USIA Washington File - 01 June 1999
Addressing an international development audience, Shinn said, "Rates of new HIV infection are now declining...in Uganda and Senegal." But he quickly warned that "only a serious political commitment by the highest levels of government will turn the HIV/AIDS tide in any particular country."
Focusing on Ethiopia, Shinn said, "Fortunately, that political commitment has been more evident in Ethiopia in recent months."
He added, however, that "unless we enhance our collective response to reduce HIV/AIDS, the socio-economic gains in the developing world will continue to deteriorate and the future of African development will be threatened.
"The United States," he pledged, "will work hard to support and enhance national HIV/AIDS prevention efforts in Ethiopia and worldwide.
Following is the text of Ambassador Shinn's remarks, as prepared for delivery:
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Remarks by David H. Shinn U.S. Ambassador to Ethiopia
In an address to the Orientation Seminar on HIV/AIDS Sponsored by UNICEF/EOC-DICAC May 27, 1999
Thank you for including me as part of the program co-sponsored by UNICEF and the Ethiopian Orthodox Church Development and Inter-church Aid Commission on the subject of HIV/AIDS in Ethiopia.
HIV/AIDS is not only a growing problem in Ethiopia, but one which is having negative impacts on economic development as well as the health of communities and individuals. It has become increasingly apparent that developing countries are most adversely affected by HIV/AIDS. In fact, over two-thirds of the world's population living today with HIV reside in sub-Saharan Africa. Household incomes, agricultural productivity, industrial production and the ability to deliver adequate health services are negatively affected by the epidemic. With the fast increasing number of illnesses and deaths and orphans from HIV/AIDS, national, regional and global development achievements are being severely challenged.
The number of new HIV infections in Ethiopia is rising fast -- from none in 1983 to an estimated three million in 1998. HIV/AIDS is no longer a problem confined only to the larger cities; it is spreading to small towns and rural communities. During my recent visit to Sekota, capital of Wag Hemra Zone, the elders told me of their concern about the rising number of HIV/AIDS cases in the area. The problem primarily affects youth and young adults, who constitute the largest segment of Ethiopia's population and are also the future leaders of the country. But HIV/AIDS is affecting all sectors of society, including infants and children, men and women, young and adult, literate and illiterate. The increasing HIV infection rate and number of full-blown AIDS cases are having negative impacts on health services in Ethiopia. By the year 2000, it is estimated that one-half of all hospital beds in Ethiopia will be required for AIDS cases, assuming that no new beds become available this year.
Based on current projections, the number of AIDS orphans will rise to 620,000 in Ethiopia by the year 2000 and reach 1.8 million by the year 2009. One study done among factories in Ethiopia documented that 50 percent of the illnesses of workers was due to AIDS. This results in higher health care costs, increased loss of working hours and premature death. The impact on the industrial and development sectors will continue to rise in Ethiopia and throughout the developing world. The labor force is already significantly affected in some companies in Zambia, Botswana, Zimbabwe and Kenya. As a result, most companies in these countries have developed workplace HIV/AIDS programs. Major negative impacts will increasingly be felt in the education, health, industrial and agricultural sectors of Ethiopia.
On a global basis, the United States has actively supported national and global prevention efforts. The American strategy for dealing internationally with HIV/AIDS is based on three premises:
-- prevention of new HIV infection;
-- reducing the personal and social impact of HIV/AIDS; and
-- mobilizing and unifying national and international efforts to combat HIV/AIDS.
We are finally beginning to see some encouraging results of international efforts to deal with this pandemic. Rates of new HIV infection are now declining, for example, in Uganda and Senegal. Only a serious political commitment by the highest levels of government will turn the HIV/AIDS tide in any particular country. Fortunately, that political commitment has been more evident in Ethiopia in recent months. Unless we enhance our collective response to reduce HIV/AIDS, the socio-economic gains in the developing world will continue to deteriorate and the future of African development will be threatened. The United States will work hard to support and enhance national HIV/AIDS prevention efforts in Ethiopia and worldwide.
Let me take a few moments to spell out more specifically what USAID has done to respond to the HIV/AIDS epidemic in Ethiopia. After resuming its program in 1992, USAID's intervention in the health sector included support for HIV/AIDS prevention. The Support to AIDS Control Project was signed with the government in 1992. The goal of this project was to increase the capability of the national aids control program to reduce HIV transmission. Its purposes were to strengthen institutions and expand the scope of government and non-government institutions to control transmission of HIV. This program, which lasted until 1996, was implemented through the USAID-financed AIDS Control and Prevention Project in collaboration with the Ministry of Health, the Ministry of Education, and NGOs such as Save the Young Generation, the Family Guidance Association of Ethiopia, the Society for Women Against AIDS-Ethiopia, the Tigray Development Association, and Population Services International.
USAID also provided a grant to the World Health Organization for providing drugs and supplies to public sector health facilities for combating sexually transmitted diseases. Other areas of USAID intervention in Ethiopia have included information and educational efforts, condom promotion and social marketing, behavioral research and surveillance, supply of preventive commodities, increasing the involvement of non-governmental organizations and capacity building for the government of Ethiopia.
USAID produced the "AIDS in Ethiopia" information booklet. It co-sponsored the 1996 "Breaking the Silence" national workshop. It conducted a high-level HIV/AIDS advocacy workshop in 1998 and supported the development of Ethiopia's national AIDS policy.
USAID has also produced advocacy materials on HIV/AIDS in Ethiopia and trained people to use these materials. The "AIDS in Addis Ababa" booklet is now ready for use and will soon be distributed. USAID has provided data analysis equipment to the Addis Ababa Health Office and the National AIDS Control Unit. It continues to provide technical support to regional and national HIV/AIDS planning and surveillance efforts.
In consultations with various partners, USAID in 1998 developed an expanded HIV/AIDS intervention package. This package emphasizes improving the AIDS policy environment, increasing access and strengthening of services, enhancing the role of community members in prevention and care and increasing preventive behavior among youth.
Most recently, I have encouraged USAID to enter in discussions with the major religious organizations in Ethiopia with the goal of developing projects that can increase awareness and reduce the prevalence of HIV/AIDS in Ethiopia. We have held discussions with the Ethiopian Orthodox Church, the Supreme Islamic Council, the Mekane Yesus Board of Directors and the Kale Hiwot Board of Directors. Proposals submitted by some of these organizations are now under review for possible support. USAID will continue to respond as fully and effectively as it can to the HIV/AIDS scourge now affecting Ethiopia.
Let me conclude with a few personal comments. In the final analysis, awareness of the HIV/AIDS problem is only a beginning. Increasingly, only behavioral change and safer sexual practices will turn the corner on the HIV/AIDS pandemic. This has not yet happened in Ethiopia or, indeed, in most countries around the world. Until each Ethiopian takes this problem seriously day in and day out and until each Ethiopian takes those measures which ensure that HIV is neither contracted nor passed along, no amount of increased awareness will stem the tide in Ethiopia. It is imperative that every Ethiopian wage his or her own personal war against HIV/AIDS for their sake, that of their friends and their families. Until HIV/AIDS is seen as a personal challenge, it will only continue to get worse.
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