Feature story

UNAIDS Executive Director’s first official visit to Rwanda

28 August 2009

First Lady of Rwanda, H.E. Jeanette Kagame with UNAIDS Executive Director, Michel Sidibé. Rwanda, 28 August 2009. Credit: UNAIDS/L.Rusanganwa

UNAIDS Executive Director Michel Sidibé is paying his first official visit to Rwanda from 27 August to 3 September to recognize and support the achievements of the Government of Rwanda in the HIV response and conduct high-level advocacy for universal access to HIV services and the Millennium Development Goals.

Mr Sidibé will meet with the President of Rwanda, H.E. Paul Kagame, and the First Lady of Rwanda, H.E. Jeanette Kagame, to discuss the current global and regional opportunities and challenges in tackling HIV and how they will influence the long-term AIDS response in Rwanda and across Africa. Meetings are also scheduled with representatives from the private sector, civil society, including people living with HIV, and high-level representatives from the government and UN agencies. The meetings will provide an opportunity to address the United Nations’ support in Rwanda’s HIV response.

Mr Sidibé will visit several projects, including Rwamagana Hospital which offers prevention of mother-to-child HIV transmission (PMTCT) services and integrated health services. It is estimated that around 56% of HIV-positive pregnant women received antiretroviral therapy (ART) in Rwanda. By the end of the year, it is expected that the coverage will reach 70%. The target coverage for 2012 is 90%.

A visit is also planned to Biryogo’s health center where the UNAIDS Executive Director will witness first-hand the delivery of integrated HIV and TB services as well as nutritional support in health settings. He will also stopover at an association of former sex workers in Muhanga District, considered a model of community best practices in HIV prevention and AIDS impact mitigation.

UNAIDS Executive Director will provide the opening remarks at the fifty-ninth session of the WHO Regional Committee for Africa. Mr Sidibé will emphasize the need to transform Africa’s pharmaceutical sector by creating an African Medicines Agency in order to face emerging health threats as well as putting Africans in control of their development.

Progress towards Universal Access

With an HIV prevalence estimated to at around 2.8%, there are an estimated 150.000 people living with HIV in Rwanda, including around 19,000 children according to the 2008 UNAIDS Report on the global AIDS epidemic. Despite these figures, Rwanda appears to be on track to meet its current universal access targets.

Review of national reports in 2008 demonstrated that universal access has catalyzed an accelerated and strengthened national HIV response with more results-based planning and a general overall increase in access to HIV services. National political leadership and coordination were found to be critical in the scale up.

However more emphasis was needed on accelerating progress on HIV prevention efforts, and to better utilise the resources available within civil society and people living with HIV.

The increase of antiretroviral therapy (free and integrated into health services) is a major success for the country. ARV coverage was 63% at the end of 2008 and the target coverage for 2012 is expected to reach 91% of the people in need. Furthermore, there has been a significant increase in percentage of facilities offering ARV services from 7% in 2004 to 45% in 2008.

Rwanda has adopted an expanded the ABC (abstinence, be faithful, use a condom) approach to include education; so that it is known as EABC and numerous partners are involved in awareness work (about 500 000 people were reached by prevention messages in 2006). However, little data are available to convey a clear sense of the scope of HIV prevention programmes with regard to most-at-risk populations.

Therefore, an evidence-based prevention strategy has yet to be developed and fully implemented with focus on developing appropriate tailored interventions for the most-at-risk populations (prisoners, sex workers and men who have sex with men).

Joint UN Plan on HIV

In January 2007, Rwanda became one of the eight pilot countries for the One UN Reform initiative. UN agencies in Rwanda are now working towards ‘One Programme’, ‘One Leader’, ‘One Office’ and ‘One Budgetary Framework’. In order to ensure that its contributions support and reinforce the priorities of the national response to HIV in Rwanda, the UN system has developed a Joint UN Plan on HIV for the period 2008-2012.

The Joint Plan comprises three main focus areas for HIV: the “Three Ones” principles (lead agencies UNDP/UNAIDS); increased awareness and intensified prevention (lead agencies UNICEF/UNFPA); and scaling-up treatment, care and support (lead agency WHO). To ensure accountability, each of the lead agencies is responsible for their own achievements.

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