Statement from Ambassador Deborah L. Birx, M.D., U.S. Global AIDS Coordinator, on the 2014 Paris Declaration to Accelerate HIV/AIDS Response in Cities

World AIDS Day 2014

December 1, 2014

“...when the President’s Emergency Plan for AIDS Relief first was launched in 2003, there were then some 10,000 infections daily. Today, new HIV infections are down by nearly 40 percent, though still higher, obviously, than we want them to be. Back then, more than 2 million people died from AIDS-related causes on a worldwide basis. Today, we’ve cut those numbers by 34 percent. Back then, AIDS threatened to wipe out a whole generation, leaving behind 14 million orphans and vulnerable children. Today, we’ve slashed new infections among children in half."

-- Secretary of State John Kerry

Making good on the 2014 theme for World AIDS Day – “Focus, Partner, Achieve: An AIDS-free Generation” – PEPFAR made a series of announcements highlighting new partnerships and initiatives to accelerate efforts to sustainably control the HIV/AIDS epidemic. Press Release» Latest Results» Proclamation»

PEPFAR WORLD AIDS DAY ANNOUNCEMENTS

$210 Million PEPFAR - Gates Foundation - Nike Foundation Partnership Targets Girls

The global HIV/AIDS response is a shared responsibility. In addition to working with partner governments in the 65 countries with bilateral and regional programs, PEPFAR builds strategic public-private partnerships to maximize the U.S. government’s investment. With over 80 percent of new HIV infections among adolescents in the hardest hit countries occurring in girls, the State Department, through PEPFAR, is partnering with the Bill and Melinda Gates Foundation and the Nike Foundation on a $210 million initiative to reduce new HIV infections in adolescent girls and young women in up to 10 countries. The goal of the partnership is to help girls develop into determined, resilient, empowered, AIDS-free, mentored and safe women. It will provide a core package of evidence-based interventions that have successfully addressed HIV risk behaviors, HIV transmission, and gender-based violence. Evidence shows that girls can reach their full potential when they have access to multiple interventions. Learn More» Press Release»

$116.5 Million Investment in Health Systems for Disease Response

Strong health systems are essential for effective and sustainable disease response. Over the past 11 years, PEPFAR investments have built and strengthened partner country health systems – enhancing their capacity to deliver life-saving HIV services, as well as enabling partner governments to train and retain essential health personnel. PEPFAR’s new human resources for health strategy includes a $116.5 million investment that will strengthen the capacity of health workers to address HIV/AIDS across Africa and will pay dividends for PEPFAR’s engagement with some of the world’s most fragile states that are grappling with Ebola and other health threats. As part of this strategy, PEPFAR will expand the role of the Global Health Service Partnership with Peace Corps and Seed Global Health to increase the number of clinicians available to provide HIV services. The strategy also includes PEPFAR’s next phase of its Medical Education Partnership Initiative and Nursing Education Partnership Initiative with Health and Human Services and partner countries. Over the next 5 years, PEPFAR will apply its experience in expanding the quantity and quality of health workforces in countries with high burden of HIV/AIDS, as well as to targeted fragile states experiencing HIV/AIDS and/or other epidemics. Learn more» Press Release»

Countries Selected for Accelerating Children’s HIV/AIDS Treatment Initiative

Cameroon, Côte d’Ivoire, Democratic Republic of Congo, Kenya, Lesotho, Malawi, Mozambique, Tanzania, Zambia, and Zimbabwe are the 10 sub-Saharan African countries selected to participate in the Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative. Launched by PEPFAR and the Children’s Investment Fund Foundation (CIFF) in August 2014, ACT is an ambitious $200 million effort to double the total number of children receiving live-saving antiretroviral treatment over the next two years across the 10 selected countries – adding an additional 300,000 children on treatment. PEPFAR and CIFF worked together to select the participating countries, which are among those with the lowest access to pediatric treatment, and the greatest disparity in treatment coverage for children compared to adults living with HIV/AIDS. Ensuring that children are healthy and live to adulthood enables them to grow economies, create jobs, and contribute to their families and communities for decades to come. Learn More» Fact Sheet» Press Release»

Accelerating Innovation with Global Pediatric Antiretroviral Commitment-to-Action

While 3.2 million children are living with HIV/AIDS today, only one fourth has access to treatment. The Global Pediatric Antiretroviral (ARV) Commitment-to-Action brings together leading organizations to accelerate the development of new high-priority pediatric ARV co-formulations for first- and second-line treatment by 2017. PEPFAR, the Pediatric HIV Treatment Initiative (a collaboration of UNITAID, Clinton Health Access Initiative, Drugs for Neglected Diseases initiative, and Medicines Patent Pool), and the Global Fund to Fight AIDS, Tuberculosis and Malaria will work together on this Commitment-to-Action. Greater access to HIV medicines will reduce illness and death, particularly among the youngest and most vulnerable children living with HIV/AIDS. To further advance the effort, PEPFAR is contributing $2 million through the U.S. Food and Drug Administration to support their work on regulatory systems in Africa, ensuring that quality and safety products (drugs and diagnostic tests) are rapidly approved by national regulatory agencies – this includes new pediatric ARV formulations. Learn More» Press Release»

