Release Type: News Article

NEW YORK – The Global Fund applauds world leaders’ commitment to scale up efforts to achieve universal health coverage by 2030, made at today’s UN High-level Meeting on Universal Health Coverage in New York. The Political Declaration “Universal health coverage: moving together to build a healthier world” stressed the need for inclusive, accessible, affordable health care, and the importance of immediate international support and long-term, sustainable financing from domestic governments.

“Today’s discussions showed an overwhelming consensus that universal health coverage is a shared value and that we must prioritize access to quality health care for all,” said Peter Sands, Executive Director of the Global Fund, who addressed the meeting. “The Global Fund is committed to working together with partners and governments to ensure universal health coverage becomes a reality.”

To ensure that countries and all partners deliver on equity and the right to health, the Global Fund, the Global Financing Facility and Gavi, the Vaccine Alliance, today called on world leaders to prioritize primary health care systems as the foundation for universal health coverage; reach the most underserved, vulnerable and marginalized people; and increase domestic resource mobilization and the prioritization of health investments.

Working with partners through the WHO-led Global Action Plan for Healthy Lives and Well-being for All, the Global Fund supports the achievement of universal health coverage through investing in resilient and sustainable systems for health; tackling gender and human rights barriers to health care access for the poorest and most vulnerable, so health services are truly “universal”; and supporting and catalyzing the sustainable financing of systems for health, including increased domestic resource mobilization.

The Global Fund is the largest multilateral provider of grants to support sustainable systems for health, investing more than US$1 billion a year on improving procurement and supply chains; strengthening data systems and data use; training qualified health care workers; building stronger community responses and systems; and promoting the delivery of more integrated, people-centered health services so people can receive comprehensive care throughout their lives.

“Building inclusive, sustainable and resilient systems for health is essential to end HIV, TB and Malaria as epidemics, and serves as our best defence against emerging threats to global health security such as multidrug-resistant TB and Ebola. Those same health systems also provide a range of critical primary health services, from sexual and reproductive health to chronic and noncommunicable diseases,” said Sands.

The Global Fund is working closely with partners to develop and implement the Sustainable Financing Accelerator as a key element of the Global Action Plan for Healthy Lives and Well-being for All. This will facilitate more effective coordination and collaboration among the key global actors engaged in supporting countries on domestic resource mobilization for health, including WHO, the World Bank, the Global Financing Facility and Gavi.

France will host the Global Fund’s Sixth Replenishment pledging conference in Lyon, France, on 9-10 October 2019. The Global Fund seeks to raise at least US$14 billion for the next three years to help save 16 million lives, cut the mortality rate from HIV, TB and Malaria in half, and build stronger health systems by 2023.

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The theme of the 2019 observance of World AIDS Day is “Communities make the difference”.

The commemoration of World AIDS Day is an important opportunity for stakeholders to recognize the essential role that communities have played and continue to play in the AIDS response at the international, national and local levels.

Communities contribute to the AIDS response in many different ways. Their leadership and advocacy ensure that the response remains relevant and grounded, keeping people at the centre and leaving no one behind. Communities include peer educators, networks of people living with or affected by HIV, such as gay men and other men who have sex with men, people who inject drugs and sex workers, women and young people, counsellors, community health workers, door-to-door service providers, civil society organizations and grass-roots activists.

World AIDS Day offers an important platform to highlight the role of communities at a time when reduced funding and a shrinking space for civil society are putting the sustainability of services and advocacy efforts in jeopardy. Greater mobilization of communities is urgently required to address the barriers that stop communities delivering services, including restrictions on registration and an absence of social contracting modalities. The strong advocacy role played by communities is needed more than ever to ensure that AIDS remains on the political agenda, that human rights are respected and that decision-makers and implementers are held accountable.

We will be sharing more updates as the event approaches.

PANCAP anticipates a highly successful World AIDS Day 2019.

What is World AIDS Day?

World AIDS Day is held on 1 December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. World AIDS Day was the first-ever global health day, held for the first time in 1988.

Image caption: Dr Minerva Pinelo conducting a capacity building session in Belize

The Caribbean Regional Network of People Living with HIV and AIDS (CRN+) has received a grant from the Caribbean Vulnerable Communities Coalition (CVC) for a project titled “CVC/COIN Challenging Stigma and Discrimination to Improve Access to and Quality of HIV Services in the Caribbean”.

