Interview with Michel Sidibé, Executive Director of UNAIDS during his visit to Bern on 13 May 2013

UNAIDS defined its strategy for 2011-15 in two words, «Objective Zero» (zero new infections, zero discrimination, zero AIDS-related deaths). What progress has been made so far?
An intensification of the fight against the HIV epidemic that has no precedent is enabling us to seriously contemplate an end to the epidemic. I am pleased to note that there has been exponential growth in the number of infected persons able to benefit today from the progress made in recent years in our efforts to combat HIV, notably in the area of therapy. Today there are nearly 8 million people living with HIV who are receiving anti-viral treatment. In the past 24 months the number of persons around the world with access to treatment that enables them to remain in good health and live a longer and more productive life increased by 63%.
New preventive strategies such as male circumcision and a combination of prevention and treatment, notably mother-and-child, have helped to produce a continuous decrease worldwide in new infections as well as AIDS-related deaths.
In 2011 UNAIDS and its partners decided on objectives that include bringing new HIV infections involving children to an end, and maintaining the life and health of mothers so that they can care for their children and see them grow up. I sincerely believe we shall be able to honour this commitment. Half of the total decrease in new HIV infections concerns newborns. In countries with a high rate of HIV and increased access to antiretroviral therapy, virtually no children are being born today with HIV infections. This inspires me with real hope for an HIV-free generation. UNAIDS efforts are focused on 30 countries that account for 90% of new infections among children. I think that a concerted effort today will enable us to achieve our objective of zero new infections in children by 2015.

Where has significant progress been made in combating AIDS since 2011? And what have been the main setbacks?
Perhaps one of the most important advances has been the development of effective antiretroviral therapy, which has enabled us to save millions of lives. Recent studies have shown that this therapy not only prolongs the patient’s life, but also prevents HIV transmission. There is a 96% reduction in the risk of a person with HIV who is receiving effective antiretroviral therapy transmitting the virus to his or her partner. We have also known for some time that this therapy is extremely effective in preventing new HIV infections in children. When a pregnant woman infected with HIV has access to antiretroviral therapy during her pregnancy, childbirth and breastfeeding, the risk of transmission of the virus to the child is never greater than 5%.
The challenge we face now is ensuring that all those who need it have access to this treatment. At present out of 15 million who need antiretroviral therapy 7 million still do not have access. UNAIDS is making every effort to ensure that by 2015 all those in need will have access to this life-saving treatment.

What is the position of UNAIDS concerning the views of certain very «conservative» movements and actors, notably with regard to the promotion of non-discrimination/non-stigmatisation, or in relation to prevention, ensuring that young people and minority groups have access to information, treatment and care services?
Universal access to the prevention and treatment of HIV means taking charge, without stigmatisation or discrimination, of all persons in need of treatment. Although significant progress has been made in ensuring access to treatment, even for the most marginalised populations, much remains to be done. UNAIDS actions and commitments are based on total respect for human rights. We are unreservedly committed to combating HIV stigmatisation and discrimination. We work with a broad range of partners including community organisations, religious organisations, governments and political leaders, scientific committees, and law enforcement agencies, among others. Our efforts are focused on developing reliable data, strengthening political commitment, encouraging a variety of actors to invest in programmes to combat stigmatisation and discrimination, promoting access to justice, providing greater support for civil society, and technical assistance to combat punitive laws and practices, stigmatisation and discrimination. Every human being has the right to health and therefore to access care services anywhere in the world.

The international community is discussing the post-2015 round of global development objectives to follow the Millennium Development Goals (MDGs). What place do you think HIV/AIDS will occupy in these discussions?
Combating the HIV epidemic has been one of the defining issues of our time and I am convinced that we can bring the AIDS epidemic to an end. We are now on the point of fulfilling the full potential of our efforts to save lives. It would be unreasonable and counterproductive to stop the unprecedented investments provided by all communities, North and South, to achieve our ultimate goal. And our mobilisation to ensure that HIV remains one of the major post-2015 objectives is continuing. Not an isolated, vertical approach but rather a global and integrative approach to healthcare that takes into account HIV and all the lessons learned in the past 30 years, with the achievement of unprecedented results for a health issue in such a short period.

What do you expect from Switzerland’s commitment? In what ways is Switzerland useful and how could it be more useful?
Switzerland and UNAIDS have been working together since the beginning of the HIV epidemic. The Confederation not only makes an important financial contribution, but also provides political leadership and action in key aspects of the fight against HIV, such as the promotion of human rights and social protection for those most vulnerable in our societies. We have always benefited from the culture and know-how of Switzerland in the area of public health. We are particularly grateful to the former Swiss President Ruth Dreifuss in this respect.
Switzerland’s extensive experience in reducing risks for injecting drug users for example, and its commitment in discussions concerning the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) are particularly helpful to UNAIDS and an inspiration in our efforts to increase awareness in other nations and to guide them.
We are grateful to the Confederation for hosting the UNAIDS headquarters in Geneva and for Switzerland's active participation in our guiding body, the UNAIDS Programme Coordinating Board.