World AIDS Day 2013
Keeping the momentum towards an AIDS free generation
This year marks 25 years since the World Health Organization (WHO) set December 1 as World AIDS Day (WAD) when the global community reviews efforts towards reducing the spread and managing the negative impact of the HIV and AIDS epidemic. The theme "Getting to Zero new HIV infections; Zero discrimination and Zero AIDS-related deaths" adopted in 2011, will run to 2015. The decision to maintain this theme points to the fact that the set targets have not been attained. The critical question is where we are in regard to achievement of the global goal of an AIDS free generation. A review of the UNAIDS update on selected targets for tackling HIV and AIDS set in 2011 presents an image of success albeit with challenges.
Remarkably, strides have been made on a number of targets since 2011. These include a reduction in sexual transmission of HIV infections by 50 per cent in at least 26 countries; 62 per cent of mothers living with HIV and AIDS received ARVs by the end of 2012; a reduction in the number of babies born with HIV by 35 per cent between 2009 and 2012; and 9.7 million people living with HIV and AIDS (PLHIV) received ARVs in 2012.
What do these statistics mean for sub-Sahara African?
While we celebrate these achievements, it is important to note that global statistics do not tell the whole story. Sub-Sahara Africa contributes a marginal proportion to these success stories. Although several countries have committed to raising national budgets for addressing the epidemic through local domestic tax levies, more work needs to be done to tackle the factors which continue to fuel the spread of HIV and AIDS in Africa.
Over the recent past, African governments have been focussing on ensuring access to treatment for PLHIV. While this is a noble human rights obligation, it is also important to note that treatment efforts should be matched with a strategic prevention programme to ensure that "we do not wipe the floor while the tap continues to leak."
More efforts are required on the following factors threatening the achievements made in the epidemic response:
• Conflict and violence in some regions in Africa (Great Lakes and west Africa) where sexual and gender-based violence against women and girls occurs.
• Poverty and inequalities particularly among the marginalised and hard-to-reach populations in Africa: income deficiencies; low or no control of productive resources needed for sustaining their livelihood; hunger and malnutrition; and lack of basic social services including education and health.
• At global and national level, a greater commitment to financing health and the AIDS epidemic by governments needs to be implemented. Duplication and resource wastage and the quality of health services particularly for HIV and AIDS need to be addressed.
• Discriminatory laws and regulations still exist in some countries. While stigma and discrimination is reported to have reduced, a new form of "double stigma" still persists through these laws and regulations aimed at curbing the epidemic spread.
Does what we do matter for the epidemic response?
Maintaining achievements and moving towards the ZERO goal in the epidemic response requires well-coordinated and collective efforts at individual levels; households and communities; and national and international level.
• Individually: we have a responsibility to learn, act and share what we know about the epidemic right from the basic knowledge of the transmission and prevention methods. The power to change your behavior lies in knowledge and commitment to sustaining positive behavior.
• Households and communities: we have a role to contribute to moving towards ZERO through our behavior as well as actions. Are we ready to change the way we perceive those who are living with the epidemic?
• National governments: They should strengthen their commitment to not only maintaining achievements recorded but also move towards a broader focus on a social model for health that addresses the multi-sector nature of the epidemic. Governments should be more transparent in the use of the limited resources and develop policies and laws which address the needs of the most at risk populations.
• Global community: The global community should support African governments towards increasing resources for addressing the epidemic. They should provide support for human rights movements as they advocate for governments to drop criminalizing laws and policies. The global community should strengthen social services and policies for countries experiencing war or those in a post-war situation, ensuring that they are able to cope with the impacts of the epidemic.
All stakeholders in the epidemic response must be held accountable to their constituencies. Only then will we move towards an AIDS-free generation.