InterPress News Service (IPS); November 21, 1997
Gumisai Mutume

An International Planned Parenthood Federation (IPPF) conference, which ended here Friday, noted that Family Planning Associations have years of experience dealing with the most personal aspects of people's live -- sexual and reproductive health.

They are therefore well-placed to help prevent the spread of sexually transmitted diseases and HIV/AIDS, the meeting said.

The meeting resolved to "create awareness of the magnitude of the problem among policy makers, community leaders, the private sector and the media, (and) to urge the donor agencies to support Family Planning Associations and other NGOs to integrate STDs/HIV/AIDS prevention and care in their sexual and reproductive health programmes."

World-wide an estimated 6.4 million people have died of AIDS thus far, and an estimated 22.6 million are living with HIV or AIDS. Everyday, one million people are infected with a sexually transmitted disease, including HIV.

"In some countries, the problem is growing at such a pace that it makes us breathless," says Ingaar Brueggemann, the IPPF's secretary general.

IPPF is the world's largest voluntary organisation in the area of family planning and reproductive health. It has member Family Planning Associations in 150 countries, catering for 350 million couples who would otherwise have no access to information, and services, on modern methods of family planning.

Brueggemann says these associations have a clear advantage in the war against the virus, as they are often the only places where women can receive some form of health care. They also have experience working with young people.

"When IPPF set up its AIDS prevention unit in 1987, many Family Planning Associations were hesitant to become involved due to the social stigma attached with AIDS, and a belief that family planning clients were not at risk," says Julie Becker also of IPPF.

"Family planning providers are not always accustomed to facing the realities of people's sexual lives and to addressing such intimate issues as sexual practices and relationships in a frank and direct way," Becker says.

However, through an integrated sexual and reproductive health approach, providers are learning to explore and better understand the context of their client's sexual lives.

In Africa, many Family Planning Associations are now following this new trend of providing comprehensive sexual and reproductive health care in Kenya, Mauritius, South Africa and Tanzania.

In Benin, Burkina Faso, Cameroon, Cote D'Ivoire, Guinea Conakry, Mali, Senegal and Togo, national HIV programmes are working on collaborative projects to assist Family Planning Associations to build their capacity in this new area.

There is a need to outline strategies to increase the capacity of Family Planning Associations to fight STDs and HIV, the conference noted.

According to Brueggemann, the spread of AIDS has been fueled by "governments' reluctance to recognise the problem, to act effectively."

"How many governments subsidise steel industries? Why is it that there is no legal obligation for governments to subsidise areas that make medication and preventive measures affordable to those who cannot afford them?"

One example often cited is zidovudine (also known as AZT), which reduces the rate of HIV transmission from mother to child, but a full course costs about 1000 U.S. dollars. In developing countries where the average annual per capita health expenditure is about 14 dollars, only the very wealthy can afford it.

HIV prevalence is still highest in sub-Saharan Africa with 19 million cases.

"By the year 2010, life expectancy will drop by 25 years in the most affected countries," says Dr Elhadj As Sy, team leader of the Joint U.N. Programme on HIV/AIDS in eastern and southern Africa.

"Women and girls are particularly vulnerable to HIV/AIDS due to their low status and discrimination," says Dr Sy. "Women and children have not been involved in the design of prevention programmes carried out over the last 15 years."

Rates of infection are alarming in the sub-region, as high as 25 percent in Botswana, 19 percent in Namibia and 22 percent in Zimbabwe, according to UNAIDS.

In sub-Saharan Africa, experts predict the virus will wipe out the gains achieved over the last 10 years in infant and child mortality. At least 42 percent of adults living with HIV/AIDS are women.

Of those infected with HIV worldwide, 90 percent live in developing countries with very little access to health care and education.(end/ips/gm/pm97)

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