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THE AFRICAN CONSENSUS AND PLAN OF ACTION: LEADERSHIP TO
OVERCOME HIV/AIDS
A.
The Consensus
Preamble
1. Personal leadership
2. Community leadership
3. National leadership
4. Regional leadership
5. International partnership
B.
Plan of Action
1.
At the national level
2. At the regional and global levels
3. Communications from this Forum
Annexes
A. The Consensus
Preamble :
Now is the decisive moment in Africa’s
struggle to overcome the continent-wide threat of HIV/AIDS. Success in overcoming the
HIV/AIDS pandemic demands an exceptional personal, moral, political and social commitment
on the part of every African. Leadership in the family, the community, the workplace,
schools, civil society, government and at an international level is needed to halt the
preventable spread of HIV/AIDS, and to provide a decent life for all citizens of Africa.
Each and every one of the leadership acts necessary to prevent HIV/AIDS and to help those
living with HIV/AIDS, without exception, are things we want anyway for a better, more
developed Africa, and must be implemented in full and without delay.
Much has been achieved. Many African
communities and several entire nations have shown that it is possible to contain and
reduce the spread of HIV/AIDS. Success is a reality in many places and is possible across
the continent. The Africa Development Forum 2000 is a breakthrough. It represents a
watershed in national leaders’ readiness to address intimate personal beliefs and
behaviour in a public and political manner. It marks an unprecedented collective
commitment to the struggle against HIV/AIDS. With the required resources and the right
leadership at all levels, we will win. Too much time has been wasted. Too many lives have
been lost. Now is the moment.
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1. Personal Leadership.
1.1. Every individual must personally break
the silence around the norms and practices that fuel the HIV/AIDS pandemic. As a citizen,
leader, wife, husband, parent, child, youth, adult, worker, or employer, there are
critical issues of information, attitudes and behaviour that must be learned and faced.
Every person must be ready to speak openly about sexual relations and the unequal power
relations within sexual relationships.
1.2. Families are the cornerstone of society.
Parents have a special responsibility to educate their children from a very early age
about the realities of HIV/AIDS and to socialise them into personal morality and social
attitudes that will help contain the pandemic.
1.3. Each person must regard themselves as
affected by the HIV/AIDS pandemic, and must acknowledge the possibility that they
themselves or a loved one may become infected.
1.4. Every person must confront the reality
of denial, stigmatisation and discrimination against people living with HIV/AIDS, and
should embrace people living with HIV/AIDS as fellow members of their families,
communities and nations.
1.5. People living with HIV/AIDS are human
beings in full possession of their human rights. They must be valued as a resource in and
of themselves, and as crucial allies in the common struggle to overcome HIV/AIDS. They
should not be used or manipulated in the campaign against HIV/AIDS.
1.6. Each person must take responsibility for
avoiding risky sexual behaviour, for protecting themselves, and for preventing the virus
being transmitted to others. For many this will mean promoting and living lives of
fidelity.
1.7. Youths have a
personal responsibility to respond to the challenge of HIV/AIDS, in their personal lives
and by setting examples to their peers.
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2. Community Leadership
2.1. The struggle against HIV/AIDS will be
won community by community, in every family, village, township, and settlement across
Africa. Authority and resources to overcome the pandemic must be devolved to the local
level.
2.2. At the community
level, there should be a common struggle to overcome HIV/AIDS, with actions and strategies
that combine all members and component parts of the community, resulting in a true local
partnership.
2.3. People living with HIV/AIDS stand at the
centre of any community efforts to overcome the pandemic, and to change attitudes to
overcome denial, stigmatisation and discrimination. Their rights must be respected in full
and their leadership potential recognised.
2.4. Women and girls must be empowered in
their homes, workplaces, schools and communities, and provided with the cultural, legal
and material means of protection from sexual abuse. Traditional leaders need to be
reliable allies in protecting women from abuse. Perpetrators of sexual and domestic
violence against women and children, must be prosecuted in the courts. Child- and
woman-friendly family courts must be created at scale and supported.
2.5. Men’s responsibilities towards
women and girl children must be emphasised. Men must be a target for educational efforts
with a view to their being important allies in the fight against HIV/AIDS.
2.6. Children orphaned by AIDS should be both
a family and community responsibility, with the family receiving sufficient support to
ensure their welfare, education and health.
2.7. Governments have a special
responsibility to promote social responsibility among soldiers and other uniformed
officers of the state. They must take the lead in preventing and punishing sexual crimes
by these servants of the state.
