The New York Times
By The Editorial Board
The world has made so much progress in reducing the spread of AIDS and treating people with H.I.V. that the epidemic has receded from the public spotlight. Yet by any measure the disease remains a major threat — 1.1 million people died last year from AIDS-related causes, and 2.1 million people were infected with the virus. And while deaths are down over the last five years, the number of new infections has essentially reached a plateau.
The United Nations announced a goal last week of ending the spread of the disease by 2030. That’s a laudable and ambitious goal, reachable only if individual nations vigorously campaign to treat everyone who has the virus and to limit new infections.
The medicines and know-how are there, but in many countries the money and political will are not. Besides shining a spotlight on the disease, it’s crucial that wealthy nations like the United States continue to pony up generously to underwrite what must be a global effort. Donors and low- and middle-income countries need to increase spending to $26 billion a year by 2020, the United Nations says, up from nearly $19.2 billion in 2014.
While still high, deaths attributable to AIDS are down 36 percent from 2010. That is largely because many more people are receiving antiretroviral drugs — 17 million people in 2015, compared with 7.5 million five years earlier. These medicines allow people to live near-normal lives and greatly reduce the risk of transmission to others.
But while some countries like South Africa (once a disaster zone) and Kenya have made tremendous progress in increasing treatment, many people who need the lifesaving therapy do not have access to it. Only 28 percent of those infected in Western and Central Africa were being treated in 2015, according to a recent United Nations report. The numbers were even lower in the Middle East and North Africa (17 percent) and Eastern Europe and Central Asia (21 percent). In some countries, people who test positive are told to come back when they get sick because of budget constraints, says Sharonann Lynch, an H.I.V. policy adviser at Doctors Without Borders. Many never return.
In other places, it can be hard to even reach people who need drugs because of war or the lack of a functional public health system. And many who need help are unwilling to come forward because they fear being ostracized or worse because they are gay, use drugs or are engaged in sex work. Discriminatory laws and attitudes in countries like Nigeria, Russia and Uganda have probably forced tens of thousands of people who need help into hiding.
In some countries, infections have actually increased, which helps explain why progress has plateaued over all. In Eastern Europe and Central Asia, for instance, 190,000 people became infected last year, up from 120,000 in 2010. And while the number of deaths is way down, the number of new infections was flat or down modestly over the same five-year period. This was also true of the United States, where an estimated 44,073 people were diagnosed in 2014, the most recent year for which the Centers for Disease Control and Prevention have published data, down from 44,940 in 2010.
These numbers do not argue for complacency, but instead for more vigorous public health campaigns, increased access to condoms, clean needles for drug users and prescriptions for pre-exposure drugs. There is still no cure for AIDS. But there are many ways to minimize its deadly consequences.
By Elton John and Desmond Tutu
8 June 2016
This week, world leaders are gathering at the United Nations to act on a groundbreaking goal: to make AIDS history. And while the goal is undoubtedly ambitious, it is achievable if we commit the political will and resources to make it happen.
The progress we have already made in the battle to contain AIDS is quite extraordinary. It is evidence of the irresistible power within the human family, when individuals, communities and countries work together to achieve common goals, to make the impossible, possible.
It was just 15 years ago, in 2001, that the United Nations convened the first High Level Meeting on HIV/AIDS.
At the time, we faced a global nightmare that looked like it would be with us for generations. The horror was palpable. Lifesaving treatment was too expensive for many, and health care systems in many poor countries too weak. Infant mortality was tripling, life expectancy was plummeting, and families, communities, economies and even some countries were teetering on the brink of collapse. Years of hard-won development progress were being wiped out overnight.
Hope and opportunity were scarce, and much-needed action seemed frozen by fear, denial and stigma.
No one knew what to expect at that meeting. Even beginning to turn the tide on AIDS seemed out of reach, but that’s just what the world came together to do.
One-hundred-and-eighty-nine states ratified the U.N. Declaration of Commitment to Fight AIDS. The United States government enacted the $30 billion President’s Emergency Plan for AIDS Relief, the largest global health initiative in history. Donors and partner governments created the Global Fund for AIDS, TB & Malaria, which has saved 17 million lives by supporting country-driven health care systems.
