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Africa: HIV/AIDS 2009 Update
AfricaFocus Bulletin
Dec 6, 2009 (091206)
(Reposted from sources cited below)
Editor's Note
"Through its partnerships with more than 30 countries through
September 2009, PEPFAR has provided direct support for life-saving
antiretroviral treatment for over 2.4 million men, women and
children. The Global Fund has supported treatment for 2.5 million
people worldwide. Approximately 1.3 million people receive
treatment supported by both PEPFAR bilateral programs and the
Global Fund, and thus are counted in the totals for each
organization. These numbers reflect the strong country-level
partnership between PEPFAR and the Global Fund." - Joint press
release by the Global Fund and PEPFAR, December 1, 2009
This AfricaFocus Bulletin contains several updates, a summary
report on the new UNAIDS annual report, a joint press release by
PEFPAR and the Global Fund, and the AIDS day speech by South
African President Jacob Zuma.
Two other AfricaFocus Bulletins posted today contain commentary on
U.S. AIDS policy, both from critics of funding "flatlining" by the
Obama administration and in a press conference by Dr. Eric Goosby,
the Global AIDS Coordinator for the U.S. Government.
USA/Africa: AIDS - No We Can't? (e-mail and web)
http://www.africafocus.org/docs09/hiv0912a.php
USA/Africa: AIDS - Yes, We Can? (web-only)
http://www.africafocus.org/docs09/hiv0912b.php
For previous AfricaFocus Bulletins on AIDS and other health issues,
visit http://www.africafocus.org/healthexp.php
++++++++++++++++++++++end editor's note+++++++++++++++++++++++
"Eight-year Trend Shows New HIV Infections down by 17% - Most
Progress Seen in Sub-Saharan Africa"
"Efforts Towards Universal Access to Hiv Prevention, Treatment,
Care and Support Are Bringing Aids out of Isolation"
The 2009 AIDS Epidemic Update report released by UNAIDS, is
available online at:
http://data.unaids.org/pub/Report/2009/2009_epidemic_update_en.pdf
This story on-line at:
http://www.unaids.org/en/KnowledgeCentre/Resources/FeatureStories/archive/2009/20091124_pr_EpiUpdate.asp
Geneva / Shanghai, 24 November 2009 - According to new data in the
2009 AIDS epidemic update, new HIV infections have been reduced by
17% over the past eight years. Since 2001, when the United Nations
Declaration of Commitment on HIV/AIDS was signed, the number of new
infections in sub-Saharan Africa is approximately 15% lower, which
is about 400,000 fewer infections in 2008. In East Asia new HIV
infections declined by nearly 25% and in South and South East Asia
by 10% in the same time period. In Eastern Europe, after a dramatic
increase in new infections among injecting drug users, the epidemic
has leveled off considerably. However, in some countries there are
signs that new HIV infections are rising again.
The report, released today by the Joint United Nations Programme on
HIV/AIDS (UNAIDS) and the World Health Organization (WHO),
highlights that beyond the peak and natural course of the
epidemic�HIV prevention programmes are making a difference.
"The good news is that we have evidence that the declines we are
seeing are due, at least in part, to HIV prevention," said Michel
Sidibe, Executive Director of UNAIDS. "However, the findings also
show that prevention programming is often off the mark and that if
we do a better job of getting resources and programmes to where
they will make most impact, quicker progress can be made and more
lives saved."
In this first double issue, the UNAIDS Outlook report further
explores how "modes of transmission" studies are changing the
approach of HIV prevention efforts. The new magazine-style report
looks at new ideas and ways to use the data collected in the
companion epidemiological report.
An estimated:
- 33.4 million [31.1 million - 35.8 million] people are living with
HIV worldwide
- 2.7 million [2.4 million - 3.0 million] people were newly
infected in 2008
- 2 million [1.7 - 2.4 million] people died of AIDS related illness
in 2008
Universal access to HIV prevention, treatment, care and support
Data from the AIDS Epidemic Update also show that at 33.4 million,
[31.1 million - 35.8 million] there are more people living with HIV
than ever before as people are living longer due to the beneficial
effects of antiretroviral therapy and population growth. However
the number of AIDS-related deaths has declined by over 10% over the
past five years as more people gained to access to the life saving
treatment. UNAIDS and WHO estimate that since the availability of
effective treatment in 1996, some 2.9 million lives have been
saved.
"International and national investment in HIV treatment scale-up
have yielded concrete and measurable results," said Dr Margaret
Chan, Director General of WHO. "We cannot let this momentum wane.
Now is the time to redouble our efforts, and save many more lives."
Antiretroviral therapy has also made a significant impact in
preventing new infections in children as more HIV- positive mothers
gain access to treatment preventing them from transmitting the
virus to their children. Around 200,000 new infections among
children have been prevented since 2001.
