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Managing Editor/Production Coordinator
Chief Scientific Advisor
Major editorial contributions:
Michael Bartos, Sandy Beeman, Anindya Chatterjee, Paul De Lay, Julian Fleet,
Robert Greener, Alec Irwin, Mike Isbell, Lesley Lawson, Miriam Maluwa,
Aurorita Mendoza, Lisa Regis
Peter Ghys, Peter Piot, Francoise-Renaud Thery, Michel Sidibe, Karen Stanecki,
Heidi Betts, Alistair Craik, Efren Fadriquela, Nathalie Gouiran, Marie-Laure Granchamp, Lon Rahn, Elena Sannikova, Olga Sheean and Elizabeth Zaniewski
This report would not have been possible without the support and valuable contributions of our colleagues in UNAIDS’ Cosponsor organizations, the UNAIDS Secretariat, national AIDS programmes and research institutions around the world. The following people are among those who made significant contributions and deserve our special gratitude:
Angeline Ackermans, Peter Aggleton, Calle Almedal, Peter Badcock-Walters, Andrew Ball, Heidi Bazarbachi, Julia Benn, Elizabeth Benomar, Alina Bocai, Ties Boerma, Raul Boyle, Don Bundy, Angela Burnett, Alexandra Calmine, Michel Caraël, Pedro Chequer, Mark Connolly, Kieran Daly, Ernest Darkoh, Michel de Groulard, Getachew Demeke, Isabelle de Zoysa, Mandeep Dhaliwal, Neelam Dhingra-Kumar, Rebecca Dodd, Enide Dorvily, Alexandra Draxler, René Ehounou Ekpini, Olavi Elo, José Esparza, Tim Farley, Nina Ferencic, Nathan Ford, Edwige Fortier, Michael Fox, Vidhya Ganesh, Geoffrey Garnett, Amaya Gillespie, Aida Girma, Nick Goodwin, Ian Grubb, Lenin Guzman, Laura Hakokongas, Keith Hansen, Mary Haour-Knipe, Lyn Henderson, Alison Hickey, Wolfgang Hladik, Gillian Holmes, Dagmar Horn, Lee-Nah Hsu, Enida Imamovic, José Antonio Izazola, Jantine Jacobi, Noerine Kaleeba, Pradeep Kakkattil, Mohga Kamal Smith, Carol Kerfoot, Brigitte Khair-Mountain, Robert Kihara, Alexander Kossukhin, Christian Kroll, Amna Kurbegovic, Robin Landis, Susan Leather, Jean-Louis Ledecq, Seung-hee Lee, Ken Legins, Gael Lescornec, Jon Liden, Tony Lisle, Carol Livingston, Ruth Macklin, Bunmi Makinwa, Valerie Manda, Geoff Manthey, Tim Marchant, Hein Marais, William McGreevey, Henning Mikkelsen, David Miller, Jadranka Mimica, Hi-Mom, Roeland Monasch, Erasmus Morah, Rosemeire Munhoz, Elizabeth Mziray, Warren Naamara, Alia Nankoe, Francis Ndowa, Paul Nunn, Philip Onyebujoh, Gorik Ooms, Victor Ortega, Jos Perriens, Eduard Petrescu, Jean-Pierre Poullier, Elizabeth Pisani, Ben Plumley, Joel Rehnstrom, Chen Reis, Sinead Ryan, Marcos Sahlu, Roger Salla Ntounga, Karin Santi, George Schmid, Kristan Schoultz, Geeta Sethi, Ismail Shabbir, Catherine Sozi, Paul Spiegel, Susan Stout, Inge Tack, Miriam Temin, Kate Thomson, Georges Tiendrebeogo, Susan Timberlake, Warren Tiwonge, Stephanie Urdang, Mirjam van Donk, Bob Verbruggen, Anna Vohlonen, Neff Walker, Bruce Waring, Alice Welbourn, Caitlin Wiesen, Alan Whiteside, Desmond Whyms, Brian Williams (WHO), Kenneth Wind-Andersen, Anne Winter, Soumaya Yaakoubi, and Alti Zwandor
|1||Global AIDS epidemic 1990–2003|
|2||Median HIV prevalence in antenatal clinic population in Andhra Pradesh, Karnataka, Maharashtra and Tamil Nadu, India, 1998–2003*|
|3||Trends in HIV prevalence among various groups, Cambodia, 1998–2002|
|4||Estimated number of new HIV infections in Thailand by year and changing mode of transmission|
|5||Epidemic in sub-Saharan Africa, 1985–2003|
|6||HIV prevalence among 15–49-year-olds in urban and rural areas, selected sub-Saharan African countries, 2001–2003|
|7||HIV prevalence among 15–24-year-olds in selected sub-Saharan African countries, 2001–2003|
|8||Median HIV prevalence (%) in antenatal clinics in urban areas, by subregion, in sub-Saharan Africa, 1990–2002|
|9||Newly diagnosed HIV infections per million population in Eastern European and Central Asian countries, 1996–2003|
|10||HIV prevalence among men having sex with men in Latin America, 1999–2002|
|11||Condom use with a non-cohabiting partner, Dominican Republic, 2002|
|12||Life expectancy at birth in selected most-affected countries, 1980–1985 to 2005–2010|
|13||Population size with and without AIDS, South Africa, 2000 and 2025|
|14||Examples of estimates of the impact of AIDS on economic growth, 1992–2000|
|15||Orphans per region within sub-Saharan Africa, end 2003|
|15a||Problems among children and families affected by HIV and AIDS|
|16||Growing role of grandparents—Relationships of double orphans and single orphans (not living with surviving parent) to head of household, Namibia, 1992 and 2000|
|17||Projected new adult infections given current degree of intervention and a timely scale up of the comprehensive interventions package|
