IAPAC Public Comment to Texas HIV Medication Program

12 April 2024

Mr. Frank Rosas
Chair, Medication Advisory Committee
Texas HIV Medication Program

Dear Mr. Rosas and distinguished Committee members,

The International Association of Providers of AIDS Care (IAPAC), which represents almost 1,000 clinician-members in Texas, urgently requests that long-acting injectable antiretroviral therapy (LAI-ART) be made immediately available to people living with HIV (PLHIV) across Texas who meet income and other eligibility factors through the Texas HIV Medication Program (THMP). As we strive to honor patient choice of effective treatment options that facilitate viral suppression leading to undetectable viral load and U=U (Undetectable=Untransmittable), it is imperative to recognize the significance of LAI-ART in this context.

Numerous studies have shown that LAI-ART has demonstrated remarkable effectiveness in achieving and maintaining viral suppression among PLHIV. Additionally, a study presented at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI) noted that for PLHIV who have consistently shown an inability to adhere to oral antiretroviral therapy (ART) regimens due to challenges with pill-taking, LAI-ART offers a critical alternative. By providing a sustained release of medication over an extended period, LAI-ART eliminates the need for daily pill-taking, thereby addressing a significant barrier to treatment adherence.

Central to the discussion of LAI-ART is the concept of “patient choice.” Autonomy is a fundamental principle in achieving positive HIV and other health outcomes. It is essential that PLHIV have access to a range of treatment options and are empowered to make informed decisions about their care. By offering LAI-ART through the THMP, we uphold the principle of patient choice and provide PLHIV with the opportunity to select the treatment modality that best aligns with their treatment preferences and life circumstances in partnership with their healthcare providers.

Moreover, THMP coverage of LAI-ART is crucial for supporting the goals of the Fast-Track Cities initiative in Texas. The network of four Fast-Track Cities in Texas (Austin, Dallas, Houston, and San Antonio, as well as their respective counties) has made significant progress in closing HIV treatment gaps and reducing HIV incidence. However, to continue this momentum and achieve targets such as a 90% decrease in HIV incidence under the Ending the HIV Epidemic strategy, the Fast-Track Cities initiative’s 95-95-95 targets, and Texas’ goal of a 75% viral suppression rate by 2025, it is essential that Fast-Track Cities in Texas have access to all tools at their disposal, including effective ART options like LAI-ART.

Finally, it is crucial to recognize the role of the national AIDS Drug Assistance Program (ADAP), and state-specific extensions such as THMP, as a safety net for medically indigent PLHIV. THMP plays a vital role in ensuring access to life-saving medications for those who may not have the financial means to afford them otherwise. By including LAI-ART within THMP coverage, we prioritize health equity in the HIV response, ensuring that no person is left behind. Access to innovative treatment options like LAI-ART should not be contingent on socioeconomic status, and by extending coverage to include LAI-ART, we take a significant step towards equitable healthcare access for all individuals living with HIV in Texas.

In conclusion, we urge the THMP Medication Advisory Committee to consider the inclusion of LAI-ART within the ADAP program. Doing so would not only honor patient choice and autonomy but also contribute to the progress towards ending the HIV epidemic and achieving the targets set forth by Fast-Track Cities.

Thank you for your attention to this important matter.

Warmest regards,

Dr. José M. Zuniga
President/CEO

 

Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, visit: https://www.iapac.org/

IAPAC Welcomes Francisco Ruiz as New ONAP Director

 Statement by IAPAC President/CEO Dr. José M. Zuniga

8 April 2024 – Washington, DC

“The International Association of Providers of AIDS Care (IAPAC) extends a warm welcome to Francisco Ruiz as the new Director of the White House Office of National AIDS Policy (ONAP). He steps into this critical role at a pivotal moment in the country’s HIV response. We want to express our deep gratitude to former ONAP Director Harold Phillips for his dedication and leadership in advancing the national HIV response during his tenure, providing a foundation for Mr. Ruiz to build upon to achieve the goals of the US National HIV/AIDS Strategy (NHAS).

As the transition in ONAP leadership takes place, it is essential to recognize the urgency of the moment. Mr. Ruiz and the entire US HIV community face the dual challenges of meeting the ambitious NHAS goals and targets in the US Ending the HIV Epidemic (EHE) strategy, as well as the United Nations Sustainable Development Goal of ending AIDS as a public health threat by 2030. The path forward demands unwavering commitment, innovative strategies, and bold action to accelerate progress, while addressing barriers to progress, including racism, stigma, and social determinants of health.

Achieving greater impact across the country requires a focused approach, particularly in the 48 county jurisdictions, Washington, DC, and San Juan, PR, as well as the seven states prioritized for the Ending the HIV Epidemic initiative. Mr. Ruiz’s leadership will be instrumental in driving collaboration, resource allocation, and targeted interventions to address disparities and gaps in HIV prevention, treatment, care, and social support within these communities, with a notable focus on marginalized and vulnerable populations. Engagement with Fast-Track Cities across the United States offers a valuable opportunity to leverage collective expertise and resources, fostering synergy, and closing gaps across the HIV care continuum.

In welcoming Mr. Ruiz, IAPAC reaffirms our commitment to working alongside him, ONAP and federal partners, and the broader HIV community to realize our collective vision of a future in which new HIV infections are exceedingly rare and AIDS-related deaths no longer occur. Together, we can confront the challenges ahead with determination, compassion, and unity, ensuring that no one is left behind in our pursuit of health equity and social justice in the US HIV response.”

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Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, visit: https://www.iapac.org/

Fast-Tracking Urban Public Health

In the February 2024 issue of The Parliamentarian, IAPAC and Fast-Track Cities Institute President/CEO, Dr. José M. Zuniga, writes that as the global Fast-Track Cities network prepares to commemorate its 10-year anniversary this year, cities as diverse as Johannesburg, Kingston, London, Mumbai, Sydney, and Toronto “remain steadfast in their priority focus on reaching the last mile towards ending urban HIV and TB epidemics, alongside the elimination of HCV infection by 2030.” He further notes “the Fast-Track Cities network is poised to achieve a wider range of global public health goals. Whether eliminating cervical cancer as a public health threat by 2030, saving 2.5 million lives from breast cancer deaths by 2040, or ensuring a 20% increase in service coverage for mental health conditions by 2030, the network is prepared to redefine urban approaches to myriad health challenges.” Click here to read his article titled, “Fast-Tracking Urban Public Health.”

