UNAIDS campaigns have dominated the global effort to end HIV/Aids as a public threat since 1999. Credit: UNAIDS

By Ed Holt
BRATISLAVA, Dec 1 2025 (IPS)

“It’s like adding fuel to an already burning fire,” says Aditia Taslim.

“We have not recovered from the impact of the US funding cuts earlier this year, and closing down UNAIDS prematurely will only make things worse, especially for key populations and other criminalized groups, including people who use drugs,” Taslim, who is Advocacy Lead at the International Network of People Who Use Drugs (INPUD), tells IPS.

Her view is shared widely by HIV activists around the world who were stunned by a proposal from UN Secretary-General Antonio Guterres in September, included in a report on progress on UN reforms, to shut down the UN’s main agency to fight HIV/AIDS next year.

UNAIDS, the civil society groups that sit on its board, experts, and national governments across the globe had already been working on a transformation plan for the agency, which would see it end in its present form around 2030 when current HIV targets expire.

And many still do not understand exactly why closure next year is now being planned.

“There is a lot of confusion around this right now. We’re not sure why 2026 was chosen. Perhaps it was because we were in fact already in a process of transformation,” Angeli Achrekar, Deputy Executive Director of the Programme Branch at UNAIDS, told IPS.

But the proposal has been met with vociferous pushback—a call from the UNAIDS Programme Coordinating Board (PCB) NGO Delegation to the Secretary General urging him to reconsider was endorsed by more than 1 000 NGOs.

World Aids Day has been commemorated since 1988 and is a significant platform for people to unite against the disease. Credit: UNAIDS

Many of those same groups have warned that if the early closure does go ahead, gains in fighting the disease will be at risk, and, some are certain, lives will be lost unnecessarily.

“If this happens, the world will be much less effective in preventing and treating HIV, which means more people dying from a disease that is completely preventable and treatable. There’s no doubt in my mind that closing UNAIDS will lead to more HIV infections and deaths,” Julia Lukomnik, Strategic Advisor at Dutch organization Aidsfonds, told IPS.

UNAIDS, which started operations in 1996, is unique among UN structures in that its governing board actually includes civil society groups. This, experts say, has meant that in all its work, those on the ground working directly with the communities affected by the disease – not just people living with HIV (PLHIV), but also key populations most at risk, including drug users, sex workers, members of the LGBT+ community, and others—have had a crucial say in developing its policy and implementing its work.

Indeed, while the agency’s activities include treatment projects, in many countries it is seen as a vital bridge, directly and through partnerships with local NGOs, between communities and local, regional, and national authorities.

“If UNAIDS were to close in 2026, the impact would be significant, particularly in countries like Vietnam where community-led organizations depend on UNAIDS for data, technical guidance, coordination, and engagement space. UNAIDS has played a critical bridging role, connecting governments, donors, and civil society in Vietnam,” Doan Thanh Tung, Executive Director at Lighthouse Vietnam, one of the largest LGBTQ+ organizations in Vietnam, told IPS.

This is of particular concern at a time when marginalization and criminalization of key populations and PLHIV in many countries is worsening.

UNAIDS has played a crucial role in advocating for the rights of key populations and PLHIV, including helping bring in landmark legislation enshrining some rights and access to services.

UNAIDS workers provide support to communities in need of their services. The organization and its workers have been badly affected by the impact of a sudden acceleration of cuts to international HIV financing. Credit: UNAIDS

Campaigners fear that without UNAIDS presence, some communities would very quickly face increased marginalization or criminalization, without anyone to speak up for them.

“We’re in a context of increasing criminalization of key populations for the HIV epidemic. We know—in part because of UNAIDS— that violating the rights of key populations leads to increased HIV cases. When you criminalize gay and trans people, you increase HIV cases. When you criminalize sex workers, you increase HIV cases. When you criminalize safe injection sites, you increase HIV cases,” said Lukomnik.

“Closing the UN body that most strongly advocates for the human rights of these groups at the very time when these rights are increasingly threatened will almost certainly increase both rights violations and HIV cases,” she added.

Within UNAIDS, officials are aware this could be a problem.

“The question is where can advocacy for key populations be maintained [without UNAIDS] in countries. UNAIDS can raise issues to do with key populations with governments. Will other organizations be able to do that?” Eammon Murphy, UNAIDS Director, Regional Support Teams for the Asia Pacific and Eastern Europe and Central Asia regions, told IPS.

“One of the critical functions we perform is being the voice of communities. The voice of the community must be safeguarded at the local, regional and global levels,” Achrekar said.

As well as allowing it to advocate for communities, the trust that communities have with the agency means it can have a better view of an epidemic in a given country than state authorities might have, say experts.

