2017 World AIDS Day Message from H.E. Joyce Banda

This year the World AIDS Day will be commemorated under the theme: Right to Health. The right to health was first articulated in the 1946 Constitution of the World Health Organization (WHO), whose preamble states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.”  The advent of HIV and AIDS has threatened this right to health on many fronts. To start with the burden of disease due to the HIV and AIDS and the allied tuberculosis epidemic and other related infectious diseases, has risen. Secondly, Africa has lost thousands of health professionals over the years as a result of AIDS. The deaths amongst human resources for health, coupled with the impact of workload of HIV and AIDS has had a profound adverse impact on overburdened and overstressed health workers as well as the already beleaguered health system.

An area of particular concern, which has become more pronounced since the advent of AIDS, is when a member of a family, especially the head of household has a serious acute or chronic health problem. Many poor families use all their resources to fund care in these catastrophic situations. This results in poor access to health care for the rest of the family members in addition to confining a whole generation to a vicious cycle of poverty.

It is, therefore, the role of every country to ensure that the right to health is not compromised. In order to sustain the national HIV and AIDS response without compromising Universal Health Coverage, governments need to put HIV prevention at the centre of National HIV and AIDS Strategies. This will ensure that the number of new HIV infections in reduced if not virtually eliminated. Today there we have the tools we need to end HIV and AIDS especially considering that the AIDS epidemic has been transformed from a deadly disease to a chronic illness. Prevention of Maternal to Child Transmission of HIV (PMTCT) has been simplified with the introduction of Option B+ where all pregnant and breastfeeding women are put on ART irrespective of their CD4 count while the adoption of the Test and Treat, Pre-Exposure Prophylaxis (PREP), Post Exposure Prophylaxis (PEP) and Treatment as Prevention (TasP) policies mean that we are at the door steps of an HIV free Generation. Governments, however, still needs to do more work on pediatric HIV and AIDS.

As we commemorate this year’s World AIDS Day, I call upon all governments and peoples of Africa to ensure that the rights of people living with HIV and AIDS are respected and that we leave no one behind. This will ensure that all people of Africa who need HIV and AIDS services can access them without fear of being stigmatized or discriminated.

SADC Parliamentary Forum 5-6 July 2017 Mahe, Seychelles

KEYNOTE ADDRESS BY HIS EXCELLENCY HIFIKEPUNYE POHAMBA, FORMER PRESIDENT OF THE REPUBLIC OF NAMIBIA AND MEMBER OF THE CHAMPIONS FOR AN HIV-FREE GENERATION AT THE SADC PARLIAMENTARY FORUM

WOMEN’S PARLIAMENT ON THE COMMISSION ON THE STATUS OF WOMEN’S RESOLUTION 60/2 (WOMEN, THE GIRL CHILD AND HIV AND AIDS)    

Director of Ceremonies,

Honourable Members of the SADC Parliamentary Forum,

Honourable Representatives of Pan African Parliament,

Honourable Representatives of the East African Legislative Assembly (EALA),

Esteemed Representatives of the Economic Community of West African States (ECOWAS),

Esteemed Representatives of the European Union (EU),

Ladies and Gentlemen,

I am honoured to have been invited to participate in this landmark gathering, where women members of the SADC Parliamentary Forum and other stakeholders seek to add momentum to the implementation of Resolution 60/2 of the UN Commission on the Status of Women. The key aim of this resolution is to stop HIV infection among our women and girls. At the outset, allow me to express gratitude to the Government and wonderful people of Seychelles for the hospitality extended to us ever since we arrived here in Mahe.  The warm welcome accorded to us has made us feel at home.

I also commend the Secretariat of the SADC Parliamentary Forum through its Standing Committee on Human Social Development and Special Programmes, the Regional Women’s Parliamentary Caucus and other partners for organising this unique Women’s Parliament.

I am convinced that the results of deliberations that will take place here over the next two days will add the necessary traction in efforts to achieve the objectives of Resolution 60/2 and its focus on addressing the impact of HIV/Aids on women and girl children.

Director of Ceremonies,

Research has repeatedly shown that African women and girls – especially in sub-Saharan Africa, bear the brunt and a disproportionately high burden of the global HIV/AIDS pandemic. In sub-Saharan Africa, starting from young age, there is a higher incidence of HIV infection among girl children than the boys.  Although the gap is not as high amongst the youth in their late 20s, the fact remains that girls and young women have a disproportionately high HIV infection rate.

