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NEW YORK/GENEVA, 13 June 2018—At the halfway point to the 2020 Fast-Track Targets agreed by the United Nations General Assembly in 2016, United Nations Member States have come together to review progress in responding to HIV. Gathered at the United Nations Headquarters in New York, United States of America, Member States presented the progress and challenges in their countries and heard from the United Nations Secretary-General, who presented his report on the global response to HIV.

The President of the General Assembly Miroslav Lajčák opened the meeting. “We cannot forget that what we are doing today ties into our other goals and objectives,” he said. “We can use today’s meeting to explore opportunities for even more action. Let’s keep going. Let’s keep fighting this virus—and the stigma that comes with it.”

The United Nations Secretary-General presented his report, Leveraging the AIDS response for United Nations reform and global health, and said, “The world is making good progress towards ending the AIDS epidemic by 2030, but progress is uneven and fragile. At this pivotal moment, we must renew our focus and shared commitment to a world free of AIDS.”

The report shows that the exponential scale-up of antiretroviral therapy has now reached more than half of all people living with HIV, which in turn has contributed to a decline of one third in AIDS-related deaths, from 1.5 million in 2010 to 1 million in 2016. It also notes the progress in stopping new HIV infections among children and highlights that eliminating mother-to-child transmission of HIV is possible if the world remains focused.
The Executive Director of UNAIDS, Michel Sidibé, attended the plenary meeting. He said, “We are at a critical juncture on the path towards ending AIDS. We must unite and use our collective force to push HIV into permanent decline.”

More than 30 Member States reported on progress in their countries, many expressing their appreciation and support for the work of UNAIDS and the Joint Programme while reiterating their commitment to achieving the targets in the 2016 United Nations Political Declaration on Ending AIDS.

“The United States strongly supports UNAIDS and its leadership in combatting the HIV/AIDS pandemic,” said Deborah Birx, United States Global AIDS Coordinator and Special Representative for Global Health Diplomacy. “UNAIDS’ focus on producing the most extensive data collection on HIV epidemiology continues to be fundamentally important and is our roadmap to controlling this pandemic. We cannot achieve the targets to end the AIDS epidemic by

2030 without the right data to track our progress, pinpoint our unmet need and effectively and efficiently direct resources for maximum impact.”
The report of the United Nations Secretary-General shows that while the number of people accessing treatment almost tripled from 2010 to June 2017, from 7.7 million people on treatment to 20.9 million, 15.8 million people are still in need of treatment, and progress in expanding access to treatment for children is particularly slow. Just 43% of children living with HIV had access to treatment in 2016.

It also flags that more needs to be done to stop new HIV infections. New HIV infections declined by 18% from 2010 to 2016, from 2.2 million to 1.8 million, but to reach the target of 500 000 new infections by 2020 HIV prevention efforts must be significantly stepped up, particularly among populations at higher risk, a sentiment echoed by many of the speakers at the plenary meeting.

Lazarus O. Amayo, Permanent Representative of Kenya to the United Nations, spoke on behalf of the African Group. “A lot remains to be done as AIDS continues to disproportionately affect sub-Saharan Africa, with the risk of new HIV infections remaining exceptionally high among young women in eastern and southern Africa,” he said. “We reiterate the need for a comprehensive, universal and integrated approach to HIV and AIDS, as well as investments towards it.” In eastern and southern Africa, young women aged between 15 and 24 years account for 26% of new HIV infections, despite making up just 10% of the population.

The report shows there is still much work to do to reach the targets in the 2016 United Nations Political Declaration on Ending AIDS, including filling the US$ 7 billion shortfall in funding for the AIDS response. It sets out five strong recommendations to get countries on track, including mobilizing an HIV testing revolution, safeguarding human rights and promoting gender equality and using the HIV Prevention 2020 Road Map to accelerate reductions in new HIV infections.

