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Africa: "We will hold you to your promises"
Apr 12, 2007 (070412)
(Reposted from sources cited below)
As African Union ministers of health gathered in South Africa this
week to discuss strategies, civil society health activists demanded
that African governments live up to previous commitments to expand
health access. "We will not go back," the activist coalition
statement concluded, "We will be watching you."
Briefing reporters before the conference, African Union Commission
chairperson Alpha Konare also soberly remarked that there was "no
positive trend" in implementation of commitments to put more
resources into addressing the continent's health crises. Dr. Sheila
Dinotse Tlou, outgoing chairperson of the conference and Botswana
Minister of Health, said that the plan being considered by the
ministers would aim at universal access to health services by 2010.
This AfricaFocus Bulletin contains the statement by civil society
health groups, an update from the UN Integrated Regional
Information Networks, and selected additional links to recent
For more on the conference of ministers of health, see
For previous AfricaFocus Bulletins on health issues, visit
For automatic translations of AfricaFocus into French and
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http://www.africafocus.org/index_pt.php These computer-generared translations, by
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A statement of people living with HIV/AIDS and their allies
Third Session of the African Union Conference of Ministers of
9-13 April 2007
[For this statement and related background information, see the
website of the Treatment Action Campaign -
Since people living with HIV/AIDS and their allies took to the
streets in Durban, South Africa during the international AIDS
conference in 2000, we have refused to be told that our lives are
expendable and AIDS treatment is only for those who can afford to
purchase antiretroviral therapy (ART).
We have made great strides together in these past seven
years-hundreds of thousands of African men, women and children are
now receiving ART and are living healthy and productive lives.
As our Ministers of Health meet this week in Johannesburg we are
demanding that our governments keep the promises they made and
specific targets they agreed to in Abuja in 2006 to universal
access to a comprehensive package of AIDS treatment, prevention and
care. These are commitments that have been endorsed by all heads of
states-they have yet to be implemented.
We are concerned that the documents being considered at the African
Health Ministers' Summit this week give scant attention to AIDS
treatment, and in particular ART. Even the Draft Implementation
Plan for Achieving Universal Access to HIV/AIDS, Tuberculosis and
Malaria Services, fails to mention the targets for treatment
committed to in Abuja last year or outline specific steps for
ensuring that all people living with HIV/AIDS (PLWHAs) who need
treatment receive it by 2010.
We will not go back to the days when only the rich in our countries
could afford antiretroviral therapy.
We will not go back to the days when HIV prevention was pitted
against treatment instead of both interventions seen as mutually
reinforcing and equally important.
We will not go back to the days when strengthening health systems
was seen as a prerequisite for antiretroviral therapy instead of a
critical way to galvanize communities to demand their right to
health and build momentum for better primary care services.
We will not go back.
As people living with HIV/AIDS and their allies, we will work in
collaboration and cooperation with our governments to ensure that:
- all people who need AIDS treatment in Africa receive it, and;
- all people living with tuberculosis (TB), the leading killer of
people living with HIV/AIDS, and multi-drug resistant (MDR) and
extensively drug resistant (XDR) TB, receive the care they need as
- And that HIV and TB programmes are integrated and decentralized
to provide the widest access to care possible.
As people living with HIV/AIDS and their allies we make the
following demands of our Ministers of Health, our Presidents and
- As agreed to one year ago at Abuja, national targets for AIDS
treatment, prevention and care must be established in all countries
on the continent that are ambitious and come as close as possible
to achieving universal access by 2010. These targets must be linked
to costed operational plans for implementation.
- Costed national plans for dealing with TB, including MDR and XDR
TB, are developed immediately.
- Both targets and costed plans should be finalized and publicly
released by 1 June 2007 for countries that have not yet done so.
- All targets must be equivalent or greater to the targets set in
Abuja, Nigeria in May 2006 as part of the African Common Position
on Universal Access, and which included targets for coverage of ART
and prevention of mother-to-child prevention services (MTCT) of at
least 80% by 2010. Most countries on the continent currently have
less than 30% coverage, and only three countries in Africa have
greater than 50% coverage, of ART.