They highlight UNAIDS’ vital role in collecting and evaluating data on the disease in specific communities and using data to develop effective interventions and national policies and set HIV targets. If that monitoring and evaluation capacity is lost suddenly with no time to replace it properly, the impact on authorities’ efforts to fight an HIV epidemic could be devastating, they argue.

“UNAIDS set the targets for the global AIDS response that has given countries the ability to shape their strategic plans to respond to HIV and AIDS. Those targets and strategic plans ensured high-impact interventions that led to a reduction of new HIV infections, addressing inequalities, gender-based violence and stigma and discrimination against people with HIV or AIDS,” Tendayi Westerhof, National Director, Pan African Positive Women’s Coalition-Zimbabwe, told IPS.

“It was responsible for the Global AIDS  Programme report that monitored progress of the AIDS response by countries. If UNAIDS is closed, this will have a huge impact on the monitoring of progress by countries in fighting AIDS,” she added.

The proposed closure of the agency also comes at a time when HIV groups are still reeling from recent upheavals in global aid funding.

The withdrawal of US aid at the start of this year, which had previously accounted for 73 percent of international HIV/AIDS financing, has already had a devastating effect on the fight against the disease, forcing many organizations on the frontline of the HIV response to close.

UNAIDS modeling forecasts the funding cuts could lead to an additional 6.6 million new HIV infections and 4.2 million AIDS-related deaths by 2029.

Closing UNAIDS against this backdrop could further imperil the sustainability of the HIV response in some places, especially in those where services for key populations are already underfunded.

“We have seen the impact of the abrupt funding cuts from the US, which have crippled a lot of harm reduction services and forced many drug user-led networks and organizations to close their operations. Harm reduction has also been severely underfunded. Closing down UNAIDS will only create reasons for governments to close down services and programmes, as well as funding for people who use drugs,” said Taslim.

“In most low- and middle-income countries, services and programmes for people who use drugs… are still heavily dependent on international donors. Closing UNAIDS prematurely means that services and programmes for our community will be the first to be removed from national priorities. There is no sustainability strategy in place for services and programmes for people who use drugs and other key populations, as well as other criminalized and marginalized communities,” he added.

Tung warned that dismantling UNAIDS at a time when global funding for HIV is shrinking “would likely erode global-to-local solidarity, reduce community engagement in the HIV response, and weaken independent data systems, which could further exacerbate the epidemic and undo decades of progress in HIV prevention and control that would be extremely difficult to recover.”

But while activists warn of the potential for a 2026 closure of UNAIDS to profoundly impact the world’s HIV response, they also point out that so far it is only a proposal and that there is some hope it may not come to pass.

“The proposal to end UNAIDS in 2026 was made by the UN Secretary General, but it’s really up to the UNAIDS PCB to make this call,” said Lukomnik.

UNAIDS officials point out that the agency had already begun a process of transforming itself.

Earlier this year, the PCB set out its plan to restructure between 2025 – 2027, and then review its structure and mandate again in 2027. It had been expected that after that, a transition period would see key UNAIDS functions shifted to other parts of the UN system or other actors involved in the HIV response by 2030.

The first phase of this restructuring involved the agency this year beginning a huge reduction in the number of its staff and offices around the world—both are to be cut by more than 50 percent.

Achrekar said the transformation was in part a response to global funding changes but also to reflect moves towards greater sustainability in the global HIV response.

“Our transformation is partly because of the current funding volatility, but it was already underway before that. We are focused on ending AIDS as a public health threat by 2030 and even before the General Secretary’s proposal, we at UNAIDS knew that we had to transform for where the HIV response was shifting to in the future—that as countries start to approach 2030 HIV targets, the HIV response would need to be sustainable after 2030. Our transformation means we can be fit for when the HIV response needs to become sustainably supported by countries,” said Achrekar.

“We are not certain if this SG proposal can be turned back. But we believe there could be a way to bring some coherence to what the SG has proposed and the transition we had already planned. UNAIDS is not afraid of transforming,” she added.

However, if the proposal does come to pass and UNAIDS closes next year, the organization is hoping others involved in the global HIV response will be able to step up, to some extent, to help maintain the response.

“We are just one player in the HIV response and all the others have critical roles too. The global solidarity in the HIV response must be maintained in future and we have to be able to safeguard what is critical in the HIV response and the people affected by HIV,” Achrekar said.

Note: This article is brought to you by IPS Noram in collaboration with INPS Japan and Soka Gakkai International in consultative status with ECOSOC.

