“We know that there are solutions. We know that there is political and societal will to bring change. The real challenge is following through. This new fourth decade of the epidemic should be one of moving towards efficient, focused and scaled-up programmes to accelerate progress for Results. Results. Results”. These are concluding words of Michel Sidibé UNAIDS Executive Director Under Secretary-General of the United Nations in the UNAIDS Report on Global AIDS Epidemic 2010

The Report enumerates the gains made in the fight against HIV/AIDS since 1999 when the epidemic is thought to have peaked globally. It notes that the number of new infections has fallen by 19%. Of the estimated 15 million people living with HIV in low- and middle-income countries who need treatment today, 5.2 million have access—translating into fewer AIDS-related deaths. The Report acknowledges that for the estimated 33.3 million people living with HIV after nearly 30 years into a very complex epidemic, the gains are real but still fragile. Future progress will depend heavily on the joint efforts of everyone involved in the HIV response.

The Report notes that new data from 182 countries, along with extensive input from civil society and other sources, clearly show that steady progress is being made towards achieving universal access to HIV prevention, treatment, care and support. HIV prevention is working. Treatment is working.

The Report provides evidence to demonstrate that investments in the HIV response can lead to clear reductions in discrimination and stigma, help people in accessing information and services to reduce their risk of HIV infection, and deliver the treatment, care, and support that will extend and improve the lives of people living with HIV.

According to the Report, efforts required to combat HIV include strengthening health systems, improving social structures, promoting gender equity while eliminating violence against girls and women. It also requires ending stigma and discrimination including against marginalized groups. The UNAIDS report acknowledges that progress on MDG 6 is intertwined with progress on other MDGs including MDG 3, 4 and 5.

For the first time, the UNAIDS report includes scorecards at the end of each chapter to track how countries are performing on each of these dimension.

The Report notes that punitive laws have negative effects on access to care and treatment for people living with HIV as well as high risk groups. The report shows that gender inequalities have added to the biological vulnerability that women face to HIV resulting in a high infection rate among women in certain countries. It further provides evidence that shows that 34% of men having sex with men are married to women as a means of protecting against stigma. This has led to the spread of HIV from a high risk group to the rest of the population.

The Report underscores the need to fully integrate HIV services into sexual reproductive health (SRH) services. This is because there is clear evidence that high prevalence rates are associated with a high unmet need for SRH services and information. Additionally, gender based violence has a positive correlation with HIV prevalence with countries such as Swaziland showing this clearly. In the area of human rights, the needs of MSM beyond health provision need to be catered for.

The Report also takes a look at HIV investments, that is, how countries are financing the response to HIV, noting that 88% of funding for low income countries comes from international sources. Therefore while investments by countries in treatment and care are increasing, HIV prevention is largely donor reliant. This trend is not sustainable. in dealing with the pandemic in low income countries. The UNAIDS  Report introduces the Donor Investment Priority index (DIPI) that measures the extent of investment priority given by governments to support their national AIDS response. Kenya’s DIPI index is 0.33 which is below the median. Some key recommendations of the report to ensure sustainability include improving cost-effectiveness of programs by measures such as interventions based on evidence such as the patterns of transmission. Improving supply chain efficiency will also help bridge the funding gaps that exist.

With the data from the Kenya AIDS Indicator Survey (2007) and other robust sources of health information, Kenya features prominently in the Global report as a country where the trends are reversing. The scorecards on each area provide a means for Kenya to benchmark and identify areas in which the country’s response to the HIV/AIDS epidemic can be improved. GTZ Health Sector Programme remains committed to supporting Kenya’s response to the HIV epidemic in all its dimensions.

The full report is available on: http://www.unaids.org/globalreport/Global_report.htm