Fast-Tracking Cervical Cancer Elimination in the Commonwealth

Remarks by Dr. José M. Zuniga, President/CEO, IAPAC and Fast-Track Cities Institute,
at the Commonwealth Secretariat Cervical Cancer Awareness Month Webinar
31 January 2024 (Virtual)

Thank you for inviting me to the Commonwealth Secretariat’s commemoration of Cervical Cancer Awareness Month. I represent the International Association of Providers of AIDS Care (IAPAC) and Fast-Track Cities Institute (FTCI), which are providing support to a network focused on accelerating urban HIV responses. This 500-plus city network has great potential to expand its scope to encompass the elimination of cervical cancer as a public health threat by 2030.

In relation to HIV, the network has effectively leveraged urban public health leadership in close to 100 Commonwealth cities around the world since its launch in 2014. These cities have achieved significant improvements in HIV treatment coverage, equitably closing gaps related to testing, linkage to care, treatment, and treatment outcomes. This type of urban public health leadership can and should be leveraged towards the goal of eliminating cervical cancer and we are eager to partner with the Commonwealth Secretariat to advance work in this regard.

Several Commonwealth countries, including Australia, South Africa, and the United Kingdom, host many Fast-Track Cities. This critical mass of Fast-Track Cities has also enabled a national consortium effect in scaling up HIV prevention. I am convinced we can achieve a similar prevention success by, for example, rolling out urban gender-neutral HPV vaccination programs across the Commonwealth, an approach we believe is essential to breaking the transmission cycle, protecting everyone from HPV-related diseases, notably cervical cancer.

Of course, the urban advantages for cervical cancer elimination extend beyond HPV vaccination. Urban settings often have better access to healthcare facilities, allowing for efficient screening and early detection programs. Robust healthcare infrastructure in cities facilitates outreach initiatives, ensuring that diverse populations receive regular screenings, HPV testing, and timely interventions. Moreover, urban centers can harness technology for health education campaigns, empowering residents with knowledge about cervical cancer prevention. Leveraging the Fast-Track Cities infrastructure and the Commonwealth’s commitment, we can utilize the concentration of resources and expertise in cities to support comprehensive and accessible urban cervical cancer elimination programs.

For all these reasons, we look forward to a strategic partnership between Fast-Track Cities, Commonwealth countries, and the Commonwealth Secretariat – a partnership that can help to leverage urban public health leadership to realize the right to health for all, including by eliminating cervical cancer. Thank you for your commitment and for inviting us to partner with you.

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About IAPAC
Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. IAPAC is also a member of the Global HPV Consortium, a public-private movement to prevent HPV infections and eliminate cervical cancer as a public health concern. For more information about IAPAC, please visit: https://www.iapac.org

About the Fast-Track Cities Institute
The Fast-Track Institute was created to support cities and municipalities worldwide in their efforts to achieve global health-related goals, including SDG 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and the urban development-focused SDG 11 (making cities and human settlements inclusive, safe, resilient and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/

 

 

World AIDS Day 2023 Remarks by

IAPAC President/CEO Dr. José M. Zuniga

December 1, 2023 – Washington, DC

 

“On World AIDS Day 2023, we gather under the theme, ‘Let Communities Lead,’ acknowledging the intrinsic role communities have played since the early days of the HIV epidemic. Communities, often marginalized and stigmatized, have been the organic force propelling progress against an insidious virus that has claimed more than 40 million lives – 630,000 last year alone.

Community resilience and determination have historically shaped our response. For more than four long decades, communities have shouldered the burden of the HIV epidemic, all while living in a world in which HIV does not exist in isolation. HIV intertwines with age, race, ethnicity, gender identity, sexual orientation, social circumstance, and other threads in the human tapestry. Today, as we commemorate World AIDS Day, we must thus reinforce intersectionality in our approach to addressing the multifaceted challenges posed by HIV. Leveraging intersectionality is crucial in guiding the HIV response as it acknowledges the unique challenges faced by individuals, recognizing that HIV is woven into the complex fabric of diverse identities.

Lived experience stands and must be sustained as a cornerstone in our collective fight against AIDS, enriching decision-making on issues often perceived as the domain of science or politics by grounding them in the human realm. Lived experiences must guide our efforts, adding depth and empathy to health policy formulation and the delivery of person-centered HIV care. By embracing these lived experiences, we can bridge the gap between symbolic rhetoric and tangible actions. Moreover, we can tailor interventions to address the specific needs of communities, fostering a more effective and inclusive approach in our efforts to end the HIV epidemic.

On this day of annual commemoration, we can also celebrate the strides that have been made. Yet we must acknowledge that our journey is far from over. As we navigate the complexities of the global health landscape, we must recognize the urgency of fortifying affected communities to continue leading the way. In reality, as we approach the mid-term to the 2030 goal of ending AIDS as a public health threat, we find ourselves off track. This stark reality calls for collective action and renewed commitment. Our path forward demands that we embolden and support all affected communities, ensuring they are not only heard but they are actively shaping and leading strategies that address the unique challenges they face, attuned with the diverse and nuanced realities that they experience in relation to HIV and beyond.

Let us use this year’s World AIDS Day to renew our commitment to the principles of community leadership and facilitate its powerful impact to save and enhance countless millions of lives. Together, we can bridge the gaps, dispel the shadows of stigma, and propel ourselves towards a future where the ravages of the HIV epidemic are but a distant memory – one in which we can celebrate that community leadership lead us towards a future free from the shadows of unnecessary suffering and hastened deaths.”

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About IAPAC

Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis (TB), as well as eliminate HBV and HCV, by 2030. IAPAC is the core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

IAPAC Endorses WHO U=U Policy Brief

Clarity of Guidance Critical to Equitable HIV Responses

BRISBANE, AUSTRALIA (July 23, 2023) – The International Association of Providers of AIDS Care (IAPAC) was among the first medical institutions to endorse Undetectable Equals Untransmittable (U=U) as an evidence-based message that de-stigmatizes an HIV diagnosis, creates demand for HIV testing and treatment, and promotes adherence to antiretroviral therapy (ART) to achieve an undetectable viral load level. Consistent with studies regarding the benefit of HIV treatment to prevent sexual transmission of HIV, IAPAC has delivered global medical education to specialized and primary care clinicians as well as community education about U=U to support its implementation in clinical and community settings.

