Development

Lyn's Comment:

There are very close links between HIV and development.  Globally the largest burden of HIV is in the so-called "developing countries".  We higlight news and respurces which we feel can add particular value to development work.  Although it might not bespecifically HIV focused, the close relationship between HIV and other health issues and behaviours make the relevant.

Share this

How Billionaires Use Non-Profits to Bypass Governments and Force Their Agendas on Humanity. 29/2/2016

Published on Alternet

As wealth becomes concentrated in fewer hands, so does political and social power via foundations and non-profits.

Bill and Melinda Gates pictured in June 2009.
Photo Credit: Wikipedia As wealth becomes concentrated in fewer and fewer hands, the billionaire class is increasingly turning to foundations and non-profits to enact the change they would like to see in the world. Amid the rise of philanthrocapitalism, growing numbers of critics are raising serious questions about whether this outsized influence is doing more harm than good.

In the January issue of the New York Review of Books, veteran journalist Michael Massing noted that, in the past 15 years alone, “the number of foundations with a billion dollars or more in assets has doubled, to more than eighty.” The philanthropic sector in the United States is far more significant than in Europe, fueled in part by generous tax write-offs, which the U.S. public subsidizes to the tune of $40 billion a year.

As Massing observes, billionaires are not just handing over their money, they have ideas about how it should be used, and their vision often aligns with their own economic interests. For this reason, the philanthropy industry deserves rigorous scrutiny, not a free pass because it is in the service of good.

Massing’s argument followed a study released in January by the watchdog organization Global Policy Forum, which found that philanthropic foundations are so powerful they are allowing wealthy individuals to bypass governments and international bodies like the United Nations in pursuit of their own agendas. What’s more, this outsized influence is concentrated in the United States, where 19 out of the top 27 largest foundations are based. These 27 foundations together possess $360 billion, write authors Jens Martens and Karolin Seitz.

Such dramatic wealth accumulation has disturbing implications. "What is the impact of framing the problems and defining development solutions by applying the business logic of profit-making institutions to philanthropic activities, for instance by results-based management or the focus on technological quick-win solutions in the sectors of health and agriculture?" the report asks.

These questions are not new, as social movements have long raised the alarm about the global impact of the ever-expanding philanthropy sector. In 2010, the international peasant movement La Via Campesina blasted the Bill and Melinda Gates Foundation’s acquisition of Monsanto shares as proof that its role in privatizing the global food supply and exporting big agribusiness, from Africa to North America, should be viewed through a commercial rather than humanitarian lens.

“It is really shocking for the peasant organizations and social movements in Haiti to learn about the decision of the [Gates] Foundation to buy Monsanto shares while it is giving money for agricultural projects in Haiti that promote the company’s seed and agrochemicals,” said Chavannes Jean-Baptiste of the Haitian Peasant Movement of Papaye and Caribbean coordinator of La Via Campesina at the time. “The peasant organizations in Haiti want to denounce this policy which is against the interests of 80 percent of the Haitian population, and is against peasant agriculture—the base of Haiti’s food production.”

The Gates Foundation more recently fell under scrutiny from the advocacy organization Global Justice Now, which released a report in January raising concerns about the institution’s track record on education, food and health care policies.

“The Gates Foundation has rapidly become the most influential actor in the world of global health and agricultural policies, but there’s no oversight or accountability in how that influence is managed,” said Polly Jones of Global Justice Now. “This concentration of power and influence is even more problematic when you consider that the philanthropic vision of the Gates Foundation seems to be largely based on the values of corporate America. The foundation is relentlessly promoting big business-based initiatives such as industrial agriculture, private health care and education. But these are all potentially exacerbating the problems of poverty and lack of access to basic resources that the foundation is supposed to be alleviating.”

Facebook CEO Mark Zuckerberg and his wife, Priscilla Chan, raised eyebrowsin December when they announced they would give away 99 percent of their wealth. As it turned out, this was not a giveaway at all, but a shifting of funds into their own limited liability company (LLC). Just weeks later, Zuckerberg lashed out at Indian media justice advocates who raised concerns about his company’s efforts to undermine net neutrality protections in their country.

Like many others, Massing is calling for greater transparency, not only for foundations but for think tanks, Hollywood, Silicon Valley and universities. Pointing to the website Inside Philanthropy, whose stated purpose is to “pull back the curtain on one of the most powerful and dynamic forces shaping society,” Massing argues that far greater and better-resourced scrutiny is needed. “There remains the question of how to pay for all this,” writes Massing, posing: “Is there perhaps a consortium of donors out there willing to fund an operation that would part the curtains on its own world?”

But some argue that we already have all the information we need to be concerned. In December, Vandana Shiva, an ecofeminist and activist, wrote in response to Zuckerberg’s move in India that a “collective corporate assault is underway globally. Having lined up all their ducks, veterans of corporate America such as Bill Gates are being joined by the next wave of philanthro-corporate Imperialists, including Mark Zuckerberg.”

“It is an enclosure of the commons,” she continued, “which are ‘commons’ because they guarantee access to the commoner, whether it be seed, water, information or internet.”

Sarah Lazare is a staff writer for AlterNet. A former staff writer for Common Dreams, she coedited the book About Face: Military Resisters Turn Against War. Follow her on Twitter at @sarahlazare.

Share this

Minister Müller Presents New Strategy On Cooperation With Religious Communities. 22/02/2016

Published at bmz

17 February 2016


 

Berlin – At an international conference entitled "Partners for Change – Religions and the 2030 Agenda", Minister Gerd Müller will today present the first-ever strategy on the role of religion and faith communities in German development policy.

Minister Müller said, "Without the involvement of the world's religions, we will not be able to meet the challenges the world is facing. Especially in these times when religion is used as an argument to justify terrorism and violence, we need to improve cooperation with all religious communities. We must not leave the field clear for the extremists. Rather, we need to strengthen those who are working for peace and development."

The strategy Religious Communities as Partners for Development Cooperation is the outcome of a broad national and international dialogue which Minister Müller launched right after he assumed office. Together with civil society, religious communities and international organisations such as the United Nations and the World Bank, the BMZ drew up the strategy to serve as guidance in the future for systematically taking cooperation with religious communities into account in the BMZ's project work.

"A values-based development policy takes the contribution of religion seriously. Wherever we can achieve more by working together, we will increase our cooperation with religious actors. We have laid down clear criteria in our strategy to guide us in this endeavour," said Müller.

In order to give this effort a push at the international level, too, the BMZ founded the International Partnership on Religion and Sustainable Development (PaRD), a joint endeavour with other donors and international organisations, for example the US, the UK, Sweden, the United Nations and the World Bank. The purpose of this Partnership is to develop common ideas on how to improve cooperation with faith communities. The Partnership is also open to civil society organisations.

Taxonomy upgrade extras: 
Share this

Theories of Development. 22/10/2015

Published at Global Learning Programme


Theories of development

 
Share this

Launching The Updated Global Strategy for Women's, Children's and Adolescents’ Health. 29/09/2015

Published at UNAIDS

25 September 2015


 

If the newly adopted Sustainable Development Goals (SDGs) are to be achieved the needs of women, children and adolescents must be at the heart of the development agenda, said United Nations Secretary-General Ban Ki-moon as he launched a bold initiative at the 70th session of the UN General Assembly.

The updated Global Strategy for Women’s, Children’s and Adolescents’ Health is intended to ensure that the SDG commitment to accelerate progress in reducing newborn, child and maternal mortality becomes a reality for women, children and young people around the globe.

Launched on 26 September during the UN Sustainable Development Summit, the initiative builds on the Global Strategy for Women’s and Children’s Health, spearheaded by the Secretary-General in 2010, that blossomed into the Every Woman Every Child global movement. This movement has seen the galvanizing of political commitment, multi-stakeholder partnerships and action that has led to significant progress in reducing maternal and infant mortality. However, Ban Ki-moon told the gathering that efforts now need to step up a gear.

To ensure that the necessary resources are available, a major section of the high-level two-hour event involved the announcement of key strategic commitments from world leaders, multilateral organizations, CEOs from the private sector and other partners.

Young people also played a vital role, taking the floor to tell the gathering what they want and need over the next 15 years and what they commit to do to improve the health of their generation. Young people representing The PACT, a coalition of youth organisations supported by UNAIDS, as well as Restless Development and Y-PEER shared commitments to the updated Global Strategy to end all preventable maternal, child and adolescent deaths by 2030 and the end of the AIDS epidemic by 2030.

Introduced by UNAIDS Executive Director Michel Sidibé, Ishita Chaudhry spoke about the importance of governments committing to adolescents and to support young people to be agents of change to help ensure that mothers, children and adolescents everywhere survive and lead healthy lives.

 

Share this

United Nations Digital Ambassador Elyx Shares New Illustrations in Support of the Sustainable Development Goals. 29/09/2015

Published at United Nations

25 September 2015


Elyx, the United Nations’ digital ambassador, this weekend released a new series of illustrations designed to further explain the Sustainable Development Goals.

Created by French artist YAK, Elyx has no race, sex or nationality but is a universal character designed to promote important issues worldwide. In the 17 new images, Elyx uses various expressions and actions to help demonstrate what each of the Global Goals mean.

Despite currently being on a 70-day virtual trip around the world to celebrate the United Nations’ 70th anniversary, Elyx’s took time to show his support for the Gloal Goals, which were formally adopted by 193 Member States at the UN Sustainable Development Summit on Friday.

Share this

Global Goals? We're Getting There. 13/07/2015

Published at Blog Bread of the World
Written by Stefanie Casdorph


14906354151_4d2f97cc78_o

At the beginning of the new millennium, world leaders gathered at the United Nations to shape a broad vision to fight poverty and its many causes and effects. This vision turned into the Millennium Development Goals (MDGs), eight goals that pledged to the world to fight for the principles of human dignity, equality, equity, and to free the world from extreme poverty.

Bread for the World has long supported the MDGs as a way to help the world’s poor move out of a cycle of hunger and poverty.

The MDGs addressed the important issues of poverty, education, women’s empowerment, health, children’s well-being, and the environment.

The first MDG was to eradicate extreme poverty and hunger. This goal had three objectives:

  1. Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day.
  2. Achieve full and productive employment and decent work for all, including women and young people.
  3. Halve, between 1990 and 2015, the proportion of people who suffer from hunger.

The United Nation’s MDG Report 2015 findings show that the world has made significant strides in fighting poverty and hunger under these goals. Although poverty is far from eradicated, here are some examples of progress that has been made in the last 25 years, according to the report:

  • The number of people living in extreme poverty around the world has fallen by more than half, from 1.9 billion in 1990 to 836 million in 2015.
  • In developing regions, the proportion of people living on less than $1.25 a day fell from 47 percent in 1990 to 22 percent in 2010, five years ahead of schedule.
  • The proportion of undernourished people in developing countries has fallen by almost half, from 23.3 percent in 1990 to 12.9 percent in 2015.
  • The number of undernourished people in developing countries has fallen by 216 million since 1990.
  • The proportion of children under five who are underweight has been cut almost in half between 1990 and 2015. One in four children under five worldwide have stunted growth, but stunting - defined as inadequate height for age - is declining.

These goals have helped the world achieve so much. Millions of people around the world are escaping hunger and poverty. However, even after making such great strides, there are still over 795 million people going hungry.

The world has the tools and the knowledge to eradicate hunger. Using the momentum and progress generated by the MDGs, the U.N. is working with governments, civil society, and other partners on an ambitious task in creating a long-term sustainable agenda – the Sustainable Development Goals.

These new goals will replace the MDGs this September with an end goal of ending extreme poverty by 2030.

Share this

Sustainable Development Goals: All You Need to Know

 The Guardian

The countdown has begun to September’s summit on the sustainable development goals, with national governments now discussing the 17 goals that could transform the world by 2030

What are the sustainable development goals?

 (SDGs) are a new, universal set of goals, targets and indicators that UN member states will be expected to use to frame their agendas and political policies over the next 15 years.millennium development goals (MDGs), which were agreed by governments in 2000, and are due to expire at the end of this year.

Why do we need another set of goals?

There is broad agreement that while the MDGs provided a focal point for governments on which to hinge their policies and overseas aid programmes to end poverty and improve the lives of poor people – as well as provide a rallying point for NGOs to hold them to account – they have been criticised for being too narrow.