There are many factors that explain higher HIV infection rates amongst girls and young women. These include intergenerational relationships, out-dated cultural practices and sexual exploitation.   These practices put our girls at women at risk. It is important that measures are put in place to combat the spread and impact of HIV/Aids on society.  This must be our collective goal as Champions of an AIDS-Free Generation, Members of Parliament and stakeholders in this important mission. 

No effort should be spared to empower girls and women through interventions such as comprehensive sexuality education (CSE).  This should be complemented with initiatives to promote self-actualisation and self-confidence for girls, to build self-esteem and to inculcate strong value systems amongst African girls.  We need to join hands and teach our girls and young women that there are more benefits from waiting and doing things at the right time. Let us teach our daughters and sisters that bigger and better cellular phones, cars, houses etc. will come at the right time. There is no need to rush. 

In many cultures in our part of the world, women are not allowed to talk.

From a young age they are socialised to be meek and quiet. We need to break this culture of silence.  Women and girls need to be able to express themselves.  It is therefore important that responsive policies are put in place remove these unhealthy cultural prohibitions to self-assertiveness. African girls have the right for self-actualisation, the freedom to challenge the status quo and to be articulate. They don’t have to beg for it.

 Director of Ceremonies,

There are many disparities regarding the harmonisation of laws related to Sexual Reproductive Health Rights (SRHR) issues, within Regional Economic Communities. For example, there is no agreed definition of a child in the SADC Region. That negatively affects efforts towards eradicating child marriage. Lack of harmonisation of laws and policies has also hampered access to services related to Sexual Reproductive Health Right, as well as HIV and AIDS.  This too, must change. 

The time to act is now so that the full intent of Resolution 60/2 of the Commission on the Status of Women can be achieved.

I wish you all productive deliberations, with the hope that this gathering will come up with effective recommendations that our policy and decision makers, as well as implementers can immediately put into motion. 

I thank you.  

 

International AIDS Day 2016

International AIDS Day 2016

Message of the Champions for an AIDS Free Generation

Issues of HIV and AIDS are very close to our hearts.

One of the most significant obstacles to responding effectively to the HIV and AIDS epidemic in Africa has been lack of an adequate mechanism to mobilise leadership and foster accountability at this level. This is why we formed the Champions for an AIDS Free Generation Programme. Over the past eight years we have worked with partners and national leaders to use their individual and collective influence and moral authority to ensure that HIV and AIDS remain high on the political agenda of the continent.

We are all witnesses to the devastation this epidemic has caused on our continent in the last 30 and more years. It has killed people, destroyed individuals, families and societies. We have seen it reduce resilience and weaken capacities, hamper development and threaten our stability. A lot has changed since then and we have made remarkable progress. AIDS is not yet over, we must remain engaged. We must recognize that the progress we have made is fragile and that our hopes for the future remain under threat from complacency, inaction and unsustainable development.

We are concerned that Africa’s demographic dividend – the youth, especially adolescent girls and young women – is under threat. The current pace of Africa’s response to HIV and AIDS is too slow to keep our fast-expanding youth population healthy and productive. We are saddened that children are still being born with HIV on our continent, when they no longer should. Key populations continue to be disproportionately affected with HIV and new infections among them are on the rise. Stigma, discrimination and punitive laws continue to threaten progress.   

We have the tools and means to prevent infections. Prevention prevention prevention is key to ensuring that the millions who are not infected remain so. We must also ensure that those who are infected have information and access to treatment.

Even as we are seeing commendable efforts in domestic resources mobilization innovations in some African countries, we remain concerned by the low allocations to HIV and AIDS by many of our countries. Africa however, cannot do it alone - our international partners should also sustain and increase their long term pledges to address the funding gap for ending AIDS.

We believe that more can and should still be done if we want to see the full benefit and to end AIDS as a public health threat. We know that failure to act is failure to save lives and therefore failure to end AIDS.

Champions for an AIDS Free Generation

Champions for an AIDS Free Generation Message on ending violence against women and girls - 2016

Her Excellency Joyce Banda, Champion and Former President of Malawi, 2016.

 

During this period of reflection for ending violence against women and girls I’d like to speak to you about pre-adolescent girls, the harmful norms they face, and the need for better research and data around them. As we look forward to implementing the SDGs by 2030, we must look back to the missteps in our undertaking of the MDGs that let the girls of this world down. This includes—most unfortunately—our lack of attention toward socialization and cultural norms at the household and community level. 