IPS UN Bureau Report

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By External Source
Nov 30 2020 (IPS)

World AIDS Day this year finds us still deep amid another pandemic – COVID-19. The highly infectious novel coronavirus has swept across the world, devastating health systems and laying waste to economies as governments introduced drastic measures to contain the spread. Not since the HIV/AIDS pandemic of the 1990s have countries faced such a common health threat.

This explains why UNAIDS has selected the theme “Global Solidarity, Shared Responsibility” for this year’s World AIDS Day.

Infectious diseases such as these remain a major threat to human health and prosperity. Around 32.7 million people have died from AIDS-related illnesses in the last 40 years. At the time of writing, 1.4 million people had already died from COVID-19 in just one year.

The HIV/AIDS response played out over a much longer trajectory than COVID-19. But it is, in some respects, a shining example of what can be achieved when countries and people work together

These diseases take incredible expertise, collaboration and dedication from all levels of society to track, understand, treat and prevent.

The HIV/AIDS response played out over a much longer trajectory than COVID-19. But it is, in some respects, a shining example of what can be achieved when countries and people work together. The work of organisations such as the World Health Organisation, UNAIDS and the International AIDS Society help to coordinate rapid sharing of information and resources between healthcare providers and communities.

The Global Fund and PEPFAR have mobilised resources that have helped to reduce morbidity and mortality in low- and middle-income regions. AIDS-related deaths have declined worldwide by 39% since 2010.

These and other groups have also fought against high drug prices that would render medication inaccessible to many in the developing world. In South Africa, the epicentre of the HIV epidemic, a day’s supply of the simplest antiretrovirals cost about R250 in 2002. Today easier, more palatable treatment taken once per day costs a few rands.

Collaboration and co-ordination has also meant that medications have been developed and tested in populations across the world. And once available, global guidelines and training opportunities ensure that healthcare provision and quality is standardised.

Many of these achievements did not come without a fight. Dedicated and sustained activism, at a political and community level were required to drive down drug pricing for the global South and is constantly required to ensure inclusive distribution of resources.

The corollary is also true – areas where the world continues to struggle arise predominantly where there’s a lack of solidarity and agreement. These include a lack of political support to implement evidence-based protection mechanisms for vulnerable or stigmatised populations. For example the legalisation of homosexuality. This results in continued but avoidable HIV infection and related mortality.

These lessons need to be taken on board as the world prepares for the next phase of managing COVID-19. All the interventions that helped contain and manage HIV and AIDS are critical in ensuring that no country, regardless of developmental status, and no population, especially those that face stigma and battle to access healthcare services, are left behind.

Building on existing systems

The lessons learnt from HIV and AIDS can be used to inform the COVID-19 response as the challenges are similar.

Many of the ongoing COVID-19 vaccine trials are taking place in multiple countries, including South Africa. The capacity to conduct these studies, including the clinical staff and trial sites, are well established as a result of decades of HIV/AIDS research. There are fears that developing nations might be excluded from accessing an effective COVID-19 vaccine. But global mechanisms are now in place to avoid this and to, instead, encourage and enable global solidarity, some of which were championed by the HIV/AIDS response.

The Access to COVID-9 Tools (ACT)-Accelerator, established by the World Health Organisation in April 2020 in collaboration with many other global organisations, governments, civil society and industry, have committed through the pillar known as Covax, to equitable distribution of a COVID-19 vaccine as well as diagnostic tests and treatments. These global institutions and mechanisms require continued support.

With the deployment of an effective vaccine, an end to COVID-19 might soon be in sight. For HIV, vaccine development has been more complex and disappointing. The global community needs to remain committed to promoting access and support for the many incredible prevention and treatment options that are available. The unprecedented effort on the part of private industry in the COVID-19 vaccine response shines a light on what can be achieved when all interested parties engage. The HIV and TB vaccine endeavours need a similar effort.

These are not the only pandemics the world will face. In fact, there are strong predictions that the emergence of new pandemics will increase in the future. This is due to the effects of globalisation, climate change and proximity to wildlife.

The best hope for humanity is to not lose sight of what these pandemics cost us in terms of loved ones, in terms of freedom and economically. We must prepare now collectively across countries and across all levels of society. These preparations need to be grounded in the lessons learnt from HIV/AIDS and re-learnt from COVID-19.

Social solidarity

The success of the global response to current and emerging pandemics will rely on the ability of the less vulnerable to acknowledge their shared responsibility and respond to those calls.

An important truth of the HIV epidemic is that it doesn’t discriminate. No infectious disease acknowledges political borders and everybody is at risk of being infected or affected. If nothing else, because of this we need to continue to work together on a global scale knowing that “no one is safe, until everyone is safe”.