|18||Reinforcing strategies of risk, vulnerability and impact reduction|
|19||Proportion of respondents stating that HIV can be transmitted through sexual contact, selected states in India|
|20||Trends in sexual behaviour among young people in selected sub-Saharan African countries, 1994–2001—Percentage of young people (15–24-year-olds) who report using a condom at last sex with a non-marital non-cohabiting partner, of those who have had sex with such a partner in the last 12 months|
|21||Trends in sexual behaviour among young people in selected sub-Saharan African countries, 1994–2001—Percentage of young people (15–24-year-olds) who had sex with a non-marital, non-cohabiting partner in the 12 months prior to the survey|
|22||Annual prevalence of HIV and other sexually transmitted diseases at the Clinique de Confiance, Abidjan, Côte d’Ivoire (1992–2002)|
|23||HIV-positive inmates in the penal system of the Ministry of Justice in the Russian Federation, 1994 through 2003|
|24||Participating countries in the joint subregional HIV prevention and care programme along the Abidjan-Lagos migration corridor|
|25||Proportion of 15–24-year-old injecting drug users infected with HIV, various studies|
|26||Changes in voluntary counselling and testing in South Africa: more sites = more tested|
|27||Khayelitsha: Availability of decentralized antiretroviral therapy access, advocacy, and multi-disciplinary support services dramatically increases demand for testing and counselling|
|28||Pregnant women attending antenatal clinics, served by ‘Call to Action’ programme in Africa*, 2000–2003** (N = 416 498)|
|29||Pregnant women attending antenatal clinics, served by ‘Call to Action’ programme outside Africa*, 2000–2003** (N = 243 103)|
|30||Young people (15–24 years old) living with HIV, by region, end 2003|
|31||Sexual and reproductive health status of 15–19-year-old girls in 2000 and 2001|
|32||Percentage of young women (15–24 years old) with comprehensive HIV and AIDS knowledge, by region, by 2003|
|33||Antiretroviral therapy coverage for adults, end 2003—400 000 people on treatment: 7% coverage|
|34||Prices (US$/year) of a first-line antiretroviral regimen in Uganda: 1998–2003|
|35||Projected annual HIV and AIDS financing needs by region, 2004–2007 (in US$ million)|
|36||Global resources needed for prevention, orphan care, care and treatment and administration and research 2004–2007 (in US$ million)|
|37||Institutional spending for HIV and AIDS 1996–2002 (US$ disbursements in millions)|
|38||Percentage that out-of-pocket AIDS expenditure constitutes of total AIDS expenditure, selected countries, 2002|
|39||Projected disbursements on HIV and AIDS by top bilateral donors (US$ in millions) for 2003|
|40||Net Official Development Assistance (ODA) as percentage of gross national income (GNI): 2003|
|41||HIV/AIDS/STI ODA, 2002—Total amount obligated in US$ million and obligations per US$ million GNI|
|42||The Global Fund to Fight AIDS, Tuberculosis and Malaria Pledges and contributions received, as of December 31, 2003|
|43||Funds committed by top 15 US grantmakers in 2002 (US$ millions)|
|44||Funding for microbicide research, in US$|
|45||Changes in AIDS Programme Effort Index scores 2000, 2001 and 2003|
|46||Relations between National AIDS Committees and bilaterals—Percentage of responding countries where UNAIDS Secretariat representatives indicated that a formal relationship existed between the NAC and bilateral donors|
|47||Level of mainstreaming in 63 low- and middle-income countries|
|48||Health and human resource constraints—Percentage of countries where the UNAIDS Secretariat representative indicated that a lack of health personnel was a major barrier to the national AIDS response|
|49||HIV prevalence by country of asylum and country of origin, by region, 2003|
|50||HIV risk factors for conflict and displaced persons camps|
|51||Participation in partnership forums by people living with HIV, 2003|
UNAIDS/04.16E (English original, June 2004)
© Joint United Nations Programme on HIV/AIDS (UNAIDS) 2004.
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The Joint United Nations Programme on HIV/AIDS (UNAIDS) brings together nine UN agencies in a common effort to fight the epidemic: the United Nations Children’s Fund (UNICEF), the World Food Programme (WFP), the United Nations Development Programme (UNDP), the United Nations Population Fund (UNFPA), the United Nations Office on Drugs and Crime (UNODC), the International Labour Organization (ILO), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the World Health Organization (WHO), and the World Bank.
