Panos Institute - September 17-30, 1999
Buki Ponle

While ordinary Africans grappled to find a solution to the worst health crisis to hit the continent in living memory, their heads of state stayed away in droves.

Even the Zambian head of state, Frederick Chiluba, sent his Vice-President to present his opening remarks. Chiluba's official reason was that he was held back by "unavoidable circumstances."

Worried health workers said whatever the reason, the fact that African leaders failed to turn up en masse indicates they are not willing to make even a symbolic gesture in the continent's fight against the AIDS epidemic.

Yet despite such a poor start, there was some evidence of political movement.

The conference, aptly tagged æLooking into the future: Setting priorities for HIV/AIDS/STDs in Africa', articulated major priorities for the continent in the new millennium. It also presented much-needed scientific and epidemiological updates.

Sub-Saharan Africa is home to 70 per cent of the people who contracted HIV in 1998 and the site of 83 per cent of all AIDS deaths so far.

An estimated 34 million people in the region have contracted the virus, 11 million of whom have died. Hardest hit is Southern Africa, where estimates show that between 20 and 26 per cent of people aged between 15 and 49 years are living with HIV/AIDS.

The virus is becoming a serious threat to human development, depleting the most educated, energetic and productive segment of the continent's population.

"I am as disappointed as any observer, [because of the non-attendance of the African leaders]," said Peter Piot, Executive Director of UNAIDS, the United Nations AIDS umbrella and one of the leading agencies sponsoring the event.

In spite of their absence, African leaders have made some commitment to fighting AIDS. A ministerial statement declared AIDS a disaster which must be fought at every level, the latest in a series of steps that have raised the level of political commitment.

In July, leaders and ministers from 20 African countries and the Organisation of African Unity (OAU) meeting in Algiers pledged their support to the cause. This followed a similar endorsement from African finance and planning ministers at the annual meeting of the United Nations Economic Commission for Africa (UNECA) in Addis Ababa in May.

The most recent measure is the announcement of the recently-launched æInternational Partnership Against AIDS in Africa.' The new head of the initiative, Dr Meskerem Grunitzky-Bekele of UNAIDS, says "many African countries are no longer under the illusion that the epidemic does not exist, or that they are immune to the disease. They are now breaking the silence surrounding AIDS and speaking up."

"It is the vision of those in the Partnership that within five years, African nations will be implementing large-scale, sustained and effective national responses to HIV and AIDS that are successful in bringing down infections substantially, especially among young people, and providing care for the infected," Grunitzky-Bekele adds.

The Partnership aims to mobilise not just governments, but also communities, non-governmental organisations, the commercial sector and individuals to counteract the negative effects of the epidemic on the continent.

Nkandu Luo, Zambian minister of health and chair of the conference, believes that the fight requires a holistic approach to squeeze out the epidemic. "A reason why HIV has escalated is lack of unity and spirit of Pan-Africanism. I get appalled when people say that it cannot work in Africa. Let us ask ourselves what we can do individually to rid our continent of this disease for no one knows whose turn is next."

Luo adds: "I hope this is not a donor-driven initiative, as I hope this was conceptualised by Africans. It should be implemented within a new culture of commitment and to live to the promises which were made at the onset."

Prof. Olikoye Ransome-Kuti, a former Nigerian health minister, believes issues such as political will and commitment, stigmatisation, youth and adolescents, religion, counselling, care and corruption in Africa must be addressed in "practical terms" if the partnership is to make an impact.

"Our work in the fight against AIDS needs leadership that is in the frontline and stays in the frontline of the war against disease, poverty, ignorance and hunger," he says, adding that African countries are notorious for wasteful spending and corruption.

UNAIDS chief Piot says AIDS prevention strategies must now include encouraging visible and sustained political support, nationally negotiated joint plans of action and increasing financial resources.

The last point is critical. Piot admits that current allocation to combat the epidemic in sub-Saharan Africa is grossly inadequate. In 1997, only US$165 million was spent on HIV/AIDS prevention and care in the region, of which African economies contributed US$15 million. For the Partnership to be successful, Piot says, Africans must demonstrate practical commitment in mobilising resources.

World Bank Vice President Callisto Madavao says corruption constitutes a major stumbling block to the campaign against AIDS. The Bank is supporting the Partnership through loans designed to increase advocacy as well as resources and technical support. The aims to make African countries are less reliant on outsiders in designing and managing prevention, care and treatment.

Binwell Kilala of the Network of Zambian People living with AIDS, appeals for support from the Partnership for people living with the virus. "We have nothing to offer except to call on the society to show compassion. We need integration as long as we live, not rejection. We need care and loans to start trading, we want drugs at affordable and accessible costs."

Zambian minister Luo's apprehension may be not confirmed. World Bank HIV/AIDS specialist Debrework Zewdie claims that the Partnership is not donor-driven. "The governments and the people of Africa will be at the driver's seat," she says.

Despite Zewdie's comments, so far only donors who have long been visible in the global partnership are pledging commitments to the Partnership. It remains to be seen if African governments will indeed take the driver's seat and set the initiative in motion.
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