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This week’s Impact newsletter features coverage of USAID participation in the International AIDS Conference in Washington, D.C., the 2012 Global Diaspora Forum, the response to famine in the Horn of Africa, and a link to the latest issue of FrontLines.  You can also see recent media coverage in the USAID in the News section.

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Mexican Diaspora Leader Gives Back Green

The Impact Blog interviewed Luis Aguirre-Torres, CEO of GreenMomentum and recipient of the White House’s Champion of Change award. He partners with USAID in his homeland of Mexico to help foster green companies. 

You have been extremely successful in helping companies become green, why is it important for you to give back to your native country of Mexico?

After several years of living abroad, I found myself in a position to give back to the country that gave me an education and inspired me to continue moving forward. I have a personal believe that the future is something we work towards and not something that simply one day magically appears. Before I always imagined a better future than what the present turned out to be; today, I understand that the future will only be different if we take an active role in making it happen. What better place to reinvent the future than my country of origin.

What is the Cleantech Challenge and how did it come about?

The Cleantech Challenge was originally conceived as a green business plan competition. However, today it has become an open forum for investors, entrepreneurs, government and development agencies to share ideas on how to develop clean technology, how to finance it and how to accelerate its implementation. It was first conceptualized after a conversation with the Director of the UNEP a few years ago, when he challenged me and my team to do something different that could impact the Mexican economy. A few weeks later, the Cleantech Challenge was born.

What would a surge in green companies in Latin America mean for the region?

We are currently seeing a surge in green companies in Mexico. This has been echoed by other countries like Colombia, Chile and Argentina, among others. For all these countries, it represents an opportunity to become part of the world’s new green economy. As it has happened in other countries, it could also lead to a surge in investment opportunities and the development of new government policies. This could accelerate economic growth through the creation of new business and job opportunities, having therefore a direct impact on the competitiveness of the region as a whole.

Do you think Latin America faces unique challenges regarding greenhouse gas emissions compared to the rest of the world?

Latin America faces a series of challenges regarding climate change. It has to develop new and more reliable mechanisms for financing the implementation of adaptation and mitigation programs. Specifically, it has to find a way of fighting climate change without negatively impacting economic growth and increasing the region’s competitiveness.

The White House just honored you with a Champion of Change award, what does this mean for you?

This has been a great experience. I feel humbled and forever grateful to those who from the beginning believed in this project. The recognition from the White House means the world to us, not only because it validates our efforts during the past four years, but also because it has allowed us to share it with the American people and the rest of the world. It has inspired me to continue working and to work towards newer and bigger things.

To read more, visit the White House’s Champions of Change webpage.

Ask the Expert: Administrator Shah on the AIDS fight

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

Dr. Rajiv Shah serves as the 16th Administrator of USAID and leads the efforts of more than 8,000 professionals in 80 missions around the world.

Originally published at Global Pulse, by John Donnelly and Charles M. Sennott.

Q: Secretary of State Hillary Clinton announced this week that the administration would be put together a blueprint in five months for an “AIDS-free generation.” She first announced this vision eight months ago. Why does it take 13 months to put together a plan?

A: Let’s start with the goal. We were all very committed to create an AIDS-free generation. … We want to take a very honest and rigorous approach. We know it will require resources. We know it requires a great deal of local knowledge and development insights to say which communities are transmitting the most, how are we going to reach them, how do you reach people who are not as symptomatic? And what are the implementation strategies that are going to allow us to target and maximize outcomes against this goal?

We are trying to step through that in a very rigorous way. We are not holding anything up by doing that analysis. We’re embarking on an aggressive scale up of treatment, of prevention, of country ownership, of investing in country systems, even as we craft a blueprint that completely guides this country and our global partners for sometime in the immediate future.

Q: Is there a need for a blueprint, and is there wisdom in waiting for the results from the HIV combination prevention trials, which will test different approaches to reduce infections all at once?

