Michel Sidibé, Executive Director of UNAIDS, answers the questions asked by Catherine Fiankan-Bokonga
This year you chose the right to health as a World AIDS Day theme. Why is that?
On every World AIDS Day, we look back, to remember our friends who have died from AIDS-related illnesses or are living with or affected by HIV. We remember their struggle to demand and claim their rights to treatment, to prevention services and to live free from stigma or discrimination. And we look forward, to ensuring that everyone, everywhere has access to the services that they need to keep well and stay HIV-free. This World AIDS Day we are focusing on the right to health to highlight the gaps in access to health, not just of people living with and affected by HIV, but of everyone. Heath inequities must be erased. Almost all of the Sustainable Development Goals are linked in some way to health, so achieving those, which include ending the AIDS epidemic, will depend heavily on ensuring the right to health.
In what country will you commemorate World AIDS Day?
I will be in Ottawa, Canada, to launch a new report called Blind Spot, which highlights the importance of reaching men and boys to end AIDS. Our report points out that men are much less likely to know their HIV status than women. And many men who are diagnosed with HIV are diagnosed late and start treatment only when they fall ill, making them much more likely to die of AIDS-related illnesses than women. As you know, Prime Minister Justin Trudeau has called himself a feminist and since the health of men and women is so intertwined this is a great opportunity for us.
What is the rate of new HIV infections in the world?
In 2016, 1.8 million people became newly infected with HIV. Since 2010, new HIV infections among adults declined by an estimated 11%, from 1.9 million to 1.7 million. In that same time, new HIV infections among children fell by 47% globally and by 56% in eastern and southern Africa, the region most affected by HIV.
And the overall trends?
The region showing the most progress is eastern and southern Africa, which has been most affected by HIV and which accounts for more than half of all people living with HIV. Certain regions, however, concern me, such as the Middle East, North Africa and eastern Europe and central Asia. Between 2010 and 2016, new HIV infections rose by 60% in eastern and central Asia and AIDS-related deaths increased by 27%. Young people are also lagging behind on multiple fronts. People in the 15–24 age group have too little knowledge of HIV testing, treatment and prevention and they continue to be at greater risk of HIV infection, especially young women in sub-Saharan Africa.
How many people are on treatment?
A total of 20.9 million people were accessing antiretroviral therapy in June 2017. That is remarkable progress considering that in 2000 just 685 000 people living with HIV had access to treatment. Such a dramatic scale-up could not have happened without the courage and determination of people living with HIV demanding and claiming their rights. Provided that scale-up continues, this progress puts the world on track to reach the global target of 30 million people on treatment by 2020.
We live in fragile times, where gains can be reversed. The biggest challenge to moving forward is complacency.
Are budgetary issues a concern to UNAIDS?
Funding for health needs to increase. Money for health is the key to reducing new HIV infections and AIDS-related deaths. There is a funding gap for HIV that is estimated at US$ 7 billion dollars by 2020.
Increasing the share of health spending as a proportion of national economies, making savings through efficiencies and partnering with the private sector will enable us to end the AIDS epidemic by 2030.
What is the situation in China? And what are the partnerships you have with China?
China has made impressive efforts in trying to control its epidemic. For a country with such a huge population, the situation could have been much worse. China’s voluntary methadone maintenance therapy programme is one of the largest in the world. Injecting drug users represented about 44% of people living with HIV in China. That figure, in part because of the maintenance therapy programme, now has come down to 8%.
Many countries are struggling with rising HIV infections among gay men and other men who have sex with men. China is no exception. In 2016, gay men and other men who have sex with men accounted for 28% of total new infections, compared to 2.5% in 2006. Fighting stigma and discrimination remains one of the main challenges in China.
At the 19th Communist Party Congress, President Xi set an ambitious path for a modernized and healthy China with ambitious targets. UNAIDS believes that this vision can include Chinese solutions to the remaining challenges in the AIDS response.
UNAIDS is collaborating with China and its Belt and Road initiative to promote African production of medicines and other pharmaceutical products in Africa as well as to address health system challenges. We also have media partnerships with the Xinhua News Agency and Star Times to reach billions of people with life-saving messages. Their global reach will enable us to keep HIV on the global agenda.
What is upcoming for you in terms of events?
After World AIDS day, I will be at the 19th International Conference on AIDS and STIs in Africa (ICASA), taking place in Abidjan, Côte d’Ivoire. UNAIDS will host several sessions on prevention, the western and central Africa catch-up plan and furthering our treatment target work in collaboration with people working in the field of HIV, governments, community leaders, scientists, civil society and people living with HIV.
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