Bouquets and brickbats …as UNAIDS boss assesses HIV responses

By Moses Magadza in Mahe, Seychelles

The world has made remarkable progress towards ending the AIDS epidemic by 2030 but there is still need to ensure that no one falls through the cracks or is left behind, the executive Director of UNAIDS and Under-Secretary-General of the United Nations, Dr Michel Sidibe, has said.

He made these remarks when he became the first United Nations staff member below the rank of Secretary General to address the joint sitting of the National Assembly of Seychelles here on Friday morning.

He said with an unprecedented HIV and AIDS epidemic, the world was at a critical moment characterized by rapid transformation.

“We are faced with seismic political change because from the north to the south, we are seeing growing conservatism; geopolitical, demographic, climate, technological and socioeconomic changes; protectionism; and isolationism becoming the words we are faced with every day,” Sidibe said.

He said young people, who make approximately 60 percent of the world’s population, bore the brunt of this rapid transformation.

“This is translating into lack of economic opportunities for young people. The major challenges we are facing are lack of cohesiveness and governance systems which could allow us to redistribute (resources) to make sure that we have true social justice and greater access for people who are left behind.”

His view was that there was poor integration of young people in the mainstream economies of many countries, with many people aged below 25 years being jobless, hopeless and vulnerable to HIV infection.

According to him, many such young people faced, also, lack of knowledge, information or skills to protect themselves or access essential services.

He said Members of Parliament in Seychelles and elsewhere had a unique role to play in creating links between different aspects of the lives of young people in a transformative manner. He suggested that MPs make access to food, health, productive lives, jobs and education priorities if they value peace and stability, saying that neglected young people had a tendency to abuse alcohol and drugs.

“We know that in this region people who inject drugs are the major vectors of HIV transmission. Reflect critically on these issues and use your critical leadership and the vision you have set for your country to (enact) laws that can address these issues,” he advised.

In addition to creating opportunities for young people, Sidibe said MPs could lead efforts towards eradicating stigma and exclusion.

He cautioned: “When people – particularly young people – are vulnerable, stigmatized, discriminated and in some cases criminalized, they go underground. They are left behind, faced with prejudice and don’t access services.”

Former UN Secretary General Kofi Anan is on record as saying that while drugs had destroyed many lives, wrong government policies had destroyed many more. Sidibe concurs but says not all is lost. He recalled that not long ago the African continent’s hospitals were full of people who were dying from AIDS-related complications while despair was deep-seated.

“Today I can say with confidence that we have moved from despair to hope,” he said.

He held up the example of South Africa which initially did not invest much in HIV treatment but now has about four million people on treatment, making her a major success story.

“For the first time in the history of this epidemic, we have more people on treatment than people waiting for treatment.”

He hailed Seychelles for firm leadership and commitment on aspects of the HIV response, particularly achieving 100 percent success in prevention of mother to child transmission (PMTCT). Official records show that over the past nearly three years, only one child has been born HIV positive from infected parents in Seychelles.

“Your country has been able to demonstrate that leadership matters, that right policies are key and that decisions taken by this Parliament to allocate resources can make a difference. These success stories must be shared.”

Still, gaps remain. Sidibe said globally, there was a “major problem” with lack of inclusiveness with respect to key populations that include people who inject drugs, men who have sex with other men, sex workers and prisoners.

He revealed that efforts to halt and reverse the global HIV epidemic in Eastern Europe and Central Asia were stalling because injecting drug users were in hiding with little or no access to harm reduction programmes.

“We are seeing a growing epidemic in those places.”

He said other countries could avoid a similar spike in HIV infections among key populations if they embraced evidence-based, rights-based and people-centered approaches in their responses to the epidemic.

While describing human health as a potential driver for socioeconomic development, Sidibe politely proposed a to-do list for the world’s Members of Parliament.

He enjoined them to use their mandate and ability to enact legislation to the maximum; reform punitive laws and rewrite bad norms; remove homophobic laws so more people seek services; and address policies and social practices that hinder access to sexual reproductive health services for young people.

Educating and training young people while creating jobs for them were other important interventions.

He warned: “When you don’t give them opportunities to have a proper SRHR education, they are taken hostage by the streets.”

There was need, also, he said, for MPs to stop gender based violence and discriminatory laws and practices that restrict women’s equal access services and commodities.

On resource mobilization, he said: “Use your financial authority to adopt budget lines that guide investment in adolescents, young people and key populations.”

With many countries still seeing health as a cost rather than an investment, he called for a paradigm shift towards investing in education, health and the social sector while focusing on young people.

MPs could deepen and broaden their oversight roles to ensure transparent, result-driven and accountable approaches while working closely with communities to make accurate data more available.

The leader of the opposition in the National Assembly of Seychelles, Mr. Wavel Ramkalawan

described Sidibe’s remarks and the work that UNAIDS was doing as encouraging. He said his country was working closely with the SADC Parliamentary Forum to address their SRHR challenges under a project funded by Sweden and Norway.

He said young people formed the majority of the approximately 90 000 people in Seychelles but a significant percentage of them had fallen into the abuse of drugs, particularly heroin.

“The scourge of drugs in our country might derail us in the fight against HIV, especially among our young people.”

Latest government estimates put the number of drug users at over 6 000 in the small island country.

He said the Government was spending a lot of resources under the country’s methadone treatment programme while cases of Hepatitis C were spiraling.

“Not too long ago we were informed of new and dangerous practices among the heroin addicts where blood was being exchanged. One addict would inject heroin and others draw the blood and inject themselves to get high.”

He said sex workers, some of whom were also injecting heroin, had more harrowing tales.

“When we hear stories of young girls who are now on the streets presenting the menu of services they offer, among which is unprotected sex for a higher price, it worries us.”

Also of great concern, Ramkalawan said, were reports of prisoners going into prison HIV or Hepatitis C free, only to leave infected.

The Leader of Government Business in the Seychelles National Assembly, Mr. Charles De Commarmond, said the presence in Seychelles of Sidibe, who is also the Under-Secretary-General in the United Nations, showed the value and respect that the UN attached to all member states of the intergovernmental organization.

He described Sidibe as a firm believer in a people-centered approach to health and development as well as a strong advocate of social justice, and said Seychelles was a small but resilient nation that would subdue the HIV epidemic. “Who would have believed that from the small settlement in 1770 would emerge a firebrand, dynamic and wonderful nation that called itself Seychelles … eager to go further?” he asked before pledging the country’s united active participation in tackling national and global challenges that include climate change, organized crime and drug trafficking.

He said the opposition and the ruling party in Seychelles were united over issues of national concern and would “bring the fight to those who wish to poison our youths.” -Moses Magadza is Communications and Advocacy Specialist at SADC Parliamentary Forum.

October 2017
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