![]() |
![]() |
||||||||
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
|
![]() |
|||||||||
![]() |
![]() |
![]() |
![]() |
![]() |
|||||
![]() |
|||||||||
![]() |
![]() |
![]() |
![]() |
![]() |
|||||
![]() |
HIV/AIDS and Earth Summit 2002 Stakeholder Viewpoints: The international partnership against AIDS in Africa (IPAA) |
Formed in 1999, the International
Partnership against AIDS is a coalition of actors who, based on a set of
mutually agreed principles, have chosen to work together to achieve a
shared vision, common goals and objectives, and a set of key milestones.
This powerful initiative aims to establish and maintain processes by
which the partners, also called the five constituencies - African
Governments, the United Nations agencies, donors, the private sector and
the community sector - are enabled to work more effectively together to
stop the spread of HIV, sharply reduce its impact on human suffering,
and halt the further reversal of human, social and economic development
in Africa. The partners believe that by acting in synergy with others
the impact of individual actions can be dramatically enhanced and they
can seek to build on development through best practice at every level.
As such, the Partnership can be understood as a series of overlapping
partnerships at different levels, and between different actors, working
towards common targets. The vision of the International
Partnership Against AIDS in Africa is that within the next decade
African nations with the support of the international community will be
implementing larger-scale, sustained and more effective multisectoral
national responses to HIV/AIDS. Through collective efforts, promotion
and protection of human rights and promotion of poverty alleviation,
countries will: ·
Substantially reduce new HIV infections; ·
Provide a continuum of care for those infected and affected
by HIV/AIDS; ·
Mobilize and support communities, NGOs and the private
sector, and individuals to counteract the negative impact of the
HIV/AIDS epidemic in Africa. 1. Context
An unprecedented crisis...
In a world where six thousand
lives are lost due to AIDS each day, nearly 70% of the world’s deaths
are to be found in a continent that is home to just 10% of the world’s
population. Infection
levels are highest in the sub-Saharan region, where access to care is
lowest, and social and economic safety nets that might help families
cope with the epidemic have been grossly inadequate. In
1999, the epidemic killed ten times as many people as died in armed
conflict, and there are currently over 10 million young people orphaned
by AIDS in sub-Saharan Africa. Life
expectancy among sub-Saharan Africans, which had risen from 44 years in
the 1950s to 59 years in the early 1990s, is now expected to drop to 45
years between 2005 and 2010. Other development indicators, such as
education levels and economic development, have similarly been affected
throughout the region. An estimated 3.8 million Africans became infected
with HIV during the year 2000, bringing the total number of people
living there with HIV/AIDS to 25.3 million. With an average of ten years
for HIV to reach fully blown AIDS, the epidemic has still not reached
its maximum potential. Needing an unprecedented response
In December 1999, the Secretary-General assembled
representatives from the five constituencies for the first time and
called on then to respond on a scale commensurate with the challenge of
AIDS. He commented, “This unprecedented crisis requires an
unprecedented response - a response from all of us, whoever and wherever
we are. A response that makes humanity live up to its name. The epidemic
is terrible, but we are not powerless against it. Already strong forces
of hope and faith are showing us what can be done. In many cases, Africa
itself is leading the counter-attack.” The IPAA proceeds from the
recognition that none of the partners – neither governments, nor civil
society, nor the various national and international organisations
working against AIDS in Africa – can mount an effective response to
the epidemic in isolation. Rather, it takes a coalition approach to
magnify the contribution of all partners, while giving a clear
leadership role to African governments. Following
the meeting with UN Secretary-General, all partners agreed on a Framework for Action, which sets out a strategy for working together
to address the AIDS epidemic. It has gone through a broad consultation
process that ensured optimal participation and ownership by all the
groups. The Framework is a living document that outlines the vision, the
principles and the overall goal of the IPAA. It also sets out expected
results and key milestones to be achieved in the next two years, and
makes clear provision for activities at all levels as well as the roles
and responsibilities of each constituency. The Framework is seen as the
foundation for strengthening and monitoring the IPAA and it will be
revisited every year. It has since been endorsed by
the UNAIDS Programme Co-ordinating Board and acknowledged by the Heads
of State Summit of the Organisation of African Unity (OAU) held in Lomé
in July, which adopted the Ouagadougou Declaration by the OAU Ministers
of Health. 2. Progress
Before
the formal launch of the IPAA during the Africa Development Forum in
Addis Ababa in December 2000, much has occurred to achieve the
milestones which were identified in the fields of advocacy and political
mobilisation, increasing financial resources, national capacity
strengthening, intensified country level action and effective
partnership mechanisms. Advocacy
and political mobilisation
The
IPAA has mobilised unprecedented leadership and commitment of African
leaders and organisations to intensify their response to HIV/AIDS. Many
presidents have broken the silence that previously surrounded HIV/AIDS
in their countries and have established high-powered commissions.