The eight MDGs – reduce poverty and hunger; achieve universal education; promote gender equality; reduce child and maternal deaths; combat HIV, malaria and other diseases; ensure environmental sustainability; develop global partnerships – failed to consider the root causes of poverty, or gender inequality, or the holistic nature of development. The goals made no mention of human rights, nor specifically addressed economic development. While the MDGs, in theory, applied to all countries, in reality, they were considered targets for poor countries to achieve, with finance from wealthy states. Every country will be expected to work towards achieving the SDGs.

As the MDG deadline approaches, around 1 billion people still live on less then $1.25 a day - the World Bank measure on poverty - and more than 800 million people do not have enough food to eat. Women are still fighting hard for their rights, and millions of women still die in childbirth.

What are the proposed 17 goals?

1)End poverty in all its forms everywhere 

2) End hunger, achieve food security and improved nutrition, and promote sustainable agriculture 

3) Ensure healthy lives and promote wellbeing for all at all ages 

4) Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all 

5) Achieve gender equality and empower all women and girls 

6) Ensure availability and sustainable management of water and sanitation for all 

7) Ensure access to affordable, reliable, sustainable and modern energy for all 

8) Promote sustained, inclusive and sustainable economic growth, full and productive employment, and decent work for all 

9) Build resilient infrastructure, promote inclusive and sustainable industrialisation, and foster innovation 

10) Reduce inequality within and among countries 

11) Make cities and human settlements inclusive, safe, resilient and sustainable 

12) Ensure sustainable consumption and production patterns 

13) Take urgent action to combat climate change and its impacts (taking note of agreements made by the UNFCCC forum)

14) Conserve and sustainably use the oceans, seas and marine resources for sustainable developmen

15) Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification and halt and reverse land degradation, and halt biodiversity loss 

16) Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels 

17) Strengthen the means of implementation and revitalise the global partnership for sustainable development

Within the goals are a proposed 169 targets, to put a bit of meat on the bones. Proposed targets under goal one, for example, include reducing by at least half the number of people living in poverty by 2030, and eradicating extreme poverty (people living on less than $1.25 a day). Under goal five, there’s a proposed target on eliminating violence against women. Under goal 16 sits a target to promote the rule of law and equal access to justice.

How were the goals chosen?

Unlike the MDGs, which were drawn up by a group of men in the basement of UN headquarters (or so the legend goes), the UN has conducted the largest consultation programme in its history to gauge opinion on what the SDGs should include.

Establishing post-2015 goals was an outcome of the  in 2012, which mandated the creation of an open working group to come up with a draft set.

The open working group, with representatives from 70 countries, had its first meeting in March 2013 and published its final draft, with its 17 suggestions, in July 2014. The draft was presented to the UN general assembly in September.

Alongside the open working group, the UN conducted a series of “global conversations”, which included 11 thematic and 83 national consultations, and door-to-door surveys. It also launched an online  asking people to prioritise the areas they’d like to see addressed in the goals. The results of the consultations should have fed into the the working group’s discussions.

Are governments happy about the proposed 17 goals?

The majority seem to be, but a handful of member states, including the UK and Japan, aren’t so keen. Some countries feel that 17 goals are too unwieldy to implement or sell to the public and would like a narrower brief. Or so they say. Some believe the underlying reason is to get rid of some of the more uncomfortable goals, such as those relating to the environment. Britain’s prime minister, David Cameron, has publicly said he wants 12 goals at the most, preferably 10. It’s not clear, though, which goals the UK government would like taken out if they had the choice.

Some NGOs also believe there are too many goals, but there is a general consensus that it’s better to have 17 goals that include targets on women’s empowerment, good governance, and peace and security, for example, than fewer goals that don’t address these issues.

Is the number of goals expected to change? Those who have been involved in the process say no, although they do expect fewer targets. Many of the proposed targets are more political statement than measurable achievement at the moment.

In his synthesis report on the SDGs in December, UN secretary general Ban Ki-moon gave no hint that he would like to see the number of goals reduced. In a bid to help governments to frame the goals, Ban clustered them into six “essential elements”: dignity, prosperity, justice, partnership, planet, people.

Amina Mohammed, the UN secretary general’s special adviser on post-2015 development planning, said it had been a hard fight to get the number of goals down to 17, so there would be strong resistance to reduce them further.

Member states will begin formal discussions on the content of the SDGs on 19 January, and are expected to meet each month until September. Any serious faultlines should be evident over the next three to four months.

How will the goals be funded?

That’s the trillion-dollar question. Rough calculations from the intergovernmental committee of experts on sustainable development financinghave put the cost of providing a social safety net to eradicate extreme poverty at about $66bn a year, while annual investments in improving infrastructure (water, agriculture, transport, power) could be up to a total of $7tn globally.

In its report last year, the committee said public finance and aid would be central to support the implementation of the SDGs. But it insisted that money generated from the private sector, through tax reforms, and through a crackdown on illicit financial flows and corruption was also vital.

A major conference on financing for SDGs will be held in Addis Ababa, Ethiopia, in July, where it is hoped that concrete financing will be agreed. 

When will the new goals come into force?

If member states agree the draft set of 17 SDGs at a UN summit in New York in September, they will become applicable from January 2016. The expected deadline for the SDGs is 2030.

Share this

The Best Way to Beat AIDS Isn't Drug Treatment. It's a Living Wage.

Published at NewRepublic
Written by Alejandro Varela


In a report marking World Aids Day on Dec. 1, the advocacy organization ONE announced that we are reaching “the beginning of the end” of the disease: For the first time, “the world added more people last year to life-saving AIDS treatment than the number of people who became newly infected with HIV in the same year.”

But of the 1.2 million Americans living with HIV only 37 percent are taking medications, and 1 in 7 are unaware that they are HIV positive, according to the Centers for Disease Control. With new infections in the U.S. hovering around 50,000 per year, the end is still a long ways off.

To get there, some policymakers are turning to a pill: New York Governor Andrew Cuomo is betting that the recently introduced pre-exposure prophylaxis (PrEP), Truvada, will help to drastically reduce HIV by 2020. The drug’s effectiveness (it’s been shown to successfully thwart virus replication in HIV negative people) and its accessibility (the governor rightfully negotiated down its cost with the pharmaceutical companies that corner the anti-HIV drug market) make it the linchpin of New York’s newest HIV initiative. Cuomo hopes PrEP will, within five years, help to reduce the annual number of new HIV cases below the number of annual deaths caused by AIDS.

But treatment can also lead to complacency and, ultimately, more pills. Cuomo’s laudable plan, the first in the nation to set the stage for HIV eradication, risks failure, if it doesn’t also address HIV’s most virulent precursor, catalyst, and enabler: Poverty.

As it happens, the maps of poverty in the United Stateswhere officially 14.5 percent of the population is poor and another 5 percent are nearly pooroverlay quite seamlessly onto the maps of HIV. That should come as no surprise to anyone who studies or treats chronic conditions, most of whichdiabetes, heart disease, kidney disease, etc.correlate with poverty.

Not only does poverty prevent us from accessing the stuff of life that buffers us from poor health, it also creates hospitable environments for disease. People living at or near poverty have greater levels of stress hormones, like cortisol, running through their bodies. And stress has a direct effect on each of the ten leading causes of death in the United States.

This isn’t the “good” stress that saves us from dangerous situations (“fight or flight”) or even the “medium” stress that causes panic before public speaking, as a work deadline looms, or on the way to the birth of your first child. The stress of poverty is a chronic stress that kills by hastening the wear and tear of processes and organs that are necessary for our survival. In fact, chronic stress is akin to untreated HIV: it assaults the immune system and quickens the transition to AIDS.

Poverty doesn’t only manifest internally. People struggling to make ends meet are more likely to be perpetrators of violence and to be its victims. They are more likely to drown their sorrows and to inject drugs. They are more likely to fall into homelessness. They are less likely to have healthy nutrition options. And they are also less likely to access and adhere to prevention or treatment regimens for all of their ailments, not just HIV.

The situation may get worse before it gets better. Research recently found that countries in recession and with growing income inequality experienced jumps in HIV incidence. It isn’t only our elevated poverty levels that put us at risk. A comparison of 141 countries ranks the United States 100th in income equality. Lesotho, which has an adult HIV prevalence of 23 percent, is in last place. The country with the most equal distribution of income is Sweden; its HIV prevalence is 0.2 percent.

Being poor is a more accurate predictor of HIV than being male, female, Black or Hispanic is. A 2010 study of poor urban areas found that race and gender were not significant predictors of HIV prevalence. Why then are our proposed solutions for a problem with economic roots overwhelmingly clinical?

Cuomo and our other leaders would do well to focus on progressive fiscal policies such as a living wage, universal health care, and a basic income. These measures would lift Americans out of poverty, save money on health costs, and, most importantly, save lives.

It won’t be easy. Even with popular support, these economic policies continue to be controversial in the halls of power. But this World AIDS Day is as good a time as any to remember that controversial interventionscondoms, disclosure, and needle exchangehave been some of the most successful in the battle against HIV.

It’s because we discriminate that HIV doesn’t have to. It just picks off the poor, disenfranchised, disempowered, and otherwise oppressed members of our society. Reducing poverty will give millions of people more room to breathe, to arrive at informed conclusions, and to make the decisions that will ultimately eradicate HIV and, in the process, ease the entire disease burden on society.

The alternative is the status quo: a long road paved with well-intentioned but inefficient, piecemeal plans and initiatives.

Share this

UNAIDS announces that the goal of 15 million people on life-saving HIV treatment by 2015 has been met nine months ahead of schedule. 17/07/15

Published by UNAIDS
14 July 2015


 The world has exceeded the AIDS targets of Millennium Development Goal (MDG) 6 and is on track to end the AIDS epidemic by 2030 as part of the Sustainable Development Goals (SDGs).

ADDIS ABABA/GENEVA, 14 July 2015—The AIDS targets of MDG 6—halting and reversing the spread of HIV—have been achieved and exceeded, according to a new report released today by the Joint United Nations Programme on HIV/AIDS (UNAIDS). New HIV infections have fallen by 35% and AIDS-related deaths by 41%. The global response to HIV has averted 30 million new HIV infections and nearly 8 million (7.8 million) AIDS-related deaths since 2000, when the MDGs were set.

“The world has delivered on halting and reversing the AIDS epidemic,” said Ban Ki-moon, Secretary-General of the United Nations. “Now we must commit to ending the AIDS epidemic as part of the Sustainable Development Goals.”

Released in Addis Ababa, Ethiopia, on the sidelines of the Third International Conference on Financing for Development, the report demonstrates that the response to HIV has been one of the smartest investments in global health and development, generating measurable results for people and economies. It also shows that the world is on track to meet the investment target of US$ 22 billion for the AIDS response by 2015 and that concerted action over the next five years can end the AIDS epidemic by 2030.

“Fifteen years ago there was a conspiracy of silence. AIDS was a disease of the “others” and treatment was for the rich and not for the poor,” said Michel Sidibé, Executive Director of UNAIDS. “We proved them wrong, and today we have 15 million people on treatment—15 million success stories.”

How AIDS changed everything—MDG 6: 15 years, 15 lesson of hope from the AIDS response celebrates the milestone achievement of 15 million people on antiretroviral treatment—an accomplishment deemed impossible when the MDGs were established 15 years ago. It also looks at the incredible impact the AIDS response has had on people’s lives and livelihoods, on families, communities and economies, as well as the remarkable influence the AIDS response has had on many of the other MDGs. The report includes specific lessons to take forward into the SDGs, as well as the urgent need to front-load investments and streamline programmes for a five-year sprint to set the world on an irreversible path to end the AIDS epidemic by 2030.

Achieving MDG 6: halting and reversing the spread of HIV

In 2000, the world was witnessing an extraordinary number of new HIV infections. Every day, 8500 people were becoming newly infected with the virus and 4300 people were dying of AIDS-related illnesses. How AIDS changed everything describes how, against all odds, huge rises in new HIV infections and AIDS-related deaths were halted and reversed.

New HIV infections

In 2000, AIDS began to be taken seriously. Far-sighted global leadership rallied, and the response that ensued made history. Between 2000 and 2014, new HIV infections dropped from 3.1 million to 2 million, a reduction of 35%. Had the world stood back to watch the epidemic unfold, the annual number of new HIV infections is likely to have risen to around 6 million by 2014.

