In an unprecedented gesture, UN Secretary General Kofi Annan invited 11 HIV/AIDS activists from diverse civil society organizations for a frank dialogue about the UN and international response to the HIV/AIDS pandemic. Dr. Peter Piot, Executive Director of UNAIDS, facilitated the meeting. The 11 civil society organizations reached quick consensus on four key issues that need to be addressed immediately, by the Secretary General and UN bodies, in order to enhance and sustain comprehensive response to the HIV/AIDS pandemic.
Equity and HIV/AIDS
The 15th international AIDS conference has come and gone, but what will we have hoped to achieve when the world meets again in Toronto in two years time? Unlike the international AIDS conference in Vancouver 1996 when Highly Active Antiretroviral Therapy (HAART) broke new scientific ground and Durban 2000 when equal access to medicines made centre-stage, Bangkok 2004 presented no revolutionary science, no dramatic breakthroughs. But it did get back to basics and the need for an holistic approach. There is no single strategy to address HIV/AIDS. It requires prevention and treatment, activist pressure and government commitment, advanced scientific research and community involvement, and above all, a human rights-based approach designed to support vulnerable individuals and groups.
Conference delegates at the recent International Aids Conference in Thailand witnessed top South African government officials facing off with leading civil society activists over the use of the antiretroviral drug Nevirapine for the prevention of mother-to-child transmission of HIV. The session eventually brought about a better understanding of this issue. The controversy followed a comment made by South African Health Minister, Dr Manto Tshabalala-Msimang, at the opening of the South African stand at the Conference on Sunday. The Minister said that recent studies did not support the use of single-dose Nevirapine for the prevention of mother-to-child transmission (PMTCT).
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"As we have learned from this epidemic, silence cannot be an option. "3 by 5" is our best chance to use time creatively and effectively to fight this epidemic. Those of us with power and responsibility are called to do everything possible over the next 18 months to make a difference, to finally dance with this epidemic at its own pace. For the activists, you must hold all of our collective feet to the hottest possible fire because large organizations and the powerful have a way of finding reasons to not take action. If you don’t continue to push us, we will falter. Bold and ambitious goals for AIDS prevention and care - and action to match – are our only options. Anything less is to miss the warning of Martin Luther King and to be guilty of an appalling and deadly silence."
* Interview with Jim Yong Kim
As 15,000 scientists, policy-makers, advocates and People Living with HIV/AIDS gathered in Bangkok for the 15th International AIDS Conference, a rising chorus of critics were challenging the strategy of President Bush’s Emergency Plan for AIDS Relief (PEPFAR). Randall Tobias, US Global AIDS Coordinator, and other US officials in Bangkok faced daily protests in Bangkok on issues ranging from the purchase of generic drugs through the President’s AIDS Plan to its highly controversial focus on abstinence-based prevention programs. "The international community has come to Bangkok under the banner of ‘Access for All’, but all too often the Administration’s AIDS plan is undermining this critical goal," said Salih Booker, Executive Director of Africa Action.
In this paper, UNAIDS argues that enhancing African ownership of the AIDS response will further the health gains made so far and will also further enhance economic growth. UNAIDS points out that only half of Africans living with HIV who are eligible for treatment are able to access it currently. African governments invest less on AIDS than would be expected, while external assistance dominates HIV investment in most countries in Africa, which destabilises the AIDS response. Africa should pursue a more balanced partnership with international partners in the AIDS response, according to the paper, using health insurance as a mechanism to channel health spending more efficiently and equitably. UNAIDS urges African governments to set up new industrial policies that can support local pharmaceutical industries. It argues that Africa can bridge the resource gap with strong political leadership, leveraging the strong economic growth, and by adopting innovative funding opportunities.
The 4th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention concluded on 27 July 2007 with a call for anti retroviral drugs developed specifically for HIV-infected children.
This joint UNAIDS/WHO report outlines the most recent trends in the global AIDS epidemic. Women are increasingly affected by HIV and make up nearly half of the 37.2 million living with HIV world wide. In sub-Saharan Africa, almost 60 percent of adults living with HIV are women. The report identifies Southern Africa as the worst-hit region with HIV prevalence rates surpassing 25 percent. Although global AIDS spending has tripled since 2001 and access to services has improved significantly, the epidemic is still spreading.
The annual AIDS epidemic update reports on the latest developments in the global HIV/AIDS epidemic. With maps and regional summaries, the 2004 edition provides the most recent estimates of the epidemic’s scope and human toll, explores new trends in the epidemic’s evolution, and features a special section on women and AIDS.
This article expresses concern about whether a reauthorised PEPFAR would ramp up prevention efforts. President Bush's target of preventing 12 million new HIV infections means lowered sights in the second five years, as PEPFAR's original goal had been to prevent 7 million new infections in five years. Advocates are now campaigning for the increase to $55 to $60 billion.