2.8. All people, regardless of their sexual
orientation, must have access to appropriate information about HIV prevention, access to
appropriate treatment and care, and should be free of stigmatisation, discrimination and
fear.
2.9. The accessibility and low price of
condoms must be ensured, and people must be taught about their importance and use. Access
for youth and rural dwellers is especially important.
2.10. Youth comprise over half of
Africa’s population, and are leaders of today and tomorrow. Youth must be clearly
recognised and encouraged both as key participants and as key targets in developing and
implementing HIV/AIDS action plans at all levels. Youth organisations require support and
resources. The youth representatives from throughout Africa played an important part in
the Forum and the Youth Statement is appended as Annex I, as an integral part of this
statement.
2.11. The many different stakeholders in
communities each have particular roles and responsibilities, which often need to be
developed more fully, to make them full allies in the common struggle against HIV/AIDS and
the support of people living with HIV/AIDS. They include:
People living with HIV/AIDS, whose
involvement is essential.
Spiritual leaders, who are among the most
influential community members, provide moral guidance and awareness.
Traditional healers have multiple roles
including palliative care, and contribution to global research efforts in search of a
cure.
Health care providers in both their roles as
health educators and care givers, are crucial allies.
Women’s groups are an integral component
of the community. Women’s leaders are educators and role models for women and girls,
and can play a key role in changing the attitudes of men.
Teachers and educators, including traditional
communicators, are pivotal intermediaries in influencing children and youth and are
influential role models. They must be trained to teach forthrightly about sex and HIV/AIDS
education.
Employers and trade unions have key roles in
workplace initiatives to combat HIV/AIDS, and overcome stigmatisation and discrimination.
Elected representatives and traditional
leaders should represent and be accountable to all their constituents, including PLWAs,
and can play an important role in advocating for their interests and mobilising
community-wide campaigns.
Older people require education and assistance
to enable them to provide aid and care for PLWAs and orphans of PLWAs. Older persons must
be used to provide education consonant with tradition and culture to families, communities
and civic groups.
2.12 Those caring for people living with AIDS
need special assistance in recognition of the special burdens and responsibilities upon
them.
2.13 In sum, there is a need for total
societal mobilisation at a community level, creating a robust ‘social immunity’
from the scourge of HIV/AIDS. This involves a seamless continuity between breaking the
silence on stigma, and providing effective prevention, treatment and care.
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3. National Leadership
3.1 National leaders’ prime
responsibility is to create the conditions for community mobilisation, across the nation,
on a scale and with a commitment comparable to mobilising for war.
3.2 Many cases of impressive national efforts
exist: the challenge is to replicate them and to scale them up to cover every community.
This may require national leaders to commit domestic resources to HIV/AIDS programmes and
to ensure that they in fact reach local groups efficiently.
3.3 National leaders’ personal example
can transform the moral and social climate in which HIV/AIDS can be discussed and
addressed openly, and denial and stigma can be overcome.
3.4 National strategies should include
scaling up the resources and systems necessary so that anti-retroviral and other essential
medications can be made available to the widest possible population as rapidly as
possible. This will take leadership, hard bargaining, and the mobilisation of domestic and
international resources.
3.5 The status of women and girls at a
national level needs special emphasis. Women must be closely involved in all components of
HIV/AIDS programmes. National leaders must initiate special programmes and set up special
institutions to promote the rights and initiatives of women. Inequitable gender relations
and opportunities lie at the core of the HIV/AIDS pandemic. Since Africa’s women
leaders have demonstrated their readiness to lead on HIV/AIDS issues, the fostering of
more women leaders of national and international stature is an important component of
overcoming HIV/AIDS. Acknowledging the central importance of this issue, the Statement of
the Gender Focus Group, Annex III, is an integral part of this statement.
3.6 National AIDS institutions and councils
should be strengthened as a matter of urgency in order to assure a broad, multi-sectoral
response at the national and community levels. Strong legal and regulatory frameworks are
required. HIV/AIDS committees should be extended to the local level across every country.
Stakeholders including PLWAs, Youth and Civil Society Organisations, must be fully
involved. Best cases in Africa demonstrate that highest level political leadership of
national AIDS councils is a requirement.
3.7 Effective multi-sectoral leadership
requires that every sector must achieve competence on how HIV/AIDS affects its activities
and how it can contribute to a multi-sectoral plan to overcome the pandemic.