In 2016 (*June 2017) an estimated:

*20.9 million [18.4 million–21.7 million] people were accessing antiretroviral therapy (in June 2017)
36.7 million [30.8 million–42.9 million] people globally were living with HIV
1.8 million [1.6 million–2.1 million] people became newly infected with HIV
1.0 million [830 000–1.2 million] people died from AIDS-related illnesses

-ENDS- 

Contact
UNAIDS | Sophie Barton-Knott | tel. +41 79 514 6896 | bartonknotts@unaids.org

UNAIDS

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

There are growing fears that many programmes administered by non-governmental organizations to assist the most vulnerable Jamaicans could be shuttered shortly as international funding dries up.

Addressing a recent Gleaner Editors’ Forum last Thursday, Kandasi Levermore, Executive Director of Jamaica AIDS Support for Life (JASL), disclosed that in a few years, several donor agencies would be transitioning, and there is no local funding to assist individuals in vulnerable groups.

“The challenge that we are going to be having in a few years when these donors transition because a lot of these projects are not funded by the Government of Jamaica, [is that] there will be a point where there will be a gap,” said Levermore.

Among the programmes likely to be affected are those involved in the empowerment of individuals living with HIV and HIV-related illnesses, women at risk of domestic violence as a result of their health status, as well as those that sensitize law-enforcement and health professionals about the treatment of persons living with HIV. “The Global Fund has been engaging in transition dialogue for years, and we finally fear that it is coming,” said Levermore. “There is going to be a gap in the country’s response. So how are we going to ensure that we sustain these activities and our scaled-up activities? That’s going to be the question that we need to answer now,” she added.

CURRENT FEARS

It is feared that these programmes could be placed on the back burner by the Ministry of Health, which is now focusing its resources on areas such as cervical cancer prevention among primary school-age girls and the growing obesity crisis in Jamaica.

“We are asking the Government to begin looking at mechanisms to sustain this type of engagement that is not now present in the structure of NGOs and how they deliver their programmes,” Levermore pleaded.

“We have been having this discussion for years, and once you talk money, you hear about fiscal space, but the real question is, ‘can the country’s response stave off the tide without a mechanism to sustain the efforts?’ ” added Levermore.

Executive Director of the Caribbean Vulnerable Communities Coalition (CVC), Ivan Cruickshank, wants the health sector to provide what he calls “trans-friendly” health services to transgender people in Jamaica.

“This means putting policies in place that can accommodate people who come in as trans and provide service to them. It would also mean the training of your healthcare providers to be able to provide trans-health services,” he said.

Speaking at a Gleaner Editors’ Forum at the newspaper’s offices on North Street in Kingston last Thursday, Cruickshank pointed out that many of the organisations working with vulnerable groups have partnered with civil-society bodies to train health workers in providing trans-health services.

“Trans-health service is a unique type of health service. So, you have to make sure that you have the policy framework that allows for the training of your medical professionals and that the service delivery points are able to deliver trans-friendly health services.”

Cruickshank revealed that there was a “particular toolkit that we have called Transit”, which provides a comprehensive package of services to transgender people, including hormone therapy.

He said that Transit would also help to ensure that persons who present themselves as transgender would be treated as such and not as males because of their physical appearances.

POLICE TREATMENT

Cruickshank also addressed the question of how transgenders should be treated by law enforcers when they commit an offense and are to be taken into custody.

He said that NGOs have worked with some police officers who have placed transgender people in a different cell.

“What they have done is that they have, pretty much, separated them, and even at some of our correctional facilities, they have separated them for their own protection and to ensure that they are addressing, in their own unique way, some of the issues that might arise.”

He estimated that the trans community represented about two percent of the Jamaican male population.

The Bishop of the Anglican Diocese of Guyana, Charles Davidson,  hosted a forum on faith for lesbian, gay, bisexual and transgender (LGBT) Guyanese at his official residence – Austin House – in Kingston, Georgetown in June 2018.

According to a release from the Society Against Sexual Orientation Discrimination (SASOD), the forum was part of a calendar of activities for the second annual Guyana Pride Festival, a week-long celebration organised by a coalition of the country’s three LGBT groups: Guyana Trans United (GTU), Guyana Rainbow Foundation (GuyBow) and the SASOD.

