Festus Mogae
5 August 2008
Mexico City — Former president Festus Mogae has addressed the 17th International AIDS Conference in Mexico City, describing his audience as "my global brothers and sisters, who share the sorrow of AIDS and the hope of overcoming it".
He added: "To all in the audience living with and affected by HIV/AIDS, I say welcome." The former head of state, who has retained the chairmanship of NACA, the local AIDS coordinating agency, said: "Together, on the eve of this great global conference, let us take a moment to look back and to see how far we have come. From fear and ignorance of this frightening new illness, that sickened and took our friends and relatives, consider the knowledge and tools that 25 years of painstaking research have put in our hands. Three million people on antiretroviral therapy worldwide is not just the greatest public health achievement of the new century, it is a tribute to all of you who have fought so hard to understand HIV and to make available the drugs that are saving these lives. I salute the activists, researchers and doctors who together have made history. I want to salute and acknowledge the leading role of pharmaceutical companies of the world who are often maligned.
"Ladies and gentlemen, over one million of those people who started therapy for the first time last year, did so in the continent of Africa. In Africa where, just a few years ago, it seemed impossible to consider giving antiretroviral (ARVs) therapy. "The drugs are too expensive, there was fear that the patients would not understand the complex regimens, that there would be an epidemic of resistant HIV... And yet country after country has proven the nay-sayers wrong and delivered this service to its people. Today, in my country Botswana alone, almost 100,000 people are receiving antiretroviral therapy - almost 95% percent of those in need. I salute the leaders and the policy makers who have committed themselves to bringing AIDS therapy to Africa. I salute our international partners and the dedicated individuals who have brought assistance and resources from so many countries.
Ladies and gentlemen, only 15 years ago no one in any country knew how to protect a baby from being infected with HIV if her mother was living with the virus. When we first introduced the new preventive drugs, uptake was slow - but we persisted. Today in Botswana transmission of HIV to babies has dropped to 4 percent - a level comparable to that in much wealthier developed countries, with much smaller epidemics. I salute the managers, the nurses and the counsellors who have made this happen; but most of all I salute the mothers who, in the face of fear, stigma, uncertainty, and often lack of support from partners, have done everything they can to protect their babies and families.
"I believe we have all come to this conference because we share a profound commitment to preventing new infections, extending treatment and care to all people with HIV and mitigating the impact of AIDS. Our efforts are unprecedented, and our successes are real and important. In recent years, finally, the annual numbers of new infections and AIDS deaths have fallen. We certainly want to recognise the progress achieved, but and it is a big but, we must also acknowledge that the progress has not been uniform.
"Africa, especially southern Africa, remains disproportionally affected by the epidemic. In our nations are two thirds of the people living with HIV worldwide - and 90 percent of all the children. Although in some countries HIV prevalence rates have stabilised, it is at levels so high that they almost defy belief: 24 percent of adults in Botswana, 23 percent in Lesotho, 26 percent in Swaziland and 18 percent in South Africa. There were 1.9 million new HIV infections in sub-Saharan Africa in 2007. As I have said before, Prevention of new infections should be our priority number one, priority number two and priority number three. Although we take pride in the tremendous progress made in treatment - we have to acknowledge that we cannot treat the epidemic away.
Within Africa also, progress has not been uniform. It is true some countries have had more success than others in expanding prevention programmes. This is not a cause for finger-pointing or blame - it is an opportunity for learning and solidarity. Why have some initiatives been successful and others not? What resources and tools do countries need to make prevention work? How is national leadership, civil society, the churches - in short, how is the entirety of society to be engaged to turn the tide against HIV and bring these terrible numbers down? To do this we will need volunteerism, ownership and activism - and leadership, which can exist at every level, and in all walks of life.
"I'd like to quote one of the Recommendations from the United Nations (UN) Secretary General's report for the High Level Meeting on AIDS held in New York in June this year. It says:
'"In countries where HIV prevalence exceeds 15 percent, only an unprecedented national mobilisation, involving every sector of society and making use of every available prevention tool, will meet the challenge posed by such catastrophic continued spread of HIV'". It is this unprecedented mobilisation for prevention that has occupied my thoughts. In many of our countries, the elements of success are already in place. Governments and their international partners have made unprecedented resources available. Some countries and communities have achieved striking results with prevention. Progress is being made - but it must be accelerated and greatly broadened. I believe that part of the solution is for African leadership to come together in a spirit of shared responsibility. Where HIV prevention has worked, time and again the solutions have come locally from the affected communities. As African leaders, we can foster the development and growth of African solutions by opening a dialogue amongst ourselves for conversation and learning.
"We need innovation and a new spirit of vigour in HIV prevention in southern Africa. We must determine what are the most effective ways to reduce transmission where multiple concurrent sexual partnerships appear to be driving the epidemic. We must tackle head on the issue of early sexual debut with vulnerable young girls. How do we teach these young women to negotiate safe sex and dominance? For our brothers and sisters that are already positive, what community support mechanisms need to be fostered to prevent further transmission? We know what works in epidemics that are still concentrated in those that engage in risky behaviour such as injecting drug use or sex work.
"How do we help governments to support programmes that are proven to be effective? We must not be afraid to take controversial steps - so long as we are careful and caring of people's needs and rights. One obvious example is the heated debate a few years ago over Botswana's decision to adopt provider-initiated opt-out HIV testing for pregnant women. The evidence now supports the decision. We must distinguish human rights, which are absolutely sacrosanct, from civil rights, which are contextual.
"This is not only about individual efforts, but also about collective responsibility, to our families, to our friends, our communities, our countries and continents, and to our global village. We must, individually and collectively, continue to speak up openly about AIDS. We must tackle both the direct risk behaviours, and the indirect causes that lie deep-rooted in society. We cannot remain passive, refusing unpleasant facts or pre-judging our fellow countrymen who are HIV positive. We must not blame or judge, but support and encourage each other, so that we can, together, achieve our goal of a generation free of AIDS. It can be done, it has to be done."
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