Speaking Notes of H.E. Pascoal Mocumbi

14 October 04
Addis Ababa, Ethiopia

Mr. Executive Secretary,
Honorable Ministers,
Excellencies,
Distinguished Guests,
Ladies and Gentlemen,

As the two previous Commissioners have so eloquently illustrated the HIV/AIDS epidemic is the worst epidemic in the modern history of Africa.

In both men and women, the virus is attacking the most productive sectors of African societies- prime-aged adults- robbing economies of scarce skills, children of their parents and a continent of a generation in the prime of their working lives.

The interaction of poverty, gender and adolescence is utterly devastating. Being born a girl is a major risk factor cutting across, even outweighing, poverty. Biologically, girls and women are more vulnerable to, and suffer more devastating consequences from sexually transmitted diseases than boys and men. Gender based violence is endemic and even condoned.

There is a pressing need to understand the implication of the loss of human capital for the ability of governments on our continent to sustain vital state structures and maintain economic development.

A country that loses skilled manpower at a faster rate than its capacity to produce it faces a downward spiral. Health and education systems that are already weak are getting weaker by the day. States with meager resources and weak institutional infrastructure, heavily constrained by foreign debt, are now charged with societies that are too hollowed out to increase the stock of human and social capital.

For African governments, the cost of writing off HIV infected people will be too high to contemplate. Our institutions and societies simply cannot afford the human resources losses implied by high rates of HIV. The very future of our societies is tied to keeping these people alive. There is no escaping the fact that the loss of teachers, health workers and civil servants at the rates witnessed today threatens deterioration and eventual collapse.

Unfortunately, there are major gaps in our understanding and knowledge about what exactly is actually happened. Across the continent, too little is known about the impact of HIV/AIDS on the skills base in all sectors. Such knowledge is vital for governments charged with economic policy and planning.

Moreover, there is no evidence that any country has begun to address comprehensively the human resource planning challenges raised by the HIV epidemic. Nor is there any sign that the capacity exists, domestically or externally, to meet the needs for critical skills and training.

We have a little or no information on the ramification of mortality amongst senior government officials. Questions remain unanswered, for example, what effects are such losses having on the delivery of public services economic development and national security? At what point might state institutions or states as a whole simply cease to function?

Governments need to rethink their growth and development strategies taking HIV/AIDS into account. The effects of HIV/AIDS on various sectors and on key economic variables need to be closely scrutinized. The resource implications, both in terms of the national workforce and public finance need to be clearly identified.

In the coming few years, perhaps the most critical measure of adequate response will be the extent to which we are managing to keep PLWHA alive longer. For that to happen, we need to begin systematic thinking now, to put in place scaled-up anti-retroviral therapy in resource poor settings. We need to work out the implications of expanded access to treatment and free medication for national and international resource mobilization.

Essentially, the challenge of mobilizing adequate response needs two elements at its core. The first is a new thinking by policy makers, based upon concrete analyses and costed policy and programme options. The second is an engagement with leaders to erase any false sense of security and put in its place a serious commitment to new modes of governance and development in the era of AIDS.

For Africa to continue making progress in good governance we need results oriented modes of governance that bring

• decline in HIV prevalence rate

• better access to voluntary testing and to drugs (ARV)

• women economic empowerment.

The governance challenges of the HIV/AIDS epidemic occur at all levels and across all sectors. National governments must play the pivotal role, in partnership with the international community and, at a domestic level, joining forces with people living with HIV and AIDS, local government, civil society and the business sector.

A fundamental task is to support the livelihoods of families and communities directly affected by HIV and AIDS, ensuring that government and international responses can be relevant to their needs.

One year after that launch of the Commission, thanks to the able leadership of our Chair, I am very pleased to say that we have made significant progress. Yesterday we deliberated for a whole day on the likely key messages that will come out of the Commission's work.

1. First, the work of the Commission will pave the way for governments to develop a systematic understanding of the impact of HIV/AIDS on human capacity and related planning issues, as well as the likely budgetary implications for effective response.

2. Second, the Commission will call for greater leadership at all levels in confronting the epidemic; particularly from national governments, International Community and Civil Society.

3. Third, by identifying the major pathways through which AIDS affects socio-economic prospects, CHGA will encourage governments to undertake a rethinking of their growth and development strategies which takes HIV/AIDS into account.

4. Fourth, CHGA will provide governments with practical recommendations on up-scaling prevention treatment and care programmes for all those who need it. The greatest challenge that awaits heavily affected countries is to extend the lifespan of those living with HIV. This includes but is not limited to anti-retroviral provision: we must also address voluntary counseling and testing, the prevention of mother-to -child transmission and nutrition.

As such, it will be crucial to identify resources moblization needs and determine the optimal way for utilizing our human financial and material resources to scale up the technical advances in the simplified administration of treatment. An important area of activity will be working out the cost and cost-effectiveness of purchasing drugs, scaling up treatment centers and training qualified health care workers.

Conclusion:

The tasks ahead in mounting an effective challenge against HIV/AIDS are many; but if the world is to stand any chance of meeting its aspirations for sustainable development, then our action must include a full-scale attack on AIDS.

This is the task of CHGA.