rights of minors and young people selling sex are often violated by the police as 51 percent are not aware of having legal rights.

“All participants started to have exchanged sexual favours with the police to avoid arrest. The police rarely file reports of violence against young people selling sex.”

Stigma and discrimination by health professionals often hampers young people selling sex to access   sexual and reproductive health and rights (SRHR) services.

“Sixty-seven percent experience stigma and discrimination because they sell sex. They prefer to visit traditional healers instead of qualified health professionals.”

Recommendations from findings included: “Creation of support and referrals systems for minors and young people selling sex. There is need to sensitise health professionals and police to reduce stigma and harassment of minors and young people selling sex.”

Minors and young people who sell sex are one of the most marginalised and vulnerable groups in society. When community organisations encounter minors working on the streets and in brothels, they face a difficult: how to work with them without risking being seen as encouraging them into the sex industry? As a result, young people and minors selling sex are often ignored in sexual and reproductive health, HIV and human rights interventions, despite their vulnerability.

Stigma against MSM continues to rise in Africa

African Men for Sexual Health and Rights (AMSHeR) launched a preliminary report that documents the typology of stigma and discrimination faced by (Gay Men, Men who have sex with men (MSM), Transgender who are HIV – positive (GMT+) at the recently ended 18^th International Conference on AIDS and STIs in Africa (ICASA) 2015.

The report also speaks on the best practices in addressing stigma and discrimination against GMT+ .

According to Kennedy Otieno who is the overall GMT+ coordinator, the preliminary report was based on a literature review and key informant interviews carried out between September 28th and October 26th, 2015. An online survey is also planned as an immediate follow up to key informant interviews.

Picture taken from the body.com

“The protocol was inspired by key topics from the Stigma Index of People living with HIV. Experiences of GMT+ explored stigma and discrimination community, social and service settings. Additional questions exploring the structural determinants of stigma and discrimination – such as access to redress/remedy - were included in the protocol.

“16 GMT+ individuals were selected as key informants for in-depth interviews. The individuals were selected through nomination and recommendation by the GMT+ group and AMSHeR member organisations. Interviews were conducted along the themes and topics agreed in the protocol,” He added.

None of the reviews described direct experiences of stigma and discrimination People living with HIV (PLWHIV) or within LGBT groups. However, the UNAIDS review of stigma index reports in East Africa revealed specific themes, which could be linked to discrimination:

•             LGBT Organisations (including those working on HIV issues) feel excluded from the stigma index process as a whole.

•             In the review, LGBT groups felt that the sampling methodology did not reach their membership and that the Index also did not include questions that reflected their issues or concerns. And more specifically, the question of stigmatisation on the basis of sexual orientation or gender identity within PLWHIV communities is never asked.

In Liberia, it was revealed that they were not being included in the study from the start, but after much lobbying and advocacy some GMT + individuals were selected to participate. Despite this effort; subsequent issues arising from GMT+ participation were never analysed or published in the final report.

GMT+ populations are especially vulnerable due to specific stigma and discrimination related to the socio-cultural environments, their identities and sexual practices.
The review of stigma index reports reveals that rights abuse, inability to access care and experiences of stigma and discrimination were more frequently reported by GMT+ respondents than the general HIV group.

The report notes the higher vulnerability of GMT+ due to their sexual orientation/practices.  The report also notes the difficulty of reacting to cases of discrimination or right abuses:  “These cases are more complex: the non-acceptation of those practices does not facilitate a favourable action to defend them”. Furthermore, the Gambia report noted that “key populations” (in general) “are hidden and silent even among PLHIV network and support groups”.

How GBV connects with HIV

Gender based violence (GBV) is rooted in socio-economic inequality and can take many forms including emotional, mental, sexual, verbal, and physical abuse. GBV can affect males and females but women and children are most vulnerable because they are seen as occupying inferior positions to men.

Although it is argued that women are biologically more vulnerable to HIV infection, it has been found that women who are exposed to GBV are also more likely to be HIV-positive because of the small tears in the vagina which allow HIV to enter the body can occur during the often violent act of rape while the use of condoms cannot be effectively negotiated for by most women.