Homosexuality and the Anglican Church

According to SASOD, the Bishop, who leads the Anglican faith in Guyana and Suriname, said that the church has nothing against homosexuality and gay persons are accepted in the congregation, the challenge faced by many however is understanding sexuality. “We may not accept the [sexual] behaviour that you do but you are still children of God. The challenge is to try and understand sexuality. There are lots of Christians who wouldn’t even have a conversation [about sexuality] but they might quote scriptures. Jesus Christ spoke more about money more than he talked about sex. We are spending a lot of time worrying about sex when we should be spending a lot of time on an individual and their wholeness,” Bishop Davidson was quoted as saying.

The Buggery Laws

He stated that people are still struggling in the Caribbean because historically same-sex intimacy was never a practice accepted in the region due to strict colonial rule. This extends to the buggery laws which he described as “crazy.” Davidson expressed hope that the laws are reviewed since they are discriminatory and recognizing that that kind of behaviour is private.

“The seventh commandment says thou shall not commit adultery, yet there is no law in the law books of Guyana that says if we catch you committing adultery we will send you to jail for two years, as the buggery law says.” He went on to say that there are members of the Church who are not married, but living with persons. “We have our own challenges in the church to begin understanding these things,” the Bishop noted.

The sixty-four-year-old Bishop expressed that in years to come life will become easier for LGBT people. He has noticed younger persons in his congregation are more educated, understanding and accepting of gender and sexual diversity. “It is not an issue for them. It is an issue for old people like me,” he remarked.

He said it is an idea that the Church itself will struggle with, but they will have to continue to struggle to fully understand without discrimination and hatred towards LGBT persons.

More conversations needed

Bishop Davidson expressed his interest in meeting with transgender sex workers who are known to be working around the St. George’s Cathedral. “Some situations are not as loving as they ought to be but you still have to love people,” he said when talking about transgender sex workers. “I want to sit with a group of sex workers to hear their stories, to find out why they are in this position and to offer them the opportunity to find employment in a different way. I am not telling them that they are not gay. All I am saying is don’t let persons take advantage of who you are, be careful and take precautions,” he added.

SASOD’s Managing Director, Joel Simpson, committed to arranging such a meeting, stating that dialogue is indeed necessary and any support to vulnerable persons would not be turned away.

“I wish you well, make the right choices and take pride in yourself. At the end of the day, love makes the world go ‘round and the church is about love so we can’t disregard LGBT persons. The conversations will go on but the struggle continues and we wouldn’t give up,” the Bishop concluded.

After ten successful years of working togeth­er to reduce the stigma associated with HIV testing, Scotiabank and LIVE Up: The Caribbean Media Alliance, wish to inform the public that 2017 was the final year of our joint partnership for the regional initiative, Regional Testing Day.

In 2017, Scotiabank formed the Interna­tional Youth Advisory Council, under the leadership of LIVE UP Executive Director Dr. Allyson Leacock. From this, ‘The Scotiabank Young People in the Community Index’ was launched, which recognizes young people as one of the world’s greatest resources. Scotiabank has therefore dedicated to committing 70 percent of all global philanthropic efforts toward causes that positively impact this segment.

With this adjustment to the Bank’s global sponsorship strategy and the untimely passing of a key member of the LIVE UP team, both entities have mutually agreed to move forward in new directions; a fitting manner in which to conclude their ten years of active partnership.

Significant Achievements:

Since the initiative’s start ten years ago, much progress has been made in the fight against HIV.

The region’s successes include:

• A reduction in people living with HIV (PLHIV) from 450,000 to 285,000.
• A reduction in the number of deaths by 40-60%.
• An increase in the number of PLHIV on treatment from under 10% to almost 50%.

The Caribbean could also be the first region in the world to eliminate mother-to-child transmission of HIV, ostensibly because of HIV testing of pregnant mothers. The World Health Organisation validated six (6) other Caribbean countries (in addition to Cuba), for having successfully eliminated mother-to-child transmission (EMTCT) of HIV on World AIDS Day 2017.