Under output 3 of the grant, CRN+ is focusing on strengthening of community systems and key population networks to use effective advocacy strategies to obtain social accountability mechanisms and scale-up of best practice interventions by national programmes.

CRN+ conducted capacity building training from 15 July to 5 August 2019 in Belize, Dominican Republic, Suriname and the Republic of Trinidad and Tobago. The training activities involved over seventy (70) representatives from CRN+ networks, National AIDS Programmes and other key population networks that collaborate with CRN+.

The training focused on three key topic areas including finance essentials and accountability, monitoring and evaluation systems and fundraising essentials.

The fundamental purpose of the capacity building training was to contribute to strengthening the CRN+ networks and increasing the capacity of members to be more effective partners in their national HIV response.

The series of capacity building training provided opportunities for CRN+ to convene additional meetings with representatives of National AIDS Programmes, Ministry of Industry and Commerce and other organisations, to discuss opportunities for improving collaboration with CRN+ national affiliates and leveraging technical and financial support for income generation and other sustainability activities.

Image: Minister of Public Health, Hon. Volda Lawrence and UNAIDS Country Director for Guyana and Suriname, Dr Michael Gboun with participants of the HIV Clinical Management and Implementation of PrEP through a Public-Private Partnership Workshop

The Ministry of Public Health (Guyana) is planning to introduce Pre-exposure prophylaxis (or PrEP) as an HIV transmission countermeasure. This is a course of drugs taken pre-emptively against the spread of the disease, mainly targetted at vulnerable groups.

The target population in Guyana for HIV transmission prevention are sex workers with a 6.1% prevalence, men who have sex with men with a 4.9% HIV prevalence, and transgender people with an 8.4% prevalence. This is according to a UNAIDS survey conducted in 2016.

PrEP, or pre-exposure prophylaxis, is an HIV prevention method. People who do not have HIV can take PrEP to reduce their risk of getting HIV if they are exposed to the virus. Another countermeasure will see the government establishing a Public-Private Partnership with doctors within the private sector to whom patients will be referred for treatment.

USAID, UNAIDS and Pan American Health Organisation/World Health Organisation (PAHO/WHO) Office in Guyana along with the Ministry of Public Health hosted an HIV Clinical Management and Implementation of PrEP through a Public-Private Partnership Workshop. The three-day workshop ran from August 12 to 14, 2019.

Minister of Public Health, Hon. Volda Lawrence, who handed over certificates to participants of the workshop, noted that PrEP is a new venture of the ministry and is expected to be an effective measure in HIV prevention.

Essentially, the goal of these two new countermeasures is to ensure that full HIV prevention coverage is attained.

“Our goal is to ensure that we reach everyone everywhere. Guyana is a very small and unique country. As a result of that, it has become a stumbling block in terms of people accessing these services,” Minister Lawrence said.

She explained that due to discrimination, people are often reluctant to know their status and may spread the virus unknowingly. It is for this reason, after examining this fact with partners, the ministry thought it best to create ways in which persons can have confidence in HIV treatment and prevention services.

“The ministry stepping out in this particular venture in terms of creating another space allows persons to have their own choice of access to services. We believe it certainly will work towards the benefit of our people. It certainly will help us in terms of reaching persons and keeping persons in the system and utilising the services available.”

UNAIDS’ new Country Director for Guyana and Suriname, Dr Michael Gboun noted that moving in this direction is important since Guyana is on a road to improving access and achieving universal coverage in health care. “This partnership is important, and more so, when we are now testing a new model, PrEP, it calls for a little bit of close monitoring, closer relationships with patients,” Dr Gboun noted.

Image: Guyanese civil society participants in a practical exercise facilitated by SASOD Guyana’s Human Rights Coordinator Sarah Bovell (right) at the Caribbean Vulnerable Communities Coalition (CVC) Advocacy Planning Validation Meeting

While Guyana adopted a “Treat All” strategy in 2018, further advocacy is needed for Guyana to reach its 95-95-95 targets for HIV testing, treatment and viral suppression.  Stemming from this, organizations providing support to vulnerable groups in Guyana met during 2017 and 2018 to discuss HIV-related advocacy needs.

