The President's Emergency Plan for AIDS Relief – June 2008 Newsletter

Inside this Edition: 2008 HIV/AIDS Implementers’ Meeting: Global and Local HIV Leaders Reflect on Road Ahead in AIDS Fight [more] U.S.-Russian Partnership Prevents Mother-to-Child HIV Transmission [more] 2nd Eastern Europe and Central Asia AIDS Conference [more] Living Positive Tour Rocks Namibian Youth with Prevention, Positive Living, and Stigma Reduction Messages [more] Swazis “Walk the Nation” for HIV/AIDS [more] 2008 HIV/AIDS Implementers’ Meeting: Global and Local HIV Leaders Reflect on Road Ahead in AIDS Fight The 2008 HIV/AIDS Implementers’ Meeting took place in Kampala, Uganda from June 3-7, 2008, drawing more than 1,700 HIV/AIDS implementers from Uganda and throughout the world. More than 70 countries were represented at the meeting, a testament to the global partnerships to fight the HIV/AIDS pandemic, and a reflection of the conference theme, “Scaling Up Through Partnerships: Overcoming Obstacles to Implementation.” H.E. Yoweri Kaguta Museveni, President of the Republic of Uganda, opened the meeting noting “I would like to salute the human race who have confronted AIDS and scored some achievements.” He added, “Here in Uganda, we were able to analyze this sickness in the early years and came to the conclusion that it was stoppable.” “You, the global implementers of HIV/AIDS and your partners, have proven the skeptics wrong,” said Ambassador Mark Dybul, PEPFAR Coordinator. “You knew what the skeptics did not – that seemingly ordinary people who appear to be without hope can do extraordinary things with a little support. As we step forward to meet the challenges before us, let’s do so with even more enthusiasm and hope.” The meeting was hosted by the Government of Uganda and co-sponsored by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS; UNICEF; the World Bank; the World Health Organization (WHO); and the Global Network of People Living with HIV/AIDS (GNP+). During the five-day conference, more than 200 abstracts were presented by representatives from governments, non-governmental organizations including faith- and community-based groups, multilateral organizations, the private sector, and groups of people living with HIV/AIDS. Through presentations, dialogue and networking, participants discussed critical barriers and shared information that will directly impact HIV/AIDS program implementation in the coming years. An archived webcast of select sessions from the meeting was provided by kaisernetwork.org, a free service of the Kaiser Family Foundation. The webcast and related online resources are available at: http://www.kaisernetwork.org/hivimplementers2008. A photo gallery featuring images from the 2008 HIV/AIDS Implementers’ Meeting is available at: http://www.pepfar.gov/press/c19566.htm. For more information on the meeting, please visit http://www.hivimplementers.org. U.S.-Russian Partnership Prevents Mother-to-Child HIV Transmission In spite of growing rates of HIV infection among women, partnerships between the United States and Russia have contributed to a dramatic lowering of HIV transmission from mothers to their newborns—from 19.3% in 2000 to 6.2% in 2007. Since 2001, the proportion of women among newly registered HIV cases in Russia has nearly doubled, from 24% to 44%, and the vast majority of these HIV-positive women are of reproductive age. According to the Russian Ministry of Health, by the end of 2006 over 33,800 newborns had been exposed to HIV, and HIV infection was confirmed in 2,043 of these babies. In Russia, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has focused on two regions, St. Petersburg and Orenburg, in which HIV prevalence in pregnant women is more than twice the national level. PEPFAR is providing critically needed support for prevention of mother-to-child HIV transmission (PMTCT) in Russia. The impact of PEPFAR-supported programs was significantly strengthened and expanded in 2005 by the Government of Russia’s declaration of PMTCT as one of its key health goals under the National Priority Project. In one partnership, PEPFAR is supporting collaboration with the St. Petersburg City Government to enhance PMTCT surveillance and conduct a pilot project of rapid testing for pregnant women in labor with unknown HIV status. During the pilot project, 80% of women tested for HIV using rapid tests received their results before delivery and 98% of HIV-exposed infants received antiretroviral prophylaxis to prevent infection. The project demonstrated the effectiveness of rapid testing in enhancing the delivery of ARV prophylaxis to mothers and infants, and helped inform Russian Government deliberations that led to widespread implementation of rapid testing programs in labor and delivery departments. In another case, PEPFAR supported a partnership with the Moscow Medical Academy to compete for one of the first Government of Russia grants on HIV prevention in 2006. They won a grant of $755,000 to disseminate new PMTCT guidelines, developed in partnership with U.S. experts, to 17 Russian regions. A subsequent government grant of $400,000 was awarded to the St. Petersburg Medical Academy of Postgraduate Studies to roll out a new PMTCT curriculum, developed with PEPFAR support, to medical schools throughout Russia. As a result, more than 320 medical and infectious disease specialists have received critical knowledge and skills related to the prevention of mother-to-child HIV transmission. A core group of trainers now routinely teach health care professionals and medical students across Russia how to prevent infection in newborns. Partnerships between the Russian Government and PEPFAR-supported organizations are building sustainable, high-quality PMTCT programs throughout Russia. Indeed, these partnerships are so successful that PEPFAR support will be phased down while the Russian government and non-governmental organization (NGO) partners continue to work together to expand effective PMTCT practices that will enable Russia to achieve significantly lower rates of transmission.   2nd Eastern Europe and Central Asia AIDS Conference Over 2000 representatives of government, civil society and the private sector from 53 countries participated in the 2nd Eastern Europe and Central Asia AIDS Conference, which was held in Moscow from May 3-5, 2008. Senior leaders from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), UNAIDS, and the International AIDS Society who spoke at the event stressed the challenges posed by the rapid growth of the HIV epidemic in the region. But participants also noted the opening of new opportunities in fighting the epidemic, such as increased funding and economic growth, political support from governments, the growing role of civil society organizations, and the active involvement of affected communities. Russia’s significant progress in scaling up measures against HIV was stressed. At the conference, Russia’s Minister for Health pledged $1.2 billion for HIV/AIDS activities over the next three years—increasing Russia’s funding from the 2006 level of $277 million to $400 million annually. She also affirmed that the response to HIV/AIDS requires the joint effort of governmental and civil society organizations, and that prevention programs being implemented by Russian NGOs will receive adequate support from government resources in the future.

