CHRISTOPHER MUMBA, Lusaka
MINISTER of Community Development, Mother and Child Health Emerine Kabanshi has launched a UNAIDS/HIV and social protection assessment project that will contribute to global consensus to end the AIDS epidemic as a public health threat by the year 2030.
The project is expected to address the social economic drivers of the HIV epidemic, reduce HIV risk behaviour, break barriers to HIV services and enhance the effectiveness of HIV programmes.
It also targets to reduce teenage pregnancies and risky behaviours that make women and girls susceptible to HIV infection.
Speaking during the launch at Hotel Intercontinental in Lusaka on April 7, Ms Kabanshi appreciated the initiative that David Chipanta of UNAIDS has taken to co-ordinate the Inter-Agency Task Team on Social Protection Care and Support, a global task team that wrote the social protection tool she was launching for the protection of vulnerable communities left behind in the fight against HIV.
The launch was witnessed by UNAIDS country director, Medhin Tsehaiu, representatives of United Nations agencies, government and civil society officials.
Dr Chipanta said during the launch that to accelerate progress, targets have been established so that 90 percent of people living with HIV, would by 2020, know their status, while an equal number will need to be on HIV treatment.
The aim of the tool is to reduce new HIV infections to less than 500,000 globally and achieve zero AIDS related discrimination. He said the 12 specific populations left behind by the HIV response are more at risk, vulnerable and more affected by HIV due to their exclusion and discrimination.
This highlights the need to strengthen HIV programmes to reach these people and meet their multiple needs including medical, social, economic, employment, housing, food and nutrition, psychosocial and legal needs.
â€œEach country and locale, given its epidemic context, evidences from the modes of HIV transmission surveys and other instruments, should prioritise and focus their interventions on populations left behind,â€ Dr Chipanta said.
Populations left behind include prisoners, people living with HIV, adolescent girls and young women, children, pregnant and lactating women living with HIV, displaced people and people who use injectable drugs.
The rest are sex workers, homosexuals, transgender, migrants, people with disabilities and people aged 50 and above. The needs of these populations extend beyond the current AIDS response and and will be better met when the AIDS response effectively works with and draws on the strengths of the like-minded movements including social protection programmes and schemes that are backed by national laws and policies.
The fast-track approach seeks to scale up proven interventions for populations left behind in key countries and key locations. HIV treatment and prevention interventions would be enhanced and strengthened once combined with social and structural approaches including social protection.
There are so many proven HIV prevention interventions beyond medicines, including condom programming, behaviour change, voluntary medical male circumcision and programmes of key populations that have demonstrated their capacity to lower HIV infections.
Social protection refers to all public and private initiatives that provide income or consumption transfers to the poor, protect the vulnerable against livelihood risks and enhance the social status and rights of the marginalised with the overall objective of reducing their economic and social vulnerability.
It encompasses economic, health financing, insurance and employment assistance as well as social care to reduce inequality, exclusion and barriers to accessing basic care.
Major donors support the expansion of social protection programmes to the cited groups by 2030, and governments are increasingly recognising the importance of protecting the most vulnerable from poverty, social exclusion, economic shocks and promoting long-term development.
Although at the end of 2014, there were 37.5 million people living with HIV, the HIV response has recorded impressive results in the past decade. New HIV infections estimated at 2.1 million, were 38 percent lower than in 2001 and AIDS related deaths declined by 35 percent to 1.5 million since 2005. A record, 15 million number of people were receiving HIV treatment and the world was on track to deliver HIV treatment to at least 15 million people living with HIV by the end of 2015. The UNAIDS investment framework modelling of 2011 suggested that between US$22 billion to US$24 billion was required to bring HIV programmes to scale by 2015.
However, people living with HIV face numerous barriers to accessing social protection services. They include lack of information on available social protection programmes, missing documents such as national identity cards that confer eligibility and entitlement to services, cumbersome and complicated procedures, stigma and discrimination and high out of pocket expenses. In some cases, they may be poor and already disadvantaged. Often, such people may be discriminated against or may self-stigma and exclude themselves from accessing the social protection services.
Although social protection services may be free at the point of use, the accompanying services and process of obtaining services, impose an economic cost that is unbearable to recipients. Medical health services, including anti-retroviral therapy may be free, but recipients may have to pay for certain tests or buy drugs for opportunistic infections in private pharmacies due to stock-outs in public hospitals.
Cross-sector linkages and complementary interventions, including access to health services, food, birth registrations, identity cards, transport, vocational skills training, mentoring and teacher support, agricultural development, livelihood promotion and protecting property rights would be expected to maximise the human development outcomes of the project.
Supported scaled-up action on HIV and social protection is both the right thing to do in terms of improving global health and development and a smart investment, in generating efficiency and ensuring effectiveness in the HIV response. Larger investments in HIV, health commodities, infrastructure and human resources will not be effective unless strategic investment is made in addressing the social economic drivers of HIV.
The author is a freelance journalist, AIDS activist and Commonwealth professional fellow.
New HIV response launched
CHRISTOPHER MUMBA, Lusaka