 

 A recent study of girls aged five to twelve in more than 200 countries over 40 years found that rather than poverty, cultural norms were the stronger determinants of girls’ under-enrollment in school.  To reach SDGs 3, 4, and 5 we should expand focus to look at pre-adolescent girls and acknowledge the role of harmful attitudes and traditions in the most formative years of their lives. We need a research agenda that places pre-adolescent girls at the center of policy to address harmful cultural practices—both as an issue of gender based violence and also as an impediment to girls reaching their potential

 

When girls are taught in the framework of certain cultural practices to lower their eyes and to sexually please men, forced into marriage or enslaved to a shrine as atonement their rights to education, health and personal dignity go out the window at an early age. This is a disadvantage boys do not have, and it is one that establishes inequality long before the girl child becomes a teenager. 

 

 Improving norms at the household and community levels will be a big step toward ensuring girls' well-being, quality education, and equality.

Women's Month

"Champions should change the generation gap - open the door for young people to take the space and emerge as leaders in the AIDS response." Deputy Executive Director of UNAIDS, Dr Loures at the Champions' Tripartite Business Summit. July 2016

"Completing their education is the key to unlock mighty doors for adolescent girls." Nyasha Sithole @Afriyan - Champions' Tripartite Business Summit. July 2016

Zero Discrimination - Justice Cameron

"Let us encourage our young leaders and young people to take up the lead, to take up this responsibility. Let us encourage them to take the power of speaking out against discrimination. We know that stigma and discrimination exacerbate the risk of HIV infection, exacerbate death from AIDS because of non testing and non-treatment. Young leaders and young people can help by changing this; by speaking out against discrimination and for inclusiveness."

Justice Cameron

Champions mission programme- Sierra Leone

1.    Overview

The HIV prevalence in Sierra Leone has stabilized at 1.5% since 2005; it is 2.3% in urban areas and 1.0% in rural areas. HIV prevalence among pregnant women at ANC stands at 3.2%, which is twice higher than the prevalence among the general population. Currently, it is estimated that there are 55,000 people living with HIV in Sierra Leone, of which 30,000 are women aged 15 and above and 4,700 are children aged 0 to 14. Unfortunately, only 34% of these PLHIV know their HIV status as positive. Every year, 2,700 are estimated to die of AIDS. The Modes of Transmission Study also revealed that about 13.7% of HIV new infections come from Mother-to-Child Transmission and 3,300 infants are born to HIV-positive women annually. The 2013 HIV Seroprevalence Study on Key Populations indicates high HIV prevalence among Men-who-have-sex-with-men (MSM – 14%), Female Sex Workers (FSW – 6.7%), and People-who-inject-drugs (PWID – 8.5%), and Prisoners (2.2%). Women are disproportionately affected by the epidemic and key populations and vulnerable groups are the key determinants of the epidemic.

2.    HIV Epidemic and response before the Ebola outbreak

The HIV prevalence in Sierra Leone has stabilized at 1.5% since 2005; It is 2.3% in urban areas and 1.0% in rural areas. HIV prevalence among pregnant women at ANC stands at 3.2%, which is twice higher than the prevalence among the general population. Currently, it is estimated that there are 55,000 people living with HIV in Sierra Leone, of which 30,000 are women aged 15 and above and 4,700 are children aged 0 to 14. Unfortunately, only 34% of these PLHIV know their HIV status as positive. Every year, 2,700 are estimated to die of AIDS. The Modes of Transmission Study also revealed that about 13.7% of HIV new infections come from Mother-to-Child Transmission and 3,300 infants are born to HIV-positive women annually. The 2013 HIV Seroprevalence Study on Key Populations indicates high HIV prevalence among Men-who-have-sex-with-men (MSM – 14%), Female Sex Workers (FSW – 6.7%), and People-who-inject-drugs (PWID – 8.5%), and Prisoners (2.2%), Police (5.8%), Fisherfolks (3.8%), Military (3.3%), Migrant Population (2.5%). Women are disproportionately affected by the epidemic and key populations and vulnerable groups are the key determinants of the epidemic.

