03 Mulumba A Sadc Hiv Prevention Vth Sahara


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03 Mulumba A Sadc Hiv Prevention Vth Sahara

  1. 1. HIV Prevention Efforts in the SADC Region Vth Sahara Conference, Midrand 2 dec.2009 Dr Alphonse MULUMBA SADC Secretariat
  2. 2. BACKGROUND HIV and AIDS = a great challenge for the regional integration The region remains the most heavily affected by the epidemic 9 countries with the highest HIV prevalence worldwide (prevalence >10%) transmission mainly heterosexual, women more infected than men diversity of epidemics between and within MS over a third of new infections and AIDS deaths per year Unless new infections of HIV are reduced significantly, the rising costs of treatment and care will be overwhelming and unachievable long term, posing a serious threat to the potential for MS to realise the human, social and economic development goals of the region.
  3. 3. REGIONAL COMMITMENTS Millennium Development Goals (MDGs), 2000 Abuja Declaration on HIV and AIDS, Malaria and other Communicable Diseases, 2001 Declaration of Commitment of UNGASS, 2001 The Maseru Declaration on HIV and AIDS, 2003, by SADC Heads of State Brazzaville Declaration on UA to HIV prevention, treatment, care and support (2006) SADC HIV and AIDS FUND . Now? Translation of these commitments into truly effective, efficient programmes brought to scale across the region
  4. 4. KEY DRIVERS OF HIV in the SADC REGION Inequalities of wealth y i lit ob Male attitudes and behavior m Ge ti on nd la x er se pu a l an d po ion sex igh at ua H ner MCP by men and l vi ge ole r n In te women with low ce Stigma, lack of consistent condom openness, unttt tt STI use, in the context of low MC Lack of consistent condom use in long term concurent Gen partnership der ine qua lit y tors ural fac Cult EXPERT THINK TANK PREVENTION MEETING, MASERU, 2006
  5. 5. HIV Prevention Efforts in the SADC Region Some positive changes in epidemic dynamics identified - growing evidence of a decline in adult HIV prevalence - prevalence declines in young women attending antenatal clinics - associated with significant changes in sexual behaviour A confirmation that investments made in social and behavioural change interventions can work for HIV prevention, but they must be scaled up with rigour and in combination with other actions that reduce HIV risk and vulnerability
  6. 6. HIV Prevention Efforts in the SADC Region Mobilising efforts and scaling up the HIV prevention response - Expert Think Tank Meeting on HIV Prevention , Lesotho 2006 Identification key drivers of the HIV epidemic and Recommendations for the acceleration of prevention efforts to address them
  7. 7. HIV Prevention Efforts in the SADC Region SADC Regional Strategy and Action Plan for Universal Access to Prevention 2008-2010 was developed with the aims of harmonizing country policies and practices and mobilizing for the effective use of resources with the goal of significantly reducing new HIV infections by 2010. SADC Regional HIV Prevention Working Group forum set up to provide broad based technical support and guidance in the implementation of the SADC Regional Strategy and Action Plan for Universal Access to Prevention (2008-2010) .
  8. 8. HIV Prevention Efforts in the SADC Region Regional SADC HIV Prevention Meeting: “Achieving Prevention Targets”, June 2009 to review progress, identify emerging evidence and priorities for HIV prevention in the coming period. MS are implementing a variety of HIV prevention strategies (BCC, HTC, PMTCT, condom, MC) Substantial progress but so far results are still mixed across MS Review and alignment of NSF on regional commitments Decline of HIV prevalence in some MS Increased PMTCT coverage Condom access and use have increased in some MS, ongoing challenge to improve levels and consistency use, and reliable access Progress in implementing activities related to MC
  9. 9. HIV Prevention Efforts in the SADC Region Regional SADC HIV Prevention Meeting: “Achieving Prevention Targets”, June 2009 Despite implementation of all these interventions, prevention is lagging behind The level of most of the prevention indicators in the region still leaves lot to be desired prevention interventions largely focus on primary prevention the programmes are unlikely to achieve the requisite positive impact. programmes are working? , good programmes are not implemented to scale?, lessons are not documented? Experiences of ‘what works’ are not shared across the region?
  10. 10. HIV Prevention Efforts in the SADC Region Regional SADC HIV Prevention Meeting: “Achieving Prevention Targets”, June 2009 Set the targets of “halving new adult HIV infections by 2015 and the virtual elimination of MTCT (thereby virtually eliminating new infant infections) •Rapid analysis of current NSF and plans to ensure a strong evidence-based prevention component •Mobilising effective leadership at all levels of GVNt to take ownership and accountability of the HIV prevention agenda •Revising budget allocations to ensure adequate funding for prevention • Increasing strategic partnerships for full implementation of HIV prevention strategies, in particular with traditional leaders, CSO •Understanding and establishing a stronger connection between HIV prevention and treatment.
  11. 11. HIV Prevention Efforts in the SADC Region HIV and AIDS STRATEGIC FRAMEWORK 2010-2015 Vision : Common future with no threat for HIV and AIDS… Goal: SADC controls and reverses as shown by achievement of MDG by 2015 P.A.2: P.A.3 Improved P.A.4: P.A. 1 : Effective Accelerating PA.5: ME and Access to care, Intensifying Prevention and dvpt and institutional counseling, test, resource social mobilisation mitigating strengthening ttt, care and mobilisation impact support Obj.1: 50% reduction of new infections OP1: Strong proactive , political leadership and champions OP2: Effective evidence based and coordinated response to HIV prevention
  12. 12. HIV Prevention Efforts in the SADC Region Regional SADC HIV Research Agenda, 2008 Role of social sciences researches in HIV prevention is KEY, as cultural norms and beliefs have a potential to fuel HIV transmission and may also support HIV prevention efforts SOCIAL SCIENCES RESEARCHES WILL HELP • in understanding better what motivates people’s behaviours • in knowing how to address these motivations appropriately • in taking in to consideration people’s cultures when developing programs addressing HIV prevention One of the priorities of the SADC Research Agenda : “Promote studies that permit better understanding of the behavioral and the psychosocial determinants of HIV related risk and protection”
  13. 13. CONCLUSION • The nature of the HIV epidemic has changed over several decades, responding to it must be rooted in current evidence and analysis • Although the key drivers are well known, it is important to better understand the distribution of the risk factors within the population • Social Sciences Research to play a Key role • To achieve success in preventing new HIV infections, robust strategic partnerships must be consolidated between government, CSO, CBO and FBO, Traditional Authorities, Regional Bodies, International Development Partners and the Private Sector With all of us working together and supporting each other, yes, we can, and we can turn back the epidemic in this region.