In an interview with Nontyatyambo Makapela from the AIDS legal network (ALN), a human rights organisation based in South Africa, I came to realise that violence and other rights abuses against women have become an integral part in the women’s rights discourse. Meaning there is arguably a  link between high cases of GBV against women and the high HIV prevalence rate by women.

“Our rights are violated everywhere as women, and because of my gender I am more prone to discrimination. There are double layers, different layers of violations that women have to go through so basically these are the realities of faced by women in the contested of HIV,” says Makapela.

 Picture taken from www.jamaicaobserver.com

She further explains how women are more vulnerable to HIV: “In reality a woman can get access to a female condom at the clinic but it’s another story when she gets home she is then compelled to negotiate the use of that female condom with my partner.”

Recently, the National Aids Council (NAC) identified gender imbalances as one of the key drivers of HIV. According to research, women in Zimbabwe account for more that 60 percent of the 1.2 million people living with HIV in the country.

Now it is therefore our role to play as society to ensure that women are not at risk to such factors that will at the end of the day make them vulnerable to diseases like HIV.

1.2 million condoms distributed at ICASA 2015

There is a renewed emphasis on condoms at the18th edition of the International Conference of AIDS and STIs in Africa (ICASA) in Harare, Zimbabwe from 29 November to 04 December 2015 as a campaign promoting their use and availability has been re-launched with the distribution of over one million condoms.

The CONDOMIZE! Campaign aims to highlight the effectiveness of condoms, male and female, for HIV prevention and calls on governments, donors and users to intensify access to, and demand for, quality condoms as a primary defence against HIV.  It advocates investing significant resources and materials into promoting condom use as the most efficient and available prevention technology in the global AIDS response. Challenging the stigma that still often surrounds condoms is also a key objective.

Picture taken from twitter.com

According to Adrian Gonzatez, creative director for CONDOMIZE, the most popular condom during ICASA 2015 was the glowing condom.

“A total of 1.2 million male condoms and 15 000 female condoms were put aside for distribution before, during and after the conference. The condoms that glow in the dark proved as the most favourite amongst members of the public because we completely ran out of them by Wednesday,” he added.

The initiative was born during the 2010 International AIDS Conference in Vienna and is a partnership between UNFPA and The Condom Project, in close collaboration with Bahamas Red Cross; DKT International, a social marketing NGO; Durex, the Female Health Company, the International AIDS Society and UNAIDS.

In addition to mass condom distribution, rap music with short videos has been created, using key messages from senior international leaders about the importance of condom use. These messages are being shown on TV screens throughout the conference.

Gonzatez said CONDOMIZE is campaign of attraction than promotion in modern and exciting ways by helping people understand very serious issues and the need to encourage condom use.

At ICASA 2015, the campaign is using education, distribution of the condoms, negotiation of condom use and destigmatisation.

The campaign noted that there is a considerable shortfall in condom availability in a number of countries. For example, in 2011 in sub-Saharan Africa there were only nine condoms available per man per year and only one female condom for every 10 women. These condoms were mostly provided by donors as most low- and middle-income countries do not have a budget line for condom procurement.

Condoms are not demons

Condoms must be used even if they are not prayed for says Pastor Paul Sanyangore at the CONDOMIZE zone during the 18th edition of the International Conference on Aids and STIs (ICASA) 2015.

Sanyangore's words of wisdom came barely a month after he prayed for condoms during a church service which left many questioning the moral element of having condoms in church.

"I encourage people to play it safe. Condoms are there to help you. They must be used even if they are not prayed for but if someone comes and says I should pray for them - I will. Condoms are not from the devil," said Sanyangore.

Although he said HIV is from the devil, he highlighted that condoms only protect people from HIV the physically.

 “With condoms, they are made to address the physical side of HIV but we need to also understand that HIV has a spiritual side. HIV is also a demon, from the devil. With my spiritual expertise, I can only address what I can, what I am able to address. So when I pray for them (condoms) I will be addressing the demon of HIV. The anointing and the power of God protects spiritual.