Figure 1: Target population with most new HIV infections

The HIV infection is highest in five main urban districts as shown in figure 2 below:

Figure 2: High burden Geographical locations 

Achievements

There has been an increase in PMTCT sites from 687 in 2012 to 691 in 2013 and Pediatric care services has been launched in 19 district hospitals. There has also been an increase in the uptake of ART from 8,529 in 2012 to 9,065 in 2013 and survival and retention rates of 93% and 71% respectively.  There is also an increase in HIV+ persons screened for TB from 5,355 in 2012 to 9,048 in 2013.  There is available evidence on key populations and their increasing involvement in planning and programming.  The main sources of funding include theGlobal Fund, the Government of Sierra Leone,  the German Development Bank, UN Partners, the Private Sector and Civil Society Organizations namely Solthis, AIDS Healthcare Foundation, Christian Aid..

Major Challenges

The achievements made were not without challenges. Current challenges include: national response largely dependent on external financing, difficulty in expanding services and retaining quality because of limited funding, shortage of qualified manpower because of high turnover of experienced staff, domestic resources are hard to come by and NAS is looked upon as a donor, high TB/HIV co- infection rate (14%) and difficulty of coordinating partners and delivery of services because of weak health systems. 

 3.    Impact of EVD outbreak on national AIDS response

The national response was greatly impacted by Ebola outbreak on the national response.  There was drop in HIV service uptake compared to the 2013 levels with sporadic use of ARVs, inconsistent PMTCT delivery, 71% decline in HIV Counselling and Testing and fear for health service delivery points.  In terms of HIV programming, the impact had been halt in in-school youth and community sensitization programmes, loss of critical 225 human resource to EVD,  increased stigma directed at PLHIVs due to mistaken identity as EVD patients, psychological impact on beneficiaries due to confidentiality breach and reallocation of funds to EVD limiting funds to HIV programmes. 

4.    Post Ebola recovery for national AIDS response

The post Ebola recovery discerned two major approaches – Immediate (July – December, 2015) and Medium Term covering the period 2016 – 2017.  The objective of the immediate approach was to restore HIV services to pre-outbreak levels.  The Interventions to be pursued to meet this objective include:

  bringing back to treatment patients who have defaulted or lost to follow up(Defaulter tracing)

•       re-establishing services in health facilities( static services)

•  re-establishing mobile outreach testing and counseling services (outreach programmes)

•  community sensitization through community radio and meetings (social mobilisation)

         condom distribution (condom promotion)

          supervision and retraining

5.    Challenges

·         Insufficient behavioural impact of prevention interventions for adolescents and young people. High rate of early marriage, low condom use and multiple sexual partners with early sexual debut

·         Large coverage gap for testing, services to prevent mother-to-child transmission and antiretroviral therapy for adults and children. Health and community systems, including procurement and supply management remain weak.

·         Over-reliance on international funding (GFATM) at 95% because actionable political commitment, multiplecompeting priorities, weak governance, low allocative efficiency and limited absorption of funds undermine the sustainability of the response.

·         Persistent stigma and discrimination, gender inequalities and violence against women.

·         Weak sex- and age-disaggregated epidemiological and programmatic national and sub-national data especially on key populations, young people and adolescents.

·         Escalating fragile political situations as well as diseases from weak health systems

·         Recurrent humanitarian emergencies (food insecurity, floods, disease outbreaks)

6.    KEY actions needed

·         Achieve 100% coverage of peadiatric ART in 12 months

·         Achieve 100% coverage of PMTCT services in 18 months

·         Reduce mother to child transmission from 12% to less than 2% in 24 months

·         Ensure provision of HIV budget in the 2006 national budget

·         Achieve 80% of ART coverage among 54,000 PLHIV

·         Provision of targeted HIV testing services for key populations and high burden geographical locations

·         Intensification of defaulter tracing and adherence support (counseling, use of expert clients, health workers, NETHIPS and vow).

·         Cities initiative with mayors and community leaders engagement and strengthening community delivery systems.

·         Self-testing and community-based testing and delivery of antiretroviral therapy through task shifting and the use of new technologies.

·         The full potential of adolescents and young women and men unleashed to help realize the demographic dividend and reduce risk of and vulnerability to HIV infection.

·         Fully leveraging TRIPS flexibilities to secure sustainable access to affordable medicines, and strengthening local capacity to develop and manufacture quality affordable health products.