IAPAC President/CEO Dr. José M. Zuniga believes today’s release of the World Health Organization (WHO) policy brief, “The Role of HIV Viral Suppression in Improving Individual Health and Reducing Transmission,” should serve as definitive guidance to allay any concerns regarding the degree of HIV transmission risk associated with the U=U message. The updated treatment algorithm presented during a WHO symposium at the International AIDS Society (IAS) 2023 conference includes three defined terms and their corresponding risk levels for transmission of HIV to sexual partners:

• Undetectable – Not detected by WHO-validated test/sample type used; ZERO RISK
• Suppressed – Detected but ≤1,000 copies/mL; almost zero risk or negligible risk
• Unsuppressed – Viral load of >1,000 copies/mL; increased vulnerability of transmitting HIV

“IAPAC endorses the WHO policy brief and its updated articulation of viral load thresholds with associated levels of transmission risk,” said Dr. Zuniga, who also serves as President/CEO of the Fast-Track Cities Institute. “The policy brief should increase clinician confidence in communicating that people living with HIV who are on ART and achieve an undetectable viral load cannot sexually transmit HIV. The risk is zero. This is a message that clinicians should convey accurately, clearly, and consistently to all people living with HIV who achieve an undetectable viral load level.”

He added that “achieving an undetectable viral load level, and the preventive benefit that it confers, should be a celebratory message that clinicians gladly deliver to people living with HIV. Positive messaging is critical if we are to facilitate long-term adherence to ART and the positive HIV and other health outcomes that come with successful HIV clinical and psychosocial management that created an enabling environment to achieve U=U.”

The WHO policy brief also clarifies that all WHO-prequalified viral load tests and sample types, including point-of-care and dried blood spot, can accurately determine whether a person living with HIV who is on ART is unsuppressed, suppressed, or undetectable. In that regard, Dr. Zuniga issued a call to action for increased efforts to scale-up access to WHO-prequalified viral load tests within the context of achieving health equity for people living with HIV.

In line with its partnership frameworks with WHO and the Prevention Access Campaign (PAC), plans to scale up its global medical and communication education efforts to action the policy brief’s guidance. According to Dr. Zuniga, “We aim to advocate the wide-scale implementation of the WHO policy brief’s recommendations so that the game-changing promise of U=U can be more widely felt across the global HIV response.”

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New Global Campaign to End HIV Stigma: #ZeroHIVStigmaDay

“Human First” Theme Emphasizes Human First Dimension of People Living with and Affected by HIV

 “Human First” Recognizes 75^th Anniversary of Universal Declaration of Human Rights

July 18, 2023 – (WASHINGTON, DC, USA, and LONDON, UK) –  Zero HIV Stigma Day is a new international HIV awareness day whose inaugural commemoration will be July 21, 2023. The day aims to unite people, communities, and entire countries to raise awareness about and take action to end HIV-related stigma that both violates human rights and jeopardizes efforts to end the global HIV epidemic. This year’s theme, “Human First,” emphasizes the human dimension of people living with and affected by HIV and reinforces that any form of stigma encountered by people living with HIV is a human rights violation.

“Given persistent levels of HIV stigma experienced in health and other settings, IAPAC and our partners launched a new global awareness day focused on ending HIV stigma in all its forms. We can only succeed in our efforts to end the global HIV pandemic if we end the gross violation of human rights that stigma represents for people living with and affected by HIV,” said José M. Zuniga, PhD, MPH, President/CEO of the International Association of Providers of AIDS Care (IAPAC) and the Fast-Track Cities Institute.

HIV-related stigma experienced in healthcare settings is widespread, impeding the ability of people living with and affected by HIV to access and use health services. According to UNAIDS, people living with HIV who perceive high levels of HIV-related stigma are 2.4 times more likely to delay enrolment in care until they are very ill. However, beyond the healthcare sector, HIV-related stigma is found in every area of social life – families and communities as well as educational and workplace settings, and within the justice system.

Zero HIV Stigma Day was first announced in 2022 by a consortium of multisector organizations, including IAPAC, (a global network of clinicians and allied health professionals) and NAZ (a UK-based sexual health charity), in collaboration with the Global HIV Collaborative and Fast-Track Cities Institute. Endorsing organizations include the Global Network of People Living with HIV (GNP+) and Joint United Nations Programme on HIV/AIDS (UNAIDS).

July 21^st was chosen to honor Prudence Nobantu Mabele (July 21, 1971 – July 21, 2017), the first woman in South Africa to disclose her HIV status in 1992. She was an activist who set a precedent for all people living with HIV to disclose and discuss their status with loved ones without shame, to seek treatment and care, and to lead happy and fulfilled lives.

“The only thing preventing us from ending all new HIV transmissions by 2030 is stigma. Normalizing HIV, delivering high quality sex and relationships education to young people, and promoting holistic care and support in bold and intentional ways is our collective responsibility. Countless activists like Prudence Mabele have shown us the power of collective voice, courage, and action to tackle HIV stigma. As we approach the first Zero HIV Stigma Day, let’s celebrate Prudence’s story as the legacy it should be,” said Parminder Sekhon, NAZ’s Chief Executive Officer.

In addition to launching a campaign brand and toolkit with social media and other creative assets, IAPAC will premiere a short documentary at 10 am ET, July 21, 2023, via the IAPAC YouTube channel, which will be housed after the premiere on the Zero HIV Stigma Day website. Human First will share lived experiences with stigma from six individuals who are either living with or affected by HIV in three countries (South Africa, United Kingdom, United States). Made possible through core funding support from ViiV Healthcare, the documentary will also feature innovative approaches to mitigate HIV stigma.