As people living with HIV/AIDS and their allies, we believe
treatment and prevention go hand in hand, and thus, we are
demanding the following:
- A scale-up of prevention services including but not limited to:
HIV testing services, prevention of mother-to-child transmission;
harm reduction and substitution services for drug users, condom
distribution and promotion and sexuality education for all ages
and; post-exposure prophylaxis for survivors of sexual violence;
- The targets for the scale-up of these services should again be
equivalent or greater than the universal access targets agreed to
in Abuja in May 2006 by all African heads of state.
We also realize that the prevention of HIV, TB and malaria
transmission require that the environment of risk in which many of
us live is ameliorated, we thus demand the following:
- A recognition of the rights of women and young girls is a
fundamental part of our response to the AIDS epidemic and health in
general in Africa. Thus, regional plans to address gender violence,
the unequal legal, social and economic status of women and girls
must be developed.
- Regional plans to address the substandard living conditions in
which so many of us live, which put us at risk of HIV, TB and
Both AIDS treatment and prevention depend on strengthening our
health systems, but AIDS is an emergency that needs an
extraordinary response. We believe that rapid scale-up of AIDS
services need not compromise health systems and AIDS can be the
engine of strengthening primary medical care in Africa--we thus
make the following demands:
- The regulation of medicines and other health commodities on the
continent must be strengthened and this issue be dealt with on an
- No country in Africa should sign free trade agreements or other
treaties that restrict their ability to ensure access to a
sustainable supply of affordable medicines by producing or
importing medicines or their active pharmaceutical ingredients as
allowed under the TRIPS agreement and TRIPS flexibilities need to
be incorporated into national laws and regulations without delay;
- The approval process for new medicines and other health
commodities should be streamlined, relying on the approval by other
rigorous regulatory agencies (e.g. USFDA, EMEA, WHO) for a
conditional approval for marketing to allow access to these
products pending national reviews;
- A framework for regulating the health claims of traditional
medicines, other alternative treatments and procedures, and fake
cures for HIV/AIDS and other diseases, needs to be established so
that people in our countries do not spend their money on unproven
remedies or fail to pursue evidence-based health interventions for
themselves or their families;
- Regional assessments to identify local needs around human
resources for health and specific plans to recruit, train and
retain health care workers need to be developed and implemented;
- Regional plans must be developed and implemented to address the
needs of migrant populations who need to receive proper medical
care no matter where they are living at any given moment;
- Health care should be free at the point of access and users' fees
for services must be abolished across the continent. Solutions to
minimizing the other costs associated with seeking care, including
transport, need to be addressed as well;
- All health services, including AIDS, STI and TB treatment, sexual
and reproductive services, should be integrated together, and
decentralized, minimizing the need for lengthy travel to receive
- All health services should be available and accessible to people
without regard to whether they are living in urban or rural
settings, and regardless of gender, sexuality, religion,
nationality or disability status [not an exhaustive list];
- Regional plans for supporting biomedical and behavioral research
on HIV/AIDS, TB, malaria and other diseases common in Africa needs
to be established to build stronger capacity for research on the
continent. This research can include clinical trials of traditional
medicines within international accepted guidelines for research,
but a clear priority must be given to the investigation of standard
medical interventions, such as drugs, vaccines, microbicides and
diagnostics, which have a rational, scientific basis for their
- All of these regional plans must be operational ones, and set out
specific tasks for completion by specified deadlines. We don't need
more plans on paper that are never implemented.
The leaders of the G-8 countries, which support a large proportion
of health efforts on the continent, are meeting later this year in
Germany. Our Ministers and Presidents must ask the G-8 countries
now to provide long-term, sustainable, coordinated support for all
of the efforts we describe above. Our countries must also meet the
15% target for national spending on health that they agreed to in
Finally, the political and economic crisis in Zimbabwe deserves
special mention as it is also a health crisis for Africa. People
living with HIV/AIDS in Zimbabwe cannot obtain the care they need
and the climate of violence is perpetuating the epidemics of HIV
and TB. The shockwaves from the crisis in Zimbabwe are
reverberating throughout the continent as refugees seek health care
and other services in neighboring countries. Our health ministers
must speak out on Zimbabwe on health and humanitarian grounds.