“Condoms are just a physical side of HIV, the anointing or the power of God addresses the spiritual side. If u came to me and they say pastor pray for it, I will pray for it,” said the man of God.

Sanyangore further explored the spiritual angle of HIV which has not been talked about by most spiritual leaders in the country.

“Condoms are not demons, condoms are not bad. You need to understand that if you put HIV, and put a condom there and if I tell you to pick from the two which one is from the devil?” he said.

The man of God also mentioned the role that churches can play in the fight against HIV and reaching the 90:90:90 target by UNAIDS.

“We are a church we believe in families, infact we are a product of families. The more people talk about these things in the families the more they are addressed,” Sanyangore said.

However, there were other members of the public that did not go well with Sanyangore’s sentiments.

“The issue of anointed condoms is not an issue. Condoms should not be anointed because they go through quality assurance test… There is no use to take condoms to church and have them anointed,” said a participant during the dialogue.

The remarks by Sanyangore come at a time when there seems to be a gap in churches as far as condom education is concerned and the methods that congregates can use to protect themselves from HIV.

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Breaking down barriers

Today, which is the international day of disabled persons, comes at a time when language and physical barriers continue to affect people living with disability.

Commemorations during the 18^th International Conference on AIDS and STIs in Africa (ICASA) 2015 will be done at the Disability Zone in the Community Village later on during the day.

This year’s theme is: Inclusion matters: access and empowerment of people of all abilities.

“The intersection of World Aids Day on December 1 and the World Disability Day on December 3, provides an opportunity to reflect on the effectiveness of the global AIDS response for the 1 billion people,15 percent of the world’s population, who live with a physical, sensory (i.e blindness, deafness), intellectual or mental health impairment. Unfortunately, there is little encouraging to report,” read a statement from the International Disability and Development Consortium (IDDC) HIV and Disability Task Group.

Arguably a greater barrier than stigma and prejudice is ignorance of what it means to live with a disability. Need for greater awareness extends to government and public health officials, health providers and community outreach workers, the very people charged with ensuring that HIV education and services, and more broadly, sexual and reproductive health, universal health coverage and gender based violence (GBV) programmes reach everyone.

In an interview with Dr Aida Zerbo from Handicap International in Senegal and also the manager of Project Access, a plethora of challenges that threaten matters of inclusivity were highlighted.

“In Africa, when it comes to access to sexual reproductive health and rights, there is no available information which in the long run fuels misconceptions such as AIDS being a myth and that it is curable. Without readily available, adequate and inclusive information, people living with disabilities are the faced with a big challenge of access health services.

“In the few instances where information could be there, challenges of language, physical and basic communication barriers make it impossible for disabled people to interact directly with health services providers. At the end of the end, there is no way of knowing if one has received the right services for the problem they have,” she said.

Dr Zerbo also mentioned that the right to privacy for people living with disability was violated by most service providers owing to communication barriers.

“When it comes to counselling, before or after testing, so many times we have heard and experienced cases whereby the confidentiality of disabled persons are broken due to the introduction of a third party who plays the role of the interpreter because most health services providers lack inclusive training on how to deal with such people,” she added.

The annual observance of the International Day of Disabled Persons was proclaimed in 1992, by the United Nations General Assembly resolution. The observance of the Day aims to promote an understanding of disability issues and mobilise support for the dignity, rights and well-being of persons with disabilities. It also seeks to increase awareness of gains to be derived from the integration of persons with disabilities in every aspect of political, social, economic and cultural life.

2016 amfAR HIV Scholars Program Announcement

APPLICATIONS DUE 17 SEPTEMBER 2015 – 5:00 P.M. EDT

amfAR, The Foundation for AIDS Research and the Center for LGBT Health Research at the Graduate School of Public Health (“Pitt Public Health”) at the University of Pittsburgh are announcing the continuation of the amfAR HIV Scholars Program: a training program for junior investigators from low- and middle-income countries who are interested in conducting HIV research among gay men, other men who have sex with men (MSM), and/or transgender individuals (collectively, GMT). 