·         Integrated Supply Chain management using push and pull system

7.    Objective of Mission

The objectives of the visit are as shown in box 1: 

Box 1: Mission objectives

·         Re-energize the profile of HIV in post Ebola context to achieve pre-ebola context

·         Scale of services in the high burden districts

·         Emphasize the importance of “Leaving No One Behind” – most vulnerable women and girls

·         Promote HIV testing in KP and high burden locations

·         Advocate of increased financing of the national response using global solidarity and shared responsibility

·         Advocate for reduction of stigma at community

·         Promote strengthening of Health systems and alternative community delivery models using lessons learned from Ebola

 

A message from H.E. Dr. Speciosa Wandira- Former Vice President of Uganda: Day of the Girl Child October, 2015.

Today’s adolescent girl is tomorrow’s mother—the sustainer of humanity. To ensure healthy lives, she must champion the end of HIV/AIDS as a public health threat.

 As Champions for an HIV-Free Generation, we underscore among other issues:

 *The necessity to Empower adolescent girls, young women and women in every country across Africa to protect themselves against HIV and to have access to life-saving HIV services.

*Evidence-informed HIV prevention policies and programs which must involve and reach adolescent girls, young women and women, and must be adapted to meet their specific needs

*Access to antiretroviral medicines for all pregnant women living with HIV to prevent mother-to-child transmission and for their own health, including follow-up throughout their lives

*Engagement of adult men to know their status, to access treatment for their own health and to protect their partners

The above goals must be underpinned by a clear framework that captures information on the need versus service delivery, not only for record keeping but as well follow up to ensure that no adolescent girls and young women are left out.

 

 

International Day of the Girl Child: A message from H.E. Dr Joyce Banda former president of the Republic of Malawi

On October 11 every year, the international community commemorates the ‘International Day of the Girl Child’. I am deeply passionate about the protection and development of the girl child. In this regard, I wish to call upon and encourage my fellow Champions for an AIDS-Free Generation in Africa and the entire international community to step up efforts to ensure the protection and development of the girl child in the context of the recently adopted United Nations (UN) Sustainable Development Goals (SDGs).

 

It is imperative that the international community remains vigilant in protecting girls against early and forced marriages, unwanted pregnancy, sexually transmitted diseases, gender-based violence, female genital mutilations and HIV and AIDS, among others.

 

I am aware that child marriages - a practice which affects 15 million girls a year with devastating repercussions on their health, education and wellbeing and the other vices against the girl child - are adequately addressed within UN SDGs framework. We must take further, effective and practical interventions to ensure speedy action on these critical issues. HIV and AIDS remain a devastating threat to the health of an adolescent girl. As leaders, let us remain vigilant in the fight against HIV and AIDS, especially where it concerns the girl child.

 

I am happy that the 2015 theme, ‘The Power of the Adolescent Girl: Vision for 2030’, is in line with the Champions for an AIDS-Free Generation call for:

 

* Empowerment of adolescent girls, young women and women in every country across Africa in order to protect themselves against HIV and to have access to life-saving HIV services. Evidence-informed HIV prevention programmes must reach adolescent girls, young women and women, but they must also be adapted to meet their specific needs;

* Access to antiretroviral medicines for all pregnant women living with HIV to prevent mother-to-child transmission and for their own health, including follow-up throughout their lives; and

 

*Engagement of adult men to know their status, access treatment for their own health and protect their partners

Finally, I call on governments and the international community to maximize investment in adolescent girls’ education. I firmly believe that when you educate a girl child, you have not only educated a family but a nation. Educated girls are better placed to make informed choices about their own future and that of their families.

I thank you,

Dr. Joyce Banda

FORMER PRESIDENT, REPUBLIC OF MALAWI

10th October 2015

Africa’s private sector pledges to partner the Champions for an AIDS-Free Generation

Representing the private sector, Brian Brink (left) agreed with the Champions that scaling up the AIDS response was imperative in order to avoid the epidemic spiralling out of control.

Representing the private sector, Brian Brink (left) agreed with the Champions that scaling up the AIDS response was imperative in order to avoid the epidemic spiralling out of control.

Representatives of African businesses met with the Champions for an AIDS-Free Generation on 15 April in Johannesburg, South Africa, to explore partnership opportunities to reduce HIV infections and end the AIDS epidemic as a public health threat.

The chairperson of the Champions, Festus Mogae, opened the discussion by emphasizing the significance of the private sector’s role in stepping up and amplifying the AIDS response across the continent.

