Your daily Selection of IRIN Africa PlusNews reports, 3/8/2005

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CONTENT:

1 - AFRICA: Interview with Piot, UNAIDS Executive Director

1 - AFRICA: Interview with Piot, UNAIDS Executive Director

ADDIS ABABA, 8 March (PLUSNEWS) - AIDS threatens the lives of 80 million

Africans by 2025, according to three scenarios spelt out in a new report

by UNAIDS. A further 90 million could be infected by that time. In an

interview in the Ethiopian capital, Addis Ababa, UNAIDS chief, Piot,

however told PlusNews that the future of the epidemic would be determined

by our actions today. Below are excerpts:

<b>QUESTION:</b> How did you come up with these three scenarios?

<b>ANSWER:</b> The three scenarios are the outcome of the committed work

of over 100 eminent Africans from all works of life. Some you wouldn’t

think they could bring something to the table but when it comes to AIDS I

still have to discover one discipline, one type of sector that does not

have something to bring.

<b>Q:</b> What can the scenarios tell us?

<b>A:</b> These scenarios have great potential to improve both our shared

understanding and our collective response to the AIDS epidemic in Africa.

They give us three diverse but equally plausible visions of the likely

future of the AIDS epidemic in Africa.

Each of them is sobering but on the other hand I think they are an

enormous source of hope for me. By providing this unusual ability to look

into the future they allow us to understand which cause of action will

lead to the best result. As we sometimes forget the future is defined by

what we do today.

<b>Q:</b> What key insights do these three scenarios offer?

<b>A:</b> The scenarios confirm that with the AIDS epidemic Africa is

facing an unprecedented and exceptional crisis, and a challenge that we

have never seen before, I would say, since slavery. It is so exceptional

in its scale, complexity and the consequences across generations; it

really is a mortgage on Africa’s future.

The future of much of Africa is literally dependent on how it responds to

the epidemic today. The crisis is so unprecedented in severity, longevity

and its impact that as societies and individuals we really don’t know

exactly how to respond. There is no pattern, there is nothing we can

follow. But I think we are getting on the right track now.

<b>Q:</b> Do the scenarios offer hope?

<b>A:</b> The scenarios confirm that in the clearest terms possible that

this is anything but a hopeless or inevitable situation. Through

determined efforts today, particularly by building on the collective

strengths of African nations, the trajectory of the AIDS epidemic in

Africa can be profoundly changed for the better, saving millions of lives.

This I would say is the core message of these scenarios.

<b>Q:</b> And what of the response?

<b>A:</b> The scenarios show that our efforts must be compatible,

short-term pragmatic solutions and a long-term strategic response. Up to

now we have mainly been reacting and running after the crisis and behind

the virus. We now have to enter into a phase of being proactive and being

strategic. Of course the core element of the short-term response now is

keeping people alive, all those who have been infected, that is to save

not only them and their families but whole economies, making sure there is

more investment in prevention, but in the long term making sure the young

generation remain HIV-free.

These scenarios focus on addressing the epidemic’s root social, economic

and politician causes. Gender inequality is one that comes out very

strongly throughout these scenarios, poverty and income inequality and

Africa’s marginalisation in the world. These scenarios show clearly that

we can only truly bring AIDS under control as part of a wider effort to

end Africa’s under-development.

<b>Q:</b> Which scenario do you think is most likely?

<b>A:</b> It is unpredictable. As we can see the responses are different

from country to country. It will be mostly a patchwork of different

scenarios across Africa. These are scenarios we want to use for policy

information in countries.

<b>Q:</b> Is progress being made?

<b>A:</b> As compared to a couple of years ago a lot of progress has been

made and things are accelerating in what we are doing and also making sure

that AIDS is part and parcel of our core development strategies. But if

the response to AIDS continues to be fragmented and as it is today, it is

going to cause not only tens of millions, but will also really jeopardise

African development in a big way. So the tough choices that need to be

made are not tough choices 20 years from now but tough choices today

because the longer we wait the tougher the choices will be.

<b>Q:</b> Is too much emphasis being placed on abstinence and being

faithful following recent research from Uganda showing a drop in

prevalence due to greater condom use?

<b>A:</b> The recent study from Uganda suggests the success in bringing

down new infections, which is absolutely real, said it is from people

dying and only using condoms. This is from one study. All other studies

from across Uganda show it is a combination of factors. One of the strong

messages out of the scenarios project is that there is not a magic bullet;

it is not one action that is going to fix this epidemic, whether that is

abstinence or whether that is condoms, you really need the combination.

In the specific case of Uganda, what had happened is that young people

have postponed the first age of sexual intercourse, there are fewer

partners and there is a massive increase in condom use. And I think indeed

that sometimes the role of condom use is underplayed. I don’t know of a

single society that has been successful in bring down the number of new

infections without massive condom promotion. But that in itself is not

enough. Saying that it would only be abstinence and being faithful is

really being fairly naïve about the realities of life.

<b>Q:</b> Does that mean, as a policy, abstinence, being faithful and

using condoms (ABC) is now outdated?

<b>A:</b> I think you need to fully role out this so-called ABC but for

many women it is irrelevant, many women are infected by their sole sex

partner and that is their husband, so marriage was not made for abstinence

to say the least if fidelity has to come from the other side and imposing

a condom on your husband is, for any country in the world, a problem. So

we have to make sure that we incorporate in our AIDS work a change in

social norms.

[ENDS]

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