In 2014, the report shows that 83 countries, which account for 83% of all people living with HIV, have halted or reversed their epidemics, including countries with major epidemics, such as India, Kenya, Mozambique, South Africa and Zimbabwe.

“As a mother living with HIV I did everything in my capacity to ensure my children were born HIV-free, said Abiyot Godana, Case Manager at the Entoto Health Center. “My husband has grabbed my vision of ending AIDS and together we won’t let go of this hope. Our two children are a part of an AIDS-free generation and will continue our legacy.” Ethiopia has made significant progress in preventing new HIV infections among children. In 2000, around 36 000 children became infected with HIV. However, by 2014 that number had dropped by 87%, to 4800, as coverage of antiretroviral therapy to prevent new HIV infections among children increased to 73%.

Stopping new HIV infections among children has been one of the most remarkable successes in the AIDS response. In 2000, around 520 000 children became newly infected with HIV. In the absence of antiretroviral therapy, children were dying in large numbers. This injustice prompted the world to act—ensuring that pregnant women living with HIV had access to medicines to prevent their children from becoming infected with the virus became a top global priority.

The unprecedented action that followed achieved results. Between 2000 and 2014, the percentage of pregnant women living with HIV with access to antiretroviral therapy rose to 73% and new HIV infections among children dropped by 58%.

By 2014, UNAIDS estimates that 85 countries had less than 50 new HIV infections among children per year, and in 2015 Cuba became the first country to be certified by the World Health Organization as having eliminated new HIV infections among children.

AIDS-related deaths

The second, critical measure for determining the success of MDG 6 is progress in halting and reversing the number of AIDS-related deaths. In 2000, AIDS was a death sentence. People who became infected with HIV had just a few years to live and the vast majority of children born with the virus died before they reached their fifth birthday.

Against incredible odds, the pace of antiretroviral therapy scale-up increased, ensuring more people remained alive and well. By 2005, AIDS-related deaths began to reverse, falling by 41% from 2005 to 2014.

Making the impossible, possible—15 million people on HIV treatment

Ensuring access to antiretroviral therapy for 15 million people is an achievement deemed impossible 15 years ago. In 2000, fewer than 1% of people living with HIV in low- and middle-income countries had access to treatment, as the sky-high prices of medicines—around US$ 10 000 per person per year—put them out of reach. The inequity of access and injustice sparked global moral outrage, which created one of the most defining achievements of the response to HIV—massive reductions in the price of life-saving antiretroviral medicines.

By 2014, advocacy, activism, science, political will and a willingness by the pharmaceutical companies has brought the price of medicines for HIV down by 99%, to around US$ 100 per person per year for first-line formulations.

In 2014, 40% of all people living with HIV had access to antiretroviral therapy, a 22-fold increase over the past 14 years. In sub-Saharan Africa, 10.7 million people had access, 6.5 million (61%) of whom were women. Ensuring treatment for 15 million people around the world proves beyond a doubt that treatment can be scaled up even in resource-poor settings.

As access to treatment increased, the world raised the bar and has repeatedly set ambitious targets, culminating in today’s call of ensuring access to treatment for all 36.9 million people living with HIV.

Progress in ensuring access to HIV treatment has, however, been slower for children than for adults. As of 2014, only 32% of the 2.6 million children living with HIV had been diagnosed and only 32% of children living with HIV had access to antiretroviral therapy.

While the price of first-line medicines has reduced significantly, the prices of second and new generation medicines are still much too high and need to be urgently negotiated down.

Knowledge ensures access

How AIDS changed everything includes exciting new information about access to treatment once people know their HIV status. Some 75% of people who know they have the virus are accessing antiretroviral therapy, showing that the majority of people do come forward for treatment and have access once they are diagnosed with HIV.

This emphasizes the urgent need to scale up HIV testing. In 2014, only 54% (19.8 million) of the 36.9 million people who are living with HIV knew that they are living with the virus.

An investment, not a cost

How AIDS changed everything shows how the economic impact is one of the greatest achievements of the response to HIV and one that will continue to yield results in years to come.

“The world went from millions to billions and each dollar invested today is producing a US$ 17 return,” said Mr Sidibé. “If we frontload investments and Fast-Track our efforts over the next five years, we will end the AIDS epidemic by 2030.”

Since 2000, an estimated US$ 187 billion has been invested in the AIDS response, US$ 90 billion of which came from domestic sources. By 2014, around 57% of AIDS investments came from domestic sources and 50 countries invested more than 75% of their responses from their own budgets—a big success for country ownership.

The United States of America has invested more than US$ 59 billion in the AIDS response and is the largest international contributor. The Global Fund to Fight AIDS, Tuberculosis and Malaria invests nearly US$ 4 billion each year towards AIDS programmes and has disbursed more than US$ 15.7 billion since its creation in 2002.

The report also shows that the next five years will be critical. Front-loading investments in the fragile five-year window up to 2020 could reduce new HIV infections by 89% and AIDS-related deaths by 81% by 2030.

Current investments in the AIDS response are around US$ 22 billion a year. That would need to be increased by US$ 8–12 billion a year in order to meet the Fast-Track Target of US$ 31.9 billion in 2020. By meeting the 2020 target, the need for resources would begin to permanently decline, reducing to US$ 29.3 billion in 2030 and far less in the future. This would produce benefits of more than US$ 3.2 trillion that extend well beyond 2030.

The report underscores that international assistance, especially for low-income and low-middle-income countries, will be necessary in the short term before sustainable financing can be secured in the long term. Sub-Saharan Africa will require the largest share of global AIDS financing: US$ 15.8 billion in 2020.

Countries that took charge have produced results

Countries that rapidly mounted robust responses to their epidemics saw impressive results. In 1980, life expectancy in Zimbabwe was around 60 years of age. In 2000, when the MDGs were set, life expectancy had dropped to just 44 years of age, largely owing to the impact of the AIDS epidemic. By 2013, however, life expectancy had risen again to 60 years of age as new HIV infections were reduced and access to antiretroviral treatment expanded.

Ethiopia has been particularly affected by the AIDS response, with 73 000 people dying of AIDS-related illnesses in 2000. Concerted efforts by the Ethiopian government have secured a drop of 71% in AIDS-related deaths between the peak in 2005 and 2014.

In Senegal, one of the earliest success stories of the global AIDS response, new HIV infections have declined by more than 87% since 2000. Similarly, Thailand, another success story, has reduced new HIV infections by 71% and AIDS-related deaths by 64%.

South Africa turned around its decline in life expectancy within 10 years, rising from 51 years in 2005 to 61 by the end of 2014, on the back a massive increase in access to antiretroviral therapy. South Africa has the largest HIV treatment programme in the world, with more than 3.1 million people on antiretroviral therapy, funded almost entirely from domestic sources. In the last five years alone, AIDS-related deaths have declined by 58% in South Africa.

Leaving no one behind

Much progress has been made in expanding HIV prevention services for key populations, even though significant gaps remain. Although more than 100 countries criminalize some form of sex work, sex workers continue to report the highest levels of condom use in the world—more than 80% in most regions.

Drug use remains criminalized in most countries, yet many do allow access to needle–syringe programmes and opioid substitution therapy. In 2014, HIV prevalence appears to have declined among people who inject drugs in almost all regions.

However, new HIV infections are rising among men who have sex with men, notably in western Europe and North America, where major declines were previously experienced. This indicates that HIV prevention efforts need to be adapted to respond to the new realities and needs of men who have sex with men.

The number of adult men who have opted for voluntary medical male circumcision to prevent HIV transmission continues to increase. From 2008 to December 2014, about 9.1 million men in 14 priority countries opted to be circumcised. In 2014 alone, 3.2 million men in 14 priority countries were circumcised. Ethiopia and Kenya have both already exceeded their target of 80% coverage.

Tuberculosis (TB) remains a leading cause of death among people living with HIV, accounting for one in five AIDS-related deaths globally. However, between 2004 and 2014, TB deaths declined by 33% thanks to the rapid increase in antiretroviral treatment, which reduces the risk that a person living with HIV will develop TB by 65%.

Some 74 countries reported having laws in place prohibiting discrimination against people living with HIV. However, at present, 61 countries have legislation that allows for the criminalization of HIV non-disclosure, exposure or transmission. In 76 countries, same-sex sexual practices are criminalized. In seven countries they are punishable by death.

Transgender people are not recognized as a separate gender in most countries and are generally absent from public policy formulation and social protection programmes. The world remains far short of achieving its goal of eliminating gender inequalities and gender-based violence and abuse.

Better data

Countries have invested heavily in monitoring and evaluating their responses to HIV. In 2014, 92% of United Nations Member States reported HIV data to UNAIDS. State-of-the-art epidemic monitoring, data collection and reporting have made HIV data the most robust in the world, far more complete than data for any other disease. This has not only enabled the world to have a clear picture of HIV trends, it has also enabled HIV programming to be tailored to the specific dynamics of each country’s epidemic.

Together with How AIDS changed everything, UNAIDS is launching its new data visualization feature AIDSinfo. This innovative visualization tool allows users to view global, regional and national data on HIV through easy-to-use maps, graphs and tables adapted for all devices.

How AIDS changed everything

The UNAIDS book gives a vivid and insightful description of the impact the AIDS response has had on global health and development over the past 15 years and of the incredible importance of the lessons learned for ensuring the success of the SDGs.

How AIDS changed everything—MDG 6: 15 years, 15 lesson of hope from the AIDS response is both a look back on the journey of the last 15 years and a look forward to the future of the AIDS response and the path to ending the AIDS epidemic by 2030.

The flagship publication from UNAIDS was released at a community event at Zewditu Hospital in Addis Ababa, Ethiopia, on 14 July 2015 by United Nations Secretary-General Ban Ki-moon, Minister of Health, Kesetebirhan Admassu of the  Federal Democratic Republic of Ethiopia, Executive Director of UNAIDS Michel Sidibé and Abiyot Godana, Case Manager at the Entoto Health Center.

2014/2015* GLOBAL STATISTICS

            15 million* people accessing antiretroviral therapy (March 2015)

            36.9 million [34.3 million–41.4 million] people globally were living with HIV

            2 million [1.9 million–2.2 million] people became newly infected with HIV

            1.2 million [1 million–1.5 million] people died from AIDS-related illnesses

THE STORY CONTINUES AT THE WHITETABLEGALLERY.ORG

Share this

UNAIDS and the World Bank Group Endorse Action Points to Address Extreme Poverty and AIDS - 21 Jan 2014

GENEVA/WASHINGTON, 15 January 2014— During a high-level meeting and discussions in Washington last week, UNAIDS and the World Bank Group endorsed four areas of action to accelerate efforts that address the interrelated challenges of AIDS, inequality and extreme poverty.

UNAIDS and the World Bank Group have committed to work closely with UNDP and other international partners, to address the social and structural drivers of the HIV epidemic that put people at greater risk of HIV and deny them access to services. These social and structural drivers include gender inequality, stigma and discrimination, lack of access to education and unstable livelihoods. UNAIDS and the World Bank Group will advocate for:

  1. Aligning health and development efforts around country-led time-bound goals towards ending extreme poverty and AIDS, with special attention to the inclusion of the poorest and most marginalized populations. Areas of focus will include: supporting countries to adopt progressive legal systems that remove discriminatory laws, especially among populations most vulnerable to HIV infection; increasing access to income, adequate housing and safe working conditions; and accelerating reforms towards universal health coverage and universal access to HIV services and commodities.
  2. Urging the post-2015 development agenda to include targets towards ending AIDS alongside the goal of universal health coverage, so that no one falls into poverty or is kept in poverty due to payment for AIDS treatment or health care.
  3. Promoting national and global monitoring and implementation research. Actions will include: working closely with global partners and countries to innovate and monitor service delivery, including for HIV, especially to the poorest and the most marginalized; and intensify implementation research to capture and codify innovative approaches to address the linkages between efforts towards ending extreme poverty and ending AIDS. As part of this effort, the World Bank Group will launch a major new trial to better understand how social protection systems reduce HIV infection, particularly among young women in the highest burden hyper-endemic countries.
  4. Convening two high-level meetings in 2014 with national policy leaders and experts on ending AIDS and extreme poverty. The first meeting will be convened in Southern Africa to share current research and discuss how it can be translated into practice. The second meeting will be held during the International AIDS Conference in July 2014 in Melbourne.

