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Geneva, Switzerland, UNAIDS, 2007 Jan. 57 p. (UNAIDS/07.04E; JC1301E)In 2005 and early 2006, the landscape of the AIDS response shifted dramatically. Global pessimism over the unchecked spread of the disease in the developing world receded in the face of impressive efforts to expand access to treatment. Signs that prevention efforts were bearing fruit were seen in a growing number of countries from the hardest-hit regions, which started to report drops in HIV rates, particularly among the young. The global community had responded to urgent appeals by enormously increasing the financial resources available to fight the disease. While millions continued to die annually, these developments gave rise to hope that there was a light at the end of the tunnel. Unimaginable even a year or two earlier, it was now possible to start talking about the prospects of providing access to HIV prevention, treatment, care and support services to all who needed them. (excerpt)
The 10-year struggle to provide antiretroviral treatment to people with HIV in the developing world.
Lancet. 2006 Aug 5; 368(9534):541-546.In March, 2006, the WHO took stock of the 3 by 5 initiative, which had been formally launched with UNAIDS 2 years earlier. With 1.3 million people on antiretroviral treatment in developing countries by the end of 2005, the world had not reached the target of treating 3 million people living with HIV/AIDS. In terms of numbers, at least, some said that the campaign failed. But the initiative did show that with the right vision and a determined effort by all relevant parties, development achievements that seem unthinkable are indeed possible. The apparent failure to achieve what was always an aspirational goal should not overshadow the fact that the progress on access to antiretroviral treatment might have no precedent in global public health. For no other life-threatening disease has the world moved from the first scientific breakthroughs to a commitment to achieve universal access to treatment in less than a decade. But we should not forget that the number of new HIV infections still outpaces the expansion of access to treatment, and that progress remains slow in view of the millions still dying from AIDS every year. (excerpt)
Choices. 2004; 7.I left the 1998 International AIDS Conference in Geneva frustrated and angry. The slogan of the conference--'Bridging the Gap'--was right on target, but none of the major players in the conference (the international agencies, governments, the big pharmaceutical companies) offered a vision, let alone a strategy, for making life-saving treatments available to the millions of HIV-positive people in poor and developing countries. As has been true since the beginning of the AIDS epidemic, it was left to HIV-positive people themselves and to advocacy groups to formulate demands, mobilize the political support to challenge the status quo and lead in the development of new policies. Dramatic changes have occurred between 1998's 'Bridging the Gap' and 2004's 'Access for All' conferences. In the intervening six years, an alliance of NGOs from around the world with a bloc of progressive poor and developing countries has won significant victories: It is no longer morally acceptable to do nothing about the death and suffering of millions; The broader global AIDS community has accepted that any effective approach to stopping the epidemic must include treatment as well as prevention and mitigation. (excerpt)
Towards the creation of strategic partnerships: improving access to drugs for HIV / AIDS. Report of a consultative meeting, 30 June - 2 July 1997, Salle C, WHO, Geneva.
Geneva, Switzerland, UNAIDS, 1998. 20 p. (UNAIDS Best Practice Collection. Key Material; UNAIDS/98.40)From January 1996, the UNAIDS Secretariat has been in consultation with key players in the pharmaceutical industry, NGOs, people living with HIV, UN, major bilateral donors, country representatives and National AIDS Programme Managers on issues relating to access to drugs for HIV/AIDS. This meeting, held on 30 June to 2 July 1997, was the climax of this consultative process. The meeting brought together people living with HIV/AIDS, NGO representatives, National AIDS Programme Managers and UN representatives. With a modified version of the Search Conference approach, the following questions were raised: What are the current and future issues on access to drugs for HIV/AIDS at country and global levels? What partnerships should be created at country level to address these issues? What should be the content of these partnerships at country level? What should the UN do at global and country level to support these partnerships? To foster regional exchange of experience as well as enhance regional specificity, participants were assigned groups on a regional basis. (excerpt)
Women, gender and HIV / AIDS. Women bear the heaviest HIV / AIDS burden, but they can’t prevent its spread by themselves.