Achievements for this Public-Private Partnership (PPP) include:

• The use of over 30 Scotiabank branches in 20 countries as testing clinics.
• The bipartisan support of competing political parties across the region at the highest level of Prime Minister and Opposition Leader for regional launches.
• A robust and consistent show of support from faith-based communities across the region, especially the Barbados Evangelical Association.
• The decentralization of testing to reach targeted vulnerable communities and populations.

Within a decade the initiative resulted in a remarkable increase in tests conducted. In 2008, 2300 people from 6 countries were tested. By the end of the initiative in 2017, 162,000 people were tested at over 300 testing sites in 21 countries.

Work to be Highly Commended:

Scotiabank’s Senior Manager, International Philanthropy, Roy Rodriguez applauded the work of both teams.

‘Scotiabank and LIVE UP have enjoyed a long and successful partnership with Regional Testing Day. We have by no means yet won the fight against HIV and AIDS, but our collaborative efforts went a long way towards the awareness that HIV testing should neither be feared nor avoided. I am also incredibly proud of our Scotiabankers across the region, who often stepped outside of their usual roles to ensure that Regional Testing Day was successfully executed year on year.’

Mr. Rodriguez also praised the tremendous work done by LIVE UP’s Executive Director, Dr. Allyson Leacock. ‘Dr. Leacock was, and continues to be resolute and steadfast in the fight against HIV/AIDS. One person with a desire to make a great difference was all it took to mobilize so many individuals and organizations into action. That is purpose!

She impressed my fellow Scotiabank executives both in the region and the global office, and there was never a doubt that she could deliver on what she set out to do. It was a pleasure having her as our teammate for the past decade.’

He added, ‘ … to the people of the region, continue to get tested. Regional Testing Day was the tool, but you are the catalyst, and this small but significant first step will help us to rid the world of this dreaded virus.’

His sentiments were echoed by Dr. Leacock, who thanked Scotiabank for their years of support. ‘This event has shown the region and the world that Scotiabank is a global leader that is exemplary in its philanthropic commitment to eliminating HIV from the public health landscape. Over the years, we have appreciated their support from leadership at the highest levels with Jim Tobin, Director, Sponsorship, Philanthropy and Strategic Partnerships. Our key contact, who showed a genuine interest in our progress and development throughout the years, was Roy Rodriguez, Senior Manager, Sponsorship, and Philanthropy.

As we mark the 10th anniversary of success, LIVE UP thanks Scotiabank and in particular Roy Rodriguez for his sustained interest and support throughout the decade of Regional Testing Day. The power of Public-Private Partnerships in advancing the region’s development agenda is exemplified in Regional Testing Day. Showcased as a best practice at the International AIDS Conference in 2012, we also thank the Pan Caribbean Partnership against HIV/AIDS-PANCAP for being the partner charged with mobilizing the region’s Ministries and Departments of Health. The 112 media houses in our LIVE UP partnership also played a critical role in sharing information and educating the region’s people on the HIV epidemic.’

Scotiabank and LIVE UP wish to thank the people of the region for their unwavering support of Regional Testing Day, and for positively impacting the Caribbean’s statistics year over year during the life of the initiative.

Outlining the economic and social toll HIV and AIDS continues to take on workers around the world, the International Labour Organization (ILO) called on Thursday for an “urgent effort” to improve treatment, step up testing and ensure healthier and more productive workplaces.

Prepared in collaboration with the UN agency dedicated to tackling the virus, UNAIDS, The impact of HIV and AIDS on the world of work: Global estimate, examines the past and future effects of the HIV epidemic, and development of antiretroviral therapy (ART), while assessing the economic and social impact on workers and their households.

The report shows that workers’ deaths attributed to HIV and AIDS are projected to fall to 425,000 worldwide in 2020, from 1.3 million in 2005; with people in their late-30s the most affected.

“This is the age workers are normally at the peak of their productive life,” said Guy Ryder, ILO Director-General.

“These deaths are totally avoidable if treatment is scaled up and fast-tracked,” he added.

In addition to the toll on lives, the report indicates that the disease costs billions of dollars in lost earnings – largely due to the hundreds of thousands of preventable HIV- and AIDS-related deaths.

Although the lost earnings have declined substantially from almost $17 billion in 2005, they are still projected to amount to $7.2 billion in 2020.