Four scholars from low- and middle-income countries will be accepted into the program for 2016. The program aims to build indigenous capacity to research GMT individuals’ health in low- and middle-income countries by training young investigators to conduct ground-breaking research on HIV among GMT individuals in resource-limited settings. The program also seeks to support emerging GMT leaders who will help define effective responses to the HIV/AIDS epidemic among GMT populations in their home countries. The training program is being conducted in collaboration with an existing training program in LGBT health research at the Graduate School of Public Health at the University of Pittsburgh.

Eligibility to Apply

Junior investigators from low- and middle-income countries in Africa, Asia, Eastern Europe, Latin America, the Caribbean, or Oceania committed to studying HIV prevention and care needs among GMT individuals in their home countries are invited to apply to this program. Applicants must be fluent in English and able to read and write English at a high academic level.

Core Training Program

The training program includes three graduate-level classes to be taken in Pittsburgh, PA, USA, from January through May 2016, which is equivalent to a full-time graduate course load. The first of these classes is an overview of LGBT health research, the second is a research methods class, and the third is an advanced research methods class that focuses on research proposal writing. As part of these classes, scholars will develop a research question and write a short proposal (10–15 pages) that will be submitted to amfAR for peer review and possible funding at a pilot project level. During their time in Pittsburgh, participating scholars will also:

• Complete on-line courses in the ethical conduct of research;
• Complete a draft questionnaire for their proposed research study;
• Create a PowerPoint presentation to be delivered to amfAR staff during a visit to amfAR’s office in New York; and
• Develop a draft IRB application

Scholars will also attend two additional research methods seminars each week: one that focuses on HIV/LGBT health research being conducted by doctoral and post-doctoral students and professors at the Center for LGBT Health Research, and another that focuses specifically on the research being designed by the scholars themselves. Additional events sponsored by the Graduate School of Public Health and the Center for LGBT Health Research are also open to the scholars.

Funding and Support

Expenses covered by the program will include round-trip travel between the scholars’ home countries and Pittsburgh, PA, USA, visa fees, housing, a modest stipend to support the scholars during their time in Pittsburgh, and training-related costs. Scholars should plan to bring their own laptop computers to Pittsburgh to support their training.

Research proposals will be submitted to amfAR at the conclusion of the training program in the hope that each scholar will receive a pilot research grant to implement his or her proposed study. Please note that this funding is not guaranteed. If research proposals are selected for funding by amfAR, scholars will begin work on their projects after returning to their home countries.

The primary goal of the program is to increase the number of investigators in low- and middle-income countries who are able to conduct research among GMT individuals, advocate for their health needs, and, as a result, improve both HIV services and care for GMT individuals in these settings. It is also hoped that the training program will function to help advance the participating scholars’ careers and future training prospects and increase the amount of research being conducted among GMT individuals in low and middle income countries.

Application Instructions

The procedures for applying to the program are simple. Only three documents are needed:

• A letter of intent (3 page limit) that includes a short work history of the applicant and explains why s/he is interested in studying HIV prevention and care needs among GMT individuals. The letter of intent should relate the applicant’s research and/or training experience relevant to their research interests, and indicate the applicant’s capacity to design and run a research project.
• A resume or CV that lists the applicant’s training and job history.
• A short outline (1–2 pages) of the research topic that the applicant would like to develop into a grant application during their time at the University of Pittsburgh. This outline should include a clear research question (or questions) and indicate the feasibility of conducting this research in the proposed setting and with the proposed population.

Applications that are designed to focus on issues relevant to the HIV treatment cascade (i.e., innovative ways to identify unknown HIV seropositives; help patients who have been diagnosed as HIV positive access medical care, stay in treatment, and improve treatment adherence; and reconnect HIV-positive patients who have dropped out of medical care) are especially encouraged.

The due date for applications is 17 September 2015 at 5:00 p.m. Eastern Daylight Time. We plan to identify the four finalists for the training program by 1 November 2015, at the latest, and scholars should plan to arrive in Pittsburgh by 5 January 2016. Interested applicants should submit the three application documents via email to Dr. Ron Stall at rstall@pitt.edu. If you have any questions or comments regarding this announcement, please send them to Dr. Stall at the same email address.

