PRESS BRIEFING BY SPECIAL ENVOY FOR HIV/AIDS IN AFRICA

 

Zambia was a country “on the move against the pandemic”, Stephen Lewis, Special Envoy of the Secretary-General for HIV/AIDS in Africa, told correspondents at a Headquarters press briefing this afternoon.

Last month’s trip had been “unusually encouraging”, he said.  It had been the fourth time he had been to Zambia in the last two years, and the shift in the response to HIV/AIDS was palpable.  While there was still pain, frustration and death “in egregious quantity”, there was also an entirely new level of determination and hope that he had not encountered before.  That was due to a “constellation of change and commitment” that had altered the entire tone and content of the response to the pandemic.

Among the latest developments, he mentioned Zambia’s decision to provide free antiretroviral treatment, which up to now had been free only in parts of Lusaka.  The political leadership was engaged as never before.  The President had opened his meeting with Mr. Lewis with an all-encompassing review of every crucial aspect of his Government’s public policy on AIDS.  Equally committed were the Minister of Health, members of the cabinet and senior officials.  But most heartening of all was the way that commitment had filtered down to the local levels.

Of course, the response to the pandemic was accelerated by significant external support, he said.  The roles of the Global Fund on AIDS, Tuberculosis and Malaria, the World Health Organization and, in part, the World Bank, could not be underestimated.  Neither could support from governments like the United States and the United Kingdom.  What was more, Zambia had just met the International Monetary Fund (IMF) conditions imposed on debt relief, so that the excruciating debt service could now be alleviated.

In round four of the Global Fund proposals, Zambia had received some $253 million, much of it designated for treatment.  Therefore, Zambia was now likely to reach its target of putting 100,000 people into treatment by the end of 2005.  It would be a great leap forward, for currently there were between 17,000 and 18,000 people in treatment.  Also, in Zambia -- more than anywhere else he had yet seen -– the model for pMTCT “Plus” [the formula for preventing Mother-to-Child Transmission] was working wonders.  The “Plus” factor involved not only preventing HIV in newborns, but also treating the mother, her partner and any HIV-positive children as soon as necessary.

Another important factor was that the country, which had been starving two years ago, was on the verge of becoming the breadbasket of the immediate subregion, he continued.  There were still parts of the country to which food needed to be distributed, but the coming of rains had transformed everything.  Sadly, however, the level of agricultural production would have been even higher had so many farmers not died from or been taken ill with AIDS.

He also emphasized the role of Advocates for People Living with AIDS, which now had 190 support groups in many districts.  Last year, he recalled meeting with the leadership of that organization, when they could not even find an office space to pursue their work.  Now, they seemed much more confident, energetic and focused.  The organization was housed in the town hall municipal offices, with the President promising an even larger space.

Finally, the role of the United Nations had proven to be indispensable, he stressed.  United Nations agencies, impressively coordinated by UNAIDS and impressively led by the Resident Coordinator, were working hand in glove with the Government to confront the pandemic.  There was, inevitably, an occasional glitch, but the overall sense was of “such collaborative good will that every exigency, small or large”, could be overcome.  His United Nations colleagues recognized -- and not everyone did -- that the international community was in the midst of an emergency in southern Africa, which threatened the very survival of nation States.  It was the ultimate measure of multilateralism to be at the centre of the response, employing every instrument at the Organization’s command. Nothing less would do.

“Having said all that, ... let me insist that I am not given to self-delusion.  The balance sheet is still in deficit”, he said.  Among the main remaining problems, he listed “huge problems of capacity” in every sector, vulnerability of women, and the situation of orphans, which “has not begun to be addressed”.  Some 23 per cent of children were already orphaned, and the numbers were expected to rise to over 30 per cent by 2010.  The treatment of children was still wanting, the paediatric formulations were still missing and the availability of counselling and testing was still insufficient.  HIV/AIDS still remained to be embodied in formal legislation, and the Government had yet to appoint a permanent director of the National AIDS Council.

In conclusion, he recalled how, at several hospices, he had been confronted with young men and women, mostly women, who were dying, unnecessarily, in the absence of drugs.  That was a heart-wrenching scene common to every country in southern Africa.  Looking at them, he could not get out of his mind the figures in the United Nations report released last week, showing that expenditures on armaments had now reached $1 trillion a year, worldwide.  The Global Fund on AIDS, Tuberculosis and Malaria was asking for less than three tenths of 1 per cent of that amount and could not seem to get it. “I wonder if anything would change if the G-8 Summit were held in Lusaka?” he asked.

Responding to a question about a growing number of sexual assaults in Zambia, he said that that, indeed, there was concern about the level of sexual violence in the country.  The concern was, of course, accentuated, because violence often allowed for transmission of the virus.  Legislation was being drawn on “child defilement”, and he had no idea why it was not called child rape, for that was what it was.

Could sexual assaults be attributed to the fact that men increasingly went looking for virgins in the belief that it would protect them from AIDS? a correspondent asked.  Mr. Lewis replied that it was hard to know how much credit should be given to the reality versus mythology.  Some believed that one should have sex with a virgin to cleanse the presence of AIDS.  At the same time, there were obvious serious problems, of older men, in particular, and young girls who were susceptible to sexual assault.  The Government was concerned about that situation.

Asked if the effort in Zambia should be used as a model for the rest of the region, he answered that, indeed, he had a sense of “movement” in Zambia.  The Government was doing a number of things that could serve as a model, but other countries were also introducing measures that could be emulated by others.

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