The humanitarian crises in Somalia and Sudan and elsewhere on the
continent should be considered health crises as well and need to be
addressed by our ministers.
The African Union must establish a functional mechanism that will
facilitate an integrated, comprehensive and rights-based approach
to combating HIV/AIDS and providing essential health services to
all who need them.
We will not go back.
We will not be silent.
We will hold you to your promises.
We will hold you accountable.
We will be watching you.
Endorsed by (list in formation):
AIDS and Rights Alliance for Southern Africa (ARASA)
AIDS Law Project (ALP)
International Community of Women Living with HIV/AIDS (ICW)
Mozambican Treatment Access Movement (MATRAM)
Network of Zimbabwean Positive Women (NZPW+)
Open Society Initiative for Southern Africa (OSISA)
Pan African Treatment Access Movement (PATAM)
Southern African Treatment Access Movement (SATAMO)
Swaziland Network of People Living with HIV/AIDS (SWANEPWA)
Treatment Action Campaign (TAC)
Treatment Advocacy and Literacy Campaign (TALC)
Zimbabwe Activists Against HIV/AIDS (ZAHA)
Zimbabwe National Network of People Living with HIV/AIDS (ZNNP+)
AIDS groups lobby health summit
AIDS activists from all over the continent have signed a petition
expressing their concerns about the AU meeting.
UN Integrated Regional Information Networks
[This report does not necessarily reflect the views of the United
Johannesburg, 10 April 2007 (PlusNews) - As a week-long meeting of
health ministers organised by the African Union (AU) got underway
in Johannesburg on Monday, AIDS activists expressed concern that
commitments on HIV/AIDS, tuberculosis and malaria, reached at
several meetings last year, were missing from the agenda.
Conference delegates are spending this week considering a draft
health strategy for the next eight years, to produce a roadmap for
strengthening Africa's weak health systems and helping the
continent achieve health-related United Nations Millennium
Development Goals by 2015.
But according to a coalition of 53 AIDS organisations and civil
society groups, the draft plan fails to include a number of targets
relating to the goal of universal access to HIV/AIDS treatment,
prevention and care agreed to by African governments at an AU
summit on AIDS, TB and malaria in Abuja, Nigeria, in May 2006.
"We believe it would be a waste of energy to start with new
commitments when, in Abuja last year, they all acceded to a
document that was well thought out and detailed," Olayide Akanni of
Journalists Against AIDS, a Nigerian organisation that is part of
the coalition, told journalists on Tuesday. "The health strategy we
have before us now contains no timelines, there's no monitoring and
evaluation plan, there's nothing to hold them to it."
A petition listing the coalition's concerns called for the Abuja
document to be used to guide the discussions in Johannesburg, and
demanded that African governments "translate their commitments to
action". Akanni said little progress towards the Abuja targets,
which include 80 percent coverage of antiretroviral treatment (ART)
by 2010, had so far been made. Most countries on the continent
currently have less than 30 percent ART coverage.
The petition also pointed to the failure of all but two African
governments to reach a 15 percent target for national health
spending, agreed to in 2001.
Among other items the coalition would like this week's meeting to
address are regional plans for tackling gender-based violence;
scaling up HIV prevention services; strengthening the regulations
that control medicines to make them safer and more affordable; and
the health implications of Zimbabwe's political and economic
Referring to the conference's theme of strengthening health
systems, the petition argued that "rapid scale-up of AIDS services
need not compromise health systems, and AIDS can be the engine of
strengthening primary medical care in Africa".
While civil society groups had been closely consulted in Abuja,
Regis Mtutu of the South African Treatment Action Campaign, an AIDS
activist group, described this week's meeting as "taking place in
"We're not anti-government, but we have a right to engage them. We
just want to see lives being saved," he said.
The petition, signed by all 53 member groups of the coalition, will
be delivered to the Sandton Convention Centre in Johannesburg,
where the AU meeting is being held, on Wednesday.
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