HIV/AIDS: A major roadblock to development

Facts about HIV/AIDS

At the end of 2011, UNAIDS, the Joint United Nations Programme on HIV/AIDS, estimated that, globally, 34 million people were living with HIV. Of that number, about 69 percent were living in sub-Saharan Africa, the region most heavily affected by the epidemic. In that same year, 2.5 million people, including 330,000 children, were newly infected with HIV.

There are now some signs of hope and progress in the fight against HIV/AIDS. According to UNAIDS, AIDS-related deaths had decreased from 2.2 million in 2005 to 1.7 million in 2011 as a result of many advances, including:

• Scaled up access to new drugs and treatments
• Improved access to health services through stronger health systems
• Effective prevention programs and public awareness  campaigns

Nevertheless, HIV/AIDS remains one of the largest roadblocks to development. Since this pandemic affects people from all walks in the prime of their lives, it has a devastating effect on the economic, social, and political status of societies. Globally, HIV/AIDS remains the leading cause of death among women aged 15 to 44.

Canada and the global fight against HIV/AIDS

Canada is an active player in the global response to HIV/AIDS and recognizes the need to increase efforts to achieve universal access to HIV prevention measures, treatment, and care. That is why the fight against HIV/AIDS is one of the main components of CIDA's children and youth strategy.

An important part of Canada's efforts to improve maternal, newborn, and child health is to prevent mother-to-child HIV transmission. Between 15 percent and 45 percent of children born to HIV-positive women can become infected with the virus during pregnancy, delivery, or breastfeeding. Interventions to prevent mother-to-child transmission of HIV, including access to antiretroviral drugs for both the mother and her child, and preventing women from getting HIV in the first place can reduce this risk of transmission to less than 5 percent.

Canada played a leading role within the UN Commission on Information and Accountability for Women's and Children's Health. The Commission recommended that access to antiretroviral treatment for HIV-positive pregnant women, due to the significant impact it has on women and children's health, be one of eleven indicators that the global community monitor.

Canada supports the Global Plan towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive (PDF, 785.3 KB, 48 pages), launched in 2011 to intensify efforts to reach global targets of reducing new HIV infections in children and maternal deaths caused by HIV.

This support is helping to meet the Millennium Development Goals, one of which targets halting and beginning to reverse the spread of HIV/AIDS by 2015.

Examples of CIDA-funded initiatives in the global fight against HIV/AIDS

Canada's support for HIV/AIDS prevention and for care and treatment of those affected by this pandemic has helped save many lives in developing countries. Between 2005-2006 and 2011-2012, this support, channelled through global initiatives, multilateral and bilateral programs, and partnerships with Canadians, totalled more than $1.12 billion.

In July 2010, the Government of Canada renewed its commitment to implement the Canadian HIV Vaccine Initiative (CHVI) in collaboration with the Bill and Melinda Gates Foundation with a contribution of $111 million. Since 2007, CIDA has allocated $30 million for the CHVI to develop an affordable, globally available HIV vaccine through the following projects:

• CHVI — Large-Team Grants
• CHVI — Sustainable Regulatory Development to Accelerate Access to HIV Vaccines
• CHVI — HIV/AIDS Prevention Trials Capacity Building — Phase II
• CHVI — HIV/AIDS Prevention Trials Capacity Building Grants Program — Phase II

Under CHVI, CIDA has also allocated $30 million for the prevention of mother-to-child HIV transmission in low- and middle-income countries. For instance, Canada is working with the World Health Organization to increase access to, and the effectiveness of, comprehensive and integrated prevention of mother-to-child HIV transmission services for mothers and children in three countries in sub-Saharan Africa.

CIDA is working closely with its United Nations partners in the fight against HIV/AIDS. For example, CIDA provides ongoing financial support to UNAIDS. CIDA also supports UNAIDS through other HIV investments with some of its UN co-sponsor organizations, including UNICEF, UN Women, UNFPA , UNDP, WHO , UNESCO, and the World Bank Group.

