HIV Aids in Africa:Targeting Zero

Published on 13th December 2013

The 2013 UNAIDS report on the HIV epidemic in Eastern and Southern Africa highlights the fact that AIDS-related deaths continue to decline, as do the annual number of new HIV infections and that more people than ever are receiving life-saving antiretroviral therapy. Many countries have reached the "tipping point" where the number of people starting antiretroviral therapy exceeds the rate of new infections.

Countries across the continent have scaled-up and sustained their responses despite financial hardship. Today, the challenges that confront us are different but no less daunting.

What was once a narrative of despair, stigma and death is now changing into one of hope, the preservation of life, dignity and the overall wellness of all human beings.

These improvements are not only helping us save lives but are also freeing-up resources to develop new insights on the diagnosis and peculiar behaviour of the HIV and the human body's response to it. This progress is also helping us with the emergence of innovations and other avenues for improving the general responsiveness of the global health.

Our success thus far should not lull us into complacency. If anything, the provisioning of treatment is an encouraging step forward, which must spur us on to achieve the universal target of zero new infections, zero discrimination and zero AIDS-related deaths.

One of the key questions we may want to reflect upon is about how we can harness the experience of the last two decades for sustainable, universal and equitable access to health care for all- irrespective of race, gender, class, creed or sexual orientation. As suggested in the recent multi-stakeholder report on Health in the post-2015 UN Development Agenda:

"The notion of good health is evolving, shifting toward creating and maintaining good health and well-being, rather than only preventing and treating disease. Heath systems must adapt to higher expectations and new demographic, environmental, and (other) health challenges."

In other words, we need to adopt a holistic and sustainable health approach geared towards meeting the specific health needs of people at various stages of life and promoting prevention as the best medicine.
In this regard, it is important that we reinforce the interrelatedness of health and sustainable development.

Investment in good health should be considered as a development imperative in and of itself because it increases the economic productivity of individuals and, consequently, the rate of economic growth.
The global response to the emergence of the HIV pandemic has therefore not only affirmed the centrality of health in the development agenda but more importantly, exposed the social determinants and disconcerting inequalities that continue to undermine our health improvement efforts.

As such our efforts continue to be geared to addressing the developmental needs of communities, while mitigating the impact of ill-health on the poorest and the most vulnerable.

We can state unequivocally that the response to the HIV epidemic has provided important lessons that will stand us in good stead for the road ahead. Key amongst the principles that should underpin our efforts going forward are the following:

    Global solidarity;
    Unity of purpose;
    Capacity to embrace diversity;
    Accountability; and
    Focus on respect for human rights.

If anything the AIDS response has demonstrated that working together across all sectors of society we can achieve much more.

Over the years African countries have received valuable global financial support that has made it possible to accelerate our AIDS response. Civil society actors have also enabled governments to expand health access to more people, especially in the hinterland of our continent. In this regard it is important for governments to promote these collaborations across government departments, non-governmental organisations (NGOs), organised labour and business so as to leverage our combined HIV prevention efforts.

As we have said before, we have made huge progress across many of the priorities that have been identified in our development agenda. Equally, we have acknowledged that governments need to improve systems of delivery in health care, education, water, sanitation and other social services in a continuum of sustainable development.

In order to achieve our goals we need to improve relationships with our social partners with a view to defining a common vision and an approach that builds on the comparative advantage of each stakeholder. Governments need to determine on the basis of evidence the most effective "best-buy" interventions and all stakeholders need to be pulling in the same direction. This decisiveness and co-ordination are required at both national and regional levels.

We also need better integration and co-ordination across governments, regions and the continent in order to maximise our efficiencies. Accountability, effective governance, strong leadership and co-ordination are essential ingredients for our success in crafting an effective response.

This requires a concerted effort to incorporate the HIV/AIDS response into national development planning and ensuring that development strategies include appropriate actions for aligning AIDS policies and programmes with budgets and medium-term expenditure frameworks.

These financial reporting mechanisms must also include clearly defined targets and outcomes to mainstream HIV/AIDS responses. This will go some distance in addressing the lack of consistency in the synchronisation and implementation of AIDS-related responses that compete with other aspects of national development plans.

The African continent has made sufficient progress in scaling-up access to anti-retroviral therapy. However, consolidating the gains that we have made will not be enough. A comprehensive, integrated and community-centred approach which seeks to address the social and structural factors that increase vulnerability to ill-health is the key to a sustainable response. Such an approach puts health at the centre of the development agenda once again.

Today is a chance to draw on these successes and to energise us for the next phase of our work as we seek to shift up another gear in the acceleration of our response.

Unless we do so, our continent will miss the opportunity to take advantage of the demographic dividend between now and 2030 that presents the opportunity to rapidly accelerate Africa's economic growth.

We have the tools necessary to defeat the AIDS and TB epidemics. The challenge is to find innovative and efficient ways to deploy these tools to improve health outcomes to achieve our common vision of Zero new HIV infections. Whilst tools are a crucial component of our arsenal, it is human interaction that adds depth to our efforts, our ability to embrace others without prejudice, our willingness to walk the extra mile to support the most vulnerable and our common humanity that will endure--- 'let each of us be the change we want to see in the world' as the great Mahatma Gandhi said.

By Kgalema Motlanthe

Deputy President, Republic of South Africa.

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