Your daily Selection of IRIN Africa PlusNews reports, 11/28/2003

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U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

Integrated Regional Information Network

CONTENT:

1 - ANGOLA: National AIDS plan launched

2 - ETHIOPIA: Interview with UNAIDS head Bunmi Makinwa

1 - ANGOLA: National AIDS plan launched

LUANDA, 28 November (PLUSNEWS) - A national strategic plan to combat

HIV/AIDS was launched in Angola this week. A collaborative effort between

the Angolan government and the United Nations, it will form the basis of

the country's efforts to tackle the epidemic over the next five years.

" I think it's a very good document, since it focuses on three main

strategies – institutional capacity, prevention, and help to people

already living with HIV/AIDS – which are completely in line the strategies

already identified by UNAIDS. It's got a good budget that give clear

indications in terms of financial resources, " UNAIDS representative, Dr

Alberto Stella, told IRIN.

Under the strategy, priority will be given to vulnerable groups such as

the youth - especially young girls - truck drivers, the military, miners,

and orphans.

But Stella said another key group that needed to be reached were the

million of refugees and displaced people returning home after the end of

three decades of civil war.

" In our opinion the country is not ready to integrate these people into

society. They risk being marginalised and put in a situation where they

are at high risk to get infected, " Stella warned.

" We have, historically, a unique opportunity because the AIDS prevalence

is lower than in other countries in the region. It's not a low

prevalence – 5.5 per cent is high – but it's lower than in other

countries. But Angola has all the ingredients to make the epidemic explode

in three or four years, " he added.

" The stories from the other countries show that you only need 10 years to

reach almost 40 percent, like in Botswana. I'm afraid that the response

capacity in Angola still is low. Nothing has been done to create better

conditions, so we are just starting, " Stella explained.

HIV/AIDS prevention programmes have so far concentrated on the urban

areas. The new strategy promises that the rural areas will get more

attention, especially in terms of education. Provincial plans should have

been finished in December, but are likely to be postponed until March.

The government has committed itself to allocating more money in coming

bugdets to HIV/AIDS. President José Edurado dos Santos said at the launch

of the plan: " It is a fight that has to be fought every day. It is the

most important fight in the world. "

Stella said political leadership was needed to maintain the momentum, with

UN agencies playing an important role in working with government

ministries.

" In some cases you have clear evidence of high-level commitment, but these

actions are not followed by concrete implementation of activities, " he

noted. " We can have hope because of the National AIDS Commission and the

involvement of the president, but you have to remember that the commission

was created a year ago and the first meeting was held today. The process

is a little bit slow. "

The performance of the strategic plan will be reviewed in 2005.

[ENDS]

2 - ETHIOPIA: Interview with UNAIDS head Bunmi Makinwa

ADDIS ABABA, 28 November (PLUSNEWS) - Bunmi Makinwa is the newly appointed

head of UNAIDS in Ethiopia. Here ahead of World AIDS Day he tells PlusNews

that total mobilisation is needed to win the fight against the virus that

has infected 2.2 million in Ethiopia.

QUESTION: What is the current situation with regard the global fund?

ANSWER: There are a number of countries especially in Africa who are

receiving support from the global fund. We are beginning to see the

disbursement of those funds at the moment in areas that were poorly funded

before - especially in the area of treatment. Most countries have got

money now to begin to do treatment for HIV/AIDS including specialised use

of anti-retroviral drugs. This is a very welcome addition. But there are

challenges. One is how to quickly put in place the

structures to handle the money. Some of this is very big money and this is

particularly an issue for Ethiopia. We are optimistic we can get this

going.

Q: Is UNAIDS taking the lead role, outside government in combating AIDS?

A: UNAIDS is the lead advocate on HIV/AIDS worldwide – that is the role we

play. Our main effort is in mobilising the UN system, government, and all

sectors to support the fight against HIV/AIDS all over the world. So we

want to help mobilise especially in the area of funding and we are happy

to say that the funding for HIV/AIDS has increased many times over in the

last three to five years. Indeed we are getting to a situation where we

are advocating on how to use those resources available in a timely and

effective manner. So the role of UNAIDS is in advocacy, in mobilising

resources including human resources, it is in providing leadership and the

right direction for governments and civil society to take.

Q: How will UNAIDS judge itself on its success or failure in Ethiopia?

A: The most important benchmark of success is in the declaration of

commitment made by countries at the UN General Assembly Special Session on

HIV/AIDS. No matter what we do, no matter what any external party does, it

is the governments of countries, the leaders who are elected by the

people, who lead them out of whatever problem or crisis they may face,

into a stable life. The Declaration of Commitment gives clear indicators

of what should be achieved and this is how governments are being held

responsible.