A: The HIV combination prevention trial in Tanzania is particularly important because that’s probably the largest scale among them. It’s going to add a great deal of knowledge and data. But the reality is the pathway that defines success is going to look different based on the unique characteristics of the pandemic in countries and in communities. We need to do those trials and learn from them. We also are moving ahead with the aggressive presumption that combination prevention, including treatment as prevention, can be an effective strategy to get to an AIDS-free generation.

Q: Regarding male circumcision, you’ve had some problems in creating demand, such as what you’ve seen in Swaziland. What approach do you use now?

A: We need to apply more local insight, partnership with local institutions, better understanding of local behaviors and cultural preferences in how we scale up male circumcision programs. It is a medical intervention that has lots of data to substantiate its efficacy, but it is also a very personal and very significant cultural statement that we even in the United States in parts of our country debate and struggle with.

The big lesson learned is to take a little bit of time to be consultative with local partners who really know and are from the cultures in which we hope to scale up access to the intervention. I think we are working in the context of an aggressive scale up of male circumcision.

Q: The closing of the Global Health Initiative office ended the original dream of moving GHI to USAID. Are you disappointed that the dream didn’t materialize?

A: I kind of focus on what works and what doesn’t work, and what’s necessary to achieve our goals at a particular time. Our administration has set three critical health goals for our work: an AIDS-free generation; child survival call to action and eliminating preventable childhood death; and the virtual elimination or significant reduction of mothers who die in childbirth.

But what we learned in order to achieve them, we can’t have the current situation, where the US is keeping its funding constant in a tough global economy, but others are doing a little bit less. We know we need to have more focus and a more integrated approach. In the call to action we bring together malaria, preventing infections from mother to child, nutrition during the first 1000 days, GAVI and other immunization, and therapy for pneumonia and diarrhea. Let’s think of these as a combination approach to achieve the results of saving 5.5 million kids.

I know from my conversations with the president and the secretary that that’s their expectation — we are delivering on that. So, you know, the organizational structuring of it evolved in order to take on these goals and to address these challenges that were in our midst. Remember, GHI was launched before funding challenges existed both for US and abroad, and I think this is responsive to the reality of what’s needed.

Q: But GHI was perceived as the signature global health program of the Obama administration.

A: Just because we don’t have a Global Health Initiative coordinator at the State Department anymore doesn’t mean we don’t have a Global Health Initiative. We believe this structural approach will be more effective in delivering the kind of integration across services that we think is at the crux of getting health outcomes for the same resources, which is what GHI is about. It is true: We had a structure, we didn’t think it was the right structure to deal with the challenges going forward. We made changes to that, but we are absolutely committed to the GHI, to the goals we’ve established and to the concept of integrating service delivery to drive better results.

Q: At a panel at the Kaiser Family Foundation, Mike McCurry called on the Obama administration to articulate one clear global health goal – not three or five. But one. What do you think of that?

A: Mike was dead right. We got to this point by focusing on immunization, focusing on getting malaria bed nets to kids, focusing on HIV/AIDS. We still need to do that. But going forward, as Mike suggested, we need integrating concepts, concepts that people can be inspired by, that are operational and real, but that bring things together so that we are not competing with each other and instead grow enthusiasm for the overall effort.

That’s what the call to action for childhood survival was all about. You see 80 countries show up in the Washington meeting, co-hosted by India, Ethiopia and the United States. Fifty-six countries signed a pledge to eliminate preventable childhood deaths. Probably 20 some have already published scorecards to demonstrate how they are going to measure that. The US agencies and others have all agree to highlight the annual rate of reduction in childhood deaths as an operational metric to focus on across all of our grants. That’s the kind of coming together around something big, inspiring, and very genuinely country driven that I think will define success in the next decade for global health.

Q: Why did the call to action work then?

A: I don’t know the analysis, I just know the answer to the question. It’s somehow the energy is coming from the countries. We had a mid-level delegation from Yemen come to the Washington meeting, and they were so inspired that when they got back, when I got to Yemen the next week, the president of Yemen and deputy health minister both approached me and said, ‘We want to be part of this call to action. We looked to our statistics, we feel we can do better.’ When that happens, and that’s the demand signal we’re getting, that to me is what this should all be about, as opposed to our trying to construct something that then we ask others to respond.