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About IAPAC

Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

About NAZ

NAZ is a minority-led HIV and sexual health agency with over 30 years grassroots experience of delivering HIV care and support and evidenced-based sexual health programs to Black and Brown and minoritized communities. Its mission is to achieve true parity in sexual health outcomes for racially minoritized communities living with and at elevated risk of HIV. For more information about NAZ, please visit: https://www.naz.org.uk/

About the Global HIV Collaborative

The Global HIV Collaborative (GHC) is a partnership of strategic global leaders and activists that strives to improve the HIV outcomes for Black communities globally. GHC works to address the current global trajectory of HIV outcomes in Black populations and seeks to prioritize the persistent issue of unequal HIV outcomes rooted in ethnic disparities. For more information about GHC, please visit: https://hiv-collaborative.org/

About the Fast-Track Cities Institute

The Fast-Track Institute supports cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/

 Statement by IAPAC President/CEO Dr. José M. Zuniga

14 July 2023, Washington, DC

BACKGROUND: The US House of Representatives Labor, Health and Human Services, Education, and Related Agencies Subcommittee of the House Appropriations Committee has proposed its spending bill for fiscal year 2024. The bill essentially eliminates funding for the US Ending the HIV Epidemic (EHE) initiative, which was launched in 2019 during the Trump Administration. Additional cuts are wide-ranging: $238.5 million from the Ryan White HIV/AIDS Program; $226 million from the CDC National Center for HIV, Viral Hepatitis, STD and TB Prevention; and $32 million from the Minority HIV/AIDS Fund.

“The International Association of Providers of AIDS Care (IAPAC) denounces draconian and harmful proposed cuts to US domestic HIV funding that would reverse progress made in efforts to end the HIV epidemic in the United States. We also call upon members of both the US House of Representatives and US Senate to reject efforts to gut the US HIV response at a time when measurable progress has been made in averting new HIV infections and AIDS-related deaths.

Given this progress, why would the US Congress wish to flush the American people’s investment down the drain? And, why, by further cutting programs that create enabling environments for positive health outcomes, would the US Congress reinforce disparity, inequity, and inequality in access to HIV services? Given the bipartisan support ending the HIV epidemic has enjoyed over many years, the generosity of the American people, and proof of concept that we can move the needle in relation to new HIV infections and AIDS-related deaths, the US Congress should do the right thing and reject efforts to gut the US HIV response.”

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About the International Association of Providers of AIDS Care

Representing 30,000 members, the International Association of Providers of AIDS Care (IAPAC) is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis (TB), as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

 

LISBON and MAPUTO (27 May 2023) – Lisbon Mayor Carlos Moedas and Maputo Mayor Eneas Comiche signed a bilateral agreement today to facilitate bidirectional exchanges as the two municipalities strive to attain the Fast-Track Cities initiative’s HIV, tuberculosis (TB), and viral hepatitis targets by 2030.

Dr. José M. Zuniga, President/CEO of the International Association of Providers of AIDS Care (IAPAC) and Fast-Track Cities Institute, joined the signing ceremony virtually. IAPAC Vice President for Regional Relations Gonçalo Lobo countersigned the agreement on behalf of IAPAC during the Lisbon segment of the ceremony alongside with Dr. Rui Portugal, General Director of Health of the country’s Directorate of Health. Dr. Michel Kouakou, Joint United Nations Programme on HIV/AIDS (UNAIDS) Country Director for Mozambique, countersigned the agreement on behalf of UNAIDS during the Maputo segment of the ceremony.

In his virtual remarks, Dr. Zuniga applauded the first formal, language-specific bilateral partnership between two municipalities in the Fast-Track Cities network, indicating that such partnerships are in negotiations with other Portuguese-speaking countries, including Angola, Brazil, and Cape Verde.

“The power of language is one of the main drivers for implementing bilateral cooperation. Our aim is to create a sub-network of Portuguese-speaking Fast-Track Cities that allows them to learn from and assist each other to attain cross-cutting goals, objectives, and targets,” Dr. Zuniga said. “Given Portugal is the host country, and often the European entry point, for migrants from African Lusophone countries as well as Brazil, this partnership also aims to narrow the gap between origin and host countries for people living with and affected by HIV who cannot navigate the healthcare systems in their host countries.”

The real-world concerns of migrant populations in relation to HIV is the focus of “I Feel Unwelcome, Vulnerable, and Helpless” – Navigating HIV Access for Key Population Migrants in Europe,” a satellite symposium that will be hosted by the African Advocacy Foundation at this year’s Fast-Track Cities 2023 conference in Amsterdam.

                    WHO, IAPAC Sign MOU Focused on                      Achieving Health-Related SDGs, ‘Health for All’

Geneva, SWITZERLAND (26 April 2023) – World Health Organization (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus and Dr. José M. Zuniga, President/CEO of the International Association of Providers of AIDS Care (IAPAC), have signed a Memorandum of Understanding that provides a framework for collaboration between the two institutions to advance mutual HIV and other health objectives.

“We are honored to sign this Memorandum of Understanding with WHO, through which we will engage in collaborative endeavors to achieve the health-related SDGs, but notably SDG 3.3, as well as WHO’s broader ‘Health for All’ objectives,” said Dr. Zuniga, who also serves as President/CEO of the Fast-Track Cities Institute. “We aim to marshal our 30,000 clinician-members and leverage the 500+ Fast-Track Cities network as we strive towards realizing the fundamental right of every human being to the highest attainable standard of health.”

“We are thrilled to announce our partnership with IAPAC in support of WHO’s mission to end the epidemics of HIV, viral hepatitis, and STIs by 2030,” said Dr. Meg Doherty, Director of WHO’s Department of HIV, Hepatitis, and STI Programmes. “Our collaboration will strengthen technical expertise and strategic efforts to disseminate the latest guidelines to healthcare workers, while providing opportunities to amplify our new global health sector strategies across the three levels of WHO. Together, we can make a real impact in ending these epidemics.”

The Memorandum of Understanding includes areas of collaborative focus across three core pillars:

• Global Health Agenda. Supporting WHO strategic objectives in furtherance of the achievement of Sustainable Development Goal (SDG) 3, including by identifying, addressing, and monitoring programmatic and structural barriers across the HIV treatment and prevention continua and promoting innovative approaches to optimize testing, linkage to care (including primary prevention), antiretroviral therapy (ART) initiation, ART adherence, and retention (and engagement/re-engagement) in care to support viral suppression and U=U (undetectable equals untransmittable).
• Normative Guidance/Strategic Information Dissemination. Promoting dissemination of WHO’s global normative guidance on HIV, hepatitis (HBV and HCV), and tuberculosis (TB) and its implementation through knowledge dissemination to clinicians and community health providers, as well as providing strategic information to WHO by monitoring WHO policy uptake at urban (and national level in countries with a critical mass of Fast-Track Cities).
• Health Resiliency. Supporting WHO in relation to health systems resilience, pandemic and other public health emergency preparedness and responses, and monitoring and addressing disruptions in health services access and utilization, notably for HIV, hepatitis (HBV and HCV), and TB.

