AMREF Urges Engagement of Communities in Unpacking Global Principles
The global AIDS community converges next week in Dakar, Senegal for the 15th Conference on AIDS and STIs in Africa taking place from December 3-7. The theme for the biennial meeting, which discusses HIV developments and trends on the continent, is ‘Africa’s Response: Face the Facts’.
Based on its 51 years of experience working with communities in Africa, the African Medical and Research Foundation will hold a skills building workshop focusing on ‘Connecting African communities with their health systems to improve the quality of HIV prevention, care and treatment’ on Thursday, December 4. AMREF will also host discussions at the conference on ‘Unpacking the Paris Principles on aid effectiveness at the community level’ on Friday, December 5, based on AMREF’s experience in Kenya.
“AMREF believes that communities must be engaged and integrated into health systems if those systems are to be effective and responsive to the health needs of the people. If communities are to be partners in health development, harmonisation of global principles and practices like aid effectiveness should not end at the national level but be incorporated in the way things are done at the community level. Using our Maanisha project as an example, AMREF wants to demonstrate how to bring these global ideals down to the level where the people are and to engage them in making them a reality on the ground,” says Dr Daraus Bukenya, AMREF’s Director for Community Partnering.
AMREF is one of the key sponsors of the conference and deputy director general Dr Florence Muli-Musiime is a member of the organising committee. Besides the two auxilliary meetings, AMREF will present posters on various projects in Tanzania, Kenya and Ethiopia.
Former Street Children Show the Way in Fight Against HIV
A group of former street children turned filmmakers from the Dagoretti slum in Nairobi have produced a television news feature highlighting the daily struggles of people living with HIV in poor settings and the leadership initiatives taken by members of those communities in dealing with the challenges of the epidemic.
Through the AMREF’s Dagoretti Child in Need Project, the team of former school dropouts who operate under the banner of Different Perspectives has produced a five-minute television news feature highlighting the fight against HIV in informal settlements. Members of the crew, who have all grown up in Dagoretti, intend to use the film to educate their peers on “making a difference in the communities in the fight against HIV and AIDS”.
Set to be released on World AIDS Day (December 1), the short film features George Olali, a community health worker who takes care of people living with HIV and TB in the Kibera slum. The soft-spoken George acts as a counsellor, friend and home-care provider and ensures that those on antiretroviral drugs (ARVs) take their medication as they are supposed to. He encourages those affected or infected by the virus, helping to ease stigma and prejudice in families and the community.
The feature gives viewers a unique chance to explore a big problem in a small part of the world through the youngsters’ lenses.
AMREF Project Manager John Muiruri says: “The film seeks to show how people and organisations living and working with disadvantaged communities are rising to the challenge of HIV. It will also be a useful tool to educate young people on how to make a difference in their communities in the fight against the virus.”
While George is a shining example of leadership and achievement against great odds, the filmmakers too have their own stories of triumph to tell – stories of victory over neglect and want as street children, having to fend for themselves from the trash cans and begging, a dalliance with drugs, as well as petty crime. Joining AMREF’s Dagoretti Child in Need Project and learning useful skills helped to turn their lives around and start them on the road to great story telling and filmmaking.
World AIDS Day 2008 offers an opportunity to challenge the global community to keep its promises and renew its commitment to tackling the enormous challenges of HIV. Experience has demonstrated that significant advances in the response to HIV and AIDS have been achieved where there is strong and committed leadership. Leaders are not necessarily politicians or bureaucrats but even individuals like George who are making a difference in the lives of others through their personal example and dedication
Aids in Africa
Sub-Saharan Africa is more heavily affected by HIV and AIDS than any other region of the world. An estimated 22 million people were living with HIV at the end of 2007 and approximately 1.9 million additional people were infected with HIV during that year. In just the past year, the AIDS epidemic in Africa has claimed the lives of an estimated 1.5 million people in this region. More than eleven million children have been orphaned by AIDS.
The extent of the AIDS crisis is only now becoming clear in many African countries, as increasing numbers of people with HIV are becoming ill. In the absence of massively expanded prevention, treatment and care efforts, it is expected that the AIDS death toll in sub-Saharan Africa will continue to rise. This means that impact of the AIDS epidemic on these societies will be felt most strongly in the course of the next ten years and beyond. Its social and economic consequences are already widely felt, not only in the health sector but also in education, industry, agriculture, transport, human resources and the economy in general.