In Botswana, where treatment coverage is 80%, AIDS-related deaths
have fallen by over 50% over the past five years and the number of
children newly orphaned is also coming down as parents are living
longer.
AIDS out of isolation
One of the significant findings of the report is that the impact of
the AIDS response is high where HIV prevention and treatment
programmes have been integrated with other health and social
welfare services. Early evidence shows that HIV may be a
significant factor in maternal mortality. Research models using
South African data estimate that about 50,000 maternal deaths were
associated with HIV in 2008.
"AIDS isolation must end," said Mr Sidibe. "Already research models
are showing that HIV may have a significant impact on maternal
mortality. Half of all maternal deaths in Botswana and South Africa
are due to HIV. This tells us that we must work for a unified
health approach bringing maternal and child health and HIV
programmes as well as tuberculosis programmes together to work to
achieve their common goal."
The AIDS epidemic is evolving and HIV prevention programmes are not
rapidly adjusting to the changes
The double report also shows that the face of the epidemic is
changing and that prevention efforts are not keeping pace with this
shift. For example the epidemic in Eastern Europe and Central Asia
once characterized by injecting drug use is now spreading to the
sexual partners of people who inject drugs. Similarly in parts of
Asia an epidemic once characterized by transmission through sex
work and injecting drug use is now increasingly affecting
heterosexual couples.
Data show that few HIV prevention programmes exist for people over
25, married couples or people in stable relationships, widowers and
divorcees. These are the same groups in which HIV prevalence has
been found to be high in many sub-Saharan countries. For example in
Swaziland people over the age of 25 accounted for more than two
thirds of adult infections yet very few HIV prevention programmes
are designed for older people.
Funding for HIV prevention has become the smallest percentage of
the HIV budgets of many countries. For example in Swaziland, just
17% of the country's total budget for AIDS was spent on prevention
despite a national HIV prevalence rate of 26%. In Ghana, the
prevention budget was cut in 2007 by 43% from 2005 levels.
Building capacity: new social networking site for global AIDS
community
Building on the need to maximize results and to better connect the
33.4 million people living with HIV and the millions of people who
are part of the AIDS response, UNAIDS has launched
http://AIDSspace.org. This social networking site is open to the
community and is free.
AIDSspace.org aims to expand informal and established networks to
include more people interested in HIV to maximize resources for a
stronger AIDS response. The premise behind AIDSspace is simple: if
hundreds of millions of people can connect on some of the most
popular social networking sites (e.g. Facebook, LinkedIn, MySpace,
Twitter, YouTube) to connect, exchange ideas, post and share
HIV-related content, they can do the same for HIV related
content�including key policies, case studies, multimedia materials,
conference posters, reports and other essential resources. Users
can also find and post jobs and reviews on service providers on
http://AIDSspace.org
PEPFAR & the Global Fund Collaborate to Treat 3.7 Million Living
with HIV/AIDS
Programs Jointly Support Majority of 4 Million on Treatment in Low
and Middle-Income Countries
1 December 2009
Washington - The U.S. President's Emergency Plan for AIDS Relief
(PEPFAR) and the Global Fund to Fight AIDS, Tuberculosis and
Malaria announced today that the two programs are jointly
supporting antiretroviral treatment for nearly 3.7 million of the
estimated 4 million individuals in low and middle-income countries
who currently receive treatment globally.
Through its partnerships with more than 30 countries through
September 2009, PEPFAR has provided direct support for life-saving
antiretroviral treatment for over 2.4 million men, women and
children. The Global Fund has supported treatment for 2.5 million
people worldwide. Approximately 1.3 million people receive
treatment supported by both PEPFAR bilateral programs and the
Global Fund, and thus are counted in the totals for each
organization. These numbers reflect the strong country-level
partnership between PEPFAR and the Global Fund. For example, in
India, U.S. Government programs provide technical assistance to
treatment services and the antiretroviral drugs are provided by the
Global Fund.
PEPFAR and the Global Fund enjoy a complementary and supportive
relationship in the fight against HIV and AIDS worldwide. In order
to exploit synergies, PEPFAR and Global Fund-financed programs
coordinate at the country level to ensure that resources are used
efficiently and effectively. Collaboration and coordination are
crucial to the efficient use of money and for making further
progress in providing AIDS treatment and care to the millions still
in need.
PEPFAR is the largest commitment by any nation to combat a single
disease in history. Through PEPFAR, U.S. Government is the first
and largest donor to the Global Fund, contributing $3.5 billion to
date, with additional pledges that will bring the total U.S.
Government contribution to $4.5 billion.
In addition to significant support for antiretroviral treatment, in
FY 2009 alone, PEPFAR directly supported more than 11 million
people with care and support programs. Throughout its history,
PEPFAR�s efforts around prevention of mother-to-child transmission
programs allowed nearly 340,000 babies of HIV-positive mothers to
be born HIV-free. More than 4 million orphans and vulnerable
children have been assisted by the program.