The results of the world’s commitment have been unprecedented. More than 15.86 million people living with HIV now have access to lifesaving treatment, new HIV infections have been cut by more than one-third for adults and nearly two-thirds for children, and AIDS deaths have dropped by more than 40%. All in all, 30 million new infections and 8 million deaths have been prevented by our work together. It’s hard to beat that kind of real world return on investment.
Moreover, AIDS investments have paid dividends many times over by positively impacting other development priorities like improving health care systems, preparing for other emerging health crises, reducing maternal and infant mortality, and promoting human rights, gender equality, civil society and democracy.
Now, the Joint United Nations Program on HIV/AIDS has stated, we have the science, the tools and the solidarity to actually end AIDS by 2030.
But our sense of urgency has not subsided and more work lies ahead. Last year alone, over 2 million people became infected with HIV and another million died of AIDS. If we do not pick up our pace and simply continue HIV prevention and treatment services at their current level, our progress will slip backward and the epidemic could again explode. But if we leverage our current momentum and, over the next five years, accelerate our scale-up for the people, places and programs with the greatest impact, we can save millions more lives and billions of dollars.
The world leaders at the 2016 High Level Meeting on Ending AIDS this week have another historic opportunity — this time to pass a political declaration that translates our vision for fast-tracking the end of AIDS into a road map for concerted action. Making this happen will require bold leadership and shared responsibility from heads of state from the north and the south; ministers of health; program implementers; faith, business and foundation leaders; civil society and all the other partners that have helped bring us to this fragile tipping point.
This would surely include the LGBT organizations that some have been trying to keep out of this meeting. In our view, progress is made by bringing people together, not pushing them apart.
We urge leaders from around the globe to be actively engaged in the High Level Meeting and help secure a global compact that commits to: fast-tracking and front-loading investments over the next five years, setting ambitious but doable global prevention and treatment targets that keep us on track, and leaving no one behind by ensuring that human rights remain at the center of the AIDS response, especially among marginalized populations in challenging settings. This is not a time to coast or move on, but to focus and accelerate.
Those on the front lines of this epidemic and their allies around the world know exactly what we need to do and are well on the path to getting it done. But more will and wallet remain essential. Sadly, experience has too often left the African landscape littered with great ideas and good intentions that stopped short of accomplishing their goals. We cannot afford to let our fight against AIDS go down that road. We have come too far, we are too close to the end and there is far too much at stake.
We have the ability and opportunity to save lives and build AIDS-free futures. Let’s seize the day and make AIDS history.
Global Fund News Release
14 January 2014
GENEVA — UNAIDS and the Global Fund to Fight AIDS, Tuberculosis and Malaria express deep concern that access to HIV services for lesbian, gay, bisexual and transgender (LGBT) people will be severely affected by a new law in Nigeria––further criminalizing LGBT people, organizations and activities, as well as people who support them.
The new law could prevent access to essential HIV services for LGBT people who may be at high risk of HIV infection, undermining the success of the Presidential Comprehensive Response Plan for HIV/AIDS which was launched by President Goodluck Jonathan less than a year ago.
The health, development and human rights implications of the new law are potentially far-reaching. Homosexuality is already criminalized in Nigeria. The new law further criminalizes LGBT people, organizations and activities. The law states: “A person who registers, operates or participates in gay clubs, societies and organisation, or directly or indirectly makes public show of same sex amorous relationship in Nigeria commits an offence and is liable to conviction to a term of 10 years imprisonment.”
The law also criminalizes any individuals or group of people who support “the registration, operation and sustenance of gay clubs, societies and organisations, processions or meetings in Nigeria.” The conviction is also 10 years imprisonment.
The provisions of the law could lead to increased homophobia, discrimination, denial of HIV services and violence based on real or perceived sexual orientation and gender identity. It could also be used against organizations working to provide HIV prevention and treatment services to LGBT people.
Nigeria has the second largest HIV epidemic globally––in 2012 there were an estimated 3.4 million people living with HIV in Nigeria. In 2010, national HIV prevalence in Nigeria was estimated at 4 percent among the general population and 17 percent among men who have sex with men.
In the 2011 United Nations Political Declaration on HIV/AIDS, all UN Member States committed to removing legal barriers and passing laws to protect populations vulnerable to HIV.
UNAIDS and the Global Fund call for an urgent review of the constitutionality of the law in light of the serious public health and human rights implications and urge Nigeria to put comprehensive measures in place to protect the ongoing delivery of HIV services to LGBT people in Nigeria without fear of arrest or other reprisals. UNAIDS and the Global Fund will continue to work with the Nigerian authorities and civil society organisations to ensure continued and safe access to HIV services for all people in Nigeria.
