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Subject: Re: AIDS Consensus Plan - Part 2
3. National Leadership
3.1 National leaders’ prime responsibility is to create the conditions for
community mobilisation, across the nation, on a scale and with a commitment
comparable to mobilising for war.
3.2 Many cases of impressive national efforts exist: the challenge is to
replicate them and to scale them up to cover every community. This may
require national leaders to commit domestic resources to HIV/AIDS programmes
and to ensure that they in fact reach local groups efficiently.
3.3 National leaders’ personal example can transform the moral and social
climate in which HIV/AIDS can be discussed and addressed openly, and denial
and stigma can be overcome.
3.4 National strategies should include scaling up the resources and systems
necessary so that anti-retroviral and other essential medications can be
made
available to the widest possible population as rapidly as possible. This
will
take leadership, hard bargaining, and the mobilisation of domestic and
international resources.
3.5 The status of women and girls at a national level needs special
emphasis.
Women must be closely involved in all components of HIV/AIDS programmes.
National leaders must initiate special programmes and set up special
institutions to promote the rights and initiatives of women. Inequitable
gender relations and opportunities lie at the core of the HIV/AIDS pandemic.
Since Africa’s women leaders have demonstrated their readiness to lead on
HIV/AIDS issues, the fostering of more women leaders of national and
international stature is an important component of overcoming HIV/AIDS.
Acknowledging the central importance of this issue, the Statement of the
Gender Focus Group, Annex III, is an integral part of this statement.
3.6 National AIDS institutions and councils should be strengthened as a
matter of urgency in order to assure a broad, multi-sectoral response at the
national and community levels. Strong legal and regulatory frameworks are
required. HIV/AIDS committees should be extended to the local level across
every country. Stakeholders including PLWAs, Youth and Civil Society
Organisations, must be fully involved. Best cases in Africa demonstrate that
highest level political leadership of national AIDS councils is a
requirement.
3.7 Effective multi-sectoral leadership requires that every sector must
achieve competence on how HIV/AIDS affects its activities and how it can
contribute to a multi-sectoral plan to overcome the pandemic.
The health sector, provided with suitable resources, must play a leading
role
in prevention, treatment and the surveillance of the pandemic. All available
measures to minimise mother-to-child transmission should be utilised.
The education sector is central to effective responses to HIV/AIDS. HIV/AIDS
and sex education must be in every curriculum. Schools must be models for
equitable gender relations and young people must be involved in the
management of school-based initiatives focusing on HIV/AIDS. All school fees
and other charges required to attend government schools must be abolished to
ensure that all children can enjoy their right to education. Donors should
provide special support to the education sector.
Youth out of school, including street children, should be targeted and
reached by appropriate strategies. Given the impact of drug abuse on the
spread of HIV/AIDS, drug abuse prevention and rehabilitation programmes
targeting specifically youth in and out of school should be implemented in
rural and urban areas.
The social welfare sector must provide assistance to those caring for people
with AIDS, and for their dependents. Assistance including counseling should
be provided for orphans.
Ministries of finance should ensure adequate resource provisioning for
HIV/AIDS programmes. They should reorient budgets and administrative
procedures so that funds related to HIV/AIDS programmes can be managed in
the
most efficient manner in order to provide funds expeditiously at all germane
levels.
The trade, industry, mining sectors must shoulder their responsibilities for
minimising transmission of HIV and for non-discriminatory employment
practices. Business and labour should be involved in developing and
implementing national HIV/AIDS action plans. Efforts should be made to
extend
these activities to the informal sector.
Local production of pertinent pharmaceuticals should be encouraged.
The rural sector is particularly at risk because of high levels of
illiteracy
and poverty. The agricultural, livestock and fishing sectors should shoulder
responsibilities, especially for education about HIV/AIDS, alongside the
authorities in rural areas.
The military must confront the reality of high levels of HIV prevalence
among
soldiers, and take necessary steps to reduce transmission. Armies must
provide for soldiers who are living with HIV. As disciplined national
institutions, armies can take a leading role in HIV/AIDS control programmes.
The military must take steps to eliminate the high level of sexual violence
against women and girls, particularly during conflicts, and ensure that
those
responsible are prosecuted and punished. Similar considerations apply to
other uniformed services of the state including the police and prison
service.
Commercial sex workers and women forced to engage in ‘survival sex’ should
be protected by the law and law enforcement officers, and provided with
education and access to condoms and medical facilities.
African research institutes should become actively engaged in research for
improved treatments for HIV/AIDS and opportunistic infections, drawing inter
alia on the expertise of traditional healers.
The media should have a crucial partnership role in public education and
shaping attitudes. Information and communication technology can play an
important role in national, regional and global transmission of information.
Artists and cultural leaders can play key roles in influencing public
attitudes and can serve as role models.
3.8 People living with HIV/AIDS must be involved in national policymaking
and
implementation in a meaningful manner.
3.9 Governments have a responsibility to improve capacities wherever needed
for the campaign against HIV/AIDS. This includes their own effectiveness and
accountability, so as to be able to fulfil their commitments to their
citizens, and to be able to receive and dispense international assistance
rapidly and efficiently. CSOs can play a vital role in monitoring
government’s performance.
3.10 Civil society organisations have taken the lead in many aspects of
HIV/AIDS control. Their roles must be appreciated and supported. NGOs must
hold themselves to high standards of accountability and transparency. The
common position of African civil society organisations represented at the
Forum is important and their Declaration is therefore appended in Annex II
as
an integral part of this statement.