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About the World Health Organization

The World Health Organization (WHO) is an international intergovernmental Organization and Specialized Agency of the United Nations and the directing and coordinating authority on international health, and provides leadership on global health matters, shapes the health research agenda, sets health norms and standards, articulates evidence-based policy options, provides technical support to countries, and monitors and assesses health trends. For more information about WHO, please visit: https://www.who.int/

About the International Association of Providers of AIDS Care

Representing 30,000 members, the International Association of Providers of AIDS Care (IAPAC) is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis (TB), as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

About the Fast-Track Cities Institute

The Fast-Track Institute (FTCI) was created to support cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about FTCI, please visit: https://www.ftcinstitute.org/

About Fast-Track Cities

Fast-Track Cities is a global network of more than 500 cities and municipalities striving to end urban HIV epidemics by getting to zero new HIV infections, zero AIDS-related deaths, and zero HIV-related stigma. Launched on World AIDS Day 2014, the partnership also advances efforts to end tuberculosis (TB) epidemics and eliminate viral hepatitis (HBV and HCV) in urban settings. The initiative is supported by four core partners: IAPAC, the Joint United Nations Programme on HIV/AIDS (UNAIDS), the UN Human Settlements Program (UN-Habitat), and the City of Paris. For more information about the Fast-Track Cities initiative, please visit: https://www.iapac.org/fast-track-cities

 

Fast-Track Cities 2023 Announcement Remarks by Dr. José M. Zuniga

January 23, 2023 – Amsterdam Town Hall

The International Association of Providers of AIDS Care (IAPAC) and the City of Amsterdam held a joint event at the Amsterdam Town Hall on January 23, 2023, to officially announce the Fast-Track Cities 2023 conference will be held September 25-27, 2023, in Amsterdam, Netherlands. Following are remarks delivered by Dr. José M. Zuniga, President/CEO of IAPAC and the Fast-Track Cities Institute at the joint event:

“Good morning and thank you for the kind introduction. I wish to extend my gratitude to Mayor Femke Halsema for her continued public health leadership around HIV, but also for her commitment to equity, inclusiveness, and solidarity – the three pillars of the Fast-Track Cities movement.

I am happy to join Deputy Mayor Shula Rijxman in formally announcing that our Fast-Track Cities 2023 conference will take place September 25-27 this year here in Amsterdam. You are one of the original 26 Fast-Track Cities that joined our network on World AIDS Day 2014 by signing the Paris Declaration on Fast-Track Cities. Since then, and as the Fast-Track Cities network has grown to more than 500 cities and municipalities in every corner of the globe, Amsterdam has been a true stand-out in the progress made towards curbing new HIV infections through an integrated and inclusive approach. You have set an example both here in the Netherlands, where we currently count two more member cities – Rotterdam and Utrecht – as well as an example to Fast-Track Cities across Europe and around the world. This was reflected in Amsterdam receiving our “Circle of Excellence” award when we last convened for Fast-Track Cities 2022 last year in Sevilla, but more importantly in the lives saved and enhanced through the dedicated efforts of community, clinical, public health, and political leaders.

In 2014, when Amsterdam became a Fast-Track City, you had already made solid progress on what were then the initiative’s 90-90-90 targets: that 90% of people living with HIV were diagnosed, that 90% of those individuals were on treatment, and that 90% of those on treatment were virally suppressed. That year, your numbers stood at 93% diagnosed, 88% of those diagnosed on treatment, and 94% of those on treatment virally suppressed. Amsterdam fully met the 90-90-90 goals one year later, in 2015 – five years earlier than the 2020 target – and by 2020, you had already almost met the 2025 targets of reaching 95% on those same metrics. This is something that only a handful of cities in the world have achieved, so it is not hyperbole to call Amsterdam a global leader in the fight to end urban HIV epidemics. Two years ago, Amsterdam announced the even more ambitious goal of getting to zero new HIV infections by 2026, and you are well on your way.

The advent of PrEP for HIV prevention – as an adjunct to treatment as prevention – has made ending urban HIV epidemics all the more possible. But you also understand and are acting on the fact that ending an urban HIV epidemic requires a strong enabling environment.

Your ongoing work, guided by your world-renowned H-TEAM, is supported by the premise that only by getting to zero new HIV infections can we really ensure that no one is left behind in our HIV responses. Reaching the 95 targets, as significant a milestone as that is for cities and municipalities to attain, still begs the question: Who is among the 5% who are still not being reached? The 95 targets also do not explicitly speak to issues such as inequity and inequality, stigma and discrimination, or about the dignity and quality of life all people living with and affected by HIV deserve and have a right to realize within communities that value inclusiveness.

But you also are acutely aware of and advancing efforts to address syndemic conditions and co-morbidities, including tuberculosis and viral hepatitis, but also mental health conditions and substance use. These syndemic conditions and co-morbidities, like HIV itself, are fueled and exacerbated when our collective efforts lack a grounding in how to optimize social and political determinants of health for all people everywhere, thus prioritizing the well-being of visible and invisible communities.

Which brings me to the theme for the Fast-Track Cities 2023 conference: ‘Integration and Inclusion for Impact.’ As cities and municipalities strive to end HIV and tuberculosis epidemics, and eliminate viral hepatitis, an integrated approach to these responses must prioritize inclusivity in health and social care. For example, Amsterdam and the Netherlands have inclusive policies around issues facing key populations with respect to these conditions, including LGBTQ rights, drug use, and sex work. Inclusive policies that respect long-marginalized communities and avoid criminalizing behaviors allow for evidence-based public health to ensure that key populations can be best reached for services. Equally important, inclusive laws and policies help to address intersecting forms of stigma and discrimination, ensuring that those living with and at risk for HIV, tuberculosis, and viral hepatitis can live full lives, unhindered by unjust and harmful social exclusion.

