The document summarizes HIV prevention efforts in the SADC region. It notes that the region remains heavily affected by HIV/AIDS and outlines various regional commitments to address the epidemic. While some progress has been made, including declines in prevalence in some areas, prevention efforts still lag and programs are not implemented at sufficient scale. The document calls for strengthening prevention through priorities like social science research, leadership, evidence-based responses, and partnerships across multiple sectors.

1. HIV Prevention Efforts in the
SADC Region
Vth Sahara Conference, Midrand 2 dec.2009
Dr Alphonse MULUMBA
SADC Secretariat

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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.