What's New

Before the scale-up of the international response to the AIDS pandemic, community responses in developing countries played a crucial role in providing services and care for those affected. This study is the first comprehensive, mixed-method evaluation of the impact of that response. The evaluation finds that community response can be effective at increasing knowledge of HIV, promoting social empowerment, increasing access to and use of HIV services, and even decreasing HIV incidence, all through the effective mobilization of limited resources. By effectively engaging with this powerful community structure, future HIV and AIDS programs can ensure that communities continue to contribute to the global response to HIV and AIDS.

The HIV surveillance system in Hong Kong comprises 5 main programmes to provide a detailed description of the local HIV/AIDS situation. They are (a) voluntary HIV/AIDS case-based reporting; (b) HIV prevalence surveys; (c) sexually transmitted infections (STI) caseload statistics; (d) behavioral studies; and (e) HIV-1 genotyping studies. The data is collected, analyzed and disseminated regularly by the surveillance team of Special Preventive Programme (SPP), Centre for Health Protection (CHP), Department of Health (DH). At present, the latest HIV/AIDS statistics are released at quarterly intervals at press media briefings and in electronic format (http://www.aids.gov.hk). Data from various sources are compiled annually and released in this report.

The Maldives Health Statistics is published with the main objective of providing easy access to up-to-date comprehensive statistical information on various aspects of health. The publication is divided into several subsections. This publication also includes updates and revisions of the data published in previous years.

Social Exclusion on the basis of gender identity and sexual orientation (SOGI) is complex and may not be readily acknowledged by authorities. Other factors that can influence exclusion are poverty, illiteracy, lack of awareness about social protection mechanisms and how these can be accessed, some religious practices, cultural norms about males and females, husbands and wives, and families, and type of occupation (such as sex work); however SOGI‐based exclusion appears to be a major cross‐cutting feature that cannot be disregarded. Many LGBT are mobile and even while living together with a partner in a stable relationship, they are not officially and legally recognized as partners, a husband‐wife team, a couple, or as a family. The study makes recommendations for policy‐makers, program planners and project implementation to consider Sexual Orientation and Gender Identity (SOGI) as crosscutting factors that can influence participation, delivery of social services, and access to education, work opportunities and justice. Awareness and Education activities on SOGI support for informal groups and associations, as well as areas for further research are recommended.

The World Mortality Report 2013, prepared by the Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, assesses changes in mortality risks at the global, regional and country levels, focusing in particular on the implementation period of the Programme of Action of the International Conference on Population and Development, from 1990-1995 to 2010-2015. The report reviews the survival targets outlined in the ICPD Programme of Action and discusses them in the context of other internationally agreed mortality reduction goals, including the Millennium Development Goals. It evaluates the progress of regions and countries with respect to life expectancy at birth, child mortality, mortality in the reproductive and working ages, and life expectancy at advanced ages and discusses the contributions of improvements in survival at different stages of life towards the achievement of the ICPD survival targets. Disparities in progress towards those targets are partially explained by examining differences between selected countries in the sex and age patterns of mortality reduction. Some priorities for future reductions in mortality risks are discussed.

While Cambodia has successfully reduced the aggregate level of HIV infection through committed government leadership, effective policies, and strong civil society engagement, HIV is still directly affecting more than 60,000 households across the country. Based on the national average household size of 4.7, this amounts to at least 280,000 individuals, or more than 2% of Cambodia's total population, who may belong to marginalized sections of society. The findings of the review are intended to generate dialogue and guide discussions among relevant government agencies, UN, and key civil society stakeholders in a collective effort to integrate HIV into social protection efforts in Cambodia. There are a number of key mechanisms, including Technical Working Groups (TWG) and Task Forces whose members will be well-placed to continue the dialogue on HIV-sensitive social protection, and mobilize the Next Steps set out in the recommendations.

The Global Burden of Disease (GBD) approach is a systematic, scientific effort to quantify the comparative magnitude of health loss due to diseases, injuries, and risk factors by age, sex, and geography for specific points in time. Box 1 describes the history of GBD. The latest iteration of that effort, the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), was published in The Lancet in December 2012. The intent is to create a global public good that will be useful for informing the design of health systems and the creation of public health policy. It estimates premature death and disability due to 291 diseases and injuries, 1,160 sequelae (direct consequences of disease and injury), and 67 risk factors for 20 age groups and both sexes in 1990, 2005, and 2010. GBD 2010 produced estimates for 187 countries and 21 regions. In total, the study generated over 1 billion estimates of health outcomes. GBD 2010 was a collaborative effort among 488 researchers from 50 countries and 303 institutions.

The Millennium Development Goals (MDGs) have mobilized action from Governments, civil society and other partners around the world, with significant results. Extreme poverty has been cut in half. More people have access to improved sources of water. Conditions are better for 200 million people living in slums. More girls are in school. Child and maternal mortality is declining. Around the world, wherever we look, the MDGs have brought success—but not complete success. Achievements vary within and among countries. Globally, we are lagging badly on some targets—especially sanitation, which poses a major threat to the health of people and the environment. The present report tracks delivery on the commitments listed under Millennium Development Goal 8—the global partnership for development. Some of the indicators show progress, but efforts towards the United Nations target of allocating 0.7 per cent of gross national income to development aid have been receding in the past two years. We must reverse this trend.

At this critical juncture, it is important to understand the lessons learnt from the implementation of HIV prevention programs and the vulnerabilities that need to be addressed to reach the goal of zero new infections. To support this understanding, the Population Council and its Knowledge Network Project partners have been engaged in a project to document and disseminate evidence-based lessons from upscaled HIV prevention programs in India. As part of this initiative, we have compiled this volume of articles published in peer-reviewed journals, which represents selected documented work. The volume is divided into four sections: Section I presents evidence on the changing epidemiology of the epidemic and the impact of HIV/AIDS prevention programs; Section II brings together learnings from program interventions including community mobilization interventions for female sex workers; Section III focuses on the vulnerabilities of high-risk groups such as female sex workers, MSM and IDUs; and Section IV includes papers on the vulnerabilities of bridge populations such as migrants, male clients of sex workers and trucker populations. Research highlights are presented at the start of each section. Sequential page numbers have been added to the published papers for easy reference.

This report provides a snapshot of available data on injecting drug use among children and young people under the age of 18. It has three main aims:

• To increase attention to an often-overlooked aspect of responses to HIV and other health harms associated with unsafe injecting.
• To begin to understand the extent of the problem internationally, and how prevalence and patterns vary between regions and countries.
• To identify gaps and limitations in data collection in order to begin filling them.