Her Royal Highness Princess Mathilde of Belgium UNAIDS Goodwill Ambassador GWA advocacy

Photo: UNAIDS Executive Director Michel Sidibe, HRH Princess Mathilde of Belgium and mother of triplets at JFK hospital in Monrovia, Liberia. Credit: UNAIDS

UNAIDS Executive Director Michel Sidibé and UNAIDS and UNICEF Goodwill Ambassador HRH Princess Mathilde of Belgium, wrapped up a joint three-day mission to Liberia, which as a post-conflict country is working to expand its HIV services.

“It is a critical moment for Liberia. If we join together we can put the brakes on new HIV infections,” said Mr Sidibé. “But if we miss this opportunity the AIDS epidemic could regain momentum and more lives will be lost.”

During their trip, Mr Sidibé and HRH Princess Mathilde visited several health and educational facilities which are leading the way in the country’s re-energized AIDS response.

One site they visited was the JFK Hospital which is located in the capital city of Monrovia and offers a range of integrated HIV and maternal health services. It provides antenatal care to approximately 50 pregnant women each month, including voluntary HIV testing and counselling and services to prevent mother-to-child transmission (PMTCT) of HIV. On average, about 200 people visit the hospital’s antiretroviral therapy clinic every week for treatment and care.

Challenges of delivering HIV services in rural settings

As well as visiting hospitals in the capital, the group also paid a visit to the Phebe Hospital, a rural health facility located in the central Liberian county of Bong that provides a range of health services to around 329 000 people in four different counties. It is considered a leading provider of HIV services including antiretroviral treatment, voluntary HIV testing and counselling, PMTCT services and treatment for tuberculosis. A total of 67 people living with HIV are receiving services and 35 are on treatment.

However rural health facilities often face particular problems in delivering health services. For example two weeks ago the machine measuring CD4 counts, which helps monitor the progress of the virus, broke down and the hospital is unsure of when it can be fixed.

“We face many challenges. We have problems with follow up and we lose about a fifth of people who test HIV positive,” said Dr Garfee Williams, the Medical Director of Phebe Hospital. “This is due to many reasons—there are of course problems of discrimination – but also a lack of resources. We just don’t have the staff to go out into communities and provide the necessary care.”

Liberia has a generalised AIDS epidemic and latest data shows that there were around 35 000 people living with HIV at the end of 2007 and 2 300 people died of an AIDS-related illness in the same year.  

Liberian President Ellen Johnson Sirleaf, HRH Princess Mathilde of Belgium, and UNAIDS Executive Director Michel Sidibé in Monrovia 18 October, 2010. Credit: UNAIDS

Following a 14-year civil war, Liberia has faced a host of post-conflict challenges that have increased the vulnerability of women and girls to HIV infection, including gender-related violence, poverty, population displacement and limited access to education and health services.

Women and girls represent 58% of the estimated 36 000 people living with HIV in Liberia. HIV prevalence among young women aged 15-24 is about three times higher than that of young men.

Liberian President Ellen Johnson Sirleaf—Africa’s first democratically-elected female head of state—today unveiled a national roadmap for improving the health and well-being of women and girls. Launched in collaboration with HRH Princess Mathilde of Belgium, a Goodwill Ambassador for UNAIDS and UNICEF, Liberia’s new Agenda for accelerating country actions for women, girls, gender equality and HIV aims to:

• Strengthen data collection and analysis to better understand the impact of the HIV epidemic on women and girls in Liberia

• Accelerate access to integrated reproductive and HIV services for women and girls

• Contribute to broader efforts to stop violence against women and girls

Liberia’s national Agenda is based on a global plan developed by UNAIDS and partners to address the gender inequalities and human rights violations that put women and girls at a greater risk of HIV. Speaking at a launch event in Monrovia, President Sirleaf said she was proud that Liberia had been selected as the first country to roll out this national Agenda.

UNAIDS Executive Director Michel Sidibé, who is on an official visit to Liberia with Princess Mathilde and UNICEF, praised Liberian authorities for placing AIDS and sexual and gender-based violence at the heart of the country’s post-war recovery efforts.

