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| KEY PRESENTATIONS AND CONTRIBUTIONS |
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| MAJOR CONCERNS RAISED: |
WELCOME ADDRESS
Dr Muganwa, Chairperson SWAA – Uganda welcomed participants to the Conference and to Uganda. She said HIV/AIDS epidemic in Africa and in many parts of the developing world was extremely serious and was depriving us of the opportunity to advance in our socio-economic, political and cultural development. AIDS is arresting and even reversing some of the significant gains made in health and in other social and economic spheres. Efforts to both prevent the further spread of HIV and to mitigate its impact have had mixed results in many parts of the world. She observed that AIDS had reached pandemic levels in many African countries, especially those in sub-Saharan Africa with increasing numbers of infected and affected children. Thus the theme of this conference, “Children and AIDS: challenges and Strategies to cope, was particularly apt, and it was time for Africa to undertake a critical appraisal of its HIV/AIDS priorities and begin to re-focus interventions and strategies to prevent HIV.
The President and Co-chair SWAA –Uganda Ms Juliet Nassuna joined her in also welcoming the delegates, She noted that Uganda was one of the countries where the effects of the AIDS epidemic had been disastrous. HIV prevalence rates increased rapidly throughout the country and by the late 1980s it appeared that Uganda had the highest rates of infection in Africa and indeed the world she said but beginning in 1993, there had been a decline in the rate of HIV infection as shown by studies on pregnant women and other population groups.
Madam Stella Obasanjo in her remarks Madam said that while it was the human and reproductive right of every infected woman to choose when to marry or to have children of their own, it was important to support them through; Education to protect themselves from getting re-infected and to prevent them infecting their partners who may not be infected or did not know their HIV sero-status. She added that those who continue to deliberately infect others should be brought to justice and possibly be penalised by law. She observed that mothers who delivered healthy babies through the MTCT interventions, should be supported with alternative feeds locally available and affordable for sustainability, instead of imported artificial feeds that they may not know how to use. She implored the community not to discriminate stigmatise women living with HIV/AIDS and their children.
Mrs Anne Mkapa, the first Lady of Tanzania, noted that HIV/AIDS was a growing problem and hoped the deliberations would provide some solutions. She advocated for Community mobilisation to support children orphaned by HIV/AIDS.
The Queen mother from South Africa urged people not to look at AIDS as another disease, but one which required everyone to support those infected and affected. She said new strategies such as male involvement in understanding interventions like prevention of mother to child transmission, and support to women in all intervention programmes, should be identified. She advised that all socio-cultural issues need to be considered while developing interventions, adding that, good cultures be promoted if they assisted prevent HIV transmission, and bad practices that fuel transmission discouraged or abandoned.
Hon. Beatrice Wabudeya on behalf of the Minister of Health, welcomed the guests and affirmed Uganda’s commitment to the theme of the conference which was “Children and IDS: the Challenges and Strategies to cope.” She said in Uganda, AIDS had been given top priority as exemplified by the openness and the highest levels of political commitment.
In her remarks Mrs Janet Museveni, the first Lady of Uganda and Guest of Honour, welcomed all participants to SWAA conference. She congratulated SWAA (Uganda) for its good organisation. She thanked the First Ladies, Mrs Stella Obasanjo of Nigeria, Mrs Anne Mkapa of Tanzania, and the Queen Mother from South Africa, for having honoured the conference by their presence. She hoped that all participants would find the conference rewarding.
As a woman engaged in social development, she noted, HIV/AIDS was a great tragedy that had hit Africa and the time when the entire population was least equipped, the social infrastructure undeveloped and fragile. The government of Uganda she said, recognised as early as 1986 that HIV/AIDS was a problem and threat to socio economic development and instituted a deliberate policy of openness and political commitment aimed at creating awareness through campaigns of information dissemination as a means of prevention and control. As a result of this, several areas of success have been registered such as the declining trends in HIV infection since the mid 1990s. There was marked positive behavioural change among the urban youth with reduction in number of sexual partners, and it has also been noticed that age of first sexual intercourse for both male and female had increased. She said there was increased access to antiretrovirals, though the Drug access initiative, and reduction of mother to child transmission and through increased awareness. She was of the view that this success though limited was realised through participation and networking by various stakeholders. She therefore called for concerted efforts to combat to it through further information dissemination.
She noted that several challenges still remained for instance, lack of discipline among people. For example, she had noted through her involvement with organisations like UWESO and Mild May Centre that sometimes when an infected spouse died, the remaining partner, husband or wife remarried and orphans were left with grandparents, or to live in child-headed households. There was danger of re-infection and infection among such couples and infection of children they may produce. She felt it was every body’s duty to protect others from getting infected by the HIV/AIDS. She called for new systems to replace traditional care systems and to promote spiritual and moral growth.