Despite unprecedented progress over the past decade in the global response to HIV, economic inequality, social marginalization and other structural factors have continued to fuel the HIV epidemic. The epidemic continues to undermine efforts to reduce poverty and marginalization. HIV deepens poverty, exacerbates social and economic inequalities, diminishes opportunities for economic and social advancement and causes profound human hardship.

“Ending the AIDS epidemic and extreme poverty is within our power,” said Michel Sidibé, Executive Director, UNAIDS. “Our combined efforts will contribute to a global movement working to ensure that every person can realize their right to quality healthcare and live free from poverty and discrimination.”

“Just as money alone is insufficient to end poverty, science is powerless to defeat AIDS unless we tackle the underlying social and structural factors,” said Jim Yong Kim, President of the World Bank Group. “To end both AIDS and poverty, we need sustained political will, social activism, and an unwavering commitment to equity and social justice.”

“Stigma, discrimination and marginalization stand in the way of fully realizing the promise of HIV prevention and treatment technologies,” said Helen Clark, UNDP Administrator. “We know that where laws and policies enable people affected by HIV to participate with dignity in daily life without fearing discrimination, they are more likely to seek prevention, care and support services.”

Improving health services and outcomes is critical to ending extreme poverty and boosting shared prosperity. The recent Lancet Commission on Investing in Health estimated that up to 24% of economic growth in low- and middle-income countries was due to better health outcomes. The payoffs are immense: the Commission concluded that investing in health yields a 9 to 20-fold return on investment.

Investing in health also means investing in equity. Essential elements of a human rights-based response to HIV include: enabling laws, policies and initiatives that protect and promote access to effective health and social services, including access to secure housing, adequate nutrition and other essential services. Such measures can help protect people affected by HIV from stigma, discrimination, violence and economic vulnerability. HIV-sensitive social protection is already a key component of the UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.

“Pills on a shelf do not save lives,” said Sveta Moroz of the Union of Women of Ukraine Affected by HIV. “To end the AIDS epidemic for everyone will require a people-centered approach driven by the community and based on social justice. It demands an approach that ensures basic human rights to safe housing, access to healthcare, food security and economic opportunity. These are rights that actively remove barriers to real people’s engagement in effective HIV prevention and care.”

UNAIDS and the World Bank Group will work to ensure that these efforts feature prominently in the post-2015 global development agenda, and are integral elements in ending AIDS, achieving universal health coverage, ending extreme poverty and inequality and building shared prosperity.

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 to maximize results for the AIDS response. Learn more at unaids.org and connect with us on Facebook and Twitter.

World Bank Group

The World Bank Group is a vital source of financial and technical assistance to developing countries around the world, with the goals of ending extreme poverty and boosting shared prosperity. Improving health is integral to achieving these goals. The World Bank Group provides financing, state-of-the-art analysis, and policy advice to help countries expand access to quality, affordable healthcare; protect people from falling into poverty or worsening poverty due to illness; and promote investments in all sectors that form the foundation of healthy societies. Learn more at www.worldbank.org/health and connect with us: @worldbankhealth.

Share this

Africa: Activists Fear Less Focus On HIV After 2015 - 02/04/2013

As a UN high-level panel completes worldwide consultations to pick development goals for 2015 and beyond, PlusNews consulted experts to see how HIV/AIDS might fit into this new agenda.

SAFAIDS

The UN Secretary General's Special Envoy for AIDS in Asia and the Pacific, Prasada Rao, told IRIN countries have generally done well on Millennium Development Goal (MDG) 6, which seeks to stop new HIV infections by 2015. Twenty-two of the 33 countries that have seen a drop in HIV incidences from 2001-2010 are in sub-Saharan Africa, the hardest-hit region. New HIV infections have been halved from their levels a decade ago, but the goal needs to be carried forward, said Rao. "We can't just drop it here. We need to go the full length."

When the MDG goals were presented in 2000 - along with a 2015 deadline to meet them - the idea of an AIDS-free world invited incredulity, said the envoy. But prevention and treatment gains in recent years changed perceptions, he added. "It is no longer [just] an aspiration, but an achievable [goal]... The time has come when we really need to look at this concept of ending AIDS and how to position it in the post-2015 agenda."

Since August 2012, the UN has held 83 national consultations on creating goals for 2015-2030. For health-related goals, a draft report has been prepared for the 27-member high-level panel. The draft is based on months of moderated debates, web-based consultations, e-surveys, e-discussions and face-to-face meetings with civil society groups, governments, researchers as well as more than 100 position papers.

Focus moving away from HIV?

The 28 February draft includes calls for HIV to be included in the new goals, but also suggestions to move beyond disease-specific goals (an "overly narrow, target-driven approach" according to the UK NGO Health Poverty Action) to address health equity, non-communicable disease and weak health systems.

During the consultations, there were already signs that HIV might lose attention, the International Council of AIDS Service Organizations (ICASO) wrote in a December 2012 release: "There are rumblings that the post-2015 health agenda will focus on cancer, diabetes, heart disease and other less politicized afflictions. HIV is no longer seen as a crisis; ironically the AIDS response is being dealt a blow by its own success."

ICASO, along with Stop AIDS Alliance and International Civil Society Support, hosted an online survey, webinars and a January meeting in Amsterdam for HIV, tuberculosis and malaria advocates.

The health draft report currently reads: "Pulling back from these goals now would waste the profitable investments made to date. Ending preventable child and maternal deaths, and ending the epidemics of HIV, tuberculosis and malaria should be reaffirmed as global priorities."

The Bill & Melinda Gates Foundation has cautioned against "an overarching health goal that covers such a long list of issues that is it impossible to set any priority" while Stop AIDS Alliance called for "approaches that place human rights and equity at the centre [and] move away from the top-down thinking that characterized the MDGs".

Clarity needed

At a meeting on health in the post-2015 agenda, held in Botswana earlier this month, participants lauded gains facilitated by MDGs - increased funding and attention to global health, for one - but also noted how these goals led to "fragmented approaches to development".

For Asia's AIDS envoy, Rao, goals have to be demystified to attract supporters, including parliamentarians, to fight HIV. "Otherwise, it looks very exotic. What do you mean by an AIDS-free generation? One of the [slogans] we used at UNAIDS was 'End AIDS', but what do you mean by 'End AIDS'? You need to translate that into clearly actionable strategies and programmes. What needs to be done in the next 10 years to end AIDS?"

For him, those steps are: reduce new HIV infections to negligible levels, with elimination targets; provide antiretroviral (ARV) treatment to at least 80 percent of those who need it; and change laws, or their enforcement, that have blocked access to HIV prevention and treatment services.

One target of MDG 6 is to provide ARVs to all in need by 2010; this target is still unmet. According to the 2012 MDG Progress Report, from 2008-2010, about 1.3 million new people were enrolled and retained on ARVs. At this rate, less than 14 million people will be receiving treatment at the end of 2015, over one million short of the 15 million target, the report calculated.

The post-2015 panel is expected to present its recommendations to the UN Secretary-General this June.

[ This report does not necessarily reflect the views of the United Nations. ]

Share this

Game On: It’s Time To Stop Looking at Development Issues as a Matter of Emergency 06/02/2013

The short game: HIV and food security  by Clement N. Dlamini

Community development in Sub-Sahara Africa has been clouded by the emergency response mentality, which was exhibited in the knee jerk reaction of many countries in the initial response to the HIV pandemic. This has resulted in governments and community leaders concentrating all their efforts on combating the disease’s impact rather than designing strategic interventions that will close the tap of new infections.

Efforts to combat the spread of HIV have proved very difficult because of this ‘emergency response’ mentality. Behavior change interventions, such as the reduction of multiple concurrent sexual partners, zero grazing, and safe sex practices, have failed because they were not informed by the recipients; instead the service providers used the top-down approach to dealing with individuals, communities and organizations. The common practice is that these interventions are designed for communities and communities end up just being consumers. Yet we all know that if communities don’t participate in the creating change, then we might as well forget about changing their behavior. 

HIV programming is just once example, but we have seen this type of response also evident in our development agenda, where donors and governments have a tendency of responding to development issues as a matter of emergency. I am not against emergency response because during disasters, emergency response can save a lot of lives that would otherwise be lost if there would not be any type of assistance in place. In Swaziland, for example, we suffered drought in the nineties, in 2001, and in 2005.  Yet through research I’ve found that there are still some pockets of the country that continue to receive food aid in 2012. Our response to food security is still an emergency response, in spite of the number of times the country has gone around the same mountain. The question I ask myself is what would happen if we could invest in disaster preparedness, which will require governments to leverage development partners’ technical support to develop strategies that will prepare communities and countries to be ready?

A good example would be the case of cereal yields in Sub-Sahara Africa that have stagnated for almost five decades between the period of 1961 to 2010.[1] During this same time, Asia and South America have experienced an increase. This doesn’t correspond to the poverty levels in this region and the food aid we are receiving from development partners. This is where the question arises—if we have had continued high levels of poverty, unemployment, HIV prevalence rates, why do we continue to treat these issues as emergency response issues?

From where I stand, I believe Sub-Sahara Africa needs a strategic response to development. I have heard some of my colleagues argue that Africa doesn’t have the same technical skills as compared to the other continents. But five decades is too long for Africa to still be struggling with such, considering the amounts invested in education. Why haven’t we learned from these calamitous experiences?

The long game: People-driven development

One reason may be that a people-driven strategic response to development remains a low priority among governments and donors. While communities may not have the technical expertise in economic development, they make it up in social capital. This is the extent to which members of a community can work together effectively to develop and sustain strong relationships; solve problems; make group decisions; and collaborate effectively to plan, set goals and get things done. Unlike other forms of community capital, social capital does not get used up, and in fact, the more it is used, the more of it is generated. That is the reason communities—whether dealing with HIV, poverty, unemployment or marginalization—have the power to become what they have always dreamed.

A people-driven approach that leverages social capital, however, requires “meaningful” participation. Developing a project in my office and then sending it down to the community for endorsement and approval doesn’t qualify. What we continue to see is a form of tokenism and or manipulation, where community consultation is disguised in two forms. The first is through a community elected “representative” who holds no real power and has no input except being present. The second is where incentives are given as a means to foster “participation,” usually involving tasks being assigned and outsiders have the power of decision and direction of processes. In both cases, there is no devolution of power, nor transparency and clarity of processes for the people. In these cases, it’s not development, nor is it people-driven.

In my years as a development practitioner I have seen that a participatory rural approach has a higher likelihood of sustainability than any top-down driven initiative. Once development becomes an imported concept that is externally driven, then it will never be sustainable since it will not be owned by the people.

Less game, more teamwork

Without sounding ungrateful, one wonders if aid agencies or donors can be effective in Sub-Saharan Africa’s course towards sustainable development. Some international NGOs have initiated water projects, cooperative schemes, and other forms of income generating activities responding to community needs as they perceive them, and have not made their lives better off. How does this occur?

What started in Swaziland as emergency relief food aid has become an annual event. Communities, even if they have received good rains and farm inputs, etc., still will not plough their fields nor even make an attempt to food production. The aid has created such a dependency syndrome that Swaziland will be left to address, not the donors when they inevitably leave.

One doesn’t want to believe the “myth” that donor agencies have another agenda besides helping those who are poor and living in the margins of society. But I can understand how people wonder if the aid we see is not pegged to vested interests. Any aid approach that doesn’t integrate the voices of those who are beneficiaries of the aid is suspect because from where I sit, it is unsustainable and keeps people trapped in the cycle of poverty.

There are better approaches that can be employed to make sure that our development approach is participatory and strategic. But if we continue to force on communities ideologies born out of top-down approaches, we are not going to see the impact and change we desire. There is need for donors to work together with government, NGOs, and communities to forge a cohesive development strategy, so we can see where aid will be most effective and useful.

Does people-driven development require long-term, more complex, more costly investments? Maybe.

Is it worth it? Definitely.


[1] UNDP. (2011). Africa Human Development Report. New York.