New Era in Data Transparency Takes Sharing and Using Data to New Heights

Sharing and utilizing data effectively is essential for improving programs and holding one another accountable for impact. This is an area where PEPFAR has been recognized for its advancements and leadership, which include working with partner countries. Today, PEPFAR makes another leap forward in data transparency through a new partnering with the Millennium Challenge Corporation to advance the U.S. government’s effort to ensure data openness and transparency. The $21.5 million partnership will establish country-based, country-driven local data hubs to improve strategic planning, quality of care, and ultimately, health outcomes. PEPFAR also announced today that additional data are now available on the PEPFAR Dashboards. Planned budgets, program results, and expenditure data were released this year – commencing the program’s unprecedented turn toward transparency. Now, disaggregated program indicator results data are available—allowing all stakeholders the opportunity to independently analyze the PEPFAR program’s effectiveness and cost efficiency at a granular level. Learn More» PEPFAR Dashboards»

New PEPFAR Report Summarizes Progress and Strategy for AIDS-Free Generation

PEPFAR released a new report titled PEPFAR 3.0 – Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation. The report documents the program’s progress and unveils PEPFAR’s strategy for working with partners to achieve an AIDS-free generation. As explained in the report, the program has moved from phase 1 (2003-2007) – the emergency response phase that brought HIV prevention, treatment and care services to millions to phase 2 (2008-2012) – the sustainability phase, where PEPFAR worked with partner countries among other partners to address the epidemic. The program is now in phase 3 (2013-present) and is focused on transparency and accountability for impact, as well as accelerating core interventions for epidemic control. PEPFAR is investing resources strategically and geographically to reach populations at greatest risk with evidence-based programs. The report also provides insight into PEPFAR’s five Action Agendas—the foundation on which an AIDS-free generation will be achieved. The Action Agendas include: Impact; Efficiency; Sustainability; Partnership; and Human Rights. Learn More»

GOMOJO Lifesaver...SAVING LIVES

taking a lead the global movement and the City of Las Vegas #VEGASTECH community into the first city in the world to become #AIDSFREE.

We are committed to PEPFAR’s Principles for the Blueprint. Our shared the vision for this blueprint is simple: Scientific advances and their successful implementation have brought the world to a tipping point in the fight against AIDS. The United States believes that by making smart investments based on sound science, and a shared global responsibility, we can save millions of lives and achieve an AIDS-free generation. Each year we looked forward to WORLD AIDS DAY to compare our progress take action on outcomes implementing new findings and directions, policy updates and for taking action on specific calls to action made to the the people in the fight for #AIDSFREEGEN.

To fulfill this vision, the blueprint is based on the following principles:

› Make strategic, scientifically sound investments to rapidly scale-up core HIV prevention, treatment and care interventions and maximize impact.

› Work with partner countries, donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations and multilateral institutions to effectively mobilize, coordinate and efficiently utilize resources to expand high-impact strategies, saving more lives sooner.

› Focus on women and girls to increase gender equality in HIV services. (we include gay men and transgender)

› End stigma and discrimination against people living with HIV and key populations, improving their access to, and uptake of, comprehensive HIV services.

› Set benchmarks for outcomes and programmatic efficiencies through regularly assessed planning and reporting processes to ensure goals are being met.

These principles drive PEPFAR’s work and are the foundation for the road maps that comprise this blueprint. Each road map—the Road Map for Saving Lives; the Road Map for Smart Investments; the Road Map for Shared Responsibility; and the Road Map for Driving Results with Science—contains specific goals and comprehensive action and implementation steps on how PEPFAR will support partner countries’ efforts to meet these goals.

Focus, Partner, Achieve: An AIDS-Free Generation

On December 1, people throughout the world observe World AIDS Day, an opportunity for the global community to honor those living with HIV; the families, friends, caregivers, and communities who support them; and those who have lost their lives to AIDS. The theme for 2014 – "Focus, Partner, Achieve: An AIDS-Free Generation" – reflects the drive to focus on interventions that work and partner with a broad range of stakeholders to achieve control of the epidemic and move closer to an AIDS-free generation.

Our Global Response

An estimated 35 million people are living with HIV/AIDS worldwide. New HIV infections have fallen 38 percent since 2001, with nearly three-fourths of the 2.1 million new HIV infections occurring in sub-Saharan African countries. As a science-based public health and disease prevention agency, CDC provides support that helps more than 60 countriesstrengthen their national HIV/AIDS programs and build sustainable public health systems. CDC conducts these activities through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the largest commitment by any nation to combat a single disease.