Carey Pike, Executive Research Assistant at the Desmond Tutu Health Foundation contributed to this article.

Linda-Gail Bekker, Professor of medicine and deputy director of the Desmond Tutu HIV Centre at the Institute of Infectious Disease and Molecular Medicine, University of Cape Town

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A poster about stigma in a HIV testing lab in Uganda. Credit: Lyndal Rowlands / IPS.

By Lyndal Rowlands
UNITED NATIONS, Dec 1 2016 (IPS)

Eighteen million people, just slightly under half of the people living with HIV and AIDS globally, are now taking life-saving medication, but global efforts to end the disease still largely depend on prevention.

While efforts to expand antiretroviral treatment have been relatively successfully, prevention efforts have been more mixed.

With the help of treatment, mother to baby transmission has dropped significantly. Transmission between adults aged 30 and over has also dropped.

However, transmission rates among adolescents have risen, causing concern, particularly about the high number of new cases among young women between the ages of 15 to 24.

According to UNAIDS, a new report published last week, “shows that the ages between 15 and 24 years are an incredibly dangerous time for young women.”

The report included data from six studies in Southern Africa, which showed that “southern Africa girls aged between 15 and 19 years accounted for 90% of all new HIV infections among 10 to 19-year-olds.”

“Young women are facing a triple threat,” said UNAIDS Executive Director, Michel Sidibé. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment. The world is failing young women and we urgently need to do more.”

The report also noted the countries that have increased their domestic funding for HIV prevention, “including Namibia, which has committed to investing 30% of its HIV budget in preventing HIV among adults and children.”

Ensuring the continued and renewed domestic and international funding for both treatment and prevention was the subject of discussion at the Center for Global Development in Washington D.C. on Monday.

The event, held ahead of World AIDS Day on 1 December, focused on a U.S. government initiative aimed at involving government finance departments, as well as health departments, in the HIV response.

Currently over 55 percent of the HIV response in low and middle-income countries comes from the governments of low and middle income countries.

However a significant amount of international support, roughly one third overall funding, comes from the U.S. government, which has made tackling HIV and AIDS a priority through the President’s Emergency Plan for AIDS Relief (PEPFAR).

However while U.S. funding for the HIV and AIDS response is considered bipartisan HIV and AIDS support, like any U.S. government program may change under Presidency of Donald Trump.

IPS spoke to Amanda Glassman, Vice President for Programs and Director of Global Health Policy at the Center for Global Development after the event:

“Of course we all hope that this is a bi-partisan consensus but the fact that we, the U.S. government, continue to pay directly for service delivery in some countries is a huge risk,” she said. “On the one hand I think maybe it makes it harder to cut, but on the other hand if it does get cut it’s a disaster.”

Of the 18 million people currently on antiretroviral treatment globally, “4.5 million are receiving direct support,” from the U.S. while an additional 3.2 million are receiving indirect support through partner countries.

While there remains broad consensus over treatment, prevention efforts are considered more politically contentious.

Previous Republican administrations have supported abstinence programs, which studies have shown to be ineffective at preventing HIV transmission.

Glassman noted that while there is more political consensus over treatment programs “you need prevention really to finish this.”

However she noted one positive example from incoming Vice-President Mike Pence’s home state of Indiana.

“(Pence) actually eliminated (needle exchange) programs and then saw HIV / AIDS go up and so he reversed his position, so I think that sounds good, he listens to evidence and action,” said Glassman.

However Pence’s record on women’s reproductive rights and his reported comments that in 2002 that condoms are too “modern” and “liberal”, may not bode well for overall prevention efforts, especially considering that addressing higher transmission rates among adolescent girls also requires addressing gender inequality and sexual violence. Update: In 2000, Pence’s campaign website also said that a US government HIV/AIDS program should direct resources “toward those institutions which provide assistance to those seeking to change their sexual behavior,” a statement many have interpreted as support for gay-conversion therapy.

Reducing the high rates of transmission among adolescent girls will not be easy. It involves increasing girls economic independence as well as helping them to stay in school longer.

“It’s a discussion of investment in secondary school … so the discussion is bigger than health,” said U.S. Global AIDS Coordinator, Deborah Birx at the event.

This is one of the reasons why involving government finance departments is important.

However finding additional funds for both education and health in the “hardest hit countries” will not be easy, said Glassman.

“(These countries) are coming in with growth projections that are much lower, they have pretty low tax yields meaning that the amount that they get from their tax base is pretty low.”

Gender inequalities drive the disproportionate rate of HIV infection among young South African women aged 15 to 24. Credit: Mercedes Sayagues/IPS

By Nqabomzi Bikitsha
JOHANNESBURG, Dec 1 2014 (IPS)

When she found out that she had human immunodeficiency virus (HIV), Thabisile Mkhize (not her real name) was scared.