Share this

SODIS - Safe Drinking Water in 6 Hours

Solar water disinfection - the SODIS-method - is a simple procedure to disinfect drinking water. Contaminated water is filled in a transparent PET-bottle or glass bottle and exposed to the sun for 6 hours. During this time, the UV-radiation of the sun kills diarrhoea generating pathogens. The SODIS-method helps to prevent diarrhoea and thereby is saving lives of people. This is urgently necessary as still more than 4000 children die every day from the consequences of diarrhoea.

You can learn more about this simple and innovative method and download resources from the SODIS Website.  You can download the Manual here (88p; 5.3MB)

Share this

The Millenium Development Goals

What are the Millennium Development Goals?

The Millennium Development Goals (MDGs) are the most broadly supported, comprehensive and specific development goals the world has ever agreed upon. These eight time-bound goals provide concrete, numerical benchmarks for tackling extreme poverty in its many dimensions. They include goals and targets on income poverty, hunger, maternal and child mortality, disease, inadequate shelter, gender inequality, environmental degradation and the Global Partnership for Development.

Adopted by world leaders in the year 2000 and set to be achieved by 2015, the MDGs are both global and local, tailored by each country to suit specific development needs. They provide a framework for the entire international community to work together towards a common end – making sure that human development reaches everyone, everywhere. If these goals are achieved, world poverty will be cut by half, tens of millions of lives will be saved, and billions more people will have the opportunity to benefit from the global economy.

The eight MDGs break down into 21 quantifiable targets that are measured by 60 indicators.

No alternate text on picture! - define alternate text in image properties-Goal 1: Eradicate extreme poverty and hunger

No alternate text on picture! - define alternate text in image properties-Goal 2: Achieve universal primary education

No alternate text on picture! - define alternate text in image properties-Goal 3: Promote gender equality and empower women

No alternate text on picture! - define alternate text in image properties-Goal 4: Reduce child mortality

No alternate text on picture! - define alternate text in image properties-Goal 5: Improve maternal health

No alternate text on picture! - define alternate text in image properties-Goal 6: Combat HIV/AIDS, malaria and other diseases

No alternate text on picture! - define alternate text in image properties-Goal 7: Ensure environmental sustainability

No alternate text on picture! - define alternate text in image properties-Goal 8: Develop a Global Partnership for Development

Share this

News

Share this

Focus on Women and Girls Key to MDG Success. 21/9/10

The importance of pursuing this strategy is evidenced by innovative programs that are addressing the multiple needs of women and girls

AllAfrica

By Janet Fleischman
19 September 2010

As world leaders gather this week in New York to assess progress on the Millennium Development Goals (MDGs), they will face stark challenges to social and economic development, given ongoing wars and the global economic recession.

Yet the MDGs also provide an opportunity – to focus on ensuring basic rights and access to health services for women and girls as the path to achieve the MDG goals. The administration of U.S. President Barack Obama, which has made women and girls a cornerstone of its Global Health Initiative, should seize the opportunity to turn these enlightened MDG goals into effective policies and programs, by making global health, development and gender interlinked components of foreign policy.

Last year, the United States government launched its Global Health Initiative and initiated the second phase of the President’s Emergency Plan for AIDS Relief (Pepfar). These programs are being rolled out against the backdrop of the Obama administration’s high-level commitment to advance a women- and girls-centered approach.

The challenge now is to maximize the opportunities and tackle the challenges in pursuing policies and programs to link HIV/Aids initiatives with other health and development areas that particularly affect women and girls, including education for girls, economic empowerment for women and reproductive health. It is clear that considerable innovation is taking place in these areas in some of the countries hardest hit by the AIDS epidemic, and that addressing these linkages is critical to meeting the needs of women and girls, and can generate concrete results.

The importance of pursuing this strategy is evidenced by innovative programs that are addressing the multiple needs of women and girls, such as the IMAGE program in South Africa.

IMAGE - Intervention with Microfinance for AIDS and Gender Equity - is a community-based intervention that started in 2001 in rural Limpopo Province that combines microfinance with a gender and HIV curriculum. IMAGE has shown that it is possible to address health and development together and to demonstrate measurable impacts in both areas, underscoring the need for future investments to support programming beyond the health sector to address women’s social and economic empowerment and their vulnerability to HIV infection.

Lina, a soft-spoken and committed outreach worker for IMAGE, explained why the approach of combining gender and health training with microfinance has been so successful in enabling women to protect themselves:

“I’ve seen a lot of changes with the women – now people are starting to talk about HIV and to talk to their children about sex and sexuality, to encourage family members to go for testing. Before I got [the IMAGE] training, I thought it was taboo to discuss these things with children.

“Microfinance is key because if you don’t bring income in the household, it’s hard to contribute to decision-making. Now we help start conversations in families – husbands and wives discuss issues…. Economic empowerment helps contribute to decision-making… Violence is going down…with training, we know how to approach the situation so we don’t escalate violence.”

After two years, the IMAGE study found that the risk of violence against women among participants was reduced by 55 percent. Among young women participating in the program, other factors related to HIV risk were also positively affected, including increased communication about HIV, a 64 percent increase in voluntary counseling and testing, and a 24 percent reduction in unprotected sex.

The study also documented positive changes in household economic wellbeing, including increased food security, expenditures and household assets, and the women maintained high loan repayment rates. The evaluation also documented improvements across a range of indicators of women’s empowerment, including increased self-confidence, autonomy, social capital, collective action and an ability to challenge gender norms.

While global attention to the importance of integrated approaches to address women’s and girls’ health is growing, many challenges remain.

In particular, the new U.S. principle of ensuring a women- and girls-centered approach will have to address the challenges inherent in programming in different health and development areas, including how to demonstrate cross-sectoral impact; how to develop a cross-sectoral approach to gender indicators and outcomes; how to replicate and scale up promising programs; how to demonstrate that linkages are key to building cost-effective and sustainable approaches; and how to create space to learn from failure, given that innovation carries certain risks.

To be successful, the U.S. government should:

- systematically hold implementing government agencies accountable to promote multisectoral linkages;
- put in place better measurement tools to track progress in addressing women’s health outcomes and achieving structural change;
- identify intermediate steps to capture impact; and
- set out long-range plans to build sustainability, encourage innovation, and ensure U.S. global leadership.

In August, President Obama said: “In Africa, in particular, one thing we do know is that empowering women is going to be critical to reducing the [HIV] transmission rate.” The MDG Summit is an unprecedented opportunity to propel the United States to develop strategies and implement programs that make a difference in the lives of women and girls.

Share this

HIV Impacts MDGS on Maternal and Child Health. 7/9/10

Lack of progress on one MDG impedes progress on the other

7 September

World leaders are meeting in New York this month to review global progress to reaching the Millenium Development Goals (MDGS) by the target date of 2015. Despite some progress, it’s not looking good.

Achieving each of the health MDGs is closely dependent on the others. Unfortunately, HIV infection continues to remain a major barrier to the achievement of MDGs 4 and 5 on maternal health and child mortality in many low-income countries.

This calls for the renewed approach of using and strengthening HIV responses as an entry point to maternal and child health services. Opportunities exist to respond in a much more integrated and effective way.

Opportunities

Prevention of mother to child transmission

The prevention of mother to child transmission (PMTCT) provides a unique point of contact with a pregnant woman, a post-natal mother and a new born child and is an opportunity to deliver specific interventions that have been shown to reduce maternal and child mortality. PMTCT programs should be used to deliver or link to antenatal care, child health services, such as vaccinations, Vitamin A supplements, insecticide treated bed nets and comprehensive counselling on contraception, nutrition and breastfeeding. 

PMTCT interventions, such as those implemented by the Alliance, are critical in ensuring women do not become infected with HIV in the first instance, and if infected they can space their subsequent children through contraception (an intervention which also reduces child mortality), and access treatment, care and support for themselves, their spouses and children, whether infected or not.

VCT and sexual and reproductive health services

Indeed, women with HIV are living longer and healthier lives, and need to exercise their rights to access good quality reproductive health services. There is an urgent need to respond to the increasing number of HIV infected women who desire to get pregnant and bear children by expanding reproductive health services within PMTCT and Voluntary Counselling and Testing (VCT) programs.

Integrating VCT with family planning and vice versa is an effective strategy for expanding both services and reaching a wider range of clients. Achieving target 2 of MDG 5, which aims to ensure universal access to good quality sexual and reproductive health (SRH) services, requires commitment to explore all opportunities to integrate SRH in all health services, including HIV.

In addition, promotion of widespread condom use as a child spacing contraception would have significant reductions in child mortality. Strategies to achieve MDG 5 must use this window of opportunity to scale up coordinated and integrated services within HIV responses.  

Child health

Likewise, the provision of support for early and exclusive breastfeeding and newborn care including immunization, hygienic cord care and early newborn complications within community based HIV activities can have a positive impact on the more than 8 million child deaths annually. HIV accounted for 2.2% of these, of which 74% occurred in countries where the Alliance works.

There is clear evidence that children who lose their mothers at birth or in early childhood are at a high risk of ill-health and death. Unless the health MDGs are addressed together, there is a risk of a ‘health trap’ in which lack of progress on one impedes progress on the other.

Apart from adversely affecting progress on MDG 4 and 5, HIV also has a negative impact on the other MDGs.  Poverty impacts on peoples’ vulnerability to HIV. It increases poverty though high economic costs at both household and national levels, threatens household food security, frustrates global efforts to achieve universal basic education by reducing school attendance and increasing mortality amongst teachers, amplifies the severity and deaths due to  malaria, and remains the single most important barrier to overcoming TB.

Integrating the Health MDGS in Practice

In 36 countries worldwide, the Alliance implements programs which have a direct positive impact on maternal and child mortality within PMTCT and child focussed programs. These include: counselling on sexual reproductive health, provision of contraception and care and support to vulnerable children within the community.

For example, in Nigeria, the Alliance’s partner NELA runs a short-stay centre which provides basic primary health care services, including rapid malaria testing, treatment of opportunistic infections, referral systems for pregnant mothers to PMTCT services and supports 52 households and 3502 adults and children with nutritional counselling and commodities, implements counselling on breastfeeding, immunization and links HIV positive women to government hospitals for PMTCT services.

In Ethiopia the Strengthening Communities Response to HIV/AIDS (SCRHA) project supported by USAID and implemented by the Alliance, PATH and partners is working through urban health extension workers to deliver palliative care including nutrition, HIV counselling and testing and PMTCT services with a preventative and referral focus. The Alliance is also supporting post natal mothers by providing community-based care and support to HIV-positive women through the postpartum period, including drug prophylaxis for themselves and their newborn infants.

In order to deliver comprehensive services referrals are made for services that aren’t offered by the Alliances’ linking organizations such as antenatal care and management of labour.  This involves the use of peer educators and community health workers to provide continuity of care and link services. This way the outreach services are extended to an even greater extent to reach marginalised and hard-to reach populations.

As leaders review the progress made, those involved need to be thinking about linking interventions to address MDGs 4, 5 and 6 together, but for this to be successful it needs to be done within the broader framework of strengthened health systems, participatory community approaches and increased financial commitment from donors. Anything less may mean that we will not achieve our goals.

Share this

HIV/AIDS Hinders Millennium Development Goals. 24/2/11

Situation requires a cohesive response from the government and society in general.

24 February 2011

Luanda — The deputy governor of Luanda for social affairs, Juvelina Imperial, said Thursday in Luanda, that HIV/AIDS currently is one of the biggest obstacles to development and is a "serious" threat to progress and achievement of the Millennium Development Goals (MDGs).

According to the official, who was speaking at the opening of the conference on partnership strategies for HIV/AIDS, the situation so requires, a cohesive response from the government and society in general.

She added that the HIV/AIDS epidemic, with profiles and different behaviours at the different provinces of the country, represents an additional challenge to efforts of promoting human development.

The conference, promoted by the Angolan Association of Journalists against HIV/AIDS, will be finished on Friday, and aims among others to strengthen the reporting mechanisms to combat this disease.

Share this

MDGs - Donors Hold Key to HIV-Free Generation. 4/1/11

Top UN health officials are confident that an HIV-free generation is possible by 2015

4 January 2010

Top UN health officials are confident that an HIV-free generation is possible by 2015, but have warned of the need to fully fund HIV/AIDS prevention and treatment programmes to ensure that steady progress in recent years does not fall by the wayside.