CDC's global HIV/AIDS activities are grounded in science and critical to saving lives and preventing new infections. Core activities focus on:

• Providing proven combination prevention interventions, including prevention of mother-to-child HIV transmission, antiretroviral treatment, and voluntary medical male circumcision.
• Reaching orphans and vulnerable children, as well as other neglected and hard-to-reach populations.
• Building and enhancing health systems, including sustainable human resources for health (e.g., healthcare workers) and accurate, reliable laboratory systems.

CDC's innovative programs are helping countries collect and use more detailed data to target HIV treatment services to where they are needed most and to reduce the cost of delivering services. These activities also support greater accountability and transparency in the use of U.S. government funds. CDC works with key partners such as the Global Fund to Fight AIDS, Tuberculosis and Malaria — to which the United States is the largest contributor — to ensure complementary programming for maximum impact of investments.

CDC has contributed to saving millions of lives through PEPFAR. Across the globe, AIDS-related deaths have fallen by 35 percent to 1.5 million in 2013 since a peak of 2.4 million in 2005. The increased life expectancies of people in their most productive years have helped build more secure families and bolstered fragile nations devastated by the HIV epidemic. New pediatric HIV infections have dropped by 58 percent since 2001, to 240,000 in 2013, a significant achievement due largely to evidence-based programming to prevent mother-to-child transmission. Still, millions of people around the globe are waiting for access to lifesaving antiretroviral drugs.

The United States has made an unwavering commitment to work with partner governments and other stakeholders to turn the tide on HIV/AIDS. The goal of achieving an AIDS-free generation worldwide is a shared responsibility, with partner countries in the central role.

Our Domestic Response

There are approximately 1.2 million people living with HIV in the United States. The number of new HIV diagnoses has remained relatively stable from 2008-2012, but the numbers are still too high, especially among gay and bisexual men, blacks/African Americans, and Hispanics/Latinos. For example, of the 47,989 people diagnosed with HIV in 2012:

• 64 percent were gay and bisexual men.
• 47 percent were blacks/African Americans.
• 18.5 percent were Hispanics/Latinos.

About 14 percent of all people living with HIV in the United States don't know they have the virus, and the only way to find out is to be tested. Fortunately, HIV testing has never been easier due to rapid tests and home testing kits available online or from drugstores. CDC recommends that everyone between the ages of 13 and 64 be tested at least once, and that those at higher risk get tested at least once a year. Gay and bisexual men may benefit from getting tested more often, such as every 3 to 6 months. CDC also encourages people who are at high risk but do not have HIV to be aware of new approaches to HIV prevention, such as pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP).

For all people living with HIV, it’s important to get and stay in HIV medical care, which includes taking medication, which can reduce the presence of the HIV virus in the body to very low levels, a state known as "viral suppression." For people living with HIV, achieving viral suppression can improve health, increase life expectancy, and reduce the chance of transmitting the virus to others.

On November 25, 2014, CDC released its latest report on the HIV Continuum of Care in a new edition of Vital Signs, which includes a Morbidity and Mortality Weekly Report (MMWR), Vital Signs: HIV Diagnosis, Care, and Treatment Among Persons Living with HIV — United States, 2011, and an accompanying fact sheet, HIV Care Saves Lives, Viral Suppression is Key. Visit the Vital Signs website to learn more. According to the Vital Signs report, of the 1.2 million Americans living with HIV in 2011, less than a third had their virus under control through effective care and treatment.

To encourage people living with HIV to get in care and stay in care, CDC recently released HIV Treatment Works, a new campaign under the Act Against AIDS initiative.

CDC's overall approach to HIV prevention and control in the United States includes funding and technical assistance for health departments; conducting surveillance and behavioral research; developing guidelines for HIV treatment, surveillance, and laboratory procedures; evaluating programs; conducting outreach and communication campaigns through the Act Against AIDS initiative; and providing training in HIV prevention and treatment.

CDC continues to work with our many partners to bring the best available prevention and treatment tools to the communities that need them most, at home and around the world. On this World AIDS Day, we are pleased to join with them in a unified effort to prevent the spread of HIV among this generation, and the generations to come.

Secretary of State John F. Kerry

Without lifesaving antiretroviral drugs, 50 percent of HIV-infected children will die before age 2 and 80 percent will die before age 5. Photo: David Snyder/CDC Foundation.

The HIV Treatment Works campaign features people living with HIV who are talking about how HIV care and treatment helps them stay healthy and protect others. Visit Act Against AIDS for more campaign resources.

