He is the global AIDS czar, leading efforts to push countries to provide universal access to HIV prevention, treatment, care and support. Michael Sidibé was appointed in December by the United Nations secretary general.

On Tuesday of last week, Sidibé -- actual title: executive director of UNAIDS -- made his first official visit to the United States. He sat down for an interview in New York with Miami Herald World Editor John Yearwood to discuss local grassroots efforts, status of the AIDS fight in Latin America and the Caribbean, and his global vision. Here are excerpts:

MH: In Miami, Barbara Gaynor founded Mothers' Voices 14 years ago after her son died of AIDS. As the global AIDS czar, what do you say to people like Barbara and how critical are organizations like hers to your success?

MS: Without them, we will fail. Because of people like Barbara, we've been able to break the conspiracy of silence. We've been able to remove the silence and create a real movement which helps us to mobilize resources to help people. Because of them, people without a voice are having a voice. I want to just say thanks to Barbara and thanks to millions of Barbaras throughout the world fighting to make sure that at least AIDS will become part of the story. Their fight is a noble one.

MH: Latin America and the Caribbean have antiretroviral therapy coverage of 62 percent. That's the highest of any region in the world, according to 2007 figures. What do you credit for that?

MS: A major, major breakthrough has been made during the last five years of increasing the coverage of treatment. Not just in the Caribbean or Latin America. If you take for example, Africa. Just five years ago, there were only 50,000 people on treatment. Today, we're talking about over 2.2 million. In the Caribbean and Latin America, governments and health system are responding quickly and the number of people who need treatment was not so high compared to the rest of the world. The Caribbean was the first region in the world to negotiate a reduction of the price of drugs for treatment, which made a big difference in increasing coverage.

MH: The region's biggest epidemics are in countries with the largest populations, such as Brazil, which is home to 40 percent of people living with the virus. How difficult is it to fight the disease in these large cities?

MS: I think the biggest problem is mainly access to the slums. We didn't have a strategy in the early days to be able to penetrate the slums and organize proper outreach services, which could help young people with necessary information and helping them to be able to protect themselves. In terms of accessing services and ensuring continuity of services, it was also difficult, given the violence [and] poverty levels.

MH: How active is UNAIDS in Cuba and what problems is your agency confronting there? Are you getting good cooperation from authorities?

MS: Cuba is a particular situation. We're covering Cuba from Jamaica so we're not directly established there. From the beginning, the leadership in Cuba has been very, very clear in terms of dealing with HIV. They have decided to move very quickly toward universal treatment. One of the big challenges for us was the whole issue of stigma and discrimination. That's still continuing to be a problem for even Cuba.

MH: What kind of impact is discrimination having on the effort to combat AIDS.

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