Former Vice-President of Uganda, Speciosa Wandira-Kazibwe, shared her story as a young doctor in Uganda at the start of the AIDS epidemic and warned against complacency. Alpha Oumar Konaré, former president of Mali, remembered the panic and hopelessness felt in Africa during the early days of the epidemic and how Africans had come together to decide that AIDS need not be fatal. He highlighted the need to build on current progress to keep young people safe and healthy.

Companies represented included pharmaceuticals giant Pfizer, leading South African health insurer Discovery, health-care company Aspen Healthcare and restaurant chain Nando’s. Other partners attending the lunch meeting included UNAIDS, the Southern African Development Community and the Economic Community of West African States.

During the discussion, representatives of major pharmaceutical companies underlined the need to find innovative ways of expanding HIV prevention programmes, with a particular focus on young people. In addition, they emphasized the importance of manufacturing medicines in Africa, including the active pharmaceutical ingredients, and stressed that the current demand on the continent would make the investment worthwhile. 

Representing the private sector, Brian Brink agreed with the Champions that scaling up the AIDS response was imperative in order to avoid the epidemic spiralling out of control. He said that big businesses in Africa were ready to rally behind the cause of the Champions.

The dialogue with the private sector came at the end of a three-day meeting of the Champions, which included talks with South African President Jacob Zuma.

Signing of The Declaration of the Champions

ΠThe Champions for an AIDS-Free Generation in Africa concluded their-three day high-level meeting in Johannesburg with the signing of The Declaration of the Champions.

The Declaration warns against complacency and calls for renewed urgency in response to AIDS.

The Champions call to action:

Œ 1. Achieve steeper declines in new HIV infections. 

 2. Focus on adolescent girls and women, the face of HIV in Africa.

Ž 3. Reduce external dependency through a common continental approach.

 4. Stronger partnerships for the urgent scale up of action. 

 

Download Declaration (PDF)

Champions for an AIDS-Free Generation in Africa celebrate partnerships

The Champions for an AIDS-Free Generation in Africa—a distinguished group of former Presidents and influential African leaders—hosted a dinner in Johannesburg, South Africa, on 13 April to celebrate the role played by partnerships in ending the AIDS epidemic.

The evening included speeches to welcome five new Champions, a powerful contribution from a mother living with HIV and a special musical performance from Loyiso Bala, UNAIDS National Goodwill Ambassador for South Africa. Private sector representatives also pledged their support to move forward with the Champions. 

Champions who attended the dinner included Festus Mogae, former President of Botswana and Chairperson of the Champions, Kenneth Kaunda, former President of Zambia, Alpha Oumar Konaré, former President of Mali, and Kgalema Motlanthe, former President of South Africa.

The dinner came at the end of the first of three days of meetings and talks between the Champions and their partners to mark a strengthened commitment to ensuring that all children are born free from HIV and that both children and mothers living with HIV have access to life-saving treatment. During the day, the Champions also announced that they are extending the scope of their work to cover adolescents and HIV.

Partners attending the three day-meeting include UNAIDS, the South African Development Community (SADC), the SADC Parliamentary Forum, the Economic Community of West African States and the South African Broadcasting Corporation) Foundation.

Quotes

"The 21st century can only be Africa's century if our young people manage to stay healthy and free from new HIV infection, because the inconvenient fact shows us that they are at high risk of new infections."

Festus Mogae, former President of Botswana and Chair of the Champions for an AIDS-Free Generation

“I am honoured to attend this very important meeting. I am going to work and work until the job of ending the AIDS epidemic is done. I don’t know about you but I’m ready.”

Joyce Banda, former President of Malawi

"Once the cause of ending AIDS is attained, the Champions become winners and we render ourselves irrelevant."

Kgalema Motlanthe, former President of South Africa

“We have the knowledge and the science to end the epidemic, but we need political leadership to break the complacency and to restore the urgency to the AIDS response.”

Luiz Loures, Deputy Executive Director, UNAIDS

"We have a duty to protect young people and provide them with the continuity of care. We must realize that we can’t do business or grow our economies with an unhealthy workforce.”

Brian Brink, representative of the private sector

"The Champions can be our voices so that governments can be encouraged to provide HIV prevention, treatment and care services to all women living with HIV."