GOMOJO KNOWS

Road Map for Saving Lives

GOMOJO KNOWS

Roadmap for Smart Investment

GOMOJO KNOWS

GOMOJO KNOWS

Road Map for Science

Roadmap for Shared Responsibility

GOOD TIMES

YOU ARE THE MIGHTY ONE

Neither the U.S. nor any other single entity can accomplish this goal alone. Rather, it requires a Country, State, City, Community, Companies, Organizations and Individuals to demonstrate political will and effective coordination of multiple partners that are providing financing and carrying out interventions both inside and outside of the health sector, and most importantly, meaningfully involve those living with and affected by HIV in all aspects of the response.

As stated earlier, the goal of creating an AIDS-free generation is a shared responsibility with partner countries in a convening role. e-based interventions, and continue to generate value for money in our fight against AIDS. Specifically, this road map outlines PEPFAR’s plan to:

1. Partner with countries in a joint move toward Country, State, City, Community, Companies, Organizations and Individual-led, managed, and implemented responses.

2. Increase support for civil society as a partner in the global AIDS response.

3. Expand collaboration with multilateral and bilateral partners.

4. Increase private sector mobilization toward an AIDS-free generation.

Accordingly, PEPFAR will work with countries to scale-up activities that have a strong evidence base to produce a population-level impact.

GOMOJO has followed 58 Billion dollars around the world and gathered the information of local organizations in Las Vegas, NV and 100's of cities across the country.

GREAT MEMORIES

Rapid Scale up of Combination Prevention Can Reduce Resource Needs and Support Sustainability

The challenge ahead is to scale up effective combination prevention quickly enough to have a transformative impact on the epidemic and make national AIDS responses sustainable over time. This requires strategic reallocation of existing resources toward high-impact interventions, and increased and sustained investments through shared responsibility, led by countries, with support from donors and other partners.

HOW-We have done the time to employ evidence-based strategies to create demand for, and utilization of, male and female condoms,by ensuring that high-quality condoms are available, correspond to consumer preferences, for different distribution channels are used.

Increase access to, and uptake of, HIV testing and counseling, condoms and other evidence based, appropriately-targeted prevention interventions. Through online and with inserts for local locations.

1. #GOMOJO provides condoms free of charge through our CBO and HBO CD partnerships

2. #GOMOJO conducts wide-scale distribution through our street teams and delivery of free condoms to Downtown Las Vegas businesses and places that serve alcohol

3. #GOMOJO has implemented several social marketing campaigns linked back to our site to promote not only condom use, stats, facts, policy, but also to education training, community partners, events, and endless other opportunities.

4. Conduct both promotion and distribution activities at the individual, organizational, and environmental levels.

5. Target:

a. Individuals at high-risk

b. Venues frequented by high-risk individuals

c. Communities at greatest risk for HIV infection

d. The general populations within jurisdictions with high HIV incidence.

6. GOMOJO Supplements the condom distribution program with more intense risk reduction interventions, or other prevention or health services, for individuals at highest risk.

Integrate distribution program activities within other community-level intervention approaches to promote condom use and other risk reduction behaviors.

7. GOMOJO has established jurisdictional organizations and seeking support for condom distribution and promotion activities in traditional and nontraditional venues.

8. GOMOJO has spent 4 years conducting community-wide mobilization efforts to support and encourage condom use.

To achieve an AIDS-free generation, countries and communities must target efforts where the virus is—reaching and supporting those populations at greatest risk and urgently needing services.

GOMOJO not only promotes the female condom as an essential part of an overall condom strategy, but is looking to partner with programs that account for each community's broader condom market and that consider the unique attributes and benefits of the female condom for various populations.

We will not support interventions that fail to target the epidemic. Concurrently, we will work to realize efficiency gains to deliver greater results for our investment. We have vastly increased PEPFAR’s value for money by reducing the cost of antiretroviral drugs (ARVs), streamlining supply chains, and working with partner countries to increase their investments, and this work will remain a

GOMOJO online and street level campaigns Target HIV/AIDS reduce co-morbidity and mortality.

GOMOJO increases access to, and uptake of, HIV services by key populations.

GOMOJO is partnered with people living with HIV who design, manage and implement HIV programs to ensure that they are responsive to, and respectful of, their needs.

GOMOJO online tools and community partnerships strengthen PEPFAR’s continued focus on women, transgender girls and gender equality.

GOMOJO will Reach orphans and vulnerable children (OVC) affected by AIDS, and support programs that help them develop to their full potential.

GOMOJO strengthens and programmatic commitment to and emphasis on reaching and supporting young people with HIV services. will continue to grow and plan includes sharing our stories to better support the efforts of the organizations on the ground.

We have found ways to strengthen PEPFAR supply chains and business processes to increase the efficiency of our investments.

Our product and training and street outreach programs increase efficiencies through innovation and our online resources provide the tools to help greater integration of services with other U.S., bilateral and multilateral global health investments.