The health sector, provided with suitable
resources, must play a leading role in prevention, treatment and the surveillance of the
pandemic. All available measures to minimise mother-to-child transmission should be
utilised.
The education sector is central to effective
responses to HIV/AIDS. HIV/AIDS and sex education must be in every curriculum. Schools
must be models for equitable gender relations and young people must be involved in the
management of school-based initiatives focusing on HIV/AIDS. All school fees and other
charges required to attend government schools must be abolished to ensure that all
children can enjoy their right to education. Donors should provide special support to the
education sector.
Youth out of school, including street
children, should be targeted and reached by appropriate strategies. Given the impact of
drug abuse on the spread of HIV/AIDS, drug abuse prevention and rehabilitation programmes
targeting specifically youth in and out of school should be implemented in rural and urban
areas.
The social welfare sector must provide
assistance to those caring for people with AIDS, and for their dependents. Assistance
including counseling should be provided for orphans.
Ministries of finance should ensure adequate
resource provisioning for HIV/AIDS programmes. They should reorient budgets and
administrative procedures so that funds related to HIV/AIDS programmes can be managed in
the most efficient manner in order to provide funds expeditiously at all germane levels.
The trade, industry, mining sectors must
shoulder their responsibilities for minimising transmission of HIV and for
non-discriminatory employment practices. Business and labour should be involved in
developing and implementing national HIV/AIDS action plans. Efforts should be made to
extend these activities to the informal sector.
Local production of pertinent pharmaceuticals
should be encouraged.
The rural sector is particularly at risk
because of high levels of illiteracy and poverty. The agricultural, livestock and fishing
sectors should shoulder responsibilities, especially for education about HIV/AIDS,
alongside the authorities in rural areas.
The military must confront the reality of
high levels of HIV prevalence among soldiers, and take necessary steps to reduce
transmission. Armies must provide for soldiers who are living with HIV. As disciplined
national institutions, armies can take a leading role in HIV/AIDS control programmes. The
military must take steps to eliminate the high level of sexual violence against women and
girls, particularly during conflicts, and ensure that those responsible are prosecuted and
punished. Similar considerations apply to other uniformed services of the state including
the police and prison service.
Commercial sex workers and women forced to
engage in ‘survival sex’ should be protected by the law and law enforcement
officers, and provided with education and access to condoms and medical facilities.
African research institutes should become
actively engaged in research for improved treatments for HIV/AIDS and opportunistic
infections, drawing inter alia on the expertise of traditional healers.
The media should have a crucial partnership
role in public education and shaping attitudes. Information and communication technology
can play an important role in national, regional and global transmission of information.
Artists and cultural leaders can play key
roles in influencing public attitudes and can serve as role models.
3.8 People living with HIV/AIDS must be
involved in national policymaking and implementation in a meaningful manner.
3.9 Governments have a responsibility to
improve capacities wherever needed for the campaign against HIV/AIDS. This includes their
own effectiveness and accountability, so as to be able to fulfil their commitments to
their citizens, and to be able to receive and dispense international assistance rapidly
and efficiently. CSOs can play a vital role in monitoring government’s performance.
3.10 Civil society organisations have taken
the lead in many aspects of HIV/AIDS control. Their roles must be appreciated and
supported. NGOs must hold themselves to high standards of accountability and transparency.
The common position of African civil society organisations represented at the Forum is
important and their Declaration is therefore appended in Annex II as an integral part of
this statement.
3.11 Religious leaders and traditional
leaders have immense influence over matters of personal morality and behaviour. They are
encouraged to be far more active in removing the stigma of HIV/AIDS and in educating their
congregations. Abstinence and fidelity would, if followed, prove an effective means of
preventing HIV transmission. Religious values such as care for the stricken, tolerance and
inclusion can assist in the campaign against HIV/AIDS.
3.12 Development and economic planning must
play a crucial role in reducing vulnerability to HIV/AIDS, by means of promoting
sustainable livelihoods and employment and through poverty-reducing wealth creation.
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4. Regional Leadership
4.1 Africa’s HIV/AIDS pandemic knows no
geographic, economic or social boundaries. It demands action at a continental level and
leadership from Africa’s regional and subregional organisations.
4.2 Much can be learned from successful
examples of the containment of the HIV/AIDS pandemic in different countries in Africa. The
regular sharing of experiences and the provision of technical advice from elsewhere in
Africa are tools towards adopting best practices across the continent.
