By Dr Timothy West, Pacific Friends of the Global Fund Representative at ICAAP11
BANGKOK - Day one of the 11th International Congress on AIDS in Asia and the Pacific (ICAAP11) featured keynote addresses from senior government officials and NGO representatives from some 80 countries, including Mr Pradit Sintavanarong, Public Health Minister of Thailand representing Ms Yingluck Shinawatra, Prime Minister of Thailand, Mr Ratu Epeli Nailatikau, President of Fiji, Ms Jan Beagle, Deputy Executive Director of UNAIDS, Mr Mechai Viravaidya, Chairman of the Population and Community Development Association (PDA) and also known as “Mr Condom” in Thailand, and Professor N.M. Samuel, President of the AIDS Society of Asia and the Pacific (ASAP). Video messages from Aung San Suu Kyi, UNAIDS Global Advocate for Zero Discrimination and Michel Sidibe, UNAIDS Executive Director were also screened.
There were strong recurring themes in presentations which set the tone and agenda for the remainder of the conference, which runs until Friday 22 November.
Most importantly, there was recognition that the United Nations Millennium Development Goals (MDGs) expire in 2015 and that post-2015, HIV may receive less attention than it has over the last thirteen years. In his video message, Mr Sidibe argued that in light of this, there were three critical questions that the conference should address. Firstly, it should determine how to meet the specific aims of MDG 6, which sets specific goals for HIV treatment and prevention, before the MDGs expire. Second, it should re-kindle HIV/AIDS activism in the community to prepare for advocacy in the post-2015 world. Third, it should start the process of defining what goals should be set in the post-2015 world. These issues should be discussed with the understanding that neither a cure nor vaccine for HIV/AIDS are on the horizon and that therefore long-term plans must be based on currently implementable policies such as treatment as prevention.
The need to focus on key at-risk groups, as well as the generalised epidemic, was also a common theme of the first day. These groups are well-recognised and in the Asia-Pacific context consist of men who have sex with men (MSM), intravenous drug users (IVDU), those who buy and sell sex, transgendered people and migrant workers. The focus should consist both of engaging and empowering these communities to represent themselves, and societal and legal change to remove discriminatory law and customs. Furthermore, discrimination against people living with HIV/AIDS (PLWHA) must also be addressed. Daw Suu Kyi said, “You and I can make a difference by reaching out and letting people lead a life of dignity regardless of their HIV status or sexual orientation. We need an Asia-Pacific community of compassion to end discrimination.”
There was a strong emphasis on the need for rational, evidence based policy. In particular, there is a need to provide anti-retroviral (ARV) therapy to all people with HIV, regardless of their CD4 cell count. Known as “early test/treat”, this policy is backed by strong scientific evidence but within the Asia-Pacific region only Cambodia has made significant headway in its implementation. Barriers to its implementation include uncertainty of long-term funding for ARV therapy. Ms Beagle pointed out that at present 62% of funding for ARV therapy within the Asia-Pacific region was from government sources, and that the maintenance of this level of domestic funding is critical to continuing and extending the delivery of ARV therapy across the region. Presently, only half of those eligible for ARV therapy receive it.
Finally, there was recognition that young people are critical to the fight against HIV/AIDS. There is a need to engage and educate young people throughout the Asia-Pacific region, and to ensure that they are able to access HIV testing and ARV therapy. For example, Thailand is presently planning law reform to allow minors to access these critical services without parental consent. In describing previous successful campaigns of youth engagement, Mr Viravaidya gave a humorous and highly informative presentation in which he described Thailand’s successful education program. This program began in the late 1980s and involved sex education across all of society, in schools at all levels, and broad distribution of condoms in such places as shopping centres, bars, toll booths, gas stations and McDonalds. Police also distributed condoms in a program Mr Viravaidya described as the “cops and rubbers” programme.
The remainder of the conference will examine these issues in detail. As Mr Sintavanarong said in the closing address for the day, ”We have the capacity, and now we need to demonstrate how the Asia-Pacific region can lead the world to zero HIV, zero discrimination and zero AIDS related deaths”.
By Dr Timothy West, Pacific Friends of the Global Fund representative at ICAAP11
BANGKOK - The 11th International Congress on AIDS in Asia and the Pacific (ICAAP11) opened today at the Queen Sirikit National Convention Centre. With a theme of “Reaching Triple Zero: Investing in Innovation”, the conference will examine the particular challenges of the Asia-Pacific context in reaching the UNAIDS vision of zero new infections, zero AIDS-related deaths and zero discrimination. While these specific challenges vary greatly from country to country, common issues include the impending expiry of the UN Millennium Development Goals in 2015, the need to better engage with communities at increased risk of HIV/AIDS, the importance of evidence-based policy such as early test/treat, the need for legal reform, and ethnic and sexual discrimination.
High-level presenters at the conference include Yingluck Shinawatra, Prime Minister of Thailand, Ratu Epeli Nailatikau, President of Fiji and Nafsia Mboi, the Indonesian Health Minister and Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. There is a diverse Australian delegation, including representatives of the Australian government and executives and staff members from organisations including ACON, AFAO and the Burnet Institute amongst others. Pacific Friends of the Global Fund is represented by Chris Puplick, advisor to the NSW Health Minister and former federal senator, Shawn Clackett, communications and administrative officer, Dr Timothy West and Dr Jeremy Law.