Q: The phrase ‘turning point’ is used a lot when it comes to the AIDS epidemic. Do you use that phrase, and if so, why is it a turning point?

A: Well, the pandemic, the turning point, my understanding, the way I use it, is to refer to a specific moment when the number of global new infections is lower than the number of people added to treatment. Every year after that, you are reducing the number of people with the disease. We are not there. We are still in situation where the aggregate number of people with the disease is growing, so the turning point is a very important concept because once you hit that point you are on the decline and you can legitimately say we’re working statistically downhill toward zero. But the drivers of the turning point are what’s critical. That’s where you see that expanding prevention in a focused way that reaches the most transmitting populations is critical to achieving the turning point. And expanding efforts that effectively reduce risky behaviors so that you don’t have another turning point, and go back up again, are all critical to solve AIDS over the long term. So I think it’s a very viable concept.

SMARTgirl Empowers Women in Cambodia

Originally posted to the FHI360 blog.  

Earlier this month, U.S. Ambassador at Large for Global Women’s Issues, Melanne Verveer, joined Assistant Administrator for Asia, Nisha Biswal for a special visit to the SMARTgirl project in Cambodia, a USAID funded project led by FHI 360. SMARTgirl aims to prevent and mitigate the impact of HIV and improve the sexual and reproductive health of entertainment workers, many of whom are sex workers. There are an estimated 35,000 entertainment workers in Cambodia, working at night clubs, bars, massage parlors, karaoke clubs (KTV), restaurants, beer gardens, as well as on the street. Prevalence of HIV is as high as 14 percent, among some groups of entertainment workers.

SMARTgirl stands apart from other programming among entertainment workers in Cambodia because of its positive, non-stigmatizing approach. It combines evidence-based interventions with the strong SMARTgirl brand, which empowers women to protect their health and well-being. SMARTgirl reaches nearly half of all EWs in Cambodia in their workplace, because it treats them respectfully, recognizes what is important to them and improves health-seeking behavior by raising self-esteem.

SMARTgirl is one of a number of projects that validates what the international community and national leaders have been emphasizing for more than a decade— that empowering women and girls are vital components of human development. Since coming into office, U.S. Secretary of State, Hillary Clinton, as well as Ambassador Verveer, have continually underscored the importance of integrating these issues into Department of State foreign policy objectives.

During Secretary Clinton’s recent ASEAN development meeting in Phnom Penh, she was influential in integrating gender equality and women’s empowerment into the Lower Mekong Initiative agenda. In a statement, she emphasized the importance of reproductive rights for achieving gender equality; an area that the innovative FHI 360 SMARTgirl program has been integrating into its HIV mitigation program:

“Reproductive rights are among the most basic of human rights. … Millions of women and young people in developing countries don’t have access to information to plan their family. They don’t have health services and modern methods of contraception. This is not only a violation of their right…it’s also a question of equity as women everywhere should have the same ability to determine this fundamental part of their lives.”

As this short video on SMARTgirl reveals, the women in the program feel inspired, often for the first time. They see themselves as “smart girls”– women who are empowered to change their lives, and educate others about health issues and rights.

Says Kheng, “Before I became a SMARTgirl leader, I used to face issues on my own, … but we have the right to help each other and we have to participate in the community where we live.”

An “IdEA” That Runs Deep: Engaging America’s Diaspora Communities

Growing up, John Henry Thompson was fascinated by technology. His family’s farm in Jamaica had no running water or electricity. But when he immigrated to New York with his parents at the age of 12, he quickly proved his technological aptitude. He devoured books on electricity and the latest editions of “Popular Mechanic.” For his seventh grade science fair, he built a rudimentary computing device. This science fair marked the beginning of what would become a lifelong passion for computer programming.