Q: Is there a clear vision among all groups, donors, the UN, civil society

on how to combat the spread of HIV/AIDS?

A: Yes but we keep on learning. We have examples of what is working and

where it is working. We need to be sure that we are committed to facing

the problem of this epidemic at every level and with all the assets that

we have. Indeed we are talking about a mass mobilisation. HIV/AIDS cannot

be dealt with by just mobilising one sector of the community. We are

talking about

total mobilisation, total resources. We also have to be aware that we are

in this for the long haul. AIDS is not going to go away in the next few

months or few years.

Q: In Ethiopia the prevalence rate is 6.6 percent. Does that reflect

reality on the ground?

A: With the instruments we have now, the prevalence rate is based on

antenatal service, which is concentrated in a number of cities. Coverage

is low in rural areas and the sites are few. But with the surveillance

study that is coming up early next year those figures should be more

accurate. The official figures are what we have but the figures have

shortcomings.

Q: Based on those shortcomings how can surveillance be improved?

Training is underway to improve data collection, financial support has

been provided and technical support offered. In addition the number of

sites has been increased and this will result in a more accurate picture.

UNAIDS would like to see some behavioural awareness surveillance. There

has been some work on awareness and behavioural change but we would like

to

see more. We look more at the trend rather than the absolute figures. If

you look at Ethiopia in the past three years over what has been happening

you will see there has been significant increase in the numbers of

infections being recorded and that is what has been happening in most

countries. What we need to focus on is this trend and focus on where it

has been increasing. It is more important to look at the trend.

Transmission rates are increasing in many countries but there are pockets

where the rates one stabilising or even decreasing.

Q: Should anti-retroviral drug treatment be free?

A: Ethiopia is a very poor country. It may be beyond the capacity of the

country to have free treatment. The government announced a few weeks ago

that treatment would be available for those who cannot afford

anti-retroviral treatment (ART). At a global level every country has to

examine its own abilities. We don’t have a universal policy.

Q: Is the groundwork and infrastructure there to scale up treatment?

A: The ministry of health has been carrying out a series of training for

health professionals and support staff for the last five or six months so

that this treatment can be possible but more work still needs to be

carried out.

Q: Does the health service have the capacity to implement ART?

A: That is where the strengthening training and capacity building comes

into play and that is what they are doing. The infrastructure is being put

in place. I think the training is being successfully carried out.

Understandably the health infrastructure was not adequate. They are more

equipped now than six months ago. But this is not just a health issue and

it is important not to overemphasis ART as a medical issue.

Q: Now that Ethiopia’s political leaders have taken notice how do you move

forward?

A: There are many ways. We realise a critical area is stigma. This is a

major problem in Ethiopia, in Africa, around the world. We need to

decrease stigma and remove it. That requires commitment at a political

level, civil society and the private sector. We need to focus on how to

use increasing resources. That is a challenge we didn’t have to deal with

two or three years ago.

Education has to change. It is no longer acceptable to have children go to

primary school and not learn about HIV/AIDS. Religious groups can no

longer go to church and not talk about HIV/AIDS. Every aspect of our life

is being touched by HIV/AIDS.

Q: Are you now 100 percent satisfied that political commitment is there?

A: Ethiopia has made a lot of progress comparatively. The commitment is

evident and is being shown. If the question is can it be better, then I

would say definitely yes. There are a lot of areas where we really ought

to move, to do more. I think at the beginning of doing more is where we

are now.

Q: Is the government’s HIV/AIDS Prevention and Control Office (HAPCO)

sufficiently strong at the regional and local level to tackle the crisis?

A: It definitely needs to be strengthened in the region and HAPCO would be

one of the first to admit this. But that is not unique to Ethiopia. One of

the things we have learnt about this epidemic is that we have to be much

more flexible and faster. Things have changed so fast so organisations and

governments have to change to meet new and emerging issues, like the

enormous

mobilisation of resources or the availability of drugs.

So HAPCO has to be more flexible and malleable to meet these changes.

HAPCO’s budget has gone from a few million to over US $100 million in a

year. How does one deal with that? This is where the international

community must support HAPCO. The challenge to HAPCO is to be more

effective, more responsive and have the ability to use the huge resources.

Even by using those resources there is a strong possibility that more will

be available. We are working very closely with HAPCO to see how it can

re-tool itself to be able to deal with this.

Q: Do you feel that the funding to Ethiopia to combat HIV/AIDS is

sufficient?

A: There needs to be more because a great deal more needs to be done. But

that is not to minimise what has come in because it has been significant.

Are those resources sufficient for the scale of the problem? No they are

not. We estimate the whole world needs US $10 billion a year to fight

HIV/AIDS but so far only US $6 billion has been committed to. We are still

short.

[ENDS]

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