Mrs. Museveni thanked donors especially UNAIDS, UNICEF, SARA, CASE-WESTERN UNIVERSITY, USAID, and WHO for the support they had given towards the organisation of the Conference, she was optimistic that success would be achieved at the end. She urged participants to unite and network in the struggle to combat HIV/AIDS.
KEY NOTE ADDRESS:
Dr. Awa Coll-Seck (UNAIDS) in the Keynote address, noted that HIV/AIDS infection rates were declining in Uganda and commended the people and leadership for providing a conducive environment that has enabled progress of various programmes.
She stressed that neither statistics nor expression of sorrow can prevent escalation of the AIDS epidemic and called on all people to cope with the situation through care and solidarity.
The situation in Africa is appalling given that the majority of all recorded cases of infection are to be found on the continent. Infection through mother to child transmission, blood transfusion, sexual abuse and exploitation accounts for the rise in prevalence. She hoped other preventive strategies would be developed through further discourse.
She advocated behavioural change, women empowerment to reduce their vulnerability, improved antenatal and delivery care practices, counselling and access to cheaper and affordable drugs such as the antiretroviral, and use of condoms and microbicides. She noted that while several communities had started these measures, more efforts were needed in the treatment of infected children through early diagnosis, regular baby care activities and clinical follow up. She said there were numerous challenges in the fulfilment of this task ranging from how differentiation of HIV-positive children would be done, to treatment of opportunistic infections and access to affordable drugs. There were also traditional health care systems, and psycho-social problems associated with young children at the loss of parents and family incomes. Cases of child headed families at a risk of stigma and discrimination, and increase in numbers of orphans and street children who themselves face sexual exploitation.
These issues she contended, needed to be collectively resolved nationally and internationally given that each community is powerless to work in isolation in support of children. She said the potential for collective action on HIV/AIDS was still untapped. These issues were echoed in the UNAIDS report on strategies to adopt:
Coordination And Sharing Of Knowledge.
Experience shows that the epidemic can be halted and reversed even when responses differ by setting. It is important that responses are led through community coordination and sharing of knowledge. Most important is to realise that there are different modes of transmission affecting different sectors of the population, and the extent of their capacity to respond. The Critical elements of which are;
· Political leadership necessary for increasing visibility of the epidemic and decreasing the stigma associated.
· Coherent national strategy and Plans which with external support and resources, can build technical, community and institutional capacity.
· Process Prevention, care and impact reduction which must proceed in unison.
· Increased level of resources on a sustainable basis to respond to the epidemic. These issues are necessary for any effective intensified response.
International Response
There is an intensified international response based on respect, protection and fulfilment of human rights, the framework of which provides for;
· National governments working with civil society to provide leadership and means required to ensure efforts to respond to country and community needs.
· Victims being actively engaged and supported in their efforts to address the epidemic in all communities.
· Addressing Gender inequalities that fuel the epidemic.
· Prevention methods, treatment and care being available on equitable and affordable basis to all.
Leadership And Coordination
To prevent denial and stigma and ensure involvement and accountability of all sectors and avoid fragmentation of effort, there must be committed leadership as an essential precaution for response. Leaders should promote openness, prevent discrimination and intolerance, understand gender inequalities and take concerted action to address them, involve people living with HIV/AIDS in efforts to prevent spread of the epidemic at national and community level, and develop multi-sectoral programmes that ensure coordination among actors to avoid duplication and focus energy and resources. This leadership should be experienced at all levels of society.
Alleviating The Social And Economic Impact
HIV/AIDS is affecting productivity and profits through its burden of sickness, absenteeism, and loss. It impacts negatively on development in terms of life expectancy and growth. As the epidemic deepens so will its impact. There is a growing problem of children orphaned by AIDS and that of HIV/AIDS in the workforce. World leaders have committed themselves that children should be assisted alleviate poverty and supported in sustainable development. Such commitment should be expanded to match the scope of the epidemic and sense of urgency. Children should be given access to education, health and social services on equal basis and monitored regularly in health care and well-being.
Reducing Vulnerability
It is common knowledge that the epidemic survives by forces of social and economic vulnerability that inhibit peoples capacity to control their risk to infection. This impact depletes the capacity of society and individuals to respond. Vulnerability includes exposure of women and girls to harmful effects of tradition and customary practices, and gender disparities. There is need to empower women to combat, poverty, hunger and disease, and other emergencies. Efforts should be made to address individual and societal vulnerability through legislation and policy measures.
Prevention
Prevention is essential in significant reduction of spread and impact. Efforts should target vulnerable populations such as sex workers, drug users and homosexuals. The global challenge is to make progress to achieving targets that encompass prevention methods such as health and sex education, access to condoms, counselling and testing, which should be broadened to encompass all social groups. Governments should intensify programme efforts to protect the health and human rights of vulnerable young people and commercial sex workers.
Care And Support
To promote a comprehensive approach to care and support what is needed is to refine strategies, set out the range of services to be provided, and standards. The challenge is in the task of building institutional capacity and resources for health and social service systems to be able to attract and train professionals, and support community-based organisations.