The good news is that ART is keeping employees healthy and productive, causing the number of workers living with HIV, either fully or partially unable to work, to drop dramatically since 2005.

The total number of those estimated to be fully unable to work is expected to decline to about 40,000 in 2020 from a 2005 level of about 350,000 – an 85 percent decline for men and a 93 percent drop for women.

The report recommended that treatment be scaled up and stressed the need to produce better-integrated health data with social and economic components to capture the full impact of AIDS-related diseases.

The Impact of HIV also looked at “hidden costs,” such as those being exacted on household members.

It predicts that in 2020, some 140,000 children will carry what ILO refers to as the “child-labor level chore burden”, while an additional full-time equivalent of 50,000 workers will perform unpaid care work.

It also shows that the number of workers living with HIV increased from 22.5 million in 2005 to 26.6 million in 2015 and is projected to rise to some 30 million in 2020, even if ART is scaled up.

“Mere scaling up of treatment is not enough,” stressed Mr. Ryder.

“Testing and HIV prevention measures also need to be stepped up if we are going to end AIDS. This makes human sense. And this makes astute economic sense,” he concluded.

The “CCAS EXPERT SUMMIT: From Care to Cure – Towards the Elimination of HIV”, will bring together an array of experts who have been selected not only for their international reputation but also for the vision they bring to their work. The summit is being described as an exciting juncture in the HIV field.  Discussions will focus on the state-of-the-art advances in HIV treatment as practitioners shift the paradigm from care to cure.

The summit will review the dramatic advances in antiretroviral therapy and the public health benefits accruing from treatment as prevention. The Caribbean is LEADING THE WORLD in eliminating mother-to-child transmission, with seven (7) Caribbean countries certified by the UN to have eliminated transmission of HIV from infected pregnant mothers to their infant.  The event will be held at the Coco Palm Hotel, Saint Lucia from 26 – 30 August 2018.

To register, click on the following link: http://www.ccasexpertsummit.org/ 

Image: Participants at SASOD’s Ninth Annual HIV and AIDS Candlelight Memorial

Even though the availability of treatment for HIV and AIDS has increased in Guyana over the years, Programme Manager of the National AIDS Programme (NAPS), Dr. Rhonda Moore has bemoaned that pervasive stigma and discrimination continue to hinder the fight.

Speaking at the ninth annual HIV and AIDS Candlelight Memorial organized by the Society Against Sexual Orientation Discrimination (SASOD) and held at the organization’s Lamaha Springs office, Dr. Moore stressed the need for greater societal involvement in tackling the disease.

According to her, Guyana has made strides in approving the accessibility of treatment for Human Immunodeficiency Virus infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) and making this treatment affordable, even free of cost, yet persons are unable to access these services. “The elephant in the room continues to be stigma and discrimination,” the Programme Manager said.

Adding to her sentiments was Managing Director of SASOD, Joel Simpson, who spotlighted the fact that while persons are discriminated against for having HIV/AIDS, the Lesbian Gay Bisexual Transgender (LBGT) community continues to be further discriminated against and marginalized.

While the provision of medical services is critical, Dr. Moore also posited that cognizance of people’s rights regardless of their sexual orientation, ethnicity, creed or other attributes is tantamount.

Dr. Moore nevertheless noted that persons living with HIV, though discriminated against and are marginalized, are “the greatest teachers” in the efforts to reduce the scourge.

“Without the involvement of persons living with HIV, policymakers will never understand what needs to be done,” she noted.

And despite dwindling donor funding internationally to reduce the HIV/AIDS-related cases, Moore assured that the government remains committed to funding treatment and testing through its National Health Strategy.

The overarching international goals that Guyana has aligned itself with include the elimination of AIDS by 2030 and the achievement of the United Nations Programme on HIV and AIDS (UNAIDS) 90-90-90 target of diagnosing 90% of all HIV-positive persons; providing Anti-retroviral Therapy (ART) for 90% of those diagnosed; and achieving viral suppression for 90% of those treated by 2020.

“All Guyanese have a right to quality care,” Moore highlighted but stressed, “This can only be achieved through working together.”