Zim HIV Incentive funding - statement

Zimbabwe has been awarded an incentive funding of about $25 million from the Global fund, a development aimed at improving efforts to eradicate HIV in the country.

This is what the statement reads:

We will be sending the formal communication shortly to initiate the grant-making process, but we thought that you would be happy to be informed that the Technical Review Panel (TRP) of the Global Fund  has approved the Incentive Funding Request, and that Grants Approval Committee (GAC) of the Global Fund has awarded the incentive funding of US$25,274,085 based on TRP prioritization and recommendation.

The GAC incentive funding recommendation covers the following:

·         Laboratory services (US$11,946,687) – To address critical gaps in laboratory services including 6 viral load machines, integrated transport system, early infant diagnosis, and lab system strengthening.

·         Paediatric ARV and CARG (US$8,297,008) – To address critical gaps in paediatric treatment and provide community-based services to adolescents.

·         Male circumcision (US$2,959,684) – To support innovative approaches to reaching adolescents, a newly identified gap, through scale up of male circumcision focused on adolescent boys and young men.

·         BCC, VCT, Data for evidence (US$2,070,706) – To support innovative approaches to reaching young women and girls, and planning for future focusing, including operational research, mapping, and demand creation.

Nine months ahead of TARGET

The world has exceeded the AIDS targets of Millennium Development Goal (MDG) 6 and is on track to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals (SDGs).

The AIDS targets of MDG 6—halting and reversing the spread of HIV—have been achieved and exceeded, according to a new report released today by the Joint United Nations Programme on HIV/AIDS (UNAIDS). New HIV infections have fallen by 35% and AIDS-related deaths by 41%. The global response to HIV has averted 30 million new HIV infections and nearly 8 million (7.8 million) AIDS-related deaths since 2000, when the MDGs were set.

“The world has delivered on halting and reversing the AIDS epidemic,” said Ban Ki-moon, Secretary-General of the United Nations. “Now we must commit to ending the AIDS epidemic as part of the Sustainable Development Goals.”

Released in Addis Ababa, Ethiopia, on the sidelines of the Third International Conference on Financing for Development, the report demonstrates that the response to HIV has been one of the smartest investments in global health and development, generating measurable results for people and economies. It also shows that the world is on track to meet the investment target of US$ 22 billion for the AIDS response by 2015 and that concerted action over the next five years can end the AIDS epidemic by 2030.

“Fifteen years ago there was a conspiracy of silence. AIDS was a disease of the “others” and treatment was for the rich and not for the poor,” said Michel Sidibé, Executive Director of UNAIDS. “We proved them wrong, and today we have 15 million people on treatment—15 million success stories.”

How AIDS changed everything—MDG 6: 15 years, 15 lesson of hope from the AIDS response celebrates the milestone achievement of 15 million people on antiretroviral treatment—an accomplishment deemed impossible when the MDGs were established 15 years ago. It also looks at the incredible impact the AIDS response has had onpeople’s lives and livelihoods, on families, communities and economies, as well as the remarkable influence the AIDS response has had on many of the other MDGs. The report includes specific lessons to take forward into the SDGs, as well as the urgent need to front-load investments and streamline programmes for a five-year sprint to set the world on an irreversible path to end the AIDS epidemic by 2030.

Achieving MDG 6: halting and reversing the spread of HIV

In 2000, the world was witnessing an extraordinary number of new HIV infections. Every day, 8500 people were becoming newly infected with the virus and 4300 people were dying of AIDS-related illnesses. How AIDS changed everything describes how, against all odds, huge rises in new HIV infections and AIDS-related deaths were halted and reversed.

New HIV infections

In 2000, AIDS began to be taken seriously. Far-sighted global leadership rallied, and the response that ensued made history. Between 2000 and 2014, new HIV infections dropped from 3.1 million to 2 million, a reduction of 35%. Had the world stood back to watch the epidemic unfold, the annual number of new HIV infections is likely to have risen to around 6 million by 2014.

