Message of the WHO Regional Director for Africa Dr Luis G. Sambo On the occasion of World AIDS Day 2007

LADIES AND GENTLEMEN, 
 
Today we commemorate the nineteenth World AIDS Day since its launch by the World Health Organization in 1988. The theme for 2007 is “Leadership”.  
 
In the last five years we have witnessed remarkable progress in rallying political leadership in the African Region; mobilizing financial and technical resources; improving access to information; HIV testing and counseling; prevention of mother-to-child transmission; and bringing life-saving antiretroviral treatment to people in need. However, we know that we must do much more to reverse the trends of this epidemic. 
 
Despite progress made towards the acceleration of HIV prevention, access to HIV testing and counseling and prevention of mother-to-child transmission  is unacceptably low. We estimate that only 12% of adults know their HIV status. In 2005, only 11% of pregnant women infected with HIV received antiretroviral therapy. Access to treatment and care increased significantly in the last four years in the African Region, from an average of 1% in 2003 to 30% in 2007. 
 
However, it is important to highlight that today 70% of people in need do not have access to these services. Efforts to scale up access to these life-prolonging medicines are hampered by important challenges such as low adherence to treatment regimens and the development of antiretroviral resistance strains. Although the prices of antiretrovirals are decreasing,  they are still unaffordable for most people in our region. Furthermore, for every patient that was treated with antiretroviral medicines last year, six new infections occurred worldwide. Therefore, the combination of intensification of HIV prevention efforts with the scaling up of treatment and care remains the only realistic and effective strategy to stem the spread of HIV infection in sub-Saharan Africa.  
 
I want to address myself to leadership at various levels in our societies: 
 
Have we kept our promise to accelerate HIV prevention in the African Region, a promise made two years ago at the fifty-fifth session of the WHO Regional Committee? Whilst we are commending Member States for having taken concrete steps to accelerate HIV prevention, we recognize that HIV prevention programmes in most countries of the African Region remain fragmented, uncoordinated and poorly funded. We realize that many programmes are being implemented without clear strategic focus based on sound knowledge of the local epidemic or the factors driving the epidemic.  
 
As we move towards universal access to HIV prevention, treatment, care and support, have we demonstrated the will to tackle this enormous challenge? Are our programmes strategic, evidence-based, cost-effective and results-oriented? Are we adequately investing the available resources where they are most needed?  
 
My colleagues in the health sector: 
 
As we commemorate World AIDS Day 2007, let us reflect on how we can exercise our leadership to improve HIV/AIDS programming in order to achieve a greater impact. We know what works and what does not work. We need to cooperate with all partners, particularly civil society and communities, to massively scale up effective interventions towards universal access. Let us define clear national and district targets for HIV/AIDS prevention, treatment and care as well as develop road maps to lead us to the desired destination. In doing so, I would like to invite you to pay particular attention to the need: 
 

  • To expand access to HIV testing and counseling as an entry point to HIV/AIDS prevention, treatment and care;
  • To maximize opportunities for HIV prevention by strengthening counseling on safe sex at all points of contact between health service providers and clients;
  • To increase the uptake of prevention of mother-to-child services as we scale up the services to prevent such transmission of HIV infection;
  • To ensure greater adherence to antiretroviral treatment, increased access to HIV/AIDS paediatric treatment, and minimal risk of development of resistance to treatment;
  • To design and implement effective strategies targeting high-risk groups, with active involvement of the beneficiaries;
  • To step up efforts to prevent and control other sexually-transmitted diseases;
  • To consider scaling up safe male circumcision services as part of a comprehensive package of HIV prevention interventions, particularly in countries with high HIV prevalence and low male circumcision rates, taking into account local sociocultural realities;  
  • To put in place effective monitoring and evaluation systems that will provide timely strategic information for programmatic decisions. 

 
Ladies and gentlemen, 
 
The commemoration of World AIDS Day offers a good opportunity to sincerely thank all development partners who are tirelessly supporting HIV/AIDS programmes in the African Region. Special thanks are extended to sister UN agencies for their active involvement and their commitment to more strategic and results-oriented partnerships.  
 
STOP AIDS; keep the promise. As leaders we must do more! 
 
I thank you.