There are many “John Henry”‘s from India to Colombia to the Philippines who have come to the United States to learn and create new futures. Currently, more than 60 million Americans are first- or second-generation Diasporas, and many of them have close ties to countries with critical needs. Instead of just sending money back home, imagine what they could do to help improve the lives and change futures.

Like John Henry, his homeland of Jamaica has come a long way in the past few decades. Yet he knows that Jamaicans haven’t leveraged that mobile lead into greater economic prosperity and better health. He knows that Jamaica can do better. And he wants to ensure that future generations of Jamaicans have the tools they need to compete in the global knowledge economy.

This is why he became a volunteer mentor and trainer for the Digital Jam 2.0 Mobile Applications Competition. Sponsored by the Government of Jamaica and the World Bank, the Mobile App Competition combined both a competition and educational workshops for app developers. As trainer, John Henry helped young developers gain the tools they needed to build effective native mobile applications.

This passion to give back to their homelands is what makes the potential for diaspora communities’ engagement in development so powerful. From their language skills and cultural familiarity to professional networks and personal ties, the diaspora community has the potential to be a significant people-to-people asset for positive development impact. If we can deepen and expand diaspora outreach, we can develop stronger bonds with other nations — through their civil societies, business leaders, inventors, and scientists. We can do things that USAID working alone never could.

That’s why USAID joined with the U.S. Department of State in 2011 to launch the International diaspora Engagement Alliance (IdEA). Recognizing the powerful yet untapped potential of diasporas in development, IdEA seeks to deepen America’s engagement and partnership with diaspora communities.

To further advance our work with diaspora communities, USAID, the U.S. Department of State, and IdEA are hosting the second Global Diaspora Forum, an annual celebration of America’s diaspora communities, July 25-26. The Forum is focused on how new technology can empower and increase diaspora philanthropy, social entrepreneurship, volunteerism, and social innovation. I encourage you to visit IdEA’s website to watch live streaming videos from the Forum and read more about diaspora communities’ contributions to their countries of origin and America’s diplomatic relationships and development commitments worldwide.

A Vaccine to Help End the AIDS Pandemic

A new energy animates the hallways of the Washington Convention Center this week, as leaders and advocates commit to a goal once thought impossible: ending the AIDS pandemic.

Indonesian volunteers light candles during a ceremony to mark World AIDS Day in Jakarta. Photo Credit: Adek Berry/AFP

Attendees at the AIDS 2012 Conference here in Washington, and at conference hubs from Nairobi to Chennai, are telling the world that we can end the AIDS pandemic. Among the astonishing accomplishments in our battles against other infectious diseases that allow us to believe this bold claim, is the long-sought eradication of polio. The world learned in January that one of the last holdouts of this viral disease – India – has not recorded a single new case of natural polio infection for more than one year.  Polio still needs to be defeated in a small number of countries, but one of its most stubborn reservoirs of the virus is clearly being drained. That is no small feat.

How was this extraordinary feat accomplished?

In short: through massive immunization campaigns and people working together around the world to end a common threat.

HIV is, admittedly, a far more challenging foe. The virus attacks our body’s immune cells, changes its appearance ceaselessly and incorporates itself into our DNA, where it cannot be extinguished. The deviousness of HIV has long challenged the brightest minds of science. But it is nonetheless a challenge that can be overcome—if, that is, we commit ourselves to supporting research and building on the progress scientists have made so far.

In the last three years alone, clinical studies have demonstrated that preventive HIV vaccines and microbicides are possible. Other research has shown that antiretroviral therapies can be used in various ways to prevent HIV transmission as well. Meanwhile, voluntary medical male circumcision is increasingly being used to reduce the risk of HIV infection.

Each and every one of these strategies must be added to the existing toolkit for HIV prevention—and used together as a tour de force—if we are to end the AIDS pandemic.

New impact modeling, conducted jointly by the Futures Institute and IAVI, suggests that the full implementation of the UNAIDS Investment Framework by 2015 could help turn the tide of this pandemic. The subsequent development and deployment of a broadly effective AIDS vaccine could then further bend the curve and bring us closer to truly ending the AIDS pandemic.