"This is an unprecedented moment [of] unprecedented momentum. I urge development partners to support the Global Fund [to Fight AIDS, Tuberculosis and Malaria] in their replenishment," said World Health Organization Director-General Margaret Chan, speaking on 21 September at an event on the sidelines of the three-day Millennium Development Goals summit at the UN headquarters in New York.

Chan added that without adequate funding all the good will, positive interventions and commitments from countries would amount to little.

The importance of preventing mother-to-child transmission of HIV (PMTCT) to achieve three of the Millennium Development Goals (MDGs) - reducing child and maternal deaths, as well as halting and beginning to reverse the spread of HIV/AIDS - "cuts out the fights and competition", for funding and programming, Chan noted.

Efforts to achieve the three goals could benefit from various women's health funding and policy commitments rolled out this week during the summit to mark 10 years since countries committed to the MDGs. But HIV, the leading cause of death among reproductive-age women worldwide, could also serve as a weak link causing women's health targets to veer off track.

About 45 percent of HIV-positive pregnant women received antiretroviral (ARV) treatment to prevent HIV transmission to their children in 2008, an increase from the 35 percent that were treated in 2007.

Scaling up treatment to the 1.4 million pregnant women living with HIV who needed ARV treatment in 2009 to prevent mother-to-child transmission "can be done," Jimmy Kolker, UN Children's Fund (UNICEF) chief of HIV/AIDS, told IRIN/PlusNews before the high-level meeting. "It doesn't require any specific breakthrough or work that isn't already there."

Global Fund seeking pledges

But efforts remain partially dependent on donor countries' contributions to the Global Fund, a major contributor to PMTCT programmes. The international aid agency is seeking replenishment of US$13-20 billion for a three-year period in a "hugely challenging economic environment", according to Global Fund Executive Director Michel Kazatchkine.

France pledged $1.4 billion to the Global Fund, which provides a fifth of all financing for AIDS globally, this week; Canada later followed with its own pledge of $540 million, while Germany will provide $25 million to Côte d'Ivoire in a debt swap agreement and Norway announced that it will increase its contribution to the Global Fund by 20 percent for the next three years, making a total contribution of $225 million.

Attention is now shifting to the USA, which is being lobbied by advocacy organizations like ONE to donate $6 billion. Kazatchkine said he was expecting an announcement this week from US President Barack Obama, but although Obama spoke of strengthening the US's commitment to the Global Fund in his speech at the summit on 22 September, he did not reveal any funding pledges.

The US contributed a record-setting $1.05 billion to the Global Fund for the 2010 fiscal year, but has been criticized for not merging AIDS programming and funding laid out in the US President's Emergency Plan for AIDS Relief (PEPFAR), and in its new $63 billion Global Health Initiative with international strategies.

The Global Fund fell short by $3 billion in its last replenishment in 2007. It reached a partial goal of $10 billion to be distributed over 2008, 2009 and 2010.

 

"Each single dollar counts and when you cut the money short you jeopardize a few more lives," said Sipho Moyo, Africa director for ONE. "We need to continue to invest in this. Donors have to put their money where their mouth is."

Scaling up PMTCT services

High-burden countries, specifically in sub-Saharan Africa, have continued to do their part in tackling mother-to-child transmission of HIV, according to Kazatchkine, switching from sub-optimal single-dose nevirapine to "the most appropriate antiretroviral regimens".

This gradual shift has resulted in an overall increase of 65 percent in PMTCT budgets in high-burden countries.

Seventy out of 123 reporting countries revealed plans to further scale up PMTCT services in 2008, a jump from the 34 countries that presented such plans in 2005.

Namibia, which has a 15 percent rate of HIV prevalence among adults, was singled out for its success in broadening its PMTCT services since 2005. Now more than 60 percent of HIV-positive pregnant women receive ARV treatment and HIV prevalence among children under one dropped from 13.5 percent in 2006 to 7 percent in 2009, according to Namibian President Hifikepunye Lucas Pohamba.

Stigma challenges

Chan praised Pohamba for his commitment to eradicating mother-to-child transmission, maintaining the upbeat tone that characterized much of the event.

"Even just a few years ago it would have been inconceivable that a panel discussion about women living with HIV could be called a time for hope," said UNICEF's Executive Director Anthony Lake. "A few years ago, for far too many women a diagnosis of HIV meant, in effect, a double death sentence for the mother and the baby."

Yet it will take more than confidence, agreement on a common strategy to eliminate PMTCT, and adequate funding, to help HIV-positive pregnant women receive testing and treatment on a universal scale, said UNICEF's Kolker.

Share this

MDGs: Donors Hold Key to HIV-free Generation. 23/9/10

Top UN health officials are confident that an HIV-free generation is possible by 2015

PlusNews
23 September 2010

New York - Top UN health officials are confident that an HIV-free generation is possible by 2015, but have warned of the need to fully fund HIV/AIDS prevention and treatment programmes to ensure that steady progress in recent years does not fall by the wayside.

“This is an unprecedented moment [of] unprecedented momentum. I urge development partners to support the Global Fund [to Fight AIDS, Tuberculosis and Malaria] in their replenishment,” said World Health Organization Director-General Margaret Chan, speaking on 21 September at an event on the sidelines of the three-day Millennium Development Goals summit at the UN headquarters in New York.

Chan added that without adequate funding all the good will, positive interventions and commitments from countries would amount to little.

The importance of preventing mother-to-child transmission of HIV (PMTCT) to achieve three of the Millennium Development Goals (MDGs) - reducing child and maternal deaths, as well as halting and beginning to reverse the spread of HIV/AIDS - “cuts out the fights and competition”, for funding and programming, Chan noted.

Efforts to achieve the three goals could benefit from various women’s health funding and policy commitments rolled out this week during the summit to mark 10 years since countries committed to the MDGs. But HIV, the leading cause of death among reproductive-age women worldwide, could also serve as a weak link causing women’s health targets to veer off track.

About 45 percent of HIV-positive pregnant women received antiretroviral (ARV) treatment to prevent HIV transmission to their children in 2008, an increase from the 35 percent that were treated in 2007.

Scaling up treatment to the 1.4 million pregnant women living with HIV who needed ARV treatment in 2009 to prevent mother-to-child transmission “can be done,” Jimmy Kolker, UN Children’s Fund (UNICEF) chief of HIV/AIDS, told IRIN/PlusNews before the high-level meeting. “It doesn’t require any specific breakthrough or work that isn’t already there.”

Global Fund seeking pledges

But efforts remain partially dependent on donor countries’ contributions to the Global Fund, a major contributor to PMTCT programmes. The international aid agency is seeking replenishment of US$13-20 billion for a three-year period in a “hugely challenging economic environment”, according to Global Fund Executive Director Michel Kazatchkine.

France pledged $1.4 billion to the Global Fund, which provides a fifth of all financing for AIDS globally, this week; Canada later followed with its own pledge of $540 million, while Germany will provide $25 million to Côte d’Ivoire in a debt swap agreement and Norway announced that it will increase its contribution to the Global Fund by 20 percent for the next three years, making a total contribution of $225 million.

Attention is now shifting to the USA, which is being lobbied by advocacy organizations like ONE to donate $6 billion. Kazatchkine said he was expecting an announcement this week from US President Barack Obama, but although Obama spoke of strengthening the US’s commitment to the Global Fund in his speech at the summit on 22 September, he did not reveal any funding pledges.

The US contributed a record-setting $1.05 billion to the Global Fund for the 2010 fiscal year, but has been criticized for not merging AIDS programming and funding laid out in the US President's Emergency Plan for AIDS Relief (PEPFAR), and in its new $63 billion Global Health Initiative with international strategies.

The Global Fund fell short by $3 billion in its last replenishment in 2007. It reached a partial goal of $10 billion to be distributed over 2008, 2009 and 2010.

“Each single dollar counts and when you cut the money short you jeopardize a few more lives,” said Sophio Moyo, Africa director for ONE. “We need to continue to invest in this. Donors have to put their money where their mouth is.”

Scaling up PMTCT services

High-burden countries, specifically in sub-Saharan Africa, have continued to do their part in tackling mother-to-child transmission of HIV, according to Kazatchkine, switching from sub-optimal single-dose nevirapine to “the most appropriate antiretroviral regimens”.

This gradual shift has resulted in an overall increase of 65 percent in PMTCT budgets in high-burden countries.

Seventy out of 123 reporting countries revealed plans to further scale up PMTCT services in 2008, a jump from the 34 countries that presented such plans in 2005.

Namibia, which has a 15 percent rate of HIV prevalence among adults, was singled out for its success in broadening its PMTCT services since 2005. Now more than 60 percent of HIV-positive pregnant women receive ARV treatment and HIV prevalence among children under one dropped from 13.5 percent in 2006 to 7 percent in 2009, according to Namibian President Hifikepunye Lucas Pohamba.

Stigma challenges

Chan praised Pohamba for his commitment to eradicating mother-to-child transmission, maintaining the upbeat tone that characterized much of the event.

“Even just a few years ago it would have been inconceivable that a panel discussion about women living with HIV could be called a time for hope,” said UNICEF’s Executive Director Anthony Lake. “A few years ago, for far too many women a diagnosis of HIV meant, in effect, a double death sentence for the mother and the baby.”

Yet it will take more than confidence, agreement on a common strategy to eliminate PMTCT, and adequate funding, to help HIV-positive pregnant women receive testing and treatment on a universal scale, said UNICEF’s Kolker.

“In every context there are challenges of stigma so mothers are not tested, or don’t come back for the results,” Kolker explained. “Or they take the medicines home but they don’t take them as instructed. Many things must change in attitude and behaviour to make services readily available.”

In 2008, only 5 percent of pregnant women in low- and middle-income countries reported that their male partners were tested for HIV. Kolker said engaging fathers is “absolutely crucial” in making services more widespread and dispelling notions about women having “low moral character” and bringing the infection into their relationships.

Share this

Millennium Development Goals Count-Down. Living with AIDS # 439. 15/7/10

Two-thirds of the deadline has already passed

Health-e

By Khopotso Bodibe
15 June 2010

In 2000, the world’s leaders committed themselves to the United Nations’ Millennium Development Goals to make our planet a healthier place to live in by the year 2015. Two-thirds of the deadline has already passed. Is the world succeeding in its commitments, for instance, to combat HIV/AIDS, malaria and other diseases which are endemic in countries such as South Africa?

Three of the eight goals are health-related. Goal 4 commits to reducing child mortality by two-thirds, while Goal 5 commits to improving maternal health and Goal 6 commits to combating HIV/AIDS, malaria and other diseases. With only five years left before the deadline South Africa and the rest of the world are racing against time to make progress. In September, world leaders will meet at a special United Nations summit in New York to review their efforts. As the clock is ticking, South Africa’s Health Minister, Dr Aaron Motsoaledi, has taken to heart how many of the health challenges we have in the country affect women and children disproportionately.   

“HIV and AIDS, TB and Malaria do affect women and children more than any sector and is wreaking havoc on the lives of our mothers and children”, Motsoaledi said.

“The Millennium Development Goal # 5 seeks to reduce by three-quarters the maternal mortality ratio by 2015. We, in South Africa have not given up hope, and instead, we are preparing to move up to the highest gear to ensure that we do achieve this goal by 2015. We are actually re-focusing all our departmental programmes to be centred around the Maternal, Child and Women’s Health Unit. We are putting up plans for strengthening this unit because the health of mothers and children directly affects the future and the development programme of the nation”, he continued.

The Health Department’s own National Committee on Confidential Enquiry into Maternal Health, which seeks to identify what causes maternal deaths, shows that an overwhelming majority of maternal deaths is due to HIV and AIDS.  

“It was found that while 54% of these deaths are due to a variety of causes – many of them, of course, preventable – a whopping 46% alone is due to HIV and AIDS”, said Motsoaledi.

Another Health Department report, “Saving Babies”, confirms that, just like their mothers, babies and children also succumb to HIV and AIDS. This has implications for the country’s ability to prevent infant mortality, which is covered in MDG Goal # 4.    

“We are having 20 000 still-births in South Africa every year. The number of neo-nates - the new-borns - who die before their first year has reached 22 000. The number who die before they reach five years has reached 75 000 and 43% of these deaths, the contributing factor, is HIV and AIDS, and we believe we should not only try to decrease the issue of mother-to-child transmission, but we should try to eradicate it altogether. This should be achievable in the next five years”, said Health Minister, Dr Aaron Motsoaledi.