These meetings resulted in an initial set of priority HIV advocacy strategies, and activities were developed to formulate an Advocacy Plan. The CVC then provided funding for advocacy activities included in the plan through the CVC/COIN Caribbean Civil Society project titled “Challenging Stigma and Discrimination to Improve Access to and Quality of HIV Services in the Caribbean.”

On July 18, 2019, Guyana’s Society Against Sexual Orientation Discrimination (SASOD Guyana) facilitated an Advocacy Planning Validation Meeting at the Guyana Marriott Hotel in Georgetown on behalf of CVC to engage key stakeholders in identifying suitable, short-term advocacy campaigns and also to revise the Advocacy Implementation Matrix for the period October 2019 to September 2022.  Fifteen persons representing 14 civil society organisations participated in the meeting.

They proposed suggestions for amending of the Implementation Matrix and selected a managing partner to coordinate the implementation of the Advocacy Plan in collaboration with the various partners. The meeting also identified two ranked priority activities.

At the meeting, challenges in reaching persons most-at-risk with testing and prevention of HIV were discussed. These include stigma and discrimination against key populations which prevent them from coming forward to be tested and treated and lack of confidentiality at treatment sites coupled with high turnover among healthcare staff due to low salaries.   These include staff who received HIV–related training resulting in clients having to rebuild trust and rapport with new healthcare staff, which takes time and can result in patient discomfort. Insufficient funding from government and the absence of Pre-Exposure Prophylaxis (PrEP) were also identified as major gaps and challenges.

Thoughtful advocacy is needed for high-quality HIV-related healthcare in Guyana in order to monitor the patient experience of health services. This scope would encompass the documentation of instances of stockouts, stigma and discrimination, breaches of confidentiality, and lack of appropriate, competent services and referrals. In addition, the Advocacy Plan recommends conducting an analysis of these situations and providing the Ministry of Public Health with clear recommendations for improvements.

The meeting also discussed the need for ongoing training of healthcare staff to prevent stigma, discrimination and judgmental attitudes. In addition, there should be enforceable measures to ensure that staff preserve the confidentiality of patient information. Further to this, there should be incentives provided to persons who access prevention and treatment services. The meeting called for government support in providing case navigators to aid retention in care and a strategy to collect data on migrant populations since there is limited data about their HIV vulnerabilities.

GENEVA, 14 August 2019—UNAIDS warmly welcomes the appointment of Winnie Byanyima as its new Executive Director. Ms Byanyima has more than 30 years of experience in political leadership, diplomacy and humanitarian engagement.

“I am honoured to be joining UNAIDS as the Executive Director at such a critical time in the response to HIV,” said Ms Byanyima. “The end of AIDS as a public health threat by 2030 is a goal that is within the world’s reach, but I do not underestimate the scale of the challenge ahead. Working with all its partners, UNAIDS must continue to speak up for the people left behind and champion human rights as the only way to end the epidemic.”

The United Nations Secretary-General, António Guterres, appointed Ms Byanyima as the UNAIDS Executive Director and United Nations Under-Secretary-General following a comprehensive selection process that involved a search committee constituted by members of the UNAIDS Programme Coordinating Board. The UNAIDS Committee of Cosponsoring Organizations made the final recommendation on the appointment to the Secretary-General.

Ms Byanyima brings a wealth of experience and commitment in harnessing the power of governments, multilateral agencies, the private sector and civil society to end the AIDS epidemic around the world. Ms Byanyima has been the Executive Director of Oxfam International since 2013. Prior to that, she served for seven years as the Director of Gender and Development at the United Nations Development Programme.

Ms Byanyima began her career as a champion of marginalized communities and women 30 years ago as a member of parliament in the National Assembly of Uganda. In 2004, she became the Director of Women and Development at the African Union Commission, working on the Protocol on the Rights of Women in Africa, an international human rights instrument that became an important tool for reducing the disproportionate effect of HIV on the lives of women in Africa.

She holds an advanced degree in mechanical engineering (in energy conservation and the environment) from the Cranfield Institute of Technology and an undergraduate degree in aeronautical engineering from the University of Manchester.