Recent advances have fueled optimism and lent a new momentum to the field of HIV vaccine R&D. This momentum must be sustained. IAVI and its many partners around the world are racing to build on this progress. We invite you to join us in our efforts.

Pioneering African Entrepreneurship on Display at Diaspora Marketplace

At USAID, a central tenet of our efforts is the belief that developing nations must take the lead on implementing innovative solutions to improve their economies and the lives of their countrymen in order for development to be effective in the long term.

This principle was on prominent display at the second African Diaspora Marketplace (ADM II) at George Washington University in Washington, D.C., held June 22 and 23, where participants showcased their promising ideas for businesses to create employment and strengthen trade in emerging markets in sub-Saharan Africa. The event, sponsored by USAID, the Western Union Company and the Western Union Foundation, was an opportunity for 44 finalists selected from a pool of 495 applicants to display their entrepreneurial prowess in a wide variety of sectors, including agribusiness, renewable energy, and information and communication technology.

The U.S.-based applicants were competing for up to $50,000 in matching grants and/or up to $20,000 in technical assistance to advance the businesses that support their African communities.

“The African Diaspora Marketplace is a great example of the type of public-private partnership we want to see more of at USAID,” said Dr. Maura O’Neill, Chief Innovation Officer and Director of the Office of Innovation and Development Alliances at USAID. “By supporting African diaspora entrepreneurs who are looking to create innovative, sustainable businesses in their country of origins, we are building the foundation for inclusive economic growth critical to sustaining long-term development. USAID is proud of our partnerships with diaspora communities—from the ADM II to our ongoing work with the International diaspora Engagement Alliance (IdEA)—and we wish the winners great success in their business endeavors.”

Michael Griffin, CEO of produce importer Sardis Enterprises International, discussed the work his company was doing in Ghana to provide opportunity for fruit growers.

“One of the biggest things is that we have a co-op,” he said. “The cooperative farms for us. Without us bringing the product in [to the U.S.], they don’t get to take their product to the export platform. … The main thing is that we help them in building some type of finance for themselves.”

Another eye-catching display at the market belonged to the Ghana Bamboo Bikes Initiative, which creates durable bicycle frames from bamboo.

“Most of the bikes that are imported into the country are of poor quality, they are very expensive, and they are not designed for rough roads that run in the country,” said Kwaku Kyei, a global strategist at the organization. “So we decided to come out with these bamboo bicycles which are multipurpose and affordable for our target groups, especially for farmers and people from the rural areas.”

David Bariho, the Technical Director for ORIBAGS Innovations, highlighted the dual benefits of his business, which produces paper and customized reusable shopping bags from agricultural waste in Uganda.

“Our aim is to increase production, fulfill the market, give our clients what they need, and increase employment for people, mostly women and youth,” he said. “These are people who give us materials, so we need to give back. … Our product, really, provides both social and environmental benefits for the community and for all people.”

This year’s 17 winners, and the innovative approach of the ADM II will be recognized at the Secretary’s Global Diaspora Forum on July 25-26. Hosted by the U.S. Department of State, USAID, and IdEA, the Global Diaspora Forum celebrates the contributions of America’s diaspora communities to development and encourages greater partnership between diasporas, the U.S. Government, the private sector, and civil society.

African Leaders Call for Scale up Voluntary Medical Male Circumcision in East and Southern Africa

Dr. Emmanuel Njeuhmeli is the Senior Biomedical Prevention Advisor with USAID and Co-Chair of PEPFAR’s Male Circumcision Technical Working Group.

Scientific advances in the treatment and prevention of HIV infection over the past years have created unprecedented optimism that the fight against the HIV/AIDS. Voluntary Medical Male Circumcision (VMMC) for HIV prevention is one such intervention that has enormous potential to alter the course of the epidemic.

Three clinical trials have definitively demonstrated that VMMC can reduce female to male transmission of HIV by approximately 60%.  This means that if brought to scale to achieve a coverage of 80% of adolescents and men, VMMC could prevent 3.4 million new HIV infections and save countries in East and Southern Africa US$16.5 billion in care and treatment costs between now and 2025.

