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Xth International Conference on HIV/AIDS and STDs in Africa The Alliance of Mayors and Municipal Leaders on HIV/AIDS in Africa Annex 2 Presentation
by Ms. Olubanke King Akérelé Distinguished guests, ladies and gentlemen: Let me start by thanking all of you who have worked so hard to organise this symposium. I would also like to gratefully acknowledge the tireless efforts of the Mayor of Abidjan and his staff and to thank you for making available the City Hall for this important occasion. I would also like to extend particular gratitude to the Mayors who have come together in Abidjan to reinforce municipal solidarity in the response to HIV and AIDS on the African continent. Your presence here is greatly encouraging and extremely valuable. I would like to acknowledge with thanks the women, men and young people who have agreed to be here today to share their stories and perspectives with us. These personal testimonies are important, for they help us all to better understand the human dimensions of this epidemic and the importance of involving people directly affected by HIV and AIDS in formulating and implementing effective responses to the epidemic. I wish to extend regrets from the Assistant Administrator and Director of UNDP’s Regional Bureau for Africa, Ms. Thelma Awori, at not being here with you today. She wishes all of you fruitful deliberations. UNDP’s contribution to this discussion is from the perspective of an organisation which has been dealing with development issues for over fifty years and from that of a co-sponsor of the Joint and Co-Sponsored United Nations Programme on HIV/AIDS, -UNAIDS – which represents the collaborative effort of six UN organisations namely UNDP, UNESCO, UNFPA, UNICEF, World Bank and WHO to promote and support an expanded and multisectoral response to the epidemic. The epidemic is systematically undermining the hard won human development gains made on the continent. It brings with it social stigma, reduced work productivity, depletion of important sectors of the work force – often the brightest and best educated, and rising health costs. No sector of society is immune to the impact of HIV and AIDS. Therefore, any effective response must address the social and economic causes and consequences of the epidemic in a holistic way that deals with not only the immediate but with the underlying causes for spread of the epidemic which all too often lie in processes of impoverishment and the absence of socially inclusive approaches to development. There is now an evolving understanding within the international development community that the determinants of sustainable human development lie not only in adequate policies or programme design and implementation, but also in the actual setting of the development intervention. This brings us to the growing awareness that development must also encompass the many elements of good governance. These elements include socially-inclusive processes of dialogue and decision-making; strengthening the institutions of civil society; participatory politics; accountability; as well as policies and instruments which ensure access by all to information, basic social services and justice. These same elements are also key to generating and sustaining responses to the HIV epidemic. These include:
The epidemic has given rise to difficult questions about rights and responsibilities, and the need for achieving societal and individual behavioural change. It requires discussion of many sensitive issues such as gender roles, power relations, sexuality, fear, stigma, discrimination, illness and death. The issues are not only medical but developmental. Responses need to be broad and multisectoral. In this regard, the contributions of Mayors are critical in developing multisectoral responses. We wish to commend them for their initiative in coming together and forming this Alliance to become more actively involved. The 1997 edition of the Human Development Report features the initial successes in the response to the epidemic in Thailand and Uganda, two of the many countries most affected by HIV and AIDS. The experience of these countries demonstrate that political leadership, community empowerment through strong collaboration with civil society, the mobilisation of the private sector and other sectors, minimizing fear, stigma and discrimination, amongst other measures, are important components of an effective and sustainable response to HIV and AIDS. But despite the encouraging results attained in a small number of countries, the majority of African countries still have a daunting task before them in dealing with the HIV epidemic in all of its complexity. According to the most recent statistics released by UNAIDS, there are now more than 30 million people around the world infected with HIV. With just 10% of the world’s population, sub-Saharan Africa is home to 70 percent of the total number of persons living with HIV/AIDS. New data also indicate that nearly half of the sexually active adult population of some cities in Botswana, Malawi and Zambia are infected. According to research carried out by the World Bank, AIDS is now the leading cause of death in Malawi, Tanzania, Uganda, Zambia, and Zimbabwe. The United States Bureau of the Census reports that AIDS will reduce life expectancy – predicted to range from the upper forties to the upper sixties in the absence of HIV – to the mid or low thirties in such countries as Botswana, Malawi, Tanzania, Uganda, Zambia and Zimbabwe. In economic sectors, a study undertaken in Kenya estimates that HIV/AIDS could increase labour costs for some businesses by 23 percent by the year 2005. The National Union of Mineworkers in South Africa reports that, by the year 2010, the mines could be experiencing 12,000 to 14,000 HIV-related deaths per year, depending on the success of HIV prevention efforts. The World Bank projects that close to 15,000 teachers in Tanzania will die of AIDS by 2010, with millions of dollars needed to train replacements. The reported HIV prevalence amongst university faculty in Kenya is 14 percent. Coupled with already high attrition rates of 25 percent and higher, this could have disastrous consequences for urban universities and national investments in higher learning. Family income and savings are being diverted to pay for medical care, funerals and support to extended family members who have lost young adults to the epidemic. Children are leaving school to care for dying parents or because families can no longer afford school fees and other family members are leaving jobs to care for the sick. Rural families are shifting production to less labour-intensive crops which can result in poorer nutrition or additional loss of income from cash crops. New households are emerging, headed by teenagers caring for younger brothers and sisters and grandparents. The epidemic is decreasing the pool of qualified teachers, health workers and civil servants and other professional groups. In many parts of Africa, governments, the private sector, communities and households now face a day-to-day experience of falling standards of living, reduced capacities for personal and professional achievement, worsening expectations of what the future holds for them, and a diminishing capacity to maintain what has been secured over past decades in terms of social and economic development. Women of all ages bear a particularly harsh burden, and children have also been profoundly affected, as the epidemic touches their families and communities. Present needs as well as the inter-generational effects of HIV/AIDS on children and on society urgently need to be addressed. UNDP is working together with governments in the region, organisations of the UN system, UNAIDS Secretariat, regional and national networks of people living with HIV/AIDS, regional and national networks on ethics, law and HIV, as well as regional and national NGOs and CBOs to promote and support expanded multisectoral responses to the epidemic. But more needs to be done. Existing responses must be re-examined in order to find more effective ways and means to address, in an integrated way, in a humane way and on a sufficient scale, the social and economic challenges now facing many households, communities and countries in Africa. This is partly a matter of resources and partly a deficiency of the worldwide response to the epidemic. Both of these challenges can be met, but only if strategic decisions are made to redirect international and national policies, programmes and resources to address these compelling and evolving needs. The Secretary-General of the United Nations, Mr Kofi Annan, has called upon the international community to intensify and expand its efforts to address the development implications and impact of the HIV epidemic. In a recent statement he noted:
The admirable and courageous efforts of many people and organisations – governmental, non-governmental and international – throughout the continent have lessened fear and stigma, provided support and care, and mobilised communities to respond to the many challenges posed by HIV/AIDS. In so doing, they are providing hope for the future. These positive efforts can and must be accelerated and expanded. At stake are the present and future generations of African women, men and children. The commitment of Mayors and municipal leaders represents a concrete expression of an expanded response to the epidemic. UNDP looks forward to building on these initial steps that you, Mayors of Africa, have taken, as well as to working with you to identify effective ways and means of ensuring the security and well-being of future generations of African women, men and children. We must all find better ways and means of translating our words and declarations into relevant and sustainable actions. Thank you.
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