Global Policy

The Global HIV/AIDS Epidemic

OVERVIEW

Since the beginning of the epidemic, HIV/AIDS has killed more than 25 million people globally, and another 33 million are estimated to be living with HIV throughout the world. In 2007 alone, two million people died of AIDS-related causes and 2.7 million were newly infected. Over ninety-five percent of people living with HIV/AIDS live in low- and middle-income countries.

THE GLOBAL RESPONSE TO HIV/AIDS

In the year 2000, as part of the UN Millennium Development Goals, all the world’s countries committed to halt and begin to reverse the spread of HIV by 2015. Although the international community has significantly increased support to global HIV/AIDS initiatives in that time frame, resources continue to fall short of meeting projected needs.

The Kaiser Family Foundation estimates that total global spending on HIV rose from US$300 million in 1996 to $13.7 billion in 2008. However, the need for resources is much greater: UNAIDS estimates that $25.1 billion will be needed to effectively respond to the HIV/AIDS epidemic in the year 2010. This shortfall limits the ability of countries most affected by the AIDS crisis to scale up effective prevention and treatment programs. Most people at risk for HIV continue to lack access to prevention, care and treatment.

Concentrated epidemics of HIV among high-risk and often marginalized groups are cause for concern. In low and middle-income countries, men who have sex with men (MSM) are on average 19 times more likely to be infected with HIV than the general population. HIV prevalence rates among MSM have been reported at 25% in Ghana, 30% in Jamaica, and 25% in Thailand. In Sub-Saharan Africa, HIV prevalence rates among MSM have been recorded at 21.4% in Malawi, 19.7% in Botswana, and 12.4% in Namibia.

A 2007 meeting of the Global HIV Prevention Working Group estimated that only 9% of men who have sex with men (MSM) are reached with HIV prevention services

The U.S. is a key supporter of global HIV/AIDS programming – contributing the highest dollar amount to prevention, care and treatment programs worldwide. U.S assistance is channeled largely through two programs: The President’s Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund to Fight AIDS, Tuberculosis and Malaria.

PEPFAR

On July 30, 2008, President George W. Bush signed into law The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (Public Law No. 110-293) which reauthorizes the program for five more years (2009-2013).

Throughout this time frame, the PEPFAR program aims to support:

• Treatment for at least 3 million people
• Prevention of 12 million new infections
• Care for 12 million people, including 5 million orphans and vulnerable children

Significantly, the new law includes a provision to provide HIV/AIDS education programs and training targeted to prevent the transmission of HIV among men who have sex with men (MSM).

THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA

Created in 2002, the Global Fund has played a leading role in fighting AIDS, TB and malaria around the world. It has grown into an organization with $15.6 billion committed to programs against the three diseases in 140 countries. As a result of the Global Fund’s work,2.3 million people are receiving life-saving AIDS medication, 5.4 million people have been treated for TB and 88 million bed nets have been distributed to prevent transmission of malaria.

The Global Fund is also working to confront extremely drug-resistant TB that threatens to undermine not only basic TB control but also AIDS treatment as well.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) is a collaborative initiative between ten United Nations system organizations to respond to the global HIV epidemic. UNAIDS works to help the world prevent new HIV infections, care for people living with HIV, and mitigate the impact of the epidemic on populations worldwide. The ten cosponsors are UNHCR, UNICEF, WFP,UNDP, UNFPA, UNODC, ILO, UNESCO, WHO and the World Bank.

UNAIDS engages a wide cross-section of stakeholders from government and civil society to support an expanded response to AIDS. In addition to developing policy briefs, action frameworks and other written materials, every two years UNAIDS publishes a report on the global AIDS epidemic, synthesizing the best available data from countries and providing an overview of the international response.

Through convening UN General Assembly Special Sessions on HIV/AIDS, the UN system has played a key role in developing international benchmarks in the global AIDS response, enshrined in the Declaration of Commitment on HIV/AIDS (2001) and the Political Declaration on HIV/AIDS (2006).


GLOBAL HIV/AIDS ADVOCACY

A growing body of peer-reviewed research provides clear evidence that men who have sex with men (MSM) around the world are at elevated risk for HIV infection. This situation is made worse by criminalization, stigma, discrimination and homophobia which can drive MSM underground, making it even less likely that men who are engaging in risky sexual practices will come forward to seek out information or health services.