With tens of thousands of people who work in the field of HIV in Washington, D.C. —political leaders, public health experts, activists, people living with HIV—all equally committed to achieving a future free of AIDS, the time is now to examine possibilities to rapidly scale up comprehensive VMMC services. Key African political and traditional leaders from some of the hardest hit countries of East and Southern Africa will participate in a satellite session tonight to discuss challenges and solutions to accelerating VMMC scale up in 14 priority countries.

These leaders understand very well the urgency of bringing this intervention to scale.  Mr. Blessing Chebundo, a member of Zimbabwe’s Parliament, was publicly tested and circumcised last month in an amazing show of leadership. I was fortunate enough to be in Zimbabwe that day and witness 44 members of Parliament in a makeshift tent at Parliament House stepping up to inspire other men in their country to do their part for HIV prevention. It was a moment I will never forget.

We know that with strong leadership, commitment and coordination this is doable. We’ve seen Kenya’s successful VMMC program where more than 400,000 voluntary medical male circumcisions have been administered since 2008. Government leadership and program flexibility have been key.  In Iringa, Tanzania, local leaders and officials, with PEPFAR support, overcame human resource and infrastructure constraints and managed to exceed their targets, performing more than 100,000 VMMC since 2010. Thirty-one thousand circumcisions were performed during an eight-week campaign. Based on modeling estimates, they’ve already prevented over 14,000 new HIV infections. Surely other countries can do this too.

Preventable HIV infections occur every day among uncircumcised men in the countries of East and Southern Africa. Each day that this proven prevention method is not brought to scale represents a lost opportunity to change the course of the epidemic.

There is no time to waste, now, it’s time to act.

Developers for Development: The Evolution of the Food Security Open Data Challenge

Geeks, Coders, Hackers, Developers, Computer Scientists, Technologists- whichever term you choose, people with technical acumen have proven to be some of the most prolific volunteers for social good.  It is not hyperbole to state that on any given weekend, in nearly every major city around the world, volunteers can be found gathering together to create products that benefit education, security, economic, and other social interests. Participants cobble together the vision, team, the code, and the experts over 48 hours, and present themselves for judging by Sunday evening.  These gatherings are dubbed “hackathons,” “codeathons” or “codesprints” and they have found success: out of the Disrupt Hackathon, which is hosted by TechCrunch and connects developers and entrepreneurs, the Docracy team formed to make legal and business documents more free and accessible, and went on to raise $650,000 over the next year to expand its operations.  StartupWeekend, a hackathon targeting entrepreneurs, claims hundreds of new startups including Reddit, a widely popular user-generated news aggregator.  In 2010, the State Department and iHub launched the Apps4Africa challenge  to connect local developers and global mentors to local NGOs to learn and solve local problems.  The winner, iCow,  is a successful mobile-phone application that tracks cows’ hormone cycles to inform better breeding, milk production, and nutrition information to Kenyan dairy farmers.

Indian woman arranges a display of grains and seeds at Millet Fest 2012, in Hyderabad on March 24, 2012. The three day event aims to promote use and increase knowledge of the nutritional benefits of millet seeds when used as part of a daily diet. Photo Credit: AFP

If you’re not familiar with the hackathon model, you’re not alone.  Government engagement with the tech community, though expanding, is limited.  And though hackathons bring together widely diverse communities to contribute their time and expertise to solve problems, they are not a flawless solution.  Rare is the startup that can convene and be commercially viable in 48 hours.  To increase the impact of the products of these hackathons, and ensure that those volunteering their time are doing so wisely, we have to improve on the existing model.

Enter White House Chief Technology Officer Todd Park, and his bold concept for public sector improvement of the hackathon model to connect developers directly to the people who will ultimately use their product, and to incubate solutions to be attractive to investors.  Under his model, weekend sessions are stretched across at least ninety days and buttress the hackathon with brainstorming and planning session weeks prior and an incubation period of the successful products for weeks following.  He outlines this model as an endeavor of the White House’s “Open Data Initiative” and, following on the successful implementation at HHS, has taken it to various other agencies including the Department of Energy, Department of Veterans Affairs, Department of Education, and USAID. Through his leadership, each agency has taken up the mantle of instituting their own open data initiatives.