Lorraine Mashishi, representative of women living with HIV

 

We cannot afford to relax until we end the AIDS epidemic: Festus Mogae

Festus.jpg

Former president of Botswana, HE Festus Mogae, and chairperson of the Champions for an HIV-Free Generation, shared a panel with other prominent speakers on how to position AIDS in the post-2015 agenda during the 20th International AIDS Conference (AIDS 2014), in Melbourne, Australia from 20–25 July 2014.

The panel, which also included UNAIDS Executive Director Michel Sidibé, the Global Fund Executive Director, Mark Dybul, and HIV activist, Yvonne Chaka Chaka, debated on how to secure a global commitment to ending AIDS as a public health threat by 2030.

“We have to remain engaged, we should not relax, we cannot afford to,” said HE Festus Mogae. “If we fail to end AIDS by 2030, we will be directly to blame because we have the knowledge and capacity to do so.”

Sub-Saharan Africa accounts for almost 70% of the global total of new HIV infections. Although new HIV infections declined by 33% between 2005 and 2013, an estimated 1.5 million new HIV infections occurred in the region. HIV treatment coverage also remains low with only 37% of all people living with HIV accessing treatment in sub-Saharan Africa. In 2013, AIDS-related illnesses claimed the lives of 1.1 million people.

AIDS 2014 gathered representatives from science, government, civil society and the private sector to discuss together at a high global level the most pressing issues linked to the AIDS response. .

HE Festus Mogae is internationally known for his tremendous contribution in stemming the tide of HIV and AIDS in Botswana, one of the countries most affected by the epidemic. He was one of the first heads of state in the world to publically test for HIV. Under his leadership, Botswana became the first African country to provide free antiretroviral therapy to people living with HIV. In 2004, he also introduced routine ‘opt-out’ HIV testing, which helped in significantly increasing the number of people who know their status.

“While we do not underestimate the substantial amount of work that has been done…to convert what was a killer disease into a chronic one,” said HE Festus Mogae, “We still have a long way to go. The challenge of HIV and AIDS is still with us.”

From song to steady progress

“What are you waiting for? It's cool. It's clean. It protects. It saves lives. Get circumcised!”

These are the opening lines of the Let’s Circumcise song, which was launched at the International Conference on AIDS and Sexually Transmitted Infections in (ICASA) in 2011, to signal the start of a movement of strengthening HIV prevention services across the continent.

Champions for an AIDS-Free Generation (Champions) collaborated with prominent African musicians—Zimbabwean guitarist, composer and vocalist, Oliver Mtukudzi, Botswanan kwaito kwasa star, Vee, and Zimbabwean reggae-dancehall artist, Winky Dto create a song about the benefits of male medical circumcision.

The song was part of an intensive campaign to promote safe male medical circumcision in 14 Eastern and Southern African countries. These include Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Uganda, Tanzania, Zambia and Zimbabwe. Free copies of the song were disseminated to local TV and radio stations for wide broadcasting in these countries. The song has also been shared on the Champions’ website to reach people globally.  

Clinical trials have demonstrated that voluntary male medical circumcision (VMMC) can reduce female-to-male transmission of HIV by 60%. If scaled up to reach 80% of adolescent and adult males within five years—and coverage maintained thereafter—it can avert more than 3.4 million new HIV infections and save an estimated US$16.5 million in care and treatment costs over 15 years.

The Champions are vocal advocates for VMMC and have spoken about its benefits on many occasions as part of their work to create an HIV-free generation.

“We have advocated for voluntary safe male circumcision in all countries we have visited,” said former president of Botswana, HE Festus Mogae. “Although countries are at various stages of implementation of the programme, most have scaled up and accelerated implementation.”

 Three years on, more and more men in the 14 targeted countries have undergone VMMC. According to the 2014 WHO data, an ‘impressive upturn’ in the number of male circumcisions has resulted in 2.7 million men in the 14 priority countries stepping forward for VMMC in 2013. This has led to a cumulative total of 5.82 million males circumcised since 2008. This represents a near two-fold increase from a cumulative 3.2 million males circumcised by the end of 2012.

 If this positive trend continues, the ambitious target of 20.8 million males circumcised by 2016 may become a reality.

 WHO Progress Brief, July 2014, http://www.who.int/hiv/topics/malecircumcision/male-circumcision-info-2014/en/

Keeping voluntary male medical circumcision high on the agenda

Champions for an HIV-Free Generation (Champions) continue to be actively engaged in promoting voluntary male medical circumcision (VMMC) in Africa, where effective prevention strategies are needed urgently to reduce the high rate of HIV infections.

