A new World Bank report launched Wednesday said African countries must continue to champion HIV prevention efforts to slow and reverse the rate of new HIV infections, so that HIV/AIDS will remain for the foreseeable future, an unprecedented economic, social and human challenge to sub-Saharan Africa.
The region remains the global epicenter of the disease.
According to the new report – The World Bank’s Commitment to HIV/AIDS in Africa: Our Agenda for Action, 2007-2011 – for every infected African starting anti-retroviral therapy (ART) for the first time, another four to six become newly infected, even as regional figures show falling prevalence in countries such as Kenya and parts of Botswana, Côte d’Ivoire, Malawi and Zimbabwe.
About 22.5 million Africans are HIV positive and AIDS is the leading cause of premature death on the continent, especially among productive young people and women.
As a result, some private firms in Southern Africa recruit two workers for every job in anticipation of losing staff to the disease.
In laying out its continuing plans to help African countries fight the epidemic, the bank’s new strategy said more than 60 per cent of people living with HIV in Africa are women and that young women are six times more likely to be HIV positive than are young men.
As a result of the epidemic, an estimated 11.4 million children under age 18 have lost at least one parent.
“With AIDS the largest single cause of premature death in Africa, we can’t talk about better, lasting development there without also committing to stay the course in the long-term fight against the disease,” said Elizabeth Lule, Manager of the World Bank’s AIDS Team for Africa (ACTafrica), whose team consulted widely with African countries, people living with HIV, sister UN agencies, NGOs, private companies and others, in devising its new HIV/AIDS strategy for Africa.
The World Bank has mobilised more than US$1.5 billion to more than 30 countries in sub-Saharan Africa to combat the epidemic since 2000.
With its African HIV/AIDS ‘Agenda for Action’, the bank said it was moving away from its initial ’emergency response’ role as the world’s principal financier of HIV/AIDS programs, towards a new mission with four new strategic objectives.
These include: at the global level, advising countries on how best to manage the complexity of the international financing they receive; and at the local level, helping countries to accelerate implementation and take a long-term sustainable development response to HIV/AIDS; strengthening the monitoring and evaluation capacity of countries to track the efficiency, effectiveness and transparency of their HIV/AIDS response; and building up stronger health and fiduciary systems.
Amalgamating HIV/AIDS services with those for reproductive and maternal health, nutrition and other diseases such as malaria and TB, would remedy a long-standing defect in many national HIV/AIDS programs to date.
The ‘feminization’ of the epidemic and its links to sexual and reproductive health and the frequency of co-infection with TB (and the emerging Extensively Drug Resistant TB) and other opportunistic diseases, amplify the importance of providing people with integrated health services.
Specifically, the bank would commit to: provide at least US$250 million a year for HIV/AIDS initiatives, based on country demand and establish a grant incentive fund of US$5 million annually to promote capacity building, analysis and HIV/AIDS project components in key sectors such as health, education, transport, public sector management and other sectoral projects.
“After 25 years, it is time to apply the lessons of experience and scale up what is working.
“With this Agenda for Action, the World Bank reaffirms its long-term commitment to assist partner countries achieve… universal access… to HIV prevention, treatment, care and support by integrating AIDS into their national development agendas, scaling up… responses and strengthening national systems,” said Peter Piot, Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS).