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Casting light on old shadows: Ending sexually transmitted infection epidemics as public health concerns by 2030.
Geneva Switzerland, World Health Organization [WHO], 2017. 8 p. (Advocacy Brief; WHO/RHR/17.17)Countries can boost the response to STIs and improve the health of millions of women, men and adolescents by adopting WHO’s Global STI Strategy. Some viral STIs, like human papillomavirus (HPV) and HIV, are still incurable and can be deadly, while some bacterial STIs – like chlamydia, gonorrhoea, syphilis and trichomoniasis – are curable if detected and treated. This brief provide milestones and targets and five strategic directions for countries to develop their own national plans.
Geneva, Switzerland, UNAIDS, 2017. 198 p. (UNAIDS/JC2900E)Since they were launched at the 20th International AIDS Conference in Melbourne, Australia, in 2014, the 90-90-90 targets have become a central pillar of the global quest to end the AIDS epidemic. The targets reflect a fundamental shift in the world’s approach to HIV treatment, moving it away from a focus on the number of people accessing antiretroviral therapy and towards the importance of maximising viral suppression among people living with HIV. This shift was driven by greater understanding of the benefits of viral suppression -- not only does treatment protect people living with HIV from AIDS-related illness, but it also greatly lowers the risk of transmitting the virus to others.
Reinvigorating the AIDS response to catalyse sustainable development and United Nations reform. Report of the Secretary-General.
[New York, New York], United Nations, General Assembly, 2017 Apr 7. 25 p. (A/71/864)Bold global commitments, shared financial responsibility and a people-centred approach based on the principles of equity have yielded shared success in the AIDS response. The 90-90-90 initiative has guided a dramatic expansion of antiretroviral treatment and greatly reduced AIDS-related deaths, while also contributing to a reduction in new HIV infections. A global plan to eliminate mother-to-child transmission of HIV has more than halved the number of new HIV infections among children. The AIDS response has made an important contribution to the demographic dividend of Africa, its recent economic growth and the emerging vision of Africa as a continent of hope, promise and vast potential. Global optimism has fuelled the highest ambition within the 2030 Agenda for Sustainable Development: ending the AIDS epidemic by 2030. A fast-track response to reach this target has been agreed by the United Nations General Assembly within the 2016 Political Declaration on HIV and AIDS: On the Fast Track to Accelerating the Fight against HIV and to Ending the AIDS Epidemic by 2030. Achieving our aims on AIDS is interlinked with and embedded within the broader 2030 Agenda: both are grounded in equity, human rights and a promise to leave no one behind. Hard-fought gains must not be lost. An international architecture that has stimulated leadership, provided direction, mobilized unprecedented levels of financial resources and saved millions of lives must not be taken for granted. Closing the investment gap of $7 billion per year and ensuring that financial resources are wisely used will avert tens of millions of new HIV infections and AIDS-related deaths, a return on investment that is nothing short of priceless. (Excerpts)
Southern African Journal of HIV Medicine. 2016; 17(1): p.Background: The World Health Organization (WHO) HIV treatment guidelines have been used by various countries to revise their national guidelines. Our study discusses the national policy response to the HIV epidemic in sub-Saharan Africa and quantifies delays in adopting the WHO guidelines published in 2009, 2013 and 2015. Methods: From the Internet, health authorities and experts, and community members, we collected 59 published HIV guidelines from 33 countries in the sub-Saharan African region, and abstracted dates of publication and antiretroviral therapy (ART) eligibility criteria. For these 33 countries, representing 97% regional HIV burden in 2015, the number of months taken to adopt the WHO 2009, 2013 and/or 2015 guidelines were calculated to determine the average delay in months needed to publish revised national guidelines. Findings: Of the 33 countries, 3 (6% regional burden) are recommending ART according to the WHO 2015 guidelines (irrespective of CD4 count); 19 (65% regional burden) are recommending ART according to the WHO 2013 guidelines (CD4 count = 500 cells/mm3); and 11 (26% regional burden) according to the WHO 2009 guidelines (CD4 count = 350 cells/mm3). The average time lag to WHO 2009 guidelines adoption in 33 countries was 24 (range 3–56) months. The 22 that have adopted the WHO 2013 guidelines took an average of 10 (range 0–36) months, whilst the three countries that adopted the WHO 2015 guidelines took an average of 8 (range 7–9) months. Conclusion: There is an urgent need to shorten the time lag in adopting and implementing the new WHO guidelines recommending ‘treatment for all’ to achieve the 90-90-90 targets.
A tool for strengthening gender-sensitive national HIV and Sexual and Reproductive Health (SRH) monitoring and evaluation systems.
Geneva, Switzerland, WHO, 2016. 126 p.WHO and UNAIDS have released a new tool for strengthening gender-sensitive national HIV and sexual and reproductive health (SRH) monitoring and evaluation systems. The tool provides step-by-step guidance to strategic information specialists and monitoring and evaluation officers of HIV and SRH programmes on how to ask the right questions in order to uncover gender inequalities and their influence on health; identify and select gender-sensitive indicators; conduct gender-analysis of SRH and HIV data; and strengthen monitoring and evaluation systems to enable appropriate data collection and gender analysis. The tool has been used by nearly 30 country teams of strategic information specialists, civil society and HIV programme implementers to analyse their own SRH and HIV data from a gender equality perspective. It can be used for training monitoring and evaluation specialists as well as a resource guide for SRH and HIV programmes to develop gender profiles of their SRH and HIV situation. “Know your epidemic, know your response” has been the cornerstone of the HIV response. This tool supports this approach by helping identify inequities and underlying drivers and hence, improve evidence-informed SRH and HIV programmes for all, but particularly for women and girls.
Get on the fast-track. The life-cycle approach to HIV. Finding solutions for everyone at every stage of life.
Geneva, Switzerland, UNAIDS, 2016. 140 p.In this report, UNAIDS is announcing that 18.2 million people now have access to HIV treatment. The Fast-Track response is working. Increasing treatment coverage is reducing AIDS-related deaths among adults and children. But the life-cycle approach has to include more than just treatment. Tuberculosis (TB) remains among the commonest causes of illness and death among people living with HIV of all ages, causing about one third of AIDS-related deaths in 2015. These deaths could and should have been prevented. TB, like cervical cancer, hepatitis C and other major causes of illness and death among people living with HIV, is not always detected in HIV services. It is vital that we collaborate closely with other health programmes to prevent unnecessary deaths. The impact of better treatment coverage means that a growing number of people will be living with HIV into old age, while there has also been an increase in new HIV infections among older people. The consequences of long-term antiretroviral therapy, combined with the diseases of ageing, will be new territory for many HIV programmes. Drug resistance is a major threat to the AIDS response, not just for antiretroviral medicines but also for the antibiotic and antituberculous medicines that people living with HIV frequently need to remain healthy. More people than ever before are in need of second- and third-line medicines for HIV and TB. The human burden of drug resistance is already unacceptable; the financial costs will soon be unsustainable. We need to make sure the medicines we have today are put to best use, and accelerate and expand the search for new treatments, diagnostics, vaccines and an HIV cure. As we build on science and innovation we will need fresh thinking to get us over the remaining obstacles. The cliché is true -- what got us here, won’t get us there. We face persistent inequalities, the threat of fewer resources and a growing conspiracy of complacency. (Excerpt)
Geneva, Switzerland, UNAIDS, Joint United Nations Programme on HIV/AIDS, 2014 Oct. 40 p.In December 2013, the UNAIDS Programme Coordinating Board called on UNAIDS to support country- and region-led efforts to establish new targets for HIV treatment scale-up beyond 2015. In response, stakeholder consultations on new targets have been held in all regions of the world. At the global level, stakeholders assembled in a variety of thematic consultations focused on civil society, laboratory medicine, paediatric HIV treatment, adolescents and other key issues. The 90-90-90 UNAIDS target seeks to: 1) By 2020, 90% of all people living with HIV will know their HIV status; 2) By 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy; and 3) By 2020, 90% of all people receiving antiretroviral therapy will have viral suppression. Key points: 1) Governments, health experts and civil society must take advantage of the next five-year window to meet the 90-90-90 target to tackle AIDS; 2) Early treatment can reduce infection rates by 90 %; 3) A paradigm shift in HIV/AIDS treatment has seen average drug prices fall from an average of US$15 000 to US$ 80; and 4) Health systems will improve as a result of investment in HIV/AIDS treatment; financing from the international community is indispensable.
[New York, New York], United Nations General Assembly, 2016 Apr 1.  p. (A/70/811)This new report warns that the AIDS epidemic could be prolonged indefinitely if urgent action is not implemented within the next five years. The report reveals that the extraordinary acceleration of progress made over the past 15 years could be lost and urges all partners to concentrate their efforts to increase and front-load investments to ensure that the global AIDS epidemic is ended as a public health threat by 2030. The review of progress looks at the gains made, particularly since the 2011 United Nations Political Declaration on HIV and AIDS, which accelerated action by uniting the world around a set of ambitious targets for 2015. The report outlines that the rapid treatment scale-up has been a major contributing factor to the 42% decline in AIDS-related deaths since the peak in 2004 and notes that this has caused life expectancy in the countries most affected by HIV to rise sharply in recent years. The report underlines the critical role civil society has played in securing many of the gains made and the leadership provided by people living with HIV. Community efforts have been key to removing many of the obstacles faced in scaling up the AIDS response, including reaching people at risk of HIV infection with HIV services, helping people to adhere to treatment and reinforcing other essential health services.
Fast track to ending AIDS. 2016 High-Level Meeting on Ending AIDS, United Nations General Assembly, New York, 8-10 June 2016.
[Geneva, Switzerland], Joint United Nations Programme on HIV / AIDS [UNAIDS], 2016.  p. (No. HLM2016AIDS)This document from the United Nations (UN) General Assembly announces a High-Level Meeting on Ending AIDS, to convene June 8-10, 2016 at the UN headquarters in New York. The meeting responds to the need for UN member states to take a "Fast-Track" approach during the next five years to reach the goal of ending the HIV epidemic by 2030, and to achieve global goals for sustainable development. Achieving these goals will require not only increased investment in outreach, care, and treatment, but broader commitment to a rights-based approach to HIV programming that includes participation from civil society. Meeting attendees will draft a new Political Declaration on Ending AIDS. The UNAIDS Fast-Track approach aims to achieve ambitious targets by 2020, including: fewer than 500,000 people newly infected with HIV, fewer than 500,000 people dying from AIDS-related illnesses, eliminating HIV-related discrimination.
Lancet. 2016 Mar 19; 387:1147.WHO convened a multidisciplinary consultation last week to identify the tools and interventions needed to outsmart the Zika epidemic. Towards the end of the meeting, delegates representing the major regulatory agencies in the USA, Europe, and Brazil, committed to putting Zika-related products on a regulatory fast-track. They also agreed that instead of waiting, as they usually do, for manufacturers to approach them, they would take the initiative and approach companies working on promising products. Their gesture, in a sense, encapsulates the success of the meeting in bringing together so many minds from so many disciplines to focus, for 3 intensive days, on a single issue of vital importance. (Excerpts)
Geneva, Switzerland, UNAIDS, 2015.  p.This document, released on the World AIDS Day 2015, provides an update on the global status of the HIV epidemic. According to the press release, the epidemic has been forced into decline. New HIV infections and AIDS-related deaths have fallen dramatically since the peak of the epidemic. The document cites a 35 percent decrease in new HIV infections; a 42 percent decrease in AIDS-related deaths since the peak in 2004; a 58 percent decrease in new HIV infections among children since 2000; and an 84 percent increase in access to antiretroviral therapy since 2010. Additionally, the global response to HIV has averted 30 million new HIV infections and 7.8 million AIDS-related deaths since 2000. While acknowledging these achievements, the report also emphasizes that accelerating the AIDS response in low-and middle-income countries could avert 28 million new HIV infections and 21 million AIDS-related deaths between 2015 and 2030, saving US$24 billion annually in additional HIV treatment costs. The next phase of the global response must accommodate new circumstances, opportunities, and evidence, including a rapidly shifting context and a new, sustainable development agenda. The single priority of the HIV response for the next 15 years is to end the epidemic by 2030.
A decade of investments in monitoring the HIV epidemic: how far have we come? A descriptive analysis.
Health Research Policy and Systems. 2014; 12:62.BACKGROUND: The 2001 Declaration of Commitment (DoC) adopted by the General Assembly Special Session on HIV/AIDS (UNGASS) included a call to monitor national responses to the HIV epidemic. Since the DoC, efforts and investments have been made globally to strengthen countries' HIV monitoring and evaluation (M&E) capacity. This analysis aims to quantify HIV M&E investments, commitments, capacity, and performance during the last decade in order to assess the success and challenges of national and global HIV M&E systems. METHODS: M&E spending and performance was assessed using data from UNGASS country progress reports. The National Composite Policy Index (NCPI) was used to measure government commitment, government engagement, partner/civil society engagement, and data generation, as well as to generate a composite HIV M&E System Capacity Index (MESCI) score. Analyses were restricted to low and middle income countries (LMICs) who submitted NCPI reports in 2006, 2008, and 2010 (n = 78). RESULTS: Government commitment to HIV M&E increased considerably between 2006 and 2008 but decreased between 2008 and 2010. The percentage of total AIDS spending allocated to HIV M&E increased from 1.1% to 1.4%, between 2007 and 2010, in high-burden LMICs. Partner/civil society engagement and data generation capacity improved between 2006 and 2010 in the high-burden countries. The HIV MESCI increased from 2006 to 2008 in high-burden countries (78% to 94%), as well as in other LMICs (70% to 77%), and remained relatively stable in 2010 (91% in high-burden countries, 79% in other LMICs). Among high-burden countries, M&E system performance increased from 52% in 2006 to 89% in 2010. CONCLUSIONS: The last decade has seen increased commitments and spending on HIV M&E, as well as improved M&E capacity and more available data on the HIV epidemic in both high-burden and other LMICs. However, challenges remain in the global M&E of the AIDS epidemic as we approach the 2015 Millennium Development Goal targets.
Geneva, Switzerland, UNAIDS, 2014 Jul.  p. (UNAIDS / JC2656)How do we close the gap between the people moving forward and the people being left behind? This was the question we set out to answer in the UNAIDS Gap report. Similar to the Global report, the goal of the Gap report is to provide the best possible data, but, in addition, to give information and analysis on the people being left behind. A new report by UNAIDS shows that 19 million of the 35 million people living with HIV globally do not know their HIV-positive status. The UNAIDS Gap report shows that as people find out their HIV-positive status they will seek life-saving treatment. In sub-Saharan Africa, almost 90% of people who tested positive for HIV went on to access antiretroviral therapy (ART). Research shows that in sub-Saharan Africa, 76% of people on ART have achieved viral suppression, whereby they are unlikely to transmit the virus to their sexual partners. New data analysis demonstrates that for every 10% increase in treatment coverage there is a 1% decline in the percentage of new infections among people living with HIV. The report highlights that efforts to increase access to ART are working. In 2013, an additional 2.3 million people gained access to the life-saving medicines. This brings the global number of people accessing ART to nearly 13 million by the end of 2013. Based on past scale-up, UNAIDS projects that as of July 2014 as many as 13 950 296 people were accessing ART. By ending the epidemic by 2030, the world would avert 18 million new HIV infections and 11.2 million AIDS-related deaths between 2013 and 2030.
Zimbabwe: An AIDS strategy focused and aligned with our vision and the United Nations targets for 2015. Case study.
[Geneva, Switzerland], UNAIDS, 2013.  p. (Case Study)This case study looks at how Zimbabwe evolved its work with UNAIDS and the Global Fund for HIV, Tuberculosis and Malaria to fit the New Funding Model for the Global Fund, and received a US$311 million three-year grant --- equal to the combined total of HIV assistance the country received from the Global Fund in the past decade. This case study examines how a country whose AIDS response was effective, people-centred and prioritized, but heavily under-funded, seized the chance to take its response to a new level, and the part UNAIDS played.
Geneva, Switzerland, UNAIDS, 2013.  p.The 2013 report on the global AIDS epidemic contains the latest data on numbers of new HIV infections, numbers of people receiving antiretroviral treatment, AIDS-related deaths and HIV among children. This report, which follows the endorsement of the 2011 United Nations Political Declaration on HIV and AIDS outlining global targets to achieve by 2015, summarizes progress towards 10 key targets and reviews commitments and future steps. While recognizing significant achievements, UNAIDS warns of slowing progress in meeting some targets. In 2012, there were 35 million people living with HIV (PLHIV), and 2.3 million new infections-a 33 percent decrease from 2001, including significant reductions in new infections among children. More people than ever are on antiretroviral therapy (ART). Twenty-six countries have achieved the global target of halving sexual HIV transmission by 2015, but other countries are not on track to meet this target, hence the need to enhance prevention efforts. Globally, countries have made limited progress in reducing HIV transmission by 50 percent among people who inject drugs. While ART coverage is high, and approaching the target of 15 million PLHIV on treatment, coverage in low- and middle-income countries represented only 34 percent of 28 million eligible PLHIV in 2013. Stigma, discrimination and criminalization towards PLHIV continue; specifically, 60 percent of countries report laws that inhibit access to HIV services by key populations. The results of this report should be used by countries to refocus and maintain their commitments. The authors urged strengthened global commitment to achieve the goal of zero new HIV infections, discrimination, and AIDS-related deaths.
Multilateral, regional, and national determinants of policy adoption: the case of HIV/AIDS legislative action.
International Journal of Public Health. 2013 Apr; 58(2):285-93.OBJECTIVES: This article examines the global legislative response to the HIV/AIDS epidemic with a particular focus on how policies were diffused internationally or regionally, or facilitated internally. METHODS: This article uses event history analysis combined with multinomial logit regression to model the legislative response of 133 countries. RESULTS: First, the results demonstrate that the WHO positively influenced the likelihood of a legislative response. Second, the article demonstrates that development bank aid helped to spur earlier legislative action. Third, the results demonstrate that developed countries acted earlier than developing countries. And finally, the onset and severity of the HIV/AIDS epidemic was a significant influence on the legislative response. CONCLUSION: Multilateral organizations have a positive influence in global policy diffusion through informational advocacy, technical assistance, and financial aid. It is also clear that internal stressors play key roles in legislative action seen clearly through earlier action being taken in countries where the shock of the onset of HIV/AIDS occurred earlier and earlier responses taken where the epidemic was more severe.
Child mortality estimation: Methods used to adjust for bias due to AIDS in estimating trends in under-five mortality.
PLOS Medicine. 2012 Aug; 9(8):e1001298.In most low- and middle-income countries, child mortality is estimated from data provided by mothers concerning the survival of their children using methods that assume no correlation between the mortality risks of the mothers and those of their children. This assumption is not valid for populations with generalized HIV epidemics, however, and in this review, we show how the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) uses a cohort component projection model to correct for AIDS-related biases in the data used to estimate trends in under-five mortality. In this model, births in a given year are identified as occurring to HIV-positive or HIV-negative mothers, the lives of the infants and mothers are projected forward using survivorship probabilities to estimate survivors at the time of a given survey, and the extent to which excess mortality of children goes unreported because of the deaths of HIV-infected mothers prior to the survey is calculated. Estimates from the survey for past periods can then be adjusted for the estimated bias. The extent of the AIDS-related bias depends crucially on the dynamics of the HIV epidemic, on the length of time before the survey that the estimates are made for, and on the underlying non-AIDS child mortality. This simple methodology (which does not take into account the use of effective antiretroviral interventions) gives results qualitatively similar to those of other studies.
Contemporary Politics. 2012 Jun; 18(2):186-199.Capacity-building has become a mainstay of many AIDS and public health programmes. This article examines its impact on civil society organisations and claims-making around citizenship, as these have been articulated through heterogeneous policy networks doing HIV prevention work. Drawing on a growing literature on the Foucauldian notions of biopower and governmentality, the genealogy of capacity-building as a globalised technology of governmentality is traced, examining its uses both at the international level and in Brazil. Brazilian civil society organisations have undoubtedly been transformed by their participation in networks carrying out capacity-building projects. While recognising these effects, the conflicts and productive tensions inherent to such networks are highlighted.