“I congratulate President Sirleaf for embracing this Agenda—for recognizing and supporting your most valuable natural resource: women and girls,” said Mr Sidibé. “Women are the solid centre of human life—of families, communities and care.”

Princess Mathilde focused her remarks on the critical importance of education in solving the nation’s ills. “Education is linked to the well-being of children,” she said. “It gives women the possibility to become economically self sufficient. It gives them the opportunity to decide on matters that concern their own lives. It gives them a voice with which to defend their own interests.”

The three-day joint mission to Liberia, which kicked off today, includes meetings with senior government authorities, associations of people living with HIV, and health and medical providers.

At the Centre de Santé Roi Baudouin, Dr Piot and Princess Mathilde met with staff who shared an overview of the health centre’s services. Dakar, 6 December 2008.
Credit: UNAIDS/Jacky D. Ly

While in Senegal attending ICASA 2008, UNAIDS Executive Director Dr Peter Piot and UNAIDS and UNICEF Special Representative HRH Princess Mathilde of Belgium spent 6 December learning firsthand the successes and challenges faced in Dakar in providing HIV prevention and treatment services, in particular for women, children and young people.

In partnership with UNICEF, the Government of Belgium, and UNAIDS’ regional office for West and Central Africa and its Senegal office, UNAIDS and UNICEF jointly visited health centres supported by UNICEF where they met with health officials, medical practitioners, community mobilizers, and people living with HIV.

Centre de Santé Roi Baudouin

Located in Guédiawaye, on the outskirts of Dakar, this district centre is a main provider of gynaecology, obstetric, and paediatric services, and receives support on maternal and child health from UNICEF.
Credit: UNAIDS/Jacky D. Ly

At the Centre de Santé Roi Baudouin, Dr Piot and Princess Mathilde met with staff who shared an overview of the health centre’s services and chatted with patients and their families. Located in Guédiawaye, on the outskirts of Dakar, this district centre is a main provider of gynaecology, obstetric, and paediatric services, and receives support on maternal and child health from UNICEF. It also provides antiretroviral treatment for more than 300 people living with HIV. Voluntary counselling and testing services are offered as well as services for the prevention of mother-to-child transmission of HIV. With tuberculosis a leading cause of death for people living with HIV in sub-Saharan Africa, the Roi Baudouin centre provides treatment to address TB/HIV co-infection.

Centre Conseil pour Adolescents – an open environment

The second visit of Dr Piot and Princess Mathilde was to the nearby Centre Conseil pour Adolescents (CCA). The CCA serves as an important access point to reach out to young people with a range of HIV prevention, care and support services. The centre has a working relationship with the health centre ensuring that young people who are in need of treatment have access to it.

The CCA provides treatment for other sexually transmitted infections. As a drop-in youth centre with a strong recreational component, the CCA is an open environment where young people feel comfortable getting information about sex and reproductive health without fearing stigma or judgement. The CCA in Guédiawaye was the first of its kind in Senegal and there are now 13 others like it throughout the country.

Self-sufficiency

Dr Piot and Princess Mathilde ended their joint UNAIDS and UNICEF visit at the Centre Régional du Recherche de Formation within the Centre Hospitalier Universitaire de Fann – a research and training institution that has a long tradition in the country. Since 2007, the centre has provided HIV treatment to more than 3,500 people in need.

Self-sufficiency is a distinguishing feature of the centre. It has a vegetable garden where fresh food is grown to help boost patients’ nutritional needs. Through its national, regional and international networks, the centre shares and receives information regarding HIV and other sexually transmitted infections. Dr Piot and Princess Mathilde were briefed on an upcoming virtual health library project hopes to expand on-line to reach more people.

UNAIDS and UNICEF Special Representative HRH Princess Mathilde of Belgium. Credit: UNAIDS/Mamadou Gomis

Participants in a series of ICASA sessions on youth leadership and Africa’s AIDS response were in clear and unanimous agreement: young people are vital to preventing new HIV infections and moving towards the goal of an AIDS-free generation.

UNAIDS and UNICEF Special Representative HRH Princess Mathilde of Belgium was one of those who reconfirmed her commitment to youth and HIV issues. Attending ICASA 2008 this week, today she participated in two sessions on heightening the engagement of young Africans’ in the AIDS response.