‘Integration and inclusion’ also mean taking innovative approaches to reach, serve, and retain in care those who are most in need of health services. Last year, we launched a Fast-Track Cities Best Practices Repository to highlight the ground-breaking work being done in our member cities. One best practices from Amsterdam involved creating an STI clinic strategy that engaged with sexual minority men and providers to increase understanding of acute HIV infection and to more rapidly initiate HIV treatment. As a result of this strategy, the percentage of newly diagnosed HIV cases that were in the acute phase rose dramatically, and the average time between diagnosis and starting treatment was reduced from 439 days to one. Not only does that strategy make a significant difference in the lives of those who are diagnosed, it also means greatly reducing the risk of new, additional infections, since we know that those who are in treatment and reach an undetectable viral load are not able to transmit HIV to others – which is known as Undetectable = Untransmittable, or U-U.

Inclusivity is also key to meeting the United Nations’ Sustainable Development Goals, or the SDGs, including SDG 3.3, ending HIV and tuberculosis as well as eliminating viral hepatitis. As I have alluded to, that goal cannot be met without addressing underlying social inequities as well as stigma. SDG 10.3 is also relevant, as it calls for ‘eliminating discriminatory laws, policies, and practices’ across societies. We know that vulnerable groups of people that face inequitable HIV outcomes in different contexts – such as LGBTQ individuals, racial and ethnic minorities, sex workers, migrants, and women and girls – face some of the most discriminatory laws and policies. And, SDG 11 calls for us to ‘make cities and human settlements inclusive, safe, resilient, and sustainable’ – a reflection of the fact that growing urbanization has to be met with inclusion if humanity is to thrive.

While ending HIV and tuberculosis, and eliminating viral hepatitis, may seem like daunting tasks, cities and municipalities such as Amsterdam are showing us that these ambitious goals are within reach. And when we see these conditions as both reflecting and exacerbating underlying social injustices, it also becomes clear that our mission is part of a broader goal to secure a better, safer, inclusive, and more equitable future for all people. Advancing our collective cause requires precisely what Amsterdam’s motto advocates: We must be brave. We must be committed. And, we must be compassionate. These three calls to action will guide us at this year’s Fast-Track Cities 2023 conference, which I look forward to opening September 25, 2023, at the RAI here in Amsterdam.

In addition to the Amsterdam Mayor’s office, I wish to recognize our partnership with GGD Amsterdam, the H-Team, Aidsfond, Soa Aids Nederland, and many other local organizations with which we are engaging to ensure that the Fast-Track Cities 2023 conference will be a resounding success. Throughout this week we were able to witness first-hand the incredible work that these organizations are doing to address social inequities and determinants of HIV, demystifying the several and complex layers of stigma, in addition to their international aid cooperation work. Despite the incredible advances in the Netherlands, further debate and political actions are needed. The PrEP delivery model needs to be rethought and politically endorsed to prioritize a powerful HIV prevention tool, notably by eliminating waiting lists. Access to transgender-specific healthcare needs to be optimized as does access to healthcare by undocumented people under the premise that healthcare is a universal right in a society that values dignity and well-being for every person. We hope that the Fast-Track Cities 2023 conference will serve as a catalyst for these types of discussions, including and recognizing affected communities’ centrality to achieving the 10 commitments laid out in the Sevilla Declaration on the Centrality of Affected Communities in Urban HIV Responses.

I also thank Gilead Sciences, Merck Sharpe & Dohme, and ViiV Healthcare for being among the corporate sponsors investing in this annual gathering of Fast-Track Cities. But, ultimately, I thank local stakeholders across the Fast-Track Cities network who are daily giving of themselves to achieve the goals, objectives, and targets to which their cities and municipalities committed in signing the Paris Declaration on Fast-Track Cities. I invite you to join us in Amsterdam later this year to share your experiences and partake in constructive dialogue about addressing cross-cutting challenges and meeting exciting new opportunities for the benefit of all people everywhere.”

IAPAC Supports Formation of UN Group of Friends for Hepatitis Elimination

Statement by Dr. José M. Zuniga, President/CEO, IAPAC and Fast-Track Cities Institute

20 September 2022 – UNGA Side Event: Building Solidarity for Hepatitis Elimination

Thank you for inviting me to join you for this United Nations General Assembly side event focused on building solidarity for hepatitis elimination. I wish I could be with you in New York City, but I am grateful to the Coalition for Global Hepatitis Elimination and the Task Force for Global Health for making my virtual participation possible.

For reference, the International Association of Providers of AIDS Care (IAPAC) is a global medical association representing more than 30,000 clinicians delivering care and treatment services for people living with HIV and comorbid diseases, including viral hepatitis. We are also the core technical partner to the Fast-Track Cities network, which numbers more than 400 cities and municipalities. These cities and municipalities are also supported by the Fast-Track Cities Institute through implementation science and operational research activities. While at its launch in 2014 the Fast-Track Cities network was initially focused on ending urban HIV epidemics with some cross-over into addressing TB coinfection, in 2019 the network’s mandate was expanded to ending urban TB irrespective of coinfection as well as embracing and urbanizing the WHO’s goals of eliminating HBV and HCV by 2030.

Our mandate’s expansion into urban HBV and HCV responses was a natural evolution for two reasons: First, given the significant advances in HIV treatment, we have the tools to guarantee people living with HIV near-normal lifespans. Why then would we wish for them to succumb to comorbid diseases and syndemic conditions? And, second, why not leverage the HIV response to facilitate greater progress in closing gaps across HBV and HCV care continua, for example? Given progress is sadly lagging to the detriment of millions of people, and because a high tide can lift all boats, we have been leveraging the HIV response across the Fast-Track Cities network to accelerate urban HBV and HCV responses.

Are we succeeding? We have been monitoring, collecting, and disseminating best practices from urban viral hepatitis elimination efforts that we posit are innovative, replicable, and scalable. Here are three examples:

• Our Fast-Track Cities colleagues in Lisbon are using community pharmacies to offer point-of-care tests for HIV, HBV, and HCV infections to expand opportunities to diagnose these three diseases outside of clinical settings, which some who accessed the testing viewed as stigmatizing.
• In Madrid, our colleagues have implemented an HIV/HCV screening program with embedded linkage to a care nurse, thus actioning differentiated service delivery in an attempt to both optimize care since, as a rule, nurse-delivered care tends to be much more person centered, and strategically expand the health workforce engaged in HCV care. Notably, the quality of care did not suffer. Indeed, only 3% of those diagnosed with HCV were lost to follow-up.
• And, in Amsterdam, our colleagues are offering testing and linkage to HCV care to clients attending homeless services as a means of conducting outreach to a hard-to-reach at-risk population. Most recent data indicate 71% of homeless people who inject drugs linked to care and 57% initiating treatment.

