H.E. Mrs. Amira Elfadil Mohamed, Commissioner for Social Affairs, African Union Commission
01 December 2020 – Addis Ababa, Ethiopia: Each year on World AIDS Day, we take time to reflect upon our worldwide response to the HIV/AIDS epidemic by remembering where we started decades ago, honouring our achievements, and pledging to work harder and smarter, for more inclusive and innovative strategies towards the end of AIDS by 2030. This year, health systems are in the most pressed state in history, as we strive to meet the socio-economic shocks and disruptions brought about the COVID-19 pandemic. It has been encouraging to see African Union (AU) Member States fight through the pandemic with a spirit of commitment, innovation, and collaboration – more than we have witnessed before. As we commemorate World AIDS Day 2020 under the theme “Global Solidarity, Shared Responsibility,” I extend gratitude to Member States and all our partners who have continued to work together to protect communities from complete outage of HIV prevention and treatment services.
Today, I will specifically reflect on the leadership, dedication and resilience directed towards the HIV response in Africa in the era of Millennium Development Goals. By mid-2015, the number of people accessing antiretroviral therapy (ART) reached nearly 16 million—double the number just five years earlier. This remarkable achievement marked the first time a global health target was met and exceeded. Currently, we are off track to reaching the targets we set for 2020: 90% of all people living with HIV knowing their HIV status, 90% of people who know their HIV-positive status having access to treatment and 90% of people on treatment having suppressed viral loads. The target for 2020 also include reducing new HIV infections by 75% and achieving zero discrimination. The presence of COVID-19 has pushed many AU Member States further off track, but I am confident that if we attained great achievements in 2015, we will do it again. I encourage AU Member States to assess their HIV response journey and strengthen the interventions and systems that have brought them positive outcomes over the years. The lessons learned in responding to HIV will play an instrumental role in the success of many of the SDGs, notably SDG 3, good health and well-being, and the goals on gender equality and women’s empowerment, reduced inequalities, global partnerships and just, peaceful and inclusive societies.
Leaders and communities need a fresh thinking in how we approach beating HIV/AIDS. We all need to leverage on pre-existing resources in the communities we live in – skills, knowledge, and practices – which are valuable tools in the fight against AIDS. Community initiatives that build upon traditional systems are more efficient as they typically: require less training and input from external sources; are more relevant as they are readily understood and accepted by community members; and more sustainable as people are quicker to identify with, adopt, and take ownership of such initiatives. When HIV awareness education and consciousness-raising is designed with the community in mind, then it demystifies the virus and breaks down associated stigmatization, discrimination, and other cultural barriers to effective action. This fosters an atmosphere in which community members feel more able to speak out and mobilize towards issues regarding HIV/AIDS. In AIDS-competent communities, it is predicted that quality of life will start to improve from the point in time that the community acknowledges the problem collectively and begins to take action.
Empowering the community to also utilise what is within their reach will ease the burden of dependency of foreign aid to finance HIV treatment and services. Funding for HIV in Africa has decreased significantly since 2018. This is consequential to efforts of maintaining HIV treatment and care on the continent. Despite this predicament, AU Member States still hold the responsibility of investing upfront in scale-up of HIV services to achieve high coverage levels will reduce HIV incidence, prevention, and future treatment expenditures by realising long-term preventive effects of ART to reduce HIV transmission. Debt sustainability for sustained HIV response is an urgent imperative for affected AU Member States and donors, but it is time to invest from resources that are locally available through innovation and improved resource pooling systems. New sources of funding, in addition to domestic sources, need to be taken up to meet future health-related obligations. The African Union Commission concluded a series of Africa Leadership Meetings (ALM) of Ministers of Finance and Ministers of Health where the ministers pledged to work together for more money for health, and more health for money. With this level of commitment, we now have the mandate to ensure that, at every level, we are building systems and structures that are responsive and flexible, ensuring all stakeholders are engaged, and are working with a long-term perspective of ending HIV in Africa by 2030.
COVID-19 has challenged how we provide health care services and emphasized that everyone, everywhere should have access to the health care they need, whenever they need it. The HIV response has severely left out some members of the community especially women, girls, refugees, and children. They all need access to HIV prevention, treatment, and care at the community level. They need a role in decision-making that affects their lives, advocating for their priorities to be part of HIV strategies, and leading grassroots-level work to enable those living with and affected by HIV to know and assert their rights. Enabling leadership and engagement of young women and adolescent girls’ in the design, implementation and monitoring of HIV programmes and policies, is key to ensure their needs are prioritized. We must create and institutionalize spaces where they can voice their priorities, and be heard. We must also provide networks of women living with HIV with adequate resources to sustain their efforts and collective action. Stigma because of COVID-19 has been a reminder that communities can provide vital support, but can also be a source of stigmatization and discrimination. This has put many people living with HIV at greater risk for HIV, and created barriers to access to services. I call on Member States to promote and build systems and procedures that allow for equitable access to health and well-being, for all.
Global, regional, national, and sub-national or local efforts need to connect in a coherent way. We need a clear and honest discussion of synergies and potential trade-offs. We need to strengthen the science-policy interface: enhancing the role of science in policy making, implementation and monitoring; and promoting the generation and dissemination of innovations and technologies that help accelerate progress. The Africa Health Strategy, the AU Agenda 2063, and Catalytic Framework to end AIDS, TB, and Malaria by 2030 all call for inclusivity and collaborative efforts towards end of disease burden in Africa. Let us work together to accelerate the implementation of these policy frameworks endorsed by AU Member States, and largely the SDGs. The HIV epidemic has led to evolution in community activism, international solidarity, and cooperation in the fields of science and medicine. Consequently, the HIV response in Africa stands as a formidable example of multilateralism and global cooperation. We must continue in this spirit, with AU Member States leading by example. Let us support ongoing initiatives such as the Free to Shine Campaign, which is co-led by the Organization of African First Ladies for Development (OAFLAD), to help end childhood AIDS in Africa by 2030 and keep mothers healthy in Africa.
In conclusion, I reiterate the Commission’s renewed commitment to work with different partners across sectors to go in the direction needed to achieve the Africa We Want. The HIV community has always been resilient, overcoming obstacles and challenges and constantly adapting our approaches for life-saving impact. The COVID-19 pandemic has indeed diverted resources from other important programmes but gains in the world’s HIV response must not be reversed. Now is the time for bold approaches against COVID-19 grounded in scientific evidence, community involvement, human rights protection, and leadership.
I thank you