Article: African Leaders Ask for Help with AIDS Crisis

26 June 2001

Article: African Leaders Ask for Help with AIDS Crisis

U.N. Special Session on HIV/AIDS opens

By Judy Aita
Washington File United Nations Correspondent

United Nations -- African leaders traveled to the United Nations June 25 to urge the international community to step up its efforts to save the continent from the scourge of the HIV/AIDS pandemic.

Speaking at the opening day session of the U.N. Special Session on HIV/AIDS, several African presidents and senior officials described the struggles their governments have undertaken to prevent the spread of the virus, care for the infected, and cope with the orphans and economic ruin the crisis has wrought.

The special session, which is being held June 25 to 27, marks the first time that the U.N. General Assembly has focused on a health issue to galvanize political commitment and leadership to fight the pandemic. With high level officials from the United Nation's 189 member states participating, it is hoped that the session will be a watershed event in the fight against HIV/AIDS.

Sub-Saharan Africa remains by far the worst affected region in the world, according to UNAIDS, the joint United Nations Program on HIV/AIDS. More than 25 million Africans are living with HIV and an additional 17 million have already died of AIDS -- three times the number of AIDS deaths than in the rest of the world. The death toll in 2000 was ten times that of the region's wars and civil conflicts.

Across the continent an estimated 1.1 million children under 15 were living with HIV at the end of 2000 -- evidence that mother-to-child transmission is also claiming an increasing number of lives, UNAIDS said in a report released June 21. Two million more women than men carry HIV. Women's physiological, social and economic vulnerability have contributed to their higher rates of infection.

By the end of 1999, 12.1 million children in the region had been orphaned by AIDS. Actually, the region is home to over 90 percent of all children who became infected through mother-to-child transmission in 2000, UNAIDS said.

Nigerian President Olusegun Obasanjo stated frankly that "the future of our continent is bleak, to say the least, and the prospect of extinction of the entire population of a continent looms larger and larger."

"We do not have any choice but to contemplate exceptional measures to contain the spread and devastation of HIV/AIDS and those measures have to be comprehensive and total at all levels -- national, regional and global," Obasanjo said.

"I wish for this special session an outcome that is successful enough to rescue humanity from the clutches of a pandemic that threatens to blight the future of humankind," the president said.

Discussing the commitment made by African leaders at the OAU Summit, the Nigerian president said that they have committed themselves to personally provide leadership in all activities established in their countries, agreed to allocate 15 percent of national budgets, and set up "Leadership AIDS Watch for Africa." But he said that there has to be additional assistance from the international community, including cancellation of Africa's debts so that resources can be freed to fight AIDS.

He also made a plea for the millions who are already infected with the HIV virus. They -- as well as the millions of children orphaned by the disease -- require primary attention, Obasanjo said.

South African Minister of Health Mantombazana Tshabalala-Msimang said that she was attending the session "not just because we care about our people and country but also because in a real way the destiny of nations and the peoples of the world will take a turn for the better or the worse depending on how we elect to conduct this important gathering."

The health minister thanked the international community for their support in South Africa's recent court case against some pharmaceutical companies and said Pretoria is determined "to forge enduring and constructive partnerships with the pharmaceutical industry."

"Affordable access for the majority is a basic requirement if this century is truly to be an African century," she said.

Urging leaders to "be bold and think more creatively," the minister said that there must be a better balance between creating a system of incentives to drive innovation and strategies to ensure that advances are translated into benefits for those most in need.

Dealing with the HIV/AIDS catastrophe against a background of pervasive poverty, underdevelopment and a range of other public health challenges, South Africa is pursuing an approach "rooted in our reality." That centers on strong preventive programs focusing on youth, empowering women and girls, and ensuring that men become part of the solution, Tshabalala-Msimang also said. Some of the key programs include a compulsory "life-skills" program in the schools, free supply of quality condoms, and public awareness campaigns that target all sectors of society.

Pakalitha Mosisili, prime minister of Lesotho, said that his government has declared HIV/AIDS "a national disaster" and is addressing the problem in all public forums and taking other public information measures, women's rights, help for AIDS orphans, and access to drugs. But, he added, "resource availability is key."

"We urge the donor community to support country efforts in addressing these issues," he said. "We are committed to an eventual HIV/AIDS-free Lesotho. We will continue our cooperation and collaboration nationally, regionally, and globally so that we may together win this fight."

The government's efforts are slowly beginning to bear fruit with about 95 percent of Lesotho's youth aware and knowledgeable about HIV/AIDS, Mosisili said. But he acknowledged that "major changes are yet to be witnessed in behavior" and the government is reorienting and strengthening its efforts to change behavior.

Lesotho is also focusing on removing the stigma attached to the disease and removing gender inequities that in the past have negatively affected the ability of women and girls to take control of their sexual health, the prime minister said.

