National ownership of the AIDS response essential for universal access in West and Central Africa
07 March 2011
Stakeholders in the AIDS response across West and Central Africa met in Dakar, Senegal from 3–4 March 2011 to review progress made towards achieving universal access to HIV prevention, treatment, care and support. The regional consultation was organized by UNAIDS in collaboration with its Cosponsors, regional civil society networks, government representatives and development partners.
Dr Modou Diagne Fada, Minister of Health and Prevention of Senegal stressed the importance of national ownership, “Leadership and national ownership of the AIDS response will accelerate our action towards achieving universal access and the Millennium Development Goals.”
Participants acknowledged that there has been progress on scaling up towards universal access to HIV prevention, treatment, care and support in the region. Access to antiretroviral treatment has increased from 1% in 2001 to 25% in 2010. There has also been an increase in coverage of prevention of mother-to-child transmission services from 4% in 2005 to 23% in 2010. Most noticeably, the HIV incidence has dropped in ten countries and HIV prevalence has been stable in seven.
The consultation also identified existing implementation gaps in order to achieve the MDGs by 2015. One example discussed was the strong dependence on external financing for HIV and Health programmes. “Advocacy for increased sustainable financing of national AIDS programmes should be evidence based and strongly linked to countries’ development agendas in order to achieve the MDGs,” said Mr Jean Tchoffo, Permanent Secretary for the Ministry of Finance of Cameroon.
Leadership and national ownership of the AIDS response will accelerate our action towards achieving universal access and the Millennium Development Goals.
Dr Modou Diagne Fada, Minister of Health and Prevention of Senegal
Another gap identified was the weak linkages of the HIV response with other health services. The Minister of Health from Burundi, Dr Sabine Ntakirutimana, highlighted the need for an enhanced integration with health services in order to achieve universal access and in particular the virtual elimination of mother-to-child transmission of HIV. “HIV should be used as an entry point to more integrated delivery of health services,” added Dr Ntakirutimana.
Political and social instability in most countries of the region, which aggravates the lack of institutional frameworks related to an effective response to HIV, was also raised by participants as a major obstacle. “In a region where more than 50% of States are either in conflict or post conflict situations it is imperative that the humanitarian response addresses the needs of people living with HIV,” said Dr Meskerem Grunitzky-Bekele, Director of the UNAIDS Regional Support Team for West and Central Africa.
Participants discussed the case of the post-electoral crisis in Ivory Coast and the ensuing instability threatening access to treatment for people living with HIV in the country. With increasing poverty levels and an HIV prevalence rate of 4.7%, the health sector in the Ivory Coast is directly affected by the current economic sanctions. Participants agreed that there is an urgent need to proactively respond to the issue, working with responsible actors to ensure access to HIV treatment is not interrupted.
According to the participants, other gaps hampering progress towards achieving universal access in the region were the inadequate allocation of resources towards the main modes of HIV transmission as well as lack of good governance and mechanisms for accountability. Stigma and discrimination and weak health systems are limiting the supply of services for HIV prevention, treatment and care.
At the end of the meeting, recommendations for enhanced national ownership to achieve universal access in the region were developed and key priorities agreed. These include: strengthening leadership; optimization of domestic and external resources; improving access to treatment; revitalization of HIV prevention; the involvement of young people as agents of change; and the promotion of human rights, gender and social equity in national AIDS plans.
Inputs from a pre-Civil Society Consultation, held on 28 February and a National Ownership Meeting on 1–2 March which also took place in Dakar were also taken into account during the consultation.