UN agency urges cities to ramp up their response to HIV

With 70 per cent of the world’s population set to be city-dwellers by 2050, the head of the Joint UN Programme on HIV/AIDS (UNAIDS) has issued a call for cities to “take the lead in making HIV history” by enhancing their response to the epidemic.

Currently, half of all people in the world live in cities, but in the next four decades, seven out of 10 global citizens will be calling mega-cities – with more than 10 million residents each – home.

“What it is clear that cities are important to the HIV response, they have not been sufficiently mobilized and supported to act,” UNAIDS Executive Director Michel Sidibé told more than 100 health sector leaders and practitioners from across China at an event yesterday in Shanghai.

The rapid growth of cities has led to conditions where HIV thrives, and it is estimated that up to 50 per cent of people living with HIV are in cities.

In some urban areas, Mr. Sidibé pointed out, the HIV epidemic is so large that it is comparable to epidemics of entire countries. For example, in Durban, South Africa, there are 740,000 people living with HIV – the same number as all people living with HIV in all of China.

“These cities are epicentres because they are attractive to people, they are dynamic and they are home to populations most at risk of HIV infection: migrants, men who have sex with men, sex workers and people who inject drugs,” he said.

The UNAIDS chief cautioned that if neglected, the epidemic will flourish, exacerbating poverty, homelessness, safety and lack of social cohesion.

He noted that city governments can influence their citizens, and they also have resources, administrative power and systems for delivering social services.

“If cities can mobilize these resources, they can be the best nexus for forging new partnerships between civil society, local and national government to achieve universal access to HIV services for prevention, treatment, care and support,” Mr. Sidibé said.

Only a few cities, however, have shown such leadership and took action in time, he cautioned. HIV prevalence among sex workers in Bangkok, Thailand, reached 18 per cent before the city government took strong measures, rolling out a 100 per cent condom use campaign that made massive strides in reversing the HIV epidemic.

“This success was driven by city authorities, working in close partnership with the police, health providers, entertainment industry owners and managers, and most importantly with NGOs [non-governmental organizations] and sex workers themselves,” the official said.