Princess Mathilde and UNAIDS Executive Director Dr Peter Piot opened the first session on youth leadership, which was moderated by UNAIDS Special Representative Gaetano Kagwa, a Ugandan national and well-known AIDS advocate. They were joined by representatives of youth non-governmental organizations from Cameroon, Botswana, Senegal, and Zambia.

(from left): HRH Princess Mathilde of Belgium; Dr Pape Salif Sow, Head of the infectious diseases, Fann University teaching hospital, Dakar; Dr Peter Piot UNAIDS Executive Director
Credit: UNAIDS/Mamadou Gomis

Dr Piot introduced Princess Mathilde and commended her for her engagement and activism with AIDS and young people.
During her opening remarks, Princess Mathilde shared three points that can be instrumental in an improved response to AIDS in Africa: young people need to be more engaged and included in HIV programmes; leaders must provide youth with platforms to be heard; and young people themselves have to step forward and serve as examples in their communities and to share knowledge about HIV prevention. Princess Mathilde concluded by calling on girls and young women to be active participants in the AIDS response.

At an afternoon session, “Intergenerational dialogue: Where are the young leaders in the African response to AIDS?” Dr Piot and Princess Mathilde were joined by other leaders and representatives from several African youth organizations.
With a strong presence of young people in the audience, the panellists expressed their optimism for Africa’s next generation but outlined the challenges that lie ahead in terms of confronting the impact of AIDS on young people – one of the groups most affected by HIV.

Throughout the day’s sessions, participants stressed the need to better address HIV and young people given that young people remain at the centre of the AIDS epidemic in terms of increasing rates of infection, vulnerability, impact, and – most importantly – potential for change.

Globally, an estimated 5.5 million of the 33 million living with HIV are young people aged 15-24 years and about 45% of new HIV infections in 2007 were among 15 to 24 year olds.

When young Tanzanian Vumilia Omar told her husband she had tested HIV positive, his reaction was one of anger and fury. “He didn’t want to look at me or our children,” she said, telling how her husband then left the family home taking all their possessions with him and leaving Vumilia and her children with nothing and nowhere to go.

Over time, Vumilia has slowly rebuilt her life – seeking advice from counselors and choosing to stand up against the stigma and discrimination she has often faced because of her HIV status. She now runs a successful tomato-selling business in the markets of Dar-es-Salaam and discusses her experiences as a young mother living with HIV in her own column in a popular magazine.

“I use more and more of my time to educate people on HIV and give advice to young people about living positively and how to live with hope,” she said.

Vumilia’s story is one of a collection of 26 similar testimonials of Tanzanians ‘living positively’ with HIV that feature in the book ‘Yaliyopita Si Ndwele’ (Life goes on), which was launched today in Dar-es-Salaam.

The book – produced jointly by UNAIDS and non-governmental organization FEMINA-HIP, with funding from Development Cooperation Ireland – was launched by UNAIDS Executive Director Dr Peter Piot at a special ceremony held as part of the high-level joint mission to the country of HRH Princess Mathilde of Belguim and the Executive Directors of UNAIDS and UNICEF.

The joint mission is visiting Tanzania from 14-17 February to gain a deeper understanding of the challenges AIDS poses for children and young people and the country’s AIDS response to date.

At the book launch ceremony, one of the collection’s authors, 13-year old Irene Kabaka, gave a statement to the delegation before handing a special copy of the book to HRH Princess Mathilde.

“Although there are only 26 stories, I am sure many people will relate to them,” she said.

In the foreword of the book, the head of the Tanzania Commission for AIDS (TACAIDS), Major General Lupogo said, “I’m impressed with the bravery of all who have broken the silence, by sharing their stories. They give strength and understanding to other citizens who will now understand their situation with empathy and humility,” he added.

‘Yaliyopita Si Ndwele’ (Life goes on) is available in Swahili. For more information, please contact FEMINA-HIP at femina-hip@raha.com

Read Vumilia’s full story from the collection, in English  

Read the foreword of the collection by Major General Lupogo, Head of TACAIDS 

Read Irene Kabaka’s statement at the book launch ceremony