Uganda's extraordinary efforts in facing the pandemic has made it the only African country to have turned a major epidemic around, according to UNAIDS.

Eriya Kategaya, foreign minister of Uganda, told the assembly that his country has cut the rate of infection by responding "courageously" in political and policy areas, technical and scientific fields, and in grass roots communities. The help and information campaigns of the Ugandan Network and Associations of People Living with HIV/AIDS have made a tremendous contribution in the fight, he said.

HIV prevalence has declined from an average of 18.5 percent in 1993 to 6.2 percent in 2000. Close to one million Ugandans have died, leaving behind more than 1.7 million orphaned children below the age of 15, the minister said. Although there has been a considerable dent in the epidemic, Uganda has not yet achieved success, so there is "no room for complacency," he said.

One of the unique factors in Uganda's response was recognizing at an early stage that HIV/AIDS is a multi-dimensional problem which requires a varied approach for the political, cultural, economic and health/clinical perspectives, Kategaya said.

African countries need access to long-term international aid to undertake effective AIDS reduction programs such as education for girls, strong health delivery systems, employment opportunities for women, and agricultural modernization to increase rural incomes, the minister said.

Praising the creation of the global AIDS fund, Kategaya said that "equitable access to effective treatments is an urgent necessity."

Restating his commitment to personally lead his nation's and the global fight against AIDS, Ghana President John Agyekum Kufuor said that HIV/AIDS is undermining the continent's social security and economic development efforts faster than the continent can contain. "It is imperative, therefore, that we marshal all support and resources to arrest the situation."

In Ghana today HIV/AIDS concerns are being mainstreamed into all aspects of life with roles for both public and private organizations, he said.

"Civil society, including NGOs (non-governmental organizations), religious groups and traditional rulers, are now fully involved in open discussions on the media. This is helping to eliminate the moral squeamishness towards sufferers and encourage open discussion and increased information to enhance management of the pandemic," Kufuor said.

Botswana President Festus G. Mogae said that "if the HIV/AIDS pandemic is not contained, it will accentuate disparities in living standards between developed and developing countries."

Because of their lack of human and material resources, including under-developed health care systems, many African countries are the least able to put into effect efficacious strategies to counter the pandemic, Mogae told the conference.

HIV/AIDS is "severely limiting development prospects of the affected countries through loss of skilled human resources, decline in productivity and re-allocation of resources," he added.

Appealing to the international community to commit substantial financial and other resources for AIDS prevention, better access to drugs, and other HIV/AIDS programs, the president said that "in the global village in which we live today...no country is safe from the ravages of the pandemic. Therefore, it is in the interest of each and everyone of us to ensure that we do everything in our power to eliminate the spread of HIV/AIDS in the quickest possible time and in the most effective way."

Rwanda President Paul Kagame noted that Rwanda is among the 14 Sub-Saharan African countries most seriously affected by HIV/AIDS and one of the contributing causes was "the 1994 genocide in which untold numbers of women and young girls were systematically raped."

"The impact of this episode of our history has not yet been fully grasped," Kagame said. "The massive internal and external dislocation and movements of millions of people during this period also contributed to the spread of HIV/AIDS."

Rwanda has undertaken a national campaign to sensitize leaders at all levels of society, the president said. That campaign has led to a significant proportion of the population to volunteer for HIV/AIDS testing, resulting in a ten-fold increase of voluntary testing since 1997.

A program for prevention of mother-to-child HIV transmission is now in place; the government is purchasing anti-retroviral drugs which are made available to the public at subsidized rates; and Rwandan youth have started anti-AIDS clubs in almost all secondary schools in the country, Kagame added.

"HIV/AIDS can be tamed and eventually defeated," the president said. "The immediate goal in this quest is a focused global strategy that is realistic, practical, and effective, particularly in regard to resource-mobilization, and management."

Opening the second day of the conference June 26, Tanzania President Benjamin William Mkapa appealed for "greater partnership and more help, with new resources, not repackaged existing aid programs."

"It is one thing for Africa to assume leadership and ownership of this holistic and integrated approach, and quite another to get it operational and produce results," Mkapa said. "The cost of implementation is patently prohibitive and overwhelming, especially as we have another war front, that against poverty."

For a country like Tanzania to develop the national capacity to treat sexually transmitted diseases, TB (tuberculosis), and malaria on its own is impossible, therefore so is the prospect of building a national system for blood screening, widespread HIV testing and counseling, delivering and monitoring the dispensation of anti-retroviral drugs, and dealing with the cost of the drugs themselves, the president pointed out.

Mkapa thanked the pharmaceutical companies that have agreed to offer AIDS drugs at cost, but, he said, "for Tanzania, where half of the people live on less than a dollar a day, drugs that cost a dollar a day remain only a dream for most of the victims."