UNAIDS and the Global Fund urge all governments to protect the human rights of lesbian, gay, bisexual and transgender people, through repealing criminal laws against adult consensual same sex sexual conduct; implementing laws to protect them from violence and discrimination; promoting campaigns that address homophobia and transphobia; and ensuring that adequate health services are provided to address their needs.
08 January 2014 – From the UNAIDS website
Millions of people live in fear and isolation because of their sexual orientation and gender identity.
Towards a free and equal world is an info-graphic that highlights the 78 countries where adult consensual same-sex sexual conduct is criminalized including the 7 countries where this conduct is punishable by death. We know that ending punitive laws based on sexual orientation and gender identity reinforces human rights and supports access to life-saving HIV services. The agenda addressing criminalization, supportive legal and protected environment is critical to achieving the UNAIDS vision of Zero new infections. Zero discrimination. Zero AIDS-related deaths.
From the 18 September 2013 Global Fund News Release
YAOUNDE, Cameroon – The Global Fund to Fight AIDS, Tuberculosis and Malaria and Cameroon jointly announced that they are both significantly increasing their funding for anti-retroviral drugs to meet the country’s fast–growing HIV treatment needs.
The Global Fund has approved a $US 20 million grant agreement for HIV treatment while Cameroon said it will nearly double the amount for purchasing anti-retroviral medicines in its annual budget, which will increase to $US 20 million in 2014 from $US 11 million.
The new joint funding initiatives, which make a big contribution to securing anti-retroviral treatment for more than 122,000 people, were announced by Cameroon’s Health Minister, Andre Mama Fouda, and by Lelio Marmora, the Global Fund’s head for Africa and the Middle East, at a news conference in Yaoundé on Tuesday evening.
“This new funding from the Global Fund and from Cameroon is going to make a real difference,” said Marmora. “We warmly welcome the government’s strong initiative in helping to put the procurement and supply of antiretroviral medicines on a strong footing.”
Minister Fouda said Cameroon was strongly committed to sharing the cost with the Global Fund of funding a significant increase in the number of people living with HIV who receive anti-retroviral treatment in the country.
“We must mobilize all our energy to achieve this goal and that means each of us must play an important part,” said Minister Fouda.
Today’s news means that extraordinary funding of $US 10 million announced by President Paul Biya in August to help cover antiretroviral needs until October 2014 will now be consolidated in the national budget on an annually recurring basis.
The number of people living with HIV who receive antiretroviral treatment has more than doubled since 2009. At the end of 2012, 122,000 people were on HIV treatment, or 42 percent of those requiring it. On average in 2012, some 1,400 new patients were starting treatment with anti-retroviral medicines every month.
Marmora and Minister Fouda said the Global Fund and Cameroon would also work together on a nationwide campaign, starting in 2015, to distribute up to 12 million long lasting insecticide-treated nets and provide every family in the country with protection against mosquitoes. More than 8 million nets distributed in an earlier campaign in 2011 will be starting to wear out by the time the 2015 campaign is launched.
“The Global Fund is strongly committed to supporting the net distribution campaign and will concentrate its resources and efforts on purchasing the long lasting nets, allowing Cameroon to distribute them throughout the country,” said Marmora.
Malaria is the leading cause of death among children under 5 in Cameroon.
The Global Fund and the U.S. President Emergency Program for AIDS Relief (PEPFAR) are also providing US$10 million of emergency funding to Cameroon in order to keep supplies of antiretroviral drugs flowing until the end of 2013.
Minister Fouda said all people, regardless of ethnic origin and religious belief, and including lesbian, gay, bisexual and transgender people (LGBT) in Cameroon had unrestrained access to healthcare. “When somebody has a health problem, we treat the illness”, he said. “The right to treatment and to receiving healthcare is not in any way discriminatory.”
Marmora said the Global Fund condemned all forms of violence against people because of sexual orientation or perceived HIV status, adding that discrimination and criminalization of lesbian, gay, bisexual and transgender people undermined efforts to defeat the HIV epidemic.
The murder of Eric Ohena Lembembe, a prominent Cameroonian journalist and LGBT activist, in July drew widespread international condemnation.