On a macro-level, a Sustainability Oversight Steering Committee has been established by the Public Health Ministry to guide the sustainability plan for continuing the gains already made vis-a-vis the goals outlined. The Committee is chaired by Public Health Minister, Volda Lawrence and includes Junior Health Minister, Dr. Karen Cummings; Dr. Moore; representatives from civil society organizations; representatives from faith-based organizations; and representatives from government ministries, among others.

SASOD has been the local organizer for the annual AIDS Candlelight Memorial in Guyana since 2010. Also in attendance at the Memorial was UNAIDS Country Director, Dr. Martin Odiit; UN Resident Coordinator and UNDP Resident Representative for the Cooperative Republic of Guyana, Mikiko Tanaka; and members and supporters of SASOD.

UNAIDS’ 90-90-90 targets focus on three global goals to be achieved by the year 2020: 90 percent of all people living with HIV will know their status, 90 percent of all people with diagnosed HIV infection will receive sustained antiretroviral therapy, and 90 percent of all people receiving antiretroviral therapy will have viral suppression. To successfully reach this goal, key populations (KPs) most at risk for HIV – including men who have sex with men, people who inject drugs, sex workers, and transgender people – need to be at the center of prevention, care, and treatment programs.

Tracking KPs’ successful access to these services is an essential part of the process of reaching 90-90-90. This is achieved by using a systematic approach to data collection and analysis through a strategic information (SI) system. SI is designed to support and shape long-term strategies for program planning and implementation, responding to stakeholder’s needs, and supporting innovations. More specifically, SI in KP programs generates data so that the decisions made in planning clinical, behavioral, and structural interventions are rooted in evidence.

SI in KP programming

HIV programs that focus on KPs require a specialized SI system to monitor the changes that occur within each population during a program’s implementation. KPs face special challenges in accessing HIV prevention, care, and treatment including their legal status, stigma and discrimination, and the influence of power structures. The information generated by an SI system can be used to identify and manage structural barriers to service uptake and understand the dynamic nature of KP individual’s behavior.

With an SI system, data are collected to ensure that KP programs are monitored from all fronts. Ideally, the system collects information beyond the standard PEPFAR indicators to ensure that data are helping shape program strategies. In the LINKAGES project, an SI system is used to collect data relating to structural interventions, including activities related to violence, stigma and discrimination, advocacy, sensitization, and peer navigation for HIV-positive KPs to ensure improved adherence to care and treatment. It also tracks activities that affect KPs in their day-to-day life and influence their behaviors. This SI system can be further customized based on country or regional needs. The SI system helps program teams with routine monitoring of the quality of their services along the HIV cascade and their progress toward reaching 90-90-90 targets.

The SI system for any KP program includes carefully tailored monitoring tools used to collect data at the grassroots level and subnational level and track the trends and gaps within a program. Data are then aggregated and used for analysis at the national level. The SI system also includes simple analytical tools that show site-level statistics on the various services provided to KPs, including behavioral, clinical, and structural interventions. SI provides the evidence needed to establish and maintain a program-wide approach to data collection, data analysis, data use, and action-oriented program planning processes.

Resources on SI

Many efforts are underway to ensure that SI systems being developed are KP-friendly and help KP-specific programs make effective use of data for strategic planning. Listed below are resources that can be used for systematic monitoring of KP programs through an SI system:

• Monitoring guide and toolkit for key populations HIV prevention, diagnosis, treatment, and care programs
• Operational guidelines for monitoring and evaluation of HIV programs for sex workers, men who have sex with men, and transgender people: Vol. I, national and sub-national levels (2013, UNAIDS/PEPFAR/Global Fund)
• Operational guidelines for monitoring and evaluation of HIV programs for sex workers, men who have sex with men, and transgender people: Vol. II, service delivery providers (2013, UNAIDS/PEPFAR/Global Fund)
• Use it or lose it: How Avahan used its data to shape its HIV prevention program in India (2008, Bill & Melinda Gates Foundation)
• ACQUA: Aastha Continuous Quality Assessment (FHI 360/Aastha, India)