Inter Press Service - September 14, 1999
Lewis Machipisa

The World Bank and UNAIDS announced the 'Intensifying Actions Against HIV/AIDS in Africa: Responding to a Development Crisis', at the ongoing Eleventh International Conference on AIDS and STDs in Africa (ICASA).

The purpose of the strategy is to raise awareness of the alarming consequences of the HIV/AIDS crisis in Africa, and to define ways Africans and the international community can fight the spread of the disease.

"Action is needed now," said Callisto Madavo, World Bank vice- president of the Africa region at the launch of the partnership.

The International Partnership Against AIDS in Africa also seeks to urgently mobilise governments, civil societies and the private sector worldwide to accelerate action to tackle the Acquired Immune Deficiency Syndrome (AIDS). The Africa Partnership also will focus greater attention on the emergency nature of the epidemic in many African countries.

According to Madavo, the International Development Association (IDA) will commit up to three billion U.S. dollars of resources annually under the partnership. The IDA, one of the Bank's affiliates, provides funds for development projects on concessionary terms to poorer developing member countries.

"The impact that AIDS is already having on sub-Saharan Africa is catastrophic and the scenario will only worsen unless global leaders work together to invest more, much more in prevention efforts, and in programmes to address the multitude of social and economic problems that AIDS has wrought," said Peter Piot, executive director of UNAIDS.

"Investments in health and social development are already eroding. We must act quickly and strategically so that these investments are not wholly obliterated," said Piot.

In some parts of Africa, AIDS has reduced life expectancy to levels of the 1980s. Today, a child born in a high HIV prevalence country can expect to live on average only 43 years.

For countries with high HIV prevalence, like Kenya and Zimbabwe, for example, it is estimated that by 2005, AIDS costs will represent more than half of the Kenyan government's health spending and nearly two-thirds of government health spending in Zimbabwe.

"Effective measures to meet this emergency exist. However, the current allocation of resources to combat the epidemic is grossly inadequate," said Piot.

It has now been clearly established that when resources are adequate and are invested wisely, AIDS can be more effectively addressed in Africa. "Countries must be the driving force behind effective responses, but they need the support of the international community to build and sustain national efforts. A quantum increase in funding for effective prevention and care programmes is required," urged Piot.

According to UNAIDS, of those presently living with HIV/AIDS worldwide, an estimated nine out of 10 children, eight out of 10 women and six out of 10 men are from the Sub-Saharan African region.

"AIDS is not going away. Even by a miracle, we will probably have to live with it for as long as we live," said Piot. "Without a major increase in resources, there is no way this continent and other continents can win this struggle." Although Africa is the hardest hit continent, resources from Africa to deal with the disease are insignificant. For example, out of the 150 million dollars directed towards AIDS programmes in Africa in 1997, only 15 million dollars was from African resources.

The new strategic plan calls on the World Bank, its development partners and African governments to make a new commitment to saving millions of people from the worst effects of HIV/AIDS.

"This commitment will need to be as broad as the epidemic itself and intense enough to make up for a late start," said Madavo.

Although prevention strategies were known early in the course of the epidemic, many interventions have been implemented on a limited scale. Only a few countries have taken sufficient action to curtail the spread of HIV/AIDS. Inaction to date has resulted in millions of new infections. For example, in 1982, there was only one African country, Uganda, with an adult HIV prevalence rate higher than two percent. Today there are 21 countries in Africa with prevalence rates of more than seven percent.

In Malawi, since 1985, the prevalence of HIV in urban antenatal women in the commercial capital of Blantyre, has increased from less than five percent to more than 30 percent, according to the World Bank.

In Francistown, Botswana, reported rates in antenatal women were less than 10 percent as recently as 1991, but rose to 43 percent in 1997, while in Ethiopia, the proportion of adults infected with HIV increased from less than one percent to almost 10 percent between 1987 and 1997.

"Despite the mounting crisis, the situation is far from hopeless," the World Bank notes. Although HIV prevalence rates are high, more than 200 million adults are not yet infected.

Under the partnership's proposed actions, the World Bank and UNAIDS, also will assist African leaders to mobilise civil society and the private sector to intensify action against AIDS within their countries.

Recognising the link between various development strategies, the World Bank says that if AIDS is to be combatted, there must be greater efforts to ensure that girls in Africa are educated.

"An increased level of education provides young girls with earning power to enhance their economic independence, which may keep them from resorting to commercial sex for economic survival, thereby reducing their risk of HIV infection," according to the World Bank. (END/IPS/lm/pm/99)
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