In 2014, the report shows that 83 countries, which account for 83% of all people living with HIV, have halted or reversed their epidemics, including countries with major epidemics, such as India, Kenya, Mozambique, South Africa and Zimbabwe.

“As a mother living with HIV I did everything in my capacity to ensure my children were born HIV-free, said Abiyot Godana from the Ethiopian community of people living with HIV. “My husband has grabbed my vision of ending AIDS and together we won’t let go of this hope. Our two children are a part of an AIDS-free generation and will continue our legacy.” Ethiopia has made significant progress in preventing new HIV infections among children. In 2000, around 36 000 children became infected with HIV. However, by 2014 that number had dropped by 87%, to 4800, as coverage of antiretroviral therapy to prevent new HIV infections among children increased to 73%.

Stopping new HIV infections among children has been one of the most remarkable successes in the AIDS response. In 2000, around 520 000 children became newly infected with HIV. In the absence of antiretroviral therapy, children were dying in large numbers. This injustice prompted the world to act—ensuring that pregnant women living with HIV had access to medicines to prevent their children from becoming infected with the virus became a top global priority.

The unprecedented action that followed achieved results. Between 2000 and 2014, the percentage of pregnant women living with HIV with access to antiretroviral therapy rose to 73% and new HIV infections among children dropped by 58%.

By 2014, UNAIDS estimates that 85 countries had less than 50 new HIV infections among children per year, and in 2015 Cuba became the first country to be certified by the World Health Organization as having eliminated new HIV infections among children.

AIDS-related deaths

The second, critical measure for determining the success of MDG 6 is progress in halting and reversing the number of AIDS-related deaths. In 2000, AIDS was a death sentence. People who became infected with HIV had just a few years to live and the vast majority of children born with the virus died before they reached their fifth birthday.

Against incredible odds, the pace of antiretroviral therapy scale-up increased, ensuring more people remained alive and well. By 2005, AIDS-related deaths began to reverse, falling by 42% from 2004 to 2014.

Making the impossible, possible—15 million people on HIV treatment

Ensuring access to antiretroviral therapy for 15 million people is an achievement deemed impossible 15 years ago. In 2000, fewer than 1% of people living with HIV in low- and middle-income countries had access to treatment, as the sky-high prices of medicines—around US$ 10 000 per person per year—put them out of reach. The inequity of access and injustice sparked global moral outrage, which created one of the most defining achievements of the response to HIV—massive reductions in the price of life-saving antiretroviral medicines.

By 2014, advocacy, activism, science, political will and a willingness by the pharmaceutical companies has brought the price of medicines for HIV down by 99%, to around US$ 100 per person per year for first-line formulations.

In 2014, 40% of all people living with HIV had access to antiretroviral therapy, a 22-fold increase over the past 14 years. In sub-Saharan Africa, 10.7 million people had access, 6.5 million (61%) of whom were women. Ensuring treatment for 15 million people around the world proves beyond a doubt that treatment can be scaled up even in resource-poor settings.

As access to treatment increased, the world raised the bar and has repeatedly set ambitious targets, culminating in today’s call of ensuring access to treatment for all 36.9 million people living with HIV.

Progress in ensuring access to HIV treatment has, however, been slower for children than for adults. As of 2014, only 32% of the 2.6 million children living with HIV had been diagnosed and only 32% of children living with HIV had access to antiretroviral therapy.

While the price of first-line medicines has reduced significantly, the prices of second and new generation medicines are still much too high and need to be urgently negotiated down.

SOURCE: http://www.unaids.org/en/resources/documents/2015/MDG6_15years-15lessonsfromtheAIDSresponse

Knowledge ensures access

How AIDS changed everything includes exciting new information about access to treatment once people know their HIV status. Some 75% of people who know they have the virus are accessing antiretroviral therapy, showing that the majority of people do come forward for treatment and have access once they are diagnosed with HIV.

This emphasizes the urgent need to scale up HIV testing. In 2014, only 54% (19.8 million) of the 36.9 million peoplewho are living with HIV knew that they are living with the virus.