The Secretary-General wishes to extend his appreciation and gratitude to the UNAIDS Deputy Executive Director, Management and Governance, Gunilla Carlsson, for her service as the Executive Director, a.i.

NASSAU, BAHAMAS — Following a recent Department of Public Health report that showed an uptick in sexually transmitted diseases among young persons, Minister of Health Dr Duane Sands said yesterday that while he does not want to overstep other ministries’ purview, he acknowledged it is time to increase sexual education among young people.

“We are prepared to discuss a lot of things in this country; like who ‘ga’ win Junkanoo and other things, but when it comes down to critical issues of health and other things we get very, very quiet,” Sands told Eyewitness News Online.

The minister opined that parents have attempted to disassociate sex from young people, but said: “we need to meet our people where they are, as they are, and not pretend as if human sexuality is not real”.

According to the Department of Public Health Surveillance Unit and STI Clinic, there were 2,616 people in The Bahamas who tested positive for Syphilis at least once during between 2014 and 2018.

The report indicated that during the period, cases increased by 63 per cent, from 439 in 2014 to 714 in 2018.

It also noted that there were 816 cases of Chlamydia and 186 cases of Gonorrhea Infection in 2017.

In 2018, there were 1,004 cases of Chlamydia and 265 cases of Gonorrhea.

Sands acknowledged that while HIV and AIDS remain top priorities, there is a need to recalibrate given the trends of certain STIs.

“Not to change or diminish the efforts to reduce HIV, but to ensure that people recognize that Syphilis, Gonorrhea and other sexually transmitted infections go along with HIV and that we should not forget that they have implications as well,” he said.

In a separate interview, University of the Bahamas Dean of Students Joe Stubbs said Bahamians have to get out of the habit of pretending that young persons are not having sex.

“The leaked videos that somehow appear on social media and the conversations that are happening, and the increase in STD rates that skyrocketed recently; If these aren’t evidence that proves our young people are actively engaged in sexual relations, then I don’t know what else we need to show us that,” he said.

“So, I definitely think we need to be having more [realistic] conversations with our young people”.

“We know what you are doing and we can’t stop you from doing it, but we can put measures in places to educate you on making better and wiser decisions”.

Meanwhile, LIFE Worship Center Pastor Denczil Rolle said there is a need now, more than ever, for churches to join the conversation.

“Destruction comes when there is an absence of knowledge,” he said

“So, we have to begin the conversation. The church cannot be afraid”.

“There was a time in church wherein ministry training you were taught to not say the word sex because it creates different impulses in the minds of different persons, but now today, you have to use it.”

On 26 July 2019, two gay men filed court proceedings to challenge St Vincent and the Grenadines’ “buggery” and “gross indecency” laws, which criminalise homosexuality. Both men, who have been advised by Jeremy Johnson QC and Peter Laverack of 5 Essex Court, assert that their dignity and autonomy are stripped by these laws. They have filed claims with Affidavits stating that they have been exiled from the Caribbean nation due to the severely draconian and damaging effects of these laws.

Javin Johnson, aged 22, successfully claimed asylum in the United Kingdom in 2017 having established that he could not live as a gay man in St Vincent. Sean Macleish, aged 53, is a Vincentian resident in Chicago, Illinois. Macleish has publicly advocated to the Caribbean nation’s Prime Minister for the removal of these laws so that he may return home with his partner but to no effect.

These challenges coincide with Prince William and his family holidaying in the country on the exclusive island of Mustique, whose website states “there are no rules on Mustique”. LGBT visitors, however, would be liable to arrest and imprisonment for up to 10 years if caught being intimate. Prince William stated this month that he would be “absolutely fine” if his own children were gay.

The two claimants are unknown to each other, having separately decided that now is the time for decriminalisation. They say that these laws violate multiple and overlapping rights in the Constitution, which are there to protect all Vincentians, no matter who they are or who they love.

These court challenges come in the wake of Jason Jones’ successful challenge to Trinidad and Tobago’s anti-gay laws, a week after a similar challenge was filed in Dominica, and with other challenges already afoot in Jamaica and Barbados.

Commonwealth Caribbean nations inherited these laws during British colonial rule. Now uniquely in the Americas, these nations continue to criminalise homosexuality, placing them in an ever-decreasing minority globally.