ICAAP occurs biennially in odd-numbered years, alternating with the International AIDS Conference, the worldwide top-level HIV/AIDS symposium. The Australian Government is a Platinum Sponsor of ICAAP11. With Melbourne hosting the AIDS 2014 conference in July 2014, the upcoming Global Fund replenishment round and the impending visit to Australia by Aung San Suu Kyi for World AIDS Day 2013, ICAAP11 is a valuable opportunity to raise the profile of Australia’s response to HIV/AIDS and to set the agenda for AIDS 2014.
From the Global Fund News Release 05 November 2013
PARIS – President Francois Hollande of France met today with the Chair of the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria, Dr. Nafsiah Mboi, to discuss joint commitment fighting disease with strong financial and moral support from France.
Dr. Nafsiah Mboi told the President that France’s distinguished leadership in global health has made a tremendous difference in the lives of millions of people around the world.
“It is my pleasure to thank you for the solidarity and leadership France has shown the global family in the continuing effort to contain AIDS, tuberculosis and malaria and to improve global public health,” said Dr. Nafsiah Mboi at the meeting in the President’s official residence, the Elysée Palace.
“We are immensely grateful to the French government and French people for sustained and generous financial support of the Global Fund,” said Dr. Nafsiah Mboi. “The knowledge and skills to control and ultimately defeat these diseases is reaching the far corners of the globe, with the help of France.”
Dr. Nafsiah Mboi was joined by Mireille Guigaz, the Vice Chair of the Board of the Global Fund, as well as Pascal Canfin, France’s Minister of Development, and Mark Dybul, the Global Fund’s Executive Director.
President Hollande said he wanted France to strengthen cooperation with the Global Fund, both at its headquarters in Geneva and in the field by stepping up involvement of the French diplomatic service, notably in francophone countries.
President Hollande today reaffirmed France’s strong financial commitment to the Global Fund despite tight budgetary constraints, saying that France will contribute €1.08 billion (US$1.4 billion) to the Global Fund for the 2014-2016 period, consistent with an announcement in July.
“The President of the Republic expressed his wishes that the replenishment conference of the Global Fund on December 3 in Washington will be a success,” said a statement by the French President’s office.
The statement cited France’s role as a pioneer in innovative financing programs such as UNITAID, a global health initiative which France helped to establish, funded mostly from a levy on airline tickets.
“The eradication of AIDS and tuberculosis and malaria requires vigorous and coordinated international mobilization,” Minister Canfin said.
“France reaffirms its determination in this fight, in which the Global Fund is one of the main tools. We are the first generation of political leaders who can contribute to bringing the three pandemics to an end.”
Mireille Guigaz indicated that “with the Global Fund, UNITAID, GAVI as well as French scientific and technical expertise and multiple firms acting in the public health sector, France as a wonderful set of tools to impact for the fight against the three diseases.”
France is the second largest contributor overall to the Global Fund after the United States, and has donated more than $3.6 billion to the Global Fund since its inception in 2002.
France has also extended the reach and impact of its investments in global health by working through the Global Fund. Since 2011, up to five per cent of France’s contribution to the Global Fund has been earmarked for capacity-building activities in Francophone countries aimed at improving the effectiveness and health impact of Global Fund grants.
Sunday 27 October 2013 12:30PM
GENEVA – In partnership with Zambia, the Global Fund to Fight AIDS, Tuberculosis and Malaria signed a US$156 million grant agreement that aims to ensure a secure supply of antiretroviral medicine to all those receiving HIV treatment. The new funding will also support work that gets 225,000 more people to start treatment over the next three years.
At present, 480,000 people in Zambia are enrolled on antiretroviral (ARV) treatment with Global Fund support.
“Continued support from the Global Fund allows us to increase HIV testing and start thousands more people on treatment,” said Dr. Joseph Kasonde, Minister of Health, Republic of Zambia. “It will also allow us to pursue the elimination of mother-to-child transmission of HIV and to increase coverage of male circumcision.”
Zambia is one of the first countries in sub-Saharan Africa to achieve universal access to ARV treatment, defined as 80 percent coverage of those eligible. More than 90 percent of adults requiring treatment were on ARV therapy in June 2013. Zambia has been working with the Global Fund, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and other partners, all of whom made important contributions to these achievements.
Zambia has adopted new WHO guidelines encouraging countries to automatically provide all HIV-positive pregnant or breastfeeding women antiretroviral therapy for life – a change that aims to both prevent transmission to infants and keep mothers healthy. Zambia has also adopted the WHO-recommended approach to couples where one person is HIV positive by providing treatment to these people regardless of the strength of their immune system – a factor that had previously determined whether treatment should commence.
The new grant, signed with the United Nations Development Programme, will also help strengthen the national supply chain and systems for assessing impact, as well as increasing the Ministry of Health’s capacity for managing health programs.
“Zambia’s strong political support and the growing level of domestic financing have helped establish interventions for attaining universal access in prevention, treatment, care and support,” said Linden Morrison, Head of the Global Fund’s High Impact Africa II Department. “Robust partnerships and investments will continue to yield impact.”
The 2012 UNAIDS report estimates HIV prevalence at 12.5 percent. More females (16.1 percent) than males (12.3 percent) are HIV-positive. Among 15 to 24 years, the estimated prevalence is 7 percent and 3.1 percent for females and males, respectively. HIV is the leading cause of death for all ages in Zambia.
Global Health News
Pacific Friends of the Global Fund to Fight AIDS, Tuberculosis and Malaria is a high-level advocacy organisation which seeks to mobilise regional awareness of the serious threat posed by HIV & AIDS, tuberculosis and malaria to societies and economies in the Pacific. In pursuing its goals Pacific Friends has a specific interest in highlighting the need to protect the rights of women and children in the Pacific.