An investment, not a cost

How AIDS changed everything shows how the economic impact is one of the greatest achievements of the response to HIV and one that will continue to yield results in years to come.

“The world went from millions to billions and each dollar invested today is producing a US$ 17 return,” said Mr Sidibé. “If we frontload investments and Fast-Track our efforts over the next five years, we will end the AIDS epidemic by 2030.”

Since 2000, an estimated US$ 187 billion has been invested in the AIDS response, US$ 90 billion of which came from domestic sources. By 2014, around 57% of AIDS investments came from domestic sources and 50 countries invested more than 75% of their responses from their own budgets—a big success for country ownership.

The United States of America has invested more than US$ 59 billion in the AIDS response and is the largest international contributor. The Global Fund to Fight AIDS, Tuberculosis and Malaria invests nearly US$ 4 billion each year towards AIDS programmes and has disbursed more than US$ 15.7 billion since its creation in 2002.

The report also shows that the next five years will be critical. Front-loading investments in the fragile five-year window up to 2020 could reduce new HIV infections by 89% and AIDS-related deaths by 81% by 2030.

Current investments in the AIDS response are around US$ 22 billion a year. That would need to be increased by US$ 8–12 billion a year in order to meet the Fast-Track Target of US$ 31.9 billion in 2020. By meeting the 2020 target, the need for resources would begin to permanently decline, reducing to US$ 29.3 billion in 2030 and far less in the future. This would produce benefits of more than US$ 3.2 trillion that extend well beyond 2030.

The report underscores that international assistance, especially for low-income and low-middle-income countries, will be necessary in the short term before sustainable financing can be secured in the long term. Sub-Saharan Africa will require the largest share of global AIDS financing: US$ 15.8 billion in 2020.

Countries that took charge have produced results

SOURCE: http://reliefweb.int

Countries that rapidly mounted robust responses to their epidemics saw impressive results. In 1980, life expectancy in Zimbabwe was around 60 years of age. In 2000, when the MDGs were set, life expectancy had dropped to just 44 years of age, largely owing to the impact of the AIDS epidemic. By 2013, however, life expectancy had risen again to 60 years of age as new HIV infections were reduced and access to antiretroviral treatment expanded.

Ethiopia has been particularly affected by the AIDS response, with 73 000 people dying of AIDS-related illnesses in 2000. Concerted efforts by the Ethiopian government have secured a drop of 71% in AIDS-related deaths between the peak in 2005 and 2014.

In Senegal, one of the earliest success stories of the global AIDS response, new HIV infections have declined by more than 87% since 2000. Similarly, Thailand, another success story, has reduced new HIV infections by 71% and AIDS-related deaths by 64%.

South Africa turned around its decline in life expectancy within 10 years, rising from 51 years in 2005 to 61 by the end of 2014, on the back a massive increase in access to antiretroviral therapy. South Africa has the largest HIV treatment programme in the world, with more than 3.1 million people on antiretroviral therapy, funded almost entirely from domestic sources. In the last five years alone, AIDS-related deaths have declined by 58% in South Africa.

Leaving no one behind

Much progress has been made in expanding HIV prevention services for key populations, even though significant gaps remain. Although more than 100 countries criminalize some form of sex work, sex workers continue to report the highest levels of condom use in the world—more than 80% in most regions.

Drug use remains criminalized in most countries, yet many do allow access to needle–syringe programmes and opioid substitution therapy. In 2014, HIV prevalence appears to have declined among people who inject drugs in almost all regions.

However, new HIV infections are rising among men who have sex with men, notably in western Europe and North America, where major declines were previously experienced. This indicates that HIV prevention efforts need to be adapted to respond to the new realities and needs of men who have sex with men.

The number of adult men who have opted for voluntary medical male circumcision to prevent HIV transmission continues to increase. From 2008 to December 2014, about 9.1 million men in 14 priority countries opted to be circumcised. In 2014 alone, 3.2 million men in 14 priority countries were circumcised. Ethiopia and Kenya have both already exceeded their target of 80% coverage.

