Fw: Press Statement by , May 2, 2003

[Guest guest]

Subject: Press Statement by , May 2, 2003

Please find attached, and below, a press statement by , UN

Special Envoy for HIV/AIDS in Africa. Mr. will be delivering the

statement at today's noon press briefing at the UN.

Please feel free to circulate and distribute to your networks.

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NOTES FOR A PRESS BRIEFING AT THE UNITED NATIONS, Friday, MAY 2, 2003,

12:30 PM: STEPHEN LEWIS, UN ENVOY, HIV/AIDS IN AFRICA.

Just last weekend, I returned from a trip to Kenya, during which I met, at

length, with the new President, and Ministers of Health, Education and

Information. I also met with the leadership of the National AIDS Control

Council, the UN country team, various representatives of civil society and

People Living with HIV/AIDS, and made a trip to Kabera, the huge,

sprawling, abject slum in Nairobi, to meet with over a hundred commercial

sex workers, all of whom are involved in a program of HIV prevention.

While everyone I met and everything I encountered was fascinating, its the

political leadership I'd like to focus on for the purposes of this press

briefing.

All too often, when I report back to the media after a visit to Africa, I'm

consumed by gloom and apocalyptic utterance. But not this time. This time I

came away with a greater degree of hope and optimism than I've felt for

months. It's hard to describe the sense of change from the previous

administration: suffice to say, where HIV/AIDS is concerned, the change is

night and day. Where before,e senior officials’ attention to AIDS was

perfunctory, on this occasion every conversation, without

exception, demonstrated a new leadership that is intense, committed to

confronting the pandemic, determined to put policies and programmes in

place, and consumed by the recognition that every single family in Kenya is

affected in some way by the ravages of HIV/AIDS.

I guess it's a trifle presumptuous to make personal comment on a

conversation with President Kibaki, but I'm going to do so nonetheless. The

President has appointed an HIV/AIDS Cabinet Committee of nine members,

which he personally chairs. He's providing very open and public leadership

on the issues of AIDS, and demands the same of his cabinet colleagues. What

was particularly impressive --- and unusual --- in the meeting with the

President (there were ten senior members of the bureaucracy present) was

his refusal to accept, at face value, any reassurances that his

administration has the pandemic well in hand. President Kibaki frequently

challenged what others said, asserting --- almost by instinct ---that the

crisis is far from under control, and insisting that the fight against the

pandemic must be intensified.

It was one of the most refreshing meetings I've attended with a Head of

State. We covered prevention, particularly in the schools; anti-retroviral

drugs, financial resources, orphaned children, stigma, the role of

religious communities, the role of parliamentarians in their

constituencies, the effects on women and girls, the lifting of school fees

and the question of prevalence rates. The discussion lasted well over an

hour.

It was followed by a meeting with the Minister of Education. This is the

arena where the full force of the new Government has been felt. As most

people doubtless know, the key promise of the election campaign was the

abolition of fees for primary school. No sooner was the present Government

elected, than the promise was fulfilled. And an extraordinary thing

happened: when school reconvened in January, 1.2 million new children

poured into the educational system within one week --- an increase of over

20 per cent! --- and the numbers are still rising, expected to reach one

and a half million by June.

The implications are stunning. One million two hundred thousand children

who had not been in school turned up for school. Kenya has an estimated one

million two hundred thousand children orphaned by AIDS. Are they identical

cohorts? Of course not. Is there a significant overlap? Everyone agrees

that the overlap is large. What, then, is the situation on the rest of the

continent for millions of other children orphaned by AIDS, particularly in

the high prevalence countries? How is it possible that a campaign to

eliminate school fees has not been launched across Africa? Where is the

leadership to come from? Why should such vast numbers of children, who have

lost one or both parents to AIDS, who have little if anything to eat, who

have no guarantee of shelter, no guarantee of health or nutritional care,

no guarantee of a home or of love or of nurture … why on top of it all,

should they be denied the right to go to school and the prospect of a

future simply because they're impoverished? Theresa something truly

dreadful about all of this.

If the experience of Kenya proves anything, it proves that those who have

argued for the abolition of fees, as a way of liberating the lives of

millions of children, were right. What is so distinctive about Kenya is the

new Government's determination to see the lifting of fees as applicable to

everything, including books, uniforms, or any extraneous levy. In the view

of the Minister of Education, the policy is driven by the guarantees

contained in the Convention on the Rights of the Child and the

internationally agreed principles of " Education for All " .