She knew little about the virus that had been living in her body since birth and did not know whom to ask. Her mother had just died and she lived with her grandmother in rural KwaZulu Natal, where the HIV prevalence is the highest in South Africa, at 17 percent.

Today, at the age of 16,  Mkhize is an enthusiastic peer educator at her school,  discussing HIV prevention, safe sex and sexual rights. “I want young women to be safe, to make healthy sexual choices,“ she told IPS.South Africa has a perfect storm of early sexual debut, inter-generational sex, little HIV knowledge, violence, and gender and economic inequalities that lead young women aged between 15 and 24 to have a disproportionately high rate of HIV infection

South Africa has a perfect storm of early sexual debut, inter-generational sex, little HIV knowledge, violence, and gender and economic inequalities that lead young women aged between 15 and 24 to have a disproportionately high rate of HIV infection.

They account for one-quarter of new HIV infections and 14 percent of the country’s 6.4 million people living with HIV, according to the ‘South African National HIV Prevalence, Incidence and Behaviour Survey’.

Alarmingly, HIV incidence – the number of new  infections per year – among women aged between 15 and 24 is more than four times higher than among their male peers.

Professor Sinead Delany-Moretlwe, director for research at Wits Reproductive Health and HIV Institute (Wits RHI) in Johannesburg, describes the factors that put young women at higher risk.

“Structural drivers – gender, social and economic inequalities – interact in a number of ways and influence behaviour such as choice of sexual partner and condom use,” she said.

Explaining that young women find it difficult to protect themselves against HIV, she noted that they “end up with controlling partners and fail to negotiate condom use or are forced to have sex.”

Tumi Molebatse, a 20-year-old student from Soweto, is an example. Years ago she had an HIV test and would like to have another with her boyfriend of two years, or at least to have safe sex.  “But my boyfriend will think I am cheating on him if I ask for condoms,” she told IPS.  “He supports me financially so it’s better to not bring it up.”

In South Africa, one of the most unequal countries in the world, relationships with older men often pen the way for young women’s social mobility and material comfort.

According to Kerry Mangold from the South African National AIDS Council, inter-generational and transactional sex increase the risk of infection because older men have higher HIV rates than young men.

“It’s not rare to see a young girl sleep with an older man for food or a little bit of money,“ said Mkhize. “Young women aspire to have nice things in life but they don’t have money, they don’t have jobs, and they go for partners who can provide those things.”

According to the ‘South African National HIV Prevalence, Incidence and Behaviour Survey’, one-third of girls aged between 15 and 19 reported a partner five years or more their senior.

Risk and choices

“At its most extreme, gender inequality manifests as gender-based violence,” says Delany-Moretlwe.

In South Africa, young women who experienced intimate partner violence were 50 percent more likely to have acquired HIV than women who had not suffered violence, according to the UNAIDS Gap Report.

Despite decades of awareness campaigns, less than one-third of young women know how to prevent HIV.

Mkhize says that many girls hear about sex and HIV from friends and teachers, and often  the information is wrong. “I know girls who believe you cannot get HIV if you boyfriend has just come back from circumcision school and so they have sex without a condom,” she told IPS.

Mangold would like to see “an enabling environment for young women to make their own choices and reduce their risk.”

Since last year, the ZAZI initiative has been trying to do just that. A sassy campaign, ZAZI (from the Nguni words for “know yourself”) builds knowledge around sexual health through social media, video clips, poetry readings, street murals, music and fun activities that boost girls’ sense of self-worth.

“We hope to discourage them from opting for relationships with older men for material gain and give them confidence to negotiate condom use,” ZAZI advocacy manager Sara Chitambo told IPS.

ZAZI’s motto is “finding your inner strength”. On its website, girls can look up practical advice on what to do if they are raped, where to find contraception and how to prevent HIV.

(Edited by Mercedes Sayagues and Phil Harris)

By Julia Kallas
UNITED NATIONS, Dec 1 2012 (IPS)

When Shorai Chitongo founded Ray of Hope, a support group for female survivors of domestic violence in 2005, she discovered that three-quarters of the survivors in the group were HIV-positive.

Shorai Chitongo, founder of Ray of Hope, a support group for survivors of domestic violence, and a national leader of the Groots Zimbabwe Home-Based Care Alliance. Photo courtesy of Ms. Chitongo

“Women’s assertiveness and high self-esteem are important ingredients to fight HIV/AIDS,” Chitongo, a grassroots leader who fights to empower and protect communities in Zimbabwe and is a national leader of the Groots Zimbabwe Home-Based Care Alliance, told IPS. Domestic violence directly increases chances of sexually transmitted infections that expose women to HIV.