With US$ 9.3 billion disbursed to more than 550 programs so far,
the Global Fund currently distributes a quarter of all
international financing for AIDS globally, as well as two-thirds
for TB and malaria.
The Global Fund is a unique global public/private partnership
dedicated to attracting and disbursing additional resources to
prevent and treat HIV/AIDS, tuberculosis and malaria. This
partnership between governments, civil society, the private sector
and affected communities represents a new approach to international
health financing. The Global Fund works in close collaboration with
other bilateral and multilateral organizations to supplement
existing efforts dealing with the three diseases.
Since its creation in 2002, the Global Fund has become the dominant
financing vehicle for programs to fight AIDS, tuberculosis and
malaria, with approved funding of US$ 18.7 billion for more than
600 programs in 144 countries. To date, programs supported through
the Global Fund have saved 4.9 million lives through providing AIDS
treatment for 2.5 million people, anti-tuberculosis treatment for
6 million people and the distribution of 104 million
insecticide-treated bed nets for the prevention of malaria.
###
For more information, please contact:
Andrew Hurst - The Global Fund
Office: + 41 58 791 16 72
Mobile: + 41 79 561 68 07
Email: [email protected]
Jennifer L. Peterson - Office of the U.S. Global AIDS Coordinator
Office: + 1 202 663 2338
Email: [email protected]
Information on the work of the Global Fund is available at
http://www.theglobalfund.org
Information on the work of PEPFAR is available at
http://www.pepfar.gov
Address by President Jacob Zuma on the occasion of World AIDS Day,
Pretoria Showgrounds
1 December 2009
http://www.info.gov.za/speeches/2009/09120112151001.htm
Deputy President Kgalema Motlanthe, The Minister of Health Dr Aaron
Motsoaledi and all Ministers and Deputy Ministers present,
Premier of Gauteng Nomvula Mokonyane and MECs present,
Executive Mayor of Tshwane Dr Gwen Ramokgopa, Deputy Chairperson of
the South African National AIDS Council, Mark Heywood,
Members of the diplomatic corps, UN AIDS Executive Director Michel
Sedibe and all representatives of international agencies,
Fellow South Africans,
Today we join millions of people across the globe to mark World
AIDS Day.
We join multitudes who have determined that this epidemic cannot be
overcome without a concerted and coordinated effort.
We join millions who understand that the epidemic is not merely a
health challenge. It is a challenge with profound social, cultural
and economic consequences.
It is an epidemic that affects entire nations. Yet it touches on
matters that are intensely personal and private.
Unlike many others, HIV and AIDS cannot be overcome simply by
improving the quality of drinking water, or eradicating mosquitoes,
or mass immunisation.
It can only be overcome by individuals taking responsibility for
their own lives and the lives of those around them.
Fellow South Africans,
As a country, we have done much to tackle HIV and AIDS.
In every sector of society, there are individuals and groups who
have worked tirelessly to educate, advocate, care, treat, prevent
and to break the stigma that still surrounds the epidemic.
Today, we wish to acknowledge their dedicated efforts.
As government we are ready to play our role of leadership, building
on the foundation that has been laid over the past 15 years.
Under the leadership of Presidents Nelson Mandela, Thabo Mbeki and
Kgalema Motlanthe, the democratic government has put in place
various strategies to comprehensively deal with HIV and AIDS,
tuberculosis and sexually transmitted infections.
Working with other sectors through the South African National AIDS
Council, we have managed to harness unity in confronting this
scourge.
The amount of resources dedicated to prevention, treatment and care
has increased with each successive year.
But it is not enough. Much more needs to be done.
We need extraordinary measures to reverse the trends we are seeing
in the health profile of our people.
We know that the situation is serious. We have seen the statistics.
We know that the average life expectancy of South Africans has been
falling, and that South Africans are dying at a young age.
We have seen the child-headed and granny-headed households, and
have witnessed the pain and displacement of orphans and vulnerable
children.
These facts are undeniable. We should not be tempted to downplay
the statistics and impact or to deny the reality that we face.
At the same time, the epidemic is not about statistics. It is about
people, about families, and communities.
It is about our loved ones.
For many families, it is a burden that they have to bear alone,
fearful of discrimination and stigma.
Dear Compatriots,
Now is not the time to lament. It is the time to act decisively,
and to act together.
Our message is simple. We have to stop the spread of HIV. We must
reduce the rate of new infections. Prevention is our most powerful
weapon against the epidemic.
All South Africans should take steps to ensure that they do not
become infected, that they do not infect others and that they know
their status.
Each individual must take responsibility for protection against
HIV. To the youth, the future belongs to you.
Be responsible and do not expose yourself to risks.
Parents and heads of households, let us be open with our children
and educate them about HIV and how to prevent it.