These are but a few examples of the urban public health leadership on display in cities and municipalities around the world, from Bangkok to Kigali and New York City to Tel Aviv. Yet, these cities and municipalities alone cannot achieve the global goals of eliminating HBV and HCV.

The new World Health Organization (WHO) Global Health Sector Strategy calls for 90% of people living with HCV to be diagnosed and of those 80% to be on treatment. My concern is that the baseline (based on 2020 data) is 30% for diagnosis and 30% on-treatment. Similarly progress towards the ambitious HBV targets when compared against baseline also reflects a need to re-focus and accelerate our efforts to eliminate HBV. Those are significant gaps requiring business unusual. In fact, we need a whole of government (including city and municipal governments) and whole of society approach, and I believe that it is in our cities and municipalities where we can be the most innovative, responsive, and timely efforts to curb morbidity and mortality related to HBV and HCV.

Bottomline, though, achieving the global goals HBV and HCV elimination requires political leadership at all jurisdictional levels, and most notably national levels, with national investments to match and adequate to the task at hand. Many countries, such as India and Egypt, and, as already noted, many cities and municipalities, are already taking bold actions, including through interventions ranging from timely administration of birth dose HBV vaccination to scaling up access to diagnostic tests and direct-acting antivirals to treat and cure HCV. But more can and must be done to avert millions of unnecessarily premature HBV- and HCV-related deaths by 2030. In fact, given the reality we have a cure for HCV, it is a public health failure of a colossal magnitude that we are not more rapidly closing gaps across the HCV continuum and thus failing to cure millions of people.

What is needed today is a re-commitment by UN member-states to work in solidarity in this common cause. That is why IAPAC and the Fast-Track Cities Institute unequivocally support the formation of a UN Group of Friends focused on attaining the attainable goal of hepatitis elimination.

September 9, 2022 (WASHINGTON, DC) – A federal judge in the US District Court for the Northern District of Texas ruled earlier this week that the Affordable Care Act’s (ACA) provision requiring employers’ health insurance plans to provide access to pre-exposure prophylaxis (PrEP) for the prevention of HIV acquisition violates the religious rights and freedoms of employers afforded under the Religious Freedom Restoration Act (RFRA).

 

The International Association of Providers of AIDS Care (IAPAC) and its clinician-members in the United States condemn this egregiously odious ruling, which only serves to permit blatantly homophobic discrimination in the guise of “religious freedom.” In violation of nondiscrimination law, and contrary to scientific evidence about HIV prevention, the employer who brought the challenge falsely claimed that providing PrEP access violates its religious freedom because such access would “encourage homosexual behavior, prostitution, sexual promiscuity, and intravenous drug use.” Moreover, the ruling jeopardizes the United States’ efforts to decrease new HIV infections by 75% by 2025. When taken as prescribed, PrEP can reduce by up to 98% the possibility of HIV-negative individuals acquiring HIV. Access to all US Food and Drug Administration (FDA)-approved medications, including those approved for HIV prevention and treatment, must remain free from partisan judicial activism.

 

Additionally, Judge O’Connor’s ruling in Braidwood Management v. Becerra that the US Prevention Services Task Force (USPSTF) was unconstitutionally delegated Congressional power(s) threatens to upend preventive medicine in the United States. Pre-exposure prophylaxis for HIV is only one of nearly 100 preventive services recommended by the USPSTF. Health plans are required to provide coverage of these preventive services without copays or other similar cost-sharing burdens placed on the insured. If this ruling is allowed to stand, it subjects crucial health screening services such as testing for sexually transmitted infections and HIV, diabetes screening, and cancer risk assessments to unlawful discrimination and makes Americans vulnerable to the whims of employers seeking to skirt the patient rights afforded by the ACA – all in the name of “religious freedom.”

 

“We stand united with like-minded medical and patient advocacy allies across the United States in declaring that the ruling in Braidwood Management v. Becerra is a threat to the health of all Americans and an unacceptable interference in efforts to prevent new HIV infections in the United States,” said Dr. José M. Zuniga, IAPAC President/CEO. “Access to PrEP in no way bridges religious freedoms but instead honors the right of every person to dignity, health, and wellbeing. We call upon the ruling’s reversal on appeal. Additionally, we call for leadership in Congress to pursue legislative remedies to RFRA – up to and including repeal – to ensure individuals and institutions wishing to blatantly discriminate cannot hide behind a false shield of religious freedom.”

Statement on IAPAC’s Priorities for Person-Centered HIV Care

Dr. José M. Zuniga, President/CEO, @IAPAC and @FTC2030

IAS Consultation Meeting – 30 July 2022 (#AIDS2022)

Good morning and thank you to the IAS for inviting IAPAC to participate in today’s consultation meeting on person-centered HIV care. I am Dr. José Zuniga, President/CEO of IAPAC as well as the Fast-Track Cities Institute.

I am happy to share IAPAC’s priorities for actioning person-centered HIV care through our 30,000-member clinician-members and the 400-plus Fast-Track Cities:

