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Aids Conference calls for more access to care

After spending a lot of years on lobbying and advocacy, it has dawned on experts that it is now time to shift attention to the provision of life prolonging drugs if the tide of the HIV/AIDS pandemic is to be stemmed.
Zachary Ochieng

African governments still have a long way to go if the war against the HIV/AIDS pandemic is to be won. This is the picture that emerged from the recently concluded International Conference on Aids and Sexually transmitted infections in Africa (ICASA), held in the Kenyan capital, Nairobi.

According to Kenyan Office of the President Minister Dr Chris Murungaru, whose docket covers Aids, current measures put in place to stem the tide of the pandemic are still inadequate. Said he: A turning point in the war against Aids in Africa must be found and emergency responses put in place because the pandemic is now a development concern.

Murungaru added that death and reduced life expectancy of the most productive segment of society poses threat to development gains made over the years. The loss of the most productive members of society poses serious food security concerns , he observed.

The 13th ICASA conference, opened by Kenya s president Mwai Kibaki on September 21, and whose theme was Access to care: Challenges was held against a background of chilling Aids statistics in the continent. Sub-Saharan Africa is currently the world s most affected region.

The UN says that even if exceptionally effective prevention, treatment and care programmes take hold immediately, the scale of the epidemic means that the human and socio-economic toll will be massive for many generations to come. Sub-Saharan Africa is now home to 24.9 million people living with HIV/AIDS. About 3.5 million new infections occurred last year alone, with 2.4 million deaths. 10 million young people aged 15-24 are infected, while 3 million children under the age of 15 are HIV positive.

In Kenya, one out of four girls aged 15-19 is infected, while 25 per cent of those in that age group are infected. According to the Director of the Kenya National Aids/STDs Control Programme (NASCOP) Dr Kenneth Chebet, Aids cases in Kenya will peak in the next two years, when 70 per cent of the hospital beds will be occupied by Aids patients, surpassing the current 50 per cent occupancy.

Dr Chebet said the trend calls for increased lobbying for care of those infected. For the last fifteen years, we have concentrated on advocacy and prevention but it is now time to lobby for care , he said.

Experts argue that in the absence of massively expanded prevention, treatment and care efforts, death toll on the continent is expected to continue rising before peaking around the end of this decade. They expect the worst of the pandemic s impact to be felt in the course of the next decade and beyond, a situation which could be reversed through wider access to medicines.

The perennial food crises in the Southern African countries of Lesotho, Swaziland and Zimbabwe are linked to the death toll of young productive adults. In Kenya, Aids has devastated educational, military and agricultural sectors. According to the National Aids Control Council (NACC), the economy loses KES 210 million (US$ 2,692,307) daily as a result of Aids deaths.

But all is not lost. There are new signs of hope that the epidemic could be brought down. Besides documented fall in prevalence rates in Uganda among pregnant women, there is now increasing evidence that the national prevalence rate in Rwanda has also gone down.

The decline has also been detected among the inner city women in Addis Ababa, where infection levels among pregnant women aged 15-24 dropped from 24.2 per cent in 1995 to 15.1 per cent in 2001.

However, in West Africa, relatively low prevalence rates in Senegal (under 1 per cent) and Mali (1.7 per cent) are shadowed by more ominous patterns of growth in other countries.

Uganda s prevalence rates have fallen from 18 per cent to 6 per cent owing to a multi-sectoral approach adopted by President Yoweri Museveni. Speaking at the conference, Uganda s minister in charge of the presidency Kirunda Kivenjinja said Museveni s candidness generated a most integrated holistic response that dealt with the complex realities of the scourge . Uganda s success has also been attributed to the elimination of stigma and discrimination.

The conference which aimed at tackling Aids-related issues affecting Africans, including accessibility to treatment and care challenged the Kenya government to establish guidelines on the procurement and distribution of Anti-retrovirals (ARVs) in the public sector, similar to what obtains in Cameroon.

Though the government is already moving towards the provision of ARVs in public hospitals, the lack of a legal framework is likely to hinder the success of the programme , said Sophie Marie, an official from the Medecins Sans Frontieres (MSF). But Charles Mbakeya, a researcher from the Kenya Medical Research Institute (KEMRI) argued that a national anti-retroviral programme is not enough in poverty-stricken and food -starved countries such as Kenya.

Some of the ARVs are too strong to be fed on empty stomachs and the provision of nutritional supplements is a must. The treatment centers to be set up must have a food provision component , he said.

As the conference got underway, a number of delegates accused African leaders of laxity and negligence in the fight against the scourge. They were accused of empty talk and no action.

Members of the Pan-African HIV/AIDS Treatment Access Movement from Kenya, Togo, Nigeria and South Africa accused some European countries of lacking commitment, saying they were willing to channel money to facilitate high profile conferences but would not donate money for the provision of drugs.

The conference was also marred by a number of side-shows, as HIV positive delegates besieged exhibition stands manned by pharmaceutical companies, demanding the lowering of prices of ARVs.

But on a positive note, as the ICASA was going on, the Organisation of African First Ladies Against Aids (OAFLA) satellite conference also took place at Nairobi s Safari park Hotel. Those who attended the conference were Kenya s First Lady Lucy Kibaki, Guinnea s Horriette Konte, Uganda s Janet Museveni, Rwanda s Jeanette Kagame and representatives of First Ladies from several African countries.

The First Ladies called for a unified approach among African countries in the war against the pandemic. No country in Africa will stem the tide of Aids single handedly. There must be collaborative efforts between various countries to help in the fight against the epidemic , said Mrs Museveni.

Kenya s Mrs Kibaki said that despite African governments limited resources, which made it difficult to respond to the HIV/AIDS crisis, a lot could be achieved by working together. The war on HIV/AIDS is a race against time. There is no more time to waste. We have already seen the magnitude of the challenge we are facing , she said.

The first ladies promised to take the challenges head on. As First Ladies, we cannot stand by passively as Aids destroys families and wipes out whole sections of our societies. It is our duty to act without delay , said Rwanda s Mrs Kagame.

At the end of their three-day conference, the First ladies signed a Nairobi declaration in which they resolved to take a leadership role in the fight against the pandemic among African women and children.

Said the declaration in part: We commit ourselves to fully advocate for appropriate support for those infected and affected by HIV, particularly women and girls and to further lobby for governments development and planning process to include gender dimensions .

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