In one instance, in an urban slum community many miles from Nairobi, the

population of the primary school, after the fee announcement, jumped from

one thousand to five thousand students. But when the Headmistress insisted

that every child must come to school in a uniform, the numbers dropped to

2,600 --- a major revelation in itself. The Ministry of Education asserted

that absolutely nothing, including uniforms, was to stand in the way of

school attendance, and the numbers are moving back up.

I don't want to pretend for a moment that there isn't a very tough, hard

slog ahead. The new government and the voters understood that abolishing

school fees would be costly in financial terms, but the free education

campaign slogan said it all: " If you think education is expensive, try

ignorance. " The Ministry is scrambling to put together the dollars to

finance the policy (a government task force announced in March that it

would cost $97.1 million through June, and another $137.1 million through

the 2003-2004 school year) " a major portion of it from the Kenyan national

treasury, part of it from the World Bank, part of it from bilateral donors.

And there are still areas of the country, particularly the nomadic

North-East, where school attendance remains unacceptably low. Moreover, the

urgent need physically to expand the school system, and to replenish the

teaching profession, shredded by AIDS, is obviously overwhelming. But the

Government is single-minded in its determination to guarantee the rights of

every Kenyan child to education, and to prove, in the process, that the

goal can be accomplished without sacrificing quality.

For the orphaned children of Kenya, the policy is a salvation. Why, then,

is it not in place across the continent? The time has more than come to

champion this cause with every Government, and to champion it with

unrelenting tenacity. No one should forget that all of the governments in

question have ratified the Convention on the Rights of the Child, article

28 of which reads, in part: " Make primary education compulsory and

available free to all " .

Let me now move to the Minister of Health. Again the conversation was

illustrative of a Government determined to break the grip of the pandemic

on Kenyan society. This Minister speaks with passionate clarity, knowledge

and resolve about the need to proceed simultaneously on care, prevention

and treatment. More, in a fashion with few parallels, this is a Minister

who understands the appalling toll being taken on the women of her country,

and the need to address their extreme vulnerability.

The Government of Kenya has just received money from the Global Fund. The

$56 million allocated to the next two years will help to provide

anti-retroviral treatment for another three thousand Kenyans. There are

roughly seven thousand in treatment now, mostly in the private sector, so

that will bring the total to ten thousand. Already the new Government has

set a target of 40,000 in treatment by the year 2005.

How will they achieve it? In four ways. First, the Government is examining

legislation to introduce a National Health Insurance Plan. It is the

intention of the Ministry of Health that treatment for opportunistic

infections, and for full-blown AIDS, be covered, at least in part, by the

Plan. In my respectful view, that's an astonishingly enlightened and

courageous position, worthy of international support. Second, the

Government hopes to persuade the private sector to further expand its

coverage. Third, the Government has set aside, in this fiscal year, with

increased recurrent funding in mind, the sum of $4 million for laboratory

infrastructure to address HIV/AIDS, and it is hoped that, inevitably, some

of the money will be directed to treatment. Fourth, the Government is even

now preparing its next proposal for the Global Fund, which will include

financing for the treatment of another ten thousand people. In that regard,

it should be added that the Government will wish to purchase generic drugs,

from the WHO list of approved anti-retrovirals, probably from India, in

order to keep the prices down. This, then, emphasizes yet again the

desperate urgency of adequate resources for the Global Fund.

While all of these intentions are truly exciting, and a dramatic departure

from the previous administration, it must be pointed out that over two

million people are living with the virus in Kenya, and it is estimated that

two hundred thousand would qualify for immediate treatment. As always, the

gap between need and reality is measured in the appalling foreshortening

of hundreds of thousands of lives. With additional resources, Kenya could

treat thousands more. With additional resources and a transfer of

technology, Kenya could establish an indigenous capacity to manufacture

anti-retroviral drugs. When will the resources come? When will the needless

carnage end?

Finally, a word about the Minister of Information. He’s about to take a

very unusual step. Using the authority granted to him under the

Broadcasting legislation, he will direct that a certain limited percentage

of air time, on all radio and television stations, be devoted to

programming on AIDS prevention. It’s a move that will undoubtedly attract

criticism, but just as in the case of his colleagues, the Minister is

unshakeable.

It’s hard to convey the startlingly changed atmosphere in the political

precincts of Nairobi and by extension, in the population overall. If ever

there was a time to turn the pandemic around in Kenya, that time is now.

There is no reason in the world, given the commitment of the new Government

to tackle HIV/AIDS, why Kenya cannot become the next Uganda. But they’ll

need lots of help: they must get it.