DEPUTY SECRETARY-GENERAL SAYS HIV/AIDS PANDEMIC ERODING AFRICA’S DEVELOPMENT

 

GAINS, RESEARCH NEEDED TO STRENGTHEN ON THE GROUND STRATEGIES AGAINST DISEASE

Following is Deputy Secretary-General Asha-Rose Migiro’s remarks about the social and economic dimensions of HIV/AIDS in Africa at the United Nations University and Cornell Lecture Series in New York, 9 September:

I am honoured to speak at this third Symposium of the United Nations University and Cornell University Africa Series.  All the themes selected for this series are of critical importance to Africa, and none more than HIV and AIDS.

The pandemic, in many parts of the continent, is eroding the developmental gains of the post-independence era.  The challenges require our collective thinking and I am heartened you are gathered here to take on this task.

As you are well aware, Africa is the continent so far most affected by HIV and AIDS.  Estimates show that, in 2007 alone, 1.6 million people in sub-Saharan Africa died from AIDS.  Another 22.5 million people are living with HIV.

The epidemic strikes at the core of human development, killing young adults at the prime of what should be their most productive years.  Loss of life and the weakening of human capabilities deprive communities of their most valued resources.

For high-prevalence countries, the epidemic systematically deprives sectors -- such as health, education and agriculture -- of skilled workers, thus reducing overall national productivity.  Many of these sectors heavily impacted are already struggling, and the multiplied effect is crippling.

Assessing the overall economic impact has not been easy.  Several studies, using a variety of economic modelling approaches, indicate that the epidemic reduces the average GDP [gross domestic product] growth rate by between 0.5 and 4 per cent in most affected African countries.  Whether the figure is 0.5 or 4, it is a big loss for poor countries whose economies need to be growing rather than contracting.

And yes, academic rigour is essential, but I encourage researchers to also think about our needs.  It would be most helpful to draw policy conclusions that organizations like ours and NGOs [non-governmental organizations] working in Africa could use to strengthen their activities on the ground.  It would also help African Governments in preparing their strategies.

We also need more information on the exact nature of the disease in a particular area.  AIDS has a different impact, both between and within countries.  I think the Commission on HIV/AIDS and Governance in Africa characterized this well when it noted in a recent report that Africa is suffering from several epidemics.

Within southern Africa, some cities are showing a declining rate of infections, while in others the rate is still rising.  In parts of southern Africa, young girls and women have up to six times the infection rates of their male peers.  A lot has been written about these variations, but not enough of these observations have translated into policy or national intervention strategies.

Take the example of Botswana, a relatively successful African economy, where the prevalence rate in the general population is 17.1 per cent.

Botswana’s annual GDP growth averaged around 13 per cent, from independence in 1966 to 1989.  Yet when the effects of AIDS began to be felt, from 1990 onwards, average annual GDP growth dropped by more than half to 6 per cent.  Life expectancy at birth also fell sharply from 65 years in the 1990 to 1995 period, to less than 40 years in the 2000 to 2005 period.

All across Africa, individuals and communities have responded to the challenge with remarkable courage and initiative.  Yet their untold suffering raises some important questions:

How are individuals and households altering their behaviour in an environment where life expectancy has dropped like this?  Will people be willing to invest in the future, or will they feel they have no future?  How will entire societies adjust to the loss of parents, partners and many others in the prime of their economic life?

Some answers can be found by conducting studies that focus on individuals, households and small businesses, to show the local impact of the disease and guide policies and action.

Household studies done in Ethiopia, Malawi, Uganda, Zambia and Zimbabwe show that affected families are spending more on medication and have lower incomes due to time spent either ill or caring for sick relatives.  Businesses also suffer through absenteeism due to the ill health of a worker or a member of the worker’s family, higher medical care and benefit costs, funeral costs for employees, attrition due to illness or death and efforts to recruit new staff.

Research efforts should recommend policies for inclusion in national strategies for dealing with the disease.  To date, few studies have been able to incorporate household level information into national action plans.  I am encouraged that this Symposium will be discussing research methodologies.

Researchers often complain about the lack of accurate statistics in many African countries, which makes it difficult to gather information for scientific evaluation.  I would like to emphasize the importance of local knowledge here.

Use local universities and local research centres to systematically document information.  They are based in Africa, are working in Africa and living in affected communities.  This will improve the quality of information available.

I commend this forum for inviting speakers and experts working and living in Africa to participate.  But beyond this, I would like to appeal to the United Nations University, to Cornell, and to all researchers and universities represented here today, to develop a durable partnership with African institutions.

International organizations should also commission more work from African institutions.  Knowledge provides a key to development.  Where this is lacking, African institutions are best placed to fill this gap.  Such collaboration will connect them directly to the international research agenda, while keeping skilled manpower on the continent.

Stigma is a lingering critical issue in fighting HIV.  Almost everywhere in the world, discrimination remains a fact of daily life for people living with HIV, men-who-have-sex-with-men, injecting drug users and other communities at risk.

Stigma remains the single most important barrier to public action.  It is the main reason why many people are afraid to see a doctor to determine their status or to seek treatment.  Stigma helps make AIDS a silent killer because people fear the social disgrace of speaking openly about the disease, or taking easily available precautions.

And stigma is a big reason the AIDS epidemic continues to devastate societies all across the globe.  We see this clearly when it comes to young women, the group most at risk of contracting HIV in several countries.  Many of them are afraid to seek advice on prevention.  Many do not trust the confidentiality of voluntary counselling and testing.  Outreach programmes need to target young women directly and legislation must protect them against reprisals.

We can fight stigma with enlightened laws and policies.  But more importantly, these policies have to be vigorously enforced.  In many countries, good policies exist on paper only with no commitment to enforcing them.  In areas where legislation protecting women is enforced, and where inheritance laws recognize women’s rights, they are less vulnerable to infection.

This calls for leadership at all levels of society.  From Presidents to teachers, religious and traditional leaders, the media -- we all have a duty to speak out loudly and clearly against discrimination.

The Secretary-General has shown leadership in the fight against HIV.  This will remain a priority for him.  He has further demonstrated this commitment by meeting regularly with staff members living with HIV and listening to them.  He often uses personal experiences garnered from these meetings to campaign against stigma and discrimination.

The entire United Nations family is committed to this fight.  Joint United Nations country teams are working to strengthen nationally owned, multi-sectorial responses through coordinated programmes, providing technical support and acting as brokers with crucial partners -- notably civil society, including people living with HIV.

UNAIDS brings together the efforts and resources of 10 United Nations system organizations in the AIDS response.  Specific to development efforts, UNDP [United Nations Development Programme] works with African countries to strengthen macroeconomic frameworks that promote sustained financing of AIDS responses and increased access to low-cost quality medication for those in need.

The fight against HIV and AIDS is one that, collectively, we can win.  The world has seen and defeated several epidemics before.  The Millennium Development Goals (MDGs) call for a halt to new infections and a reversal of the spread of HIV by 2015.  As part of this effort, universal access to treatment must be achieved by 2010.  We must also leverage the lessons and successes of the response to AIDS to other health-related MDGs.

You come from various backgrounds and you have dealt with the range of topics before you, sometimes in different ways.  I trust that you will have stimulating conversations and benefit from the experiences of your peers. 

Your work must succeed; there is no option for failure.  And you can count on the Secretary-General and I as strong supporters in your endeavours.

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For information media • not an official record