Countdown 2015: Sexual and Reproductive Health and Rights for All. 2004; (Spec No):65-68.Women, especially young women, are increasingly the face of the HIV/AIDS epidemic. About half of all adults infected with HIV worldwide are women, although this proportion varies by region. In sub-Saharan Africa, 75 percent of those infected are young women and girls, and the proportion of pregnant young women in capital cities who are HIV positive—an indicator of how the epidemic is spreading— remains high in five of the most populous countries in sub-Saharan Africa. Recent data from South Africa, one of the countries hardest hit by HIV/AIDS, showed that 10.2 percent of all 15- to 24-year-olds were infected in 2003, and three of every four HIV-infected young people were female. In the United States, AIDS is now the leading cause of death among African-American women age 25-34. Even in Thailand and Cambodia, relative HIV-prevention success stories, the epidemic increasingly affects women: The rate of new infection is now higher among women than men, and many of those women are the wives of HIV-positive men. (excerpt)
Global AIDSLink. 2001 Aug-Sep; (69):14, 16.After recognizing the need to include the experiences of all regions, countries and communities addressing the fight against HIV/AIDS, the United Nations embarked on a unique process to include hundreds of NGOs in UNGASS. They instituted a unique accreditation process for this session and then witnessed an unprecedented number of non- ECOSOC (Economic and Social Council) accredited organizations take part in the Special Session. Since most AIDS-focused organizations are not members of ECOSOC, many of these NGOs would have been unable to participate in the UN events under the traditional set of regulations. Nearly a thousand individuals representing a host of NGOs from around the world participated in UNGASS, making this one of the largest events of its type at the UN. (excerpt)
Johannesburg, South Africa, ActionAid International, 2004 Jun. 11 p. (3 by 5 Discussion Paper)This paper addresses these concerns. Prevention, care and support: in the push to provide antiretrovirals, prevention, care and support programmes must not slip down the priority list of the world’s governments. ActionAid International calls on developing countries to demonstrate clearly in their 3 by 5 plans how ARV treatment delivery will interface with, and be balanced by, other prevention, care and support initiatives, including the promotion of good nutrition. Equity: initially, the limited supply of ARVs under 3 by 5 will be the focus of a struggle between different interest groups trying to ensure access for their client populations. ActionAid International’s past experience would suggest that men, and those that are better off or living in urban areas, will win out over women, children, marginalised groups and those living in rural areas. We call on all involved in developing 3 x 5 plans to ensure equity in access by focusing on the special needs of women, marginalised groups, poor and rural communities. Ideally, such groups should be involved in the design and implementation of care services that will be appropriate to their needs and be located close to where they live. Health systems: ActionAid International welcomes the recent emphasis given by the WHO World Health Assembly to health system strengthening as an essential component in delivery of 3 by 5. In many of the countries most affected by HIV/AIDS health systems are not working, having been undermined by World Bank/IMF structural adjustment programmes as well as attrition caused by HIV/AIDS. The rapid rebuilding of health systems is a basic requirement if 3 by 5 is to succeed. ActionAid International calls on donors to provide increased funding and support and to ensure that large-scale capacity building programmes for health service personnel are instituted without delay. (excerpt)
Public report. First meeting of the UNAIDS Global Reference Group on HIV / AIDS and Human Rights, January 23-24, 2003, Geneva, Switzerland.
Geneva, Switzerland, UNAIDS, 2003. 13 p.There is more than 20 years of experience showing that the promotion and protection of human rights is critical to mitigating the impact of HIV/AIDS epidemic on peoples lives. However, the integration of human rights into HIV/AIDS work is increasingly under attack by governments and public health officials. The field is therefore now at an important juncture of it's history. There is a growing and crucial need for efforts that would highlight the effectiveness of the diverse ways in which the connections between HIV/AIDS and human rights are being understood and worked on. It is most critical to continue to keep abreast of and address current human rights issues in relation to HIV/AIDS. It is also essential to consider what is needed to collect the evidence of what has been effective; and to develop better ways to ensure that rights are genuinely integrated into the HIV/AIDS work happening within countries. To help meet these goals, the Joint United Nations Programme on HIV/AIDS (UNAIDS) established a Global Reference Group on HIV/AIDS and Human Rights (Reference Group). This technical group has been put together to serve as an independent advisory body to UNAIDS, including Secretariat and Cosponsors and other organizations involved in policy, advocacy, programme development, implementation, monitoring, evaluation, research and training related to a rights-based approach to HIV/AIDS. In fulfilling its mandate, the Reference Group will liaise closely with other UNAIDS Reference Groups, namely, HIV/AIDS Estimates, Modeling and Projections; the International AIDS Economic Network; the Reference Group on Injection Drug Use; and the Reference Group on Epidemiology. The Reference Group will cover a wide range of topics including, but not limited to the following: 1. Stocktaking of standards and approaches to integrating human rights in the response to HIV/AIDS leading to a common methodology for analysis and terminology. 2. The development of rights-based indicators, including those to monitor HIV/AIDS risk, vulnerability and impact reduction. 3. The development of human rights and legal guidelines and methods to support countries in the design of national AIDS strategies, policies, and legislation. 4. The development of a strategic approach for integration of HIV/AIDS-related issues in UN human rights treaty bodies, charter-based bodies and other human rights mechanisms. (excerpt)
Science in Africa. 2004 Jan;  p..Short-term relief followed by long-term disaster is not sound policy. Nonetheless, that could be a result of the Aids strategy being contemplated by the World Health Organisation, which on December 1 - World Aids Day - announced a plan to treat 3-million people with HIV/Aids by 2005. The WHO is proposing that billions of dollars be spent on increasing access to anti-retroviral drugs. That is a noble intention. However, it may not be the most cost-effective way to stem the tide of HIV/Aids: it may even be counterproductive. Let's be clear. Reducing the cost and increasing the supply of medicines to the poor is a good thing. But on its own it is not enough. Nor should it be today's priority. The roots of Africa's health care crisis run far deeper and broader than a mere shortage of drugs. Spending billions on drugs is likely to prove a disappointing waste. (excerpt)
Bulletin of the World Health Organization. 2003 Oct; 81(10):699.WHO’s new Director-General has just declared AIDS to be a global health emergency. This move is not unprecedented but does signal a welcome departure from business as usual. Can declarations change the world? They can if they lead to action commensurate with the problem. (excerpt)
Positively Aware. 2003 Mar-Apr; 14(2):20-24.Developing and implementing a model HIV prevention program at the grass-roots level in the People's Republic of China is a very difficult undertaking, but this is the task we have agreed to with the Health Bureau of Zhejiang Province in China. The U.S. Centers for Disease Control and Prevention (CDC), World Health Organization (WHO) and various universities in the U.S. are actively involved with HIV/AIDS in China; but all of these undertakings are between professionals, usually physicians, or high level administrators on all sides. What has not been done, and what is unique to the relationship that Howard Brown Health Center (HBHC) is developing, is to work directly with the people in China who will implement the treatment and prevention programs among the Chinese population. Getting out in the field among the Chinese populations most at risk-men who have sex with men (MSM), intravenous drug users (IDUs), and female sex workers-is a major milestone. (author's)