Focus on global partnership against HIV/AIDS

The Abuja Declaration on HIV/AIDS and other infectious diseases signed by African leaders late last month to end a two-day special summit, represents the strongest, concerted gesture made so far to confront the continent’s biggest health emergency. Perhaps most significant is the decision to set a target of allocating no less than 15 percent of the national budget of African countries to health compared to a previous average of about five percent. But equally significant is the decision of several leaders to attend and that of most countries to send delegations. Evident in the proceedings during the summit was a renewed vigour by the African leadership, for long accused of not doing enough to combat the scourge of HIV ravaging the continent, to confront an African health crisis and make the most as well of international support. “Africa is exceptionally afflicted by the HIV/AIDS epidemic,” the declaration acknowledged. “This generalised epidemic is affecting a wide cross-section of our people, thus decimating the adult population, the most productive group, and leaving in its wake millions of orphans, and disrupted family structures.” With the continent accounting for over 70 percent of the world’s 36 million HIV victims, this assertion is definitely not an overstatement. The steps taken by African leaders were aided by international commitment, demonstrated at the summit, towards forming a partnership with Africa to halt the march of HIV/AIDS, tuberculosis and other infectious diseases on the continent. In this respect the UN Secretary-General Kofi Annan set the tone by asking for a special fund of between US $7-10 billion to fight infectious diseases world wide. “The war on AIDS will not be won without a war chest of a size far beyond what is available so far,” Annan said. “Money is needed for education and awareness campaigns, for HIV tests, for condoms, for drugs, for scientific research, to provide care for orphans, and of course improve our healthcare systems.” Fears that the sum might be considered too much by the wealthier countries were quickly dispelled by former United States President Bill Clinton who gave his backing to the UN Secretary-General’s proposals. “Today it is Africa that is the epicentre of the AIDS problem. But if we don’t turn the tide, in the next decade it may be India or China or the former Soviet Union where it is spreading at the highest rates,” Clinton said in his address to the summit. Support for the proposal also quickly came from leading US businessman, Bill Gates of Microsoft Corporation, who said he was encouraged that consensus was building in support of Annan’s call for a global response to the HIV/AIDS crisis. “Now is the time for world leaders to affirm their support for the UN call to action through new and unprecedented financial commitments,” Gates said. Annan later explained at a news conference that he had already had discussions with donor governments and representatives of the private sector on the need to set up the funding, and there were already several indications of readiness to contribute. By the time of the UN General Assembly Special Session on HIV/AIDS in June, a number of governments were expected to have announced the amount they would like to pledge, he said. Several heads of UN organisations, especially those involved in the Joint UN Programme on AIDS or UNAIDS were personally present at the summit. And in their individual statements they pledged their organisations’ experience and expertise towards helping African countries improve their health systems. The summit, coming close on the heels of the ending to the law suit filed by pharmaceutical companies against the South African government over use of generic anti-retroviral drugs, provided yet another opportunity for the pharmaceutical industry to demonstrate good faith. Annan revealed that a meeting he held with chief executives of the world’s six leading pharmaceutical companies early in April produced an undertaking to cut the prices of anti-retroviral drugs by as much as 80 percent or give them free in some cases. In a message to the summit, the chief executive of GlaxoSmithkline, J.P. Garnier, represented by the company’s Vice President for sub-Saharan Africa, Gunther Faber, said that more than 20 African countries had indicated readiness for a partnership with the company in national health plans including treatment of HIV/AIDS. Of the number, six - Senegal, Uganda, Rwanda, Cote d’Ivoire, Cameroon and Mali - have begun implementation. “We want to see this partnership work. We want to see more patients treated and move from the thousands that will benefit from this programme to the tens of thousands if not millions,” said Garnier. However, there are still a number of shortcomings. And African governments appear quite aware of them, particularly the low level of education so far provided citizens on the nature of the HIV/AIDS epidemic in most African countries. “Education constitutes the most powerful, cost-effective tool for reaching the largest number of people with information and personal development strategies that promote long-term behaviour change,” reads part of the Abuja Declaration. But one of the starkest illustrations of the consequences of lack of education about the disease comes from Nigeria. It is the case of 41-year-old Georgina Ahamefula, one of the people living with HIV/AIDS who were at the summit to give personal testimonies. Formerly a health worker, she was tested for HIV in 1995 by her employers without her knowledge. She was dismissed from the job when the test result turned out positive. Subsequently, she filed a lawsuit challenging her dismissal, but the presiding judge would not even let her come into the courtroom on the grounds that she was likely to infect people in the court. Apart from brutal stigmatisation and discrimination of victims in most countries of Africa, many people in the most vulnerable segments of the population are not even aware of the risks they face from HIV/AIDS. The figures range from 74 percent of girls and 62 percent of boys between 15 and 19 in Mozambique to 22 percent of girls and 8 percent of boys in the same age bracket in Cote d’Ivoire, underlining the need to intensify education and awareness campaigns. In the words of Nigeria’s President Olusegun Obasanjo, the convener of the summit: “To prevent further spread of the HIV virus, the only weapons we have are information, education and communication, all linked to treatment programmes for those already infected.”