AIDS IS NOT OVER: Address inequalities, Accelerate Inclusion and Innovation”, ICASA 2023

Submitted by kiawoinr@who.int on Thu, 07/12/2023 - 11:08

Opening Remarks by WHO Regional Director for Arica, Dr Matshidiso Moeti 

His Excellency Emmerson Mnangagwa, President of the Republic of Zimbabwe,

Honourable Ministers,

Dr David Pagwesese Parirenyatwa, ICASA 2023 President and President of the Society for AIDS in Africa,

Civils Society and community leaders and representatives

Dr John Nkengasong, US Global AIDS Coordinator 

Ms Winnie Byanyima, Executive Director of UNAIDS, 

Distinguished guests, 

Ladies and gentlemen,

I want to start by saying how pleased I am to be with you today; my profound thanks, on behalf of WHO, for the invitation.

Thank you, Your Excellency President Mnangagwa, and the government and people of Zimbabwe, for hosting the ICASA 2023.

On a personal note, Zimbabwe is a second home for me and my family, for many reasons, starting from my teens when I went for dental treatment and Xmas shopping in Bulawayo from Francistown. I then lived here when I led the work in the region on WHO’s ‘3 by 5’ initiative to accelerate access to ARVs, with Amb Nkengasong as a close partner in our laboratory capacity-building work.

We have, collectively, made tremendous progress in addressing the multifaceted suffering and devastation, at personal, family, national, and continental levels, caused by the HIV pandemic, one of the greatest health crises in human history. 

As the former national AIDS programme manager who had the distinction of representing the world’s worst highest HIV prevalence country at international conferences in the 1980s and early ‘90s, I celebrate this progress. 

You know, AIDS is a story often told by numbers. We say and hear things like, “The African Region is home to two-thirds of people living with HIV and AIDS.” Of course, it translates to heart-breaking numbers, and they help us understand the sheer, overwhelming magnitude of this tragedy and challenge. But, repeated by themselves, statistics hide the individual stories, tragedies, hopes, and heroic courage of people living with HIV and AIDS and their families.

People like Dudu Dlamini, who came out as HIV positive and was murdered by her neighbours in Durban, South Africa. 

Noreen Kaleeba, from Uganda, whose husband passed away from AIDS upon returning to Uganda after graduate study in the United Kingdom in 1987, was able to turn her tragic reality into a transformative HIV/AIDS activism and advocacy in her native Uganda and beyond .

I remember Tendai, from Zimbabwe, the first person openly living with HIV to get vaccinated for COVID-19, who used her story to fight misinformation publicly. 

I remember Dorothy, from South Africa, who offered her house as a venue for a WHO HIV mobile clinic so services could continue in her neighborhood.

And I remember that Bayo, from Nigeria, named her child “Goodnews.” She wanted to prove to other Nigerian women that it is possible to keep the disease from passing to a child.

These are stories of hope and courage. They are the stories that touch our souls and call us to increased action.

They are, above all, stories of voices from communities. In the early days of the response, when the world was in denial, communities spoke up to fight the silence and stigma. They were at the forefront of the battle against discrimination. They were the advocates who campaigned and took action for increased access to antiretroviral therapy and care, ensuring that no one would be left behind.

During the COVID-19 pandemic, they played a key role in assuring access to antiretrovirals and other health services through their structured advocacy. We are determined to incorporate their experiences into the region’s future health service delivery strategies.

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Ladies and gentlemen,

Thanks to our joint efforts – by PEPFAR, by the WHO ‘3 by 5’ initiative in which we drove task shifting, decentralisation and primary care to leverage the existing capacities in our health systems, by the Global Fund, by the World Bank, by governments and communities, we’ve seen major progress.

Between 2010 and 2022, new HIV infections dropped by 53%, and HIV-related deaths fell by 48%.

In the same period, the number of people on antiretroviral treatment increased from 21% to nearly 80% of those eligible.

Zimbabwe, our host country, and others such as Botswana and Eswatini have achieved or even surpassed the 95-95-95 target . Thank you, President Emmerson Mnangagwa, for your direct role in this achievement. High-level political leadership in HIV/AIDS control makes all the difference.

Another major factor in successful HIV management is the integration of services. Here also, Zimbabwe has increased demand for integrated sexual and reproductive health and HIV services through the one-stop-shop method introduced in 2020 by the Ministry of Health and Child Care. 

The method has provided a comprehensive package of quality family planning services, such as contraceptives and HIV prevention and treatment services, in an environment free of stigma and discrimination.

The success of collective effort on the West African Catch Up Plan, showing the power of partnership and coordination in combating disease, needs to be sustained. 

For our success to be complete, we must address challenges. 

The response to HIV has evolved in an increasingly complex environment, amplified by the COVID-19 pandemic which shifted resources, drawn attention to health system gaps, and further exposed disparities and inequalities among vulnerable populations.

I am encouraged by the renewed focus on primary health care, health systems, including efforts by the Global Health Initiatives to work even more closely together for synergy, efficiency and better outcomes for all. WHO is ready to collaborate in this direction, emphasizing person-centered care. 

Your Excellency, partners, colleagues and friends, AIDS IS NOT OVER because, with the increase in access and uptake of lifesaving antiretrovirals, our focus now needs to be on preventing new infections. 

This means focusing on and working with key populations – adolescents and young women, sex workers, men who have sex with men, injecting drug users, transgender people, and prison populations, and ensuring the many barriers they continue to face in accessing health services are eliminated.

We need to collectively do more, including reviewing and reforming legislation and policies that create barriers to evidence-based interventions and services.

We thank them for their courage and the innovations they have fostered and pushed. We urge that these lessons be taken on board as we work to overcome inequity in health. They need a place in decision-making mechanisms at the highest level.

AIDS IS NOT OVER because we must leverage innovations, including new treatment regimens, new prevention approaches, and vaccines, supported by research that includes the needs of resource-limited settings.

It is critical that these, and technology be urgently scaled up and adapted to our context. This includes gene therapy, self-testing technology, expanded access to pre-exposure prophylaxis, and the use of artificial intelligence (AI) and digital technology.

The speed with which COVID-19 tools were developed, approved and used has shown it’s possible. 

The successful clinical trials of new malaria vaccines are another example. We need to leverage experts, networks and partners to support research and development in Africa, to bridge the gaps in local manufacturing of drugs, vaccines and diagnosic tests on the continent, and contribute to the new public health order.

WHO will continue to engage with our Member States within the broader partnership to provide policy and strategic direction and technical resources to end HIV epidemics.

Working with diverse stakeholders, governments, communities, and research and funding partners, and advancing South-South cooperation, we shall sustain our commitment to end the epidemics of HIV and other communicable diseases.

That way, the struggles and hopes of the Tendais, Dorothys, and Bayos who live the daily drama of this epidemic would see a brighter future.

I wish everyone a productive and stimulating conference. Thank you very much for your attention

Thank you.