How are different countries in Africa affected?
Both HIV prevalence rates and the numbers of people dying from AIDS vary greatly between African countries. In Somalia and Senegal the HIV prevalence is under 1% of the adult population, whereas in Namibia, South Africa, Zambia and Zimbabwe around 15-20% of adults are infected with HIV.
In three southern African countries, the national adult HIV prevalence rate has risen higher than was thought possible and now exceeds 20%. These countries are Botswana (23.9%), Lesotho (23.2%) and Swaziland (26.1%).
West Africa has been less affected by AIDS, but the HIV prevalence rates in some countries are creeping up. HIV prevalence is estimated to exceed 5% in Cameroon (5.1%) and Gabon (5.9%).
Until recently the national HIV prevalence rate has remained relatively low in Nigeria, the most populous country in sub-Saharan Africa. The rate has grown slowly from below 2% in 1993 to 3.1% in 2007. But some states in Nigeria are already experiencing HIV infection rates as high as those now found in Cameroon. Already around 2.4 million Nigerians are estimated to be living with HIV.
Adult HIV prevalence in East Africa exceeds 5% in Uganda, Kenya and Tanzania.
Trends in Africa's AIDS epidemic
Large variations exist between the patterns of the AIDS epidemic in different countries in Africa. In some places, the HIV prevalence is still growing. In others the HIV prevalence appears to have stabilised and in a few African nations - such as Kenya and Zimbabwe - declines appear to be under way, probably in part due to effective prevention campaigns. Others countries face a growing danger of explosive growth. The sharp rise in HIV prevalence among pregnant women in Cameroon (more than doubling to over 11% among those aged 20-24 between 1998 and 2000) shows how suddenly the epidemic can surge.
Overall, rates of new HIV infections in sub-Saharan Africa appear to have peaked in the late 1990s, and HIV prevalence seems to have declined slightly, although it remains at an extremely high level. Stabilisation of HIV prevalence occurs when the rate of new HIV infections is equalled by the AIDS death rate among the infected population. This means that a country with a stable but very high prevalence must be suffering a very high number of AIDS deaths each year. Although prevalence has declined, the number of Africans living with HIV is rising due to general population growth.
What is the effect of these high levels of HIV infection?
Over and above the personal suffering that accompanies HIV infection, the AIDS epidemic in sub-Saharan Africa threatens to devastate whole communities, rolling back decades of development progress.
Sub-Saharan Africa faces a triple challenge of colossal proportions:
Providing health care, support and solidarity to a growing population of people with HIV-related illness, and providing them with treatment.
Reducing the annual toll of new HIV infections by enabling individuals to protect themselves and others.
Coping with the cumulative impact of over 20 million AIDS deaths on orphans and other survivors, on communities, and on national development.
What is the impact of AIDS on Africa?
HIV & AIDS are having a widespread impact on many parts of African society. The points below describe some of the major effects of the AIDS epidemic. For a more detailed examination, visit our African impact page.
In many countries of sub-Saharan Africa, AIDS is erasing decades of progress made in extending life expectancy. Millions of adults are dying from AIDS while they are still young, or in early middle age. Average life expectancy in Sub-Saharan Africa is now 47 years, when it could have been 62 without AIDS.
The effect of the AIDS epidemic on households can be very severe. Many families are losing their income earners. In other cases, income earners are forced to stay at home to care for relatives who are ill from AIDS. Many of those dying from AIDS have surviving partners who are themselves infected and in need of care. They leave behind orphans, grieving and struggling to survive without a parent's care.
In all affected countries, the HIV/AIDS epidemic is putting strain on the health sector. As the epidemic develops, the demand for care for those living with HIV rises, as does the number of health workers affected.
Schools are heavily affected by HIV/AIDS. This a major concern, because schools can play a vital role in reducing the impact of the epidemic, through education and support.
HIV/AIDS dramatically affects labour, setting back economic activity and social progress. The vast majority of people living with HIV/AIDS in Africa are between the ages of 15 and 49 - in the prime of their working lives. Employers, schools, factories and hospitals have to train other staff to replace those at the workplace who become too ill to work.
Through its impacts on the labour force, households and enterprises, HIV/AIDS can act as a significant brake on economic growth and development. HIV/AIDS is already having a major affect on Africa's economic development, and in turn, this affects Africa's ability to cope with the epidemic.
