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SA cities sign up to meet 90-90-90 targets

Globally, there are 36.7 million people living with HIV/AIDS. Cities and urban areas are particularly affected by HIV, with the 200 cities most affected by the epidemic estimated to account for a third of the global HIV/AIDS burden. Fast-tracking HIV responses in cities is therefore crucial to ending the AIDS epidemic.

The Paris Declaration was signed by 27 cities on World AIDS Day 2014. These cities committed to prioritising their response to HIV with the goal of attaining the ambitious UNAIDS 90-90-90 targets (that is 90% of people living with HIV aware of their status, 90% of diagnosed PLHIV on ART, and 90% of PLHIV on ART with viral suppression) as well as zero discrimination and stigma targets.

The mayor of eThekwini, who was among the signatories in Paris, committed to organising a follow-up Fast-Track Cities meeting in South Africa to support cities in formulating their own plans to meet the 90-90-90 targets. Genesis was contracted by UNAIDS to support the planning and facilitation of this meeting. UNAIDS contracted Genesis Analytics to support this meeting, through providing background support and facilitation at the meeting.

Mayors and councillors from 19 municipalities were invited to the meeting, which cover almost 50% of the people living with HIV in South Africa. Approximately 52% of new HIV infections among young women aged 15-24 years occur in these municipalities and 78% of South Africans living with HIV who are still in need of ART reside in these municipalities. In addition, 55% of AIDS related deaths in the country occur in these municipalities. Therefore, addressing the epidemic in these high-burden cities is of high priority.

The municipalities included Buffalo City, Cape Town, Ekurhuleni, eThekwini, Johannesburg, Mangaung, Nelson Mandela Bay, Tshwane, eMalahleni, Emfuleni, Kimberley, Mafikeng, Mbombela, Mogale, Msundunzi, Polokwane, Rustenburg, Ulundi and uMhlathuze.

In preparation for the meeting, Genesis conducted rigorous analysis and research on the 19 municipalities to characterise each of their health profiles and better understand their different responses to the HIV epidemic. We used the data to develop informative municipal fact sheets, in partnership with each district. This collaborative approach ensured agreement on the data prior to the meeting such that discussions were evidence-informed and strategic. The fact sheets were printed as large banners at the meeting to facilitate exchange and learning.

The meeting, attended by 80 representatives, was facilitated by Dr Saul Johnson, who balanced the competing priorities and voices of multiple stakeholders. Participants were guided in reviewing the municipal fact sheets, discussing best practices, and agreeing on indicators and targets to track progress.

The meeting successfully built stakeholder consensus and drove the development of fast-track action plans for each municipality. The Mayors all personally committed their support and leadership to achieving these plans, eleven of whom signed the Paris Declaration to pledge this commitment. Genesis therefore effectively facilitated the alignment of municipal responses for achieving the UNAIDS 90-90-90 targets.

The work done at the meeting will ensure that all the major South African cities in South Africa will have a plan for dealing with HIV, for meeting the 90:90:90 targets, with support from their mayors and assisted by UNAIDS and SALGA.

TOP: Thabo Manyoni, mayor of Mangaung and chairperson of SALGA, signs the Paris declaration to end the AIDS epidemic in Mangaung.

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