In April, South Africa introduced new and better guidelines for the prevention of mother-to-child HIV transmission and the treatment of people co-infected with HIV and TB. More people are now accessing preventative and life-prolonging medicines. But more still needs to be done to reach those left out of the system.

Executive Director of the Global Fund to fight AIDS, TB and Malaria, Professor Michel Kazatchkine, urged South Africa to step up its efforts. Kazatchkine urged South Africa to remember the pleas made by the late child activist Nkosi Johnson and Constitutional Court Judge, Edwin Cameron as well as former president, Nelson Mandela, at the 13th International AIDS Conference in Durban in 2000, when they asked for a better response to HIV and AIDS, which is covered in MDG # 6. 

“I remember Nkosi Johnson who spoke in the stadium at the opening ceremony and gave a face and a voice to children living with HIV. I remember Judge Edwin Cameron who urged us to, quote: ‘Make the future different’. And, of course, I remember vividly President Mandela who spoke passionately about the fact that something needs to be done, quote: ‘As a matter of greatest urgency’, said Kazatchkine.

“So, ten years later, let us not forget these words. Let us not forget that only half of the patients in urgent need have access to life-saving treatment; that access to prevention measures remains too limited; and that human rights abuses against people living with HIV and most at risk groups of the population continue. Let us, therefore, also resolve to follow through on what Nkosi Johnson, Edwin Cameron and Nelson Mandela asked us to do”, he urged.      

Together with AIDS, combating malaria forms the basis of the United Nations’ Millennium Development Goal # 6. In its response to Malaria, South Africa has partnered with eight countries in the southern African region to form E8 or Elimination 8. The eight countries have vowed that, at least, by 2020 they should have eliminated malaria from the SADC community. The road still to be traveled to achieving these goals is not too long. One of the key determinants for success is finance. There is concern that African governments will not attain these objectives as the global community is shrinking their aid to poor countries. Poor countries themselves are spending too little on their health programmes.

Share this

Millennium Development Goals: Fight against AIDS Hit by $10bn Shortfall. 19/9/10

Success in halting infection in sub-Saharan Africa could falter as international aid starts to shrink, warns UNAids chief

The Observer

By Peter Beaumont
19 September 2010

A decade-long effort to reverse the spread of HIV/Aids in sub-Saharan Africa – which has seen new infections drop by a dramatic 25% in some of the worst-hit areas – is under threat because of a massive shortfall of funds.

The fight against HIV has been one of the success stories of the eight Millennium Development Goals, which aim, with MDG 6, to halt and reverse the spread of the disease by 2015. New infections have fallen by more than 25% in 22 countries in sub-Saharan Africa. This is the region hardest hit by HIV, accounting for 67% of all people living with the virus worldwide, 71% of Aids-related deaths and 91% of all new infections among children.

"The world has made a giant leap towards reaching MDG 6. It is within our grasp," Michel Sidibé, the head of UN HIV/Aids agency UNAids, said last week. However, he warned that European countries were giving $623m less this year to HIV/Aids programmes around the world, and there is a shortfall of $10bn in the funds needed to achieve universal access to HIV treatment, including prevention programmes, setting up healthcare systems and caring for HIV orphans.

"I am scared," he told Reuters AlertNet. "For the first time, we are seeing a decline in financial commitment from donor nations."

African countries with the biggest epidemics, such as Nigeria, South Africa, Zambia and Zimbabwe, have seen some of the biggest falls in the infection rate, thanks to better use of prevention methods and greater access to life-preserving drugs, according to a UNAids report charting the progress of the globally agreed MDG.

"For the first time change is happening at the heart of the epidemic," Sidibé said. However, he added that the $10bn shortfall in the funding for HIV/Aids in 2009 could put further progress at risk. UNAids said an estimated $25.9bn was needed for the global response, of which only $15.9bn is currently available.

The success seen so far in sub-Saharan Africa is extraordinary given the deep pessimism that existed a decade ago over the hold of the disease there. The figures reflect the striking impact of a large, effective and well-funded prevention programme matched with better treatment for those with the disease.

Success in Africa, however, is in danger of being overshadowed by the spread of infection in eastern Europe and central Asia, both of which have rapidly expanding HIV epidemics – the disease is spreading in those regions at a rate of 500 new infections a day.

UNAids said access to treatment for HIV has increased 12-fold in six years, and 5.2 million people now get the drugs they need. But another 10 million who need the drugs do not get them.

"To sustain the gains we are making, further investments in research and development are needed – not only for a small wealthy minority, but also focused to meet the needs of the majority," Sidibé said.

UNAids recommends governments allocate between 0.5% and 3% of their revenue to combating HIV and Aids, depending on the prevalence of disease in their country.

Share this

Replenish or MDGs perish. 22/9/10

World leaders have two weeks left to find the $20billion the Global Fund needs to set the world on track to meet the Health MDGs

Treatment Action Campaign
22 September 2010

Maternal health and child mortality Millennium Development Goals in many countries can only be met if AIDS, TB and malaria are addressed and the Global Fund replenished with $20 billion over the next two weeks, say activists.

Activists to call a Day of Action on Tuesday September 28 in at least 20 African cities, and supported by groups around the world, to fully fund the Global Fund to Fight AIDS, Tuberculosis and Malaria

Wednesday September 22 (Nairobi, Washington)--World leaders have two weeks left to find the $20billion the Global Fund needs to set the world on track to meet the Health Millennium Development Goals (MDGs), activists said today at the start of a week of activism which culminates in a Global Day of Action next Tuesday September 28 to advocate for the replenishment of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

At the recently concluded MDG Summit in New York UN Secretary-General Ban Ki-Moon declared that the MDGs are achievable, and called on donors to open their pockets at the Global Fund Replenishment meeting he is chairing 4-5 October.

“We are delighted that the world has woken up to the fact that efforts to tackle child mortality and maternal health (MDGs 4 and 5) are off-track – but politicians are making a grave and foolish error if they think they can deal with this at the expense of the fight against HIV/AIDS, TB and Malaria (MDG 6),” said Rachel Ong, Chair of the Global Network of People living with HIV/AIDS (GNP+) and one of the initiators of the Global Fund replenishment campaign. “Maternal health and child mortality goals have no place being pitted in competition with action to tackle AIDS, TB and malaria.”

In South Africa AIDS is the main cause of death among women and children, and throughout Africa AIDS, TB and malaria are killing millions of children and women every year.

“The choice is simple: replenish or the MDGs will perish,” said Vuyiseka Dubula, the HIV+ Secretary General of South Africa’s Treatment Action Campaign (TAC), one of the leading forces behind the Global Week of Action. “If leaders have decided that maternal and child mortality are the problem, then they must know that finding $20billion for the Fund is a big part of the solution.”

In less than a decade the Global Fund has saved nearly 6 million lives and the organisation is highly regarded as a responsible steward of donor money, already proving itself capable of handling traditional aid and innovative financing.

“All countries should play their role. Contributions are needed from all governments, including lower-income countries, who have a duty to prioritise health. But the urgent priority right now is to replenish the Global Fund to put the world on track to meet the health MDGs,” said Paula Akugizibwe from the AIDS and Rights Alliance for Southern Africa (ARASA). “The establishment of the Global Fund was an unprecedented show of unified political will to respond to pressing global health crises. If governments turn their backs on their own commitments now after all the progress that has been made, they are sending the clear message that they view health – and hence, basic human development – as optional, depending on the price tag.”

Ong Akugizibwe and Dubula are among a global coalition of activists who have convened a week of activism culminating in a Global Day of Action to demand that the Global Fund gets the funds it needs. The week of action started on Monday 20 September with marches in Paris, France and outside the UN MDG Summit in New York.

It culminates on Tuesday 28 September in dozens of marches, press conferences and other actions organised by community groups across the African region taking place in Kenya, South Africa, Swaziland, Zambia, Lesotho, Malawi, Botswana, Mauritius, Tanzania, Mali, Ethiopia, Cameroon and Nigeria. At the same time a viral video campaign will be launched across 30 Asian countries, and supportive actions will take place in Canada, Italy, Russia and other places.

Share this

Tracking Progress on MDG Six. 21/9/10

major gaps remain that could prevent many countries from achieving the 6 MDGs

PlusNews
21 September 2010

Nairobi - Significant strides have been made in the global fight against HIV, but major gaps remain that could prevent many countries from achieving UN Millennium Development Goal (MDG) six relating to HIV/AIDS, malaria and other diseases.

IRIN/PlusNews examines global efforts to halt and begin to reverse the spread of HIV/AIDS.

Access to treatment - More than five million people currently have access to life-prolonging antiretroviral drugs, a 12-fold increase over the past six years. However, this still represents just one third of people who need HIV treatment.

In 2008, 38 percent of the 730,000 children estimated to need antiretrovirals (ARVs) in low- and middle-income countries had access to them.

UNAIDS is calling for the implementation of a new treatment approach called "Treatment 2.0", to drastically scale up testing and treatment; it estimates that successful implementation of "Treatment 2.0" could avert 10 million deaths by 2025, and reduce new infections by a third.

New infections - Twenty-two of the worst affected countries in sub-Saharan Africa have reduced HIV incidence by more than 25 percent in the last eight years, according to UNAIDS. Some of the best performers in reducing new infections are Ethiopia, Nigeria, Zambia and Zimbabwe; HIV incidence is on the rise in Uganda, once a leader in the fight against HIV.

Eastern Europe and Central Asia remain the only regions where incidence is increasing.

Globally, there are still five new infections for every two people put on ARVs.

Prevention of mother-to-child transmission - According to the UN World Health Organization's (WHO) 2009 report, Towards Universal Access, the 20 countries with the highest burden of HIV among pregnant women have scaled up HIV counselling and testing to at least 75 percent of their antenatal care facilities.

Kenya, Malawi, Mozambique, South Africa, Tanzania and Zambia are among the countries that provided HIV testing to 60-80 percent of pregnant women, while Botswana, Namibia and São Tomé and Principe exceeded the 80 percent mark.

In 2008, 45 percent of pregnant women living with HIV in low- and middle-income countries received ARVs to prevent HIV transmission to their infants - up from just 10 percent in 2004.

HIV-related maternal and child mortality - In 2008, 9 percent of all maternal deaths in sub-Saharan Africa were HIV related, according to a new report, Trends in Maternal Mortality: 1990-2008 by WHO and the UN Children's Fund, UNICEF. In Latin America and the Caribbean, HIV/AIDS was responsible for 5.2 percent of maternal deaths.

The report notes that there is evidence that women with HIV infection have a higher risk of maternal death.

Access to prevention of mother-to-child-transmission (PMTCT) improves outcomes for children as well, with studies showing that in KwaZulu Natal, South Africa, child mortality declined by 34 percent following improvement in PMTCT. According to UNICEF, HIV is one of four diseases that accounted for 43 percent of all deaths in children under five worldwide in 2008.

Condom availability and use - Globally, condom use has doubled over the past five years, according to UNAIDS. An estimated 13 billion condoms per year will be needed by 2015 to help halt the spread of HIV, but only four condoms were available for every adult male of reproductive age in sub-Saharan Africa.

Female condoms are even less accessible. According to the UN Population Fund, UNFPA, in 2009, one female condom was distributed for every 36 women worldwide.

Condom use remains low in many high prevalence countries. According to UNAIDS, in South Africa, the proportion of adults reporting condom use during last sex rose from 31 percent in 2002 to 65 percent in 2008, but in Burundi, only about one in five people reported using a condom during commercial sex episodes.

New prevention technologies - The first positive results from a microbicide trial have injected fresh hope into efforts to halt the spread of the virus; the gel, containing the ARV Tenofovir, was found to be 39 percent effective in reducing a woman's risk of becoming infected with HIV.

"Treatment 2.0" also promises benefits for prevention, with evidence showing that people on ARV treatment are much less likely to transmit the virus.

A Thai vaccine trial completed in 2009 also provided the first evidence that a vaccine can provide some protection against HIV.

Several trials are under way to test the efficacy of pre-exposure prophylaxis (PrEP) whereby HIV-negative people take a single ARV drug or a combination of drugs with the hope that it will lower their risk of infection if exposed to HIV.