4.3 Essential and comprehensive care and
treatment for people living with HIV/AIDS is required. A continental strategy to ensure
the affordable provision of essential anti-retroviral drugs and treatments for
opportunistic infections is needed very rapidly. This requires a determined pan-African
strategy in partnership with international donors and pharmaceutical companies.
4.4 The International Partnership against
AIDS in Africa has been established to develop a more conducive framework for true
partnerships and better coordination among key stakeholders at all levels. It is intended
to assist in providing the much-need additional resources, technical support, information
sharing and coordination of donor efforts, under the leadership of African governments.
The IPAA should be fully implemented.
4.5 Peace is an essential pre-requisite for
effective programmes against HIV/AIDS. The extent of ongoing war in Africa seriously
undermines any realistic programmes to combat HIV/AIDS in the affected areas. It is
therefore imperative that African governments and regional and subregional organisations
take decisive steps to create and maintain peace and security and promote democratisation
as a means of facilitating conflict resolution.
4.6 Long-distance migration, mobility,
displacement and refugee flows are risk factors for HIV/AIDS that demand inter-state
cooperation to develop and implement policies against HIV/AIDS. Policies and programmes
aimed at migrant, mobile and displaced populations should be developed and implemented.
However, no measures should be implemented that curtail freedom of movement.
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5 International Partnership
5.1 An estimated US$3 billion is now required
annually to contain the HIV/AIDS pandemic, including prevention, treatment, community
support, research, training and surveillance. This may soon rise to as much as US$ 10
billion if anti-retroviral treatments are made available to all PLWAs. These resources are
available, nationally, regionally and globally.
5.2 The first source for resource commitment
must be domestic. In the framework of multi-sectoral strategies, adequate provision for
HIV/AIDS programmes should be prominently reflected in every ministerial budget. Certain
national leaders have committed themselves to putting their nations on a ‘war
footing’. In resource terms, this implies spending more on combating HIV/AIDS than on
peacetime defence expenditure.
5.3 This also requires mobilisation of
resources from every possible source such as the domestic private sector and community
resources.
5.4 Foreign donors and international
financial institutions must greatly increase their financial commitments to HIV/AIDS and
development programmes. This assistance, wherever possible, should be in the form of
grants, not loans, and should benefit from expedited procedures.
5.5 A substantial reduction in the prices of
anti-retroviral drugs and treatments for opportunistic infections is required. African
governments, donors and international financial institutions must work in partnership to
reduce the prices of drugs to a level commensurate with their production costs.
5.6 International research efforts to develop
vaccines against HIV and treatments for AIDS and opportunistic infections should be
substantially increased, and carried out in partnership with African communities and
research institutes, ensuring that resulting benefits reach Africa.
5.7 There is a need for an international code
of good practice to be developed and utilised to safeguard and guarantee the rights of
workers with HIV/AIDS, and to specify the responsibilities of employers. The ILO should
provide support and technical assistance to employers’ and workers’
organisations and to labour ministries to strengthen their capacity for the effective
implementation of national action plans and policies. Recognising the importance of this,
the Conclusions and Recommendations of the ILO Pre-forum Tripartite Event are appended as
Annex IV, as an integral part of this statement.
5.8 Debt relief is an important source for
both money and political commitment, and as a means of mainstreaming HIV/AIDS programming
into development and poverty reduction policies. The HIPC programme of debt reduction
should be expanded and accelerated particularly where resources will be re-channeled to
HIV/AIDS and poverty reduction.
5.9 Other sources of finance such as
corporations and foundations, and innovative ways of generating revenue, should also be
sought.
5.10 The African diaspora is an important
source of resources, expertise and networks that can be utilised as part of a true and
effective partnership. Therefore, African governments should take specific steps to scale
up existing diaspora initiatives, understand the full dimension of this group and extend
this support into new areas of priority. Dialogue needs to commence as an urgent priority
to encourage the diaspora community to raise funds, mobilise scientific resources and
expertise and combine their strengths with emphasis on HIV/AIDS.
5.11 International assistance efforts should
be coordinated, transparent and accountable. Mechanisms to ensure the quick, effective,
direct and accountable delivery of resources to local groups and programmes will be
required.
The HIV/AIDS pandemic is manageable. With the
required political commitment, provision of resources, and strategies that include all
stakeholders as valued partners, the HIV/AIDS pandemic can be rolled back and contained.
The experience of certain African countries shows that this is achievable. What has been
accomplished must be sustained and spread across the entire continent. Africa’s
HIV/AIDS pandemic will be overcome at a continental level or not at all.
