Ants Can Kill the Elephant

The following is excerpted from a longer piece by Mannasseh Phiri originally appearing in Zambia’s Sunday Post. Phiri is a long-time HIV prevention practitioner and advocate.

If you have ever heard me make a presentation on HIV and AIDS in Zambia in the last 10 years, you will know that I always start with a picture of a magnificent specimen of a bull elephant standing in its majesty on the banks of the mighty Zambezi. As I show the picture I tell the story of how the African elephant in many ways behaves like HIV—quietly consuming a huge amount of resources.

I was thinking about how I seriously need to rehash, freshen or renew my own presentations’ opening story about the similarity the African elephant to the virus HIV [when I was reminded of] a piece of African wisdom that I hadn’t heard since I was child. “When ants are well organised, they can kill an elephant”. HIV/AIDS is a giant elephant and if we the people organise ourselves well, like ants, we can conquer HIV!

I was recently holed up in hotel in Johannesburg with other ‘ants’—feeding off each other’s energy, enthusiasm, sense of purpose, conviction and determination that the end for this elephant is possible and can be achieved. For this meeting [the AVAC Partners’ Forum] the ants came from Kenya, Rwanda, South Africa, Uganda, Zambia and Zimbabwe—all of them researchers, advocates and activists—with the combined power to make a whole herd of elephants scamper in fear.

It was not just the energy and enthusiasm of the “ants” that floored me. Their technical knowledge and understanding of the detailed intricacies and nuances of the research work they are doing made me ashamed of coming from Zambia. While cutting edge research in HIV prevention with oral antiretrovirals, vaginal and rectal gels, and vaginal rings is going on and advancing HIV science in Kenya, Uganda, Rwanda, Malawi, Zimbabwe and South Africa, Zambia is dithering with approvals because of suspicion.

I feel like the day is not far when I shall no longer need to always wear the AIDS red ribbon and the Until There’s A Cure copper bangle on my left wrist. Thanks to the meeting of the ants, the elephant’s days are numbered.

The Importance of Location and Population to the HIV Response

This graphic from AVAC’s Microbicides by the Numbers one-pager shows on which populations the burden of the epidemic falls in different regions.

Achieving the End

Recent breakthroughs in HIV prevention research have created unprecedented opportunities to curb new HIV infections, save lives and set the world on a path towards eliminating HIV transmission.

Reaching the Tipping Point: The time to act is now

AVAC Playbook 2012-2013: Progress toward global goals

AVAC first published its Playbook of global goals for ending AIDS in late 2011. This infographic from the AVAC Report 2012 builds on the objectives from 2011 and identifies five priorities for action in 2013.

Defining Combination Prevention: Ongoing trials in sub-Saharan Africa

The Change We Need to End AIDS in Uganda

2012 AVAC Fellow Alice Kayongo played a leading role in developing a civil society report, “The Change We Need to End AIDS in Uganda”, which details concerns and recommendations for shaping the national AIDS response in Uganda. This report was presented at the Joint Annual Review (JAR) of the country’s five-year National Strategic Plan (NSP) for responding to HIV/AIDS, which was first launched about a year ago. The mid-October JAR meeting was an opportunity to review progress and gaps. In the weeks leading up to the JAR, civil society participated in reviews of draft assessments of progress on the various elements of the NSP, including prevention, treatment and care, and health systems strengthening.

Kayongo was joined in this coalition effort by Sylvia Nakasi and Bharam Namanya of UNASO (2011 Fellow and Host Supervisor, respectively), and Leonard Okello, Alice’s Fellowship supervisor and Lillian Mworeko of ICW-EA (2012 Host)—as well as a broad range of other advocates.

The report, presented at the JAR, included a 10-point plan to halt new infections, save lives and ensure leadership, and provided a detailed critique of the national AIDS response to date.

This advocacy comes on the heels of a dynamic and successful campaign to increase funding for and recruitment of more than 6,000 health care workers throughout Uganda.

For a copy of the report, reach out to fellows@avac.org.

Promoting Combination Prevention Through Song

Remember prevention is better than cure,
Combination prevention will see us through
To conquer this infection, it needs you;
An AIDS free generation begins with you.

Last month 2012 AVAC Fellow Chamu Mashoko and a number of Zimbabwean musicians released “For You, I Will”. The song, which uses the message of taking care of yourself as a commitment to those you love to promote combination prevention, is part of Mashoko’s AVAC Advocacy Fellowship project.

