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The Hummingbird Unitaid News - July 2018

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CONTENTS

1. Do it yourself. A campaign to bring HIV self-testing to South Africa

2. Three things to watch for at AIDS 2018

3. Here's how Asia Pacific is redoubling the fight against malaria

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Do it yourself

Inside an HIV self-testing campaign in South Africa

There's plenty to do at Hillbrow's shopping mall in Johannesburg, South Africa: get groceries, buy sports equipment, and now, you can find out your HIV status.

One in ten people in some areas are living with HIV, but many of them have never had a test. Globally, one in three do not know their status, and risk spreading the virus.

Peer educators are promoting self-screening kits as part of a US$ 72 million Unitaid-funded project. They target men and young women, who are among the hardest to reach with HIV testing,

Mogkadi reaches people who may be reluctant to take tests at clinics due to long lines and fear of revealing their status. "Discrimination is still a huge thing," she says.

She hands out up to 300 kits a day. People can choose to use them at home or on site. "Finding out about your status is scary, but HIV is no longer a death sentence," says Mogkadi.

HIV self-testing is easy. Test-takers use an oral swab and wait for 20 minutes. They are linked to prevention if the test is negative, and to a follow-up test, counseling and treatment if it is positive.

People who know their HIV status are firmly in control of their health. One self-test at a time, Hillbrow is bringing that knowledge to everyone.

3 THINGS TO WATCH FOR AT AIDS 2018

The global health community wants 30 million people to be on HIV treatment by 2030, up from almost 20 million today. But reaching the next ten million with testing, treatment and prevention services presents a special challenge.

At the 22nd International AIDS Conference (AIDS 2018), scheduled for 23-27 July, the world’s experts will discuss ways to intensify the response to the HIV epidemic to reach all vulnerable communities. Particularly, those who are stigmatized or have little access to health care facilities.

Interested in AIDS 2018 in Amsterdam? Here are some themes to watch for:

1. Gaps in the global response

Reaching more children, adolescent girls and men is not only a matter of equity, but it is also essential to ending the global HIV epidemic.

“We must reach all population groups, otherwise we will not meet the 2030 goals,” says Unitaid’s HIV strategy manager Carmen Pérez

This includes high-risk populations such as transgender people, inmates, men who have sex with men, young people and sex workers.

“We need to develop and scale-up better treatment, testing and prevention methods. Innovative solutions that take into consideration the people who are not being reached by other tools,” says Pérez. HIV self-testing and preventive oral treatment (PrEP) are two strategies AIDS 2018 will shine a light on.

2. One patient, various infections

The global health community faces a double challenge: making the most of the available resources, while all vulnerable people get access to prevention, testing and treatment. Here is where integration comes in.

People living with HIV are often affected by other infections such as hepatitis C; tuberculosis, which is the leading cause of death among AIDS patients, and the human papilloma virus, which may lead to cervical cancer.

The conference will take a hard look at how to better tackle co-infections. Experts have been exploring two strategies: using innovative technologies that test for multiple infections and the ‘one patient, one visit’ approach.

3. Prevention

Stepping up prevention is crucial to maintaining and advancing the gains made against HIV/AIDS, as shown by the resurgence of HIV in Eastern Europe and Central Asia.

This year’s conference will examine ways to improve prevention in different health care settings, particularly among young people.

On the agenda: how to better test people for HIV and link them to prevention and treatment services, and how to better deliver preventive oral medication (PrEP) to reduce the risk of HIV infection from sex in high-risk groups.

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Asia Pacific is redoubling the fight against malaria-carrying mosquitoes —and here's how

The Asia Pacific Leaders Malaria Alliance (APLMA) and Unitaid have launched the Vector Control Platform for Asia Pacific (VCAP), a collaborative platform that links national regulators, policy-makers, industry, academia and the global health community.

The aim is to boost development and use of antimalarial tools such as mosquito nets and insecticides.

We spoke to the CEO of APLMA Dr. Ben Rolfe on the sidelines of the 1st Malaria World Congress in Melbourne in early July to learn about the region's progress, and strategies to overcome challenges. Here are the takeaways from our conversation:

1. The progress

The Asia Pacific region has halved the burden of malaria in ten years, and since 2014 has increased domestic financing 40%.

2. The setbacks

The first threat is the emergence of multidrug-resistant malaria in the Greater Mekong sub-region, particularly in Cambodia.

Another problem is the resurgence of malaria in the Solomon Islands and Papua New Guinea, whose health system has collapsed over the past three years because of budget cuts forced by declining oil prices, notes Rolfe.

"In Papua New Guinea, we are seeing up to an eight-fold increase in malaria since 2014, after a decade of sustained progress," says the CEO of APLMA Ben Rolfe

3. The path toward elimination

The challenge now is to sustain political leadership as we move towards the end game, and to secure enough external and domestic financing, says Rolfe.

"As malaria becomes increasingly rare, we have to keep the political momentum that we have built since the malaria 2012 conference"

Achieving the 2030 goals will also mean joining forces with product development, innovation and scale-up partners. Unitaid and The Global Fund are two such partners.

4. Competing emergencies

How can malaria remain high on the political agenda when the world has to grapple with such health emergencies as Zika & Ebola?

"Creating political leadership is hard work but straightforward. The real challenge is catalyzing action behind that leadership"

APLMA convenes senior officials once a year to review progress and get support from ministries of finance, foreign affairs and defence, as well as health.

For Rolfe, multisectoral leadership is what keeps the political momentum going, together with the support from the African Leaders Malaria Alliance, parliamentarians, Unitaid and the Global Fund. "There is cause for optimism," he says.

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