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B. Plan of Action
1. At the National Level
1.1 Each country should hold a representative
national workshop by mid-February 2001, to determine how the Consensus and Plan of Action
of the ADF can be turned into action at the country level.
1.2 All governments should prepare reports
for the Special Summit of the OAU on HIV/AIDS by mid-March. These should include concrete
action on national initiatives at the highest level and resource allocation.
1.3 Civil society organisations, especially
PLWAs and Youth, should strengthen their cooperation, evaluate their experience, and
prepare for their contribution to the OAU Special Summit.
1.4 By the end of 2001, each country should
ensure that it has in place a National AIDS Commission (or equivalent) and a strategic
plan, backed up by appropriate legislation, modalities for the involvement of PLWAs and
other stakeholders, and mechanisms for regular monitoring of progress.
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2. At the Regional and Global
Levels
2.1 Africa’s Regional Organisations,
spearheaded by the ECA, will ensure that the ADF Consensus and Plan of Action are kept
high on the agendas for meetings of African leaders including Heads of State, at regional,
subregional and supraregional levels (e.g. Organisation of the Islamic Conference). In
view of a history of resolutions that were not implemented, it is essential that the
commitments that are made henceforth are binding and are fully implemented in accordance
with agreed action plans and timescales.
2.2 During 2001, subregional summits are
urged to address the HIV/AIDS challenge as a matter of high priority. To this end, the
official subregional organisations should similarly place HIV/AIDS as a top priority in
their work.
2.3 At the ECA Conference of Planning and
Finance Ministers (Algiers, 23-25 April 2001), the interweaving of Poverty Reduction, Debt
Relief and HIV/AIDS strategies should be considered, and common positions on
international resourcing for combating HIV/AIDS agreed upon.
2.4 The Special Summit of the OAU on HIV/AIDS
and other communicable diseases, in Abuja, 25-27 April 2001, should be a pivotal event for
the continental campaign to overcome HIV/AIDS. This Consensus statement and Plan of Action
should be presented to the Heads of State and Government Summit for their adoption and
commitment to implementation. Civil society organisations, PLWA, youth and other
stakeholders must be represented as participants.
2.5 The OAU Annual Summit in Lusaka in July
2001 should devote a special session to HIV/AIDS and request that the issue remain on the
agenda for future summits, in which the Secretary General of the OAU will present a report
on progress made in combating HIV/AIDS and challenges which require most urgent attention.
2.6 At the UN General Assembly Special
Session on HIV/AIDS, in June 2001, African participants should present a common position
based on this Consensus, and a common coordinated demand for international assistance,
debt relief, and provision of affordable drugs.
2.7 At the UN General Assembly Special
Session on Children in September 2001, it should be clearly stated that HIV/AIDS is the
number one threat to Africa’s children. In addition, it must be stated that there is
a collective responsibility to ensure that the next generation of Africans does not have
to face the scourge of the HIV/AIDS pandemic.
2.8 The UN Secretary General, in partnership
with others, and with the close involvement of UNAIDS and ECA, should embark on a major
fundraising campaign. Major private sector corporations, foundations and individual
philanthropists should be invited to contribute to the initiative, which should be aimed
at filling the funding gaps identified by UNAIDS. The campaign should be carried out in
partnership with key African stakeholders, especially PLWAs, to encourage a global public
response to Africa’s HIV/AIDS pandemic.
2.9 The IPAA should take a lead,
in partnership with African regional organisations, governments and civil society, in
speedily implementing agreed commitments to bringing anti-retroviral and other AIDS
treatments within reach of African people living with HIV/AIDS. The IPAA is invited to devise a
mechanism of accountability for commitments made in this Consensus and follow-on meetings
of African leaders and their partners.
2.10 NGOs and other advocacy forces in Africa
and internationally are encouraged to organise a campaign, comparable to Jubilee 2000,
aimed at pressuring pharmaceutical companies and financial institutions to make
anti-retroviral drugs available at reasonable costs to treat all PLWAs in Africa.
2.11 The Youth Against AIDS Network should be
encouraged to continue expanding its regional network of young Africans, building on
existing structures and organisations. It is the view of the Forum that the YAAN must have
appropriate financing to become a vibrant continent-wide network.
2.12 In addition to the above, mechanisms
should be created so that recurrent reviews, sharing of best practices and peer review
takes place at all required levels.
3. Communications from this
Forum
3.1 The major presentations by notables
attending the forum should be made widely available to African radio and TV services.
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