“If women are assertive enough, they are able to negotiate safe sex as equal partners and not as subordinates,” Chitongo explained.

IPS correspondent Julia Kallas spoke with Chitongo about the links between sexual violence and HIV/AIDS and how women’s grassroots efforts can promote HIV care and support.

Q: In 2005, your domestic violence case captured national media attention and sympathy. What spurred you to found Ray of Hope? What kind of program does Ray of Hope have to support HIV-positive women?

A: The formation of Ray of Hope dates back to 2005, when l saw a documentary on a local TV program and learned that the organisation Girl Child Network was offering loans to women under its Community Empowerment and Development Program.

Perceiving this as my only opportunity to disentangle myself from the jaws of domestic violence, which l thought was a result of economic dependency on my husband, l decided to approach GCN. The staff there referred me to a woman named Betty Makoni, as they felt that my case was too dangerous for them, since my husband was violent and lawless.

Betty was greatly touched by my story and that of my three children, who ended up on the streets while l was in hiding for one and a half years in neighbouring Botswana. Previously, I had unsuccessfully approached various women’s organisations and law enforcers but had lost hope. Not even my close relatives were afraid to shelter me in their homes. But Betty offered me sanctuary in rural Mutasa.

While I was living there, a local woman was brutally murdered by her husband in full view of their three children. This incident made me realise that l was not the only survivor of domestic violence; there were other cases out there that went unreported. With Betty’s support, l gained the courage to mobilise other women survivors of domestic violence to form a support group, which provided the space to talk about their concerns away from their male-dominated homes.

The result was an influx of women with shocking stories of abuse. Women travelled more than 30 kilometres bare-footed just to pour out what had burdened them for years. Most disturbing about these desperate women was that they did not bear domestic violence alone but with their children. Sadly, their children were the major reason for their silently enduring abusive and life-threatening relationships.

These meetings transformed the women. They went from being silent victims to a group that was determined to change their lives.

During one of our meetings, we discovered that three-quarters of the women in our group, which had over 100 members, were HIV-positive and that almost all members of the group were in primary and secondary community care work. We then agreed that every program that we were going to implement should mainstream HIV/AIDS.

Q: As a representative of caregivers as a leader of the Groots Zimbabwe Home-Based Care Alliance, what do you believe is needed to improve women and girls’ access to HIV prevention information, technologies, and services by 2015?

A: What is required is the formulation of deliberate policies at national level to provide women with access to information technology relevant for the dissemination of HIV/AIDS information. Creating information centres in rural and peri-urban rural areas would help to give women this access. People should also organise themselves into groups and seek access to computers and other IT facilities.

HIV/AIDS information should cross all women’s groups: political, social, religious, economic and cultural. Education in our country should focus on promoting knowledge of relevant information to deal with HIV/ AIDS, especially in rural areas where literacy rates are lower.

(Click here to watch a video of Chitongo and other members of the Home-based Care Alliance sharing personal stories about the work they do.)

Q: What message would you like to pass to the international community on World AIDS day?

A: While the world accepts and appreciates that HIV/AIDS is a universal problem, it also has to recognise that some social groups are predisposed to catching it due to social, economic and cultural conditions. The more disempowered one is culturally, socially and economically, the more one is exposed to infection.

The world’s attention should now focus on addressing social inequalities on the basis of gender, religion and economics so everybody has equal access to the means through which HIV/AIDS can be combated.

Q: Is there a close link between HIV/AIDS and domestic violence in Zimbabwe?

A: Yes. HIV-positive women are at great risk of all forms of domestic violence. The situation becomes even more complex when they fall chronically ill because their husbands neglect them or send them back to relatives to be cared for or to die, but in most cases their relatives will not accept them.

In addition, women are blamed for bringing HIV home, so they are constantly shunned, stigmatised, violently divorced and in some cases sent away. HIV-positive women also encounter violence when negotiating with their partners for safe and protected sex.

Dietary requirements for HIV positive women also normally result in conflict and misunderstanding, which then lead to violence, and their decision to cease childbearing leads to domestic violence as well.

Q: What needs to be done to help women make safe sex choices and breaki the norm of constantly submitting to men’s sexual whims?

A: Knowledge creates power, assertiveness and high self-esteem. It is necessary to deliberately focus on female empowerment through education so that women approach problems with confidence. If women become more aware of their rights, they will approach the problem of submitting to men’s whims with more vigour to resolve it.