Voluntary counselling and testing is a vital point of entry for prevention and care as it helps overcome stigma and denial and leads to better management of illnesses. The development of effective anti-retroviral therapies has positive effects on social and economic impact. Unfortunately, access to these drugs and treatment is beyond reach of the majority. There is need to address the disparities in access to care and treatment. Governments need to put in place strategies that provide sustained development of HIV/AIDS related health and social services working with the private sector to ensure essential care is available on an affordable basis to those who need it, and that Anti-retroviral drugs are available at prices commensurate with local purchasing power.
Research And Development
Research into effective prevention and care technologies for HIV/AIDS such as vaccines, microbicides, new treatments and regimen is proceeding. Governments should increase their investments in this research to achieve broad access to new preventive and therapeutic approaches.
Resources
The challenge for governments is to mobilise resources to meet the scale and devastating impact of the epidemic. The resources are for expanding national capacities, essential infrastructure and training to mitigate the social and economic impact, expand preventive interventions and implement a broad care and support agenda. Increased investment from donors, domestic budgets, private firms and foundations and needed to meet these resource needs. For instance to state that about $7–10 Million are required each year is indicative of resources needed to service the expanded programme of reducing vulnerability and alleviating the impact. Areas of greatest prevalence should be budgeted for to make a critical contribution to halting the spread of the epidemic and increasing the quality of life of those affected. Governments should mobilise national and international financial resources commensurate with the estimated cost of containing the epidemic.
Special Session On HIV/Aids
A special UN session on HIV/AIDS to address international action to combat AIDS and secure a global commitment and resources was planned for the near future. In this session, governments were expected to develop and negotiate commitments and priorities for future action, which would culminate into a declaration of commitment by the General Assembly. This would in future be a reference for decision-making on AIDS by governments and non-governmental organisations. It would be a potentially powerful advocacy tool for civil society actors. The General Assembly recognises the importance of the contributions of civil society actors and underlines the need for active involvement of representative in the preparations. Participants were urged to ensure that priorities of the African region were reflected in those negotiations.
OTHER MAJOR CONCERNS RAISED:
The negative impact of HIV/AIDS now reverberates in all social sectors and poses a major threat not only to families and communities but, to the entire development processes of the Africa region. It is important to assist communities identify their needs and inherit capacities to address them through community driven initiatives with strategies to facilitate them. This was an underlying message in other key contributions.
The role of the media in reporting on children affected by AIDS.
There is need to raise awareness about AIDS and mobilise resources for people infected and affected. This can be done through raising funds and sensitising the media to break down the conspiracy of silence about HIV/AIDS. Unfortunately, advocacy cannot be done at individual level alone, it is necessary to build networks to get a big collective voice.
The media should be used to highlight work at grass root level. Advocacy through journalism should be pursued. Many journalists were however, found to be ignorant about HIV/AIDS issues. They are aloof from these health concerns and report in an alarmist manner.
There is need to develop capacity at rural community level to produce radio programmes and newsletter which address HIV/AIDS. There should be no assumption that media practitioners are well informed. They should be educated to protect themselves and to report on HIV/AIDS. Indeed workshops on children and AIDS should target Journalists to make them understand the relationship between children, their guardians or parents in relation to the epidemic, and whether the stories they produce cause further stigma and discrimination.
It is important to keep the subject in the news by buying space, air-time or writing Newsletters to cover various activities by communities leaders and NGOs on HIV/AIDS.
Spiritual dynamics of coping with HIV/AIDS.
Churches have a number of programmes in peer education and home care skills for children and youth, they also host clubs where youth experiences are shared which assists in behavioural change, change of attitudes, and development of interest of care for victims. The church also promotes positive parenting through Mothers’ and Fathers Unions, besides running health clinics
Traditional healers on the other hand deal with counselling and administration of traditional medicines some of which are potent in treating opportunistic ailments. In traditional counselling, it is imperative that positive cultures are enhanced and negative ones improved so as to improve responses to HIV/AIDS and reproductive health. This is a pointer to the importance of including spiritual guidance, and traditional healers in central responses to HIV/AIDS as a great portion of the population in most communities seek their services.
Enhancing capacity of children to cope.
There is need to know the magnitude of the problem to reckon with. Nearly 9.4 million people Sub-Saharan Africa alone are infected. It is important to keep them alive yet, inaccessibility to drugs and other forms of therapy is an issue to contend with. There should be a commitment to contribute by the community in terms of harnessing resources, ensuring that families are facilitated to be part of the resource.
Involvement should not be by those who test positive or bereaved families alone, because this increases stigmatisation. Rather, the affected should in conjunction with the communities help children to cope. Family support is vital in assisting children to cope and care for those diagnosed with HIV. In relation to this, resources in communities should be identified and exploited to facilitate community intervention programmes.
Strengthening of children in communication skills and systematic counselling would help them cope better. Basic morals and discipline are values which, are building blocks of children’s uprightness, should not be |
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