The sun is setting on those years when leadership on HIV/AIDS lacked in Africa. And we have had the opportunity to witness the progress that resources and enlightened political leadership can produce.
We have also seen the consequences when denial and shame have been allowed to prevail, Callisto Madavo, the World Banks Vice-President for Africa and Jean-Louis Sarbib, the World Banks Senior Vice-President for Human Development, write Wednesday in The Daily Nation (Kenya) and The East African Standard (Kenya).
Spurred by the success of forceful leadership in combating the pandemic in countries like Uganda and Senegal, a remarkable turnaround is in progress.
Today, the pandemic is clearly the cruelest thing sub-Saharan Africa has ever known: over 20 million lives have been lost, 25 million are infected with the HIV virus (70 percent of total world infections), 12 million have been orphaned, three million new infections occur each year leading to more than two million annual deaths.
In most countries, the pandemic has eroded many of the economic and social progress of the past 30 years.
In response to the tragedy and partially in reward for the forthrightness shown by a number of African leaders, the international community has committed unprecedented levels of resources in external help – nearly 2 billion US dollar (12 milliarder DKR) from the World Bank and the Global Fund alone in the past three years – to combat the pandemic.
Last month the World Banks Board of Executive Directors approved a 60 million dollar grant to accelerate access to HIV/Aids treatment in three pilot countries: Burkina Faso, Ghana, and Mozambique.
The goal is to prolong the lives of people living with the pandemic, improve their economic productivity, and help mitigate the growing problem of orphans and vulnerable children.
In all three countries, the Bank will complement the World Health Organization-led 3×5 Initiative, whose objective is to provide drugs to at least 3 million people living with HIV/Aids in developing countries by the end of 2005.
As the global community converges on Bangkok for the 15th International Aids conference, denial of the tragedy is not the problem any longer. Rather, the problem seems to be one of ensuring faster, more flexible, and aggressive strategies to avail treatment to all who need it.
To achieve this, governments, health agencies and donors must streamline their procedures, lift bureaucratic bottlenecks and facilitate access to treatment for all.
However, even with gains, solutions to many problems remain elusive. While the cost of antiretroviral drugs (ARVs) have fallen by 98 percent since 1996, they are still available to only 100.000 of the close to four million people in Sub-Saharan Africa who need such drugs to forestall the onset of full-blown Aids.
Progress depends on stronger political leadership that would not be seized by the kind of paralysis we have often witnessed when confronted with the enormity of the challenge. This has consigned the pandemic and those who suffer from it to a stigma they do not deserve, and their families to an unnecessary guilt and anguish.
We need deeper, more coordinated and flexible financial support, helping to establish a foundation of reliable, durable support in Aids-affected countries. Collaboration among partners in this effort can help deliver aid more efficiently, without overburdening fragile capacity in recipient countries.
Grassroots leadership is proving just as important, if not even more important. Over 25.000 subprojects on HIV/Aids have been funded in 28 African countries by the World Banks Multi-country Aids Program (Map), which has committed over 1 billion US dollar in assistance, tapping effectively into the latent capacities available through community-based organizations and other partners in civil society.
In contrast, the public sector in many African countries has been extremely slow in disbursing much- needed funds from the Map and other donor initiatives. Reversing that trend is a crucial, Madavo and Sarbib write.
Kilde: www.worldbank.org