Panafrican (OAU) and subregional institutions such as SADC, ECOWAS, ECA[1] have committed themselves
to support the IPAA and the implementation of the Framework for Action.
In January of 2000, the UN Security Council debated the AIDS pandemic,
the first time that a development issue has achieved such attention. As
a result HIV/AIDS strategies for countries in conflict, including issues
related to the military and peacekeeping operations are being developed.
AIDS has also been the focus of attention at major summits such as the
G-8 2000 meeting in Japan, the Heads of State Summit of the OAU in Lomé,
the 13th International AIDS meeting in Durban and the Africa
Development Forum in Addis Ababa this year. A Joint Advocacy Programme
for the IPAA which is now being implemented in various countries intends
to enlist both the political commitment and the financial
support for HIV/AIDS programmes. Mobilising
financial resources
The
growing commitment of African governments is resulting in a re-alignment
of funding priorities at national level. Many governments are organising
roundtables to mobilize funds for intensified action against AIDS.
Cosponsors and donors are significantly increasing their financial and
technical resources. Substantial grants have been made by private sector
organisations such as the UN foundation and Gates Foundation among
others. The pharmaceutical companies in collaboration with the UNAIDS
Secretariat and the Cosponsors are exploring ways to accelerate and
improve the provision of HIV/AIDS related care and treatment in
developing countries. The UNAIDS Secretariat is also working closely
with the World Bank, UNDP and UNICEF to maximize benefits for HIV/AIDS
programmes in debt relief accords. Strengthening national capacity
Emphasis
is being placed on strengthening the managerial capacity within
countries, while at the same time ensuring better coordination of
external support and advice. Task teams have been formed to improve
information systems (SAFCO[2],
SAFAIDS[3])
and resource networks around specific themes (e.g. migration, young
people, etc.). Cosponsors and donors have
added regional technical posts. The UNAIDS Secretariat has developed a
directory of technical expertise on AIDS in Africa, and is now
finalising a common database for the use of all partners. Tools for
prioritisation and costing of the national strategic plans against AIDS
were also developed. Intensified action in countries
The key focus of the Partnership is
at country level, and the first principle of the Framework for Action is
African ownership and leadership of the Partnership at all levels. ·
The IPAA reinforced the national strategic planning (NSP) process, a concept for HIV/AIDS which was
started in 1997. It includes a dynamic and participatory process that
involves all sectors and levels of government including NGOs, religious
organisations and international development partners to produce a
multisectoral and decentralised response to the epidemic. The IPAA has been instrumental in helping countries to formulate
the NSP (Ghana and Burkina Faso) and revise costing and priorities of
completed plans (Ethiopia, Malawi, Zambia and Mozambique). This has
resulted in the formation of wider and more effective partnerships and
has encouraged increased internal and external mobilization of financial
and human resources. ·
Following the increased commitment of governments, high level national coordinating
bodies were established and empowered. The IPAA has provided
technical expertise to build the capacity of National AIDS Councils and
their Secretariats in among others Mozambique, Nigeria, Botswana,
Zambia, Uganda, Ethiopia and Tanzania.
·
Through the District Response Initiative based on a broader community
mobilization and participation, the Partnership has supported countries
in strengthening the capacity of communities to respond to the epidemic
in order to decentralise
the response against AIDS. The decentralisation also creates
linkages between health care providers and communities. Ghana, Tanzania,
Burkina Faso, Malawi, Mali, Uganda, Zambia and Zimbabwe are receiving
technical and financial support to scale up District Responses. Through
implementation of community responses the organisational capacity of
national community based organisations and non-governmental
organisations is also being strengthened. More partners are now
expressing their interest in contributing to increasing capacity at
community level. ·
In regard to resource
mobilisation, the quality of the participatory, multisectoral
and costed national strategic plan resulted in successful roundtables
that will enable the implementation of the plan. The experiences and
lessons learned in roundtables have been documented and are being
disseminated to assist other countries in preparing their own
roundtables. In the framework of the AIDS-for-Debt Initiative, UNAIDS is
assisting African countries to place AIDS policies within such documents
as the Poverty Reduction Strategy Papers (PRSP), as well as including
their NSPs into the medium-term public expenditure frameworks (MTEPs). Over the past 12 months, more than a dozen countries in
Africa have highlighted HIV/AIDS in their PRSPs as an important factor
in reversing national and household poverty. A number of these countries
have for the first time set aside funds from their own national budgets,
as part of the HIPC debt relief process, to finance part of the national
AIDS response. Burkina Faso, Cameroon, Malawi, Mali, Mozambique,
Tanzania, and Uganda are each allocating $2-5 million of national
resources liberated through debt relief to the fight against AIDS each
year. Also as part of the debt relief process these countries are
committing themselves to implementing concrete actions in such areas as
AIDS prevention and care and support, that can be monitored in
collaboration with civil society and international partners.
