HIV prevalence reduced in Sadc, but Sub-Saharan Africa still tops

Virginia Muwanigwa Gender Protocol
This is the eighth in a series of articles analysing regional progress on gender equality and women’s empowerment. With 2015 finally here, notable progress has been made in reducing HIV and aids prevalence and stemming new infections.

The sadc Gender Protocol Barometer 2014 notes that new infections among adults have decreased by over 50 percent in Botswana, Malawi, Namibia, Zambia and Zimbabwe.

According to the publication, new infections among adults have also decreased by over 25 percent in Mozambique, South Africa and Swaziland.

Botswana, Lesotho, Malawi, Namibia, Mozambique, Swaziland, South Africa, Zambia and Zimbabwe, however, still have adult prevalence rates of over 10 percent. Among these, Swaziland and Botswana still have prevalence rates above 20 percent.

The sadc Gender Protocol, in Article 27 on HIV and aids, states that States’ Parties shall take every step necessary to adopt and implement gender sensitive policies and programmes, and enact legislation that will address prevention, treatment, care and support in accordance with, but not limited to, the Maseru Declaration on HIV and aids.

In 2003, member states signed the declaration to prioritise the fight against HIV and aids in the sadc region.

sadc thus agreed ‘to focus on prevention and social mobilisation campaigns, accelerating development to create an enabling environment for the diseases’ eradication, committing adequate funding for the sadc HIV and aids Strategic Framework and healthcare, and strengthening institutional monitoring and evaluation mechanisms to improve system of information exchange’.

The publication also notes that Sub-Saharan Africa continues to be the most affected area in the world with sadc accounting for 55 percent of all people living with HIV and 38 percent of the total number in the whole world.

sadc also accounts for 50 percent of the children living with HIV in Sub-Saharan Africa and 45 percent of the total global number.

This is corroborated by the Millennium Development Goals (MDG) Report 2014, which reveals that Southern Africa and Central Africa, the two regions with the highest HIV incidence globally, saw sharp declines of 48 percent and 54 percent, respectively. However, there were also an estimated 2,3 million cases of people of all ages newly infected and 1,6 million deaths from aids-related causes. Sub-Saharan Africa was the region where 70 percent, 1,6 million cases, of the estimated number of new infections in 2012 occurred.

The Maseru framework has likely led to expanded provision of anti-retroviral therapy, and in turn, the rapid reduction of aids — related deaths in the region. The numbers of new HIV infections is, however, increasing at a rate that out-paces treatment: for every two people enrolled in HIV treatment, five become newly infected, according to the barometer.

Anti-retroviral therapy is saving lives and must be expanded further. Access to anti-retroviral therapy (ART) for HIV-infected people has been increasing dramatically, with a total of 9,5 million people in developing regions receiving treatment in 2012. ART has saved 6,6 million lives since 1995.

Expanding its coverage can save many more. In addition, knowledge about HIV among youth needs to be improved to stop the spread of the disease. Have halted by 2015 and begun to reverse the spread of HIV and aids.

The sadc Gender Protocol also sought to ensure that the policies and programmes referred to take account of the unequal status of women, the particular vulnerability of the girl child as well as harmful practices and biological factors that result in women constituting the majority of those infected and affected by HIV and aids.

This has led to a scaling up in campaigns and national and regional level that sought to link women’s sexual and reproductive health rights, with violence and with HIV and aids. Women, however, still account for 58 percent of those living with HIV in the Sub-Saharan region.

Women continue to bear the greatest burden of care.

While men have increasingly entered the arena for community-based care, this has not been largely voluntary as in the case with women.

Gender disparities continue to be a major driver of the pandemic.

This is despite that states’ parties committed to, by 2015: develop gender sensitive strategies to prevent new infections; ensure universal access to HIV and aids treatment for infected women, men, girls and boys; and develop and implement policies and programmes to ensure appropriate recognition of the work carried out by care givers, the majority of whom are women, the allocation of resources and the psychological support for care-givers as well as promote the involvement of men in the care and support of people living with HIV and aids.

The African Union Special Summit, Abuja in 2013 called for strong commitment of the “Abuja Actions toward the elimination of HIV and aids, tuberculosis and malaria in Africa by 2030”. The continental leaders cited ‘. . . progress made in the fight against HIV and aids, TB and Malaria since 2000 and in strengthening health systems, which has resulted in lives saved, enhanced productivity and improvement in quality of life on the continent.’

Concern was, however, raised that the tremendous progress made in the fight against HIV and aids, TB and Malaria, had not reversed the fact that Africa still remains one of the most affected regions in the world by the scourge intersecting with threats to national and continental socio-economic development, peace and security; among others.

The resolution at that high level was to consolidate implementation of the Abuja Commitments; implement effective and targeted poverty elimination strategies and social protection programmes that integrate HIV and aids, TB and Malaria for all particularly vulnerable populations; increase access to prevention programmes targeting the youth, especially young women, to ensure an aids-free generation as well as eliminate mother-to-child transmission of HIV while keeping mothers alive.

Key perhaps was the agreement to take responsibility for mobilisation of domestic resources to strengthen the health system while ensuring that strategies are in place for diversified, balanced and sustainable financing for health, in particular aids, TB and Malaria through development of strategic health investment plans and strategies for innovative financing, including from the private sector.

The Sustainable Development Goals (SDGs), expected to succeed the MDGs, state that by 2030 the UN aims to: “end the epidemics of aids, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases”.

UNAIDS has embarked on the Three Zeros campaign which champions the post 2015 agenda to achieve zero new infections, zero stigma and discrimination, as well as zero aids related deaths.

Virginia Muwanigwa is a gender activist and chairperson of the Women’s Coalition of Zimbabwe which is the focal point to the sadc Gender Protocol Alliance. She is also the director of the Humanitarian Information Facilitation Centre.

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