UNAIDS, as a cosponsored programme, unites the responses to the epidemic of its nine cosponsoring organizations and supplements these efforts with special initiatives. Its purpose is to lead and assist an expansion of the international response to HIV/AIDS on all fronts. UNAIDS works with a broad range of partners – governmental and nongovernmental, business, scientific and lay – to share knowledge, skills and best practices across boundaries.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) brings together nine United Nations system organizations.
For 58 years, the United Nations Children’s Fund (UNICEF) has been working with partners around the world to promote the recognition and fulfilment of children’s human rights. This mandate was established in the Convention on the Rights of the Child, and is achieved through partnerships with governments, nongovernmental organizations and individuals in 162 countries, areas and territories. UNICEF brings to UNAIDS this extensive network and its ability for effective communication and advocacy. UNICEF’s priorities in addressing the AIDS epidemic include prevention among young people, reducing mother-to-child transmission and caring for and protecting orphans, vulnerable children, young people and parents living with HIV or AIDS.
The World Food Programme (WFP) is the world’s largest humanitarian agency. It helps poor households affected by hunger and AIDS by using food aid and other resources to address prevention, care and support. WFP’s food assistance helps keep parents alive longer, enables orphans and vulnerable children to stay in school, permits out-of-school youth to secure viable livelihoods and enables tuberculosis patients to complete their treatment. WFP works in partnership with governments, other United Nations agencies, non-governmental organizations and communities and helps people—regardless of their HIV status—who lack adequate food to secure nutrition and food security.
The United Nations Development Programme (UNDP) is a development agency with strong country presence. Its role is to promote an enabling policy, legislative and resource environment which helps create an effective response to AIDS. UNDP supports countries in placing AIDS at the centre of national development agendas; promotes government, civil society, private sector and community leadership; helps countries to develop capacity for action as well as to plan, manage and implement responses to the epidemic. UNDP also works to ensure that women and people living with HIV are empowered and directly involved in the response to AIDS.
UNFPA, the United Nations Population Fund, builds on over three decades of experience in reproductive health and population issues by focusing its response to the epidemic—in over 140 countries—on HIV prevention among young people and pregnant women, comprehensive male and female condom programming and strengthening the integration of reproductive health and AIDS. UNFPA further contributes through meeting the reproductive health rights and needs of HIV-positive women and adolescents, promoting voluntary counselling and testing as well as services which prevent mother-to-child HIV transmission, improving access to HIV and AIDS information and education and to preventive commodities, including those needed in emergency settings. It also provides demographic and socio-cultural studies to guide programme and policy development.
The United Nations Office on Drugs and Crime (UNODC) is responsible for coordinating and providing leadership for all United Nations drug control activities, and for international cooperation in preventing and combating transnational crime and terrorism. In this context, UNODC supports comprehensive approaches to HIV prevention and care among injecting drug users. In prison settings, UNODC assists in implementing international instruments, norms and standards, which ensure that all inmates receive health care, including for HIV and AIDS. UNODC helps governments to combat people trafficking, and provides guidance to reduce trafficked victims’ health consequences, particularly from HIV infection and AIDS.
The International Labour Organization (ILO) promotes decent work and productive employment for all, based on principles of social justice and non-discrimination. The ILO’s contribution to UNAIDS includes: its tripartite membership, encouraging governments, employers and workers to mobilize against AIDS; direct access to the workplace; long experience in framing international standards to protect the rights of workers; and a global technical cooperation programme. The ILO has produced a Code of Practice on HIV/AIDS and the world of work—an international guideline for developing national and workplace policies and programmes.
Within the UN system, the United Nations Educational, Scientific and Cultural Organization (UNESCO) has a special responsibility for education. Since ignorance is a major factor in the AIDS epidemic, prevention education is at the top of UNESCO’s agenda. Education is needed to make people aware that they are at risk or vulnerable, as well as to generate skills and motivation necessary for adopting behaviour to reduce risk and vulnerability and to protect human rights. UNESCO works with governments and civil society organizations to implement policies and programmes for prevention education, and to mitigate the impact of AIDS on education systems.
The objective of the World Health Organization (WHO) is the attainment by all peoples of the highest possible level of health. Its work in HIV and AIDS is focused on the rapid scale up of treatment and care while accelerating prevention and strengthening health systems so that the health sector response to the epidemic is more effective and comprehensive. WHO defines and develops effective technical norms and guidelines, promotes partnership and provides strategic and technical support to Member States. The Organization also contributes to the global AIDS knowledge base by supporting surveillance, monitoring and evaluation, reviewing the evidence for interventions and promoting the integration of research into health service delivery.
The World Bank’s mission is to fight poverty with passion and professionalism. To combat AIDS, which is threatening to reverse the gains of development, the Bank has committed more than US$2 billion for HIV and AIDS projects worldwide. Most of the resources have been provided on highly concessional terms, including grants for the poorest countries. To address the devastating consequences of AIDS on development, the Bank is strengthening its response in partnership with UNAIDS, donor agencies and governments. The Bank’s response is comprehensive, encompassing prevention, care, treatment and impact mitigation.
Joint United Nations Programme on HIV/AIDS (UNAIDS)