Progress that is saving lives

Worldwide

Canada has always been an active supporter of the Global Fund to Fight AIDS, Tuberculosis and Malaria, contributing more than $1.5 billion to the fund since its founding in 2002, with the most recent pledge totalling $540 million over three years. Since 2004, thanks to the Global Fund:

• 4.2 million people received antiretroviral treatment for HIV/AIDS
• 250 million HIV counselling and testing sessions were conducted
• 6.3 million children orphaned by or vulnerable to AIDS were provided with basic care and support services
• 1.7 million HIV-positive pregnant women received antiretroviral drugs to prevent HIV transmission to infants

As part of promoting equality between women and men and helping to reduce the vulnerability of women to HIV, CIDA is supporting UN Women's Fund for Women's Property and Inheritance Rights. Through this project, between March 2010 and September 2011:

• 650 community level leaders, 650 paralegals, and 9,000 community members were trained and sensitized on customary law, land titling, succession planning, and will writing with the aim of providing better legal aid and services to women living with or affected by HIV/AIDS
• 1,200 women living with or affected by HIV/AIDS have increased their  knowledge and awareness of their property and inheritance rights and the available legal services in the community, both formal and informal
• In at least three countries, new national legislation or policies to promote women's property and inheritance rights were introduced or enacted

In Haiti

The CIDA-funded Support to combat sexually transmitted infections and HIV/AIDS in Haiti (PALIH) project, co-organized by the Center for International Cooperation in Health and Development and the Centre for International Studies and Cooperation, aims to reduce the prevalence of these diseases in the department of Artibonite by improving health system structures and the quality of services available to the general population and groups most at risk. In 2010:

• Capacities for managing and overseeing the department's health services improved considerably
• 1,143,470 residents had access to quality services for managing sexually transmitted infections
• 24 regional health units adapted to the people most at risk (sex workers and their clients, youth at risk, female victims of violence, and persons living with HIV) were put in place
• Quality of prevention services was improved by training health care personnel, by disseminating prevention messages, and by increasing the number of sales of and distribution outlets for condoms
• The question of equality between women and men was better integrated into programs to prevent and combat HIV/AIDS

Today, 99 percent of the health establishments in Bas-Artibonite offer community services and have at their disposal the entire range of drugs to combat sexually transmitted infections. CIDA is contributing $19 million over six years to this project.

In Tanzania

The second phase of the Rapid Funding Envelope for HIV/AIDS project in Tanzania provides grants to civil society organizations for short-term projects related to HIV/AIDS. The basic aim of the Rapid Funding Envelope (RFE) is to improve the capacity building of the organizations to deliver services where they will have a greater effect, that is, in the communities of Tanzania.

One of the projects funded by Canada as part of the RFE and managed  by Chama cha Wazee na Wastaafu Arusha (Association for the Elderly and Retired in Arusha) helped lessen the effect of HIV/AIDS on the elderly who are suddenly called on to take care of HIV-positive relatives or to raise grandchildren orphaned by AIDS. As a result:

• A home care model was developed and implemented in 57 communities
• 18 home care workers and 18 educators were trained and equipped to help 114 seniors improve their skills
• Kits were given to those elderly persons to help them care for the ill, but also to prevent the transmission of HIV/AIDS while dispensing care
• 45 representatives were trained to raise awareness of the effects of AIDS on the elderly

In Zimbabwe

From 2006 to 2010, CIDA contributed $2.9 million to the Research Institute of the McGill University Health Centre to support the second phase of the Centre's project on the prevention of mother-to-child transmission of HIV in three districts of Zimbabwe: Chirumanzu, Shurugwi and Gutu. In 2010:

• 1,068 nurses, nursing assistants, and other health care workers were trained on integrated preventive care for HIV
• The number of at-risk babies having received preventive treatment increased by about 25 percent compared to 2006
• 3,059 community workers and community leaders learned about HIV prevention and mother-to-child HIV transmission
• 58 health centres were upgraded so they could offer integrated preventive care to some 200,000 persons
• Some 2,400 healthcare workers were trained on the delivery of essential health services to pregnant women and on preventive treatment for babies exposed to HIV
• 36,887 men and women were informed on the prevention of HIV transmission through breastfeeding as part of awareness campaigns
• 18,796 community residents were informed on established prevention methods as part of workshops on prevention of mother-to-child HIV transmission and equality between women and men

In South Africa

In South Africa, Canada provided $5 million to the Hospice Palliative Care Association of South Africa to improve the delivery of sustainable palliative home care to HIV-infected individuals and their families. In 2010:

• Some 14,000 patients a month had received care from the fifty CIDA-funded centres, all of which provide care to children infected with and affected by HIV/AIDS Twenty-three of the centres have programs geared to children and adolescents.

At the XVII International AIDS Conference, in 2008, Canada reaffirmed its commitment to the HIV/AIDS Response Fund in South Africa, with a view to helping local organizations reduce the incidence and prevalence of HIV/AIDS and the effect of the infection/disease on citizens. In all:

• 1,709,164 men, women, boys, and girls have benefited from the fund's activities since 2005

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