Speech of Dr. Luis Sambo, WHO Regional Director for Africa at the Conference on “HIV, The Forgotten Epidemic”

Submitted by dinara on Mon, 17/07/2017 - 17:47

Meeting for Friendship Among Peoples August 2012, Rimini, Italy

The Director of the Italian Development Cooperation;

The General Secretary of the AVSI Foundation;

The Deputy Executive Director of UNAIDS;

The Executive Vice-President, GILEAD Sciences;

The Distinguished Professor of Virology;

Distinguished Audience, Ladies and Gentlemen;

It is a privilege to participate in the 33rd edition of the “Meeting for Friendship Amongst Peoples” under the theme “By Nature, Man in Relation to the Infinite”.  I am aware that previous editions of this meeting have been important forums for the encounter of experiences and peoples of different cultures who share a positive desire for a better world. I am convinced that the vision that will come out of this 33rd edition will go a long way for the betterment of the lives of peoples.

I sincerely thank the organizers for asking me to speak at this Conference on “HIV, the Forgotten Epidemic”.  
Let me start by saying that Sub-Saharan Africa is the hardest hit by the HIV/AIDS pandemic. It bears the highest burden of HIV/AIDS compared to other regions of the world. In 2011, 22.5 million, representing 65.8 percent of people living with HIV/AIDS were in Sub-Saharan Africa.  In the same year, 1.7 million (68% of the global total) of people newly infected with HIV were in Africa. Moreover, 70% of deaths due to AIDS occurred in Sub-Saharan Africa.

On the whole the estimated adult HIV prevalence in Africa is 4.8% while the average prevalence for the world is just 0.8%. The youth and females are particularly vulnerable to HIV infection and are most affected. The use of antiretroviral drugs for HIV prevention of mother-to-child transmission has led to virtual elimination of perinatal HIV transmission in Western countries. In Sub-Saharan Africa, approximately 300,000 children were newly infected with HIV in 2011.  Therefore, we cannot afford to let HIV/AIDS be a forgotten epidemic.

HIV/AIDS has touched all aspects of the lives of both the infected and the affected. By overwhelming the continent’s health and social services, by creating millions of orphans and by decimating people in the productive age group, HIV/AIDS continues to cause a negative demographic, social and economic impact. As parents and workers succumb to HIV-related diseases, the structures and divisions of labour in households and communities are disrupted, and daily lives are affected with women bearing an especially heavy burden.  From there, the effects cascade across society, and increasing poverty and dependency levels.

HIV prevention is the most effective approach to reducing new infections and minimizing the impact of the epidemic. Since the last decade, countries in Sub-Saharan Africa have been expanding coverage and improving the quality of HIV prevention services which combine behavioral, biomedical and structural interventions.  These include, among others, behavioral change counseling for individuals, couples and communities; condom promotion, optimizing the benefits of antiretroviral therapy for HIV prevention especially in the prevention of HIV transmission to children and removing HIV related stigmatization and discrimination.

Some progress has been made in Africa: The number of young people and children newly infected with HIV continues to decline. The number of children who were infected with HIV reduced from 500.000 in 2003 to 300.000 in 2011. We can now realistically envision dramatic reductions of new HIV infections in children if we collectively implement the “Global Plan for the Elimination of Mother to Child Transmission of HIV”. This will be a way towards achieving an HIV free generation. The World Health Organization will continue to partner with UNAIDS and other agencies and in these efforts.

More people than ever before are receiving antiretroviral therapy. In 2011, more than six million people were receiving treatment in Sub-Saharan Africa, compared with just 100,000 in 2003.  This has resulted in fewer people dying of AIDS related causes which have transformed society’s perception towards AIDS not as a death sentence but as a chronic disease.  For example, an estimated 500,000 fewer people died from AIDS related causes in 2011 in Sub-Saharan Africa, than 2006, representing a 31% reduction in mortality associated with HIV/AIDS.

This has all been possible through the collective responsibility of all stakeholders.  There has been significant financial investment into the AIDS response, more affordable drugs and commodities have been made more accessible to all countries, innovative service delivery approaches have been expanded, activism has promoted visibility of the HIV/AIDS epidemic and communities have been at the forefront of the response. We also recognize the scientific advances that have been made in the recent past.

To maintain this momentum, several challenges have to be addressed.  We need to scale up further the interventions which we know to be effective against the epidemic.  More research has to be done to pursue effective solutions towards HIV prevention, integrated service delivery, new medicines, and vaccine development. We have to find local solutions in Africa, to promote access to medicines, including the manufacturing of antiretroviral medicines and commodities. We need to tackle poverty and ignorance among families and households. We need to empower the youth and women to address the factors that make them especially vulnerable.  

Ladies and gentlemen, the world is at a crossroads, where previous investments are showing tangible results at the same time that some donors are questioning the long-term sustainability of AIDS investments given the magnitude of unmet need. One cannot retreat now. It is the collective responsibility of all to finish what has been started, in order to make universal access to prevention, treatment and care a reality.

Countries are meeting the investment challenge for the HIV response. With international funding flattening, more African countries are increasing their share of investments. Domestic investments for HIV/AIDS response in Sub-Saharan Africa almost doubled between 2006 and 2011, but international investments still account for two-thirds of all AIDS-related spending. It is imperative that both domestic and international funds are used more efficiently, for greater benefits of affected populations.

There is the need for new financing mechanisms beyond the traditional concept of development assistance to move towards universal access to health care. Increased country ownership, and strong and effective involvement from governments, civil society, communities, Persons Living with HIV and health professionals are all critical pre-conditions to an effective and efficient global response. I want to appreciate the role and commitment of the Pontifical Council of Health Care Workers of the Vatican and its network of health care facilities in Africa in providing HIV/AIDS preventive and curative services; and showing compassion for those affected.

Ladies and gentlemen, more than thirty years into the HIV/AIDS epidemic it is my conviction that achieving an AIDS-Free Generation in the future is possible.  This can happen with sustained financial, political and scientific commitment. 
It is with coordinated efforts to expand HIV prevention and treatment interventions, integrating HIV/AIDS into broader health services, increasing funding and improving human rights across vulnerable populations including reducing stigma and discrimination, will we begin to move towards an AIDS free generation. The goal is ambitious, but achievable.  Each of us has an important role to play. Let us all play our individual and collective roles.

I thank you for your attention.