·
One of the challenges in the response to HIV/AIDS in sub-Saharan Africa
is the scaling up programmatic interventions to achieve national
coverage. Partners have accelerated this process by providing financial,
technical and material sources. Care and support programmes have been
expanded in Swaziland, Mozambique, Uganda, Tanzania, Côte d'Ivoire and
Ghana. Partners have worked together with countries in accelerating
Mother-to-Child-Transmission in many countries. Effective
partnership mechanisms
UNAIDS Cosponsors and donors
identified HIV/AIDS as a top priority and have started to expand and
reorient their programmes substantially. Regional community networks
such as AfriCASO, NAP+, SWAA[4]
mobilised the community organisations to actively participate in the
national response, and global NGOs are becoming more active within the
IPAA. The private sector is also increasingly involved and has started
broadening corporate responses, workplace policies and programmes.
At
international level, efforts have been made to give all partners access
to the information they need through an information-sharing system which
is being established and managed by the UNAIDS Secretariat. A communication strategy is gradually being implemented to enhance information
dissemination among all partners at all levels. A regular electronic
information bulletin on key
activities of the African governments, UN agencies, donors, the private
sector and the community sector is now sent out. A website
with several types of background information and activities of countries
on the international response has been established within the UNAIDS
website. All major documents of the activities and decisions on the
international response are widely distributed throughout all levels of
the IPAA. At
country level, the IPAA also provides a forum for information exchange
and planning. Based on national contexts and realities, mechanisms vary
e.g. Expanded Theme Group in Ghana, Zambia, Ethiopia; Technical Working
Group in Malawi; Task Force in Burkina Faso; Partnership Forum in
Tanzania and South Africa. 3.
Challenges
The
IPAA is moving but much more needs to be done to address the magnitude
of the impact of the epidemic on the individuals, the family, the
society and the development of the sub-Saharan countries. To accomplish
the objectives of the Partnership, stated in the Framework for Action,
we need to intensify our effort, especially in the following areas:
§
Many countries have now completed their national strategic plans, and
others are in the process of doing so, but it can not be forgotten that
the enormity of the epidemic makes it an emergency crisis, and
programmes must move quickly from planning into practice. The cost of
waiting to ensure a ‘perfect’ programme is a luxury that simply
cannot be afforded. The plans that have been made already, and those
being made, must be implemented with the shortest possible delay. §
The establishment of clear and thorough mechanisms for resource
mobilization and for channeling the funds directly to the communities
will ensure that the limited resources reach where they are so
desperately needed. §
At present the resources are unable to keep pace with the epidemic. Many
more resources are required in order to stem the devastation that has
been caused by the epidemic throughout sub-Saharan Africa. It is of
vital importance that all actors further intensify their contributions. §
The
co-ordination of the national response by the government is a key
element for success. It is therefore essential that partners support the
strengthening of the capacity of the national co-ordinating bodies. §
Strengthening
the leadership role of the community, especially traditional leaders,
religious leaders, youth groups, women's groups and networks of PLWHA,
so that they may build partnerships at national and local level will
contribute effectively to the national response.
4.
Conclusion
The IPAA comes at a critical moment in the continent’s development, a time when African solutions are needed to solve a serious problem stalking the continent. Though much has been done in a relatively short period, it is now the time to accelerate the implementation of all programmes. It is essential that all partners realise that the only means by which progress can be made against HIV/AIDS is by working in coalition, and the most appropriate mechanism we have for implementing is the International Partnership against AIDS in Africa. Nelson
Mandela in his address to the 13th International AIDS
Conference in Durban said “I come from a long tradition of
collective leadership, consultative decision-making and joint action
towards the common good. We have overcome much that many thought
insurmountable through an adherence to those practices. In the face of
the grave threat posed by HIV/AIDS, we have to rise above our
differences and combine our efforts to save our people. History will
judge us harshly if we fail to do so now, and right now.” Web link to further information about the IPAA is at: http://www.unaids.org/africapartnership/index.html
HIV/AIDS and Earth Summit 2002 Stakeholder Viewpoints: The international partnership against AIDS in Africa (IPAA)
[1] the Southern African Development Community (SADC), the Economic Community of West African States (ECOWAS) and the East African Community (ECA) [2]
SAFCO (SIDA en Afrique du Centre et de l'Ouest) aims to encourage
discussion and electronic dissemination of AIDS related information
in the region. [3]
Southern Africa AIDS Information Dissemination Service (SAFAIDS) is a
sub-regional non-governmental organization based in Zimbabwe
established in 1994. Its main purpose is to help strengthen capacity
to address the impact of AIDS and to promote HIV prevention in
southern Africa. [4] AFRICASO (African Council of AIDS service organisation); SWAA (Society of women with AIDS in Africa); NAP+ (Network of African People living with HIV/AIDS) |