To Mashoko, a song was an obvious way to spread this message. “Music is a universal language and among most Africans, important information is disseminated through music.” The song incorporates different styles of music and is performed in the three main spoken languages of Zimbabwe with the hope of furthering its appeal. It is the latest entry into the Zimbabwean HIV prevention songbook. In July 2012 a trio of famous musicians from Africa, including Oliver Mtukudzi and Winky Dee of Zimbabwe and Vee from Botswana, released a song on voluntary medical male circumcision at the International AIDS Conference.

Since its release, Mashoko and his collaborators have been interviewed on radio and in print and people have expressed an interest in a music video.

Click to listen to “For You, I Will” and read the lyrics.

For you, I’m really going to get HIV tested!
Take all the measures that will prevent us from being infected.
And let’s encourage everybody who is affected,
They need to feel respected and not to be rejected.

Click here to listen.

Press Release

AVAC statement on PEPFAR Blueprint

New York, NY – PEPFAR’s blueprint has enormous potential to accelerate global HIV prevention efforts. It rightly emphasizes that we need to ‘follow the science’ if we intend to deliver life-saving HIV prevention and treatment breakthroughs to millions of people worldwide. The blueprint underscores that success depends on scaling up combinations of effective strategies. It also places much-needed emphasis on voluntary medical male circumcision, which could prevent millions of HIV infections and do so more affordably than almost any other method today.

It’s particularly encouraging that the blueprint focuses on translating scientific breakthroughs into lives saved. Powerful new HIV prevention options could together lead to dramatic reductions in HIV infections, but we don’t have all the information we need to scale them up in the right combinations for various communities. Urgent questions about the real-world use of new prevention tools in combination have been clear for months or even years, yet the work to answer them is barely under way. That’s as unconscionable as it is unnecessary.

The blueprint also recognizes that ending AIDS will not be easy or quick. While current options can have a tremendous impact, continued science and innovation are essential to ultimately halt new HIV infections and deaths from AIDS.

The US has shown great leadership, and now it’s time for the rest of the global community to step up. Frankly, we are not on pace to end AIDS – but we could be. Global agencies, governments, donors and advocates need to work with PEPFAR now to agree on the most urgent priorities, set specific goals and demonstrate real progress within the next year.

A PDF version of this is available for download.

Contact:

Mitchell Warren, mitchell@avac.org, +1-914-661-1536

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About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.

Press Release

amfAR and AVAC launch Global Action Agenda for Ending AIDS; report lays out policy priorities and milestones through 2015 to hasten a “tipping point” in drive to end AIDS

Washington, DC — Two of the world’s leading AIDS advocacy organizations today released a global action agenda aimed at accelerating progress towards the end of the AIDS epidemic. Announced ahead of the XIX International AIDS Conference in Washington, D.C., the agenda identifies five major short-term priorities for global AIDS programs together with realistic, annual targets that must be achieved through 2015. The recommended actions, if taken together, could accelerate achievement of a “tipping point” in the global AIDS epidemic, at which — for the first time ever — the number of people gaining access to HIV therapy will outpace the number of people becoming newly infected.

The report, An Action Agenda to End AIDS, was developed by AVAC and amfAR, The Foundation for AIDS Research, and was informed by an analysis of modeling research and consultations with top HIV prevention experts. The Action Agenda, available online at www.EndingAIDS.org, will be the focus of a satellite session at the International AIDS Conference on Monday, July 23 at 6:30pm ET, as well as a press conference on Tuesday, July 24 at 2:00pm ET.

“It’s time for talk about ending AIDS to make way for action,” said Mitchell Warren, executive director of AVAC. “When we look back a decade from now, we’ll judge ourselves on whether we made the kinds of hard choices outlined in this plan. If we do, we’ll soon begin to bring the epidemic under control, creating a world defined by declining HIV infections and a growing capacity to treat people in need. If we don’t, we will instead witness millions more preventable HIV infections and needless deaths.”

Recent breakthroughs have expanded the range of effective HIV prevention methods and led to new optimism in the AIDS field. After clinical trials demonstrated that antiretroviral treatment (ART) in HIV-positive people can reduce the risk of HIV transmission, and that voluntary medical male circumcision (VMMC) and other new tools can significantly reduce the risk of HIV infection in HIV-negative people, leaders including U.S. President Barack Obama and Secretary of State Hillary Clinton publicly embraced the possibility of creating an “AIDS-free generation.” Despite these encouraging statements, however, global AIDS efforts continue to lack coherent priorities and are threatened by cuts in funding.