The challenges were filed by local lawyers, Zita Barnwell and Jomo Thomas, listing English barristers Jeremy Johnson QC and Peter Laverack of 5 Essex Court, London, as the intended trial advocates. 5 Essex Court was instructed by a team at Hogan Lovells, which includes Charles Brasted, partner, Tom Smith, senior associate, and Iris Karaman, trainee solicitor.”

The two challenges are expected to be heard together in the High Court in Kingstown. The British Privy Council may have ultimate say on these colonial-era laws, as St Vincent and the Grenadines still sends its appeals to the old imperial court in London.

Calling on the World

The Global Fund is calling on the world to step up the fight against AIDS, Tuberculosis (TB) and Malaria.  After years of remarkable advances, new threats have slowed progress and enabled the diseases to gain ground.

• Nearly 1,000 girls and young women are infected with HIV every day.
• Tuberculosis is now the world’s leading infectious killer.
• A child dies from Malaria every 2 minutes.

In 2019, we have a unique opportunity to take a massive step toward the Global Goal of ending these epidemics by 2030.  The Global Fund aims to raise at least US$14 billion to save 16 million more lives and prevent 234 million infections and cases.  We need your help to make this happen. Join us at this important moment as we call on the world to #StepUpTheFight.

An Open Letter to 7-Year-Olds

On Tuesday, 30 July, the Global Fund launched an Open Letter addressed to 7-year-olds around the world, the group that turns 18 in 2030.  While today’s adults are leaving the next generation with a long to-do list, we’re making a promise to 7-year-olds everywhere to do everything we can to end AIDS, TB and Malaria by 2030, so they don’t have to.

Signed by the Global Fund’s most influential supporters and partners with the aim of encouraging wide public support, the Open Letter is a global call to action in the final phase of the #StepUpTheFight campaign to commit to the shared goal to end these epidemics.

Download and sign the Open Letter to 7-year-olds here or visit https://www.stepupthefight.org/

Support the launch of the Open Letter and post a tile with one of the suggested messages to your social media channels.  To download the social media messages, click on the following link: https://digital.theglobalfund.org/CS.aspx?VP3=SearchResult&VBID=278T3ZOXVMB

Based on new evidence assessing benefits and risks, the WHO recommends the use of the HIV drug dolutegravir (DTG) as the preferred first-line and second-line treatment for all populations, including pregnant women and those of childbearing potential.

Initial studies had highlighted a possible link between DTG and neural tube defects (birth defects of the brain and spinal cord that cause conditions such as spina bifida) in infants born to women using the drug at the time of conception. This potential safety concern was reported in May 2018 from a study in Botswana that found 4 cases of neural tube defects out of 426 women who became pregnant while taking DTG. Based on these preliminary findings, many countries advised pregnant women and women of childbearing potential to take efavirenz (EFV) instead.

New data from two large clinical trials comparing the efficacy and safety of DTG and EFV in Africa have now expanded the evidence base. The risks of neural tube defects are significantly lower than what the initial studies may have suggested.

The guidelines group also considered mathematical models of the benefits and harms associated with the two drugs; the values and preferences of people living with HIV, as well as factors related to the implementation of HIV programmes in different countries, and cost.

DTG is a drug that is more effective, easier to take and has fewer side effects than alternative drugs that are currently used. DTG also has a high genetic barrier to developing drug resistance, which is important given the rising trend of resistance to EFV and nevirapine-based regimens. In 2019, 12 out of 18 countries surveyed by WHO reported pre-treatment drug resistance levels exceeding the recommended threshold of 10%.

All of the above findings informed the decision to update the 2019 guidelines.

In 2019, 82 low- and middle-income countries reported to be transitioning to DTG-based HIV treatment regimens. The new updated recommendations aim to help more countries improve their HIV policies.

As for any medications, informed choice is important. Every treatment decision needs to be based on an informed discussion with the health provider weighing the benefits and potential risks.

WHO also stresses the importance of providing information and options to help women make an informed choice. To this end WHO has convened an advisory group of women living with HIV from diverse backgrounds to advise on policy issues related to their health, including sexual and reproductive health. WHO highlights the need to continually monitor the risk of neural tube defects associated with DTG.