2011 High Level Meeting on AIDS
More than 3,000 people, including more than 30 Heads of State, Government and Vice Presidents, have come together at the United Nations in New York for the UN General Assembly High Level Meeting on AIDS.
The High Level Meeting on AIDS took place 10 years after the historic 2001 UN Special Session on HIV/AIDS, and the 2006 signing of the Political Declaration where UN Member States committed to moving towards universal access to HIV prevention, treatment, care and support.
The meeting, which ran from 8 to 10 June 2011, provided an opportunity to take stock of the progress and challenges of the past 30 years and shape the future of the AIDS response.
The meeting included official plenary and five panel sessions, along with 40 individual side events. On the final day, UN Member States adopted a declaration that will guide country responses to HIV over the next five years.
The declaration not only recommits the global community to achieve universal access by 2015, but also articulates a number of global targets, transforming the principle of universal access from a vague aspirational goal into concrete and measurable objectives:
- Fifty per cent reduction in sexual transmission of HIV
- Fifty per cent reduction of HIV among people who inject drugs
- Fifty per cent reduction of tuberculosis (TB) deaths in people living with HIV
- Ensure no children are born with HIV and reduction of AIDS-related maternal deaths
- 15x15 (15 million people on antiretroviral treatment by 2015)
- Mobilise funding (US$22–24 billion per year)
- Fifty-five Operative Paragraphs in the Political Declaration
Implications for Eastern and Southern Africa
Eastern and Southern Africa is the epicentre of the global HIV epidemic with close to 50 per cent of all persons living with HIV. Consequently, its contribution to the global response should be at least 50 per cent.
- In 2010, 1.2 million new HIV infections occurred in Eastern and Southern Africa, representing almost half (46 per cent) of all new HIV infections globally.
- While new infections have declined in the region, Eastern and Southern Africa still needs a prevention revolution if global targets are to be met.
- Eight countries have annual new infections of approximately 50,000 or more; 900,000 infections occurred in the eight countries.
- Young women aged 15–24 years are eight times more likely than men to be HIV positive.
15 x 15
- The number of persons on antiretroviral treatment (ART) in the region was 4.2 million in 2010, while the unmet need for ART was 3.4 million (56 per cent coverage).
- Epidemiological projections show that if the 15x15 target is met by 2015, 79 per cent of those in need of ART will be receiving it. New targets have to exceed 79 per cent to meet 15x15 targets.
- Using the new WHO Guidelines (CD4 < 350), most countries have not yet achieved 60 per cent ART coverage.
- Rwanda, Botswana and Namibia have made excellent progress.
- High impact countries: large population with HIV with less than 60 per cent coverage (using CD4 350 guidelines), namely South Africa, Mozambique, Malawi, Kenya, Tanzania, Uganda, Zimbabwe and Ethiopia.
Elimination of Mother-to-Child Transmission (eMTCT)
- Approximately 390,000 babies were born with HIV in 2010 globally; 56 per cent or 220,000 were in Eastern and Southern Africa.
- Nearly 90 per cent of all new HIV infections among children globally occur in 22 countries – 21 of those countries are in Africa, and 14 are in Eastern and Southern Africa.
- The Global Plan on eMTCT is achievable only if countries achieve more than 90–95 per cent coverage for high quality Prevention of Mother-to-Child Transmission (PMTCT) services.
- Regional coverage for PMTCT services in 2010 was 77 per cent.
- Nine countries have more than 10,000 infections in babies each year; four countries have more than 20,000.
Reduce TB Deaths
- Sixty-one per cent of the 1.3 million global TB cases in people living with HIV occurred in Eastern and Southern Africa in 2008.
- Less than half (45 per cent) of all TB patients know their HIV status; a small proportion of people living with HIV was screened for TB or received TB preventive therapy.
- Eight countries – South Africa, Zimbabwe, Uganda, Kenya, Tanzania, Mozambique, Ethiopia and Zambia – account for over half (53 per cent) of the global burden of HIV-related TB.
- In 2008, US$4.6 billion was spent on HIV and AIDS programmes in Eastern and Southern Africa.
- This represents 30 per cent of global spending, yet the region has 50 per cent of the global epidemic.
- How much of the US$22–24 billion should go to regional programmes by 2015?
- High Need Cluster: Nine countries with low income and high reliance on external sources: Mozambique, Zambia, Rwanda, Malawi, Tanzania, Kenya, Uganda, Ethiopia and Zimbabwe
- Global Fund cancellation of Round 11 will affect Eastern and Southern Africa more than any other region.