In addition, enacting policies giving equal opportunity in social and economic life regardless of gender will build women’s assertiveness. Men have the advantage of power behind them, but give women equal access to that power and they will not submit to men’s whims.

Excerpt:

By Rebecca Hanser
UNITED NATIONS, Dec 1 2012 (IPS)

As the international community comes together on Dec. 1 to celebrate World AIDS Day, a new report from UNAIDS reveals that while significant progress has been made in preventing and treating HIV/AIDS, stigmatisation, violence and discrimination against members of the gay community continue relentlessly.

Michael Ighodaro is a gay rights activist in the United States and Africa. Credit: Rebecca Hanser/IPS

Michael Ighodaro, a gay rights activist recently diagnosed with HIV/AIDS, is living proof of the incessant human rights violations in his native country of Nigeria.

After he was brutally attacked, beaten and violated and his apartment burned down, Ighodaro was forced to flee to the United States. He now lives in New York and continues his work as an activist to raise awareness about violence against gays.

“In Nigeria, it was like I was living a lie. In the streets you cannot walk the way you want to walk and cannot openly confess you’re gay,” he told IPS.

Ighodaro spoke to IPS U.N. correspondent Rebecca Hanser about his life and struggles in Nigeria as a gay man with HIV and his work as a gay rights activist.

Excerpts from the interview follow.

Q: Having been born in Nigeria, a country known for its intolerance towards homosexuality, can you describe your younger years and what it was like for you to cope with this intolerance?

A: I discovered that I was gay when I was only seven years old. My mother noticed I was different from my brothers and sisters and she thought I was sick so she brought me to churches and made me visit witchdoctors to find out what was wrong with me.

When they concluded I was gay, I had no idea what that meant, because I was still very young. My mother said that it was evil and I had to be cured, which made me believe it was a bad thing to be gay and I became afraid to talk about it.

However, it didn’t stop me from being who I am. At the age of seventeen I was dating boys. My parents couldn’t take it anymore and forced me to leave my home. My dad didn’t want to pay for my school anymore so I also had to drop out of high school. At that age, it was hard for me not to have a family or a home or friends. I had just my gay friends, and still it was very lonely.

Q: What was your life like in Nigeria after you moved out of your home?

A: When I moved away from my home I felt free and did everything I wanted. I had a very active sex life and it gave me such a liberating feeling to finally be able to give in to it. Unfortunately, at that point I didn’t know anything about condoms, lubricants or safe sex. Things would’ve worked out differently if I had been better informed or educated.

I found out that I was HIV-positive when I was 23 years old. That’s also when I discovered what killed some of my closest gay friends in Nigeria. That really hurt me and woke me up.

In Nigeria, it was like I was living a lie. In the streets you cannot walk the way you want to walk and cannot openly confess you’re gay. You have to say you’re straight if you want to have access to something. You have to buckle up so much that at a certain point you even start to believe your own lies.

Q: Progress has been made in preventing HIV, but stigmatisation, violence and discrimination remain rampant. What are your thoughts on this imbalance?

A: Gay people are not just being stigmatised in Africa but all over the world. The worst part is that we are even being stigmatised in our own communities. In the gay community, members are mostly struggling with gay laws, the fight for gay rights and HIV prevention strategies, but they somehow neglect gay people with HIV.

They fail to specifically talk about gays with HIV, because you have to remember that a gay man with HIV is different from a gay man without it. These are two different things.

Q: You are also an active gay rights activist both in Africa and now also here in the United States. What message do you try to convey through your work?

A: There are many organisations I am involved with, even now in Africa, like ICARE, which is supported by the organisation African Men for Sexual Health and Rights (AMSHR). I also recently started an organisation here in the United States called African MSM Plus. It focuses on counselling and supporting gay men with HIV.

I am also an IRM-advocate. IRMA is an organisation that fights for more advanced rectal microbicide research for people who engage in anal intercourse. In Africa I am also involved in an LGBT (lesbian, gay, bisexual and transgendered) organisation called Mind Builders initiative.

Unfortunately, these organisations in Africa have to work “underground” because there is no tolerance for such gay community centres. We have to hide, which is hard because we also offer walk-in sessions. But we keep doing this work because it is necessary. We shouldn’t only look at the challenges ahead of us but instead at our successes.

My message is short and powerful: stay yourself, because you cannot stop people from thinking differently.

Q: In terms of violence and discrimination, what is the worst that has ever happened to you?

A: The night I was beaten up and attacked – it is all in my head. Whenever I close my eyes, I can still see the guys that did this to me. I try to forget, but every night in my sleep I still see them in front of me, calling me a faggot. It is terrible, but it’s something I have to live with for the rest of my life.