Tuberculosis (TB) remains a leading cause of death among people living with HIV, accounting for one in five AIDS-related deaths globally. However, between 2004 and 2014, TB deaths declined by 33% thanks to the rapid increase in antiretroviral treatment, which reduces the risk that a person living with HIV will develop TB by 65%.

Some 74 countries reported having laws in place prohibiting discrimination against people living with HIV. However, at present, 61 countries have legislation that allows for the criminalization of HIV non-disclosure, exposure or transmission. In 76 countries, same-sex sexual practices are criminalized. In seven countries they are punishable by death.

Transgender people are not recognized as a separate gender in most countries and are generally absent from public policy formulation and social protection programmes. The world remains far short of achieving its goal of eliminating gender inequalities and gender-based violence and abuse.

Better data

Countries have invested heavily in monitoring and evaluating their responses to HIV. In 2014, 92% of United Nations Member States reported HIV data to UNAIDS. State-of-the-art epidemic monitoring, data collection and reporting have made HIV data the most robust in the world, far more complete than data for any other disease. This has not only enabled the world to have a clear picture of HIV trends, it has also enabled HIV programming to be tailored to the specific dynamics of each country’s epidemic.

Together with How AIDS changed everything, UNAIDS is launching its new data visualization feature AIDSinfo. This innovative visualization tool allows users to view global, regional and national data on HIV through easy-to-use maps, graphs and tables adapted for all devices.

How AIDS changed everything

The UNAIDS book gives a vivid and insightful description of the impact the AIDS response has had on global health and development over the past 15 years and of the incredible importance of the lessons learned for ensuring the success of the SDGs.

How AIDS changed everything—MDG 6: 15 years, 15 lesson of hope from the AIDS response is both a look back on the journey of the last 15 years and a look forward to the future of the AIDS response and the path to ending the AIDS epidemic by 2030.

The flagship publication from UNAIDS was released at a community event at Zewditu Hospital in Addis Ababa, Ethiopia, on 14 July 2015 by United Nations Secretary-General Ban Ki-moon, Minister of Health, Kesetebirhan Admassu of the  Federal Democratic Republic of Ethiopia, Executive Director of UNAIDS Michel Sidibé and Abiyot Godana from the Ethiopian community of people living with HIV.

Cuba ends mother-to-child transmission of HIV and syphilis

Cuba is the first country in the world to eliminate mother-to-child HIV transmission, the World Health Organization announced.

Picture taken from CNN.com

Officials said it shows that an end to the AIDS epidemic is possible, and they expect more countries to seek validation from the World Health Organization. The country was also the first to eliminate mother-to-child transmission of syphilis.

"Eliminating transmission of a virus is one of the greatest public health achievements possible," Dr. Margaret Chan, the WHO director-general, said in a Tuesday press release. "This is a major victory in our long fight against HIV and sexually transmitted infections, and an important step towards having an AIDS-free generation."

The WHO and the Pan American Health Organization began to work with Cuba and other countries in 2010 to eliminate mother-to-child transmission of HIV and syphilis. The country's efforts include prenatal care, HIV and syphilis testing for pregnant women and their partners, treatment for women who test positive and their babies, cesarean deliveries and breastfeeding substitution. Maternal and child health programs are integrated with HIV and sexually transmitted infection programs.

Prevention can mean no babies with HIV

Preventive treatment for mother-to-child transmission of HIV and syphilis is not 100% effective, so the World Health Organization defines elimination as a reduction of transmission to a level that it no longer constitutes a public health problem. In 2013, two babies were born with HIV in Cuba, and five were born with congenital syphilis.

Worldwide, the number of children born with HIV dropped to 240,000 in 2013 from 400,000 in 2009, the WHO reported. In order to reach a target of no more than 40,000 new child infections in 2015, health officials say more effort will be needed around the world.

An estimated 1.4 million women with HIV become pregnant worldwide every year, the WHO reported, and if they're untreated, they have a 15% to 45% chance of transmitting the virus during pregnancy, labor, delivery or breastfeeding. But when antiretroviral medicines are given to mothers and children, the risk drops to slightly more than 1%.

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