Inter Press Service - September 23, 2003
Ferial Haffajee

"Caring for someone means taking him or her to the hospital and sometimes spending the whole day with them. Then there's caring at home," she says.

And there is also the caring that goes beyond the physical work. "It's about offering strength and hope. We should not under-estimate the importance of caring with hope," says the young woman who is a picture of pretty health in modern Xhosa outfit though she has been HIV-positive for 14 years.

Now she volunteers her time as a "care-giver" - the term that describes the volunteers (and in some cases paid) workers who are at the frontline of an epidemic that has reached what the United Nations agency, UNAIDS, calls a "new wave" in the pandemic.

"The AIDS wave is now washing over Southern and Eastern Africa, devastating families and communities," says the UNAIDS report called "Accelerating Action against AIDS in Africa" and released on Monday at the start of the 13th international conference on AIDS in Africa (ICASA).

Held every second year, these continental conferences track patterns in the pandemic and bring country delegates together to share experience and knowledge. The good news is that AIDS infection rates in East Africa are flattening out though Southern Africa is still hard-hit. UNAIDS describes the different phases of AIDS as "waves".

"HIV is the first wave of the epidemic, entering silently and virtually unnoticed. The onset of AIDS, the second wave, follows lethally behind, its effects no longer possible to ignore," says the report.

This is the epicentre Mabele works in. In addition to being an artist, she is also an activist for anti-retroviral drug treatment and ascribes her own health to the fact that she is on life-saving drugs.

Access to drug treatment has emerged at this week's meeting as a major lobby as it can prolong the lives of those living with HIV/AIDS. The rationale is not emotional alone, but is also a method of ensuring that the fall-out on African economies and social networks from AIDS is lessened.

By the end of 2002, Mabele was one of only 50,000 people in sub-Saharan Africa on the drugs - about one percent of those who need it. "Humankind should feel ashamed that the tools and knowledge to confront AIDS are denied to the vast majority of people who need it. The international community has the capacity - so the question is, do we lack the morality?" asks Michel Sedibe, the UNAIDS director of country and regional support.

The answer to this question is "apparently not", if increases in funding revealed at the meeting are used as a barometer. Funds by multilateral agencies and national governments to fight HIV/AIDS more than doubled to 950 million U.S. dollars since 2000. It is good news because the funding jump suggests new political will, but it is still a far cry from what is needed - 2 billion U.S. dollars at the end of 2002; and 6 billion U.S. dollars by 2005.

UNAIDS says there are still gaps between funding pledges and disbursement and between policy and implementation by governments. The new wave of HIV/AIDS, says Sedibe, "requires that governments, donors, and others immediately make the leap from funding pledges to intensified disbursement of monies in order for treatment, care and prevention programmes to be implemented and make a real difference on the ground".

In addition to money, another factor is proving a make or break factor to fight HIV/AIDS: political will. It is the key success factor behind declining infection rates in Senegal, Uganda and Botswana, says Sedibe. Both Senegal and Uganda have managed to bring down their rates of HIV infection to below 10 percent of the population, while Botswana's strategy is offering pointers to the 16 African countries with high rates of infection.

Botswana, with the world's highest rate of infection, also has one of the most effective treatment programmes and multi-sectoral response to the pandemic, is a model.

Multilateral strategies are vital because they do not see the pandemic as a medical problem alone, but also pay attention to the social and welfare factors. It also means a response that does not see AIDS as government's problem alone, but mobilises the churches, youth, trade unions and volunteers like Mabele. (END/2003)
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