Male circumcision, proven to reduce men's risk of infection through sexual intercourse by up to 60 percent, is being rolled out in several African countries

Tuberculosis - TB remains a major cause of death for people living with HIV. WHO estimates that in 2008, there were 1.4 million TB cases among people living with HIV and over 500,000 deaths. Drug-resistant TB is on the rise in several countries, but diagnosis remains very low.

TB research remains under-funded and the most widely used TB diagnostics are over 100 years old. For many co-infected patients in the developing world, late diagnosis leads to death.

The authors of a recent article published in medical journal The Lancet argue that TB control is crucial to achieving the MDGs, given its link to HIV mortality as well as maternal and child mortality.

Recent developments such as a new drug to treat TB and rapid, more accurate TB tests could lead to improvements in the diagnosis and management of the highly infectious disease.

New research showing that starting TB patients on ARVs earlier leads to better outcomes could also reduce mortality in co-infected patients.

Share this

UN Chief Urges World Leaders to Meet Millennium Goals. 20/9/10

U.N. Secretary-General Ban Ki-moon has called on world leaders to reaffirm their commitments to drastically reducing global poverty, hunger and disease within the next five years

Voice of America News

By Margaret Besheer
20 September 2010

World leaders have gathered in New York for a three-day summit on ending global poverty, hunger and disease within the next five years. The secretary-general called on the international community to keep its promise to help the world's most vulnerable people.

U.N. Secretary-General Ban Ki-moon said when leaders agreed on the eight Millennium Development Goals during a summit in 2000, it was a great breakthrough.

"Together we created a blueprint for ending extreme poverty. We defined achievable targets and timetables," he said. "We established a framework that all partners, even those with different views have been able to embrace."

This week's summit is intended to review progress, identify gaps and commit to concrete steps to reach the Millennium Development Goals on schedule. A document setting out specific actions on how to do that for each of the eight goals has already been agreed on and is expected to be adopted at the end of the summit.

The goals include eradicating extreme hunger and poverty, achieving universal primary education, promoting gender equality and empowering women, reducing child mortality, improving maternal health and combating HIV/AIDS, malaria and other diseases.

Mr. Ban outlined some of the successes during the past 10 years in implementing the goals:

"New thinking and path-breaking public-private partnerships," he said. "Dramatic increases in school enrollment. Expanded access to clean water. Better control of disease. The spread of technology - from mobile to green."

But progress has been uneven, and the summit aims to give a boost to the goals that are lagging, such as improving maternal health and reducing child mortality. On Wednesday, the Secretary-General will launch a Global Strategy for Women's and Children's Health as part of that effort.

The latest MDG progress report warns that several of the goals are likely to be missed in many countries. The challenges are greatest in the least-developed countries, land-locked developing countries and small island developing states, as well as countries either in or emerging from conflict and those most affected by climate change.

The report also found the global economic and financial crisis has impacted jobs and incomes worldwide, severely hurting the ability of the poor to feed their families. There is also concern that donor countries affected by the financial crisis are taking austerity measures that could erode their contributions to development assistance.

The secretary-general has warned that falling short of the Millennium Development Goals could lead to an increase in global dangers from political instability to disease to harming the environment.

About 140 world leaders, including President Barack Obama will address the summit before it concludes Wednesday.

Share this

UNAIDS Board Adopts New Strategy to Help Achieve 2015 HIV Goals. 8/12/10

The Board also approved measures for greater internal efficiency and effectiveness and examined issues such as gender-sensitivity of AIDS responses, ‘AIDS, security and humanitarian responses’ and ‘food and nutrition security and HIV’

8 December 2010

GENEVA, 8 December 2010—The governing body of the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Programme Coordinating Board (PCB), has adopted a new UNAIDS strategy to advance global progress in achieving universal access to HIV prevention, treatment, care and support services and to halt and reverse the spread of HIV. 

The strategy, for the period 2011-2015, was endorsed during the 27th Board meeting, which took place in Geneva from 6-8 December. The AIDS response is a long term investment and the strategy aims to revolutionize HIV prevention, catalyse the next phase of treatment, care and support, and advance human rights and gender equality.

Priority areas highlighted in the strategy include: stopping new HIV infections; integrating the AIDS response into other health and development efforts; setting goals to end stigma and discrimination; promoting new and innovative partnerships; and focusing on accountability and country ownership of national responses.

In his report to the Board, UNAIDS Executive Director Michel Sidibé said, “Now more than ever, the AIDS response must deliver value for money. This strategy has been designed to produce high-quality, high value results far into the future.”

The UNAIDS strategy is a roadmap for the Joint Programme with concrete goals marking milestones on the path to achieving UNAIDS’ vision of “Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths.”

The strategy will also be used as a reference in the lead up to the High Level Meeting on HIV in June 2011. United Nations Member States will come together next year to review progress made since the 2001 Declaration of Commitment on HIV/AIDS and commit to actions in taking the response forward.

In putting the strategy into operation, UNAIDS will focus on value for money in the effective and efficient delivery of business practices. It will also ensure that resources are focused for results and guided by the Unified Budget and Accountability Framework.

At the PCB meeting, Board members strongly supported the decision to move to a single administrative system for the UNAIDS Secretariat. It encouraged ongoing efforts to use the most effective administrative policies and to minimize administrative costs by seeking the most cost-effective provision of services.

During the meeting, the Board was presented with a comprehensive report on UNAIDS’ activities in relation to gender and HIV. This included a review of the action framework and implementation of UNAIDS’ operational plan for women and girls. The links between sexual and reproductive health and HIV were also covered.

Dr Françoise Barré-Sinoussi, Co-Chair of the UNAIDS High Level Commission on HIV Prevention and Nobel Prize laureate for Medicine in 2008 for her role in the discovery of HIV, addressed the PCB as its keynote speaker. The Board also held a thematic session, led by UNAIDS Cosponsor the World Food Programme, focused on food and nutrition security and HIV.

More than 300 participants and observers from UN Member States, international organizations, civil society and non-governmental organizations attended the meeting, which was chaired by the Netherlands with El Salvador acting as vice chair and Japan as rapporteur. In 2011, El Salvador will assume the role of chair, and the Board elected Poland as vice chair and Egypt as rapporteur.

The UNAIDS Executive Director’s report to the Board, the decisions, recommendations and conclusions, and an overview of all documents presented at the meeting can be found on the 27th PCB web page.

Share this

World Failing to Meet 2010 HIV/AIDS Care Target: UN. 29/9/10

Fail to meet an end-2010 deadline for "universal" access to HIV/AIDS care and treatment

Asia One Health

By Peter Capella
29 Setember 2010

Geneva (AFP) - UN agencies warned on Friday that the world will fail to meet an end-2010 deadline for "universal" access to HIV/AIDS care and treatment, while new crisis-driven funding cuts could unravel any gains.

The World Health Organisation, UNAIDS, and the UN Children's Fund UNICEF said in a joint report that the target of universal access - defined as access for 80 percent of the HIV positive population - to prevention, treatment and care was within "clear reach" for "a good number of countries."

"Nevertheless, this report also demonstrates that, on a global scale, targets for universal access to HIV prevention, treatment and care will not be met by 2010," the report said.

Despite accelerating progress, the report covering 183 nations underlined that only one-third of those in need worldwide have access to life-saving anti-retroviral drugs to counter the human immunodeficiency virus (HIV) that causes AIDS.

Some 5.2 million people received such treatment last year in low to middle income countries, the key battleground for the fight against the near three decades old pandemic with the highest burden of the disease.

That marked a 30 percent increase over a year earlier and a 13-fold increase in six years, but another 10 million people approximately did not have such treatment in those countries.

Only eight middle to low income nations - including Cambodia, Cuba and Rwanda - had achieved the treatment target by the end of 2009, it found.

The agencies spearheading the fight against HIV/AIDS underlined that the scale of prevention measures was still insufficient, four years after the UN's member states set the broad 2010 access target.

"It's unacceptable that 7,000 people a day are dying of a chronic, treatable illness," added Kevin Moody of the Global Network of People Living with AIDS.

The report also estimated that most people with HIV were still unaware that they were infected - about 60 percent of people in low and middle income countries, WHO HIV/AIDS coordinator Yves Souteyrand told journalists.

The most vulnerable, including those with HIV, sex workers, drug users, men with a homosexual experience and migrants were still victims of stigma and discrimination, adding to their marginalisation from treatment and care, the report argued.

"At the same time, the financial crisis and resulting economic recession have prompted some countries to reassess their commitments to HIV programmes," it added.

Reduced funding "risks undoing the gains of the past years," said the heads of the agencies, including WHO Director General Margaret Chan, amid warnings that the effort was 10 billion dollars short last year.

More than 33 million people around the world have HIV, according to most recent UN estimates for 2008.

The report nonetheless highlighted patchy progress in 144 low and middle income countries, with "significant" inroads in several impoverished and hardest hit sub-Saharan African countries.

More than 80 percent of HIV positive pregnant women received services and medicines to prevent mother-to-child transmission in 15 such nations, including Botswana and South Africa.

Fourteen countries, including Brazil, Namibia and Ukraine, provided HIV treatment for children in need.

"We are on the right track, we've shown what works and now we need to do more of it," said Paul De Lay, deputy executive director of UNAIDS.

In 2003, the WHO and UNAIDS set a similar target with the "Three by Five" initiative, which aimed to give three million infected people in poor countries access to anti-HIV drugs by the end of 2005.

It also missed, some 1.7 million short, although the WHO said the goal was fulfilled by 2007 after initially helping to triple the number of people on antiretrovirals.

Wednesday's report urged more political pledges and funding, as agency officials set their sights on universal access in 2015.

Share this

UNFPA Report: Exploring Links Between HIV And Climate Change. 18/11/09

“Poor women in poor countries are among the hardest hit by climate change, even though they contributed the least to it.” UNFPA Executive Director Thoraya Ahmed Obaid

18 November 2009

UNAIDS

The success of the global response to AIDS will rely on tackling not only the encroaching virus itself but also the affects of climate change such as food and water shortages, growth in poverty and an increase in natural disasters, argues the State of World Population 2009, released today by the United Nations Population Fund (UNFPA).

The report also contends that, equally, strengthening the response to the AIDS epidemic will mean that individuals, communities and societies will have greater social resilience in the face of a range of climate change threats and will be better able to deal with their consequences. HIV and climate change are perceived as profoundly linked, a perception shared by a range of UN bodies, including UNAIDS and the United Nations Environment Programme, UNEP.

Subtitled, ‘Facing a changing world: women population and climate’, The State of World Population places women at the very centre of the attempt to confront climate change and maintains that policies, programmes and interventions are more likely to mitigate its worst effects if they reflect the rights and needs of women.

Women are said to bear the brunt of climate change, partly because in many countries they make up the majority of the agricultural workforce hard hit in an environmental crisis, and because they often do not have sufficient control of their lives and access to as many opportunities to generate income as men – they are more likely to be poor and to see their poverty increase. As UNFPA Executive Director Thoraya Ahmed Obaid has it, “Poor women in poor countries are among the hardest hit by climate change, even though they contributed the least to it.”

Numerous examples of extreme climate change are cited, from melting glaciers in Bolivia, to the destruction of crops by typhoons in the Philippines, and from drought in east and southern Africa to floods in Vietnam. In each scenario, women are shown struggling to keep their livelihoods and families intact, and, in some cases, fighting for their lives.

According to the report, empowering women and girls, especially through investments in health and education, help boost economic development and reduce poverty, thus having a beneficial impact on coping with climate change. Girls with more education are more likely to protect themselves against HIV and to have smaller and healthier families as adults. In general, access to reproductive health services such as family planning means lower fertility rates and this has a clear bearing on lessening the potential impact of environmental crises and making sustainable development more likely.

“Women should be part of any agreement on climate change—not as an afterthought or because it’s politically correct, but because it’s the right thing to do,” says Ms Obaid. “Our future as humanity depends on unleashing the full potential of all human beings, and the full capacity of women, to bring about change.”

The State of World Population 2009 argues that ensuring gender inequity is challenged in all its facets is an urgent necessity, not just to improve the lives of individual women but to stave off the worst consequences of environmental crisis. This sense of urgency is relayed to the leaders and negotiators due to meet in Copenhagen for December’s critical climate change conference. They are urged to “think creatively” not just about emissions and targets but about population, reproductive health and gender equality and how they can contribute to “a just and environmentally sustainable world.”

 

Share this