• We advocate universal standards of care that are competency-based and developed with significant input from people living with and affected by HIV. These standards should address the pervasive issue of stigma, including by formalizing U=U as a clinical competence.
• We urge greater integration between the clinical, behavioral, and social dimensions of HIV responses. Silo-ing continues to be a major barrier for people living with or affected by HIV to access and utilize the whole-person care they need to succeed beyond achieving viral suppression or avoiding HIV acquisition.
• Moreover, we welcome the scale-up of innovations to make HIV services more affordable, accessible, and convenient. However, these innovations must be framed within the context of person-centered care and reflect the voice of those most affected by HIV.
• We call for health systems strengthening focused on continuous quality improvement that prioritizes whole person-centered care. We note, however, that support for and an augmentation of the health workforce is critically needed, including due to significant burn-out resulting from the dual HIV and COVID-19 pandemics.
• And, to strengthen our responses, we recommend the use of metrics to inform decision-making. Relevant indicators could include the proportion of people living with HIV who are involved in decision-making about their care, who are satisfied with their relationship with health professionals, and who are satisfied with services provided by their health facilities.
• We must also prioritize community engagement in planning, delivering, and monitoring HIV services. True engagement that avoids tokenism is critical to facilitate accountability, build mutual trust, improve health outcomes, and contribute to our efforts to stem new HIV infections and avert AIDS-related deaths.
• We advocate a disruption of a culture within health systems that facilitates inequities, stigma and discrimination, and poor health outcomes. We welcome, too, efforts to correct dominant (or malignant) narratives about race, gender identity, and sexual orientation so that we center care around lived experienced without reinforcing labels, objectification, stigmatization, and marginalization.
• On that note, we place extraordinary value on a collective commitment to equity and the concept of leaving no one behind. When “patients” are seen as people rather than numbers, serving the most marginalized becomes a prerogative rather than a liability.
• And, relatedly, we advocate a focus on the dignity of people living with and affected by HIV. We must honor the human right to dignity just as much as we honor the right to health and well-being. In doing so, we will gain the added benefit of better health outcomes and improved quality of life.

Those are IAPAC’s priorities as we progress on a trajectory from disease-oriented to patient-centered and now to person-centered HIV care. The distinction between the latter two may be more subtle, but it is nonetheless critical. Just as people are not experiencing HIV in a vacuum, they also do not experience life in a vacuum. Health is one part of their whole person – a star in a constellation of needs, hopes, strengths, and challenges – that we must strive to optimize a person’s within a holistic context.

July 21: New International Awareness Day with an Aim to End HIV Stigma

21 July 2022 (LONDON, ENGLAND, UK, and WASHINGTON, DC, USA) – Commemorating the birthday of late South African AIDS activist Prudence Mabele (1971-2017), a consortium of community, medical, and urban health organizations today announced their joint effort to create #ZeroHIVStigmaDay (July 21), a new international awareness day calling attention to the persistent levels of stigma experienced by people living with and affected by HIV.

The four organizations comprising the consortium are NAZ (a UK-based sexual health charity whose services are dedicated to people experiencing better sexual health) and the International Association of Providers of AIDS Care (IAPAC, a global network of clinicians and allied health professional working to end the HIV pandemic), in collaboration with the Global HIV Collaborative and Fast-Track Cities Institute.

“In this fifth decade of the global HIV pandemic, stigma continues to undermine progress and, in combination with fear and shame, is still driving late diagnosis of HIV in a way that is unacceptable and entirely preventable,” said Parminder Sekhon, Chief Executive Officer of NAZ. “Building on the legacy of Prudence Mabele, a fearless and irrepressible activist, we pledge to work towards a collective day of action in her name. We have 365 days to work together to shape a seminal day of global action. If we are to have any hope of ending HIV and crossing the finishing line together, we must join forces, voice by voice to end HIV stigma.”

A recent IAPAC LBGTI Health Equity Survey across 50 cities and municipalities worldwide found that HIV stigma remained a serious concern for 91% of respondents [1]. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), people living with HIV who perceive high levels of HIV stigma are 2.4 more times likely to delay enrollment in care until they are very ill [2], which leads to premature death and negates the prevention benefit of successful HIV treatment. Modern antiretroviral therapy (ART) adhered to as prescribed and resulting in an undetectable viral load both slows disease progression and offers people living with HIV an opportunity to live a near-normal lifespan. Additionally, people living with HIV who are on ART and have an undetectable viral load for six months or more and take their medications as prescribed pose no risk of transmitting HIV to their sexual partners, which is the basis of the U=U (Undetectable = Untransmittable) public health message.

“HIV stigma is jeopardizing our ability to end AIDS as a public health threat by 2030. By eliminating HIV stigma, we can dismantle the barriers people living with and affected by HIV confront when accessing testing, prevention, and treatment services. But we must also root out inequities and inequalities exacerbated by the ‘otherness’ ascribed to communities affected by HIV,” said Dr. José M. Zuniga,
President/Chief Executive Officer of IAPAC and the Fast-Track Cities Institute. “Zero HIV Stigma Day, and its full year of affiliated actions, represents a concerted global effort to harness our collective power towards the aim of realizing the human right to dignity, health, and well-being for everyone everywhere.”

For more information about #ZeroHIVStigmaDay, please visit: https://www.ZeroHIVStigmaDay.org

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About Prudence Mabele
Prudence Mabele was the first Black South African woman to publicly share her HIV status. She advocated for the rights of women and children living with HIV and against gender-based violence. She was diagnosed with HIV in 1990 and went public with her status in 1992. She set up the Positive Women’s Network in 1996. She died in 2017. For more information about her, please visit: https://en.wikipedia.org/wiki/Prudence_Nobantu_Mabele

About NAZ
NAZ is a minority-led HIV and sexual health agency with over 30 years grassroots experience of delivering HIV care and support and evidenced-based sexual health programs to Black and Brown and minoritized communities. Its mission is to achieve true parity in sexual health outcomes for racially minoritized communities living with and at elevated risk of HIV. For more information about NAZ, please visit: https://www.naz.org.uk/

About IAPAC
Representing 30,000 members, IAPAC is the largest association of clinicians and allied health professionals working to end the epidemics of HIV and tuberculosis, as well as eliminate HBV and HCV, by 2030. IAPAC is also a core technical partner to the Fast-Track Cities network and the Secretariat for its Fast-Track Cities Institute. For more information about IAPAC, please visit: https://www.iapac.org/

About the Global HIV Collaborative
The Global HIV Collaborative (GHC) is a partnership of strategic global leaders and activists that strives to improve the HIV outcomes for Black communities globally. GHC works to address the current global trajectory of HIV outcomes in Black populations and seeks to prioritize the persistent issue of unequal HIV outcomes rooted in ethnic disparities. For more information about GHC, please visit: https://hiv-collaborative.org/

About the Fast-Track Cities Institute
The Fast-Track Institute was created to support cities and municipalities worldwide in their efforts to achieve Sustainable Development Goal (SDG) 3.3 (ending the epidemics of HIV and TB), the World Health Organization goal of eliminating HBV and HCV, and SDG 11 (making cities and municipalities inclusive, safe, resilient, and sustainable). For information about the Fast-Track Cities Institute, please visit: https://www.ftcinstitute.org/