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By Julia Kallas
UNITED NATIONS, Dec 1 2012 (IPS)

On World AIDS Day, the fact that the number of children newly infected with HIV continues to decline is welcome news to UNITAID, the International Drug Purchase Facility hosted by the World Health Organisation.  But UNITAID is also well aware of how much more remains to be done for  children already living with the disease.

Philippe Douste-Blazy, of France, is a special advisor who promotes UNITAID and other sources of innovative financing for the achievement of the United Nations Millennium Development Goals (MDGs).

“There was some progress made but there is still a lot to be done by the international community,” Douste-Blazy told IPS regarding the fight against HIV/AIDS. “Unfortunately we do not have enough money to achieve the MDGs by 2015,” he added.

Douste-Blazy spoke to IPS U.N. correspondent Julia Kallas about the progress that has been made in preventing mother-to-child transmission of HIV but also how the international community must continue providing childhood HIV treatments to developing countries. Excerpts from the interview follow.

Q: What is the current funding scenario for treating childhood HIV in developing countries?

A: About 3.3 million children are living with HIV today. Unfortunately we do not have enough money to reach the Millennium Development Goals (MDGs) in general but in particular to reach the health-related MDGs – HIV, tuberculosis and malaria.

We must find funding now because with the current economic crisis, we will see a dramatic decrease in Official Development Aid (ODA). It will be difficult for all countries to help. We cannot ask the Greek government, for example, to donate 3 billion dollars for development countries because they are seeing an increase in poverty themselves. So we are going to see an increase in childhood mortality.

We have to create innovative financing for development. For example, UNITAID has placed a small tax on plane tickets. This funding helps combat childhood HIV.

Children are rarely born with HIV in wealthy countries because mothers living with HIV are treated during pregnancy to ensure that their babies are born HIV-free. Still, more than 1,000 children are born HIV-positive every day – 99 percent of them in Africa. Only 28 percent are treated.

We analysed what companies were interested in producing antiretroviral drugs. Our long-term funding gave suppliers the incentive to manufacture child-friendly formulations so we were able to buy pills for five years. Several generic suppliers that entered the market brought the price of the pills down by 70 percent.

Before, no child was treated by periotic antiretroviral, but with an adult’s syrup, 18 times a day. Now with only two pills a day, children can be treated.

Q: World AIDS Day is on Dec. 1. Should we be celebrating major progress?

A: Yes. We can see that there was some progress made, but there is still a lot to be done by the international community. For the first time more than 50 percent of the 15 million patients who need antiretroviral therapy have access to it.

It is also huge progress that we have 7 million fewer new HIV infections around the world, in particularly in Sub-Saharan Africa. Unfortunately in Eastern Europe, Russia and Indonesia, however, the infection has increased.

Q: Can you talk about the development of the three-in-one fixed-dose combination AIDS medicines for children?

A: Since its creation UNITAID has been working on combating paediatric HIV by creating a market for quality child-friendly antiretroviral treatments. Before, there was no incentive for pharmaceutical companies to invest in child-friendly antiretroviral drugs. HIV treatments for children in low-income countries were syrups designed for adults – up to 18 foul-tasting doses a day.

So the three-in-one fixed-dose combination AIDS medicines for children are a major innovation, from 18 doses a day to a pill twice a day. It is huge progress. Every year UNITAID finances the treatments of more than 100,000. Now is the time to follow up on our work with paediatric HIV.

Q: How should the new post-2015 sustainable development agenda address HIV/AIDS, and what can be done more effectively?

A: We cannot continue if we do not have money. Every head of state, head of government or member of parliament says we are going to reach the MDGs. It is not true.

To combat HIV we need three things. First is prevention. We need to help prevent high-risk people such as prostitutes and homosexuals from becoming infected. Secondly, we must ensure universal access of treatment. Only 54 percent of adults and 28 percent of children are being treated today.

Finally, we need to raise funds to achieve the MDGs – we need more innovative financing. With UNITAID, we proved that this is possible.

Q: Can you talk more about the one-dollar plane tax idea created by you, former Brazilian president Lula and former French president Chirac? What needs to be done to get more countries involved in this project?

A: UNITAID’s funding model is based on an air ticket solidarity levy. Every American who goes to France is going to pay one extra U.S. dollar to support our program. It is the same thing in 15 other countries. In five years we raised 2.5 billion dollars, and it is predictable, sustainable funding.

For the traveller, it is painless – people who can pay for a plane ticket can easily pay an extra dollar. It is not even the price of a coffee. With this funding we help combat childhood HIV. Eight out of 10 children are treated thanks to this system. Now we are working to convince more countries to become involved in this program.

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