Tuesday, 27 December 2011

World Aids Day - a time to unite to ensure ongoing commitment

HIV and Aids must not fall off the radar – the issue is as pertinent and urgent as ever. When the Health Minister Aaron Motsoaledi was appointed after the last South African elections, he drove the national programme with admirable focus and commitment. He set bold targets for counselling and testing and for increasing the numbers of people on treatment. He confirmed and consolidated the end to denialism and ensured the revival of the National Strategic Plan as a platform for action.

The attention in the public space shifts and changes all the time; this causes particular problems for those working directly on the challenges and impacts of HIV and Aids. As he assumed office, the Health Minister powerfully foregrounded HIV and Aids and government's key strategies. Then, for a time (especially during 2010), the national discussion was dominated by the proposed National Health Insurance. HIV and Aids featured somewhere in those debates, but not centrally so. In the current period, society and the public are not being galvanised to continuing action on the issue. Aids co-ordination seems weak and, of late, there is little vigilance in ensuring steady resource flows to organisations and community groups dealing with the pandemic.  This then is the challenge: HIV/Aids sometimes recedes into the background as far as the national agenda is concerned.

Apart from the high numbers of people requiring treatment and the need for ongoing prevention work, there are a range of crucial issues. One of those is funding. where the Global Fund commitments in the past failed to meet minimum needs and requirements. The latest blow has been the announcement, in December 2011, that the Global Fund will face severe cutbacks this year and predicts a negative budget for 2012. This is due to governments everywhere reneging on their commitments – and short-sightedly so; they are making the political choice to targeting HIV/Aids funding for cutbacks, instead of dealing with excess and misgovernance, as part of their response to the global recession. Another element of this has been the failure of African governments to meet the Abuja commitments, that is, to spend at least 15% of their overall budgets on health.

Because I have worked in behaviour change communications, I place particular emphasis on this aspect of HIV/Aids work. No doubt the counselling and testing operations, the plans to ensue greater use of male circumcision, increased access to treatment and emphasis on stemming mother to child transmissions are critical. However, I have a particular concern about the decline of attention and resources to communications interventions. The latter kind of intervention forms an important adjunct to the other programmes, and is key to ensuring a proper and holistic societal response – including a reduction in stigma and discrimination.

This World Aids Day needs to see a re-dedication to a holistic response to HIV and Aids. It should also be used as a platform to fight attempts – in terms of the choices nation states make as they deal with economic crises – to cut back on funding for global HIV and Aids programmes.-