HIV Prevention Efforts in the

SADC Region

Vth Sahara Conference, Midrand 2 dec.2009

Dr Alphonse MULUMBA

SADC Secretariat

BACKGROUND

HIV and AIDS = a great challenge for the regional integration

� The region remains the most heavily affected by the epidemic

� 9 countries with the highest HIV prevalence worldwi de (prevalence >10%)

� transmission mainly heterosexual, women more infected than men

� diversity of epidemics between and within MS � over a third of new infections and AIDS deaths per year

Unless new infections of HIV are reduced significantl y, the rising costs of treatment and care will be overwhelming and

unachievable long term, posing a serious threat to th e potentialfor MS to realise the human, social and economic devel opment

goals of the region.

REGIONAL COMMITMENTS

� Millennium Development Goals (MDGs), 2000� Abuja Declaration on HIV and AIDS, Malaria and othe r

Communicable Diseases, 2001� Declaration of Commitment of UNGASS, 2001 � The Maseru Declaration on HIV and AIDS, 2003, by

SADC Heads of State� Brazzaville Declaration on UA to HIV prevention,

treatment, care and support (2006)� SADC HIV and AIDS FUND

. Now? Translation of these commitments into truly effective,

efficient programmes brought to scale across the region

KEY DRIVERS OF HIV in the SADC REGION

tt

MCP by men and

women with low

consistent condom

use, in the context of

low MC

Male attitudes and behaviorGender and sexual violenceIn

terg

eneratio

nal sex

Stigma, lack of

openness, unttt

STI

Lack of consistent condom use in long term concurent

partnership

Inequalities of wealth

High p

opulatio

n mobili

ty

Cultural factors

Gender inequality

EXPERT THINK TANK PREVENTION MEETING, MASERU, 2006

HIV Prevention Efforts in the SADC Region

� Some positive changes in epidemic dynamics identified

- growing evidence of a decline in adult HIV prevalen ce- prevalence declines in young women attending

antenatal clinics- associated with significant changes in sexual

behaviour

A confirmation that investments made in social and

behavioural change interventions can work for HIV prevention,

but they must be scaled up with rigour and in combination with

other actions that reduce HIV risk and vulnerability

HIV Prevention Efforts in the SADC Region

� Mobilising efforts and scaling up the HIV prevention response

- Expert Think Tank Meeting on HIV Prevention , Lesotho 2006

Identification key drivers of the HIV epidemic and

Recommendations for the acceleration of prevention efforts to

address them

HIV Prevention Efforts in the SADC Region

� SADC Regional Strategy and Action Plan for Universal Access to Prevention 2008-2010 was developed

� SADC Regional HIV Prevention Working Group

with the aims of harmonizing country policies and practices and

mobilizing for the effective use of resources with the goal of

significantly reducing new HIV infections by 2010.

forum set up to provide broad based technical support and

guidance in the implementation of the SADC Regional Strategy

and Action Plan for Universal Access to Prevention (2008-2010)

.

HIV Prevention Efforts in the SADC Region

� Regional SADC HIV Prevention Meeting: “Achieving Prevention Targets”, June 2009

� to review progress, identify emerging evidence and p riorities for HIV prevention in the coming period.

MS are implementing a variety of HIV prevention strate gies (BCC,HTC, PMTCT, condom, MC )

Substantial progress but so far results are still mixed across MS�Review and alignment of NSF on regional commitments� Decline of HIV prevalence in some MS � Increased PMTCT coverage � Condom access and use have increased in some MS, ongoingchallenge to improve levels and consistency use, and reliable access� Progress in implementing activities related to MC

HIV Prevention Efforts in the SADC Region

� Regional SADC HIV Prevention Meeting: “Achieving Prevention Targets”, June 2009

Despite implementation of all these interventions, p revention islagging behind� The level of most of the prevention indicators in the region still leaves lot to be desired�prevention interventions largely focus on primary preven tion

� the programmes are unlikely to achieve the requisite pos itive impact .

programmes are working? , good programmes are not implemented to scale?, lessons are not documented? Experiences of ‘what works’ are not shared across the reg ion?

HIV Prevention Efforts in the SADC Region

� Regional SADC HIV Prevention Meeting: “Achieving Prevention Targets”, June 2009

Set the targets of “halving new adult HIV infections by 2015 and the virtual elimination of MTCT (thereby virtually elimin ating new infant infections)

•Rapid analysis of current NSF and plans to ensure a strong evidence-based prevention component•Mobilising effective leadership at all levels of GVNt t o take ownership and accountability of the HIV prevention a genda•Revising budget allocations to ensure adequate fund ing for prevention• Increasing strategic partnerships for full implementat ion of HIV prevention strategies, in particular with traditiona l leaders, CSO•Understanding and establishing a stronger connection b etween HIV prevention and treatment.

HIV Prevention Efforts in the SADC RegionHIV and AIDS STRATEGIC FRAMEWORK 2010-2015

Vision : Common future with no threat for HIV and AIDS…

Goal: SADC controls and reverses as shown by achievement of MDG by 2015

P.A.3

Accelerating

dvpt and

mitigating

impact

P.A. 1 : Effective

Prevention and

social mobilisation

P.A.2:

Improved

Access to care,

counseling, test,

ttt, care and

support

Obj.1: 50% reduction of

new infections

P.A.4:

Intensifying

resource

mobilisation

PA.5: ME and

institutional

strengthening

OP1: Strong proactive , political leadership and

champions

OP2: Effective evidence based and coordinated

response to HIV prevention

HIV Prevention Efforts in the SADC Region

� Regional SADC HIV Research Agenda, 2008 Role of social sciences researches in HIV prevention is KEY, as

cultural norms and beliefs have a potential to fuel HIV transmission and may also support HIV prevention efforts

� One of the priorities of the SADC Research Agenda : “ Promote studies that permit better understanding of th e behavioral and the psychosocial determinants of HIV re lated risk and protection ”

SOCIAL SCIENCES RESEARCHES WILL HELP

• in understanding better what motivates people’s behaviours• in knowing how to address these motivations appropriately• in taking in to consideration people’s cultures when developing programs addressing HIV prevention

CONCLUSION

• The nature of the HIV epidemic has changed over seve ral decades, responding to it must be rooted in current ev idence and analysis

• Although the key drivers are well known, it is importan t to better understand the distribution of the risk factors within the population

• Social Sciences Research to play a Key role • To achieve success in preventing new HIV infections , robust

strategic partnerships must be consolidated between government, CSO, CBO and FBO, Traditional Authorities, Regional Bodies, International Development Partners a nd the Private Sector

With all of us working together and supporting each other, yes,

we can, and we can turn back the epidemic in this region.