“At this moment of great opportunity, we need to be clear about the critical choices ahead,” said Chris Collins, Vice President and Director of Public Policy at amfAR. “The world can begin to turn the epidemic around within the next three years — but only if we agree on the major priorities, commit to realistic milestones and hold ourselves accountable. This new agenda outlines the critical decisions we need to make in the coming years to put us on a path to beginning to end the AIDS epidemic.”

Year-by-year action steps for all stakeholders

The agenda lays out essential steps that must be taken — year by year through 2015 — by national governments; international organizations, donors and stakeholders; civil society; researchers; and technical agencies. These action steps fall within five overarching priorities:

  • Make hard choices by emphasizing, above all other efforts, the rapid scale-up of core interventions that can have the greatest impact. These include HIV testing and treatment, VMMC, prevention of mother-to-child (vertical) transmission, and evidence-based, human rights-based interventions for gay men, sex workers, injection drug users and others at greatest risk.
  • Mobilize sufficient, sustainable resources to ensure the rapid scale-up of these core interventions.
  • Agree on clear roles and responsibilities and hold one another accountable for results, through agreed timelines, target outcomes, transparent reporting, and real-time assessment of results.
  • Build the evidence base to end AIDS, by prioritizing research on the most effective ways to implement new prevention strategies, as well as the continued search for a preventive vaccine and a cure.
  • Use every dollar of funding as effectively as possible by lowering the unit costs of core interventions, improving program management, and strategically targeting services.

Tracking critical milestones through 2015

In addition, the report lists a series of key results that must be achieved each year from 2012 through 2015 to fully capitalize on recent research advances. These include cutting the numbers of new HIV infections and deaths, as well as more specific epidemiological and policy-based milestones tied to the global scale-up of critical interventions.

By steadily reducing annual new HIV infections and simultaneously continuing to expand access to HIV treatment, the report authors project that a global “tipping point” can be achieved within two to three years. At that time, roughly 1.75 million people would gain access to HIV therapy yearly, exceeding — for the first time ever — the number of annual HIV infections, which would fall close to 1.5 million. This shift would mark a critical step in controlling the global epidemic.

The targets reflect best-case scenario calculations based on published modeling and epidemiological data, as well as analysis provided by experts in the field. A bibliography and explanation of methodology can be found at www.EndingAids.org.

The feasibility of the report’s targets was also reinforced by encouraging new data released by UNAIDS on July 18. The agency reported that more than 8 million people in low- and middle-income countries were receiving HIV therapy in 2011, a 20 percent increase from the year before. Annual HIV infections declined to 2.5 million in 2011, from 2.7 million the year before.

“The past decade has taught us that when global AIDS efforts have clear priorities and realistic targets, they can have a huge impact,” said Nelson Otwoma, National Coordinator of the National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK). “We’ve already accomplished so much, and now the opportunities are greater than ever. If we can agree on a plan and act decisively to make it happen, then countries around the world will have much to celebrate in the years ahead.”

AVAC and amfAR will continue to track global progress against the recommendations and targets in the Action Agenda over the coming years. Status updates, analysis and other information will be released periodically and made available on www.EndingAIDs.org.

Top AIDS leaders to discuss Action Agenda at IAC satellite, July 23

On Monday, July 23 at 6:30pm, a panel of top experts will discuss the new Action Agenda and provide their assessments of what advocates, policymakers, and scientific and government leaders must do to ensure that the rhetoric of the International AIDS Conference becomes the foundation for an urgent, systematic plan to end AIDS.

The event will be moderated by celebrated journalist Charlayne Hunter-Gault, and will feature Dr. Antony Fauci (National Institute of Allergy and Infectious Diseases), Dr. Agnes Binagwaho (Minister of Health, Rwanda), Dr. Deborah Birx (CDC Center for Global Health), Dr. Helen Rees (Wits Reproductive Health and HIV Institute, South Africa) and other prominent global AIDS leaders.

Details of the event are available online.

This press release is also available as a PDF.

Contact:
Kay Marshall, kay@avac.org, +1-347-249-6375
Cub Barrett, cub.barrett@amfar.org, +1-212-806-1602

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About amfAR: amfAR, The Foundation for AIDS Research, is one of the world’s leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy. Since 1985, amfAR has invested more than $340 million in its programs and has awarded grants to more than 2,000 research teams worldwide.

About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.