The 2010 World Cup was a moment of great pride for all Africans.
It provided an opportunity to show the world the incredible progress that has been achieved across the continent and demonstrated the unyielding spirit of optimism that is quintessentially African.
With World Aids Day, perhaps we should similar take stock of the progress and how far we have come in the fight against this deadly disease.
Less than a decade ago Aids was moving unchecked through our communities, leaving death and suffering in its path. Fewer than 50 000 Africans were receiving life-saving antiretroviral treatment.
Now, thanks in part to programmes such as the Global Fund, and the strong commitment of our governments, nearly four million Africans — enough to fill Soccer City Stadium more than 44 times — have access to the treatment they need to live longer, more productive lives.
Our governments’ collective leadership on HIV/Aids is strengthening, the stigmatisation of those living with the disease is declining, and 22 countries in sub-Saharan Africa have reduced new HIV infections by more than 25%.
The South African government’s new policy in particular, which has significantly increased its investment in treatment for Aids and the prevention of HIV, has already begun to show positive results.
Specifically, it has reduced the number of babies born with HIV transmitted from their mothers and increased the number of people receiving antiretroviral treatment and living longer with HIV/Aids, when, in the past, it would have been a death sentence. But there is a grave threat to this progress: a global recession that has tightened the budgets of African and donor governments alike.
Gains in jeopardy
The tremendous gains we’ve made over the past decade in the fight against HIV/Aids are now in jeopardy, and recent global financial meetings in Canada and New York have shown that even donors who understand the importance of global health investments are seeing aid budgets increasingly squeezed. At least for now large donor funding increases for Aids seem to be a distant dream.
So what does this mean for Africans and African leaders? To maintain progress we must continue to insist on the resources needed to keep our people alive and, at the same time, take a very hard look at how we can do even better with what we have.
Indeed, there is much we can do to improve both the efficiency and effectiveness of the resources that are allocated to the prevention, treatment and care of HIV/Aids.
There are three steps we can take. Firstly, we must improve prevention. The promise of treatment for everyone living with Aids cannot be fulfilled until we slow substantially the rate of new infections.
Funding must be focused on interventions that are proven to be effective and are targeted to those who are most at risk. We must overcome cultural barriers to reaching young people with accurate information about HIV, and we must provide them with access to condoms if they are sexually active.
We now have the tools to virtually eliminate mother-to-child transmission of HIV, so there is no excuse in 2010, other than our own inaction, for children to be born HIV positive.
Ensuring that mothers have access to antiretroviral drugs during pregnancy and teaching mothers how to minimise the chances of passing the virus on to their newborn can cut the risk of infection almost entirely. We need to seek out HIV-positive women, offer them quality family-planning services and provide education and treatment for those who become pregnant.
Improvements needed
For young men living in countries with high rates of HIV infection, male circumcision by a trained medical provider needs to be widely available — it can reduce by over 60% the risk of a man getting infected by an HIV-positive woman.
Secondly, we must improve governance and transparency. Even with all the resources and good intentions, programmes will only be successful if they are well managed and citizens are fully informed and engaged.
Primary responsibility lies with our ministries of health and of finance, which must work together to prioritise domestic spending for HIV/Aids and to report on where the funds are going and what results they are producing.
Where external aid is utilised, our leaders at all levels need to get tough on criminals who try to siphon off resources for Aids treatment, and work in partnership with donors and civil society to ensure that our in-country capacity to track and evaluate funding is as strong as possible.
The citizens of donor countries that provide assistance are also entitled to know that we have an aggressive intolerance for corruption of any kind. Equally importantly, donors should seek to ensure that national health systems are not undermined, while they deliver or implement HIV/Aids programmes on the ground.
Thirdly, we must make the case for Africa.
While we should not advocate perpetual indefinite donor dependence, as long as we continue to rely on the assistance of donors to fight Aids aggressively, it is in our interest to be more vocal about the successes of these funds and how they can best be utilised.
Indeed, as resources become increasingly tight and donors change eligibility and prioritisation criteria, it will become ever more important for our leaders, celebrities, and citizens when they travel abroad to represent us, to be unabashed in detailing both how effective investments have been in saving lives and in sharing what works and what has not worked in each of our countries.
It is up to the leaders, in partnership with civil society, to advise donors on such key issues as when integration should be a focus, where clinics are best situated, how cultural practices should influence policy and which local partners are strong. We are our own best advocates and donors need to hear from us.
On World Aids Day I hope that we can all make a commitment to fulfilling our responsibility to help end Aids in Africa in our lifetime. It will take all of us, working together as one, to make a difference.
Dr Sipho Moyo is ONE’s Africa director. ONE is a grassroots advocacy and campaigning organisation that fights extreme poverty and preventable disease, particularly in Africa. www.one.org