3.11 Religious leaders and traditional leaders have immense influence over
matters of personal morality and behaviour. They are encouraged to be far
more active in removing the stigma of HIV/AIDS and in educating their
congregations. Abstinence and fidelity would, if followed, prove an
effective
means of preventing HIV transmission. Religious values such as care for the
stricken, tolerance and inclusion can assist in the campaign against
HIV/AIDS.
3.12 Development and economic planning must play a crucial role in reducing
vulnerability to HIV/AIDS, by means of promoting sustainable livelihoods and
employment and through poverty-reducing wealth creation.
4. Regional Leadership
4.1 Africa’s HIV/AIDS pandemic knows no geographic, economic or social
boundaries. It demands action at a continental level and leadership from
Africa’s regional and subregional organisations.
4.2 Much can be learned from successful examples of the containment of the
HIV/AIDS pandemic in different countries in Africa. The regular sharing of
experiences and the provision of technical advice from elsewhere in Africa
are tools towards adopting best practices across the continent.
4.3 Essential and comprehensive care and treatment for people living with
HIV/AIDS is required. A continental strategy to ensure the affordable
provision of essential anti-retroviral drugs and treatments for
opportunistic
infections is needed very rapidly. This requires a determined pan-African
strategy in partnership with international donors and pharmaceutical
companies.
4.4 The International Partnership against AIDS in Africa has been
established
to develop a more conducive framework for true partnerships and better
coordination among key stakeholders at all levels. It is intended to assist
in providing the much-need additional resources, technical support,
information sharing and coordination of donor efforts, under the leadership
of African governments. The IPAA should be fully implemented.
4.5 Peace is an essential pre-requisite for effective programmes against
HIV/AIDS. The extent of ongoing war in Africa seriously undermines any
realistic programmes to combat HIV/AIDS in the affected areas. It is
therefore imperative that African governments and regional and subregional
organisations take decisive steps to create and maintain peace and security
and promote democratisation as a means of facilitating conflict resolution.
4.6 Long-distance migration, mobility, displacement and refugee flows are
risk factors for HIV/AIDS that demand inter-state cooperation to develop and
implement policies against HIV/AIDS. Policies and programmes aimed at
migrant, mobile and displaced populations should be developed and
implemented. However, no measures should be implemented that curtail freedom
of movement.
5 International Partnership
5.1 An estimated US$3 billion is now required annually to contain the
HIV/AIDS pandemic, including prevention, treatment, community support,
research, training and surveillance. This may soon rise to as much as US$ 10
billion if anti-retroviral treatments are made available to all PLWAs. These
resources are available, nationally, regionally and globally.
5.2 The first source for resource commitment must be domestic. In the
framework of multi-sectoral strategies, adequate provision for HIV/AIDS
programmes should be prominently reflected in every ministerial budget.
Certain national leaders have committed themselves to putting their nations
on a ‘war footing’. In resource terms, this implies spending more on
combating HIV/AIDS than on peacetime defence expenditure.
5.3 This also requires mobilisation of resources from every possible source
such as the domestic private sector and community resources.
5.4 Foreign donors and international financial institutions must greatly
increase their financial commitments to HIV/AIDS and development programmes.
This assistance, wherever possible, should be in the form of grants, not
loans, and should benefit from expedited procedures.
5.5 A substantial reduction in the prices of anti-retroviral drugs and
treatments for opportunistic infections is required. African governments,
donors and international financial institutions must work in partnership to
reduce the prices of drugs to a level commensurate with their production
costs.
5.6 International research efforts to develop vaccines against HIV and
treatments for AIDS and opportunistic infections should be substantially
increased, and carried out in partnership with African communities and
research institutes, ensuring that resulting benefits reach Africa.
5.7 There is a need for an international code of good practice to be
developed and utilised to safeguard and guarantee the rights of workers with
HIV/AIDS, and to specify the responsibilities of employers. The ILO should
provide support and technical assistance to employers’ and workers’
organisations and to labour ministries to strengthen their capacity for the
effective implementation of national action plans and policies. Recognising
the importance of this, the Conclusions and Recommendations of the ILO
Pre-forum Tripartite Event are appended as Annex IV, as an integral part of
this statement.
5.8 Debt relief is an important source for both money and political
commitment, and as a means of mainstreaming HIV/AIDS programming into
development and poverty reduction policies. The HIPC programme of debt
reduction should be expanded and accelerated particularly where resources
will be re-channeled to HIV/AIDS and poverty reduction.
5.9 Other sources of finance such as corporations and foundations, and
innovative ways of generating revenue, should also be sought.
5.10 The African diaspora is an important source of resources, expertise and
networks that can be utilised as part of a true and effective partnership.
Therefore, African governments should take specific steps to scale up
existing diaspora initiatives, understand the full dimension of this group
and extend this support into new areas of priority. Dialogue needs to
commence as an urgent priority to encourage the diaspora community to raise
funds, mobilise scientific resources and expertise and combine their
strengths with emphasis on HIV/AIDS.
5.11 International assistance efforts should be coordinated, transparent and
accountable. Mechanisms to ensure the quick, effective, direct and
accountable delivery of resources to local groups and programmes will be
required.
The HIV/AIDS pandemic is manageable. With the required political commitment,
provision of resources, and strategies that include all stakeholders as
valued partners, the HIV/AIDS pandemic can be rolled back and contained. The
experience of certain African countries shows that this is achievable. What
has been accomplished must be sustained and spread across the entire
continent. Africa’s HIV/AIDS pandemic will be overcome at a continental
level
or not at all.
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