Lancet. 2011 Aug 27; 378(9793):768.Add to my documents.
Combination HIV prevention: Tailoring and coordinating biomedical, behavioural and structural strategies to reduce new HIV infections. A UNAIDS discussion paper.
Geneva, Switzerland, UNAIDS, 2010 Sep.  p. (UNAIDS Discussion Paper No. 10; UNAIDS - JC2007)This discussion paper summarizes the approach to HIV prevention programming known as “combination prevention” that UNAIDS recommends to achieve the greatest and most lasting impact on reducing HIV incidence and on improving the well-being of affected communities around the world.
Geneva, Switzerland, UNAIDS, 2011.  p.A new report by the Joint United Nations Programme on HIV / AIDS (UNAIDS), released on 21 November, shows that 2011 was a game changing year for the AIDS response with unprecedented progress in science, political leadership and results. The report also shows that new HIV infections and AIDS-related deaths have fallen to the lowest levels since the peak of the epidemic.
Global HIV / AIDS response. Epidemic update and health sector progress towards Universal Access. Progress report 2011.
Geneva, Switzerland, WHO, 2011.  p.The Progress report 2011: Global HIV / AIDS response reviews progress made until the end of 2010 in scaling up access to health sector interventions for HIV prevention, treatment, care and support in low– and middle-income countries. It is the fifth in a series of annual progress reports published since 2006 by WHO, UNICEF and UNAIDS, in collaboration with national and international partners, to monitor key components of the health sector response to the HIV epidemic. The key findings of the report: update on the HIV epidemic; selected health sector interventions for HIV prevention; knowledge of HIV status, scaling up treatment and care for people living with HIV; scaling up services for key populations at higher risk of HIV infection; scaling up HIV services for women and children; towards elimination of mother to child transmission and improving maternal and child health in the context of HIV.
[Geneva, Switzerland], WHO, 2011 Nov 30.  p.Derived from the Report on Global HIV / AIDS Response, this fact sheet presents data on new HIV infections, AIDS-related deaths, and HIV prevalence. Information on HIV treatment, care, and support, prevention of mother-to-child transmission of HIV, prevention in the health sector, knowledge of HIV status, and services for key populations is also included. The fact sheet concludes with a section on Beyond 2011: Treatment gains amid funding uncertainties.
Report on country experience: A multi-sectoral response to combat polio outbreak in Namibia. Draft background paper.
[Unpublished] 2011. Draft background paper commissioned by the World Health Organization for the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October 2011.  p. (WCSDH/BCKGRT/19/2011; Draft Background Paper 19)Namibia witnessed an outbreak of Wild Polio Type 1 virus in 2006. A total of 323 suspected cases of Acute Flaccid Paralysis were reported, of which 19 were confirmed as Wild Polio Virus Type 1. The outbreak affected mostly the older population and thirty-two of the suspected cases died. The country mounted an immediate response that enabled the whole population to be vaccinated against polio virus. The outbreak of the epidemic witnessed an unprecedented response with the country coming together in the spirit of one Nation facing a common enemy. The reported deaths in some communities engendered fear among the populace and motivated the people to seek early treatment and prevention from further spread of the outbreak. The key to the successful response to the outbreak included: Political commitment; Resource mobilization and availability; Support of international community; Good community mobilization and cooperation from the communities; Commitment and dedication from the Health Care Providers and the volunteers; Team work and delegation; Good communication and support from the media. (Excerpt)
Gender mainstreaming in emerging disease surveillance and response, Western Pacific Region. Draft background paper.
[Unpublished] 2011. Draft background paper commissioned by the World Health Organization for the World Conference on Social Determinants of Health, Rio de Janeiro, Brazil, 19-21 October 2011.  p. (WCSDH/BCKGRT/16/2011; Draft Background Paper 16)The primary lessons learned from this case study are that gender awareness training of staff and staff collective planning are useful avenues by which to begin the process of gender mainstreaming. Additionally, full support from all levels of leadership has been crucial to the success of gender mainstreaming within the Division. In particular, support for gender mainstreaming and pressure to implement gender mainstreaming by Division and Regional Office leadership have been crucial to the early success of these efforts. (Excerpt)