Preface

Foreword

Overcoming AIDS: the ‘Next Agenda’

A global overview of the AIDS epidemic

The impact of AIDS on people and societies

Focus - AIDS and orphans: a tragedy unfolding

Bringing comprehensive HIV prevention to scale

Focus - HIV and young people: the threat for today’s youth

Treatment, care and support for people living with HIV

Focus - AIDS and human rights: the need for protection

Financing the response to AIDS

National responses to AIDS: more action needed

Focus - AIDS and conflict: a growing problem worldwide

Focus - The essential role of people living with AIDS

Table of country-specific HIV/AIDS estimates and data, as of end 2003

Annex – HIV/AIDS estimates and data, end 2003

References

Managing Editor/Production Coordinator

Chief Scientific Advisor

Sandra Woods

Catherine Hankins

Principal writers:

Editorial/Research Assistant

Sue Armstrong

Susan Squarey

Chris Fontaine

Project Supervisor

Andrew Wilson

Marika Fahlen

© Joint United Nations Programme on HIV/AIDS (UNAIDS) 2004.

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WHO Library Cataloguing-in-Publication Data

UNAIDS.

2004 report on the global HIV/AIDS epidemic : 4th global report.

1.HIV infections – epidemiology 2.HIV infections – therapy 3.Acquired immunodeficiency syndrome – epidemiology 4.Acquired immunodeficiency syndrome – therapy I.Title.

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)
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