Welcome Address to the Joint Meeting of the Regional Advisory Panel and the Regional Clinical Coordination sub-Committee

By Augustin Fosu
Director
Economic and Social Policy Division
Maputo, June 22-24, 2006

Chairperson
Distinguished Experts
Colleagues
Ladies and Gentlemen

On behalf of the UN Under-Secretary General and Executive Secretary of ECA, Abdoulie Janneh, I welcome you to this joint meeting of the Regional Advisory Panel and the regional Clinical Coordination sub-Committee meeting.

As your Secretariat, I want to acknowledge the support of our collaborators, World Health Organization and the World Bank, in this initiative. We are especially grateful to the government of Mozambique for the warm reception accorded us and its leadership in the fight against HIV/AIDS in this country. I am sure that Mozambique will present some valuable lessons for the rest of Africa, especially the countries linked to it by road – such as Malawi, South Africa and Zimbabwe.

Ladies and Gentlemen

I know that I do not need to rehash the sense of urgency surrounding treatment acceleration and our three pilot studies in Mozambique, Ghana and Burkina Faso. The realities of HIV/AIDS are clear to us all. To date, about 24 million people in sub Saharan Africa are infected and 2 million of them, many in their prime and most productive years, died last year alone. As our Executive Secretary stated recently before a high level audience including heads of state, in Addis Ababa, Africa is facing a critical emergency: our collective roofs are on fire, and we dare not go to sleep.

Nearer home, here in Mozambique, there has been a steady increase in prevalence – from 8.2 per cent in 1998 to 16.2 percent in 2004. Every year, about 30,000 children are born with HIV/AIDS in this country: half of them die in the first year and the rest before the end of the second year. This is clearly unacceptable.

Therefore, we have to redouble our efforts in all fronts if we are to have a chance against this pandemic. We will not make progress by doing business as usual. In this regard, let me echo UNAIDS's Executive Director, Mr. Peter Piot: We must run a marathon at the pace of a sprint. What this means is that we need to scale up all our efforts – in prevention, treatment, care and support.

Ladies and Gentlemen

At ECA, we have been working in support of this broader vision, since our landmark African Development Forum of 2000, which identified broad leadership as a potent weapon against HIV/AIDS. We also served as the operational Secretariat of the Secretary General's Commission on HIV/AIDS and Governance in Africa, whose report “Securing Africa's Future ” will soon be released. The report's recommendations are bound to strengthen our fight, assuring ultimate triumph.

In the context of the Universal Access initiative ---that is access to prevention, treatment, care and support to as many Africans as need them by 2010--- ECA played a major role in fashioning an African common position in Brazzaville. The Brazzaville Commitment was, thereafter, endorsed by our heads of state in Abuja and later presented at UN General Assembly Special Session early this month in New York by the Chairperson of the African Union, President Sassou Nguesso.

But apart from the common position, Africa can also boast of a spate of other declarations, agreements, targets and commitments, including the Gaborone Declaration, the Abuja Call for Accelerated Action, the Decision of AU Heads of State, and the Resolution of Ministers of Health on Health Financing. What therefore remains is the question of implementation, which, I believe the necessary political will at country level will trigger. That is why these pilot studies are critical.

In the next two days, we are going to hear about the status of implementation of TAP in our three pilot countries of interest ---the key challenges, success stories and factors that are critical to successful implementation, especially as they relate to drug resistance and patient tracking.

I know that many of us here also visited treatment centers in Sofala about two days ago, while others visited treatment sites in Maputo. As you know, while prevalence rates are high in places like Sofala, Tete, Zambezia and Manica, the good news is that they appear to be stabilizing. If we step up our efforts, these rates are sure to begin falling, driving us closer to our targets.

At our last RAP meeting in Nairobi last year, we agreed on a number of questions which we should adapt to the realities of our pilot countries. We must seek to understand, for instance, the full socio-economic benefit of treatment for the patient and the family. What is the impact of treatment availability on prevention in both HIV negative and positive persons? How do we avoid the development and spread of resistance? How can we identify the potential beneficiaries of anti retroviral therapies and how do we make sure they benefit in a timely manner?

These research questions are still valid, and while their relevance and applicability will vary with the context of the countries in question, the answers to these questions should prove invaluable to the rest of Africa in our quest to accelerate HIV privation, scale up treatment and redouble our efforts at stamping out stigma and discrimination.

As we do this, we have to give serious thought to the question of long-term health financing with a continuation strategy. Africans on treatment should not be abandoned after two or three years on treatment. That would be counter-productive. But what are the macro-economic implications of a lifetime treatment on a struggling African economy? Will other vital sectors be negatively impacted? Can we have a system that cushions such impacts? Can external financing be more predictable, guaranteed and stable?

These are some of the key issues we must grapple with as we seek to stop the HIV/AIDS pandemic. ECA will be prepared to assist in this and other respects.

Ladies and Gentlemen

May the next few days offer useful lessons for our ailing continent. I thank you for your attention.