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.