AIDS Project Los Angeles (APLA) advocates for greater attention to MSM in the global HIV & AIDS epidemic. In September 2008, APLA held its first congressional briefing on MSM and the Global HIV & AIDS Epidemic, and will continue work to ensure implementation of HIV prevention for MSM through PEPFAR.

In addition to domestic advocacy, APLA also supports the work of the Global Forum on MSM and HIV by acting as the organization’s fiscal and administrative agent. Guided by its own steering committee of 20 members from 17 countries in the Global South and North, the MSMGF is committed to responding to HIV/AIDS among men who have sex with men worldwide through advocacy, information exchange, knowledge production, network development and programs that promote human rights and support the empowerment of MSM around the world.

GLOBAL HIV & AIDS AMONG MSM

2009 Congressional Forum on HIV, Human Rights and Men who have Sex with Men (MSM)

On Wednesday September 16, 2009, UNAIDS in collaboration with the HIV Policy Working Group on MSM and Other Sexual Minorities coordinated a Congressional Forum on HIV, Human Rights and Men who have Sex with Men (MSM). The event took place in Rayburn House Office Building on Capitol Hill in Washington, D.C., in cooperation with the Honorable Howard Berman (D-CA) and the Honorable Barbara Lee (D-CA).

The goal of this event was to raise awareness of the human rights issues that exacerbate HIV transmission among MSM globally, and explore the underlying social, political and economic factors that hinder access to HIV-related services.

Presentations were made by:

Ambassador Eric Goosby
U.S. Global AIDS Coordinator

Tudor Kovacs
Population Services International, Romania
Slides

Jaevion Nelson
Jamaica Youth Advocacy Network (JYAN), Jamaica

Michel Sidibé
Executive Director, UNAIDS

Dr. Cheikh E. Traoré
Senior Advisor, Sexual Diversity, UNDP
Slides

Krista Lauer, MSc.
Policy Associate, Global Forum on MSM & HIV
Slides

This event was made possible through the collaborative effort of UNAIDS and members of the HIV Policy Working Group on MSM and Other Sexual Minorities: Advocates for Youth, AIDS Action Council, the International HIV/AIDS Alliance, amfAR, AIDS Project Los Angeles, Gay Men’s Health Crisis, the Global Health Council, the International Gay and Lesbian Human Rights Commission, the International Women’s Health Coalition, the Global Forum on MSM & HIV, the National Association of Social Workers, and Population Services International.

Many thanks to our partners, to our panelists and to all of the congressional offices who cooperated with us on this briefing.

(L to R): Krista Lauer, the Global Forum on MSM & HIV; Dr Cheikh E. Traoré, UNDP Senior Advisor on Sexual Diversity; Tudor Kovacs, Population Services International, Romania, Ambassador Eric Goosby, U.S. Global AIDS Coordinator and UNAIDS Executive Director Michel Sidibé.
Photo credit: UNAIDS/Jati Lindsay

2008 Congressional Briefing on MSM and HIV
On Monday September 15, 2008, APLA coordinated a congressional briefing on men who have sex with men (MSM) and the global HIV & AIDS epidemic, held in the Capitol Building in Washington, D.C.

The goal of this event was to raise awareness of the disproportionate impact of HIV & AIDS among MSM globally; of the complex factors that fuel transmission; and progress towards universal access to HIV-related services for MSM. To view PDF slides of our expert panelists’ presentations, please use the links below.

This event was made possible through the collaborative effort of AIDS Action Council, AIDS Foundation of Chicago, amfAR, AIDS Project Los Angeles, Gay Men’s Health Crisis, the Global Forum on MSM and HIV, and the AIDS Institute. Many thanks to our partners, to our panelists and to all of the congressional offices who cooperated with us on this briefing.

Presentation slides:

Chris Beyrer
Director, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health
HIV/AIDS epidemics among men who have sex with men (MSM) in Africa, Asia, Latin America and the Caribbean, and the CIS - PDF

Robert Carr
Executive Director and co-founder, Caribbean Vulnerable Communities Coalition
Gender, Human Rights and HIV - PDF

Kevin Frost
Chief Executive Officer, amfAR
MSM, HIV and the Road to Universal Access – How Far Have We Come? - PDF

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