Ladies and gentlemen,
We are still marking the 16 days of activism against violence on
women and children. During this period, it is important that we
also remember to uphold the rights of women and children, including
their right to protection from infection with HIV.
Many women are unable to negotiate for protection due to unequal
power relations in relationships.
As we mark the International Day of Persons with Disabilities on
Thursday, the 3rd of December, let us remember the impact of HIV on
persons with disability.
We have to tailor government programmes and messages to also speak
to the needs of this sector.
Fellow South Africans,
To take our response a step forward, we are launching a massive
campaign to mobilise all South Africans to get tested for HIV.
Every South African should know his or her HIV status. To prepare
for a continuous voluntary testing campaign, we would like to
announce a few new measures, to expand our response.
All children under one year of age will get treatment if they test
positive. Initiating treatment will therefore not be determined by
the level of CD cells.
This decision will contribute significantly towards the reduction
of infant mortality over time.
All patients with both tuberculosis (TB) and HIV will get treatment
with anti-retrovirals if their CD4 count is 350 or less. At present
treatment is available when the CD4 count is less than 200. TB and
HIV/AIDS will now be treated under one roof.
This policy change will address early reported deaths arising from
undetected TB infection among those who are infected with HIV.
We have taken this step, particularly on learning that
approximately 1% of our population has TB and that the co-infection
between TB and HIV is 73%.
All pregnant HIV positive women with a CD4 count of 350 or with
symptoms regardless of CD4 count will have access to treatment. At
present HIV positive pregnant women are eligible for treatment if
their CD4 count is less than 200.
All other pregnant women not falling into this category, but who
are HIV positive, will be put on treatment at fourteen weeks of
pregnancy to protect the baby. In the past this was only started
during the last term of pregnancy.
In order to meet the need for testing and treatment, we will work
to ensure that all the health institutions in the country are ready
to receive and assist patients and not just a few accredited ARV
centres. Any citizen should be able to move into any health centre
and ask for counselling, testing and even treatment if needed.
The implementation of all these announcements is effective from
April 2010. Institutions are hard at work to ensure that systems
are in place by the 31st of March.
What does this all mean? It means that we will be treating
significantly larger numbers of HIV positive patients. It means
that people will live longer and more fulfilling lives.
What does it NOT mean? It does not mean that we should be
irresponsible in our sexual practices.
It does not mean that people do not have to practice safer sex. It
does not mean that people should not use condoms consistently and
correctly during every sexual encounter.
We can eliminate the scourge of HIV if all South Africans take
responsibility for their actions.
I need to re-emphasise at this point that we must intensify our
prevention efforts if we are to turn off the tap of new HIV and TB
infections. Prevention is our most powerful and effective weapon.
We have to overcome HIV the same way that it spreads - one
individual at a time. We have to really show that all of us are
responsible.
The HIV tests are voluntary and they are confidential. We know that
it is not easy. It is a difficult decision to take.
But it is a decision that must be taken by people from all walks of
life, of all races, all social classes, all positions in society.
HIV does not discriminate.
I am making arrangements for my own test. I have taken HIV tests
before, and I know my status. I will do another test soon as part
of this new campaign. I urge you to start planning for your own
tests.
Ladies and gentlemen,
We are also mindful of the social impact of the epidemic, and
continue to provide psycho-social support and home based care,
through the Home Community Based Care and child care programmes of
government.
Let me use this opportunity to salute all our caregivers including
those neighbours who assist and support families in distress.
We also thank our international partners, who continue to provide
material support to our campaign against AIDS.
On this day, our hearts go out to all South Africans who are in
distress as a result of this epidemic. To families looking after
sick relatives, we wish you strength. We understand what you are
going through.
To those who have lost their loved ones to the epidemic we share
your pain, and extend our deepest condolences.
Fellow South Africans,
At another moment in our history, in another context, the
liberation movement observed that the time comes in the life of any
nation when there remain only two choices: submit or fight.
That time has now come in our struggle to overcome AIDS.
Let us declare now, as we declared then, that we shall not submit.
We have no choice but to deploy every effort, mobilise every
resource, and utilise every skill that our nation possesses, to
ensure that we prevail in this struggle for the health and
prosperity of our nation.
History has demonstrated the strength of a nation united and
determined.
We are a capable, innovative and motivated people.
Together we fought and defeated a system so corrupt and reviled
that it was described as a crime against humanity.
Together we can overcome this challenge.
Let today be the dawn of a new era.
Let there be no more shame, no more blame, no more discrimination
and no more stigma.
Let the politicisation and endless debates about HIV and AIDS stop.
Let this be the start of an era of openness, of taking personal
responsibility, and of working together in unity to prevent HIV
infections and to deal with its impact.
Working together, we can achieve these goals!
I thank you.
Issued by: The Presidency
1 December 2009
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with
a particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.
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