Living Positive Tour Rocks Namibian Youth with Prevention, Positive Living, and Stigma Reduction Messages

In Namibia, a five-man a cappella group, Vocal Motion 6 (VM6), and an HIV-positive woman, Herlyn Uiras, take to the road once a month to bring prevention, stigma reduction, and positive living messages to high school students all over the country with music and the telling of Ms. Uiras’ personal story. A typical visit begins with their mini-van and trailer emblazoned with a portrait of VM6 and Ms. Uiras under the banner heading “The Living Positive Tour,” pulling up to a school where excited students are taking their places on a playground or in an auditorium. Performances begin with the band’s unique rendition of the Namibian national anthem. The five-part harmony captivates the audience. After band members introduce themselves with personal messages and another song, Ms. Uiras begins an extended conversation - interspersed with songs, role playing, and interactive games - with the audience in which she tells her story of how she contracted HIV after being raped by a truck driver while joyriding to Johannesburg, South Africa. She asks students to take a lesson from her life and tells them that she is proud to use her HIV-positive status to help others. Audience members react to Ms. Uiras, often embracing and accepting her. For many, it is the first opportunity to come into contact with a person who has had the courage to declare her status. Question-and-answer sessions follow performances, and there are always many

questions - often tough and some emotional - for Ms. Uiras and for the young men of VM6, all dedicated to being role models in the fight against HIV/AIDS. They answer blunt questions from the students about HIV testing, sex, and relationships. Questions and conversation continue as band members and Ms. Uiras, surrounded by students, pack up microphones and sound equipment and get ready to depart. Often, a school administrator approaches the tour manager to ask when the tour can make a return visit. At one school, a principal stated that this was the most important thing the students had heard, and if it didn’t change behavior, nothing would. He then followed the tour to the next school with his video camera. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supported a pilot project with VM6 and Ms. Uiras in July 2007. The tour first visited the critical northern regions of Namibia for a week and performed in front of enthusiastic students and teachers at schools and churches in the towns of Oshakati, Ongwediva, Rundu, and Grootfontein. After the successful pilot, the Living Positive Tour expanded to include three more week-long tours. In October 2007, the tour performed at eleven high schools and colleges in the capital city of Windhoek. On Namibia’s coast in December 2007, the tour experimented with different audiences by departing from its typical youth outreach to bring its HIV/AIDS messages to the general public at holiday events, on the beaches, and at town halls as well as to at-risk populations including prisons, a refugee camp, and a marginalized ethnic community, the Toppenaurs. In February 2008, the tour went south to high schools and churches in Rehoboth, Mariental, Keetmanshoop, and Karasburg. By the end of the February tour, the group had performed in front of almost 26,000 Namibians – roughly 80% of them between the ages of 15 and 24, the target population - in six months.

Swazis “Walk the Nation” for HIV/AIDS

For two weeks in March 2008, participants from across the Kingdom of Swaziland walked from the Mozambique border to the South African border in an effort to raise local and international awareness about HIV/AIDS, bring information and services to rural communities, and encourage behavior change. Over 100,000 residents participated in the grassroots “Walk the Nation” campaign, which was supported by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). During the campaign, mobile HIV counseling and testing services and educational events were available along the walk route. At the end of the campaign, the “Walk the Nation Journal,” an account of HIV/AIDS in rural Swaziland, was delivered to the government to inform HIV/AIDS policy.