Eva Mashoo
29 June 2008
Nairobi — ORGANISATIONS INVOLVED in the fight against HIV/Aids, malaria and tuberculosis in the developing world need to improve the co-ordination of their programmes and co-operate more to avoid losing the gains made against the three diseases, a recent conference in Kampala was told.
The 2008 Implementer's Forum for the Global Fund against HIV/Aids, Malaria and Tuberculosis attracted more than 1,700 delegates from across the world to Kampala to discuss challenges of effectively fighting the three epidemics, which are the leading causes of death in the developing world.
Held under the theme: "Scaling Up Through Partnerships: Overcoming Obstacles to Implementation," participants recognised the need to rapidly expand HIV/Aids prevention, treatment, care and support programmes in the countries affected by the epidemic and in others that have previously registered gains.
It was a timely message for Uganda, which initially reduced the HIV prevalence rate from highs of 30 per cent of the adult population to around 6 per cent. Authorities in Uganda have warned that more people are getting infected each year, partly as a result of complacency about the disease.
During the forum, President Yoweri Museveni expressed dismay at the stagnation of Uganda's HIV prevalence rate and called for a scaling up of prevention strategies.
A senior official from the Global Fund against Malaria, HIV/Aids and Tuberculosis said the suspension of the programme in Uganda three years ago due to its mismanagement, had slowed progress in the fight against the three diseases.
Delegates to the conference heard, however, that a lot of progress in research has been registered and programmes to give out mosquito-treated bed nets and expand malaria treatment programmes have increased.
IT WAS ANNOUNCED, ON THE back of these developments, that the Global Fund would provide a new tranche of about $270 million to help fight HIV/Aids, malaria and TB in Uganda over the next five years.
It was revealed that a critical barrier to implementation has been the apparent reluctance of larger organisations to work with smaller implementers yet the provision of HIV services require mentoring of small clinics and medium-sized health centres, as well as systems for referral to bigger, better equipped hospitals.
Other challenges identified include the lack of universal access to anti-retroviral treatment for poorer people as well as some minorities such the gay community, which demonstrated against the discrimination against them in Uganda.
Homosexuality is a criminal offence in Uganda, but officials from UNAids called upon the government to reconsider its view and help the gay community and other disenfranchised groups get access to treatment.
The forum heard that Aids kills about 40 children every hour worldwide and called upon implementers to expand paediatric treatment programmes for HIV and Aids.
Dr Peter Piot, the UNAids executive director challenged leaders to contextualise Aids within the realms of social and economic development as well as security.
According to UNAids, some 420,000 children were infected with HIV in 2007 worldwide, bringing to 2.5 million the number of children living with the disease. Of the 2.1 million people who died of Aids in 2007, more than one in seven was a child.
Dr Piot's deputy, Michel Sidibe, added: "HIV prevention remains a major challenge for HIV implementers; it is time to rethink prevention approaches, tailor them to the realities of the epidemics, and define them not through quick wins and silver bullets, but through a better understanding of communities and practices."
THE DIRECTOR GENERAL OF the Uganda Aids Commission, Dr Kihumuro Apuuli, told the gathering that evidence-based responses in Uganda had helped identify the major drivers of the epidemic and that priority interventions would be deployed over the next five years with a view to reducing new infections by 40 per cent by 2012.
He said: "The major drivers or sources of the epidemic and new infections are sexual transmission, which takes up 76 per cent, and mother-to-child transmission [usually at childbirth]. The other drivers contribute less. They are mainly found among married couples living together and above 30 years. This is attributed mainly to having multiple sexual partners."
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