In July 2012, during the 19th International AIDS Conference in Washington DC, U.S., the Champions, PEPFAR, UNAIDS, WHO and AVAC brought together African politicians and traditional leaders, as well as key figures in the international HIV response, to share their views on the challenges and solutions to VMMC.

The discussion was framed in the context of a five-year action framework, endorsed in December 2011 by UNAIDS, WHO, PEPFAR, BMGF, the World Bank and Ministries of Health from 14 priority countries, to accelerate the scale up of VMMC.

The 14 countries have some of the world’s more severe HIV epidemics and include Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Uganda, Tanzania, Zambia and Zimbabwe.

Following clinical trials in 2007 which showed that VMMC can reduce female-to-male transmission of HIV by 60 per cent, WHO and UNAIDS recommended that countries or provinces within countries with high HIV prevalence and low rates of male circumcision expand VMMC as part of a comprehensive package of HIV prevention services.

The Champions have worked tirelessly to increase acceptance and uptake of VMMC services among the 14 priority countries through in-country visits and advocacy at high-level meetings and international conferences.

“Over the next five year, enough men can be circumcised through VMMC to prevent 3.4 million new HIV infections and save billions in care and treatment costs,” said former President of Tanzania and one of the Champions, HE Benjamin Mkapa. “Scaling up this intervention is an urgent priority. Although it means an upfront investment, the results are significant long-term cost savings.”

Progress in implementation of VMMC has, however, been uneven, with some countries, like Kenya and Tanzania, making impressive progress and others struggling to move beyond the pilot phase.

The five-year framework’s immediate ‘catch-up’ phase is therefore designed to quickly achieve coverage of sexually active adolescent and adult males, and a second phase to integrate VMMC into infant healthcare services.

According to WHO , the results achieved so far show that reaching the ambitious target of 20.8 million males circumcised by 2016 can be reached. In 2013, 2.7 million men alone in the 14 priority countries underwent VMMC. This means that a total of 5.82 million males have been circumcised since 2008.

“I am proud of the men of Uganda for accepting the good science behind VMMC and stepping up for male circumcision,” said Dr. Speciosa Wandira former Vice President of Uganda and member of the Champions, when talking about her own country. “Women—in their roles as sisters, mothers, wives and partners—also play a pivotal role in supporting men to make this decision.”

WHO Progress Brief, July 2014, http://www.who.int/hiv/topics/malecircumcision/male-circumcision-info-2014/en/

Focused advocacy work in Kenya

The Champions for an HIV-Free Generation (Champions) are powerful advocates and use their influence and experience to urge governments and partners to take greater action in addressing the HIV epidemic. 

 In 2012, the Kenyan government committed to increasing domestic funding to its national AIDS response following a high-level advocacy mission in Nairobi with four members of Champions, Festus Mogae of Botswana, Dr. Kenneth Kaunda of Zambia, Benjamin Mkapa of Tanzania—all former African presidents—and Professor Miriam Were of Kenya, former chairperson of the National AIDS Control Council in Kenya. President Mwai Kibaki made the commitment during a press conference he co-hosted with the Champions at the end of the Champion’s visit to Kenya in August 2012.

 During their three-day advocacy visit, the Champions also held discussions with the Cabinet sub-Committee on HIV under the authority of the Prime Minister of Kenya, Raila Odinga, as well as the Parliamentary Health Committee on Health. They advocated for the elimination of new HIV infections among children and lobbied for greater domestic resources for the HIV response.

In 2013, an estimated 13 000 children became newly infected with HIV compared to 21 000 in 2009, showing a 38% decline. An estimated 60 141 children living with HIV were receiving ART in 2013, representing only 31% of all children living with HIV.

 The Champions met with representatives from networks of people living with HIV, faith-based organizations, men who have sex with men, sex workers and the private sector. They also visited a community-based programme in Kibera—the largest temporary settlement in Eastern Africa—where the role of civil society in promoting and increasing demand for HIV services was showcased.

 At the end of the visit, the Champions commended the country for its Rapid Response Initiative—a home-grown, innovative approach used to increase HIV counselling and testing levels, medical male circumcision rates and uptake of prevention of mother-to-child transmission services. They considered the initiative a best practice that should be replicated in other sub-Saharan Africa countries.