USAID is  building its first data initiative around food security, and I encourage anyone who is curious to get involved.  All backgrounds and interests are welcome; participants need not be an expert in food security nor in software, a willingness to contribute to the efforts of innovative solutions and commercially viable products is all that’s required.  Writers, designers, networkers, and creative thinkers from all walks are welcome.  As access to information increases globally, so does the potential for innovation and great ideas to be borne and fomented across borders.  USAID is convening a global community to engage more directly with those who are willing to volunteer their time and expertise to the cause of development, and who want to work together to “hack” new and creative solutions to long-standing development priorities.  Just yesterday, Secretary Clinton observed “Data not only measures progress, it inspires it.” At USAID we want to build and support the platform for those who are inspired to create and sustain lasting progress.

For more information and to participate, visit agrilinks.org/openagdata and contact OpenAgData@USAID.Gov

The Journey of Life for Children Living with HIV – From Diagnosis to Adulthood

Not long ago, it was expected that children living with HIV would not survive to adulthood.  Today, children living with HIV are thriving through adolescence into adulthood, and doing so in large numbers.

Though effective antiretroviral treatment is allowing many to live long and healthy lives, living with HIV remains a complex burden for these age groups. Treatment, care and support needs are challenging and ever-changing.  Focusing on clinical services alone is insufficient.  Children and adolescents living with HIV have a range of other essential needs that must be supported.  They require psychosocial support, sexual and reproductive health education, alcohol and substance use counseling, and information on voluntary and safe disclosure, loss, grief, and bereavement.   Children and adolescents are often confronted with a multitude of emotions, questions, and concerns regarding the complexities of disclosure, their health, and their future.

PEPFAR, WHO, UNICEF, national governments, NGOs, organizations of people living with HIV, and others are working to support children living with HIV as they transition from childhood to adolescence and adulthood.

One of USAID’s foremost concerns is how best to support and address the unique health, psychological, and social needs of adolescents living with HIV as they transition into adulthood and into adult care environments.  Only an estimated 15% of HIV-exposed infants are identified and in southern Africa less than 12% those between 15 and 24 years of age have been tested and know their HIV status results.   USAID acknowledges the urgent need for age-appropriate HIV testing and counseling for children and youth to identify those that remain undiagnosed. 

With the participation of children and adolescents living with HIV in USAID programs, we continue to better understand how best to reach adolescents with the services they need.   For one, HIV remains highly stigmatized.  Children and adolescents living with HIV are confronted with complex challenges regarding disclosure with their peers and even family members.   They are in need of support to practice voluntary and safe disclosure, maintain treatment literacy and adherence, and have healthy relationships.

This is a historic moment in human history. We know what works in the effort to combat major killers of children and we are in a unique position to further reduce childhood all-cause mortality and virtually eliminate new pediatric HIV infections while keeping mothers healthy.

The focus on adolescents living with HIV is important to USAID and part of a greater initiative to meet the health needs of children.  For fifty years, USAID has been committed to improving child health.

In June, the Child Survival Call to Action challenged the world to reduce child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035.  Reaching this historic target will save an additional 45 million children’s lives by 2035.

Fifty-six governments and over 100 civil society partners committed to sharpening national plans for child survival, monitoring results, and focusing greater attention on the most disadvantaged and vulnerable children.

For children and adolescents living with HIV, we must manage their care with the desire and actions that show their self-worth including treatment and clinic adherence.  And let’s continue to prioritize meeting essential needs so children and adolescents can make a healthy transition into adulthood and a fruitful, productive life thereafter.

Join the USAID-sponsored International AIDS Society satellite:  Journey of Life for Children Living with HIV – From Diagnosis to Adulthood Sunday, July 22, 2012 from 9:00-11:00.

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